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The educational purpose of "three-wide education" is in line with the overall goal of talent cultivation in colleges and universities, and fits the development laws of ideological and political work in colleges and universities in the new era. It is an important measure to leverage the joint efforts of education and improve the quality of education. Under the concept of "three-wide education", medical ethics education in higher vocational medical colleges lacks systematization and big data support, medical students’ "knowing morality" and "conducting morality" are not unified, the content of medical ethics teaching is outdated, and teaching methods are single, which is inconsistent with students’ innovative cognitive thinking and derailed from clinical and social real needs, making it difficult to arouse students’ interest in learning. Against the backdrop of continuously improving professional literacy requirements for medical students, this paper explored the medical ethics education path of "combining moral and technical education" for vocational medical students under the concept of "three-wide education", and formed training paths such as "three integration of medical ethics, three progressions of knowledge and action", the coordinated education of ideological and political courses and ideological and political education in the course, the "trinity" of school, family, and society, the innovative multi-dimensional medical ethics education teaching methods, the construction of a medical ethics practice platform, and the establishment of medical ethics cultural education data management platforms, with a view to providing reference ideas for the cultivation of medical ethics among vocational medical students.
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Objective:To explore the effect of solution-focused approach on medication adherence in patients with cerebral ischemic stroke.Methods:A total of 120 patients with cerebral ischemic stroke from May to August 2019 in the Second Affiliated Hospital of Harbin Medical University were divided into the experimental group and the control group by random digits table method with 60 cases in each group. The patients in the control group received the routine nursing in the hospital and extended nursing outside the hospital, while patients in the experimental group received the solution-focused approach based on the control group. The intervention effects of the two groups were evaluated by Morisky Medication Adherence Scale (MMAS-8), Beliefs about Medication Questionnaire(BMQ), Richard Gray's scoring method of medication compliance confidence and willingness to take medication, and the changes of blood pressure.Results:Finally, 57 cases were included in the control group and 58 cases in the experimental group. There was no significant difference in the scores of medication compliance between the two groups before intervention( P>0.05). The scores of the control group and the experimental group were 5.110 ± 1.194, 6.160 ± 1.064 at 1 month after intervention and 5.044 ± 1.010, 6.306 ± 0.685 at 3 months after intervention, the differences were statistically significant ( t=4.98, 7.83, both P<0.05).There was no significant difference in medication belief score, medication compliance confidence score, willingness to take medication score, systolic blood pressure and diastolic blood pressure between the control group and the experimental group before intervention( P>0.05). One month after intervention, those index mentioned above were (2.561 ±2.605) points, (7.123 ± 1.310) points, (6.368 ± 1.234) points, (131.86 ± 13.13) mmHg(1 mmHg=0.133 kPa), (84.33 ± 7.05) mmHg in the control group, and (4.345 ± 3.006) points, (7.603 ± 1.388) points, (6.948 ± 1.527) points, (126.52 ± 12.44) mmHg, (83.95 ± 8.07) mmHg in the experimental group. Three months after intervention, those index mentioned above were (1.667 ± 2.149) points, (6.737 ± 1.218)points, (5.702 ± 1.362) points, (130.47 ± 13.77) mmHg, (84.25 ± 7.71) mmHg in the experimental group, and (4.879 ± 2.760) points, (7.793 ± 1.321) points, (7.207 ± 1.373) points, (125.71 ± 11.18) mmHg, (82.98 ±7.41) mmHg in the control group. One month and three months after intervention, the scores of medication belief and willingness to take medication in the experimental group were higher than those in the control group, and the systolic blood pressure was lower than that in the control group. Three months after interevention, medication compliance confidence was higher than that in the control group. The differences were statistically significant ( t values were -2.24-6.96, all P < 0.05). Repeated measurement analysis of variance showed that there were interactions between the group effect and time effect of medication compliance, medication belief, medication compliance confidence, willingness to take medication and systolic blood pressure ( F values were 12.81-26.17, all P<0.05). Conclusions:Solution-focused approach can significantly improve patients' medication adherence, beliefs about medication, medication compliance confidence, willingness to take medication, and effectively control blood pressure fluctuations.
