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Comprehensive improvement in course teaching quality is an important link in deepening the reform of undergraduate education and teaching. Since 2018, West China Medical School, Sichuan University, has implemented the collective lesson preparation system of "two meetings, seven decisions, and three preparation sessions" for undergraduate clinical courses, thereby effectively implementing subject cooperation, organizational guidance, and resource integration among clinical teachers and determining the key elements of the course through "teaching, learning, and exam preparations" before class. In the process of course operation, the concept of quality control based on plan-do-check-act cycle is deeply integrated with the collective lesson preparation system, and active implementation of the whole-process quality control loop of planning (plan), organization and implementation (do), inspection of results (check), and treatment and improvement (action) has effectively improved the teaching quality of undergraduate clinical courses.
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Abstract@#Flexibleis an important classification of flat foot. Flatfoot occurs due to a variety of reasons and causes the medial longitudinal arch to collapse or disappear. However, many children still do not develop a normal foot arch as the grow, and a failure to intervene in a timely manner will greatly harm a child s normal mobility development. Timely detection and intervention are the key to improve the prognosis. There is a lack of uniform quantitative criteria for the diagnosis of flexible flatfoot. Currently, the commonly used diagnostic methods include physical examination, foot printing, plantar pressure test and imaging examination. This article reviews the risk factors, diagnosis, prevention and treatment of Flexible Flatfoot.
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As a treasure resource of novel drug lead compounds, how to rapidly and high-efficiently screen and isolate active components from natural products is critical. Thanks to its high resolution, high automation and flexible integration, online two-dimensional liquid chromatography has great potential for screening active ingredients from complex matrices by integrating a highly specific bio-recognition process into a two-dimensional liquid chromatography system before, on or after the column separation. This review comprehensively summarized recent developments, applications and shortcomings of online two-dimensional liquid chromatography for natural product screening from different integration modes, including pre-column, on-column and post-column screening methods.
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Objective:To explore the differences of the resting-state functional connectivity(FC) between goal-directed network and habituation networks in patients with early- and late-onset obsessive compulsive disorder (OCD) and the correlation between the strength of FC in the differential brain regions and cognitive flexibility.Methods:From October 2019 to April 2021, 40 patients with OCD were included in this study, including 22 patients with early-onset OCD and 18 patients with late-onset OCD.The cognitive flexibility of all subjects was assessed using the Wisconsin card sorting test (WCST), the Stroop task and the trail making test (TMT). The brain regions which were associated with goal-directed network(caudate, orbitofrontal cortex, ventromedial prefrontal cortex, and anterior cingulate cortex) and the brain regions which were associated with habituation network(putamen, supplementary motor area and insula) were selected as FC regions of interest (ROI). The DPABI and SPM12 plug-ins in the matlab2011a platform were used for whole brain FC analysis to compare the difference of FC between patients with early-onset OCD and patients with late-onset OCD on the two networks.The data were analyzed by SPSS 25.0 with χ2 test, independent samples t-test, and Pearson correlation analysis. Results:Compared with patients with early-onset OCD, patients with late-onset OCD had significantly enhanced FC of the left supplementary motor area with the left putamen and left insula.The total number of persistent errors of WCST in patients with late-onset OCD was greater than that in patients with early-onset OCD ((20.61±11.30), (14.95±8.94), P<0.05). The FC of the left putamen-left supplementary motor area was significantly and positively correlated with the total number of sustained responses ( r=0.678, P=0.003) and the total number of incorrect responses ( r=0.590, P=0.013) in patients with late-onset OCD.The FC of the left supplementary motor area-left insula was significantly positively correlated with the number of responses required to complete the first classification in patients with late-onset OCD ( r=0.485, P=0.049). Conclusion:Patients with late-onset OCD have stronger habituation network FC than patients with early-onset OCD, and the enhanced FC correlates with patients' cognitive flexibility performance, while late-onset OCD has more impaired cognitive flexibility than early-onset OCD.
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Blood glucose monitoring is of great significance to diabetic patients, and the development of rapid, accurate and real-time glucose detection technology has become a research hotspot nowadays. This study introduces the concept and classification of the enzyme-free glucose sensor, expounds enzymefree glucose sensor electrode characterization methods and the application progress of different materials in enzyme-free blood glucose sensors. Meanwhile, some problems of enzyme-free glucose sensor existing in the current research and its future application prospects also will be discussed.
