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Objective:To analyze the common disease spectrum and medication of field medical team in our hospital in summer, and to provide medical and medicinal material supply for field medical team.Methods:The data of all cases of field medical team members during the training period were collected. The types and composition ratio of diseases were analyzed, the drug consumption was counted, and the drug use indicators were calculated including daily drug dose (DDDs), daily drug dose cost (DDDC), drug utilization rate (DUR) and drug ranking ratio (R).Results:During the 12 days of the field training in summer, 77 field medical team members had 91 medical visits and 117 cases of diseases, including 44 males and 33 females, with an average age of 39.7 years. There were 52 cases of respiratory diseases, 21 cases of digestive diseases, 18 cases of mosquito bites and skin diseases, 15 cases of trauma and skeletal muscle system diseases, 5 cases of ophthalmic diseases, 2 cases of neurological diseases, 2 cases of gynecological diseases, 1 case of oral diseases and 1 case of heat stroke. The top five drugs of DDDs and DUR were respiratory drugs, sensory organ drugs, dermatological drugs, antibiotic drugs, digestive system drugs and musculoskeletal system drugs.Conclusions:The disease composition and drug demand of field training in summer have certain characteristics. It is of great guiding significance to know the characteristics of disease incidence and drug consumption of field training for the medical support ability and training tasks for field medical teams in field training in summer.
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Internet of Things (IoT) technology plays an important role in smart healthcare. This paper discusses IoT solution for emergency medical devices in hospitals. Based on the cloud-edge-device architecture, different medical devices were connected; Streaming data were parsed, distributed, and computed at the edge nodes; Data were stored, analyzed and visualized in the cloud nodes. The IoT system has been working steadily for nearly 20 months since it run in the emergency department in January 2021. Through preliminary analysis with collected data, IoT performance testing and development of early warning model, the feasibility and reliability of the in-hospital emergency medical devices IoT was verified, which can collect data for a long time on a large scale and support the development and deployment of machine learning models. The paper ends with an outlook on medical device data exchange and wireless transmission in the IoT of emergency medical devices, the connection of emergency equipment inside and outside the hospital, and the next step of analyzing IoT data to develop emergency intelligent IoT applications.
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Internet of Things , Reproducibility of Results , Internet , Machine Learning , TechnologyABSTRACT
Objective:To study the correlation of serum tenascin C (TNC) and bronchopulmonary dysplasia (BPD) comorbid pulmonary hypertension (PH) in preterm infants.Methods:From January 2017 to June 2020, preterm infants (gestational age<32 weeks) diagnosed of severe BPD admitted to the Neonatal Intensive Care Unit of our hospital were prospectively studied. Comorbidity of PH was evaluated using echocardiography and the infants were assigned into PH (+) group and PH (-) group. At the same time, serum TNC was examined and the correlation between serum TNC level and PH in infants with severe BPD was analyzed.Results:A total of 59 infants with severe BPD were enrolled, including 21 cases comorbid PH (35.6%). The serum TNC level in the PH (+) group was significantly higher than the PH (-) group [(123.7±41.1) ng/ml vs. (78.2±20.2) ng/ml, P<0.05]. Correlation analysis showed a positive correlation between the serum TNC level and systolic pulmonary artery pressure (sPAP) ( r=0.861, P<0.001).The area under the receiver operating characteristic curve of serum TNC predicting BPD comorbid PH was 0.884. The sensitivity and specificity of serum TNC predicting BPD comorbid PH were 84.0% and 76.9% with TNC≥87.7 ng/ml as the cut-off. Conclusions:Severe BPD comorbid PH is common. The serum TNC level in infants with severe BPD comorbid PH is increased and positively correlated with sPAP. The serum TNC level has certain clinical value in predicting and evaluating the severity of BPD comorbid PH.