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Genetic gain-of-function mutations of warm temperature-sensitive transient receptor potential vanilloid 3 (TRPV3) channel cause Olmsted syndrome characterized by severe itching and keratoderma, indicating that pharmacological inhibition of TRPV3 may hold promise for therapy of chronic pruritus and skin diseases. However, currently available TRPV3 tool inhibitors are either nonselective or less potent, thus impeding the validation of TRPV3 as therapeutic target. Using whole-cell patch-clamp and single-channel recordings, we report the identification of two natural dicaffeoylquinic acid isomers isochlorogenic acid A (IAA) and isochlorogenic acid B (IAB) that selectively inhibit TRPV3 currents with IC50 values of 2.7 ± 1.3 and 0.9 ± 0.3 μmol/L, respectively, and reduce the channel open probability to 3.7 ± 1.2% and 3.2 ± 1.1% from 26.9 ± 5.5%, respectively. In vivo evaluation confirms that both IAA and IAB significantly reverse the ear swelling of dermatitis and chronic pruritus. Furthermore, the isomer IAB is able to rescue the keratinocyte death induced by TRPV3 agonist carvacrol. Molecular docking combined with site-directed mutations reveals two residues T636 and F666 critical for the binding of the two isomers. Taken together, our identification of isochlorogenic acids A and B that act as specific TRPV3 channel inhibitors and gating modifiers not only provides an essential pharmacological tool for further investigation of the channel pharmacology and pathology, but also holds developmental potential for treatment of dermatitis and chronic pruritus.
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For provincial children's hospitals and children's hospitals affiliated to medical colleges and universities with a high level of the diagnosis and treatment,they are the center of referral and need to retain pediatricians and build a high-level team of pediatricians.With the authors' own experience in Cincinnati Children's Hospital Medical Center in the US,this article briefly introduces the current clinical operation mode in American children's hospitals,especially the consultation system mainly composed of attending physicians and the mode of continuing medical education based on both clinical and scientific research.Such experience provides a reference for pediatricians in China.
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To evaluate immune efficacy of the recombinant Lactobacillus casei, we constructed pLA-Newcastle disease virus (NDV)-F/L. casei and obtained the expression products. PCR amplified the NDV F gene carrying part of the major epitopes. The target gene was inserted to the shuttle plasmid pLA, and then transformed into Escherichia coli BL21 (DE3) in order to screen positive recombinant plasmid. The positive recombinant plasmid was transformed into L. casei by electroporation to construct pLA-NDV-F/L. casei. The positive strains were identified by PCR. The reactivity of the recombinant bacteria was identified by Western blotting and the protein expression was detected by indirect immunofluorescence, flow cytometry and laser confocal microscopy. The 14-day-old chickens in each group were vaccinated by oral plus nose drops. The pLA-NDV-F/L. casei twice immunization group and three times immunization group, the commercial vaccine group, the pLA/L. casei group, the unchallenge PBS and the challenge PBS group were established. IgG in serum and sIgA in the lavage fluid of intestinal, nasal and lung were detected by ELISA. The protection rate of chickens was evaluated. The results showed that 94.10% of the recombinant bacteria expressed the F protein. The recombinant protein was highly expressed on the surface of L. casei with a protein size of 62 kDa, which specifically bound to anti-NDV serum. The levels of anti-F IgG and sIgA antibodies in each test group were significantly higher than those in the control groups. The duration of antibody in the pLA-NDV-F/L. casei three-time immunization group lasted 28 days longer than that in the twice immunized group, and there was no significant difference between antibody peak values. The attack protection rates in each group of immunized pLA-NDV-F/L. casei three times, twice, attenuated vaccine, pLA/L. casei and PBS were 80%, 80%, 90%, 0% and 0%, respectively. Therefore, the antigenic protein of NDV F was successfully expressed by L. casei expression system, which has of reactogenicity and immunogenicity, and could induce protective immune responses in chickens.
