Diagnosis and treatment of 18 cases of Chiari malformation with hoarseness / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the diagnosis and treatment of Chiari malformation patients with hoarseness and other otorhinolaryngological symptoms. Methods: The clinical data of 18 patients of Chiari malformation with hoarseness were retrospectively collected, which was composed of 5 men and 13 women, aged 3-71 with median age of 52. All the patients were admitted to the Affiliated Hospital of Qingdao University from January 1989 to January 2020. All patients underwent brain MRI and laryngoscopy. The patient's symptoms and first diagnosis department, diagnosis time, total course of disease, hoarseness course, diagnosis and treatment, and postoperative recovery time were summarized. Follow-up time was 3-16 years, with median follow-up time of 6.5 years. Descriptive methods were used for analysis. Results: The first visit departments of 18 patients included neurology (9 cases), otorhinolaryngology head and neck surgery (5 cases), pediatrics (2 cases), orthopedics (1 case) and respiratory department (1 case). Except for the 7 cases in neurology department, the other 11 patients were not diagnosed in time. The disease duration of 18 patients with Chiari malformation ranged from 2 months to 5 years, and hoarseness was present from 20 days to 5 years. After diagnosis, 9 patients underwent posterior fossa decompression surgery, and 1 of them underwent syrinx drainage at the same time. The symptoms of 8 cases improved significantly after operation, with the improvement time from 1 to 30 days. In addition, 9 patients chose conservative treatment, among whom 8 had no improvement in symptoms and 6 progressed. Conclusions: Posterior fossa decompression is an effective treatment for Chiari malformation, and the prognosis is good. Timely diagnosis and treatment can improve the prognosis of patients.

Efficacy and safety of dapagliflozin combined with metformin in treatment of type 2 diabetes mellitus / 中国医师进修杂志

Objective:To analyze the efficacy and safety of dapagliflozin combined with metformin in the treatment of type 2 diabetes.Methods:A prospective research method was adopted. A total of 60 patients with type 2 diabetes who were treated in Huainan Chaoyang Hospital from January 2019 to December 2021 were collected as research objects, and the above patients were divided into the observation group (30 cases) and the control group (30 cases) according to the random number table method. After admission, they were treated with oral metformin sustained-release tablets combined with exercise and diet control. On this basis, the observation group was treated with dapagliflozin, while the control group was treated with glimepiride. The blood glucose-related indexes after 3 months of treatment, blood lipid indexes after 1 month of treatment, and adverse reactions were compared between the two groups of patients.Results:After 3 months of treatment, the fasting blood glucose (FBG), 2 h postprandial blood glucose (2 h PBG) and glycosylated hemoglobin (HbA 1c) of the two groups were significantly lower than those before treatment, observation group: (6.60 ± 1.01) mmol/L vs. (7.76 ± 1.82) mmol/L, (10.43 ± 2.74) mmol/L vs. (14.05 ± 3.84) mmol/L, (5.90 ± 1.56)% vs. (8.46 ± 2.07)%; control group: (6.77 ± 0.95) mmol/L vs. (7.82 ± 1.38) mmol/L, (10.17 ± 2.23) mmol/L vs. (14.01 ± 2.63) mmol/L, (6.14 ± 1.51)% vs. (8.73 ± 1.58)% ( P<0.05), but there was no difference in FBG, 2 h PBG and HbA 1c between the two groups ( P>0.05). The total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in the observation group were significantly lower than those in the control group: (5.02 ± 0.98) mmol/L vs. (5.71 ± 0.77) mmol/L, (2.81 ± 0.69) mmol/L vs. (3.39 ± 0.87) mmol/L ( P<0.05). There was no difference in adverse reactions ( P>0.05). Conclusions:For patients with type 2 diabetes mellitus, on the basis of metformin sustained-release therapy, whether combined with dapagliflozin or glimepiride therapy has good hypoglycemic effect, but dapagliflozin has more advantages in improving blood lipids.

