Serum lipoprotein-associated phospholipase A2 level is positively correlated with the recurrence risk of acute ischemic cerebral infarction in hypertensive patients / 南方医科大学学报

OBJECTIVE@#To explore the relationship between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) level and the risk of acute ischemic stroke (AIS) recurrence in hypertensive patients.@*METHODS@#This retrospective case-control study was conducted among 211 hypertensive patients with AIS treated in Foshan First People's Hospital, including 35 patients with recurrence of AIS during the 1-year follow-up as confirmed by head CT/MR. In the overall patients, 60 had grade 1 hypertension (including 5 recurrent cases), 76 had grade 2 hypertension (with 11 recurrent cases), and 75 had grade 3 hypertension (with 19 recurrent cases). Univariate analysis, multivariate logistic regression analysis, trend analysis, and smooth curve fitting analysis were performed to explore the correlation between serum Lp-PLA2 level within 24 h after admission and the risk of AIS recurrence. The predictive efficacy of serum Lp-PLA2 level for AIS recurrence in different hypertension grades was evaluated using ROC curve analysis.@*RESULTS@#Serum Lp-PLA2 level, age, NIHSS score at admission, mRS scores at 7 days, homocysteine level and smoking status differed significantly between patients with and without AIS recurrence (P < 0.05). After adjustment for confounding factors, multivariate regression analysis showed that the highest tertile of Lp-PLA2 level was associated with a 4.13-fold increase of AIS recurrence risk compared with the lowest tertile (OR=5.13, 95% CI: 1.35-19.40), and each 1 ng/mL increase of Lp-PLA2 level was associated with a 1% increase of AIS recurrence risk (OR= 1.01, 95% CI: 1.01-1.02). Serum Lp-PLA2 level was shown to positively correlate with AIS recurrence risk, and in patients with grade 3 hypertension, its areas under the ROC curve for predicting AIS recurrence was 0.869 with a specificity of 0.893 and a sensitivity of 0.737.@*CONCLUSION@#Serum Lp-PLA2 concentration is an independent risk factor and potentially an effective predictor for AIS recurrence in patients with grade 3 hypertension.

Advances and challenges in using nirmatrelvir and its derivatives against SARS-CoV-2 infection / 药物分析学报

On December 22,2021,the United States Food and Drug Administration approved the first main protease inhibitor,i.e.,oral antiviral nirmatrelvir(PF-07321332)/ritonavir(Paxlovid),for the treatment of early severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Nirmatrelvir inhibits SARS-CoV-2 infection,but high doses or long-term treatment may cause embryonic developmental toxicity and changes in host gene expression.The chiral structure of nirmatrelvir plays a key role in its antiviral activity.Ritonavir boosts the efficacy of nirmatrelvir by inactivating cytochrome P450 3A4 expression and occupying the plasma protein binding sites.Multidrug resistance protein 1 inhibitors may increase the efficacy of nirmatrelvir.However,Paxlovid has many contraindications.Some patients treated with Paxlovid experience a second round of coronavirus disease 2019(COVID-19)symptoms soon after re-covery.Interestingly,the antiviral activity of nirmatrelvir metabolites,such as compounds 12-18,is similar to or higher than that of nirmatrelvir.Herein,we review the advances and challenges in using nirmatrelvir and its derivatives with the aim of providing knowledge for drug developers and physicians in the fight against COVID-19.

Role of gut microbiota in perioperative neurocognitive disorders after cardiopulmonary bypass surgery in rats with humanized gut flora / 南方医科大学学报

