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Objective:To investigate the application value of WeChat-based problem-based learning teaching method combined with micro-classroom in the teaching of contrast-enhanced gastrointestinal ultrasound imaging for residents in standardized residency training.Methods:A total of 40 trainees who underwent the standardized residency training in the Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University from January 2019 to June 2021 were selected as the research objects. They were randomly divided into the experimental group (WeChat-based PBL teaching method combined with micro-classroom) and the control group (traditional teaching method). The teaching content was the diagnosis of gastrointestinal ultrasound imaging. After the theoretical learning and practice, assessments of contrast-enhanced gastrointestinal ultrasound imaging including theory and operating practice were performed to all students. SPSS 22.0 was used for t test and rank sum test.Results:After training, the theoretical test scores of the experimental group were higher than those of the control group [(93.09±2.31) vs. (90.63±2.26)], and the difference was statistically significant ( P<0.05). However, there was no significant difference between the two groups in the number distribution of students at all levels of operational practice ( P>0.05). Conclusion:The WeChat-based PBL teaching method combined with micro-classroom is beneficial to improve students' knowledge of contrast-enhanced gastrointestinal ultrasound imaging, and is worth being popularized and applied in clinical teaching.
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Objective:To comprehensively understand the current situation of outpatient management in tertiary medical institutions in Anhui Province under the COVID-19 epidemic, and to provide empirical reference for effective prevention and control of the epidemic.Methods:In December 2020, a stratified cluster sampling method was used to investigate and score the current situation of outpatient management in 56 tertiary medical institutions in Anhui Province. The survey content included four dimensions: appointment and triage setting and management, fever clinic setting and management, nosocomial infection prevention and control management, and medical resource storage management. The scoring results were divided into three grades, namely " good" (total score≥90 points), " acceptable" (85≤total score<90 points)and " inadequate" (total score<85 points). SPSS 21.0 software was used for data statistical analysis. Independent sample t-test was used to compare the outpatient setting and management scores of medical institutions, and the proportion of assessment grades was used chi-square inspection.Results:The outpatient setting and management of 56 tertiary medical institutions in Anhui Province were evaluated as good in 36, acceptable in 6 and inadequate in 14. The outpatient setting and management score was(81.55±24.94), including(16.53±2.66)in " appointment and triage setting and management" , (47.62±19.60) in " fever clinic setting and management" , (8.69±1.44)in " nosocomial infection prevention and control management" , and (8.75±3.02) in " medical resource storage management" . The total scores and four dimension scores of 39 general hospitals were higher than those of 17 specialized hospitals, and the differences were significant( P<0.05). Conclusions:The overall situation of outpatient epidemic prevention and control management in tertiary medical institutions in Anhui Province is good, but the construction and control of specialized hospitals need to be further strengthened.
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@#Left ventricular outflow tract obstruction (LVOTO) in Ebstein's anomaly is a rare complication, and LVOTO related to surgery is rarer. We present a 46 years old female patient who was dignosed with Ebstein's anomaly, then suffered from cardiac arrest because of LVOTO secondary to cone reconstruction in ICU.
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OBJECTIVE@#To analyze the molecular genetics of a Chinese pedigree with congenital hand foot cleft.@*METHODS@#Single nucleotide polymorphism microarray (SNP array) was used to analyze the whole genome copy number variation.@*RESULTS@#SNP array analysis showed that there was a 433 kb repeat in 10q24.31-10q24.32 region, which contained LBX1, BTRC, POLL, OPCD and FBXW4 genes.@*CONCLUSION@#Microduplication of chromosome 10q24.31-10q24.32 may be the cause of congenital hand foot cleft in this pedigree.
