Practice and thinking on teaching reform of Chinese medicine course Acupuncture-moxibustion Therapeutics based on "trinity" comprehensive evaluation / 中华医学教育探索杂志

Guided by the emphasis on learning process, the educational reform has designed a "trinity" comprehensive evaluation system (quantitative clinical practice, in-class medical record analysis, and staged comprehensive written test) as the formative evaluation of the course. Through this assessment system, students' self-learning potential is stimulated, clinical skills practice is strengthened, and "taking exams to promote learning and taking exams to promote teaching" is realized. In the practice of teaching reform, it has been found that compared with the conventional teaching class, the students in the teaching reform class have higher participation and are more satisfied with the process assessment of the "trinity" comprehensive evaluation system.

Discussion on the Problems of the Chief Review System in the Ethics Review of Clinical Research / 中国医学伦理学

By analyzing the problems such as the non-standard phenomenon in the implementation and operation of the current chief review system, the unclear responsibility of the chief review committee, and the lack of sound safeguard measures in the implementation of the chief review system, this paper put forward some suggestions, such as establishing and perfecting the chief review system of the ethics committee, clearly specifying the responsibilities and rights of the chief review committee, comprehensively strengthening the safeguard work and other improvement measures for the implementation of the chief review system, so as to provide suggestions for the more standardized and efficient operation of the chief review system in ethics review in China.

Analysis and Suggestions on Work Ethic Risk Factors of Caregivers of the Elderly with Disability and Dementia / 中国医学伦理学

Through the definition of the concepts of disabled and demented elderly, caregivers, work ethic, and ethical principles of caring for elderly with disability and dementia, this paper analyzed the ethical risk factors from the work ethics level of caregivers, the overall service ability and management level of care industry, the caregivers’ occupational burnout, and the degree of social public support and recognition of caregivers’ profession. It is proposed that paying attention to the cultivation of the caregivers’ work ethic quality, establishing the work ethic supervision and evaluation system of caregivers of the elderly with disability and dementia, exploring the successful experience of integrating ethic norms into the care of the elderly with disability and dementia, and safeguarding the rights and interests of the caregivers of the elderly with disability and dementia, so as to gradually reduce the work ethic risk of caregivers of the elderly with disability and dementia, improve the work ethic quality of caregivers, and safeguard the rights and interests of the disabled and demented elderly to the greatest extent.

Survival of children with recurrent medulloblastoma undergoing sequential therapy: an analysis of 101 cases / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of children with recurrent medulloblastoma (MB) and treatment regimens.@*METHODS@#A retrospective analysis was performed on 101 children with recurrent MB who were admitted to the hospital from August 1, 2011 to July 31, 2017. The children were followed up to July 31, 2020. The Kaplan-Meier method was used for survival analysis. The Cox regression model was used for multivariate regression analysis.@*RESULTS@#Of the 101 children, 95 underwent remission induction therapy, among whom 51 had response, resulting in a response rate of 54%. The median overall survival (OS) time after recurrence was 13 months, and the 1-, 3-, and 5-year OS rates were 50.5%±5.0%, 19.8%±4.0%, and 10%±3.3% respectively. There was no significant difference in the 5-year OS rate between the children with different ages (< 3 years or 3-18 years), sexes, pathological types, or Change stages, between the children with or without radiotherapy before recurrence or re-irradiation after recurrence, and between the children with different times to recurrence (< 12 months or ≥ 12 months after surgery) (@*CONCLUSIONS@#As for the recurrence of MB, although remission induction therapy again can achieve remission, such children still have a short survival time. Only reoperation can significantly prolong survival time, and therefore, early reoperation can be considered to improve the outcome of children with recurrent MB.

Clinical effect of surgery combined with chemotherapy and radiotherapy in children with central primitive neuroectodermal tumor and prognostic analysis / 中国当代儿科杂志