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Objective:To translate the Pediatric Respiratory Assessment Measure into Chinese, and to test its reliability and validity.Methods:According to the Brislin translation model, the English version of Pediatric Respiratory Assessment Measure was translated into Chinese, and then was back-translated and modified for cultural adaptation. From June 2019 to December 2020, convenience sampling method was used to evaluate the severity of 50 children with acute attack of bronchial asthma aged 2-14 years in the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University, in order to evaluate its reliability and validity.Results:The Cronbach α of the Chinese version of Pediatric Respiratory Assessment Measure was 0.838, the inter-rater reliability was 0.984; the average scale-content validity index was 0.97. One common factor was extracted, the cumulative variance contribution rate of superior sternal fossa depression was 61.83%. The criterion related validity between the evaluation results of doctors, nurses, respiratory therapists and the grading standard of bronchial asthma severity in the " Guidelines for the diagnosis, prevention and treatment of bronchial asthma in children ( 2016 edition)" were 0.903, 0.884 and 0.889, the ROC curve of the scale was 0.867 (95% CI 0.754-0.980). Conclusions:The Chinese version of Pediatric Respiratory Assessment Measure has good reliability and validity, which can be used to evaluate the severity of acute attack of bronchial asthma in children aged 2-14 in China, and provide a basis for further diagnosis and treatment.
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Since the enrollment in 2002, the cultivation model of "4+4" program of clinical medicine in Shanghai Jiao Tong University School of Medicine has been continuously explored and practiced. With the goal of cultivating high-level compound outstanding medical innovative talents with multi-disciplinary cross-capacity, through strengthening the heuristic teaching, establishing the medical-engineering cross-course, emphasizing the training of scientific research ability, and taking teaching reform in the basic clinical single-circulation organ system integration course, we have established a talent training system with the characteristics of Shanghai Jiao Tong University School of Medicine, which is characterized by "thick foundation, strong practice, re-transformation, shaping norms, and international integration", and intend to make further exploration in the field of post-graduation education convergence.
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Objective:To observe and analyze the macular choroidal thickness and choroidal blood perfusion (CBP) in eyes with idiopathic macular hole (IMH) and their correlation.Methods:A cross-sectional observational clinical study. From March 2019 to October 2021, 60 IMH patients with 60 eyes (IMH group) and 60 healthy volunteers with 60 eyes (control group) who consecutively visited Department of Ophthalmology of The First Affiliated Hospital of Zhengzhou University were included in the study. Among the 60 eyes in the IMH group, 8, 8, 15, and 29 eyes were at stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. There was no significant difference in age, spherical equivalent power and axial length between the two groups ( t=1.327, 0.157, 0.542; P>0.05). The average macular choriodal thickness (AMCT) and CBP in different regions of the macular region of the examined eye were measured using a swept-frequency light source optical coherence tomography scanner. According to the zoning method for the treatment of diabetic retinopathy, the choroid within 6 mm of the fovea was divided into 3 concentric circles with the fovea as the center. They are the central area with a diameter of 1 mm, the inner ring area of 1-3 mm, and the outer ring area of 3-6 mm; the inner ring area and the outer ring area were divided into 4 areas by 2 radiations respectively, including the upper part of the inner superior (IS), the lower part of the inner inferior (Ⅱ ), and the nasal side of the inner nasal (IN), inner temporal (IT), outer superior (OS), outer inferior (OI), outer nasal (ON), outer temporal (OT), a total of 9 regions. The distribution characteristics of AMCT and CBP in different regions were observed. The correlation between AMCT and CBP was analyzed by Pearson correlation; the correlation between AMCT, CBP and IMH stage was analyzed by Spearman correlation. Results:Compared with the eyes of the control group, the AMCT of the affected eyes in the IMH group was significantly thinner in all areas of the macula, and the difference was statistically significant ( t=2.378, 4.641, 2.888, 3.390, 3.575, 4.870, 4.077, 4.946, 4.578; P<0.05). Compared with the control group, the CBP in the OS and OT regions of the affected eyes in the IMH group was significantly lower, the difference was statistically significant ( t=3.424, 4.516; P<0.05). The results of Pearson correlation analysis showed that there was a significant positive correlation between AMCT and CBP in the OT region ( r=0.314, P<0.001). Spearman correlation analysis showed that there was a significant positive correlation between AMCT and IMH staging in each region ( r=0.375, 0.374, 0.289, 0.379, 0.441, 0.392, 0.303, 0.341, 0.292; P<0.05). There was no significant correlation between CBP and IMH staging in IN, OI and OT regions ( r=-0.138, -0.016, -0.221; P>0.05); CBP and IMH staging in other regions were significantly negatively correlated ( r=-0.560, -0.390,-0.819, -0.692, -0.329, -0.587; P<0.05). Conclusions:The choroidal thickness in the macular region of the eyes with IMH is significantly thinner than that of the normal subjects; there is choroidal hypoperfusion in local areas. There is a significant positive correlation between local regional AMCT and CBP; IMH stage is higher, the trend of AMCT in each region is thickening, and the CBP in most regions decrease.
