Application of scenario simulation teaching model of multimorbidity co-treatment in standardized training for general practice residents / 中华全科医师杂志

From February 1 to April 30, 2021, 48 general practice resident physicians in the First Affiliated Hospital of Naval Medical University were randomly divided into study group and control group with 24 in each group. The common comorbidities of the community-dwelling elderly, namely diabetes, diabetic retinopathy and osteoporosis were selected as teaching cases. The residents in control group received conventional teaching, while the scenario simulation teaching model of multicomorbity co-treatment was applied for the study group. The teaching effect, satisfaction and self-efficacy scores were compared between two groups. After training, the knowledge levels, the mastery of referral indicators and the performance of fundus ophthalmoscopy in the study group were significantly better than those in the control group ( t=2.27, 6.34, 4.09; P<0.05). They were (80.96±11.27) vs. (73.96±10.09), (10.33±2.41) vs. (6.38±1.88), (70.27±10.44) vs. (63.50±7.98), and students′ satisfaction and self-efficacy evaluation were higher than those of the observation group (all P<0.05). It is suggested that the simulation teaching of multi-disease co-treatment scenario is more beneficial than the traditional teaching to improve the comprehensive care ability of standardized training physicians in general practice for patients with chronic disease.

Survey on the rationality and standardization of clinical oxygen therapy in a general hospital in Shanghai / 中华全科医师杂志

Objective:To survey the current status of oxygen therapy in a comprehensive hospital in Shanghai and to assess its rationality and standardization.Methods:Cluster sampling method was adopted in selecting in-patients who received oxygen therapy from various departments in Changhai Hospital from March 2018 to June 2018. General information such as gender, age, and department were recorded. The self-developed Oxygen Therapy Form for Inpatients was used to collect clinical data such as admission diagnosis, oxygen therapy indications, oxygen therapy orders, and related parameters. BTS guideline for Oxygen use in adults in Health care and Emergency Settings was used to assess the rationality and standardization of oxygen therapy. Results:In this survey, 464 patients were assessed for their oxygen treatment orders. According to the guidelines, the overall reasonable rate of oxygen therapy was 92.2% (428/464); the standardization rate of oxygen therapy was 22.4% (104/464). Among them, the reasonable rate of oxygen therapy in internal medicine ward (64.7%, 46/71) was lower than that in surgery ward (98.3%, 304/309) and in wards of other specialties (92.8%, 78/84) (χ 2=91.09, P<0.01); while the reasonable rate of general ward (90.9%, 362/398) was lower than that of ICU (100.0%, 66/66) (χ 2=6.47, P<0.05). In the standardization assessment, the wards of other specialties (54.8%, 46/84) were better than the internal medicine ward (26.8%, 19/71) and the surgery ward (12.6%, 39/309) (χ 2=68.35, P<0.01); while the ICU (65.2%, 43/66) was superior to the general ward (15.3%, 61/398) (χ 2=80.81, P<0.01). Conclusions:The rationality of oxygen therapy in the general hospital is acceptable, but the standardization needs to be improved. There are some differences in the rationality and standardization of oxygen therapy orders among different departments and different levels of wards.

Survey on the rationality and standardization of clinical oxygen therapy in a general hospital in Shanghai / 中华全科医师杂志

Objective@#To survey the current status of oxygen therapy in a comprehensive hospital in Shanghai and to assess its rationality and standardization.@*Methods@#Cluster sampling method was adopted in selecting in-patients who received oxygen therapy from various departments in Changhai Hospital from March 2018 to June 2018. General information such as gender, age, and department were recorded. The self-developed Oxygen Therapy Form for Inpatients was used to collect clinical data such as admission diagnosis, oxygen therapy indications, oxygen therapy orders, and related parameters. BTS guideline for Oxygen use in adults in Health care and Emergency Settings was used to assess the rationality and standardization of oxygen therapy.@*Results@#In this survey, 464 patients were assessed for their oxygen treatment orders. According to the guidelines, the overall reasonable rate of oxygen therapy was 92.2% (428/464); the standardization rate of oxygen therapy was 22.4% (104/464). Among them, the reasonable rate of oxygen therapy in internal medicine ward (64.7%, 46/71) was lower than that in surgery ward (98.3%, 304/309) and in wards of other specialties (92.8%, 78/84) (χ2=91.09, P<0.01); while the reasonable rate of general ward (90.9%, 362/398) was lower than that of ICU (100.0%, 66/66) (χ2=6.47, P<0.05). In the standardization assessment, the wards of other specialties (54.8%, 46/84) were better than the internal medicine ward (26.8%, 19/71) and the surgery ward (12.6%, 39/309) (χ2=68.35, P<0.01); while the ICU (65.2%, 43/66) was superior to the general ward (15.3%, 61/398) (χ2=80.81, P<0.01).@*Conclusions@#The rationality of oxygen therapy in the general hospital is acceptable, but the standardization needs to be improved. There are some differences in the rationality and standardization of oxygen therapy orders among different departments and different levels of wards.