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Humans , China , DNA Copy Number Variations/genetics , Foot Deformities, Congenital/genetics , Hand Deformities, Congenital/genetics , PedigreeABSTRACT
Objective:To compare the effects of bubroscopolamine combined with diclofenac on pain relief and recurrence in patients with stone-forming renal colic.Methods:From December 2016 to December 2018, 86 cases of calculus renal colic were selected.According to random number table method, the patients were randomly divided into control group and observation group, with 43 cases in each group.Both two groups were given plenty of antimicrobial agents and static drops of butyl bromide scopolamine treatment, the control group was intramuscularly injected diclofenac sodium, while the observation group was rectally administered diclofenac sodium suppositories.The pain relief of the two groups was observed, and the incidence of adverse reactions and clinical efficacy of the two groups were compared.Results:After 0.5 h of treatment, the total effective rate of pain relief in the control group was 88.37%(38/43), which was significantly higher than 48.84%(21/43) in the observation group (χ 2=8.384, P<0.05). The VAS score of the observation group was (2.62±1.02)points, which was significantly lower than that of the control group[(4.21±0.84)points]( t=4.394, P<0.05). After 1 h of treatment, there were no statistically significant differences in the total effective rate of pain relief and VAS score between the two groups (all P>0.05). The incidence and recurrence rates of adverse reactions in the control group were 18.60%(8/43) and 20.93%(9/43), respectively, which were significantly higher than those in the observation group [4.65%(2/43) and 4.65%(2/43), χ 2=7.394, 8.769, all P<0.05]. There was no statistically significant difference in pain relief between the two groups after secondary treatment (all P>0.05). Conclusion:The analgesic effect of intramuscular injection of diclofenac sodium is significantly faster than rectal administration in patients with stone renal colic, but the adverse reactions of this method are more and the curative effect lasted for a short time.Rectal administration of diclofenac sodium suppository is safe and stable for patients with stone renal colic, so it is worthy of popularizing in clinic.
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OBJECTIVE@#To explore the clinical and genetic characteristics of a patient with 17-hydroxylase/17,20-lyase deficiency.@*METHODS@#The patient was infertile without contraception. Laboratory examination showed her chromosomal karyotype to be 46, XX. DNA sequencing was performed to detect variants of CYP17A1 gene in the patient and her family members.@*RESULTS@#Sanger sequencing revealed that the patient has carried homozygous variant c.1486C>T in the exon 8 of the CYP17A1 gene, which resulted in substitution of arginine by cysteine (p.Arg496Cys). Her family members were all heterozygotes for the same variant.@*CONCLUSION@#Homozygous variant of the CYP17A1 gene c.1486C>T probably underlay the 17-hydroxylase deficiency in this patient. Above finding has enabled accurate genetic counseling and prenatal diagnosis for her family.
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Dust mites are one of the most common inhalant allergens in the world.The prevalence of dust mite allergy is on the rise in the worldwide,it is a chronic worldwide health problem that seriously affects the work,study and daily life of patients.This review demonstrates the allergic diseases caused by dust mite,the sensitized protein components of the dust mite and the research progress of allergen-specific immunotherapy,and the application of anti-IgE monoclonal antibodies to IgE-mediated allergic reactions is also briefly described.
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OBJECTIVE To invest igate the correlation between fractional exhaled nitric oxide(FeNO) and lung function in artemisia argyi allergy patients. Whether the course of disease and rhinitis score are correlated with FeNO and lung function. METHODS A total of 88 patients with mugwort pollen allergy, who visited the hospital between August and September 2017 and August and September 2018, the results of their FeNO and Pulmonary ventilation function, were included in this study. RESULTS Compared with patients with a duration of 9 years or more, FeNO and FEV1％ of patients with a duration of 5 years were significantly different(P =0.004, P =0.032), and FeNO increased with the extension of the duration, while FEV1％ decreased gradually. FeNO was negatively correlated with FEF25％-75％pred and FEV1％, while there was no correlation with FEV1％pred. Rhinitis score was positively correlated with FeNO. There was no correlation with FEV1％pred, FEV1％, FEF25％-75％pred. CONCLUSION With the development of mugwort pollen allergy, the probability of airflow limitation is also increased. To some extent, FeNO can predict the changes of airway function early, and can be used as a monitoring indicator for asthma prediction.FeNO value can reflect the degree of inflammation of the body, and can be used in the auxiliary diagnosis of the severity of allergic rhinitis patients.