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Objective:To observe and analyze the macular choroidal thickness and choroidal blood perfusion (CBP) in eyes with idiopathic macular hole (IMH) and their correlation.Methods:A cross-sectional observational clinical study. From March 2019 to October 2021, 60 IMH patients with 60 eyes (IMH group) and 60 healthy volunteers with 60 eyes (control group) who consecutively visited Department of Ophthalmology of The First Affiliated Hospital of Zhengzhou University were included in the study. Among the 60 eyes in the IMH group, 8, 8, 15, and 29 eyes were at stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. There was no significant difference in age, spherical equivalent power and axial length between the two groups ( t=1.327, 0.157, 0.542; P>0.05). The average macular choriodal thickness (AMCT) and CBP in different regions of the macular region of the examined eye were measured using a swept-frequency light source optical coherence tomography scanner. According to the zoning method for the treatment of diabetic retinopathy, the choroid within 6 mm of the fovea was divided into 3 concentric circles with the fovea as the center. They are the central area with a diameter of 1 mm, the inner ring area of 1-3 mm, and the outer ring area of 3-6 mm; the inner ring area and the outer ring area were divided into 4 areas by 2 radiations respectively, including the upper part of the inner superior (IS), the lower part of the inner inferior (Ⅱ ), and the nasal side of the inner nasal (IN), inner temporal (IT), outer superior (OS), outer inferior (OI), outer nasal (ON), outer temporal (OT), a total of 9 regions. The distribution characteristics of AMCT and CBP in different regions were observed. The correlation between AMCT and CBP was analyzed by Pearson correlation; the correlation between AMCT, CBP and IMH stage was analyzed by Spearman correlation. Results:Compared with the eyes of the control group, the AMCT of the affected eyes in the IMH group was significantly thinner in all areas of the macula, and the difference was statistically significant ( t=2.378, 4.641, 2.888, 3.390, 3.575, 4.870, 4.077, 4.946, 4.578; P<0.05). Compared with the control group, the CBP in the OS and OT regions of the affected eyes in the IMH group was significantly lower, the difference was statistically significant ( t=3.424, 4.516; P<0.05). The results of Pearson correlation analysis showed that there was a significant positive correlation between AMCT and CBP in the OT region ( r=0.314, P<0.001). Spearman correlation analysis showed that there was a significant positive correlation between AMCT and IMH staging in each region ( r=0.375, 0.374, 0.289, 0.379, 0.441, 0.392, 0.303, 0.341, 0.292; P<0.05). There was no significant correlation between CBP and IMH staging in IN, OI and OT regions ( r=-0.138, -0.016, -0.221; P>0.05); CBP and IMH staging in other regions were significantly negatively correlated ( r=-0.560, -0.390,-0.819, -0.692, -0.329, -0.587; P<0.05). Conclusions:The choroidal thickness in the macular region of the eyes with IMH is significantly thinner than that of the normal subjects; there is choroidal hypoperfusion in local areas. There is a significant positive correlation between local regional AMCT and CBP; IMH stage is higher, the trend of AMCT in each region is thickening, and the CBP in most regions decrease.
