Design and practice of clinical case-based learning in medical imaging teaching / 中华医学教育探索杂志

Objective:To explore the application value of clinical case-based learning in medical imaging teaching.Methods:A total of 145 clinical medical students from three classes in the third year were enrolled and they were divided into three classes. One class took case-based learning, one class took traditional teaching, and one class took both. The teaching content was the preclinical medical professional course—Medical Imaging. Continuous variables were expressed in accordance with normal distribution (mean standard deviation). Differences in mean and median values were evaluated by using t test and the Mann-Whitney U test, respectively. Categorical data were compared using the chi-square test. Results:There was a significant difference between the combined teaching class and the case-based learning class or the traditional teaching class in the final exam ( P=0.002). There was also a significant difference between the combined teaching class and the traditional teaching class in the film reading quiz ( P=0.035). More than 70% of students recognized the case-based learning. Conclusion:Case-based learning is helpful to improve students' flexible application of relevant knowledge and skills of analysis and communication.

Effects of dezocine-remifentanil intravenous anaesthesia on perioperative signs, serum TNF-alpha and IL-6 in liver cancer patients undergoing radiofrequency ablation

Objective: To analyse the impact of dezocine-remifentanil intravenous anaesthesia on perioperative signs, serum tumour necrosis factor-alpha [TNF-alpha], and interleukin-6 [IL-6] in liver cancer patients undergoing radiofrequency ablation [RFA]

Study Design: An experimental study

Place And Duration Of Study: Renmin Hospital of Wuhan University, Wuhan, China, from January 2017 to February 2018

Methodology: Eighty patients with small hepatocellular carcinoma [SHCC] were selected as the research object. They were divided into Group A and Group B with the random number table method, with 40 cases in each group. Group A were given dezocine-remifentanil intravenous anaesthesia and Group B were given midazolam-remifentanil intravenous anaesthesia. Patients' situations in the surgery were compared between the two groups. Changes in heart rate [HR], mean arterial pressure [MAP] and blood oxygen saturation [SpO₂] were recorded before the surgery [T₀], at 5 minutes after the RFA [T₁] and at the end of the RFA [T₂]. Levels of tumour necrosis factor-alpha; [TNF-alpha;] and interleukin-6 [IL-6] on the 1² day after the RFA were compared between the two groups

Results: The wake-up time in Group A was shorter than Group B [p<0.001], and the VAS pain score in Group A was lower than Group B [p<0.001]. At T₁, the MAP in Group A was higher than Group B [p<0.001]. There was no significant difference in MAP between the two groups at T₀ and T₂ [p=0.881, 0.696, respectively]. At T₁ and T₂, the HR in Group A was lower than Group B [all p<0.001]. There was no significant difference in HR between the two groups at T₀ [p=0.684]. There was no significant difference in SpO₂ between the two groups at T₀, T₁ and T₂ [p=0.654, 0.884 and 0.798, respectively]. On the 1st day after the RFA, the level of TNF-alpha;, IL-6 in Group A were lower than those of Group B [all p<0.001]. There was no significant difference in the incidence of intraoperative complications between the two groups [p=0.644]

Conclusion: Compared with midazolam-remifentanil intravenous anaesthesia, the dezocine-remifentanil method has a better analgesic effect, shorter wake-up time, and can effectively regulate the expression of inflammatory cytokines TNF-alpha; and IL-6. However, the effect of remifentanil on the respiratory function is dose-dependent. Therefore, respiratory cycle monitoring and management should be strengthened during the surgery

The role of 3.0 T MR hysterosalpingography work?up in the diagnosis of female infertility / 中华放射学杂志