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OBJECTIVE; To improve the PIVAS quality management, reduce dispensing error and promote the safety of drug use.METHODS: The quality control circle (QCC) was used for quality management in PIVAS of our hospital. The reasons for dispensing errors were analyzed to determine the key improvement points using "the reduction of dispensing error of admixture drugs" as theme. Improvement plan was formulated, and effective countermeasures were determined by PDCA (Plan, Do, Check, Action) cycle management. The tangible results (the rate of dispensing errors) and intangible results were compared before (Feb. 2016) and after QCC (Aug. 2016). RESULTS: Some effective measures were formulated and implemented, including unified arrangement, introducing PIVAS MATE process management software, personnel post training, refining drug withdrawal management, visual management, etc. The tangible results included the rate of dispensing error decreased from 1. 81‰ to 0. 53‰; the rate of goal achievement reached 108. 47％; the rate of target progress was 70. 72％. The intangible results included optimizing drug dispensing process, standardizing drug withdrawal systent and personal training system. Those achievement improved confidence, responsibility, sense of cooperation and cohesiveness of QCC members. Additional result was obtained, i. e. utility model patent for avoiding light storage box. CONCLUSIONS: QCC can effectively improve the management quality of PIVAS workflow and the safety of intravenous medication.
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Objective To compare the evaluation of care behaviors among inpatients and nurses, in order to know the implementation of caring behavior from different perspectives, and to provide evidence for better humanistic care in hospitals. Methods The nurses' humanistic practice ability scale and the caring behavior scale were used to investigate 160 nurses and inpatients respectively in The Third Affiliated Hospital of Southern Medical University. Results The total score of nurses' self rating for caring behavior was (4.15 ± 0.58) points, while the score of self-management ability was lowest, which was (3.84 ± 0.67) points;and the total score of nurses' caring behaviors was (3.49 ± 0.92) points, while the lowest scoring dimensions were respect and connection (3.42 ± 0.95) points. Nurses and patients both feel better at basic care (such as meeting basic needs, providing good environment), psychological care (such as giving support and) and professional care (such as health education), but both of them think that nurses did not do good enough in the provision of high-level emotional needs (such as diversified care, spiritual sustenance)and participation in nursing programmes. Conclusions The evaluation of nursing caring behavior is in the middle and upper level, which shown that the nurses have certain humanistic care and practical ability in clinical practice, and have been recognized by patients, but there is still a lot of room for improvement, and suggested that nursing administrators should give nurses enough respect and consideration while considering patients.
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Immunosuppression plays a vital role in the pathophysiological mechanism of sepsis, and it is the main cause of death in patients with sepsis during the later phase. Sepsis induced immunosuppression is gradually recognized. Its underlying mechanisms involve immune cell apoptosis, autophagy, cell metabolism reprogramming, endotoxin tolerance, central nervous system regulation, and epigenetic regulation. New approaches that target the host immune response and reconstruct the immune balance are the keys to improve the prognosis of patients with sepsis. With the help of immune status monitor, novel immunomodulatory agents, such as thymosin α1, γ- interferon (IFN-γ), interleukin-7 (IL-7), granulocyte-macrophage colony stimulating factor (GM-CSF) and anti-programmed death receptor 1 (PD-1) antibody, are expected to become a new strategy for the treatment of sepsis in future.
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Objective:To study the inhibitory effect of human embryonic stem cells on the HepG2 cells in vitro.Methods:The co-culture system of Human embryonic stem cells (H9) and liver cancer HepG2 cells was established.The effect of H9 on the biological behavior of HepG2 cells was observed by microscope,the flow cytometry was used to detcct the apoptosis of tumor cells and the cell cycle alteration.Transwell assay was used to detect the migration and invasion of tumor cells.Gene microarray technique was used to examine the change of gene expression profile of HepG2 cells.Results:In the process of co-culture,the growth of hepatoma cells was inhibited.With the extension of the culture time,cells decreased gradually,and occurred signs of aging or apoptosis.Flow cytometry test results showed that the apoptosis rate of hepatoma ceils was significantly increased,and the cell cycle was blocked in the G0/G1 phase.Transwell test results showed that the invasion and migration of HepG2 cells were decreased.The gene chip results showed that the whole genome expression profile of HepG2 cells had a significant change.Conclusion:The human embryonic stem cells had an inhibitory effect on HepG2 cells in vitro.