OBJECTIVE@#To investigate whether gut microbiota disturbance after cardiopulmonary bypass (CPB) contributes to the development of perioperative neurocognitive disorders (PND).@*METHODS@#Fecal samples were collected from healthy individuals and patients with PND after CPB to prepare suspensions of fecal bacteria, which were transplanted into the colorectum of two groups of pseudo-germ-free adult male SD rats (group NP and group P, respectively), with the rats without transplantation as the control group (n=10). The feces of the rats were collected for macrogenomic sequencing analysis, and serum levels of IL-1β, IL-6 and TNF-α were measured with ELISA. The expression levels of GFAP and p-Tau protein in the hippocampus of the rats were detected using Western blotting, and the cognitive function changes of the rats were assessed with Morris water maze test.@*RESULTS@#In all the 3 groups, macrogenomic sequencing analysis showed clustering and clear partitions of the gut microbiota after the transplantation. The relative abundances of Klebsiella in the control group (P < 0.005), Akkermansia in group P (P < 0.005) and Bacteroides in group NP (P < 0.005) were significantly increased after the transplantation. Compared with those in the control group, the rats in group NP and group P showed significantly decreased serum levels of IL-1β, IL-6 and TNF-α and lowered expression levels of GFAP and p-Tau proteins (all P < 0.05). Escape platform crossings and swimming duration in the interest quadrant increased significantly in group NP (P < 0.05), but the increase was not statistically significant in group N. Compared with those in group P, the rats in group NP had significantly lower serum levels of IL-1β, IL-6 and TNF-α and protein expressions of GFAP and p-Tau (all P < 0.05) with better performance in water maze test (P < 0.05).@*CONCLUSION@#In patients receiving CPB, disturbances in gut mirobiota contributes to the development of PND possibly in relation with inflammatory response.

Effectiveness and Safety of Chinese Medicine at Shenque (CV 8) for Primary Dysmenorrhea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials / 中国结合医学杂志

BACKGROUND@#Primary dysmenorrhea (PD) is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life. In Chinese medicine, navel therapy, treatment provided at Shenque (CV 8), is used as a treatment option for PD.@*OBJECTIVE@#To evaluate the effect of navel therapy on pain relief and quality of life in women with PD, compared with Western medicine (WM).@*METHODS@#China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), SinoMed and Wanfang Database, MEDLINE, the Cochrane Library, Embase, Web of Science, and the International Clinical Trial Registry of the U.S. National Institutes of Health were searched from their inceptions to April 1, 2021. Randomized controlled trials (RCTs) assessing therapeutic effects of navel therapy on PD were eligible for inclusion. RevMan 5.4 software was used for data analyses. The certainty of the evidence was assessed using the online GRADEpro tool.@*RESULTS@#Totally 24 RCTs involving 2,614 participants were identified. Interventions applied to acupuncture point CV 8 included: herbal patching, moxibustion or combined navel therapy (using at least 2 types of stimulation). Compared to placebo, there was a significant effect in favor of navel therapy on reducing overall menstrual symptom scores at the end of treatment [mean difference: -0.82, 95% confidence interval (CI): -1.00 to -0.64, n=90; 1 RCT]. As compared with Western medicine, navel therapy had a superior effect on pain intensity as assessed by Visual Analogue Scale at the end of treatment [standardized mean difference (SMD): -0.64, 95% CI: -1.22 to -0.06, I2=80%, n=262; 3 RCTs]; on symptom resolution rate at 3-month follow-up (risk ratio: 1.94, 95% CI: 1.47 to 2.56, n=1527, I2=38%; 13 RCTs); and on global menstrual symptoms score at the end of treatment (SMD: -0.67, 95% CI: -0.90 to -0.45, I2=63%, n=990; 12 RCTs). Subgroup analyses showed either a better or an equivalent effect comparing navel therapy with Western medicine. No major adverse events were reported. The methodological quality of included trials was poor overall.@*CONCLUSIONS@#Navel therapy appears to be more effective than Western medicine in decreasing menstrual pain and improving overall symptoms of PD. However, these findings need to be confirmed by well-designed clinical trials with adequate sample size (Systematic review registration at PROSPERO, No. CRD42021240350).

Systematic review and Meta-analysis of efficacy and safety of Compound Glycyrrhizin Injection in improving chronic hepatitis B liver damage / 中国中药杂志