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Humans , Blood Glucose , Blood Glucose Self-Monitoring , Electrodes , Glucose , Monitoring, PhysiologicABSTRACT
Objective:To investigate the related risk factors related to patellar dislocation combined with osteochondral fracture (OCF).Methods:A case control study was conducted to analyze the clinical data of 278 patients with patellar dislocation admitted to Second Hospital of Lanzhou University from January 2016 to June 2020, including 98 males and 180 females; aged 12-41 years [(21.1±4.6)years]. The patients were divided into OCF group ( n=112) and non-OCF group ( n=166) according to the surgical records and occurrence of OCF or not under intraoperative arthroscopy. The data of the two groups were recorded, including basic characteristics (ie, sex, age, sides of injury, whether or not the epiphysis is closed), patella height, patellar inclination angle, tibial tubercle-trochlear groove (TT-TG), femoral trochlear shape, tibial lateral rotation angle and femoral anteversion angle. Univariate analysis was adopted to evaluate the correlation of the data with patellar dislocation combined with OCF. Multivariate Logistic regression analysis was used to determine the independent risk factors of patellar dislocation combined with OCF. Results:Univariate analysis showed that patellar dislocation combined with OCF was related to male, patellar inclination angle and femoral anteversion angle ( P<0.05 or 0.01), while not to age, epiphysis is closed or not, sides of injury, patella height, TT-TG, femoral trochlear shape and tibial lateral rotation angle (all P>0.05). Multivariate Logistic regression analysis showed that male ( OR=1.75, 95% CI 1.07-2.90, P<0.05) and increased femoral anteversion angle ( OR=3.12, 95% CI 1.89-5.17, P<0.05) were significantly correlated with patellar dislocation combined with OCF. Conclusion:Male and increased femoral anteversion angle are independent risk factors for patellar dislocation combined with OCF.
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italic>α-Glucosidase inhibitors play an important role in the treatment of diabetes. This study established a high-resolution bioassay profiling platform for rapidly screening α-glucosidase inhibitors in natural product extracts. Five α-glucosidase inhibitors were identified from Malus hupehensis, namely, 3-hydroxyphloridzin, quercetin-3-O-β-D-glucopyranoside, phloridzin, avicularin and quercitrin. The establishment and successful application of this platform provides a powerful tool for the efficient discovery of anti-diabetic active ingredients in complex systems.
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Sleep is a complex physiological process of great significance to physical and mental health, and its research scope involves multiple disciplines. At present, the quantitative analysis of sleep mainly relies on the "gold standard" of polysomnography (PSG). However, PSG has great interference to the human body and cannot reflect the hemodynamic status of the brain. Functional near infrared spectroscopy (fNIRS) is used in sleep research, which can not only meet the demand of low interference to human body, but also reflect the hemodynamics of brain. Therefore, this paper has collected and sorted out the related literatures about fNIRS used in sleep research, concluding sleep staging research, clinical sleep monitoring research, fatigue detection research, etc. This paper provides a theoretical reference for scholars who will use fNIRS for fatigue and sleep related research in the future. Moreover, this article concludes the limitation of existing studies and points out the possible development direction of fNIRS for sleep research, in the hope of providing reference for the study of sleep and cerebral hemodynamics.