Progress in diagnosis and treatment of ovarian metastases in rectal cancer / 中华胃肠外科杂志

Rectal cancer is the most common tumor of digestive tract. For female patients, ovarian metastasis ranks the second place in intraperitoneal organ metastasis. Its symptoms are occult, easily missed and insensitive to systemic treatment, so the prognosis is poor. Surgery is the treatment of choice for patients with rectal ovarian metastases, whether R0 resection is possible or not, and reducing tumor load is associated with better prognosis. With the continuous development of hyperthermic intraperitoneal chemotherapy (HIPEC), tumor reduction can reach the cellular level, which can significantly improve survival. Prophylactic ovariectomy remains a controversial issue in patients at high risk of ovarian metastasis. In this review, we summarize the diagnosis, treatment and prevention strategies of rectal cancer ovarian metastases, hoping to provide some reference for clinical practice.

A qualitative study on the working status of outpatient nurses in general practice departments in general hospitals in Beijing / 中华全科医师杂志

Objective:To survey the working status of outpatient nurses in general practice departments of general hospitals.Methods:From March to April 2021, personal in-depth interviews were conducted with outpatient nurses from general practice residency training bases in Beijing. The thematic framework analysis method was used to analyze the interview data and refine the themes.Results:Fourteen nurses working in general practice outpatient clinics were interviewed in this study. Four themes were extracted from the interview data: (1) inadequate staffing of full-time outpatient nurses in general practice departments of comprehensive hospitals; (2) unclear job functions for outpatient nurses in general practice departments; (3) no standardized patient health education in the department; (4) no relevant training received systematically.Conclusion:General practice departments in general hospitals should setup full-time general practice nurse positions, clarify the job responsibilities, strengthen the relevant training and enhance core competency for nurses working in general practice department.

Prevention and control of novel coronavirus infections in primary care institutions at early stage of the epidemic: a qualitative study / 中华全科医师杂志

Objective:To analyze the status of prevention and control of COVID-19 in primary care institutions at the early stage of the epidemic.Methods:Thirty healthcare professionals from various places of China were recruited in the study from 6 thto 16 th February 2020 through WeChat platform advertising and by purposive sampling method. They were general practitioners (GPs), administrators, and other specialists, all of whom were involved in the prevention and control of COVID-19. Personal interview and focus group discussion were conducted online. The topic guide was as follows: (1) Introduction of the work that primary healthcare professionals carried out during the outbreak of COVID-19. (2) Difficulties and challenges that healthcare professionals encountered. (3) Opinions on the prevention and control of COVID-19. (4) Advices on future outbreak of similar epidemics or disease. NVivo 12 software system was used to code and classify the interview content, and thematic framework analysis was used to sort out and analyze the data and extract the interview themes. Results:Six themes were extracted: (1) The community hospital leaders led the work in time but job distribution and prevention procedures were insufficient; and the workload of GPs was heavy. (2) Primary care settings had carried out pre-screening and triage; while outpatient clinic continued to provide health care service for local residents, especially stressing online service and consultation to reduce the population mobility. (3) GPs should make full use of technical advantages and participate in joint prevention and control. (4) GPs offered various health education to residents to improve their awareness of self-protection. (5) GPs lacked professional skills and needed more related training, while the current training were still insufficient. (6) There were not enough supplies and GPs had increasing worries about the infection risks.Conclusions:GPs play an important role in effectively curbing the spread of the epidemic. It is suggested that the setting of triage and fever clinic in primary care institutions need to be readjusted; and the training of prevention and control knowledge and skill for GPs need to be strengthened in the future.

Prevention and control of novel coronavirus pneumonia in non-government primary medical institutions / 中华全科医师杂志