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Objective:To evaluate the post-marketing safety and immunogenicity of a 23-valent pneumococcal polysaccharide vaccine (PPV23).Methods:From September 2020 to June 2021, a clinical trial of single-dose PPV23 was conducted in people ≥3 years old in Centers for Disease Control and Prevention of Guizhou, Hunan and Fujian provinces. Blood samples were collects from the subjects before and 30 d after vaccination. ELISA was used to quantitatively detect IgG antibodies against capsular polysaccharides of 23 Streptococcus pneumoniae serotypes in serum samples. The adverse events (AEs) were monitored within 7 d after vaccination. Results:A total of 409 subjects were enrolled and included in safety analysis. Except for one with antibody level inversion, the other 408 participants were included in immunogenicity analysis. The levels of antibodies against the 23 Streptococcus pneumoniae serotypes were all increased after vaccination by an average of 4.24 folds. The two-fold growth rates of the antibodies ranged from 51.72% to 96.81% with a total two-fold growth rate of 78.59%. The overall rate of AEs was 27.14% (111/409). Local AEs were mainly pain, induration, redness and swollen. No serious adverse events related to vaccination occurred. Conclusions:This study preliminarily demonstrated the good immunogenicity and safety of PPV23 vaccine.
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Objective To investigate the clinical characteristics, treatment and prognosis of the eighth edition of AJCC stage Ⅲ gallbladder cancer (GBC). Methods We collected the clinical data and follow-up results of 3485 patients with AJCC 8th stage Ⅲ gallbladder cancer. Kaplan Meier survival curves of ⅢA and ⅢB, T3N0M0 (ⅢA), T1-2N1M0 (ⅢB) and T3N1M0 (ⅢB) were drawn and compared. Single factor analysis and Cox multiple factor regression analysis were used to analyze the relation between clinical characteristics, treatment plan, stage Ⅲ subtype and prognosis. Results One-year survival rate of stage ⅢB gallbladder cancer patients was 49.70%, higher than those of stage ⅢA(36.41%); the 1-year survival rate of stage T1-2N1M0 (ⅢB) gallbladder cancer patients was 65.52%, higher than those of stage T3N0M0 (ⅢA) (36.41%) and stage T3N1M0 (ⅢB) (37.05%). According to Cox multivariate analysis, age, tumor grade, tumor size, operation mode, radiotherapy, chemotherapy, AJCC 8th TNM specific subtype and T stage were independent related factors affecting the prognosis of stage Ⅲ GBC patients (P < 0.01). Conclusion The overall survival of stage ⅢB GBC is better than that of stage ⅢA. The risk of stage Ⅲ GBC death was T1-2N1M0 (ⅢB) < T3N0M0 (ⅢA) < T3N1M0 (ⅢB). Radical cholecystectomy (number of dissected lymph node≥6), radiotherapy and chemotherapy are beneficial to the improvement of prognosis of stage Ⅲ GBC patients.