Research progress of lung cancer complicated with venous thrombosis / 中华全科医师杂志

Lung cancer and venous thrombosis (VTE)are two conditions that frequently cause death and disability.Recent studies have shown that lung cancer patients have high incidence of VTE,which would lead to poor prognosis.This article summarizes the research progress in the epidemiology,mechanism,clinical characteristics and risk factors of complicated venous thrombosis in lung cancer patients,and provides information for its diagnosis,prevention and treatment.

Hepatotoxicity in lung cancer patients with hepatitis B virus infection / 中华全科医师杂志

Due to high prevalence of lung cancer and hepatitis B virus infection in China, lung cancer patients complicated with HBV infection are not rare.The incidence of liver function impairment in lung cancer patients with HBV infection is much higher than those without HBV infection.Some special risk factors and mechanism of liver function impairment in lung cancer patients with HBV infection have been reported.This article reviews the incidence,mechanism and treatment of liver function impairment in those patients so as to provide information for prevention and management of this condition.

Fibroblasts weaken the anti-tumor effect of gefitinib on co-cultured non-small cell lung cancer cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Non-small cell lung cancer (NSCLC) is the most common lung malignancy worldwide. The metastatic potential of NSCLC cells has been shown to be associated with the tumor microenvironment, which consists of tumor cells, stroma, blood vessels, immune infiltrates and the extracellular matrix. Fibroblasts can produce numerous extracellular matrix molecules and growth factors. Gefitinib has been evaluated as a first-line treatment in selected patients, and it has shown favorable efficacy especially in NSCLC, but it is not effective for everyone.</p><p><b>METHODS</b>In this study, we examined the antitumor activity of gefitinib on lung fibroblasts co-cultured of lung cancer cells. A series of co-culture experiments that employed cell counting kit-8 (CCK8), transwells, real-time polymerase chain reaction (RT-PCR) and Western blotting with HFL-1 fibroblasts and A549 human lung carcinoma cells were performed to learn more about tumor cell proliferation, migration and invasion; and to determine any change of epithelial mesenchymal transition (EMT)-associated tumor markers vimentin, matrix metallopro-teinase 2 (MMP2) and chemotaxis cytokines receptor 4 (CXCR4) mRNA levels.</p><p><b>RESULTS</b>A549 cell proliferation in the presence of HFL-1 cells was not significantly increased compared with A549 cells alone, but A549 cell spheroid body formation was increased after co-culture, and treatment with gefitinib increased further. Our study also revealed that fibroblasts attenuated the lung cancer cell inhibition ratio of migration and invasion after gefitinib treatment in vitro. To further study this mechanism, RT-PCR analysis showed that vimentin, MMP2 and CXCR4 mRNA levels were more highly expressed in the lung cancer cells after co-culture, but did not obviously decrease compared with the control cells following gefitinib treatment. This suggests the mechanism by which fibroblasts attenuate gefitinib-induced expression of EMT-associated tumor markers. Finally, our results demonstrated that co-culture with A549 lung cancer cells does not alter the cell cycle distribution of HFL-1 fibroblasts. Furthermore, HFL-1 fibroblasts had no effect on the cell cycle distribution of HFL-1 cells treated with gefitinib.</p><p><b>CONCLUSION</b>Gefitinib has lower anti-tumor activity on A549 lung cancer cells when co-cultured with HFL-1 fibroblasts.</p>

Splenic sarcoidosis: a case report and review of literature / 中华内科杂志

Objective To describe the clinical features and imaging characteristics of nodular splenic sarcoidosis. Methods We describe a patient with splenic sarcoidosis and review the related medical literature, the etiology, symptomatology, pathology, diagnosis, differential diagnosis, management and prognosis of splenic sarcoidosis. Results The etiology of this rare disease remains unknown. Symptoms are scanty and usually mild; computed tomography usually reveals splenomegaly or the presence of multiple nodules, confusing with metastatic tumor in spleen. On histopathologic examination, sarcoid produces noncaseating granulomas. Sarcoid is typically treated only when symptomatic. Oral corticosteroids is the most important method of treatment in patients with progressive loss of organ functions. Prognosis has closed relationship with early clinical manifestation. Conclusion Splenic sarcoidosis is rare and often misdiagnosis as other diseases.