Objective:To understand the coronavirus disease 2019(COVID-19)prevention and control work and the problems and difficulties faced by non-government primary medical institutions in China during the epidemic period.Methods:A survey on the coronavirus disease 2019(COVID-19)prevention and control work of non-government primary medical institutions was conducted on April 14 to 21, 2020 with the self-designed questionnaire. The questionnaire contained three parts: the first part was basic information of medical staff in non-government primary medical institutions, including position and institutional information; the second part was the status quo of non-government primary medical institutions participating in the prevention and control of COVID-19, including the specific work and difficulties faced by the responders during the epidemic period; and the third part was the prevention and control effect of COVID-19 in the responders′ institutions, including whether there were confirmed cases and infected medical staff. An online invitation was issued among the members of General Practice Branch of Chinese Non-government Medical Institution Association. The invited participants included the heads, general practitioners and other medical personnel of the non-government primary medical institutions the invited participants voluntarily scanned the online two-dimensional code to fill in.Results:A total of 761 individuals in primary health institutions from 20 provinces, municipalities and autonomous regions in China participated in the survey. There were 290 (38.1%) men and 471 (61.9%) women with age of 40(32, 48) years; 83.0% (632/761) had worked for more than 5 years; 33.8% (257/761) owned primary professional titles and 33.0% (251/761) owned intermediate titles. Among all participants 28.5% (217/761) were general practitioners, 26.9% (205/761) were institutions/department managers, 14.6% (111/761) were specialists and 40.3% (307/761) were other related personnel. A total of 549 institutions continued to operate during the epidemic period and 96.5% (530/549) participated in the work related to the prevention and control of the epidemic, including prescreening and triage, health consultation, follow-up of suspected patients, donation, quarantine of suspected cases, follow-up of close contacts/discharged patients, diagnosis and treatment of patients with new coronavirus pneumonia. 44.7% (340/761) of respondents participated in the epidemic prevention as front-line staff and directly contacted patients/suspected patients, and 63.1% (480/761) participated in the epidemic prevention work of primary medical institutions, including clinical outpatient service, prescreening triage and screening. The working sites were not limited to the institutions, but also other sites including high-speed railway station. The 97.8% (744/761) responders expressed their willingness to participate in epidemic prevention work under the unified leadership and command of the state. The 63.9% (486/761) of the responders were worried about the lack of protective equipments and measures, and 90.4% (688/761) respondents showed that they needed medical supplies (protective equipment: masks, goggles, protective gowns, etc.).Conclusion:The participation of non-government primary medical institutions and their staff in COVID-19 infection prevention and control is a key component of the epidemic prevention process.

Analysis of fungal diversity on the surface of Armeniacae Semen Amarum using a DNA metabarcoding technique / 药学学报

Medicinal and edible Armeniacae Semen Amarum (ASA) is susceptible to fungal contamination because it is rich in oil and other nutrients. In this study, the fungal community diversity in ASA samples was analyzed based on a DNA metabarcoding technique to provide evidence for its safe use. Twelve batches of ASA samples samples from four medicinal material markets and three processing approaches were collected. Total DNA was extracted, the ITS2 sequences were amplified, and high-throughput sequencing was performed using the Illumina MiSeq PE300 platform. The results show that Ascomycota was the most dominant fungus in ASA samples. The predominant genus in sample SW1_P was Diutina, whereas the most predominant genus in the other samples was Aspergillus. Three harmful fungi were identified, namely, Aspergillus flavus, Wallemia sebi, and Rhizopus arrhizus. In addition, significant differences were observed in the relative abundance of Botryosphaeriales and Alternaria in ASA samples from different collection sites. Meanwhile, there were significant differences in the relative abundance of Hypocreales and Cladosporium in ASA samples from different processing approaches. In summary, the DNA metabarcoding technique can effectively clarify the fungal community diversity and quickly detect potential toxigenic fungi in ASA samples, thus providing a warning for mycotoxin contamination.