To evaluate the efficacy and safety of Compound Glycyrrhizin Injection(CGI) in improving liver damage in chronic hepatitis B(CHB). PubMed, Web of Science, SinoMed, CNKI, Wanfang and VIP databases were retrieved from their inception to February 10, 2020. The randomized controlled trial(RCT) of CGI in the treatment of CHB was included. Data were independently extracted by two authors, and the methodological quality was evaluated using the Cochrane bias risk assessment tool by other two authors. Statistical analysis was performed using RevMan 5.3 software. A total of 18 two-armed RCTs were included, involving 1 915 participants. The methodological quality of all studies included was generally low. In the comparison between CGI and diammonium glycyrrhizinate, the results showed that CGI was superior to the control group in improving the overall clinical effectiveness, but there was no statistical difference between the two groups in increasing ALT normalization rate, reducing ALT and AST level. In the comparison between CGI and diammonium glycyrrhizinate+other general hepatoprotective drugs, the results showed that CGI was superior to the control group in reducing AST level, while there was no statistical difference between the two groups in reducing ALT level and increasing overall clinical effectiveness. In the comparison between CGI+other commonly used drugs(including energy mixture, glutathione, vitamins, potassium magnesium aspartate) and diammonium glycyrrhizinate+other commonly used drugs, the results showed that CGI combined with other commonly used drugs was better than the control group in reducing ALT and AST level and improving the clinical total effective rate, and there was no statistical difference between the two groups in increasing the rate of ALT normalization. In the comparison between CGI+other commonly used drugs and other commonly used drugs, the results showed that CGI combined with other commonly used drugs was superior to the control group in reducing ALT and AST level and improving the overall clinical effectiveness. In the comparison between CGI+vitamins and diammonium glycyrrhizinate+potassium magnesium aspartate+vitamins, the results showed no statistical difference between the two groups in reducing AST level. A small number of studies included reported that CGI caused mild adverse reactions when used alone or in combination with other drugs. Based on the results, CGI has a certain effect in improving CHB liver damage, but the evidence is not enough to prove that CGI would cause serious adverse events. In the future, more well-designed and strictly-enforced RCT with an adequate sample size are needed to further evaluate the effect CGI in alleviating CHB liver damage.

Practice and thinking of Otorhinolaryngology Clinical Skill Competition / 中华医学教育探索杂志

This paper introduces the clinical skill competition organized by the faculty of Otolaryngology Department of Shanghai Jiao Tong University School of Medicine, and analyzes the main problems in implementing items of basic life support, single ear compression bandage, debridement and suturing, foreign body removal from pharynx and larynx area, nasal packing and hemostasis and comprehensive skills. According to contestants' performances, their abilities in clinical analysis and operating skills have been tested, and their professional humanities have been cultivated. Thus, the aim of "promoting learning through examination and substituting competition for practice" is achieved through the competition. Clinical skill competitions can be used widely as supplement form of medical education for its practicability, entertainment, innovation and interaction.

Meta-analysis of the diagnostic value of the Simple Five item Scoring Scale for Sarcopenia in elderly patients with sarcopenia / 中国实用护理杂志

Objective:To evaluate the diagnostic accuracy and clinical applicability of the Simple Five item Scoring Scale for Sarcopenia (SARC-F) by systematic review and Meta-analysis.Methods:PubMed, The Cochrane Library, Wed of science, EMBASE, MEDLINE, Ovid, China HowNet database, China biomedical data, VIP database and Wanfang database were searched by computer, and all the researches related to SARC-F questionnaire's diagnosis of sarcopenia from the establishment of the database to March 1, 2020 were collected. Two researchers independently selected literature, extracted data, and evaluated the bias risk of the study. Revman 5.3 software, Stata16.0software were used to comprehensively evaluate the diagnostic value of SARC-F questionnaire for sarcopenia.Results:A total of 13 studies involving 8 860 patients were included. The results of meta-analysis showed that the sensitivity and specificity of the diagnostic criteria established by the European Working Group of Sarcopenia, the Asian Working Group for Sarcopenia and the International Working Group for Sarcopenia were used as the gold standard. The area under the receiver operating characteristic curve was 0.71, 0.69 and 0.67 respectively, and the Q-index was 0.659 3, 0.650 9 and 0.631 6.Conclusion:SARC-F questionnaire has a certain value in the screening and diagnosis of sarcopenia. In the future research, it is suggested to add the simple measurement of muscle quality on the basis of this scale to improve the accuracy of the questionnaire screening

Review of systematic reviews of acupuncture for diabetic peripheral neuropathy / 针灸推拿医学（英文版）

