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Objective To evaluate the implementation effect of the teaching of high-altitude military medical geography , and to provide guidance for the teaching reform of this curriculum . Methods A questionnaire survey was conducted on the curriculum of high-altitude military medical geography among 108 undergraduate students majoring in high-altitude medicine in 2011 class (5 years). The contents of the investigation included learning motivation, learning interest, learning outcome, curriculum contents, and practical teaching. SPSS 18.0 was used for the treatment of investigation results. Results Among the 103 students who participated in the questionnaire survey, 69 (67.0％) were interested in the curriculum itself and 77 (74.8％) were interested in the knowledge of high-altitude human geography. There was a lack of understanding of the importance of the curriculum and its impact on future work. The examination results showed that most students mastered the contents of this curriculum and the overall teaching goal was reached, with an excellent and good rate of 63.0％(68 students). Conclusion The curriculum construction should be combined with the requirements for the first job after graduation. The curriculum system should be further perfected and its contents should be optimized to give full play to its interdisciplinary characteristics. The contents of human geography can be added to stimulate students' learning enthusiasm.
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Objective@#To explore the accuracy in localizing occult insulinomas with Glucagon-like peptide-1 receptor(GLP-1R) PET-CT with 68Ga-exendin-4.@*Methods@#In this prospective cohort study, patients with biochemically proven endogenous hyperinsulinemic hypoglycemia and negative contrast-enhanced CT with pancreatic perfusion scans were enrolled consecutively at Department of Nuclear Medicine, Peking Union Medical College Hospital from February 2014 to June 2018.There were 37 males and 32 females, with age of (43.2±17.9)years. 68Ga-exendin-4 PET-CT, MRI and endoscopic ultrasound(EUS) were done before elective surgery. Sensitivity, specificity, accuracy, positive predictive value(PPV) and negative predictive value(NPV) of the above imaging modalities were calculated.@*Results@#A total of 69 patients were recruited. Thirty-two patients were diagnosed with insulinomas at histology. Four patients with positive 68Ga-exendin-4 PET-CT findings did not undergo surgery so far. Twenty-eight patients were proven to be noninsulinoma induced hyperinsulinemic hypoglycemia. Five patients were unknown of etiology of hypoglycemia. The sensitivity, specificity, accuracy, PPV and NPV of 68Ga-exendin-4 in localizing occult insulinomas were 96.9%(31/32), 100%(30/30), 98.3%(59/60), 100%(29/29), 96.8%(30/31), respectively.The sensitivity, specificity, accuracy, PPV and NPV of MRI were 74.1%(20/27), 9/11, 76.3%(29/38), 90.9%(20/22), 9/16, respectively. The sensitivity, specificity, accuracy, PPV and NPV of EUS were 75.0% (15/20), 2/2, 77.3%(17/22), 15/15, and 2/7.@*Conclusion@#68Ga-exendin-4 PET-CT has a high sensitivity, specificity and accuracy for detection of occult insulinoma, which shows superiority to MRI and EUS.
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[Objective] To introduce the experience of Professor ZHANG Biao in the treatment of infantile dyspepsia. [Methods] Through the long-term study with Professor ZHANG, large amounts of medical records are collected and generalized, so that the experiences concerning infantile dyspepsia are summarized, when and how to choose activation, tonification or digestion depends on excess and deficiency,and proven cases are presented. [Results] It is thought that infantile dyspepsia mostly belongs to excess syndrome, or excess syndrome combined with deficiency syndrome, so the treatment is heiping digestion, tonifying spleen and harmonizing stomach. Professor ZHANG thinks that the cause of children's dyspepsia is the weakness in spleen and stomach eventually. It is characterized by excess in syndromes and deficiency in root causes. Its clinical manifestations are concurrence of excess and deficiency. As for the treatment, there's no need to wait for the pathogenic qi to disappear. The basic principle of treatment is always to activate the spleen, regulate qi and help digestion. Professor ZHANG raises that syndromes with more deficicency than excess are treated by activating spleen, which is complemented by tonification. That is to say, activation and tonification are combined, while helping digestion is considered, also. But as to syndromes with more excess than deficiency, the treatment will be activating spleen combined with helping digestion, also with regulating qi. He also cares for children 's regulating and giving reasonable advice. [Conclusion]According to the children's characteristics of physiology and pathology, we should pay more attention to excess and deficiency to choose better method, at the same time, proper feeding and teaching are also important.