Effect of transcutaneous electrical acupoint stimulation on venous thrombosis after lung cancer surgery: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on venous thrombosis and quality of life after lung cancer surgery, basing on the conventional nursing and early functional exercise.@*METHODS@#A total of 120 patients diagnosed as non-small cell lung cancer (NSCLC) and received radical resection of lung cancer surgery for the first time were randomized into a conventional nursing group, a rehabilitation training group and a TEAS group, 40 cases in each group. Conventional nursing was adopted in the conventional nursing group. Conventional nursing combined with early functional exercise were adopted in the rehabilitation training group, the exercise was taken 20 min each time, once in both morning and afternoon for 5 days. On the basis of the treatment in the rehabilitation training group, TEAS was applied at Zusanli (ST 36), Xuehai (SP 10), Sanyinjiao (SP 6), etc. in the TEAS group, with disperse-dense wave in frequency of 30 Hz/100 Hz and tolerable intensity, 30 min each time, once in both morning and afternoon for 5 days. The incidence of venous thrombosis in each group was observed at the 5th day after surgery. Before surgery and at the 5th day after surgery, the Caprini thrombus risk assessment was performed, the Karnofsky performance status (KPS) scale and the functional assessment of cancer therapy-lung (FACT-L) were used to evaluate the quality of life.@*RESULTS@#At the 5th day after surgery, no thrombosis was found in the TEAS group, the incidence of venous thrombosis in the TEAS group was lower than 15.0% (6/40) in the conventional nursing group (@*CONCLUSION@#On the basis of the conventional nursing and early functional exercise, TEAS can reduce the incidence of venous thrombosis, effectively prevent thrombosis and improve quality of life.

Clinical observation on muscle regions of meridians needling method in improving upper limb function for children with cerebral palsy of spastic hemiplegia type / 针灸推拿医学（英文版）

Objective: To observe the improving effect of muscle regions of meridians needling method on the upper limb function in children with cerebral palsy of spastic hemiplegic type. Methods: A total of 100 children with cerebral palsy of spastic hemiplegia type were divided into a treatment group and a control group according to the visiting sequence, with 50 cases in each group. The control group was treated with conventional rehabilitation plus conventional acupuncture treatment. The treatment group was treated with conventional rehabilitation plus muscle regions of meridians needling method. The electromyography (EMG) signal values of triceps brachii and pronator teres were detected before treatment, and 3 months and 6 months after treatment. The clinical efficacy was evaluated by Peabody developmental motor scale-fine motor (PDMS-FM) and fine motor function measure (FMFM). Results: Three and six months after treatment, the EMG signal values of triceps brachii and pronator teres, grasping scores and visual-motor integrated scores of PDMS-FM and the FMFM scores in both groups increased to varying degrees compared with the same group before treatment, and the intra-group differences were all statistically significant (all P<0.05). Six months after treatment, the results of the above three items in the treatment group were all better than those in the control group, and the differences between the groups were statistically significant (all P<0.05). Conclusion: Muscle regions of meridians needling method added on the basis of conventional rehabilitation can effectively reduce the muscle tone of upper limb and enhance the muscle strength, and improve the upper limb function in children with cerebral palsy of spastic hemiplegia type. The efficacy is superior to that of the conventional rehabilitation plus conventional acupuncture treatment.

Preliminary Study on Drug Susceptibility Profile and Resistance Mechanisms to Macrolides of Clinical Isolates of Non-tuberculous Mycobacteria from China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Macrolide susceptibility and drug resistance mechanisms of clinical non-tuberculous mycobacteria (NTM) isolates were preliminarily investigated for more accurate diagnosis and treatment of the infection in China.</p><p><b>METHODS</b>Four macrolides, including clarithromycin (CLAR), azithromycin (AZM), roxithromycin (ROX), and erythromycin (ERY), were used to test the drug susceptibility of 310 clinical NTM isolates from six provinces of China with the broth microdilution method. Two resistance mechanisms, 23S rRNA and erm, were analyzed with nucleotide sequence analysis.</p><p><b>RESULTS</b>Varied effectiveness of macrolides and species-specific resistance patterns were observed. Most Mycobacterium abscessus subsp. massiliense were susceptible and all M. fortuitum were highly resistant to macrolides. All the drugs, except for erythromycin, exhibited excellent activities against slow-growing mycobacteria, and drug resistance rates were below 22.2%. Only four highly resistant strains harbored 2,058/2,059 substitutions on rrl and none of other mutations were related to macrolide resistance. G2191A and T2221C on rrl were specific for the M. abscessus complex (MABC). Seven sites, G2140A, G2210C, C2217G, T2238C, T2322C, T2404C, and A2406G, were specifically carried by M. avium and M. intracellulare. Three sites, A2192G, T2358G, and A2636G, were observed only in M. fortuitum and one site G2152A was specific for M. gordonae. The genes erm(39) and erm(41) were detected in M. fortuitum and M. abscessus and inducible resistance was observed in relevant sequevar.</p><p><b>CONCLUSION</b>The susceptibility profile of macrolides against NTM was demonstrated. The well-known macrolide resistance mechanisms, 23S rRNA and erm, failed to account for all resistant NTM isolates, and further studies are warranted to investigate macrolide resistance mechanisms in various NTM species.</p>