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Objective:To investigate the expression and the significance of inflammatory cytokine IL-6 through regulating Gli1 in acute pancreatitis.Methods: In this study,C57 mice were randomly divided into three groups:control group,model group,inhibitor group.caerulein intraperitoneal injection induce acute pancreatitis model.Use HE staining and amylase to testify the model successfully.Use RT-qPCR,Western blot to detect the expression of Gli1 in the pancreas,liver,lung,kidney and intestine and ELISA method to detect inflammatory cytokines IL-6.Results: Compared with control group,the expression of Gli1 is higher in model group,then the expression of IL-6 increases in inhibitor group which uses Gant61 to suppress Gli1 compared with model group.Conclusion: Gli1 may involved in the process of the distant tissue injury and repair in acute pancreatitis and through regulate its downstream cytokines like IL-6 to play a protective role in acute pancreatitis.
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Objective To investigate the role of apoptosis and the regulating role of receptor interacting protein 1(RIP1) in acute pancreatitis .Methods Thirty C57 mice were divided into three groups :control group ,acute edematous pancreatitis (AEP) group and acute necrotizing pancreatitis (ANP) group .The AEP group was continuously injected by cerulein 50 μg/kg for 13 times ,the ANP group was continuously injected by cerulein 50μg/kg for 13 times and lipopolysaccharide 15 mg/kg once;the con‐trol group was injected by the same volume of normal saline for 7 times .The acinar cell apoptosis was observed by the terminal de‐oxynucleotidyl transferase‐mediated deoxyuridine triphosphate nick‐end labeling (TUNEL) assay .The RIP1 mRNA expression was measured by real time fluorescence PCR .The expression of RIP1 protein was detected by Western blotting .Results The mouse models of AEP and ANP were established successfully .Compared with the control group ,acinar cell apoptosis existed in both AEP and ANP model groups ,moreover compared with the AEP group ,apoptosis in the ANP group were decreased ,the differences were statistically significant(P<0 .05) .Compared with the control group ,the expression of RIP1 mRNA and protein in the AEP group was increased ,while which in the ANP group were decreased ,the differences were statistically significant(P<0 .05) .Conclusion RIP1 participate in the pathogenesis of acute pancreatitis ,which may associate with acinar cell apoptosis .
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Objective To investigate the changes of protein and energy intakes and the z-score of weight for age in appropriate for gestational age (AGA) and small for gestational age (SGA) preterm infants with gestational age less than 34 weeks. Methods The data from 314 hospitalized premature infants ( 268 cases of AGA and 46 cases of SGA) during January 2012 to December 2014 were retrospectively collected. The intakes of protein and energy and the changes of weight within 2 weeks after birth were compared. Results Compared with AGA group, the hospital stays, durations of parenteral and enteral nutrition and total enteral nutrition, and time to achieve full dose feeding were signiifcantly longer in SGA group (P?
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Objective To explore the differences in clinical and pathological characteristics of idiopathic membranous nephropathy between elderly and non elderly patients.Methods The clinical and pathological data,which were used for biopsy diagnosing idiopathic membranous nephropathy in elderly patients (aged ≥65 years) versus non elderly patients (aged ＜65 years) in our hospital during the recently 10 years,were retrospectively analyzed and compared.Results The elderly patients with idiopathic membranous nephropathy accounted for 26.29％ and patients aged less than 45 years with idiopathic membranous nephropathy accounted for 25.26％.The proportions of idiopathic membranous nephropathy in the two different age groups were similar.The occurrence rate of hypertension and microscopic hematuria as well as levels of blood serum creatinine and urinary N-acetyl-β-D-glucosaminidase were higher,while the urinary osmotic pressure,estimated glomerular filtration rate (eGFR) and blood albumin were lower in elderly group than in non-elderly group (all P＜0.05).The proportions of glomerulosclerosis,tubulointerstitial lesions and vascular lesions were higher in elderly group than in non-elderly patients (all P＜ 0.05).There were no significant differences in the immunofluorescence intensity of IgG,positive rates of IgA,C3,C4 and Fi between the two groups,while the positive rate of C1q was lower in elderly group than in non elderly.Among 51 patients receiving IgG4 immunohistochemical staining,the positive rate of IgG4 staining and the intensity were higher in elderly group than in non-elderly [100.00％ vs.81.25％,(2.11±0.46) vs.(1.59 ± 0.95),both P ＜ 0.05].Conclusions The proportion of idiopathic membranous nephropathy is increased in non-elderly patients.Elderly patients are more susceptible to hypertension,hematuria and renal dysfunction.The positive rate and the intensity of IgG4 are higher and the positive rate of C1q is lower in elderly group than in non-elderly group,which indicate that patients with negative IgG4 and positive C1q have secondary causes which have not yet been demonstrated,and they should be closely observed during the follow-up.