Objective To evaluate the role of 3.0 Tesla magnetic resonance hysterosalpingography (MR?HSG) work?up in the diagnosis of female infertility. Methods Between July 2015 and December 2018, a total of 1 052 infertile women aged from 20 to 40 years in the Affiliated Hospital of Nanjing University of Chinese Medicine were prospectively enrolled in the study. All the patients underwent pelvic plain scanning and X?ray hysterosalpingography (HSG) followed by MR?HSG examination, and the patency of the fallopian tubes as well as the abnormalities of the uterus and ovaries were evaluated. Among which 33 cases were randomly selected. The chi?square test and Kappa test were used to compare the difference and the consistency of the two methods in the evaluation of fallopian tubes. Results MR?HSG and HSG had good consistency in evaluating tubal patency (Kappa=0.88, P<0.01), and there was no statistically significant difference between the two groups (P=0.65). The examination of MR?HSG was successfully completed in 97.1%(1 021/1 052) cases. There were 81.7% (834/1 021) cases had at least one abnormality. Bilateral tubal, uterine and ovarian abnormalitiesoccurred in 42.6% (435/1 021), 34.2% (349/1 021)and 46.8% (478/1 021) cases, respectively. In which tubal abnormalities display the results as follows: bilateral obstructed 4.7% (48/1 021), bilateral poor pass 8.5% (87/1 021), one smooth one obstructed11.7% (119/1 021), one smooth one poor pass 12.6% (129/1 021), and one poor pass one obstructed 5.1% (52/1 021). Conclusion 3.0 T MR?HSG is expected to be a routineexam for evaluating female infertility, which allows a comprehensive assessment of tubal patency and other pelvic abnormalities of infertile women.

Effect of propofol pretreatment on NF-κB activity during hepatic ischemia-reperfusion injury in rats / 中华麻醉学杂志

Objective To evaluate the effect of propofol pretreatment on nuclear factor kappa B (NF-κB)activity during hepatic ischemia-reperfusion(I∕R)injury in rats. Methods Twenty-four patho-gen-free healthy male Sprague-Dawley rats, aged 2 months, weighing 200-250 g, were divided into 3 groups(n=8 each)using a random number table:sham operation group(group S),group I∕R and propofol pretreatment group(group P).Hepatic I∕R injury was induced by 45 min occlusion of the hepatic artery and portal vein entering the middle and left lobes of the liver followed by reperfusion. In group P, propofol 12 mg·kg-1·h-1was infused via the femoral vein until the end of ischemia starting from 30 min before ische-mia in group P. Blood samples were collected from the inferior vena cava at 120 min of reperfusion for deter-mination of the levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β). The rats were then sacrificed and livers were re-moved for determination of phosphorylated NF-κB p65(p-NF-κB p65)expression in liver tissues(by West-ern blot)and apoptosis in hepatocytes(by TUNEL).Apoptosis index(AI)was calculated. Results Com-pared with group S, the levels of ALT, AST, TNF-α and IL-1β in serum and AI were significantly in-creased,and the expression of p-NF-κB p65 in liver tissues was up-regulated in I∕R and P groups(P<005). Compared with group I∕R,the levels of ALT,AST,TNF-α and IL-1β in serum and AI were signifi-cantly decreased,and the expression of p-NF-κB p65 in liver tissues was down-regulated in group P(P<005). Conclusion The mechanism by which propofol pretreatment reduces hepatic I∕R injury is associat-ed with inhibiting NF-κB activity in rats.

Role of GSK-3β in the protective effect of propofol pretreatment against hepatic ischemia-reperfusion injury and oxidative stress in rats / 中华肝胆外科杂志

Objective To investigate the protective effect of propofol pretreatment against hepatic ischemia-reperfusion injury and oxidative stress in rats and the mechanism of the role of GSK-3 β.Methods Sixty SD rats were randomly divided into four groups:sham operation group (S group),ischemia-reperfusion group (I-R group),propofol pretreatment group (P group),TDZD-8 pretreatment group (T group).The hepatic ischemia-reperfusion rat models were established by the method of Nauta.Rats were subjected to 30-min,60-min and 90-min 70％ warm ischemia of liver followed by reperfusion for 120 min,respectively.Propofol (12 mg/kg · h) was injected via femoral vein 30 min before ischemia till the end of reperfusion in P group and TDZD-8 (1 mg/kg) were injected via femoral vein 20 min before ischemia in T group.The animals were killed at 120 min after reperfusion.Blood samples and the liver tissue were obtained.The levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST),lactate dehydrogenase (LDH),malondialdehyde (MDA) and superoxide dismutase (SOD) were analyzed.Liver morphological changes were observed using optical microscopy.p-GSK-3β Ser9 and total GSK-3 β expression was determined by Western blot.Results Compared with S group,AST,ALT,LDH and MDA level was increased,SOD level was reduced,and p-GSK-3 β Ser9 expression was significantly reduced in I-R group.Compared with I-R group,the content of AST,ALT,LDH and MDA was reduced significantly,SOD increased significantly,and the content of p-GSK-3β Ser9 increased significantly in P group and T group.There were no significant differences between P group and T group.The hematoxylin-eosin staining of hepatic tissues revealed in I-R group had severe structural damage and periportal inflammatory cells infiltrated,hepatocyte necrosis and sinusoidal congestion.In P group and T group,liver tissues had normal structure,less cell death,edema and inflammatory cell infiltration.Conclusions Propofol can significantly reduce hepatic ischemia reperfusion injury by reducing oxidative stress and lipid hydroperoxides.This protective effect of Propofol may be associated with the inhibition of GSK-3 β by GSK-3 β Ser9 phosphorylation.