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Objective:To explore the value of growth differentiation factor 15 (GDF15) in the early diagnosis of acute chest pain.Methods:A total of 96 patients with acute chest pain admitted to the Emergency Department of Hainan Hospital of PLA General Hospital from January to November 2020 were retrospectively collected. The sex, age, troponin T, creatine kinase, creatine kinase isoenzyme, GDF15 and B-type natriuretic peptide of patients within 30 min after admission were recorded, and the differences of each index in different groups were compared. ROC curve was drawn to evaluate the diagnostic value of GDF15 and TNT/BNP in acute coronary syndrome (ACS). The Gensini score, left ventricular ejection fraction, length of stay in hospital and the number of stents were calculated, and the correlation between these indexes and GDF15 concentration was evaluated.Results:The general trend of acute chest pain was more male than female (72.92% vs. 27.08%) , the oldest group was the UA group (64.67 ± 13.87) years old , the youngest group was cardiac arrest group (47.29 ± 9.99) years old . There were higher rates of hypertension in the STEMI group, NSTEMI group and UA group, and none of the groups showed significant advantage in diabetes. The GDF15 concentration was higher in ACS related chest pain group [(2.360 ± 1.710) ng/mL vs. (1.380 ± 1.040) ng/mL, P<0.01]. The area under the Receiver Operating Characteristic Curve (AUC) of GDF15 combined with TNT was up to 0.863. GDF15 concentration was negatively correlated with ejection fraction, positively correlated with Gensini score, positively correlated with the number of stents implanted, and positively correlated with the length of hospital stay. Conclusions:GDF15 is valuable in the diagnosis and prognosis of acute chest pain. The combination of GDF15 and TNT can improve the diagnostic rate of ACS.
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Objective:To explore the early warning and prediction value of GDF15 for sudden death patients.Methods:From January to December 2018, 49 patients with sudden death who were treated in the Emergency Department of the First Clinical Center of PLA General Hospital were included in the case group, and 46 healthy physical examiners in the Physical Examination Center of the Hospital were randomly selected as the control group. The general situation, comparison of myocardial markers and analysis of the basic data of the case group were carried out, so as to evaluate the early warning value of each myocardial marker in sudden death.Results:Patients aged 40-49 years old accounted the highest proportion among sudden death cases, reaching 26.54%. Sudden death under 60 years old accounted for 59.19%, and the ratio of male to female was 3.83:1. There were significant differences between the case group and the control group in CK-MB [(41.35±98.38) vs. (3.13±2.17), P=0.009], CK [(2652.82±6845.66) vs. (102.73±47.93), P=0.012], and GDF15 [(549.80±809.79) vs. (115.70±167.42), P=0.001]. At the same time, the AUC value of GDF15 was 0.816, which has the highest diagnostic value for sudden death. And CK-MB, CK and GDF15 had no correlation with age. Conclusions:GDF15, as a biological marker, has a good early warning function in sudden death.
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Objective:To explore the early warning of blood growth differentiation factor-15 (GDF15) as a new stress indicator.Methods:A total of 53 armed police soldiers selected to participate in high-intensity training, measuring the soldiers' serum GDF15, high-sensitivity C-reactive protein (S-CRP), and C-reactive protein (CRP) before and after the high-intensity training , Interleukin-6 (IL-6), Procalcitonin (PCT) levels, compare the coefficient of variation of each index; use SPSS 24 software for statistical analysis, measurement data are expressed as mean ± standard deviation (Mean±SD), The comparison of measurement data adopts group t test. Results:The GDF15 level of fighters after high-intensity training was (176.28±97.45) pg/mL, which was higher than (120.35±69.87) pg/mL before high-intensity training. The difference was very significant ( P <0.001). After high-intensity training, IL-6 and CRP levels were lower than before high-intensity training, the difference was statistically significant ( P<0.05); there was no statistically significant difference in S-CRP and PCT before and after high-intensity training ( P>0.05). The coefficient of variation of GDF15 index is smaller than S-CRP, CRP, IL-6, PCT. Conclusion:Blood growth differentiation factor-15 (GDF15) is of great significance in warning the stress state after high-intensity training. It has higher sensitivity than other conventional stress indicators like S-CRP, CRP, IL-6 and PCT.