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Humans , Brain/diagnostic imaging , Hemodynamics , Polysomnography , Sleep , Spectroscopy, Near-InfraredABSTRACT
Transcranial direct current stimulation (tDCS) is a non-invasive low-current brain stimulation technique, which is mainly based on the different polarity of electrode stimulation to make the activation threshold of neurons different, thereby regulating the excitability of the cerebral cortex. In this paper, healthy subjects were randomly divided into three groups: anodal stimulation group, cathodal stimulation group and sham stimulation group, with 5 subjects in each group. Then, the performance data of the three groups of subjects were recorded before and after stimulation to test their mental rotation ability, and resting state and task state electroencephalogram (EEG) data were collected. Finally, through comparative analysis of the behavioral data and EEG data of the three groups of subjects, the effect of electrical stimulation of different polarities on the three-dimensional mental rotation ability was explored. The results of the study found that the correct response time/accuracy rate and the accuracy rate performance of the anodal stimulation group were higher than those of the cathodal stimulation and sham stimulation groups, and there was a significant difference (
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Humans , Electric Stimulation , Electroencephalography , Frontal Lobe , Reaction Time , Transcranial Direct Current StimulationABSTRACT
OBJECTIVE@#To observe the curative effect of one-stage reconstruction of anterior cruciate ligament(ACL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL) in patients with KD-Ⅲ-M knee injury, and to compare the operation time, hospitalization cost and curative effect after arthroscopic reconstruction of PCL with LARS artificial ligament and autogenous hamstring tendon, ACL reconstruction with autogenous hamstring tendon and MCL repair combined with limited incision.@*METHODS@#From March 2016 to January 2019, a total of 36 patients met the criteria of this study. Twenty patients in group A were treated with autogenous hamstring tendon reconstruction of ACL and PCL and repair of MCL, including 17 males and 3 females, with an average age of (34.7±9.2) years old. Sixteen patients in group B with LARS artificial ligament reconstruction of PCL, with an autogenous hamstring tendon reconstruction of PCL and MCL repair as before as group B, including 15 males and 1 female, with an average age of (36.8±8.6) years old. The operation time, hospitalization time and total hospitalization cost were compared between the two groups. The preoperative and postoperative functions of the two groups were evaluated by Hospital for Sepcial Surgery (HSS) score and Lysholm score respectively, and the curative effects were compared within and between groups.@*RESULTS@#All the patients in the two groups were followed up for at least 1 year. There were no complications such as infection and poor wound healing in both groups. There was significant difference in operation time between (120.25±9.55) min in group A and (106.63±8.85) min in group B (@*CONCLUSION@#There was no significant difference in the average hospitalization days between the two groups, but the operation time in group A was longerthan that in group B, and the hospitalization cost in group B was higher than that in group A. There was no difference in HSS score and Lysholm score before and follow-up for a certain period of time after operation.
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Adult , Female , Humans , Male , Middle Aged , Anterior Cruciate Ligament/surgery , Anterior Cruciate Ligament Injuries/surgery , Arthroscopy , Hamstring Tendons/surgery , Knee Dislocation , Knee Joint/surgery , Posterior Cruciate Ligament/surgery , Posterior Cruciate Ligament Reconstruction , Treatment OutcomeABSTRACT
Since the outbreak of Novel Coronavirus Pneumonia(NCP), hospitals have taken the fight against the virus as its own responsibility, and keep standing in the front line of epidemic prevention and control. The continuous input of anti-epidemic forces in hospitals also brings challenges to the medical supplies support, including the management of protective supplies and the maintenance of medical equipment. In the face of increasing security pressure, the medical materials support team broke the game on multiple fronts. Firstly, the team implements active material procurement strategy, sets material distribution priority according to risk level, releases materials uniformly based on stock and use, and implements traceability management of donated materials to ensure material supply. Secondly, centralized allocation management of equipment, emergency installation, advanced maintenance and emergency maintenance work is effectively completed. Thirdly, disinfection strategies for items and equipment are developed safely and effectively with the aid of disinfection equipment functions. At last, personnel management and training have been strengthened. These measures have provided strong support for the orderly prevention and control of the epidemic.
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Natural products have been a major source of leading compounds in drug discovery. How to effectively screen active compounds from complex matrix remains an interesting topic. In this review, we comprehensively summarized advanced liquid chromatography based approaches in natural products screening, including pre-column, on-column and post-column screening methods. Their advantages, disadvantages and prospect are also discussed.