OBJCTIVE@#To study the clinical effect of surgery combined with chemotherapy and radiotherapy in children with central primitive neuroectodermal tumor (cPNET), as well as the risks factors for poor prognosis.@*METHODS@#A retrospective analysis was performed for the clinical data of 42 children who were diagnosed with cPNET from June 2012 to September 2018.@*RESULTS@#The 42 children had a median overall survival (OS) time of 2.0 years and a median event-free survival (EFS) time of 1.3 years; the 1-, 3-, and 5-year OS rates were 76.2%±6.6%, 41.4%±8.7%, 37.3%±8.8% respectively, and the 1-, 3-, and 5-year EFS rates were 64.3%±7.4%, 32.7%±8.0%, 28.0%±8.1% respectively. The univariate analysis showed that there were significant differences in the OS and EFS rates among the children with different patterns of surgical resection, chemotherapy cycles, and risk grades (P<0.05), and there was also a significant difference in the OS rate between the children receiving radiotherapy and those not receiving radiotherapy (P<0.05). The multivariate Cox regression analysis showed that chemotherapy cycles and risk grade were independent influencing factors for EFS and OS rates (P<0.05). The EFS and OS rates increased with the increase in chemotherapy cycles and the reduction in risk grade.@*CONCLUSIONS@#Multimodality therapy with surgery, chemotherapy, and radiotherapy is an effective method for the treatment of cPNET in children. Early diagnosis and treatment and adherence to chemotherapy for as long as possible may improve EFS and OS rates.

(image) of meridian sinew and meridian sinew differentiation in treatment with cupping therapy / 中国针灸

Cupping therapy is closely related to the meridian sinew system. " (image) of meridian sinew" is the reflection of " thinking" in meridian sinew system, e.g. morphology, function, color and lustre, temperature. Taking "(image) of meridian sinew" as the diagnosis object, the exploration is conducted in the paper in terms of classical theory, clinical practice and modern research. " (image) of meridian sinew" and "meridian sinew differentiation" are the important components in the improvement of cupping therapy system and the clinical development of acupuncture and moxibustion.

Effect of electroacupuncture on muscular atrophy and Slit/Robo signaling in sciatic nerve and lumbar spinal cord tissues in rats with sciatic nerve injury / 针刺研究

OBJECTIVE: To observe the effect of electroacupuncture (EA) of "Huantiao"(GB30) and" Zusanli"(ST36)on muscular atrophy and expression of Slit-Robo GTPase-activating protein(srGAP)1, 2 and 3 in the injured sciatic nerve and lumbar spinal cord tissues in sciatic nerve injury (SNI) rats, so as to reveal its mechanisms underlying improvement of peripheral nerve injury (PNI)．. METHODS: A total of 120 healthy male SD rats were randomly divided into control, sham-operation, model and EA groups (n＝30 rats in each) which were further divided into 7, 15 and 23 d subgroups (n＝10 rats in each subgroup). The SNI model was established by transecting the right sciatic nerve beneath the piriformis and immediately subsequent end-to-end suture. Rats of the sham operation group received an incision of the corresponding skin and suture. EA (5 Hz/20 Hz, 2－3 mA) was applied to the right GB30 and ST36 for 15 min, once daily, 6 days a week separately for 1，2 and 3 weeks. Rats in the sham-operation and model groups were grasped in the similar procedure as the EA group. The wet weight of gastrocnemius muscles (WWG) on both sides was measured to calculate the recovery rate (weight of the right WWG/weight of the left WWG×100%), and the expression levels of srGAP1, srGAP2 and srGAP3 proteins in the sciatic nerve and the spinal cord (L4-L6) tissues were detected by Western blot. RESULTS: After modeling and compared with the control and sham-operation groups, the recovery rate of WWG was significantly reduced, and the expression levels of srGAP1, srGAP2 and srGAP3 proteins of the sciatic nerve and lumbar spinal cord on day 7, 15 and 23 were considerably increased in the model group (P<0.01). Following the EA treatment, the reco-very rate of WWG was obviously increased and the expression levels of srGAP1, srGAP2 and srGAP3 proteins of both sciatic nerve and spinal cord on day 7, 15 and 23 were further significantly up-regulated in the EA group relevant to the model group (P<0.05，P<0.01). In addition, the expression levels of the 3 proteins in both sciatic nerve and lumbar spinal cord peaked on day 15 and attenuated on day 23. CONCLUSION: EA of GB30 and ST36 may relieve gastrocnemius atrophy in SNI rats, which is related to its function in up-regulating the Slit/Robo signaling in the sciatic nerve and lumbar spinal cord to promote the axonal targeting regeneration and repair of axonal plasma nutrition transportation.

