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Objective:To investigate the application of mind map combined with daily mini-clinical evaluation exercise in standardized training of gynecological residents.Methods:A total of 100 trainees who received standardized training in Department of Gynecology, Women and Children's Hospital of Chongqing Medical University, were selected as subjects, and they were divided into control group (traditional teaching) and observation group (mind map combined with daily mini-clinical evaluation exercise) according to the order by which they entered the department for training, with 50 trainees in each group. After teaching, the two groups were compared in terms of assessment results of clinical practice exercise and degree of satisfaction with teaching. SPSS 22.0 statistical software was used for the t-test. Results:After the application of mind map combined with daily mini-clinical evaluation exercise in the standardized training of gynecological residents, compared with the control group, the observation group had significantly higher assessment results of inquiry ability, specialized physical examination, clinical diagnosis, diagnosis and treatment regimen, clinical practice ability, communication ability, clinical thinking ability, decision-making ability for clinical issues, and overall performance ( P<0.05). Compared with the control group, the observation group had significantly higher levels of mastery of clinical inquiry ability, specialized physical examination, development of diagnosis and treatment regimen, doctor-patient communication ability, and clinical practice ability, as well as a significantly higher overall teaching satisfaction score ( P<0.05). Conclusion:Mind map combined with daily mini-clinical evaluation exercise is a simple and feasible teaching method and can help to improve the comprehensive clinical practice ability of trainees receiving standardized residency training, and therefore, it holds promise for application in teaching.
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Objective:To analyze the effects of different blood sampling methods on the incidence of iatrogenic blood loss, anemia, transfusion, and complications in very low birth weight infants (VLBWI) during hospitalization.Method:A retrospective analysis was performed on VLBWIs (birth weight <1 500 g) admitted to the neonatal intensive care unit of the Second Hospital of Yangtze University, Jingzhou Central Hospital, Hubei province, from January 2014 to December 2018. According to the first blood sampling method, these infants were subjected to the umbilical cord blood and peripheral blood groups. Blood sampling, transfusion, complications, and outcomes were compared between the two groups. Independent samples t-test, rank-sum test, and Chi-square (or Fisher's exact) test were used for statistical analysis. Results:(1) Totally 240 neonates enrolled, including 104 cases in the umbilical cord blood group and 136 in the peripheral blood group. There was no statistical significance in the general information and blood test results for the first time between the two groups. (2)The blood volume collected in the first week in the umbilical cord blood group was lower than that in the peripheral blood group [6.5 ml (1-23 ml) and 10 ml (1-30 ml), Z=－4.706, P<0.01]. Differences between the two groups in the blood volume at 2-9 weeks were insignificant (all P>0.05). The number of blood collection procedures in each of the first four weeks after birth in the umbilical cord blood group was less than that in the peripheral blood group ( Z value was－9.124,－2.272,－4.688, and－2.017, respectively, all P<0.05), but no statistical difference was found at the fifth week ( P>0.05). The time of the first red blood cell transfusion (RBCT) in the umbilical cord blood group was later than that in the peripheral blood group [4 weeks (1-7 weeks) vs 3 weeks (1-5 weeks), Z=－2.839, P<0.05]. The proportion of infants who have received RBCT twice or more times in the umbilical cord blood group was lower than that in the peripheral blood group [39.7% (25/63) vs 56.8% (50/88), χ2=4.312, P<0.05]. The rate of RBCT during the first three weeks in the umbilical cord blood group was lower than that in the peripheral blood group [34.9% (22/63) vs 59.1% (52/88), χ2=8.583, P<0.05]. There were no significant differences in the volume of RBCT per time, adverse reactions after transfusion, and the erythrocyte count, hemoglobin, and hematocrit before and after the first RBCT between the two groups. (3) The incidence of neonatal respiratory distress syndrome, neonatal necrotizing enterocolitis, bronchopulmonary dysplasia, retinopathy of prematurity, and intraventricular hemorrhage (grade Ⅲ-Ⅳ) and their outcomes were similar between the two groups (all P>0.05). Conclusion:Blood sampling methods show no significant effect on the total incidence of anemia and RBCT in VLBWIs during hospitalization. Umbilical cord blood sampling may delay the first RBCT time of VLBWIs and reduce the rate of RBCT in the first three weeks, but do not affect the incidence of complications.