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Objective: To observe the effect of Baihu and Renshen Decoction on intestinal barrier and TLR4/NF-κB inflammatory signaling pathway in type 2 diabetes MKR mice. Methods: A total of 32 MKR mice were randomly divided into model group, low dose Baihu and Renshen Decoction group, high dose Baihu and Renshen Decoction group and metformin group after 4 weeks with the high-fat diet. Another eight FVB/N mice were served as control group. After 4-week intragastric administration, fasting blood glucose (FBG), oral glucose tolerance test (OGTT), the levels of interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and lipopolysaccharide (LPS) in serum were examined. The morphological changes of colon tissue were observed by hematoxylin-eosin (HE) staining. The mRNA expression of TLR4, NF-κB, ZO-1, Claudin-1 and Occludin were measured by qRT-PCR method. The protein expression of ZO-1, Claudin-1 and Occludin in colon were measured by Western blotting. Results: Compared with model group, FBG in each administration group were significantly decreased (P < 0.01), serum IL-6, IL-1β, TNF-α, LPS and TLR4, NF-κB mRNA expressions were decreased (P < 0.05, P < 0.01) in high dose Baihu and Renshen Decoction group and metformin group. The mucosal epithelium integrity was improved. The mRNA and protein expression levels of ZO-1, Claudin-1, Occludin were increased (P < 0.05, P < 0.01) in high dose Baihu and Renshen Decoction group and metformin group; The mRNA expression levels of ZO-1, Claudin-1, Occludin were increased (P < 0.05) in low dose Baihu and Renshen Decoction group, while protein expressions showed no statistical difference. Conclusion: Baihu and Renshen Decoction can consequently reduce the levels of LPS and pro-inflammatory cytokines in MKR mice, regulate TLR4/NF-κB signaling pathway. It can significantly improve insulin resistance and reduce blood glucose levels by improving endotoxaemia, ameliorating intestinal injury and attenuating inflammation.
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Cognitive enhancement refers to the technology of enhancing or expanding the cognitive and emotional abilities of people without psychosis based on relevant knowledge of neurobiology. The common methods of cognitive enhancement include transcranial direct current stimulation (tDCS) and cognitive training (CT). tDCS takes effect quickly, with a short effective time, while CT takes longer to work, requiring several weeks of training, with a longer effective time. In recent years, some researchers have begun to use the method of tDCS combined with CT to regulate the cognitive function. This paper will sort out and summarize this topic from five aspects: perception, attention, working memory, decision-making and other cognitive abilities. Finally, the application prospect and challenges of technology are prospected.
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Humans , Cognition , Cognition Disorders , Memory, Short-Term , Neuropsychological Tests , Prefrontal Cortex , Transcranial Direct Current StimulationABSTRACT
OBJECTIVE@#To estimate the univariate heritability of resting heart rate and common chronic disease such as hypertension, diabetes, and dyslipidemia based on extended pedigrees in Fujian Tulou area and to explore bivariate heritability to test for the genetic correlation between resting heart rate and other relative phenotypes.@*METHODS@#The study was conducted in Tulou area of Nanjing County, Fujian Province from August 2015 to December 2017. The participants were residents with Zhang surname and their relatives from Taxia Village, Qujiang Village, and Nanou Village or residents with Chen surname and their relatives from Caoban Village, Tumei Village, and Beiling Village. The baseline survey recruited 1 563 family members from 452 extended pedigrees. The pedigree reconstruction was based on the family information registration and the genealogy booklet. Univariate and bivariate heritability was estimated using variance component models for continuous variables, and susceptibility-threshold model for binary variables.@*RESULTS@#The pedigree reconstruction identified 1 seven-generation pedigree, 2 five-generation pedigrees, 23 four-generation pedigrees, 186 three-generation pedigrees, and 240 two-generation pedigrees. The mean age of the participants was 57.2 years and the males accounted for 39.4%. The prevalence of hypertension, diabetes, dyslipidemia in this population was 49.2%, 10.0%, and 45.2%, respectively. The univariate heritability estimation of resting heart rate, hypertension, and dyslipidemia was 0.263 (95%CI: 0.120-0.407), 0.404 (95%CI: 0.135-0.673), and 0.799 (95%CI: 0.590-1), respectively. The heritability of systolic blood pressure, diastolic blood pressure, fasting glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol was 0.379, 0.306, 0.393, 0.452, 0.568, 0.852, and 0.387, respectively. In bivariate analysis, there were phenotypic correlations between resting heart rate with hypertension, diabetes, diastolic blood pressure, fasting glucose, and triglyceride. After taking resting heart rate into account, there were strong genetic correlations between resting heart rate with fasting glucose (genetic correlation 0.485, 95%CI: 0.120-1, P<0.05) and diabetes (genetic correlation 0.795, 95%CI: 0.181-0.788, P<0.05).@*CONCLUSION@#Resting heart rate was a heritable trait and correlated with several common chronic diseases and related traits. There was strong genetic correlation between resting heart rate with fasting glucose and diabetes, suggesting that they may share common genetic risk factors.