Risk factors for recurrence within 2 years in children with medulloblastoma / 中国当代儿科杂志

OBJECTIVE@#To investigate the risk factors for recurrence of medulloblastoma (MB) within 2 years and their influence on progression-free survival (PFS).@*METHODS@#A retrospective analysis was performed for the clinical data of 123 children with MB who were admitted from January to December, 2017. According to the presence or absence of recurrence, they were divided into recurrence group with 30 children and non-recurrence group with 93 children. The risk factors for recurrence within 2 years were analyzed, and PFS was compared between the children with different risk factors.@*RESULTS@#Large-cell/anaplastic type and M stage were risk factors for MB recurrence within 2 years. The risk of recurrence in the children with M+ MB was 3.525 times that in those with M0 MB, and the risk of recurrence in the children with large-cell/anaplastic MB was 3.358 times that in those with classic MB (P<0.05). The survival analysis showed that the median PFS time was 20 months in the children with M+ MB, and the 20-month PFS rate was 50% ± 11% in the children with M+ MB and 81% ± 5% in those with M0 MB (P<0.05). The 20-month PFS rate was 80% ± 5% in the children with classic MB, 65% ± 10% in those with desmoplastic/nodular MB, 86% ± 13% in those with MB with extensible nodularity, and 36% ± 20% in those with large-cell/anaplastic MB (P<0.05).@*CONCLUSIONS@#Recurrence is an important influencing factor for the prognosis of MB, and M+ stage and large-cell/anaplastic MB are risk factors for recurrence. Children with such risk factors tend to have a low PFS rate.

Effect of bevacizumab in treatment of children with optic pathway glioma / 中国当代儿科杂志

OBJECTIVE@#To investigate the effect of bevacizumab in the treatment of children with optic pathway glioma (OPG).@*METHODS@#A retrospective analysis was performed for the clinical data of 30 children with OPG who underwent chemotherapy. According to whether bevacizumab was used, they were divided into conventional chemotherapy (carboplatin, vincristine and etoposide) group with 12 children and combined chemotherapy (bevacizumab, carboplatin, vincristine and etoposide) group with 18 children. The children were followed up to 6 months after chemotherapy, and the two groups were compared in terms of visual acuity and tumor size before and after chemotherapy and adverse reactions during chemotherapy.@*RESULTS@#The combined chemotherapy group had a significantly higher proportion of children achieving tumor regression than the conventional chemotherapy group (P0.05). No chemotherapy-related death was observed in either group.@*CONCLUSIONS@#Bevacizumab combined with conventional chemotherapy can effectively reduce tumor size. Compared with conventional chemotherapy, such combination does not increase adverse reactions and can thus become a new direction for the treatment of OPG in children.

Applications of Chest Wall Reconstructive Materials / 中国医学科学院学报

Chest wall reconstruction is a key approach to restoring the structure and function of the defective chest wall after tumor excision. While autologous flaps have been ideal materials for soft tissue reconstruction,the optimal skeletal reconstructive material still remains controversial. Currently,besides autologous bones,non-biodegradable materials have been used widely,which offer sufficient strength and stability but with some inevitable complications. Many studies have explored the clinical applications of biodegradable materials and the improvements in their characteristics,and some of these materials may be clinically feasible. This article reviews the recent advances in the applications of reconstructive materials.

Tuina for Leg Length Discrepancy and Lumbosacral Pain Due to Sacroiliac Joint Subluxation / 针灸推拿医学（英文版）

Objective: To observe theclinical effect of tuina reduction manipulation on leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation. Methods: A total of 60eligible cases were randomly allocated into an observation group and a control group, 30 in each group. Cases in the observation group were treated with conventional tuina plus reduction manipulation of sacroiliac joint subluxation; whereas cases in the control group were treated with conventional tuina plus acupuncture. The clinical effects were observed after 10 times of treatment. In addition, the relapse rates were observed 2 months after treatment. Results: The total effective rate in the observation group was 80.0%, versus 50.0% in the control group, showing a statistically significant difference (P Conclusion: Tuina reduction manipulation can obtain substantial therapeutic effect for leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation, coupled with a low relapse rate.