Micro-dissection testicular sperm extraction for non-obstructive azoospermia patients with the history of secondary testicular injury / 中华男科学杂志

<p><b>Objective</b>To investigate the value of micro- dissection testicular sperm extraction (micro-TESE) in the treatment of non-obstructive azoospermia (NOA) in patients with the history of secondary testicular injury.</p><p><b>METHODS</b>Totally, 121 NOA patients with the history of secondary testicular injury underwent micro-TESE in our hospital from September 2014 to December 2017. We analyzed the correlation of the sperm retrieval rate with the causes of testicular injury and compared the outcomes of the ICSI cycles with the sperm retrieved from the NOA males by micro-TESE (the micro-TESE group) and those with the sperm ejaculated from severe oligospermia patients (sperm concentration <1×10⁶/ml, the ejaculate group). Comparisons were also made between the two groups in the female age, two-pronucleus (2PN) fertilization rate, transferrable embryos on day 3 (D3), D3 high- quality embryos, D14 blood HCG positive rate, embryo implantation rate, and clinical pregnancy rate.</p><p><b>RESULTS</b>Testicular sperm were successfully retrieved by micro-TESE in 86.0% of the patients (104/121), of whom 98.4% had the history of orchitis, 75.5% had been treated surgically for cryptorchidism, and 63.6% had received chemo- or radiotherapy. No statistically significant differences were observed between the micro-TESE and ejaculate groups in the 2PN fertilization rate (59.4% vs 69.3%, P > 0.05), D14 blood HCG positive rate (44.6% vs 57.9%, P > 0.05), embryo implantation rate (31.8 %% vs 32.6%, P > 0.05) and clinical pregnancy rate (41.5% vs 48.7%, P > 0.05). However, the rate D3 transferrable embryos was significantly lower in the micro-TESE than in the ejaculate group (40.5% vs 52.2%,P < 0.05), and so was that of D3 high-quality embryos (32.5% vs 42.1%, P < 0.05).</p><p><b>CONCLUSIONS</b>Micro-TESE can be applied as the first choice for NOA patients with the history of secondary testicular injury, but more effective strategies are to be explored for the improvement of ICSI outcomes with the sperm retrieved by micro- TESE.</p>

Comparison of methods for stable co-expression of different subtype drug-matabolizing enzymes in HepG2 cells by piggyBac transposon / 中国药理学与毒理学杂志