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Objective To retrospectively analyze the application of lung ultrasound in neonatal de-partment of our hospital in the past three years,and summed up the clinical diagnosis and treatment changes brought by it. Methods The clinical data of infants accepted the bedside lung ultrasound examination from May to December 2016(early carry out stage),from January to December 2017(adaptation stage),from Jan-uary to August 2018(normal conduct stage) in our NICU of Jingzhou Central Hospital were collected. The clinical data of 878 infants with different stages of application were compared and analyzed. Results In 878 children,1 225 of lung ultrasound were performed,64. 1% of patients had pulmonary disease,and 35. 9% had no lung disease. There were 67 cases of neonatal respiratory distress syndrome,278 cases of wet lung,259 ca-ses of pneumonia,64 cases of meconium aspiration syndrome,72 cases of acute respiratory distress syn-drome,63 cases of atelectasis and 14 cases of pleural effusion. A total of 1 122 times of lung X-ray examina-tion were performed in 878 children. The number of X-ray examinations per capita decreased from 2. 48 times in 2016 to 1. 40 times in 2017 and 0. 84 times in 2018. A total of 32 times of pulmonary CT examination were performed. The number of lung CT inspection decreased from 0. 060 times in 2016 to 0. 038 times in 2017 and 0. 029 times in 2018. Lung ultrasound was convenient for dynamic observation,and could be used to de-termine the improvement,aggravation or new pulmonary lesions. Conclusion Lung ultrasound is accurate in the diagnosis of lung disease in NICU,especially for children with long hospital stay,repeated illness and dif-ficult to withdraw. It is easy to carry out in clinic,at the bedside,which can reduce the times of chest X-ray and CT per capita examination. Lung ultrasound is an effective and feasible method for NICU to diagnose lung diseases and it is worth promoting.
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OBJECTIVE:To provide reference for safe drug use of paclitaxel in clinic. METHODS:The literatures about anaphylactic shock induced by paclitaxel were retrieved from China Hospital Knowledge Database during 2006-2016. After screening literatures which met inclusion criteria,the literatures were analyzed statistically in respects of the distribution of patient's gender and age,primary disease,distribution of occurrence time of anaphylactic shock,prophylactic drug use,route of administration and dosage,combined with chemotherapy drugs,prodromal clinical manifestations,first-aid measures and prognosis,etc. RESULTS:A total of 53 cases of anaphylactic shock induced by paclitaxel were included,among which there were 16 male and 37 female,aged 17-72 years;female patients over 40 year-old took up the highest proportion(30 cases,56.60%). The major primary diseases were lung cancer(15 cases,28.30%),breast cancer(12 cases,22.64%)and ovarian cancer(11 cases,20.75%). Anaphylactic shock mainly occurred within 5 min after intravenous dripping(34 cases,64.15%). 45 cases (84.90%)received antiallergic prophylactic program before using paclitaxel;53 patients were given intravenous dripping with single dose of 30-300 mg. Among 53 patients,25 patients were given paclitaxel alone,and other patients were given paclitaxel combined with chemotherapy drugs. The prodromal clinical symptoms of anaphylactic shock mainly involved cardiovascular system (123 case time,36.07%),skin and mucous membrane system(73 case time,21.41%)and respiratory system(67 case time, 19.64%). 2 patients(3.77%)died after rescue treatment. CONCLUSIONS:More attention must be paid to the occurrence of anaphylactic shock induced by paclitaxel.
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Objective To investigate the gene carrying rate,gene type and composition ratio of thalassemia among pre-pregnant population in Chongqing area.Methods A total of 1054 people were enrolled in the hospital from April 2014 to March 2016 for thalassemia screening.The content of screening included mean corpuscular volume (MCV),mean corpuscular hemoglobin (MCH) and hemoglobin electrophoresis.Thalassemia gene was examined in people with any abnormal term of screening result.Results In 10854 cases,1117 cases showed positive in thalassemia primary screening,and the positive rate was 10.29％.458 cases were tested positive of thalassemia gene,the carrying rate of thalassemia was 4.21％.In which,253 cases of pure a-thalassemia were tested.The carrying rate of α-thalassemia was 2.33％.The most common kind in α-thalassemia was--SEA whose constituent ratio were 52.17 ％.197 cases of pure β-thalassemia were tested,the carrying rate of β-thalassemia was 1.81％.The most common kind in β-thalassemia was CD17 (A→T),whose constituent ratio were 31.47 ％.11 cases were diagnosed with αβ-thalassemia.Conclusion Chongqing is high-prevalence area of thalassemia.It is important to conduct thalassemia genetic screen before pregnancy which plays a vital role in improving population quality and achieving prepotency.
