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Objective:To explore the evaluation and demand of clinical medical postgraduates for the supervisors' ethics and morality, and to explore ways to construct their ethics and morality in medical education.Methods:In the study, 2 268 clinical medical postgraduates in a medical university in Jiangsu Province were investigated with their satisfaction, compliance and suggestions. Rank sum test was carried out for the satisfaction by using SPSS 26.0, and qualitative analysis was carried out for suggestions.Results:The overall satisfaction of graduate students to the ethics and morality of supervisors was high. All the items described in the supervisors' ethics were "very consistent" more than 80%. Through qualitative analysis, the feedback were divided into six themes namely "supervision and feedback", "supervisor training", "reward and punishment system", "communication", "caring for students" and "academic guidance".Conclusion:The evaluation of clinical medical supervisors' ethics and morality is generally at a high level. The cultivation and guidance of supervisors' ethics and morality, supervision mechanism, and reward and punishment system still need to be improved.
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Objective:To observe the clinical efficacy of modified Danggui Niantongtang combined with Xuanbitang in treating damp-heat type acute gouty arthritis, and investigate its effect on levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α). Method:Totally 126 patients were randomly divided into control group and observation group, with 63 cases in each group. In addition to non-medication treatment, patients in control group were given conventional western medicine treatment for 1 week, while patients in observation group were given modified Danggui Niantongtang combined with Xuanbitang for 1 week. The levels of IL-1β，IL-6，IL-8，TNF-α before and after treatment were observed. Result:The total effective rate was 79.37% in control group and 95.24% in observation group, with significant differences (P<0.05). After treatment, the scores of arthralgia, tenderness, swelling, activity restriction in both groups were significantly decreased (P<0.01), and those in observation group were lower than those in control group (P<0.05). The levels of uric acid (UA), high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR) were significantly decreased (P<0.01) after treatment, and those in observation group were lower than those in the control group (P<0.05). The levels of IL-1β，IL-6，IL-8，TNF-α were significantly decreased (P<0.01) after treatment, and those in the observation group were lower than those in the control group (P<0.05). Conclusion:Compared with conventional western medicine treatment, modified Danggui Niantongtang combined with Xuanbitang has a better efficacy in treating damp-heat type acute gouty arthritis and reducing levels of IL-1β，IL-6，IL-8，TNF-α.
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Objective:To systematically review the clinical effectiveness of combined postoperative adjuvant transcatheter arterial chemoembolization (TACE) with portal vein chemotherapy (PVC) versus TACE alone in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT).Methods:Databases including PubMed, Embase, Cochrane Library, Medline, Web of Science, CNKI, China Biology Medicine, Wan Fang and VIP were searched from Jan 1st 2000 to Jun 30th 2019 for eligible studies on clinical effectiveness of combined postoperative adjuvant TACE with PVC versus TACE alone in patients with HCC and PVTT. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The secondary endpoint was adverse events. These endpoints were evaluated by odds ratio ( OR) and 95% confidence interval ( CI) using Review Manager 5.3 software. Results:Nine studies with 642 patients were enrolled in this meta-analysis. There were 323 patients in the TACE group and 319 patients in the TACE plus PVC group. The pooled OR for the 1-, 2-, and 3-year OS were all significantly better in the TACE plus PVC group than the TACE group (1-year OS, OR=2.20, 95% CI: 1.53-3.17; 2-year OS, OR=2.44, 95% CI: 1.69-3.53; 3-year OS, OR=2.30, 95% CI: 1.52-3.46) (all P<0.05). Similarly, significantly better results were observed in the pooled OR for the 1-, 2-, and 3-year DFS (1-year DFS, OR=2.56, 95% CI: 1.70-3.86; 2-year DFS, OR=2.27, 95% CI: 1.19-4.32; 3-year DFS, OR=3.03, 95% CI: 1.55-5.92) (all P<0.05). There were no significant differences in the incidences of adverse events between the two groups (all P>0.05). Conclusion:Postoperative adjuvant TACE combined with PVC for patients with HCC and PVTT was safe and effective, and was significantly better than TACE alone in long-term prognosis. Large-scale, multi-center, prospective studies are needed to support the conclusion.
