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Objective:To explore the application effect of problem-based learning (PBL) combined with WeChat assisted teaching pattern in teaching rounds of encephalopathy department.Methods:Undergraduate interns of Batch 2018 from the encephalopathy department were enrolled in the study. The observation group ( n=36) was taught by PBL combined with WeChat teaching mode. The control group ( n=36) was taught by the conventional teaching mode. At the end of rotation, the scores of theoretical and practical skills tests of the two groups were compared, and at the same time, the results of the survey were compared according to the questionnaire. SPSS 19.0 was used for statistical analysis of the data. Results:The test scores of the observation group were significantly higher than those of the control group ( P<0.05). The recognition in nine aspects of the observation group was also significantly higher than that of the control group, such as the interaction with the teaching teachers, the effect of improving clinical learning interest and the ability of inspiring thinking and innovation ( P<0.05). There was no significant difference in recognition about improving the efficiency of clinical teaching rounds between two groups ( P>0.05). Conclusion:PBL combined with WeChat teaching rounds model has certain advantages over traditional rounds in TCM clinical teaching, which are mainly manifested in the mastery of clinical knowledge, the communication ability of interns, the ability of interaction and cooperation, the ability of innovation and thinking, and the improvement of learning initiative.
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Objective: To understand the harm degree of underground noise and provide basis for noise control. Methods: In November 2019, 13 typical coal mines in Sichuan Province were selected as the research objects, and a total of 1203 sites and 609 jobs of noise exposure were investigated. Results: The noise intensity P75 >80 dB (A) was measured. The noise intensity of the inspection place of the air compressor is >86 dB (A) , the noise intensity of the inspection place of the gas drainage and the operation place of the main fan is between 80-85 dB (A) . Conclusion: Besides the harm of dust, noise exposure should also be paid attention to, and the measures of sound absorption and sound insulation should be taken or personal protection should be strengthened.
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Coal , Coal Mining , Dust/analysis , Noise , Occupational ExposureABSTRACT
Objective:To investigate the relationship between serum thyrotropin(TSH)levels and major cardiovascular risk factors in elderly type 2 diabetes(T2DM)patients with normal thyroid function.Methods:A total of 510 elderly T2DM patients with normal thyroid function were included in this study, including 265 males and 245 females.Blood samples of all patients were collected after an overnight fast.Thyroid function and blood levels of lipids, glucose, glycated hemoglobin(HbA1c)and other components were measured.Basic information of all patients was collected and body mass index(BMI), visceral adiposity index(VAI)and lipid accumulation product index(LAP)were calculated.Results:The levels of BMI, VAI, LAP, triglycerides(TG), total cholesterol(TC), low density lipoprotein(LDL-C), HbA1c, fasting blood glucose(FBG)and 2h-postprandial blood glucose(2 h PBG)were higher in the high TSH group than in the low TSH group(31.7±5.5 kg/m 2vs.27.6±2.1 kg/m 2, 7.20±1.18 vs.5.88±0.51, 61.88±6.36 vs.52.76±7.09, 6.49±2.64 mmol/L vs.5.84±2.41 mmol/L, 2.73±1.30 mmol/L vs.1.99±0.54 mmol/L, (2.86±0.93 mmol/L vs.2.55±0.81 mmol/L, 9.10±1.35% vs.7.80±1.76%, 9.64±2.03 mmol/L vs.7.55±1.72 mmol/L, 19.20±2.99 mmol/L vs.15.33±2.36 mmol/L, t=5.32, 8.06, 10.88, 8.13, 8.30, 5.90, 5.83, 6.51 and 6.82, all P<0.05). Multivariate Logistic regression analysis showed that cardiovascular risk factors including HbA1c( OR=1.21, 95% CI: 1.01-1.52, P=0.020), LDL-C( OR=1.88, 95% CI: 1.78-2.01, P=0.000), LAP( OR=3.01, 95% CI: 2.98-3.12, P=0.010), and BMI( OR=2.58, 95% CI: 2.45-2.68, P=0.000)were influencing factors for TSH. Conclusions:In elderly patients with T2DM, TSH levels within the normal range but close to the upper limit are closely related to cardiovascular risk factors such as increased visceral fat and high TG levels, and may increase the risk of cardiovascular disease.
