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ObjectiveTo design and evaluate the ideological and political teaching in the Medical Statistics as a public basic course for postgraduates in a medical school. MethodsThrough expert consultation， literature review， investigation， we designed the main points in the ideological and political teaching for the Medical Statistics. Students' satisfaction and demand of ideological and political teaching were investigated by a questionnaire. Furthermore， effect of ideological and political teaching was evaluated. ResultsA total of 178 out of 201 graduate students in Grade 2020 in a medical university completed the survey， accounting for 88.56%， with a response rate of 100%. Among them， 84.27% of the students believed it was necessary to implement ideological and political teaching for the Medical Statistics， and 90.45% expected that ideological and political teaching could be combined with case studies. The comparison before and after class showed that the students’ correct understanding of data acquisition has been greatly improved from 78.65% to 100%. In addition， the proportion of those who were dedicated to studying increased from 89.88% to 97.75%. ConclusionThe ideological and political teaching for Medical Statistics can be implemented in combination with case studies. Ideological and political teaching may improve the courses with practical operation of knowledge and skills.
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Objective:To study the influence of time-dependent acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score on 14-day death risk in patients with severe stroke, and to provide reference for clinical diagnosis and treatment.Methods:Data of 3 229 patients with severe stroke were enrolled from Medical Information Mart for Intensive Care-Ⅲ (MIMIC-Ⅲ). According to the main types of stroke, the patients were divided into subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), ischemic stroke (IS) and other groups. According to age, patients were divided into > 60 years old and ≤ 60 years old subgroups. According to the baseline of sequential organ failure assessment (SOFA) score, they were divided into subgroups of > 3 and ≤ 3. The daily measured values of APACHE Ⅱ scores in each patient were recorded. And all-cause death within 14 days after admission to intensive care unit (ICU) was used as the outcome index to obtain the survival status and survival time of patients. Joint models for longitudinal and time-to-event data were established to evaluate the effect of APACHE Ⅱ score measured at multiple time points on the death risk of patients, and a subgroup analysis was performed.Results:Among the joint models, the one which include APACHE Ⅱ score, and the interaction items between APACHE Ⅱ and age showed the better fitting. Further analysis showed that APACHE Ⅱ score was affected by age, gender, hospital admission, baseline SOFA score and smoking history. After controlling for these confounding factors, APACHE Ⅱ score was significantly associated with 14-day all-cause death in patients with severe stroke [hazard ratio ( HR) = 1.48, 95% confidence interval (95% CI) was 1.31-1.66, P < 0.001], which indicated that the risk of death increased by 48% (95% CI was 31%-66%) for each 1-point increase in APACHE Ⅱ score. Subgroup analysis showed that for different types of severe stroke patients, APACHE Ⅱ score had a greater impact on the risk of 14-day death in SAH patients ( HR = 1.43, 95% CI was 1.10-1.85), but had a smaller impact on ICH and IS groups [HR (95% CI) was 1.37 (1.15-1.64) and 1.35 (1.06-1.71), respectively]. There was no significant difference in APACHE Ⅱ score on the risk of 14-day death between the patients aged > 60 years old and those aged ≤ 60 years old [ HR (95% CI): 1.37 (1.08-1.72) vs. 1.35 (1.07-1.70), respectively]. Compared with patients with SOFA score > 3, APACHE Ⅱ score had a greater impact on the risk of 14-day death in patients with SOFA score ≤ 3 [ HR (95% CI): 1.40 (1.16-1.70) vs. 1.34 (1.16-1.55)]. Conclusion:Time-dependent APACHE Ⅱ score is an important indicator to evaluate the risk of death in patients with severe stroke.