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Objective:To investigate the clinical efficacy of modified Bingtitang in treatment of type 2 diabetes mellitus(T2DM) and its effect on pancreas islet function. Method:A total of 108 patients with T2DM were divided into two groups according to the digital number table method, with 54 cases in each group. The control group were given routine therapy of diabetic diet, proper exercise and blood sugar control, while the treatment group were orally given traditional Chinese medicine (TCM) and modified Bingtitang in addition to the therapy of the control group. The blood sugar, pancreas islet function-related indexes, TCM syndrome score, serum retinol binding protein 4 (RBP4) and Betatrohin levels were compared between two groups before and after treatment. The total effective rate was also compared. Result:After treatment, the fasting blood glucose (FPG), glycated hemoglobin (HbA1c), blood glucose variation coefficient (CV-FPG), insulin resistance index (HOMA-IR) of the treatment group were lower than those of control group (PΔI30/ΔG30)of treatment group were higher than those of the control group (PPPPConclusion:In addition to the routine treatment, modified Bingtitang can effectively control blood sugar, improve pancreas islet function, and alleviate TCM syndromes, with a significant effect on T2DM. Its mechanism may be related to the regulation of serum RBP4 and Betatrohin levels.
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Objective To determine the impact and the risk factors of different methods of preoperative biliary drainage (PBD) for malignant obstruction jaundice (MOJ) on overall survival (OS).Methods Databases including the PubMed,Medline,Web of Knowledge,and other databases were searched up to 30th April,2018 for clinical studies which compared the OS rates between percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD) for MOJ.Hazard ratio (HR) and Odds Ratio (OR) with 95％ confidence interval (CI) were performed using the Review Manager 5.3 software to synthesize the results.Results Nine studies were enrolled in this meta-analysis,which included 818 patients in the PTBD group and 1253 patients in the EBD group.EBD was shown to be superior to PTBD in OS (HR=0.63,95％ CI:0.51～0.77,P＜0.05).Risk factors analysis showed that patients in the EBD group had a higher rate of early tumor stage (P＜0.05) and a lower rate of lymphatic metastasis (P＜0.05).When compared with the PTBD group,the EBD group had a lower rate of intraoperative bleeding (P＜0.05),and a higher rate of adjuvant therapy (P＜0.05).Conclusion In PBD for patients with resectable MOJ,there was insufficient evidence to support EBD to be superior to PTBD in OS.
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In order to explore genetic basis for the biosynthesis of secondary metabolism,the transcriptome of Cornus officinalis was sequenced by the new generation of high-throughput sequencing technology,A total of 96 032 unigenes were assembled with an average length of 590.53 bp. Among them, 35 478 unigenes were annotated in the public databases NR,Swissprot,COG,GO,KOG,Pfam and KEGG. Based on the assignment of KEGG pathway, 84 involved in ridoid biosynthesis and 487 unigenes involved in others secondary metabolites biosynthesis were found. Additionally,53 unigenes and 72 unigenes were predicted to have potential functions of cytochome P450 and UDP- glycosyltransferases based on the annotation result, which may encode responsible for secondary metabolites modification. This study was the first comprehensive transcriptome analysis for C. officinalis, and the candidate genes involved in the biosynthesis of secondary metabolites were obtained. The transcriptome data constitutes a much more abundant genetic resource that can be utilized to benefit further molecular biology studies on C. officinalis.
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<p><b>OBJECTIVE</b>To explore the relationship between total plasma homocysteine (tHcy) levels, dietary habits and susceptibility of gastric cancer (CGC) in Yangzhong and Yixing cities, the two high GC risk areas in Jiangsu province.</p><p><b>METHODS</b>A population-based case-control study was conducted including 391 histologically-confirmed adenocarcinoma GC cases and 608 age and sex frequency-matched cancer-free controls. The plasma tHcy concentration was measured by enzymatic biochemical assay of homocysteine on microtiter plates, using crude lysate containing recombinant methionine 7-lyase. The relationship between different tHcy levels and risk of GC was analyzed and factors as vegetables and fruits intake, smoking and drinking status were also evaluated together with tHey levels on the risk of GC.</p><p><b>RESULTS</b>The average tHcy levels in GC cases were significantly higher than that in controls (P = 0.002). In addition, according to the quartile levels (7.9, 10.1, 13.7 micromol/L) in the controls, the risks of GC had an increase of 67% (adjusted OR = 1.67, 95% CI: 1.12-2.48), 98% (adjusted OR = 1.98, 95% CI: 1.33-2.94) and 112% (adjusted OR = 2.12, 95% CI: 1.44-3.15) compared to the lowest quartile of tHcy (< or = 7.9 micromol/L), respectively while the increasing trend was significantly noticed (chi2 = 15.78, P < 0.001). The increase of vegetables and fruits intake could decrease the risk of GC. Results from crossover analyses indicated that subjects with less vegetables and fruits intake or both smoking drinking together with plasma tHcy >15.0 micromol/L could increase the GC risk, when compared to the effect on GC risk of each factor.</p><p><b>CONCLUSION</b>These findings supported the hypothesis that the high level of plasma tHcy and the badness dietary habits were associated to the increased risk of GC. Further larger scale and genetics involved studies on the environment and genetic factors were needed to confirm our findings.</p>