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OBJECTIVE：To observe the safety and other related indexes of canagliflozin in the treatment of type 2 diabetes complicated with high risk of cardiovascular disease. METHODS ：Totally 306 patients，admitted to Hainan Provincial People ’s Hospital and Haikou People ’s Hospital ，with type 2 diabetes complicated with high risk of cardiovascular disease were selected from Dec. 2018 to Apr. 2019. They were divided into observation group （153 cases）and control group （153 cases）according to random number table . The control group was treated with in sulin，metformin or sulfonylureas conventional hypoglycemic therapy ， and the observation group was treated with Canagliflozin tablets 100 mg，once a day ，po，on the basis of control group. The course of treatment was 1 year in both groups. The levels of HbA 1c，BMI，SBP，DBP and eGFR before and after treatment were observed in 2 groups，and the incidence of safety （including death from cardiovascular causes ，myocardial infarction ，ischemic stroke ， hospitalization for heart failure and death from any cause etc. ） after treatment and serious ADR/ADE （including hypogly- cemia，diabetic ketoacidosis ，fracture，acute kidney injury 68622942。E-mail：zhaixin0123@126.com etc.）during the treatment were recorded. RESULTS ：A total of 5 patients in the control group were not followed up ， in which 3 quited and 2 were lost ；and 4 patients in the observation group were not followed up ，in which 1 quited and 3 were lost . Before treatment ，there were no statistical significance in the levels of HbA 1c，BMI，SBP，DBP and eGFR between 2 groups（P＞0.05）. After treatment ，HbA1c levels of 2 groups，BMI and SBP of observation group were all significantly lower than those before treatment with the same group ；HbA1c level and SBP of observation group were significantly lower than those of control group （P＜0.05）. eGFR levels of 2 groups after treatment were significantly higher than before treatment with the same group ，while the observation group was significantly higher than that of contrl group. The incidence of death from cardiovascular causes and death from any cause in observation group were significantly lower than control group （P＜0.05）. There were no statistically significant differences in other safety indexes and the incidence of serious ADR/ADE between 2 groups（P＞0.05）. CONCLUSIONS ：Canagliflozin can significantly reduce the incidence of death from cardiovascular causes and death from any cause in type 2 diabetes patients complicated with high risk of cardiovascular disease，ameliorate blood glucose and blood pressure ，and do not increase the occurrence of serious ADR/ADE.
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OBJECTIVE： To investigate the protective effect and potential mechanism of epigallocatechin gallate （EGCG） on myocardial ischemia-reperfusion injury. METHODS： H9C2 cardiomyocytes were treated with tert-butyl hydroperoxide （TBHP） to establish ischemia-reperfusion cell model. The cell viability was measured by MTS after pretreated with different doses of EGCG （3.125， 6.25， 12.5， 25， 50， 100， 200 μmol/L）， and the survival rate was calculated. The expression of apoptotic proteins （Bcl-2， Bax） in cardiomyocytes pretreated with different doses of EGCG （100， 200 μmol/L） were detected by Western blotting. Male C57BL/6 mice were randomly divided into sham operation group， model group and EGCG group （5 mg/g）， with 15 mice in each group. Sham operation group and model group were given constant volume of normal saline intragastrically， while EGCG group was given relevant medicine intragastrically， once a day， for consecutive 7 d. Twelve hours after last medication， myocardial ischemia-reperfusion injury model was established by anterior descending coronary artery ligation. The area of myocardial infarction was observed by double staining of Evan’s blue and TTC； the percentage of infarction area to cross-sectional area was calculated；SOD activity and MDA content in serum were determined by WST-1 assay； the expression of apoptotic proteins （Bcl-2， Bax） in myocardial tissue were detected by Western blotting， while the phosphorylation levels of signaling pathway related proteins （PI3K， p-PI3K， Akt， p-Akt） were also detected. RESULTS： Cell test results showed that， compared with control group， survival rate and relative expression of Bcl-2 were decreased significantly in model group， while relative expression of Bax was increased significantly （P＜0.05）. Compared with model group， survival rate of cardiomyocyte in 25， 50， 100， 200 μmol/L EGCG groups as well as relative expression of Bcl-2 in 100， 200 μmol/L EGCG groups were increased significantly， while relative expression of Bax