OBJECTIVE To study the methodology of achieving stable co-expression of drug-metab?olizing enzymes in the HepG2 cells by the piggyBac (PB) transposon system. METHODS N-terminal attachment of enhanced green fluorscent protein plasmid (pEGFP- N2) and 2A peptide linked recombinant PB transposon plasmid containing dual-genes encoding drug metabolizing enzymes cyto?chrome P450 3A4 (CYP3A4) and CYP2C19 (pPB-CYP3A4-2A-2C19) were transfected into HepG2 cells respectively by Lipofectamine?LTX reagent, GenJetTM (Ver.Ⅱ) reagent and Neon?Transfection System reagent, which were widely used for large-sized DNA fragments transfection. 48 h later, the transfection efficiency and cell toxicity were detected and compared between the three methods so as to find a method with relatively high efficiency and low toxicity for later transfection.Then,three groups of recombinant PB transposons-single-gene transposon (PB-CYP3A4), 2A peptide linked dual-gene transposon (PB-CYP3A4-2A-2C19) and multiple single-gene transposon mixture〔PB-CYP3A4, PB-CYP2C8, PB-CYP2A6, organic anion transporting polypeptide 1B1 PB transposon (PB-OATP1B1)〕-were transfected into HepG2 cells respectively with the above established method.The puromycin (Puro)-resistant and GFP positive cell clones were picked up and further cultured. The mRNA, protein and metabolic levels of drug-metabolizing enzymes in monoclonal cell lines were detected by quantitative real-time PCR,Western blotting and high performance liquid chromatography-tandem mass spectrometry respectively after screening by Puro and green fluorescence. Comparisons of different groups were made using statistical analysis. RESULTS The comparison of three different transfection methods indi?cated that the transfection efficiency of GenJetTMwas up to(94.2±2.5)% and (89.3±3.3)%,significantly higher than those of the other two methods (P<0.01), along with lower cytotoxicity. Then GenJetTMwas chosen for later transfection. In the Puro-resistant monoclonal cell lines of single transposon PB-CYP3A4,PB-CYP3A4-2A-2C19 groups,the mRNA,protein and enzyme activity levels of drug-metabo?lizing enzymes were significantly increased respectively.The recombinant transposon (PB-CYP3A4-2A-2C19) containing 2A peptide could achieve stable and efficient co-expression of two metabolizing enzymes CYP3A4 and CYP2C19,while the expression of drug-metabolizing enzymes remained unbal?anced and random in those of multiple single-gene transposon mixture group (PB-CYP3A4, PB-CYP2C8,PB-CYP2A6,PB-OATP 1B1)(CYP3A4 was expressed in some cell clones only).CONCLUSION GenJetTM could be an effective method for the PB recombinant transposon transfection into HepG2 cells, by which the PB transposon could mediate stable expression of drug-metabolizing enzymes. In terms of multi-gene expression,a low and unbalanced expression is found by multiple transposons co-transfection method,which is different from that by virus mediated method.In contrast,mono-PB trans?poson linked by 2A peptide can achieve stable expression of multi-genes.

Role of debating competition in medical immunology teaching / 中国免疫学杂志

It is to promote the initiative of college students through the debating competition in the study of the medical immu-nology.The debating competition and questionnaire survey were performed among the teaching-reform students in Grade 2015 from Changzhi Medical College.The statistical analysis is made on the final examination scores of teaching-reform class and the parallel control class.The final exam of the teaching-reform students were all above 80 points.There was a significant difference for the scores compared with students in the parallel control class.The questionnaire survey was demonstrated that they preferred this learning,who are willing to take part in a similar event.The debating competition is a good way to advance the profile of medical immunology.

Effects of p53 on predictive value for efficacy of endocrine drugs in postoperative postmenopausal breast cancer patients with HR positive and HER-2 positive / 实用肿瘤学杂志

Objective The aim of this study was to investigate the predictive value of p53 protein expression in postmenopa-usal hormone receptor(HR)positive and HER-2 positive postoperative breast cancer patients with adjuvant endocrine drugs. Meth-ods A total of 172 cases of postoperative breast cancer patients were collected in Harbin Medical University Cancer Hospital from January 2005 to December 2011. All patients were postmenopausal,including 84 patients received aromatase inhibitors(AI)treatment and 88 patients received tamoxifen(TAM)treatment. The median follow-up time was 68 months(4~131 months). χ2test was used to analyze the relationship between p53 protein expression and the clinicopathological features of breast cancer. Kaplan-Meire analysis, Log-rank test and Cox regression model were used for survival analysis. Results The expression of p53 protein was not correlated with tumor size,lymph node status,histological grade,ER and PR expression. Cox univariate analysis showed that p53 protein was re-lated to lymph node status(χ2=46. 602;P<0. 001)and radiation therapy(χ2=9. 617;P=0. 002). But p53 expression was not asso-ciated with DFS in breast cancer patients(χ2=0. 002,P=0. 968). Cox multivariate analysis showed that DFS was only associated with lymph node metastasis in breast cancer patients(HR=2. 121,95% CI:1. 630 ~2. 760,P<0. 001). Subgroup analysis showed that DFS in patients with p53-positive was superior to patients with p53-negative in oral TAM(χ2=4. 695,P=0. 030). In patients with oral AI,DFS in with p53-negative patients was superior to p53-positive patients(χ2= 5. 995,P=0. 014). Conclusion The posi-tive expression of p53 protein is a predictor of effective treatment of TAM,while the negative expression of p53 protein is a predictor of effective treatment of AI.