Objective: To review the systematic reviews of acupuncture for diabetic peripheral neuropathy (DPN) and to provide evidence for clinical decisions. Methods: Published systematic reviews targeting acupuncture treatment of DPN were searched using computer through both Chinese and English databases till July 1, 2019. Two researchers screened the papers based on inclusion and exclusion criteria and conducted report quality evaluation, methodological quality assessment and evidence quality grading using the preferred reporting items for systematic reviews and meta-analyses (PRISMA), assessment of multiple systematic review 2 (AMSTAR 2) and grading of recommendations assessment, development and evaluation (GRADE). Results: Ten systematic reviews were included, involving 11 outcome measures. According to PRISMA, 6 items were sufficiently reported while 1 item was not; AMSTAR 2 appraised that all the included systematic reviews were of low quality in the methodological evaluation; according to GRADE, of the 30 clinical evidences, only 5 were graded moderate while the remained were graded low or extremely low. Descriptive analysis showed that acupuncture can significantly improve DPN symptoms, accelerate the conduction velocities of sensory and motor nerves, and up-regulate the content of plasma nitric oxide (NO), while the adverse reaction rate was low. Conclusion: Acupuncture can produce satisfactory clinical efficacy in treating DPN, but the existing problems, such as low-quality evidence, unitary outcome measures, poor methodological quality of systematic reviews and nonstandard reporting, need to be treated cautiously; meanwhile, more high-quality clinical trials are required to elevate the level of evidence.

Clinical analysis of type Ⅱ Alexander disease and literature review / 中华神经科杂志

Objective:To analyze the clinical features, imaging findings and gene test of patients with type Ⅱ Alexander disease.Methods:All the clinical data of three cases with type Ⅱ Alexander disease from August 2018 to June 2020 in the Department of Neurology, Qilu Hospital of Shandong University (Qingdao) and Qilu Hospital of Shandong University were collected, and their clinical and imaging findings were analyzed retrospectively.Results:All the three patients were middle aged and old men with a chronic progressive course, beginning with weakness of one or both lower limbs, followed by dizziness, dysarthria, dysphagia, sphincteral disturbances, constipation and orthostatic hypotension. Three patients all experienced misdiagnosis (hydrarthrosis, cerebral vascular disease, alcoholism, respectively) at early stage of the disease. Cranial magnetic resonance imaging (MRI) showed mild supratentorial periventricular leukodystrophy, which was not specific. Sagittal cranial MRI demonstrated medulla oblongata and upper cervical cord atrophy called “tadpole atrophy”, which had high suggestive value. The results of gene analysis showed heterozygous mutation of glial fibrillary acidic protein gene, which had been reported as pathogenic gene; c.1091C>T (p.A364V) in exon 6, c.722C>T (p.R258C) in exon 4 and c.197G>A (p.R66Q) in exon 1, respectively.Conclusions:Type Ⅱ Alexander disease is an autosomal dominant disease, most with point mutations, rarely with deletion mutations. Type Ⅱ Alexander disease should be suspected when a patient had signs of lower brainstem involvement such as dizziness, ataxia, pyramidal sign, autonomic dysfunction, especially when cranial MRI showed mild supratentorial leukodystrophy, and medulla oblongata and upper cervical cord atrophy.

Improvement Effects of α-lipoic Acid on Glucose Metabolism Disorder of Insulin Resistant HepG 2 Cells / 中国药房

OBJECTIVE：To study the i mprovement effects of α-lipoic acid on glucose metabolism disorder of insulin resistant HepG2 cells. METHODS ：The effects of 25-1 000 µmol/L α-lipoic acid on survival rate of human hepatoma cell HepG2 were determined by MTT assay so as to determine the concentration of α-lipoic acid. Negative control group ，insulin resistance group （1× 10－7 mol/L insulin ），combination resistance group （30 µmol/L sodium arsenite+ 1×10－8 mol/L insulin ），α-lipoic acid low- concentration，medium-concentration and high-concentration groups were set up. HepG 2 cells were treated with α-lipoic acid for 12 h and then cultured with corresponding concentration of sodium arsenite or/and insulin for 24 h. The glucose oxidase method was used to detect the glucose consumption ，colorimetric method was used to detect hexokinase activity and pyruvate kinase activity ， and anthrone method was used to detect glycogen content. Western blot assay was used to detect the protein expression of GLUT 4， p-GSK3β and GSK3β as well as the ratio of p-Akt/Akt and p-GSK3β/GSK3β. RESULTS：25，50，100 µmol/L α-lipoic acid had no significant effect on the survival rates of HepG 2 cells（P＞0.05），and survival rates of H epG2 cells were higher than 96％，so they were used as the low ，medium and high concentration for follow-up study. Compared with negative control group ，glucose consumption，the activities of hexokinase and pyruvate kinase ，glycogen content ，protein expression of GLUT 4 and p-GSK 3β，the ratio of p-Akt/Akt and p-GSK 3β/GSK3β were decreased significantly in insulin resistance group and combined resistance group， while the protein expression of GSK 3β was increased significantly（P＜0.05）. Compared with combination resistance group ，the glucose consumption （except for α-lipoic acid low- concentration group ），the activities of h exokinase（except for α-lipoic acid low-concentration and medium-concentration groups ） andpyruvate kinase （except for α-lipoic acid low-concentration com and medium-concentration groups ）， glycogen contents ， protein expression of GLUT 4 （except for α-lipoic acid mail：bliang163@163.com low-concentration group ）and p-GSK3β，the ratio of p-Akt/ Akt（except for α-lipoic acid low-concentration and medium-concentration groups ）and p-GSK 3β/GSK3β（except for α-lipoic acid low-concentration groups ）were increased significantly in α-lipoic acid groups ，while protein expression of GSK 3β（except for α-lipoic acid low-concentration and medium-concentration groups ） was decreased significantly （P＜0.05）；glycogen content ， protein expression of GLUT 4 and the ratio of p-GSK 3β/GSK3β in α-lipoic acid high-concentration group as well as the protein expression of p-GSK 3β in α-lipoic acid medium-concentration and high-concentration groups were improved significantly （P＜0.05）. CONCLUSIONS：α-lipoic acid can improve the disorder of glucose metabolism in insulin resistant HepG 2 cells，the mechanism of which may be associated with the increase of glucose consumption ，the activities of glucose metabolism related enzymes and glycogen content ，and expression up-regulation of the phosphorylation levels of Akt and GSK 3β protein，the expression of GLUT 4 and p-GSK 3β proteins，down-regulation of the expression of GSK 3β protein.