in 100， 200 μmol/L EGCG groups were decreased significantly （P＜0.05）. Animal experiments showed that no ischemia of myocardial tissue and enlargement of cardiac cavity were observed in sham operation group. Myocardial infarction was observed in model group. Compared with sham operation group， percentage of infarction area to cross-sectional area， the serum content of MDA， the relative expression of Bax in myocardial tissue and p-PI3K/PI3K， p-Akt/Akt were increased significantly in model group， while SOD activity and relative expression of Bcl-2 were decreased significantly （P＜0.05）. Compared with model group， myocardial infarction area of mice in EGCG group was reduced， the percentage of infarction area to cross-sectional area， the serum content of MDA， the relative expression of Bax in myocardial tissue and p-PI3K/PI3K， p-Akt/Akt were significantly decreased， the activity of SOD activity and the relative expression of Bcl-2 were increased significantly （P＜0.05）. CONCLUSIONS： EGCG can protect against myocardial ischemia-reperfusion injury， the mechanism of which may be associated with inhibiting the apoptosis of myocardial cells， improving oxidation stress， regulating the expression of apoptotic protein， reducing the phosphorylation level of PI3K/Akt signaling pathway-related proteins.
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Objective To explore the effects and mechanism of cigarette smoke extract (CSE) on the proliferation of air?way smooth muscle cells (ASMCs) and the expression of CCAAT/enhancer-binding protein (CEBPα) and calreticulin. Meth?ods (1) The ASMCs were stimulated with different concentrations of CSE for twenty-four hours. According to the concentra?tions of CSE,the cells were divided into control group, 2.5%CSE group, 5%CSE group and 10%CSE group. The prolifera?tion of ASMCs was measured by MTT colrimetric method. The CEBPαmRNA was analyzed by RT-PCR. Western bloting as?say was performed to detect the levels of CRT and CEBPαprotein. (2) In 10%CSE group, transfection of the siRNA respec?tively for negative control or calreticulin was performed in accordance with instructions. The cell proliferation and the expres?sion of calreticulin and CEBPαwere compared in negative control siRNA group and calreticulin siRNA group. Results (1) With the increasing of the concentrations of CSE, the protein expression of CEBPαdecreased gradually (P0.05). (2) Under the 10%CSE, the expression of CEBPαwas significantly higher in CRT siRNA group than that in negative control group (P<0.05),but the cell proliferation and CRT were significantly lower in the calreticulin siRNA group than those in negative control siRNA group (P<0.05). Conclusion The CSE exposure contributes to the expression of calreticulin protein,and then inhibits the translation of CEBPαmRNA,thus promotes the proliferation of ASMCs.
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Objective To investigate the expressions of transforming growth factor beta-1 (TGF-β1) and nuclear factor kappa B (NF-κB) in patients with chronic obstructive pulmonary disease (COPD),and to explore the mechanism of pathogenesis in COPD.Methods A total of 40 patients undergoing lung resections for pulmonary tumor were selected.Patients were divided into 2 groups according to COPD diagnostic criteria:the control group [patients without COPD,13 males,7 females,with an average age of (61.7±8.8) years] and the COPD group [patients with COPD,15 males,5 females,with an average age of (60.5 ± 9.4) years].Peripheral lung tissues from tumor lesions were detected in this study.The qualitative and quantitative expressions of NF-κB were determined by immunohistochemistry and Western blot,respectively.TGF-β31 mRNA level was determined by reverse transcription polymerase chain reaction (RT-PCR).Results The levels of TGF β1 mRNA and NF-κB protein and the NF-κB nucleus positive rate were significantly higher in the COPDgroup than in the control group [(0.42±0.11) vs.(0.34±0.13),(0.24±0.08) vs.(0.12±0.04),57.9％ vs.26.7％,respectively,all P＜0.05].The TGF-β31 mRNA level was positively correlated with the NF-κB protein expression in the 2 groups (r=0.497,0.618,both P＜0.01).The ratio of 1 second forced expiratory volume/forced vital capacity (FEV1/ FVC) was negatively correlated with TGF-β1 mRNA level and NF-κB protein expression (r=-0.624,r=-0.659,both P ＜0.01) in the COPD group.Conclusions The expression levels of NF-κB and TGF-β1 are significantly increased in patients with COPD,and there is a positive correlation between TGF-β1mRNA level and NF-κB protein expression.NF-κB may participate in regulating TGF-β1 mRNA expression and in contributing to the airway remodeling,thereby in effecting pulmonary function.
