Flipped classroom in physical therapist education: a systematic review / 中国康复理论与实践

@#Objective To systematically summarize the effect of flipped classroom (FC) in physiotherapy teaching.Methods The following electronic bibliographic databases were searched from inception to June, 2021: CENTRAL, Medline, EMBASE, CINAHL plus, Academic Search Premier, Teacher Reference Center, ERIC, and Education Research. Original researches about FC for physiotherapy teaching were searched. The researches were screened, selected, extracted and assessed independently by two researchers, and, systematically reviewed.Results and Conclusion A total of 1 307 literatures were retrieved, and seven studies involving at least 770 student participants were finally included, which published mainly from 2013 to 2019. The subjects were students majored in physiotherapy, and the primary outcome index was exam results. FC teaching model generally can improve students' written test scores and enhance their high-level thinking ability. Students and teachers generally hold a positive attitude towards the FC teaching model.

Influence of teachers' role change on simulation teaching effect of bone marrow puncture / 中华医学教育探索杂志

Objective:To explore the reform and practice of bone marrow puncture simulation teaching to improve the learning ability of undergraduates.Methods:In this study, 112 students in Shengjing Hospital Affiliated to China Medical University were selected and divided into experimental group and control group. The control group received routine bone marrow puncture teaching and training, and the experimental group received bone marrow puncture teaching and training mainly to improve the students' practical ability. Evaluation indicators were teaching effect and teaching satisfaction. SPSS 22.0 was conducted for chi-square test and t test. Results:The students in the experimental group were better than those in the control group in preoperative preparation, puncture site selection, operation methods, precautions and understanding of examiner's questions ( P < 0.001), and the students in the experimental group were more satisfied with course design, classroom interaction, increasing learning interest and improving the mastery of operation skills than those in the control group were ( P < 0.001). Conclusion:The role change of teachers and the simulation teaching of bone marrow puncture to improve the practical ability of undergraduates increases the students' enthusiasm for learning the operation of bone marrow puncture, improves the quality of teaching and the students' operation skills of bone marrow puncture, and promotes the comprehensive development of students, which is worthy of further promotion.

Solitary fibrous tumor/hemangiopericytoma of central nervous system: a clinicopathologic analysis of 71 cases / 中华病理学杂志

Objective@#As solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) share the same molecular genetics features, the 2016 WHO classification of central nervous system (CNS) tumors had created the combined term SFT/HPC and assigns three grades. This study aims to investigate the clinicopathologic characteristics, diagnosis, differential diagnosis and prognosis of CNS SFT/HPC.@*Methods@#Seventy-one cases of CNS SFT and HPC were retrospectively reclassified and studied. Histopathological, immunohistochemical and imaging features were analyzed. The follow-up data were analyzed.@*Results@#There were 37 male and 34 female patients. The median age was 48 years (range, 3-77 years). Twelve cases (17%) were WHO grade Ⅰ, 26 (37%) were WHO grade Ⅱ and 33 (46%) were WHO grade Ⅲ. Microscopically the tumor could show traditional SFT phenotype, HPC phenotype or mixed phenotype. Immunochemically, 97%(69/71) were positive for STAT6, with 96%(66/69)showing diffuse strong staining. Approximately 90% were diffusely positive for bcl-2, CD99 and vimentin. The expression rate of CD34 decreased with increasing tumor grade, and the mean expression rate was 78%. SSTR2a was variably expressed in 10% (7/71) of cases including one case showing strong cytoplasmic staining. A few cases expressed EMA, CD57 and S-100 focally. The Ki-67 index ranged from 1% to 50%. Thirty four patients were followed up for 8-130 months; 12 patients(35%)had recurrences, and two (6%) had liver metastases.@*Conclusions@#CNS SFT/HPC is relatively uncommon. There was significant morphological overlap or transition between different grades. STAT6 is a specific marker for the diagnosis of this tumor. Surgical resection is the preferred treatment. WHO grade Ⅱ and Ⅲ SFT/HPC show rates of local recurrence and systemic metastasis, with liver being the most common site of extracranial metastasis.

Correlation between Expression of Inducible Nitric Oxide Synthase and Neural Cell Apoptosis after Chronic Compression of Cauda Equina Nerve in Rats / 中国医科大学学报

Objective To study the relationship between the expression of inducible nitric oxide synthase(iNOS)and neural cell apoptosis after chronic cauda equina compression. Methods Totally 30 male adult SD rats were randomly divided into 2 groups as the control group and the experi?mental group. The control group received sham operation with single laminectomy of L5 lumina. In the experimental group,the silicon sheet was in?serted into the spinal canal of L4 to cause single level compression of cauda equina. The L4 level of spinal cords were harvested at 2 weeks,4 weeks,8 weeks,and 12 weeks after operation in the experimental group,and at 4 weeks in the control group respectively,and then immunohistochemistry and image analysis were performed to observe the expression of iNOS in spinal cord and the TUNEL method was applied to observe cell apoptosis. The morphology of cells was observed by transmission electron microscope. Results There was few amount of iNOS expressed in the control group. The expression of iNOS was slight at 4 weeks in the experimental group and was higher at 8 weeks and 12 weeks compared with the control group. Small amount of neural cell apoptosis was evidenced in the control group,while neuron apoptosis appeared remarkably in the experimental group since 4 weeks and increased with the extension of time. Transmission electron microscopy found apoptosis changes in neurons in the experimental group. Conclusion The expression of iNOS increases in corresponding spinal cords after chronic compression of cuada equine and neural cell apoptosis oc?curs,indicating that iNOS is positively correlated with neural cell apoptosis.