Application of multi-touch virtual anatomy system in the otolaryngology teaching / 中华医学教育探索杂志

The residents and low-grade resident trainees of the Department of Otorhinolaryngology Head and Neck Surgery of the Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine were selected as subjects. In the multi-touch virtual anatomy system, the lecturers made the anatomical signs of otolaryngology head and neck surgery, and applied them through the training method. Then the teachers explained the three sub-specialties of the nose, throat, neck and ear in the multi-touch virtual dissection table. The teaching method can stimulate the learning interest because of its vivid three-dimensional sense. The characteristics of teaching and learning are beneficial to the cultivation of medical education teachers. In addition, the one-time investment of equipment breaks through the supply bottleneck of traditional anatomical consumables and promotes active learning among medical students. The multi-touch virtual anatomy system can effectively improve the teaching methods, facilitate the interesting teaching, and has broad application prospects in medical teaching.

Study on early integrated Chinese and western medicine cluster intervention strategy in preventing intensive care unit acquired weakness / 中国实用护理杂志

Objective:To investigate the effect of early integrated Chinese and western medicine cluster intervention strategy on the prevention of intensive care unit acquired weakness(ICUAW).Methods:A total of 70 patients admitted to the ICU were divided into the intervention group and the control group by random digits table method with 35 cases each. The control group was given limb pressure treatment and limb rehabilitation exercise according to ICU nursing routine, and the intervention group was given early integrated Chinese and western medicine cluster intervention based on the control group, after intervention, the incidence of ICUAW, muscle strength, Barthel index score, mechanical ventilation time, length of stay in ICU and total length of stay between the two groups were compared.Results:The Medical Research Council score of the intervention group and control group were respectively (53.23±5.94) and (43.94±12.58), the Barthel index score were (79.57±7.80) and (66.14±19.25), the incidence of ICUAW were 17%(6/35) and 46%(16/35), the mechanical ventilation time were (162.26±72.27) and (254.06±126.22) h, the length of stay in ICU were (12.20±4.98) and (15.57±6.04) d, the total length of stay were (18.83±6.76) and (23.09±7.88) d, and the differences were statistically significant ( t values were -3.82-3.69, χ2 value was 6.63, P<0.05 or 0.01) . Conclusions:Early integrated Chinese and western medicine cluster intervention strategycan reduce the incidence of ICUAW, improve the muscle strength and daily life activities of patients, shorten the mechanical ventilation time, ICU length of stay and total length of stay in critically ill patients.