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Objective:To observe the effect of early goal directed sedation (EGDS) on cerebral oxygen metabolism in patients with acute brain injury.Methods:A prospective cohort study was conducted. A total of 108 patients with acute brain injury admitted to the intensive care unit (ICU) of the Third Medical Center of the PLA General Hospital from January 2015 to December 2019 were enrolled. According to the patient's condition, dexmedetomidine contraindication and tolerance, and combined with the wishes of patients' families, they were divided into EGDS group and on-demand sedation group. Routine treatments such as surgery, mechanical ventilation, dehydration and reduction of intracranial pressure with mannitol, hemostasis or antiplatelets therapy were given according to the patient's condition. All patients were continuously given sufentanil by intravenous infusion for analgesia. Patients in the EGDS group were sedated by continuously intravenous infusion of dexmedetomidine (0.2-0.7 μg·kg -1·min -1) for 72 consecutive hours. Patients in the on-demand sedation group received intravenous bolus of propofol (0.5-1.0 mg/kg) when treatments were interfered due to agitation. Hemodynamic indexes [heart rate (HR), mean arterial pressure (MAP), cerebral perfusion pressure (CPP), intracranial pressure (ICP)], sedation indexes [bispectral index (BIS)], severity indexes [acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, Glasgow coma score (GCS)] and cerebral oxygen metabolism indexes [jugular venous blood lactate (Lac), jugular venous oxygen saturation (SjvO 2), cerebral arterial oxygen content (CaO 2), cerebral extraction rate of oxygen (CERO 2), cerebral arteriovenous blood oxygen content difference (a-vDO 2)] were compared between the two groups before sedation and at 24, 48 and 72 hours of sedation. Results:① Among the 108 patients, 3 patients with cerebral hemorrhage received secondary surgery or had worsening of cerebral hernia were excluded. 105 patients were enrolled in the study, including 54 patients in the EGDS group and 51 patients in the on-demand sedation group. There were no statistically significant differences in gender, age, type of craniocerebral injury, GCS score, proportion of mechanical ventilation and operation ratio between the two groups. ② Compared with before sedation, Lac, CERO 2 and a-vDO 2 of both groups gradually reduced over time of sedation while SjvO 2 and CaO 2 were gradually higher. Those changes were more quickly in the EGDS group, Lac, SjO 2, CERO 2 and a-vDO 2 significantly improved at 24 hours of sedation compared with those before sedation. Above indexes at 72 hours of sedation in the EGDS group were obviously better than those in the on-demand sedation group [Lac (mmol/L): 1.81±0.31 vs. 2.19±0.12, SjvO 2: 0.714±0.125 vs. 0.683±0.132, CaO 2 (mL/L): 201.21±15.25 vs. 179.65±14.07, CERO 2: (27.87±3.66)% vs. (33.00±2.58)%, a-vDO 2 (mL/L): 44.32±5.68 vs. 48.57±8.22, all P < 0.05]. ③ Compared with before sedation, HR, MAP and ICP decreased in the two groups over time while CPP, BIS and GCS score showed increasing trend, especially more quickly in the EGDS group, HR at 24 hours of sedation, MAP, CPP, BIS and GCS score at 48 hours significantly improved as compared with those before sedation. Hemodynamics and sedation related parameters and GCS score at 72 hours of sedation in the EGDS group were significantly better than those in the on-demand sedation group [HR (bpm): 70.69±7.80 vs. 79.85±9.77, MAP (mmHg, 1 mmHg = 0.133 kPa): 84.23±8.76 vs. 89.97±9.48, ICP (mmHg): 14.23±8.76 vs. 15.97±9.48, BIS: 60.56±24.58 vs. 56.86±33.44, GCS score: 8.06±3.63 vs. 7.86±2.98, all P < 0.05]. The APACHE Ⅱ scores were significantly reduced at 72 hours of sedation in both groups as compared with those before sedation, while there was no statistical difference between the two groups. Conclusion:Compared with the on-demand sedation, EGDS could reduce cerebral oxygen metabolism, improve the coma degree, and reduce the severity of the disease in patients with acute brain injury.