Predictive role of cerebrospinal fluid hydrogen sulfide in central nervous system leukemia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Central nervous system leukemia (CNSL) is an important relapse in children with acute lymphoblastic leukemia (ALL). We investigated the possible role of endogenous hydrogen sulfide (H(2)S) of cerebrospinal fluid (CSF) in predicting CNSL.</p><p><b>METHODS</b>From August 2008 to December 2010, 380 children were enrolled in this study at Shijitan Hospital, China. These children were from 2 to 16 years old, and the median age was 6.5 years. They were divided into a CNSL group (7 cases), a leukemia group (307 cases), a non-leukemia group (26 cases) and a healthy group (40 children). CSF specimens were obtained from conventional lumbar punctured, then centrifuged and supernatants preserved for H(2)S detection. Leukemic cells precipitates from CSF were found in three cases, the hCSE and hCBS mRNA expression was detected by reverse transcription polymerase chain reaction (RT-PCR), and H(2)S levels in serum were also measured. The receiver operating characteristic (ROC) curve and area under curve (AUC) were used to assess the predictive diagnosis role of CSF H(2)S in children with ALL and CNSL.</p><p><b>RESULTS</b>The serum H(2)S contents of the CNSL and leukemia groups were (96.98 ± 15.77) µmol/L and (93.35 ± 17.16) µmol/L respectively, much higher than those of healthy, (44.29 ± 2.15) µmol/L, and non-leukemia, (46.32 ± 6.54) µmol/L, groups (P < 0.01). Compared with the leukemia group, CSF H(2)S content of the CNSL group was significantly high (P < 0.01). Meanwhile, in contrast to the non-leukemia group, CSF H(2)S contents of the CNSL and leukemia groups were both significantly increased (P < 0.01). In addition, leukemic cells from CSF precipitations could express CBS and CSE mRNA. Furthermore, the ROC analysis showed the UAC was 0.929 (95%CI: 0.857 - 1.000), and the optimum cut-off value of CSF H(2)S was 12.08 µ mol/L, and the sensitivity and specificity were 83.3% and 97.2% respectively.</p><p><b>CONCLUSIONS</b>CSF H(2)S contents were significantly increased in children with CNSL. After treatment, H(2)S contents were decreased subsequently. Therefore, we speculated that H(2)S levels of CSF would predict CNSL in ALL children.</p>

Analysis of discrepancies between clinical and autopsy diagnoses in 188 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To analyze the discrepancies between clinical and autopsy diagnoses in hospitals of different grades and with respect to duration of hospitalization.</p><p><b>METHODS</b>A total of 188 autopsy cases collected from hospitals of different grades were retrospectively reviewed and the discrepancies between clinical and autopsy diagnoses were analyzed.</p><p><b>RESULTS</b>The overall rate of misdiagnosis was 48.9% (92/188). The misdiagnosis rate in grade I hospitals (75.8%, 25/33) was significantly higher than that in grade III (39.6%, 38/96; chi(2) = 12.861, P = 0.000) and grade II hospitals (49.2%, 29/59; chi(2) = 6.179, P = 0.016 ). The misdiagnosis rate of patients beyond 24 hours of admission was lower than that admitted within 24 hours (chi(2) = 20.991, P = 0.000). The overall rate of missed diagnosis was 34.6% (65/188). The rate of missed diagnosis in grade I hospitals was remarkably higher than that of the grade III hospitals (chi(2) = 8.241, P = 0.006). There was no difference between grades I and III hospitals on the rate of missed diagnosis within 24 hours of admission, however, this rate was lower in grade III hospitals in comparing with that of grade I hospitals in patients admitted beyond 24 hours (chi(2) = 5.181, P = 0.047). The distribution of disease entities commonly encountered in patients of both misdiagnosis and missed diagnosis were heart problems, infections, arterial diseases and pulmonary embolism.</p><p><b>CONCLUSIONS</b>The rate of discrepancies between clinical and autopsy diagnoses is relatively high. The misdiagnosis and missed diagnosis rate in grade I hospitals was significantly higher than that in grade III hospitals and was closely related with the duration of hospitalization. Autopsy study thus still remains an important measure in clinical audit.</p>

Design and validation of bone marrow histological scoring system for myelodysplastic syndrome / 上海第二医科大学学报

Objective To design a bone marrow histological scoring system for myelodysplastic syndrome(MDS) in order to provide an objective evaluation of clinical diagnosis,disease development and outcome prediction. Methods HE and Gomori staining were used to observe the morphological alterations in 149 bone marrow biopsies.Immunohistochemical staining for MPO,CD235,F8,CD42b,CD61 and CD34 was performed.The scores of distinct morphological changes of MDS were valued. Results The bone marrow histological scoring system for MDS was established and validated.The scoring system comprised 8 distinct histological features of MDS in bone marrow biopsy.When the score was ≥5,there was significant difference between normal bone marrow biopsy and bone marrow biopsy with MDS(P

Effect of Bacillus Bifidus Preparation on the Prevention of Gastrointestinal Side Effects in Children with Acute Lymphocyte Leukemia during High-Dose Methotrexate Chemotherapy / 实用儿科临床杂志