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Objective To analyze the situation of high-risk human papillomavirus(HPV) infection and its relationship with cervical lesions among rural women in Chongqing City. Methods A total of 20000 rural women were selected from the districts of Wanzhou, Yongchuan,Banan and Tongnan of Chongqing City from January to April 2016. The cervical cancer preliminary screening was performed by detecting HPV gynotyping. The cases of HPV 16 and HPV 18 positive or other 12 high risk HPV types positive with abnormal colposcopy examination conducted the colposcopy fixed point biopsy. Results The positive rate of high-risk HPV infection was 9.66% among rural women in Chongqing City. The positive rates of high-risk HPV infection and different types of high-risk HPV infection had difference among different age groups. Among women of high-risk HPV infection positive, the occurrence rate of CIN1 was 2.33 %,which of CIN2,CIN3 and AIS was 1.35 %,and which of cervical cancer was 0.31%, the incidence rate of different grades of cervical lesions had no statistical difference among different age groups. Among women with different types of high-risk HPV infection,the incidence rate of different grades of cervical lesions in women of HPV 16 positive was highest, those with the other 12 types of high risk HPV positive had the lowest occurrence rate of different grades of cervical lesions, the differences were statistically significant. Conclusion HPV genotyping detection can increase the efficiency of cervical cancer screen ing and is more suitable for the screening of large population.
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Objective To study the efficacy and safety of different doses of caffeine citrate and aminophylline treatment for apnea of prematurity. Methods Preterm infants who met the inclusive criteria were admitted to NICU of JingZhou Central Hospital from October 1st, 2013 to October 1st, 2015. They were randomly assigned to three groups. Infants assigned to high dose caffeine group were received a loading dose of 40 mg / kg daily, followed by the maintaining dose of 20 mg / kg daily. Neonates in low dose caffeine group were administered with the loading dose of 20 mg / kg daily, followed by maintaining dose of 10 mg / kg daily. Infants in the aminophylline group received a loading dose of 5 mg / kg, then with maintaining dose of 2 mg / kg every 12 hours. Caffeine citrate or aminophylline therapy were continued until the infants were free from apnea for a period of 7 days or when the gestational age of 34 weeks were reached. Extubation failure rate, frequency of apnea, duration of apnea, mechanical ventilation, as well as oxygen therapy, length of hospital stay, mortality, and the adverse effects were compared among three groups. Results 90 infants were enrolled for study, with 30 in each group. Extubation failure rate, frequency of apnea, apnea duraion and oxygen therapy duration of infants in high dose caffeine groups were all significantly lower than those of infants in low dose caffeine group and aminophylline group (P 0. 05). Duration of mechanical ventilation and CPAP, length of hospital stay, incidence of complications (BPD, ROP, IVH, PVL, NEC ), mortality were of no significant difference among three groups ( P > 0. 05 ) . Conclusions High dose caffeine therapy for apnea of prematurity is more effective in decreasing incidence of extubation failure and apnea, as well as decreasing duration of apnea and oxygen therapy. Tachycardia is the only adverse effect of high dose caffeine therapy discovered by this study.
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Objective To explore the effect of mouse proliferation-associated protein 2G4 (p38-2G4) high-expression on the proliferation and erythriod differentiation of murine erythroleukemia ( MEL ) cells.Methods To establish the recombinant lentivirus vector p 38-2G4-pLJM1, the p38-2G4-pLJM1 was cotransfected into HEK293T cells to obtain lentivirus with pCMV-VSV-G and pCMV-dR8.2.Lentivirus were infected into MEL cells to establish the stably p 38-2G4 high-expressed MEL cells.Western blotting was used to analyse the high-expression efficiency.MTT assay and benzidine staining were applied to detect the cell viability and hemoglobin synthesis of the stable cell line in presence /absence of inducers.Results Western blotting showed that the p38-2G4 high-expression stable cell strain had a higher expression of p38-2G4 as compared to the control group ( MEL) ( P 0.05), but the hemoglobin synthesis had been reduced as compared to the control group (P<0.05).Conclusion p38-2G4 high-expression does not affect the cell viability of MEL cells , but inhibits the erythriod differentiation of MEL cells in three independent experiments .