Clinicopathological significance of D2-40 expression in craniopharyngioma / 临床与实验病理学杂志

Purpose To investigate the expression pattern and c1inicopatho1ogica1 significance of D2-40 in craniopharyngioma( CP). Methods Immunohistochemica1 method was used to assess D2-40 expression in 126 cases of craniopharyngioma. Statistic software was used to ana1yze the corre1ation between D2-40 expression and c1inicopatho1ogica1 features. Results The overa11 positive rate of D2-40 expression in 126 craniopharyngioma was 87. 30%. The rate of +, and  were 44. 44%( 56/126 ),37. 30%( 47/126 )and 5. 56%(7/126)respective1y. In adamantinomatous CPs,D2-40 expression was observed in epithe1ia1 components corresponding to the stratum intermedium,whi1e in papi11ary CPs,it was immuno-positive in basa1 ce11s. With the increasing of the existence of inf1amma-tion in tumor,D2-40 expression was up-regu1ated. Tumor ce11s were over-expressed for D2-40 in basa1 ce11s and stratum intermedium ce11s of the invasive frontier. D2-40 expression was higher in the invasive craniopharyngioma than in the non-invasive craniopharyngio-ma. In addition,D2-40 expression was higher in the recurrent craniopharyngioma than in the non-recurrent craniopharyngioma. There were no significant re1ationship between D2-40 expression and gender,and histo1ogica1 c1assification of tumors. Conclusions D2-40 expression is associated with the deve1opment of craniopharyngioma,which can 1ead to enhance the tumor ce11 invasion,and may be re-1ated to inf1ammation-re1ated mechanisms. D2-40 expression may be one of the recurrence factors in patients with craniopharyngioma.

The finite element analysis of polyetheretherketone/hydroxyapatite/carbon fiber cage / 生物医学工程学杂志

To compare the bio-mechanical characteristics of cages of two types, i. e., polyetheretherketone/ hydroxyapatite/carbon fiber (PEEK/HA/CF) and titanium combined with internal pedicle screw fixation in lumbar model, and to provide experimental evidences for clinical application, we constructed a three-dimensional finite element model of an intact L2-L4 segment by using computer tomography scans of a healthy male. The three-dimensional finite element models of an intact L2-L4 segment and single cage plus bilateral vertebral pedicle screw fixation were established. The angular motion of fused segment and stress distribution in the bone graft and cage and L3 inferior endplate under different loads were recorded. The result showed that the peak Von Mises stresses of the bone graft of PEEK/HA/CF group were at least 2.2 time as that of titanium group. The peak Von Mises stresses of L3 inferior endplate of the titanium group were at least 2. 3 times as that of PEEK/HA/CF group. These stresses were concentrated at places where the cage interfaced with the endplate. The angular variation of the titanium group showed similarity to PEEK/HA/CF group. The PEEK/HA/CF cage could provide stability similar to that of titanium cage in the presence of posterior instrumentation. It could increase the load transfer through the bone graft and promote the bone fusion. It could also reduce the stresses in endplates adjacent to the cage and reduce the subsidence of the cage.

Research on the extracorporeal cytocompatibility of a composite of HA, carbon fiber and polyetheretherket-one / 生物医学工程学杂志

The present research was to study the biocompatibility of a composite of hydroxyapatite (HA), carbon fiber (CF) and polyetheretherket-one (PEEK) by co-culturing with the osteoblasts in vitro. Cell relative growth (RGR) was used as a quantitative assessment for cytotoxicity of the biomaterials by CCK-8. The proliferation index of the co-cultured cells and ALP activity was measured to study the effect of PEEK-HA-CF composites. Morphological properties of the osteoblast cells in vitro were observed by scanning electro-microscopy (SEM). The PEEK-HA-CF materials have no cytotoxicity to osteoblasts. The proliferation index of PEEK-HA-CF was higher than that of Ti alloy group, but these was no significant difference compared to that of control group. The ALP activity was the highest on PEEK-HA-CF composites surface after 7 days. The osteoblast cells co-cultured with the PEEK-HA-CF composite were adhered well to the biomaterial as observed under the SEM. The results suggested that the PEEK-HA-CF composites had good biocompatibility in vitro and might be a novel orthopedic implanted material.