Effects of targeted silencing ANX A3 on morphine analgesic tolerance and inflammation in rats / 解放军医学杂志

Objective: To investigate the effects and possible mechanisms of targeted silencing ANXA3 on morphine analgesia and inflammation in rats. Methods: Male SD rats were injected intrathecally with 15 μg morphine for 7 days to establish a chronic morphine analgesic tolerance model. Thirty rats were randomly divided into morphine group, negative control group and ANXA3 siRNA group. The maximum possible percentage of analgesic effect (%MPE) was calculated by measuring the paw withdrawal thermal latency (PWL) of rats in each group at the 1st, 3rd, 5th and 7th day of the experiment. On the 7th day, rats were anesthetized and sacrificed after behavioral test, and the spinal cord enlargement of rats in each group were collected. The mRNA and protein levels of ANXA3 were detected by RT-PCR and Western blotting, and of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) were determined by RT-PCR and ELISA kits. In addition, Western blotting was used to evaluate the phosphorylation levels of extracellular signal-regulated kinase (ERK) and c-Jun NH2-terminal kinase (JNK). Results: After injection of morphine, no significant difference existed in %MPE between the negative control group and the morphine group, while the %MPE was obviously higher in ANXA3 siRNA group than in the negative control group (P<0.05) on the 3rd day (78.27% ± 8.50% vs. 71.75% ± 5.98%), 5th day (64.37% ± 25.94% vs. 43.56% ± 2.69%) and 7th day (39.96% ± 3.27% vs. 13.81% ± 1.25%) after morphine injection. The relative expression levels of ANXA3 mRNA and protein showed no significant difference between morphine group and the negative control group, but was lower in the relative expression levels of ANXA3 mRNA and protein in ANXA3 siRNA group than in the negative control group (0.47 ± 0.09 vs. 1.14 ± 0.08, 0.38 ± 0.05 vs. 1.15 ± 0.21, P<0.05). Compared with morphine group, no significant difference existed in TNF-α, IL-1β and IL-6 protein concentrations in the negative control group. The protein concentrations of TNF-ct, IL-1β and IL-6 were lower in ANXA3 siRNA group than in the negative control group [(210.15 ± 19.86) pg/g vs. (394.93 ± 54.18) pg/g], [(313.42 ± 42.19) pg/g vs. (534.26 ± 49.78) pg/g] and [(434.68 ± 49.15) pg/g vs. (794.92 ± 98.32) pg/g, P<0.05]. Compared with morphine group, no significant difference existed in the relative expressive levels of p-ERK and p-JNK in the negative control group. The relative expressive levels of p-ERK and p-JNK proteins were obviously lower in ANXA3 siRNA group than in the negative control group (0.55 ± 0.04 vs. 1.07 ± 0.12 and 0.68 ± 0.07 vs. 1.15 ± 0.04, respectively. P<0.05). Conclusion Targeted silencing ANXA3 may enhance the morphine analgesic effect and reduce inflammatory response by regulating the phosphorylation level of ERK and JNK signaling pathway.

Preliminary study on the application of real-time anatomical demonstration in the theoretical teaching of otorhinolaryngology-head and neck surgery / 中华医学教育探索杂志

Objective@#To investigate the effects of real-time anatomical demonstration and traditional teaching in otorhinolaryngology-head and neck surgery.@*Methods@#Students who studied this course from Shanghai Jiao Tong University School of Medicine were divided into two groups: clinical students in 5-year program (n=22) were assigned to the experimental group and students from"5+3" stomatology major (n=35) were assigned to control group. Both groups had two class hours, with the same teacher teaching at the same day. Students in the experimental group were taught with theoretical teaching combined with real-time anatomical demonstration, while students in the control group was taught with traditional theoretical teaching with multimedia content. Students in the two groups completed the questionnaire and received quiz; SPSS 19.0 was used to perform the independent-samples T test of between-group data.@*Results@#According to the questionnaire, scores for different items of the teaching method in the experimental group were higher than those in the control group. But according to the examination scores, average scores of the theoretical examination in the control group was (85.143±8.268), which was obviously higher than that of (64.545±11.434) in the experimental group, with statistically significant differences (t=7.885, P=0.000).@*Conclusion@#Teaching effect combined with real-time anatomical demonstration is not obvious to short-term examination, which may be related to the short-term understanding and absorption of knowledge for students in different majors, but it is coherent with the difference of entrance-examination scores of students from the two groups. This teaching model can stimulate students' interest in learning, and help them choose their professions, which may have certain advantages in the future long-term teaching effect.