Objective To observe the effect of bacillus bifidus preparation on the prevention of gastrointestinal side effects in children with acute lymphocyte leukemia (ALL) during high-dose methotrexate (HD-MTX) chemotherapy.Methods One hundred and fifty-two ALL children were randomly assigned into 2 groups according to the suggestion of diagnosis and treatment of ALL in childhood.There were 76 patients in each group.In the treatment group,there were 46 male and 30 female,aged 2 to 13 years old (the median age was 8 years).While in the control group,there were 41 male and 35 female (the median age was 8.2 years).They were treated with the same chemotherapy schedule (HD-MTX),supportive therapies and infection preventive measures.ALL children in the treatment group were additionally given the bacillus bifidus preparation (one tablet for 2 to 6 years old,and two tablets for 7 to 15 years old,3 times daily),if their WBC was more than 2.0?109 L-1.Those in the control group were given vitamin B complex tablets (one tablet for 2 to 6 years old and two tablets for 7 to 15 years old,3 times daily).Results ALL children in treatment group had less diarrhea,abdominal pain,nausea and vomiting,or liver function impairment induced by chemotherapy than those in control group.However,the bacillus bifidus preparation had no significant effects on the symptoms of fever and oral mucosal erosions in the period of chemotherapy.Conclusion The bacillus bifidus preparation is clinically useful for the prevention of gastrointestinal side effects associated with HD-MTX chemotherapy.

Serum Concentration Monitoring and High-Dose Methotrexate Chemotherapy for Osteosarcoma in Children / 实用儿科临床杂志

1.0 ?mol/L),the toxicity and side effects of MTX increased significantly.The most common drug side effects were gastrointestinal symptoms and leucopenia.The oral mucosal lesions became worse in 12 g/m2 group.Conclusion The monitoring of HD-MTX plasma concentration provides an objective clinical basis for the individualized chemotherapy.

Effect of association of Shiquandabu Tang with Hetaokun on liver and immunity of tumour mouse / 中国中药杂志

<p><b>OBJECTIVE</b>To discuss the effect of the association of Shiquandabutang with Hetaokun on the protection to liver and immunity of tumor mouse S180.</p><p><b>METHOD</b>Through the comparison between tumor transplanted and tumor cultured completely out of cell body, the effect was investigated, with Hetaokun singly used and Shiquandabutang associated with Hetaokun, on the level of SGPT, licking up function of monocyte macrophage, thymus index, spleen index and transform percentage of lymphocyte of the mouse S180. The scanning electron micrographs indicated the protective function of the association of Shiquandabutang with Hetaokun for liver.</p><p><b>RESULT</b>12.5 mg x kg(-1) Hetaokun could obviously restrain the tumor when it was singly used at 73.1%, but it increased SGPT at the same time. The association of Shiquandabutang with Hetaokun could protect liver of the mouse S180. SGPT (P > 0.05) was compared with the common ones and the result showed that the association of shiquandabutang with Hetaokun could make K value increase (P > 0.01). Through the scanning electron micrographs, association of two medicines was found to change liver cells little and expansion of rough Neizhiwang was not found. Compared with the control group, the immunity of the two tumor mouse groups taking the medicine mentioned above was promoted obviously.</p><p><b>CONCLUSION</b>The association of Shiquandabutang with Hetaokun can enhance the efficiency and decrease poison of them to body. With the promotion of immunity of the body, the efficiency is enhanced on the whole.</p>

Research on ultrasonic detection of air bubble in race track / 医疗卫生装备

The method for ultrasonic detection of air bubble in race track is studied in this paper. A automatic detection system is established, which mainly consists of the ultrasound emitter and receiver, high-speed A/D acquisition card and PC.

Changes of Type Ⅰ Collagen in Pulmonary Arteries of Rats with Monocrotaline-Induced Pulmonary Hypertension / 实用儿科临床杂志

Objective To examine the expression of typeⅠcollagen in pulmonary arteries of rats with monocrotaline(MCT)-induced pulmonary hypertension(PH) and explore the mechanism of pulmonary vascular structural remodeling.Methods Twelve male Wistar rats were randomly divided into 2 groups: the MCT group(n=6) and the control group(n=6),which received a single intraperitoneal injection of MCT solution(60 mg?kg-1,the first day) or 9 g?L-1saline,respectively.After 3 weeks,mean of pulmonary artery pressure(mPAP),the value of right ventricle/(left ventricle plus septum)[RV/(LV+S)] and body weight were measured.Lung sections(HE stained) were observed under lightmicroscope for changes of the pulmonary arteries.The protein expression of typeⅠcollagen in pulmonary arteries was detected by immunohistochemical technique.Results Three weeks after MCT injection,compared with control group,mPAP and RV/(LV+S) increased significantly in MCT group[mPAP:(10.60?2.06) mmHg(1 mmHg=0.133 kPa) vs(32.40?3.24) mmHg,P