BMP-2 gene carried by biodegradable scaffold and fibrinous gel for repairing segmental radial defect in rabbit / 生物医学工程学杂志

Adenovirus carrying BMP-2 gene, after being mixed with fibrinous gel, was siphoned off on biodegradable scaffolds (PLA/PCL). The composite was used to repair 1.5 cm long radius defect in rabbits. Four methods were in use in the experiments: Ad-BMP-2 plus fibrinous gel and PLA/PCL (Group A), reconstructed hBMP-2 plus fibrinous gel and PLA/PCL (Group B), Ad-Lacz plus fibrinous gel and PLA/PCL (Group C), and fibrinous gel and PLA/PCL (Group D). Results showed that the defects treated in Group A were repaired with much more new bone regenerated, bridged earlier and stronger than those in Group B 12 weeks after operation. The defects treated in the other two groups could not attain osseous tissue healing. BMP-2 gene carried by biodegradable scaffold and fibrinous gel is easy to conduct and has very strong osteoinduction ability. It is really a good method to repair segmental bone defects.

Finite element modeling of lumbar spine and study on its biodynamics / 生物医学工程学杂志

A detailed three-dimensional nonlinear finite element model of lumbar segment L3-L5 was developed to investigate the influence of vibration on the components of human spine. The results show that the vibration effects of different spinal components are not exactly the same, and the stress near the posterior region of L4-L5 annulus is higher than that of its anterior region. The vibration exerts a great influence on the facet joint of L4-L5 segment. The changing amplitudes of stress and deformation of spine reduce by 50% on the condition that the damping ratio is 0.08.

Effects of Simulated Environment of Spaceflight on Phonetic Features of Speech / 航天医学与医学工程

Objective To study changes of phonetic features of mandarin speech when the talker is in stressed environment of spaceflight.Methods The mandarin speech database was established from volunteers speech in 72 h psychological isolation & sleep deprivation experiment,60 d head-down-tilt bed-rest experiment and 60 d sealed module experiment.The phonetic features were fundamental frequency,syllable duration and short-term energy of speech.Results In above three kinds of stressed environments,the changes of fundamental frequency were correlated with appearance of annoyance emotion of volunteers.But changes of syllable duration and short-term energy were related to different time points during experiments.Conclusion According to the findings,acoustic changes of speech under simulated environment of spaceflight may provide important reference to the study of emotional speech recognition in spaceflight for the future.

Oligonucleotide Hybridization Detection Based on Surface Plasmon Resonance Technology / 航天医学与医学工程

Objective To establish a kind of detection technique of nucleic acid based on surface plasmon resonance(SPR) and to set up the foundation of real-time, online space microbial detection. Methods A portable online bio-molecules analyzer based on SPR biosensor was applied. The probe was mercapto-modified at the 5’ end and immobilized on the sensor surface. Then the target sequences in the solution were monitored and sensitivity, specificity and reproducibility of the method were investigated. Results The results showed that detection method with good specificity and sensitivity could realize online detection of target sequence. The system could detect 2.3 nmol/L target sequence, CV value of nine detections was 3.5% and that of thirty detections was 14.7%. Conclusion The established nucleic acid detection method has the advantage of high sensitivity, good specificity and reproducibility, which can be applied in the field of nucleic acid detection.

The treatment of traumatic thoracolumbar dislocation with interbody compression fusion using pedicle screw system / 中华骨科杂志

Objective To investigate the efficacy of one-stage posterior procedure including reduction, segmental instrumentation, foraminal enlargement and interbody compressive fusion in treating traumatic thoracolumbar fracture and dislocation. Methods 17 patients, which were 11 males and 6 females with a mean age of 37.1 years (range, 23-56 years) were recruited. The injury mechanism consisted of motor vehicle accident, falling from the height and horizontal compression crash. The preoperation neurological function were complete paraplegia in 4 cases, and incomplete paraplegia in 13 cases. Laminectomy and bilateral partial facetectomies were performed in injuried levels to free the nerve roots, followed by intervertebral foraminal enlargement and distraction through inserted pedicle screws. Intervertebral disc including upper and lower endplate were removed with rongeur, and morselized cancellous bone were fulfilled into cavity. Reduction and interbody compressive fusion were achieved through compression on the segmental pedicle screw system to make contact the posterior wall of adjacent vertebrae. Results No intraoperative and postoperative complications were observed. All patients except one underwent successful follow-up for an average of 25.6 months, ranging from 19 to 37 months. The neurological function of the patients were restored partially or complete during follow-up. The thoracolumbar spine were stable during physical examination, and all patients were satisfied with surgery. Radiographic evaluation showed close conjunction of adjacent posterior edges of vertebral body in 12 cases, and all cases demonstrated solid bony fusion without loss of reduction. No implant failure or neurological complication were found during follow-up. Conclusion Interbody compressive fusion by pedicle screws with foraminal enlargement procedure is a reliable and effective method in the management of thoracolumbar fracture and dislocation, which can achieve early stabilization and interbody bony fusion.