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Objective To determine whether glucagon-like peptide-1 (GLP-1) receptor PET/CT with 68Ga-exendin-4 is accurate in localizing insulinomas, by comparing with conventional imaging techniques.Methods In this prospective cohort study, patients with biochemically proven endogenous hyperinsulinemic hypoglycemia from March 2014 to November 2016 were recruited consecutively.68Ga-exendin-4 PET/CT, CT, MRI, endoscopic ultrasound (EUS), and SSTR imaging were performed before elective surgery.Surgical pathology results were considered as the gold standard.Sensitivity based on patient-analysis and positive predictive value (PPV) based on lesion-analysis were calculated and compared using χ2 test and generalized score test.Results A total of 109 patients were recruited (47 males, 62 females;average age (45.1±14.8) years), and 96 of them with insulinomas proved pathologically were included in the main assessment.Thirteen patients with positive 68Ga-exendin-4 PET/CT findings did not undergo surgical intervention.Based on patient-analysis, the sensitivities of 68Ga-exendin-4 PET/CT, CT, MRI, EUS and SSTR imaging for detecting insulinomas were 98.96%(95/96), 81.25%(78/96), 79.41%(54/68), 81.40%(35/43) and 21.84%(19/87), respectively.Based on lesion-analysis, the PPV of the above 5 methods were 100%(102/102), 97.56%(80/82), 95.16%(59/62), 83.72%(36/43) and 90.48%(19/21), respectively.68Ga-exendin-4 PET/CT showed the highest diagnostic sensitivity than others (all P<0.01) and higher PPV than MRI, EUS and SSTR imaging (all P<0.05).Conclusion 68Ga-exendin-4 PET/CT is a highly sensitive imaging technique for detection of insulinoma.
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Objective To determine whether glucagon-like peptide-1 (GLP-1) receptor PET/CT with 68Ga-exendin-4 is accurate in localizing insulinomas,by comparing with conventional imaging techniques.Methods In this prospective cohort study,patients with biochemically proven endogenous hyperinsulinemic hypoglycemia from March 2014 to November 2016 were recruited consecutively.68Ga-exendiri-4 PET/CT,CT,MRI,endoscopic ultrasound (EUS),and SSTR imaging were performed before elective surgery.Surgical pathology results were considered as the gold standard.Sensitivity based on patient-analysis and positive predictive value (PPV) based on lesion-analysis were calculated and compared using x2 test and generalized score test.Results A total of 109 patients were recruited (47 males,62 females;average age (45.1±14.8) years),and 96 of them with insulinomas proved pathologically were included in the main assessment.Thirteen patients with positive 68Ga-exendin-4 PET/CT findings did not undergo surgical intervention.Based on patient-analysis,the sensitivities of 68Ga-exendin-4 PET/CT,CT,MRI,EUS and SSTR imaging for detecting insulinomas were 98.96％ (95/96),81.25％ (78/96),79.41％ (54/68),81.40％ (35/43) and 21.84％ (19/87),respectively.Based on lesion-analysis,the PPV of the above 5 methods were 100％ (102/102),97.56％ (80/82),95.16％ (59/62),83.72％ (36/43) and 90.48％ (19/21),respectively.68 Gaexendin-4 PET/CT showed the highest diagnostic sensitivity than others (all P＜0.01) and higher PPV than MRI,EUS and SSTR imaging (all P＜0.05).Conclusion 68Ga-exendin-4 PET/CT is a highly sensitive imaging technique for detection of insulinoma.
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[ ABSTRACT] AIM: To investigate the role of anterior thalamic nucleus in trigeminal nerve electrostimulation ( TNS)-induced effects on seizures and hippocampal damage.METHODS: The rats were intraperitoneally injected with pilocarpine to induce chronic epilepsy, and then received sham treatment, TNS treatment and TNS treatment after stereotac-tic lesion to the anterior thalamic nucleus.The TNS treatment lasted for 1 month in each group.Another injection of pilo-carpine was conducted to induce seizures, and the severity and duration of seizures were quantitatively evaluated.TUNEL, Fluoro-Jade B ( FJB) and Nissl staining were applied to determine in situ apoptosis, neuronal degeneration and neuron loss in the hippocampal CA1 area respectively.RESULTS:Compared with TNS group, TNS treatment after stereotactic lesion to the anterior thalamic nucleus significantly increased the severity and duration of seizures (P<0.05), and the numbers of TUNEL positive cells, FJB positive cells and lost neurons in the hippocampal CA1 area (P<0.01).CONCLUSION:Anterior thalamic nucleus plays a role in TNS-induced reduction of seizures and hippocampal damage.The mechanisms might be due to the chronically activation of the cortex through anterior thalamic nucleus pathway induced by TNS, resulting in the down-regulation of neuronal excitatory susceptibility.