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Objective:To find out the problems still existing in the teaching reform through the investigation and research of eight-year program graduates of clinical medicine.Methods:In 2017, 118 questionnaires were issued to Batch 2005-2006 graduates of eight-year program in clinical medicine, and 103 valid questionnaires were retrieved. The questionnaire was based on that of the Fuyi Design of the Education Department in Zhongshan Hospital affiliated to Fudan University. The questionnaire was revised on the basis of the pre-survey and the statistical analysis was carried out on the data using Excel 2010.Results:We found that 60.2% of the graduates were satisfied with the training mode of eight-year program, 69.9% of the graduates gave a satisfactory evaluation on the teaching quality in the teaching hospital, and 63.1% of the graduates believed that the curriculum still need partial adjustment.Conclusion:Based on the finding, medical talent training mode is relatively mature in Batch 2005-2006 eight-year program of clinical medicine. The future medical education reform of the eight-year program should be more embodied in innovating the grafting mode of professional medical degree system, strengthening enrollment publicity, adopting diversified enrollment, strictly controlling procedure, carrying out integrated curriculum reform, enhancing clinical teaching design, at the same time further improving teachers' comprehensive quality, and speeding up the construction of clinical teaching staff.
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OBJECTIVE@#To explore the genetic basis for a child with mental and motor retardation, language impairment, facial dysmorphism and epilepsy.@*METHODS@#Whole exome sequencing was carried out to detect pathogenic variant in the proband, and candidate variant was selected based on his phenotype. Sanger sequencing was used to verify the variant in the proband, his parents and other family members.@*RESULTS@#The proband was found to carry a frameshifting mutation of MBD5 gene, namely c.2217delT (p.F739Lfs*6), which was inherited from his mother and unreported previously. Sanger sequencing confirmed that his brother carried the same mutation with a similar phenotype. His mother also had poor language expression when she was young, in addition with poor academic performance, though she could do some housework and had no history of convulsion.@*CONCLUSION@#A novel pathogenic variant of the MBD5 gene was discovered, which has enriched the mutational spectrum of the MBD5 gene. Above discovery has enabled genetic counseling and prenatal diagnosis for the family.
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Child , Female , Humans , Male , Pregnancy , DNA-Binding Proteins/genetics , Intellectual Disability/genetics , Mutation , Pedigree , Phenotype , Exome SequencingABSTRACT
The medical fungus Hirsutella sinensis has been used as a Chinese folk health supplement because of its immunomodulatory properties. Our previous studies established the antifibrotic action of Hirsutella sinensis mycelium (HSM) in the lung. The epithelial-mesenchymal transition (EMT) is involved in the pathogenesis of idiopathic pulmonary fibrosis. The present study investigates the role of HSM in mediating EMT during the development of pulmonary fibrosis. HSM significantly inhibits bleomycin (BLM)-induced pulmonary fibrosis by blocking the EMT. In addition, the expression levels of midkine are increased in the lungs of the BLM-induced group. Further analysis of the results indicates that the mRNA level of midkine correlated positively with EMT. HSM markedly abrogates the transforming growth factor β-induced EMT-like phenotype and behavior in vitro. The activation of midkine related signaling pathway is ameliorated following HSM treatment, whereas this extract also caused an effective attenuation of the induction of EMT (caused by midkine overexpression) in vitro. Results further confirm that oral medication of HSM disrupted the midkine pathway in vivo. Overall, findings suggest that the midkine pathway and the regulation of the EMT may be considered novel candidate therapeutic targets for the antifibrotic effects caused by HSM.