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Objective To investigate the association of cysteine aspartic acid specific protease 8 (CASP 8) gene-652 6N Insertion/Deletion polymorphisms and susceptibility of type 2 diabetes mellitus (T2DM). Methods CASP 8 gene -652 6N I/D polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism and DNA sequencing in 414 controls and 410 patients with T2DM. Results I/I, I/D and D/D genotype frequency were 56.5%, 38.9%, 4.6%in controls and 58.0%, 32.9%, 9.0%in T2DM group respectively (P<0.05). The risk in D/D genotype people was 1.916 times than I/I genotype (adjusted OR=1.916, 95%CI=1.199~3.054, P<0.05). The fasting blood sugar of D/D genotype people was significantly higher than that of I/D and I/I genotype people (P<0.05). Conclusions CASP 8 gene-652 6N I/D polymorphisms are associated with T2DM outbreak.
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Requirement for Medical English teaching in physical medicine physicians training has been on the agenda to fit the new condition of globalization. According to the development of physical medicine in China and students English level, courses of medical English were set to match the requirements of both scientific research and clinic works. We try to improve students' medical English level through lectures in multimedia classroom and a lot of practical activities after class.
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<p><b>OBJECTIVE</b>To study the chemical constituents from the root barks of Morus atropurpurea.</p><p><b>METHOD</b>The chemical constituents from the 70% ethanol extract of M. atropurpurea were isolated and purified by column chromatographic methods. Their structures were identified by physico-chemical properties as well as spectral data.</p><p><b>RESULT</b>Fifteen compounds were isolated and identified as sanggenol O(1), kuwanon S(2), moracin C(3), mulberrofuran A(4), mulberrofuran B(5), mulberrofuran C(6), mulberrofuran G(7), mulberroside A(8), mulberroside C(9), 1-deoxynojirimycin(10), 2-O-alpha-D-galactopyranosyl-1-deoxynojirimycin(11), fagomine(12), betulinic acid(13), ursolic acid(14) and beta-sitosterol(15).</p><p><b>CONCLUSION</b>Compounds 1-6 and 8-13 were isolated from M. atropurpurea for the first time.</p>
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Molecular Structure , Morus , Chemistry , Plant Extracts , Chemistry , Plant Roots , ChemistryABSTRACT
This study was aimed at exploring the high intensity focused ultrasound(HIFU) therapeutic dosimetry and its biologic effect. In-vitro, bovine liver was immersed into 0.9% NS and degassed for application. The JC Model-focused ultrasound tumor therapeutic system was used in the experiment. The HIFU parameters were: frequency 1.6 MHz, depth 20 mm, acoustic power from 16.44 W to 196.32 W. Under each power, at radiating times from is to 20 s, bioptic specimens were obtained from all samples. The results showed when the acoustic power was equal to or higher than 179.96 W, only is of radiating is adequate to induce coagulative necrosis, and when the acoustic power was lower than 65.44 W, the radiating time to produce coagulative necrosis was about 7 s. In the range of 65.44-179.96 W, at each time when the acoustic power was set up with an increment of 16.36 W, the time to produce coagulative necrosis was 1-2 s shorter. The form of biological focal region (BFR) varied with the acoustic power and HIFU irradiation time. The size of BFR increased with the increase of HIFU irradiation dosage (acoustic power x exposure time). There is positive correlation between the size of BFR and the dosage of HIFU irradiation (y = 0.0164x(1.05591), R5 = 0.9238, P < 0.05).