Preliminary study on the application of real-time anatomical demonstration in the theoretical teaching of otorhinolaryngology-head and neck surgery / 中华医学教育探索杂志

Objective To investigate the effects of real-time anatomical demonstration and traditional teaching in otorhinolaryngology-head and neck surgery.Methods Students who studied this course from Shanghai Jiao Tong University School of Medicine were divided into two groups:clinical students in 5-year program (n=22) were assigned to the experimental group and students from"5+3" stomatology major (n=35) were assigned to control group.Both groups had two class hours,with the same teacher teaching at the same day.Students in the experimental group were taught with theoretical teaching combined with real-time anatomical demonstration,while students in the control group was taught with traditional theoretical teaching with multimedia content.Students in the two groups completed the questionnaire and received quiz;SPSS 19.0 was used to perform the independent-samples T test of between-group data.Results According to the questionnaire,scores for different items of the teaching method in the experimental group were higher than those in the control group.But according to the examination scores,average scores of the theoretical examination in the control group was (85.143 ± 8.268),which was obviously higher than that of (64.545 ± 11.434) in the experimental group,with statistically significant differences (t=7.885,P=0.000).Conclusion Teaching effect combined with real-time anatomical demonstration is not obvious to short-term examination,which may be related to the short-term understanding and absorption of knowledge for students in different majors,but it is coherent with the difference of entrance-examination scores of students from the two groups.This teaching model can stimulate students' interest in learning,and help them choose their professions,which may have certain advantages in the future long-term teaching effect.

Study on Prevention Effect and Mechanism of Miao Medicine Liangjiang Weiyang Capsule on Gastric Ulcer Model Rats / 中国药房

OBJECTIVE： To study the protective effect and mechanism of Miao medicine Liangjiang weiyang capsule on gastric ulcer model rats. METHODS： Rats were randomly divided into normal group （normal saline）， model group （normal saline）， positive control group （omeprazole， 0.02 g/kg） and Liangjiang weiyang capsule low-dose， medium-dose and high-dose groups （0.3， 0.6， 1.2 g/kg）， with 12 rats in each group. All rats were intragastrically administered once a day for consecutive one week. 1 h after last administration， all rats except those in normal group were given the absolute ethanol to induce gastric ulcer model. 1 h after modeling， gastric juice volume， gastric juice pH， pepsin activity， gastric ulcer area and inhibitory rate of gastric ulcer were recorded in each group. Histopathological changes of gastric mucosa in rats of each group were observed by HE staining. The serum levels of TNF-α and IL-6 were determined by ELISA. The expression of nuclear factor-κB pathway related protein （p-NF-κB p65， p-IκBα） in gastric tissue of rats were determined by Western blot. RESULTS： Compared with normal group， gastric juice volume， pepsin activity， gastric ulcer area， TNF-α and IL-6 levels in serum， p-NF-κB p65 and p-IκBα levels in the gastric tissue were significantly increased/rised （P＜0.05）， while gastric juice pH was significantly decreased （P＜0.01）； there were gastric mucosal hyperemia and redness， obvious defect of mucosal epithelial cells， destruction of gland structure and incomplete cell structure. Compared with model group， gastric juice volume， pepsin activity， gastric ulcer area and the levels of TNF-α and IL-6 were reduced/decreased significantly in positive control group， Liangjiang weiyang capsule medium-dose and high-dose groups （P＜0.05 or P＜0.01）， while pH value of gastric juice was increased significantly （P＜0.05）； gastric mucosa was normal， gland destruction was alleviated and cell structure was intact. The levels of p-NF-κB p65 and p-IκBα in gastric tissue were significantly decreased in Liangjiang weiyang capsule high-dose groups （P＜0.05）. CONCLUSIONS： Liangjiang weiyang capsule play a role to protect gastric ulcer by increasing gastric juice pH， inhibiting pepsin activity， reducing the release of inflammatory factors as TNF-α， IL-6 and inhibiting the expression of NF-κB pathway related protein.

Irreversible electroporation ablation of tumor: an analysis of perioperative complications / 介入放射学杂志