Relying on the SPOC platform to flipping medical immunology classroom teaching / 中华医学教育探索杂志

Objective To explore the application and effect of SPOC platform in medical immunol-ogy teaching. Methods The teaching reform class of Grade 2015 (41students) of Changzhi Medical College was taken as the experimental group, while the parallel class of imaging (37 students), preventive specialty (40 students), Class Nine of clinical medicine (37 students) and oral specialty (39 students) were randomly selected as the control group. "SPOC learning platform + traditional teaching" method was used for teach-ing and learning in the course of the test group. The traditional teaching method was utilized in the control one. For this type of teaching activity, a questionnaire survey was carried out among the students in the reform class, and the final exam score was used as the measure standard. The data were analyzed by SPSS 17.0 software. Results The results demonstrated that the students preferred to learn on the SPOC platform for mobile phones, and the number was significantly higher than that of learning through the computers. Students in the reform class basically liked this type of learning, and their final exam scores were more significant difference than the other classes in the same grade (t'=15.21, P=0.000). The classes in the experimental group and the control group were taken as the research objects, and the rank-sum test was performed, which was statistically significant ( χ2=81.65, P=0.000). Then, the two groups were compared in different classes: the statistical difference between the teaching reform class and image 1502 (t'=11.52, P=0.000), prevention 1502 (t'=7.38, P=0.000), clinical medicine 1509 (t'=8.93, P=0.000), oral 1501 class (t'=8.93, P=0.000) were found. The questionnaire survey demonstrated that 90.24% (37 students) of the reform class liked this form of learning and at the same time, it was suggested that the learning content on the platform should be further linked to the clinical practice and combined with scientific research to expand the students' thinking. Conclusion The SPOC learning platform has turned over the teaching of medical immunology and improved students' motivation and interests in learning.

Effects of Spirulina Kinase on Vascular Endothelial Function of Model Rats with Atherosclerosis / 中国药房

OBJECTIVE:To study the effects of spirulina kinase(SPK)on the vascular endothelial function of model rats with atherosclerosis. METHODS:60 rats were randomly divided into normal control group(distilled water),model group(distilled wa-ter),positive control group(simvastatin,0.005 g/kg)and SPK low-dose,medium-dose,high-dose groups(80,160,320 U/kg). Except for normal control group,rats in other groups were induced for model of atherosclerosis. All groups were intragastrically ad-ministrated relevant medicines at the same time,once a day for consecutive 12 weeks. Total cholesterol(TC),triglyceride(TG), low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α) contents in serum of rats were measured. And the changes of thoracic aortic endothelium morphology were ob-served by HE staining. RESULTS:Compared with normal control group,TC,TG,LDL-C,IL-6,TNF-α contents in serum of rats in model group were increased(P<0.01),HDL-C content in serum was decreased(P<0.01);vascular endothelial cells fell off, intimal proliferation projected into the lumen,smooth muscle cell proliferated and disordered,medium film elastic fiber disintegrat-ed and fractured. Compared with model group,TC,TG,LDL-C,IL-6,TNF-α contents in serum of rats in administration groups were decreased(P<0.05 or P<0.01),HDL-C content in positive control group and SPK medium-dose,high-dose groups was in-creased (P<0.05). Vascular endothelial cell morphology was improved significantly in administration groups,in which,vascular endothelial cells were structurally intact in SPK medium-dose,high-dose groups,inner membrane was basically smooth;medium smooth muscle cells arranged slightly disordered in SPK medium-dose group. Compared with normal control group,there were no obvious changes. CONCLUSIONS:SPK shows obvious lipid-lowering and anti-inflammatory effects,it can protect vascular endo-thelial function. The mechanism may be related to reducing TC,TG,LDL-C,HDL-C,IL-6,TNF-αcontents and increasing HDL-C content in serum.