Clinical Observation about Urokinase vs.Low Molecular Weight Heparin for Acute Pulmonary Thromboembolism / 中国药房

OBJECTIVE:To study the efficacy of Urokinase vs.Low Molecular Weight Heparin in the treatment of acute pulmonary thromboembolism.METHODS:A total of 35 patients with acute pulmonary thromboembolism who had no past history of heart and lung diseases were enrolled and randomly assigned to two groups following ultrasonography and pulmonary ventilation/perfusion scanning:15 were given thrombolysis therapy with urokinase,and 20 given anticoagulation therapy with low molecular weight heparin.Symptoms,arterial blood gas analysis,electrocardiogram,echocardiogram were compared in two groups before and after treatment.RESULTS:The patients receiving thrombolysis therapy had better improvement in symptoms,arterial blood gas index,echocardiogram and the pulmonary ventilation/perfusion scanning than in those receiving anticoagulation therapy(P

Synergistic effect of toremifene and cisplatin on human lung cancer cell line A549 / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the toxic effect of toremifene (TOR) and its synergistic effect with cisplatin (DDP) on human lung adenocarcinoma cell line A549.</p><p><b>METHODS</b>The cytotoxic effects of these agents on human lung cancer cell line A549 were monitored by a tetrazolium-based colorimetric assay (MTT assay). The cell cycle and DNA content were detected by flow cytometer technic. p21 expression level was monitored by Western blot.</p><p><b>RESULTS</b>Toremifene inhibited the growth of A549 cell, with > or = 5 micromol/L significantly enhancing the chemosensitivity of cisplatin. TOR enhanced the antitumor activity of DDP at S, G(2) and M phases of cells. And p21 expression was increased after TOR and DDP had been given.</p><p><b>CONCLUSION</b>Toremifene (> or = 5 micromol/L) combined with cisplatin shows significant synergistic anti-tumor effect on A549 cells.</p>

Expression of Stat 3 protein in lung carcinoma and its clinical significance / 第二军医大学学报

Objective: To analyze the relationship between Stat 3 protein expression and clinical staging, tissue types, P53 protein and PCNA in lung carcinoma, and to investigate the role of Stat 3 protein in the pathogenesis of lung carcinoma. Methods: Using immunohistochemical technique, Stat 3 protein, P53 protein and PCNA were detected in different tissue in 42 patients with lung carcinoma without radiotherapy and chemotherapy. Results: The positive rate of Stat 3 was 81.0% in lung carcinoma. The expression intensity of Stat 3 in lung carcinoma was not associated with T,N and clinical stage , but it was associated with the expression intensity of P53 and PCNA and it was related to tissue types.Stat 3 protein were markedly higher in NSCLC than that in SCLC. Conclusion: The expression of Stat 3 protein is abnormal in lung carcinoma. Stat 3 may involve in regulation of p53 gene in lung carcinoma cell and accelerate proliferation of lung carcinoma cell, it may play an important role in generation of lung carcinoma. Inhibition of Stat 3 pathways may become a new therapy for lung carcinoma.

The role of nitric oxide and nitric oxide synthase in killing tumor cells / 第二军医大学学报

Objective: To study the role of inducible nitric oxide synthase (iNOS) in activated macrophages and nitric oxide (NO) in the defence against tumors. Methods: Macrophages were obtained by alveolar lavages of mice and activated through incubation with recombinant murine INF? in vitro. P815 cells were added to the culture. Culture supernates were collected to measure the activity of iNOS and NO. Tumoricidal activity of macrophages was determined in presence and absence of the specific inhibitor of NO synthase: L NMMA. Results: NO production and activity of iNOS induced by activated macrophages were positively related with concentration of INF? in macrophage P815 coculture. The addition of L NMMA to the culture suppressed NO production, the inhibitory rate of activated macrophages against P815 cells was reduced distinctly ( P