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Animals , Antibodies, Viral , Chickens , Immunization , Lacticaseibacillus casei , Newcastle disease virus , Vaccines, Attenuated , Viral VaccinesABSTRACT
Objective To explore an auxiliary method to improve DWI image quality of testis.Methods Thirty healthy male volunteers were selected,and EPI-DWI and FSE-T2WI scanning with the same parameters were successively performed according to three different schemes.Scheme A:Padding ultrasonic coupling agent-soft rubber bag at the scanning position.Scheme B:Padding physiological saline-soft rubber bag at the scanning position.Scheme C:No preexamination treatment at the scanning position.FSE-T2WI (the same scheme and the same slice) was used as the reference of anatomic form,and the images were conducted by two attending doctors.The image geometric distortion,signal uniformity and anatomical clarity were scored by 5 points method.SNR and CNR of were calculated by one of the two doctors.The scoring consistency between the two doctors was evaluated.The scoring of image geometric distortion,signal uniformity,anatomic clarity,SNR and CNR of the three schemes were statistically analyzed.Results The scoring consistency of image geometrical distortion,signal uniformity and anatomical clarity of the three schemes were relatively good or better between the two doctors (Kappa=0.805,0.737 and 0.713).There were significant differences of image geometrical distortion,signal uniformity and anatomical clarity scoring obtained from three schemes (comparisons between groups and overall comparison,all P＜ 0.05),superiority:Scheme A＞ Scheme B＞ Scheme C.Conclusion Ultrasonic coupling agent-soft rubber bag padding method can significantly improve DWI imaging quality of testis.
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Objective To investigate the features and discrepancies of the ultrasound findings of shoulders in patients with rheumatoid arthritis (RA) and polymyalgia rheumatica (PMR).Methods Patients with RA and PMR who complained of pain,swelling or limited mobility of shoulder were enrolled for bilateral ultrasound assessment.Inflammatory lesions including long head biceps (LHB) tenosynovitis,subacromial-subdeltoid (SASD) bursitis,tendinosis of supraspinatus (SS) tendon effusion/synovitis in glenohumeral (GH) and acromioclavicular (AC) joints,as well as structural damages including SS tear,bone erosions and osteophytes on humeral head and AC joints were evaluated.Comparison of frequency of ultrasound features between the two groups was analyzed byx2 test.Results A total of 458 shoulders from 192 RA and 37 PMR patients were assessed by ultrasound.In RA patients,the most prevalent inflammatory findings were LHB tenosynovitis (31.3％),followed by SASD bursitis (25％),SS tendinosis (11.5％),AC and GH effusion/synovitis (10.4％ and 5.7％,respectively).LHB tenosynovitis was the most frequent finding in PMR patients (37.8％),followed by SS tendinosis (27％),SASD bursitis (24.3％),AC and GH effusion/synovitis (2.7％ and 0,respectively).Partial or complete tear of SS tendon was found in 9.9％ RA and 8.1％ PMR patients,respectively.SS tendinosis was more frequently presented in PMR than RA patients (x2=6.255,P＜0.05),while GH effusion/synovitis was more common in RA group (x2=3.983,P＜0.05).Bone erosions and osteophytes were common in both groups.SASD bursitis and SS tendinosis appeared to be more unilateral (77.1％ and 77.3％,respectively),while GH effusion/synovitis tended to be bilateral (63.6％) in RA patients.Conclusion Intra-articular inflammatory involvement (GH effusion/synovitis) is more frequent in RA,while peri-articular inflammatory involvement (SS tendinosis) is more frequent in patients with PMR.SASD bursitis and SS tendinosis appears to be unilateral,while GH effusion/synovitis tends to be bilateral in RA patients.