Arctiin ameliorates advanced oxidation protein product-induced epithelial-to- mesenchymal transition in HK-2 cells by inhibiting endoplasmic reticulum stress / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of arctiin on advanced oxidation protein product (AOPP)-induced epithelial-to-mesenchymal transition (EMT) in tubular cells and explore the mechanisms underlying this effect.</p><p><b>METHODS</b>Human proximal tubular cells (HK-2 cells) were treated with bovine serum albumin (BSA) or AOPPs in the presence or absence of arctiin. The expressions of E-cadherin, vimentin, and GRP78 at the protein and mRNA levels in the cells were examined using Western blotting and quantitative real-time PCR. The level of reactive oxygen species (ROS) was measured by flow cytometry with DCFH-DA as the fluorescent probe.</p><p><b>RESULTS</b>Compared with BSA-treated cells, the cells treated with AOPPs showed decreased expression of epithelial cell marker E-cadherin and overexpression of mesenchymal marker vimentin and endoplasmic reticulum stress marker GRP78 with an increased ROS level. These changes induced by AOPPs were partly inhibited by arctiin.</p><p><b>CONCLUSION</b>Arctiin can ameliorate AOPP-induced EMT in tubular cells by inhibiting endoplasmic reticulum stress, and oxidative stress response may participate in this process.</p>

P38 MAPK signaling pathway mediates advanced oxidation protein product-induced epithelial-to-mesenchymal transition in tubular cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate whether the p38 mitogen-activated protein kinase (MAPK) signaling pathway mediates advanced oxidation protein products (AOPPs)-induced epithelial-to-mesenchymal transition (EMT) in tubular cells.</p><p><b>METHODS</b>Human proximal tubular cells (HK-2 cells) exposed to AOPP-bovine serum albumin (BSA) were examined for expressions of p38 MAPK and phosphorylated p38 MAPK using Western blotting. Western blotting and quantitative RT-PCR were used to examine the protein and mRNA expressions of EMT markers E-cadherin and vimentin and endoplasmic reticulum stress marker glucose-regulated protein (GRP) 78 in cells treated with SB203580 (an inhibitor of the p38 MAPK signaling pathway) prior to AOPP exposure. The cells treated with AOPPs following pretreatment with salubrinal (an inhibitor of endoplasmic reticulum stress) were also examined for expressions of p38 MAPK and phosphorylated p38 MAPK.</p><p><b>RESULTS</b>AOPP treatment induced the phosphorylation of p38 MAPK in HK-2 cells. AOPP-induced decrease in E-cadherin expression and overexpression of vimentin and GRP78 were partly inhibited by pretreatment of the cells with SB203580. Salubrina partly suppressed AOPP-induced phosphorylation of p38 MAPK in the cells.</p><p><b>CONCLUSION</b>p38 MAPK signaling pathway, which is regulated by endoplasmic reticulum stress, might mediate AOPP-induced EMT in HK-2 cells.</p>

Observations on the Efficacy of Warm Needling Moxibustion plus Tricolor Medicinal Paste in Treating Knee Osteoarthritis / 上海针灸杂志