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Objective To demonstrate the validity of volumetric QCT and dual energy X-ray absorptiometry( DXA )in bone mineral density (BMD) measurement and compare the difference in discriminating osteoporotic postmenopansal women with and without vertebral fracture. Methods One hundred and eighteen postmenopausal women [ mean age (62. 1 ± 7.0) years ] who received thoracolumbar radiographic examination were enrolled and divided into four groups (normal, osteopenia, osteoporotic and osteoporotic fractured group) also based on their BMD value of lumbar vertebra(AP-SPINE) measured by DXA: >x- 1s,x- 1s-x-2s, <x-2s without and with osteoporotic vertebral fracture. The second to four lumbar vertebrae were performed axial scan (for conventional 2D trabecular BMD measurement, 2D-TRAB by corresponding QCT software) and volumetric scan using MSCT. The volumetric data were transferred to the workstation ADW4. 2 for VR and MPR processing, and volumetric BMD were obtained based on the histogram of CT value, including integral BMD (3D-INTGL), cortical BMD (3D-CORT) and trabecular BMD (3D-TRAB), with the unit of mg/cm3. Apparent bone volume to total volume ratio ( App BV/TV% ) was calculated on the base of trabecular bone whose CT values were among 60 HU, 80 HU, 100 HU, 120--400 HU, respectively. Analysis of covariance (ANCOVA) and calculation of coefficient of determination ( R2 ) were performed for each parameter among the 4 groups. Results The values of 2D-TRAB, 3D- INT, 3D-TRAB, App60 BV/TV%, App80 BV/TV%, App100 BV/TV% and App120 BV/TV% in osteoporotic fractured group [(48.8±24.9) mg/cm3, (94.4±20.2) mg/cm3, (59.3±28.0) mg/cm3, (56. 1 ± 22. 8)%, (43.2±22. 2)%, (31.3±19. 4)%, (21.3±15. 6)% ] were significantly lower than those in osteoporotie group [ (74.9 ± 21.0) mg/cm3, ( 115.0 ± 14. 3 ) mg/cm3, (82. 0 ± 23.7) mg/cm3, (75.2 ± 16.8)%, (62.6 ± 20.5)%, (48.8 ± 21.7)%, (35.5 ± 20.1)%], osteopenia group [(89.2 ± 23.8) mg/cm3,(126.9 ± 12.9)mg/cm3, (97.8±25.2) mg/cm3, (85.1±13.7)%, (75. 1±17.9)%, (62.8±20.9)%, (49.2±21.9)%], and normal group[(120.6 ± 19.4) mg/cm3, (154.0 ± 16.3) mg/cm3, (131.1±21.1) mg/cm3, (95.6±5.3)%, (91.4±8.7)%, (84.7 ± 12.4)%, (75. 2 ± 15.5) % ], P <0. 01, respectively. For DXA parameter, there was no significant difference of AP-SPINE values found between osteoporotic fractured group [(0. 84±0. 16) g/cm2] and osteoporotic groups [ (0. 85±0. 06) g/cm2 ,P >0. 05 ]. In osteoporotic groups, AP-SPINE was not correlated significantly with other variables except 3D-CORT ( R2 = 0. 189, P < 0. 01 ) ; parameters of App60,80,100,120 BV/TV% were correlated significantly with 3 D-TRAB (R2 = 0. 955, 0. 951,0. 941,0. 912, P < 0. 01, respectively) and 2 D-TRAB(R2 = 0.912, 0.910, 0.878, 0.821, P < 0.01, respectively). The precision of 3D-BMD measurement was between 0. 70%--2. 25%. Conclusions Parameters derived from 3D-vQCT technique can discriminate osteoporotic postmenopausal women with fractured vertebrae from those without fractured vertebrae, and have better the capability than DXA. Among them, 3D-INTGL was the best parameter for diagnosing serious osteoporosis. App BV/TV% could be used to reflect the lost of trabecular bone precisely and to clinically predict fracture risk.
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Background and purpose:Resistance to anticarcinogen is one of the key factors that affect the treatment efficiency in lung cancer. The purpose of this study was to investigate the clinical significance of the multidurg resistance-related proteins P-gp, multidrug resistance-related proteins(MRP),lung resistance associated protien(LRP) and GST-?by detecting their expression in lung cancer and to investigate the mechanism of resistance to anticarcinogen. Methods:S-P immunohistochemistry was used to examine the expression level of proteins P-gp, MRP, LRP and GST- ?in 226 samples of lung cancer and 23 samples of normal lung tissues. Results:The positive rates of P-gp, MRP, LRP and GST-? in lung cancers were 46.0%, 42.0%, 54.4%, 62.4% respectively. Significant difference existed between tumorous tissue and normal lung tissue (17.4%, 13.0%, 17.4%, 21.7%). The positive rates of P-gp, MRP, LRP and GST-? in poorly differentiated-type of NSCLC were 33.3%, 22.8%, 33.3%, 47.4%, compared with differentiated-type of NSCLC (59.7%, 58.1%, 73.6%, 79.1%) (P
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Purpose:To understand the effect of ligustrazine on preventing the thrombosis "after percutaneous transluminal angioplasty(PTA).Materials and Methods:Dogs models(n=10)with exper- imental renal arterial stenosis were selected and randomly divided into control and experimental groups with 5 dogs for each. Experimental group dogs were injected ligustrazine(40mg/kg)15 days before PTRA.Peripheral blood samples were collected before recelived drug,before and 4 hours after PTRA in the experiment group;before and 4 hours after PTRA in the control group.Plasma concentrations of thromboxane B2_(TXB_2)and 6-keto-PGIl? were determined by radioimmunoassay.Rates of platelet ag- gregation were also determined by ADP-induced.All dogs were killed 4 hours after PTRA.Renal arteries were removed before killing.The thrombus volume at PTRA sites were measured.Results:Liguslrazine might significantly inhibit platelet aggregation,decrease TXA_2 produced by platelet and increase PGI_2 synthesized in the blood vessel.Therefore,ligustrazine might significantly inhibit thrombosis at the PTRA sites.It Suggests that Ligustrazine could be an effective drug for preventing restenosis of thromboses after PTA.