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Humans , Bleomycin , Epithelial-Mesenchymal Transition , Midkine , Mycelium , Pulmonary Fibrosis/drug therapyABSTRACT
OBJECTIVE@#To explore the genetic basis for a couple with normal phenotype but repeated pregnancies with fetuses affected by osteogenesis imperfecta.@*METHODS@#Whole exome sequencing (WES) was carried out on fetal specimens and parental DNA to detect potential pathologic variants. Suspected variants were verified by Sanger sequencing. Semen sample of the husband was collected for the extraction of genome DNA, and whole genome amplification (WGA) was performed for single sperms isolated from the sample.@*RESULTS@#WES has identified a heterozygous c.1378G>A (p.G460S) variant of the COL1A2 gene in the fetus, which was predicted to be pathogenic but not detected in peripheral blood samples of both husband and wife. The heterozygotic variant was detected in semen DNA from the husband. Among 15 spermatozoa, 4 were found to harbor the variant.@*CONCLUSION@#The fetus was diagnosed with osteogenesis imperfecta, and the gonadal mosaicism probably accounted for the repeated abnormal pregnancies. Possibility of gonadal mosaicism should be considered when counseling couples with normal phenotype and genotype but recurrent abnormal pregnancies and/or births of children with similar phenotypes and genetic variants.
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Adult , Child , Female , Humans , Male , Pregnancy , Collagen Type I , Genetics , Fetus , Gonadal Disorders , Genetics , Mosaicism , Mutation , Osteogenesis Imperfecta , Diagnosis , Genetics , Prenatal Diagnosis , Exome SequencingABSTRACT
OBJECTIVE@#To study the genotype and phenotype of fetuses with 22q11.2 microdeletion and other abnormalities such as cardiac malformation and cleft palate.@*METHODS@#Fetal ultrasound was carried out at 12 weeks to 20 to 24 weeks of gestation. After excluding the chromosomal karyotype abnormality, single nucleotide polymorphism (SNP) array was used to detect copy number variations of 5 fetuses with heart development abnormality or other structural abnormalities. The fetus with 22q11.2 microdeletion and its parents were also subjected to multiplex ligation-dependent probe amplification (MLPA) assay.@*RESULTS@#SNP array analysis showed that the 5 fetuses had all carried a 2.27-3.02 Mb deletion of the 22q11.2 region. MLPA assay confirmed that LCR22-A-B was involved in all cases, and that all deletions were de novo in origin.@*CONCLUSION@#It is of great significance to exclude 22q11.2 microdeletions in fetuses with cardiac malformations. The deletion regions of these fetuses are similar but different, and the phenotypic difference is related to their genotypes.
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Based on the author's experience in the training of teachers for team-based learning (TBL) in Kaohsiung Medical University, this study reviewed the specific methods of fairy tales in the training of TBL teachers. The selection of fairy tale cases should consider the background of the trainees and try to meet the needs of interdisciplinary integrated courses. Case editing and questions should reflect the importance and necessity of TBL pre-reading. In addition, this study explored the psychological mechanism, training advantages, training difficulties, and popularity of TBL teacher training based on fairy tales.
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Objective :To explore influence of posture control combined core muscle group training on motor function of lower limb ,balance function and walking ability in patients with stroke .Methods :A total of 94 patients with hemiplegia after stroke during rehabilitation period ,who were treated in our hospital from Dec 2015 to Dec 2017 , were selected .Patients were randomly and equally divided into routine rehabilitation group and combined training group (received posture control and core muscle group training based on routine rehabilitation group ) ,both groups were treated for four weeks .Scores of Fugal‐Meyer motor assessment (FMA) scale ,Berg balance scale (BBS) and Holden functional ambulation classification (FAC) were observed and compared between two groups before and af‐ter treatment .Results :Compared with before treatment ,there were significant rise in scores of lower limb FMA , BBS and FAC class in two groups after four‐week treatment , P＝0. 001 all.Compared with routine rehabilitation group after four‐week treatment ,there were significant rise in lower limb FMA score [ (22.61 ± 1. 84) scores vs. (25.84 ± 1.67) scores] ,BBS score [ (23. 28 ± 1.92) scores vs .(28.82 ± 1. 36 ) scores] and FAC class [ (2. 96 ± 0.71) classes vs.(4.02 ± 0.46 ) classes] in combined training group , P＝ 0. 001 all.Conclusion : Posture control training combined core muscle group training can significantly promote rehabilitation of lower limb motor function , improve balance and walking ability in patients with hemiplegia after stroke ,which is worth extending .