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Objective To explore the differentially expressed proteins during erythroid differentiation .Methods The murine erythroleukemia ( MEL) cell were treated by DMSO , and the comparative proteomic was systematically analyzed and identified on different differentiating time points .ratio of cell differentiation and viability were detected by benzidine staining, MTT assay and Ter119 immunofluorescence.Using two-dimensional gel electrophoresis combined with mass spectrometry technology and bioinformatics analysis , we conducted a comparative proteomic analysis on MEL cells during the process of induced differentiation to screen and identify differential proteins .Results The MEL cells induced by 1.2%DMSO for 0 hour, 6hours, 12hours, 24hours, 36hours, 48hours, 72 hours, 96 hours, 120 hours were collected for proteomic analysis, by two-dimensional gel electrophoresis combined with mass spectrometry .A total of 87 kinds of proteins were successfully identified .MEL cells exposed to DMSO at a final concentration of 1.2% for 120 hours reached the highest differentiation rate of 67%.MTT assay showed that 1.0%, 1.2%, 1.4% DMSO had no inhibiting effect on cell vitality.Conclusion DMSO may induce MEL cells to differentiate and have no inhibiting effect on cell vitality .The 87 kinds of differentially expressed proteins from two-dimentional gel electrophoresis may be divided into twelve categories ;the most three parts are 41%enzyme protein, 15%structural protein and 13%regulatory protein.
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Objective To explore the early diagnostic value of Golgi membrane protein 73 (GP73),alpha-fetoprotein (AFP) and alpha-fetoprotein-L3 (AFP-L3) in patients with high risk of primary hepatic carcinoma (PHC).Methods Sixty-four cases of PHC were selected as the PHC group,60 cases of liver cirrhosis(LC) as the LC group,53 cases of hepatitis as the hepatitis group and 51 healthy checked-up people as the control group.Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum level of GP73 in all the cases.AFP-L3 was isolated by using affinity micro centrifugal column,AFP and AFP-L3 were detected with chemiluminescent immunoassay and then the proportion of AFP-L3 was calculated.Results The positive rate of serum GP73,AFP and AFP-L3 in PHC group was significantly higher than that in LC group and hepatitis group [78.1％ (50/64)vs.25.0％ (15/60),17.0％ (9/53);48.4％ (31/64) vs.31.7％ (19/60),22.6％(12/53) ;53.1％(34/64) vs.30.0％(18/60),20.8％(11/53)] (P ＜ 0.05),In control group,GP73,AFP,AFP-L3 was no positive.The levels of GP73,AFP and AFP-L3 in PHC group were significantly higher than those in LC group,hepatitis group and control group [(245.69 ± 89.18)μ g/L vs.(116.37 ±38.52),(97.29 ± 24.58),(23.48 ±9.12) μ g/L; (403.27 ± 128.46) μg/L vs.(75.62 ± 19.35),(66.49 ± 15.14),(3.46 ± 1.02) μg/L; (15.64 ±3.19)％ vs.(5.24 ± 1.15),(4.21 ± 0.96),(2.95 ±0.73)％] (P ＜0.05).The levels of GP73,AFP in LC group and hepatitis group were significantly higher than those in control group (P ＜ 0.05).The levels of GP73,AFP and AFP-L3 had no statistically significant difference between LC group and hepatitis group (P ＞ 0.05).Sensitivity and accuracy of three combined detection for PHC was 96.9％(62/64),91.7％(209/228),significantly higher than that of AFP,AFP-L3 single detection (P ＜ 0.05).GP73 single detection and any two combined detection was no significant difference in sensitivity and accuracy,compared with three combined detection (P ＞ 0.05).The levels of GP73 in PHC patients with different age,gender,serum level of AFP,TNM stage and tumor diameter had no statistically significant difference (P ＞ 0.05).The levels of GP73 in PHC patients with positive HBsAg,extrahepatic metastases and LC had significant difference (P ＜ 0.05).Conclusions The diagnosis value of GP73 is evidently higher than AFP and AFP-L3 for PHC,and combined determination is superior to single marker.Combined determination enhances the degree of precision in populations with high risk of PHC diagnosis.