Objective To summarize and analyze the perioperative complications of irreversible electroporation (IRE) ablation in treating tumors at different locations and to discuss their managements. Methods A total of 200 patients with tumors, including pancreatic tumor (n=71), liver tumor (n=64) and other tumors (n =65), were enrolled in this study. All patients received IRE ablation treatment. The perioperative complications were recorded and the data were statistically analyzed. The causes of severe complications and the treatment of complications were discussed. Results None of the patients died during the course of IRE ablation procedure. Severe postoperative complications occurred in the patients with pancreatic tumor or liver tumor, including duodenal artery bleeding in 3 patients with pancreatic tumor, which occurred at 10 days, 11 days and 15 days after IRE ablation respectively, and gastrointestinal bleeding (n =1) and biliary septic shock (n=1) in 2 patients with liver tumor, which occurred at 9 days after IRE ablation, the clinical symptoms were controlled after interventional embolization and/or vascular ligation together with anti-infective therapy. All minor complications were relieved after symptomatic treatment within 14 days. Conclusion IRE ablation has less systemic inflammatory response, and both the intraoperative and postoperative adverse reactions can be easily controlled, besides, IRE ablation has higher clinical safety. Although IRE ablation procedure may damage the internal or peripheral vessels of the pancreatic tumor, this severe complications can be effectively avoided if proper measures are adopted based on the causes of complications. (J Intervent Radiol, 2018, 27: 223-227)

A primary exploration for the monitoring and early warning system of hemostatic consumables / 中国医学装备

Objective: To explore how to establish a supernormal management system with functions of early warning and intervention through monitoring the dynamic state of clinical use of hemostatic consumables in the operation-decision system of hospital so as to provide reference bases for strengthening management of clinical application of hemostatic consumables in hospital. Methods: The supernormal early warning materials of the same hospital consumable in the Jan, Feb. of 2017 and the Jan, Feb. of 2016 were ranked, respectively. And the usage amount of hemostatic materials, service condition of hemostatic materials in variously clinical department and the used dynamic state of hemostatic materials in patient were carried out statistical analysis. And then, the policy suggestion of supernormal early warning intervention for hemostatic materials was primarily proposed. Results: Since the monitoring of operation-decision system of hospital for consumables was adopted, the service condition of hemostatic materials in most of clinical departments of Jan., Feb. of 2017 were better than that of Jan., Feb of 2016. Conclusion: Through the standardization construction for hospital, the clinical application management of hemostatic materials has been strengthened, and the safety, efficiency, economy and intelligent use of hemostatic materials have been ensured.

Analysis of NK Cells and Receptors in Peripheral Blood of Patients with HBV Related Acute-on-chronic Liver Failure in Different Phases / 中山大学学报(医学科学版)

[Objective]To investigate the character of expression of NK cells and its receptors in peripheral blood of pa-tients with HBV-related acute-on-chronic liver failure(HBV-ACLF)in different phase.[Methods]There are thirteen pa-tients with HBV-ACLF in advanced phase group and thirty-three patients in plateau phase group,with thirteen healthy per-son in control group.The frequency of NK cells and expression of NK cell activating receptors(NKAR)including NKG2D, NKp30 and NKp46,NK cell inhibitory receptors(NKIR))cludingsd ate the character of including NKG2A,KIR2DL1, KIR2DL3 and KIR3DL1,NK cell killing function related factors including Perforin,GranzymeB and FasL in peripheral blood of all patients were detected by flow cytometry.[Results]The percentage of NK cells in advanced group was lower than plateau group and healthy control group(H=7.771,P=0.021).The expression of KIR3DL1 in healthy control group was high-er than advanced group and plateau group(Z=6.639,P=0.036)while the expression of FasL was significantly lower than ad-vanced group and plateau group(Z=22.5,P<0.001).[Conclusion]Patients in advanced group had lower frequency of NK cells,lower expression of inhibitory receptor KIR3DL1 and higher expression of FasL than patients in plateau group and healthy control group,which is associated with immune status of patients in different phase of liver failure.

Enhancement of histone deacetylase inhibitors SAHA in chemotherapeutic sensitivity of ovarian cancer SKOV3 cells / 吉林大学学报(医学版)

Objective: To investigate the biological effects of histone deacetylase inhibitors (HDACIs) suberoylanilide hydroxamic acid (SAHA) combined with vincristine (VCR) on the ovarian cancer SKOV3 cells, and to clarify their mechanisms. Methods: The human ovarian cancer SKOV3 cells were divided into control group, SAHA group, VCR group and SAHA+VCR group. CCK-8 method was used to detect the surival rates of SKOV3 cells in various groups. The apoptotic rates, the autophagy rates and the distribution of cell cycles of SKV03 cells in various groups were detected by flow cytometry (FCM). Results: The CCK-8 results showed that compared with control group, the survival rates of SKOV3 cells in SAHA group and VCR group were decreased significantly. Compared with VCR group or SAHA group, the survival rates of cells in SAHA + VCR groups were decreased significantly (P