The role of microRNA in drug resistance of breast cancer / 实用肿瘤学杂志

Breast cancer is a major disease which threatens the health of women around the world.Breast cancer patients have acquired resistance to existing treatment methods become the current clinical problems.MicroRNA(miRNA) is an endogenous non-coding RNA that participates in the regulation of a variety of biological processes,including cell proliferation,invasion,metastasis,epithelial interstitial transformation and drug resistance.Acquired resistance includes a variety of complex mechanisms that can affect the expression of cell-associated proteins through the abnormal expression of specific microRNAs,the binding of antineoplastic agents to the corresponding target,and the pathways associated with apoptosis.This article will focus on the expression of abnormal microRNA in acquired drug resistance which was caused by endocrine therapy,chemotherapy and molecular targeted therapy of breast cancer.miRNAs are considered as promising biomarkers and targets for diagnosis,treatments for acquired drug resistance of breast cancer.

Content Analysis and Comparative Study of Amino Acids in Ejiao from 18 Manufacturers / 中国药房

OBJECTIVE:To provide reference for quality evaluation of Ejiao. METHODS:The contents of 17 amino acids in 18 batches of Ejiao from 18 manufacturers were analyzed by automatic amino acid analyzer;the content data was processed by prin-cipal component analysis (PCA) and hierarchical clustering analysis (HCA),in order to understand the relationship among these amino acids and categorize the Ejiao products. RESULTS:Except for a batch of Ejiao,the other 17 batches contained 17 various amino acids,including 7 necessary amino acids(Thr,Val,Met,Ile,Leu,Phe and Lys)for human being,especially the contents of Gly and Pro were higher. The total content of amino acids was arranged from 66.1% to 82.0%,showing great difference. Four main components were extracted by PCA,the cumulative contribution of which was 89.578%,and accordingly it may be consid-ered that Pro,Ala,Glu,Asp,Leu,Ile and Thr were characteristic amino acids of Ejiao products. In hierarchical clustering analy-sis,3 tree figures of commercial Ejiao product were achieved and Euclidean distance was varied among 0-25. CONCLUSIONS:There is great difference in total control of amino acid in commercial Ejiao product;Ejiao products from various manufacturers dif-fer in their amino acid contents. Ejiao is rich in collagen,and therefore,using amino acid determination would be helpful to moni-tor its quality.

Design and Implementation of Monitoring Information System for Disinfection Effect / 医学信息学杂志

The paper introduces design principle and demand of the monitoring information system for disinfection effect,expatiates on the design and realization from the aspects like service process and functional modulens,explains design of the database table and points out that the system is able to realize effective real-time,scientific,standardized and systematized monitoring.

The effects of Spirulina kinase in rats with acute blood stasis / 重庆医学

Objective In this study ,the effect of Spirulina kinase(SPK)on hemorheology ,platelet aggregation and cAMP in acute blood stasis rats model were investigated .Methods Forty SD rats were randomly divided into normal control group ,model group ,aspirin group and the high and low dose of SPK groups .All treatments were performed by gavage once a day for 7 days .Sub-cutaneous injection of adrenalin combined with ice water bath were used to establish the acute blood stasis rat model .The whole blood viscosity ,plasma viscosity ,red blood cell hematocrit (Hct) ,erythrocyte aggregation index (EAI) ,red blood cell deformation index(DI)anderythrocyterigidityindex(ERI)weredetectedbyautomaticbloodflow speedanalyzer .Meanwhile,thelevelofcAMP was detected by ELISA method .Rat platelet aggregation induced by ADP and the maximum aggregation rate was measured by tur-bidimetry .Results Results showed that SPK could significantly decrease the whole blood viscosity ,plasma viscosity ,Hct ,EAI and platelet aggregation rate ,increase the level of cAMP compared with model group(P<0 .05) ,but had no effect on DI and ERI .Con-clusion SPK can markedly improve the abnormal changes of hemorheology in acute blood stasis rats and inhibit the platelet aggregation .