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Objective To develop the optimal simplified combination of joints for ultrasonographic assessment of joint inflammation of wrists and hands in patients with rheumatoid arthritis (RA).Methods US examination was performed using grey-scale (GSUS) and power Dop.pler (PDUS) semi-quantitative scoring systems with scores 0-3 in 22 joints of 705 RA patients,including all proximal interphalangeal (PIP),metacarpophalangeal (MCP),and bilateral wrist joints.Continuous variables were presented as mean and standard deviation if normally distributed,and dichotomous variables were presented as frequencies.T test and Wilcoxon signed test were applied for statistical analysis.All correlations among US variables were assessed using Spearman's rank correlation test.Candidate joint set was selected by multiple stepwise linear regression analysis.Results Through multiple linear stepwise regression analysis,the standard coefficient of wrist,MCP5,MCP2 and MCP3 joints under GSUS was higher than other joints.And the adjusted R2 of the model composed of wrist,MCP5,MCP2 and MCP3 joints was greater than 0.9.Among the sum GS and PD scores of various selected joint combinations,total score-8 (GS vs PD),including bilateral wrist,MCP2,MCP3,MCP5 joints,not only showed highest sensitivity and negative predictive value (97.3 5％ vs 97.20％;92.67％ vs 97.21％,respectively),but also had the highest correlation with the total score-22 (GS,PD) (r=0.989,0.972,P＜0.01).Conclusion Total score-8,including bilateral wrist,MCP2,MCP3,MCP5 joints,is simple and efficient enough for monitoring active synovitis of wrists and hands in patients with RA in daily practice.
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Objective To develop the severity score of pediatric hand foot and mouth disease (HFMD),guide health care providers in the early detection and intervention of critical ill cases,in order to improve the survival rate and reduce the incidence of complications and mortality.Methods Based on PCIS,the severity score of HFMD in children was designed by adding fever and nervous system damage symptoms,which was the common symptoms of severe cases.The data of the cases who admitted in April 2008 to November 2010 (group A,88 cases) was retrospectively analyzed to evaluate the validity and credibility of the score.The score were prospectively applied to all of the HFMD cases who admitted from May 2011 to October 2013(group B,118 cases),delivering corresponding treatment and care measures based on scoring result as well.At last the outcome of the two groups was compared.Results It exhibited quite good consistency between the scores and the clinical condition of patients with HFMD.The general information of two groups was not significantly different,but the survival rate,the incidence of neurological sequel and the mortality between two groups were significantly different by x2 test.Conclusions The score can objectively and accurately assess the severity of HFMD in children.Clinical application of this scoring method to assess the children with HFMD can identify critical ill cases as early as possible.Corresponding intervention delivering in time may improve the outcome.It is proved to have positive clinical value to increase the survival rate,decrease the incidence of neurological sequel and the mortality of critical ill HFMD cases,and is worthy of clinical application in pediatric department.
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Development of aviation biofuels has attracted great attention worldwide because that the shortage of fossil resources has become more and more serious. In the present paper, the development background, synthesis technologies, current application status and existing problems of aviation biofuels were reviewed. Several preparation routes of aviation biofuels were described, including Fischer-Tropsch process, catalytic hydrogenation and catalytic cracking of bio-oil. The status of flight tests and commercial operation were also introduced. Finally the problems for development and application of aviation biofuels were stated, and some accommodation were proposed.
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Aviation , Methods , Biofuels , Chemistry Techniques, Synthetic , MethodsABSTRACT
Objective To observe the toxic effect of the mixture of organophosphorus pesticide (MOP) on maternal rats and on the growth and development of their offspring. Methods Totally 40 Sprague-Dawley pregnant rats were randomly divided into three MOP dose groups and one control to which their offspring would be assigned. The experimental dosage of MOP and distilled water were administered orally starting on gestation day 15 and continued for 35 days. The physical development indices and the learning ability of F1 rats were measured during lactation. The pathological changes of uterus and liver of F0 rats were observed after weaning, while the weight ratio of uterus and some viscera to body of the F1 were examined. Results There were obvious changes of uterus and liver in the high-dose group of F0. The body-weight accretion of the F1 in high-dose group was obviously lower than that in control group (P<0.05). Some of the MOP F1 rats development indices delayed significantly (P<0.05), the learning ability decreased obviously, and the time of setting up memory prolonged (P<0.05). The ratio of the uterus weight to body-weight in the F1 MOP groups was significantly higher than that in control group (P<0.05). Conclusion The experiment doses of MOP are proved to have significant reproductive toxicity on perinatal rats.