ObjectiveTo investigate the clinical efficacy of warm needling moxibustion plus tricolor medicinal paste in treating knee osteoarthritis.MethodNinety-one patients meeting the diagnostic criteria were randomly allocated to a treatment group (45 cases) and a control group (46 cases). The treatment group was given warmneedling moxibustion plus tricolor medicinal paste and the control group, warm needling moxibustion alone. The clinical therapeutic effect and the WOMAC score were observed in thetwo groups. An improvement in the symptoms of knee osteoarthritis was assessed in the patients after treatment.ResultIn both groups, there were statistically significant pre-/post-treatment differences in the pain and daily activity scores and the WOMAC total score (P0.05). There were statistically significant differences in the daily activity score and the WOMAC total score (P0.05) between the two groups.Conclusion The study shows that warm needling moxibustion plus external application of tricolor medicinal paste has a marked improving effect on the pain, swelling and physiological functions in patients with knee osteoarthritis. Improving lower limb function further in daily activities can produce a satisfactory and stable therapeutic effect.

Effect of isoflurane anesthesia on noise-induced hearing loss in guinea pigs / 中华麻醉学杂志

Objective To evaluate the effect of isoflurane anesthesia on noise-induced hearing loss in guinea pigs.Methods Forty-eight healthy adult male guinea pigs,aged 3 months,weighing 400-500 g,were randomly divided into 4 groups (n =12 each) using a random number table:control group (C group),isoflurane group (I group),noise-induced hearing loss group (N group),and isoflurane + noise-induced hearing loss group (I + N group).Isoflurane was inhaled for 140 min at a concentration of 1％ in I and I + N groups.N and I + N groups were exposed to the noise of 4 kHz center frequency and 118-122 dB sound pressure level for 120 min starting from 20 min after administration.Mean arterial pressure (MAP) was recorded at 10,40,70,100 and 120 min of exposure to noise and cochlear blood flow (CoBF) was recorded before administration and at 10,40,70,100 and 120 min of exposure to noise.Auditory brainstem response (ABR) threshold was recorded before administration and at 1 h,72 h,and 10 days after the end of exposure to noise.Arterial blood samples were obtained and the plasma noradrenaline (NE) concentration was detected by HPLC before exposure to noise and immediately after the end of exposure to noise.Results Compared with group C,MAP and the change rate of CoBF were significantly decreased,and the plasma NE concentration was increased immediately after the end of exposure to noise in I group,and MAP was increased,the change rate of CoBF was decreased,and the plasma NE concentration immediately after the end of exposure,and ABR threshold after the end of exposure were increased in N and I + N groups.Compared with N group,MAP was significantly decreased,the change rate of CoBF was increased,the plasma NE concentration immediately after the end of exposure,and ABR threshold at 1 and 72 h after the end of exposure were increased,and no significant was found in ABR threshold at 10 days after the end of exposure in I + N group.Conclusion Isoflurane anesthesia exerts temporary but not permanent protective effects against noise-induced hearing loss in guinea pigs and partial inhibition of activation of sympathetic nerve and increased CoBF may be involved in the mechanism.

Investigation on19 patients with sinus tachycardia from atypical asthma / 中国基层医药

Objective To investigate the therapeutic effects of sinus tachycardia patients with atypical asthma.Methods The data of 19 patients with sinus tachycardia resulted from atypical asthma,including clinical data and the treatment results were retrospectively analyzed.Results There were 19 patients received lung function check,among them total 19 patients were atypical asthma whose tachycardia were cured,the heart beating rate was significantly lower after treated [(86.79±3.91) vs (108.89±4.23),t=6.921,P=0.000].Condusion The lung function check was requisite for patients with sinus tachycardia resulted from atypical asthma and the tachycardia can be cured by curing asthma drugs and calcium channel blocking agent.

Research advances in antitumor activities of pyrimidine derivatives / 药学学报

Pyrimidine derivatives have been the subject of much attention in pesticide and medicine fields owing to their unique biological properties. Particularly, a large number of these compounds have recently been reported to show substantial antitumor activities, and some of them have been investigated in clinical trials. Although these structurally novel compounds have a common chemical moiety of a pyrimidine ring, there are a variety of mechanisms of their antitumor action, such as, inhibition of cyclin-dependent-kinases, inhibition of protein tyrosine kinase, inhibition of carbonic anhydrases, inhibition of dihydrofolate reductase and disruption of microtubule assembly. In this paper, we described the latest advances in the research of such pyrimidine derivatives as antitumor drug according to their action on targets.