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Objective To observe neurophysiological changes and pulmonary function in obstructive sleep apnea syndrome (OSAS) and analyze their inter-relationship. Methods Sixty OSAS patients were studied. Their lung function and phrenic motor nerve conduction (PNC) were examined. Thirty cases without respiratory disorder served as controls. The lung function tests included percentage of the predicted value of vital capacity ( VC% ), percentage of the predicted value of maximal voluntary ventilation ( MVV% ), percentage of the predicted value of forced expiratory volume in one second ( FEV1% ), inspiratory capacity ( IC), and expiratory reserve volume (ERV). The phrenic nerve was stimulated electrically, and the latent period and the diaphragmatic compound muscle action potential (dCMAP) were recorded. Results The VC%, MVV%, FEV1% , IC and ERV of the patients with OSAS were significantly lower than those of the controls. There was no significant difference between the patients and the controls with regard to their PNC latency. In the OSAS patients the amplitude ratio of their dCMAPs was positively correlated with VC% , MVV% , FEV1% , IC and ERV, and negatively with an apnea hypopnea index (AHI).Conclusions PNC examination can provide valuable information for evaluating diaphragmatic dysfunction in those with abnormal lung function. Decreased dCMAP might be associated with abnormal lung function.
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<p><b>OBJECTIVE</b>To investigate the anti-inflammatory effects on the vessel wall of rosuvastatin in apolipoprotein E-deficient mice.</p><p><b>METHODS</b>Eight-week-old apolipoprotein E-deficient mice fed a normal chow diet were treated with vehicle or various doses of rosuvastatin (1, 5, or 20 mg/kg) by subcutaneous injection for 2 or 6 weeks prior to sacrifice. Endothelial adhesiveness for monocytes was determined by functional binding assay. The expressions of vascular cell adhesion molecule-1 and monocyte chemotactic protein-1 in the vessel wall were detected by quantitative real-time polymerase chain reaction.</p><p><b>RESULTS</b>Endothelial adhesiveness for monocytes was significantly attenuated after 2 or 6 weeks treatments with 5 or 20 mg/kg rosuvastatin. Rosuvastatin also significantly reduced the expressions of vascular cell adhesion molecule-1 and monocyte chemotactic protein-1 in the vessel wall.</p><p><b>CONCLUSION</b>The anti-inflammatory effects of suvastatin might be responsible for attenuating the pathogenesis of atherogenesis in apolipoprotein E-deficient mice.</p>
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Animals , Mice , Apolipoproteins E , Genetics , Cell Adhesion , Endothelium, Vascular , Cell Biology , Fluorobenzenes , Pharmacology , Mice, Inbred C57BL , Mice, Knockout , Monocytes , Metabolism , Pyrimidines , Pharmacology , Rosuvastatin Calcium , Sulfonamides , Pharmacology , Vascular Cell Adhesion Molecule-1 , MetabolismABSTRACT
AIM:To observe the change of insulin-like growth factor-2(IGF-2)in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS),and to explore the relationship of IGF-2,OSAHS and cardiovascular disease complicated with it.METHODS:The level of serum IGF-2 in 40 OSAHS patients and 20 healthy controls was measured by enzyme-linked immunosorbent assay(ELISA).The expression of IGF-2 mRNA in peripheral blood mononuclear cells was detected by reverse transcription polymerase chain reaction(RT-PCR).RESULTS:The serum level of IGF-2 and the expression of IGF-2 mRNA in peripheral blood mononuclear cells were significantly higher in OSAHS group than those in control group(P