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The 987P fimbriae of enterotoxigenic Escherichia coli (ETEC) mediates adhesive interactions with brush border vesicle (BBV) of the intestinal epithelial cells from the neonatal piglets. By adhering to intestinal epithelial cells, producing localized multiplication, the 987P ETEC can progress to mucosal surface colonization and concomitant effective enterotoxin delivery. To identify the receptors for the 987P, BBV proteins from piglet intestinal villous epithelial cells were separated by SDS-PAGE and analyzed by Ligand blot, protein bands with a set of 32-35 kD recognized by the 987P fimbriae were subjected to in gel proteolysis with trypsin. The tryptic fragments were separated by microbore reversed phase HPLC(RP-HPLC), samples shown to contain one major peak by MALDI-MS were submitted to Edman sequencing, three peptides were sequenced successfully and the all of three peptides matched the sequences of human or porcine histone H1 proteins. Porcine histone H1 proteins isolated from both piglet intestinal epithelial cells and BBV demonstrated the same SDS-PAGE migration pattern and 987P-binding properties as the 987P-specific protein receptors from piglet intestinal brush border did. The above results indicated that the 987P protein receptors are piglet BBV-derived Histone H1 proteins.
Subject(s)
Animals , Adhesins, Escherichia coli , Metabolism , Amino Acid Sequence , Enterotoxigenic Escherichia coli , Metabolism , Virulence , Escherichia coli Infections , Microbiology , Fimbriae Proteins , Metabolism , Fimbriae, Bacterial , Chemistry , Histones , Genetics , Metabolism , Host-Pathogen Interactions , Intestinal Mucosa , Metabolism , Molecular Sequence Data , Receptors, Cell Surface , Genetics , Metabolism , SwineABSTRACT
Objective To study the distribution of genotypes of Candida albicans isolated from different body sites of patients with candidal vulvovaginitis(CVV).Methods PCR was designed to amplify group I intron-containing region in25S rDNA of Candida albicans.The strains of Candida albicans could be classified into three genotypes:genotype A(~450bp),B(~840bp)and C(~450bp and~840bp),on the basis of different ranges of bands of amplicons.Results Sixty women with CVV were recruited,of whom54were caused by Candida albicans.Among the54patients39had non-recurrent CVV and15had recurrent CVV(RCVV).Candida albicans could be isolated simultaneously from different body sites in32of54patients,including19(19/39)with non-RCVV and13(13/15)with RCVV.A total of92strains of Candida albicans were isolated from vagina,tongue and anus in54patients with CVV.Eighty strains of genotype A,8of genotype B and4of genotype C were found.The same genotypes of Candida albicans in different body sites were identified in24patients,and the different genotypes were identified in8patients.Conclusion Genotype A is predominant in CVV.The other two genotypes(B and C)are not commonly seen,and mainly isolated from non-vaginal sites.The colonization of Candida albicans in the non-vagina sites is more frequent in RCVV than that in CVV,and the intestinal reservoir theory may play a role in the relapse of RCVV.
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<p><b>OBJECTIVE</b>To improve the results of the soft tissue expansion technique.</p><p><b>METHODS</b>Two expanders were buried in the same soft tissue pocket in an overlapping pattern. The inflation process was carried out routinely.</p><p><b>RESULTS</b>19 cases of various tissue defects were treated with the overlapping tissue expansion technique since March 1999. Good results have been achieved.</p><p><b>CONCLUSION</b>The overlapping tissue expansion technique can provide much more expanded tissue and reduce complications compared with the traditional expansion technique. It is especially suitable for repair of the defects at the facial and cervical region.</p>
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Adolescent , Adult , Child , Female , Humans , Male , Burns , General Surgery , Dermatologic Surgical Procedures , Skin , Wounds and Injuries , Skin Transplantation , Surgical Flaps , Tissue Expansion , MethodsABSTRACT
Objective To study the methods of graduation of benign prostatic hyperplasia.Methods Transrectal digital palpation,transabdominal and transrectal ultrasonography,uroflowmetry and measuring residual urine volume were carried out for 320 cases of benign prostatic hyperplasia.Results①The measuring prostatic volume by means of transrectal digital palpation and ultrasound was similar.There was no significant difference between the groups(P=0.991).②The obstructive degree of the urethra was not consistent with the prostatic volume(P<0.01),it was closely related to the degree and site of hypertrophy node.③Measurement of size of prostatic internal gland,proportion between internal and external gland,site of internal ostium of urethra and sonography during urination were carried out by transrectal ultrasonography.The results were similar with obstruction pressure of the urethra and clinical manifestation(P=0.848, 0.966,0.592).Conclusions The transrectal ultrasonography graduation is not only a reliable method for diagnosis of benign prostatic hyperplasia,but also can guide the treatment of benign prostatic hyperplasia.