Synthesis and antitumor activities of pyrimidines / 南方医科大学学报

<p><b>OBJECTIVE</b>To synthesize cyclin-dependent kinase (CDKs) inhibitors and assay their antitumor activities.</p><p><b>METHODS</b>A series of pyrimidines containing different arylamino and 1-(methylsulfonyl)piperidin moieties were designed by combining the segments 1-(methylsulfonyl)piperidin and pyrimidine heterocycles according to the super-position principle of the reinforcement of biological activities.</p><p><b>RESULTS</b>Their structures were characterized by MS and 1H NMR spectra and all the synthesized compounds were screened for their antimicrobial activity with MTT assay.</p><p><b>CONCLUSION</b>The preliminary bioassay showed that compound 3 b displayed good antitumor activity (IC(50)=13.6 µmol/L). The preliminary structure activity relationship analysis of these analogues suggest that the steric factor may have important impact on the anti-tumor activity.</p>

Investigation on autologous coronary intervention in patients with angina recurrence of graft vessels occlusion after coronary artery bypass graftting / 中国基层医药

Objective To investigate the effect of autologous coronary intervention in patients with angina recurrence of graft vessels occlusion after coronary artery bypass graftting(CABG).Methods Retrospectively analyzed the data of 10 patients with angina recurrence because of graft vessels occlusion.treated by CABG,including in clinical data,arteriography and the interventional results.Results Among 10 patients,9 patients received chronic total occlusion(CTO) PCI,another 1 patients received left main stem(LM) intervention.There were none had angina recurrence after PCI in 10 patients.Conclusion Conclusion Autologous coronary intervention in patients with angina recurrence of graft vessels occlusion after coronary artery bypass graftting was the safety and effective treatment.

Investigation on percutanous transluminal intervention in patients with angina recurrence after coronary artery bypass grafting / 中国基层医药

ObjectiveTo investigate the short-term and long-term interventional therapeutic effect of coronary heart disease(CHD)patients with angina recurrence after coronary artery bypass grafting(CABG). MethodsThe data of patients with angina recurrence treated by CABG,including clinical data,arteriography and the interventional results were retrospectively analyzed. Results There were 12 patients received intervention,among them 6 patients received coronary artery intervention,another 6 patients received graft vessels intervention.During operation and hospitalization,among 12 patients there were none had angina recurrence,acute myocardial infarction,revascularization and mortality.The total 12 patients were followed for 9 ～ 21months,there were two patients had angina recurrence cured by drugs,but none with mortality,acute myocardial infarction and revascularization. ConclusionThe intervention for patients with angina recurrence after grafting was a safe and effective treatment.

Prognostic value of acute heart block after alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the prognostic value of acute heart block (AHB) after percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM).</p><p><b>METHODS</b>Ninety-four HOCM patients underwent PTSMA were included in this study. Twelve-lead electrocardiograms were obtained during and post PTSMA. Association between clinic events and incidence of post-PTSMA AHB was analyzed.</p><p><b>RESULTS</b>AHB was induced in 26 patients by PTSMA and disappeared in 11 patients shortly post PTSMA, subacute intraventricular conduction disturbances was seen in 11 (42.3%), subacute I degrees AVB in 2 (7.7%) and subacute III degrees AVB in another 2 (7.7%) patients. Among 68 patients without AHB during PTSMA, intraventricular conduction disturbances was evidenced in 14 patients (20.6%), I degrees AVB in 2 (2.9%) and III degrees AVB in 1 patient (1.5%) after PTSMA. AHB patients with subacute heart block were associated with poor prognosis (conduction block duration was 42.00 h) while patients without AHB was associated with benign prognosis even with new onset of subacute heart block (conduction block duration was 7.33 h, P < 0.01).</p><p><b>CONCLUSION</b>Patients with AHB during PTSMA are at higher risk for subacute heart block, especially intraventricular conduction disturbances. AHB patients with subacute heart block were associated with poor prognosis and longer recovery time of conducting system.</p>