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Female , Humans , Male , Middle Aged , Blood Pressure , Chronic Disease , Heart Rate , Hypertension , PedigreeABSTRACT
The article analyzed the problems in the clinical practice evaluation of eight-year program and illuminate the characteristics of the process evaluation based on Sojump , and pointed out that the implementation of the process evaluation into the clinical practice evaluation is the inevitable trend in the development of clinical teaching. Combining with the case study of eight-year program in West China Medical School, the article described the implementation of process evaluation in detail. On the basis of the Sojump as the platform for evaluation, the evaluation questionnaire according to the practice rotary table has con-ducted, and the"evaluation-feedback-evaluation-feedback"model had been set up. The application of pro-cess evaluation has promoted the effect of the clinical teaching. However, in the following practice, it is necessary to solve the problems as the evaluation of each teacher can't be specific and students' awareness and cognition of teaching evaluation can't be guaranteed, etc.
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@#【Objective】To evaluate the feasibility of magnetization transfer(MT)magnetic resonance(MR)imaging for predicting the risk of intestinal fistula in patients with Crohn disease (CD). 【Methods】 The study prospectively enrolled 12 consecutive patients with CD and abdominal MT imaging were performed before elective surgery. The bowel wall MT ratio normalized to skeletal muscle was calculated;region- by- region correlations with the surgical specimen were performed. Histopathologic evaluation of fibrosis was executed by using Masson trichrome. Wilcoxon rank test , Spearman rank correlation, and receiver operating characteristic curve (ROC) were used for statistical analysis.【Results】Among 15 surgical intestinal segments from 12 patients,5 lesions were found with intestinal fistula and of them 12 bowel specimens were obtained. The other 10 intestinal segments were without complications and 23 bowel specimens were enrolled. The intestinal fistula bowel showed a significant higher (P=0.045) normalized MT ratio. ROC analysis revealed an area under the curve of 0.674(95%CI:0.537-0.811)for differentiating intestinal fistula bowel from the non- fistula one. The sensitivity,specificity was 93.3% and 51.1% with a cut-off value of 76.8%,respectively. For the Masson score,significant difference(P=0.012)was found between the complicated intestinal specimens and the non-complicated ones. Additionally, the normalized MT ration was statistical correlated with Masson score (r=0.708,P<0.001).【Conclusion】MT imaging could be a potential method to predict the risk of intestinal fistula in patients with CD.
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The chemical constituents from 95% ethanol extract of Dendropanax proteus rhizomes and their anti-inflammatory activities were investigated. These compounds in 95% ethanol extract of D. proteus rhizomes were isolated and purified by silica gel column chromatography, medium-pressure liquid chromatography, preparative liquid chromatography, etc. Their structures were elucidated based on the spectral data and physicochemical properties. All the compounds were tested for their ability to inhibit lipopolysaccharide (LPS) induced nitric oxide production in the murine microglia BV2 cell line. Nine compounds were isolated from the ethyl acetate fraction of 95% ethanol extract of D. proteus rhizomes, and identified as (-)-syringaresinol (1), (+)-(7S,8S)-1',4-dihydroxy-3,3',5'-trimethoxy-7',8,9'-trinor-8,4'-oxyneoligna-7,9-diol (2), erythro-guaiacylglycerol-β-O-4'-coniferyl ether (3), threo-guaiacylglycerol-β-O-4'-coniferyl ether (4), coniferyl alcohol (5), 7-O-ethylguaiacylglycerol (6), vanillin (7), syringaldehyde (8), and excoecanol B (9). Compounds 2 and 4 showed neuritis inhibitory activity against microglial inflammation factor, their half inhibitory concentrations (IC50) were 5.85, 7.29 μmol ·L-1, respectively. Compounds 1-6,8-9 are isolated from this plant for the first time, compounds 2 and 4 exhibit the potent inhibitory activity.
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Tumor lysis syndrome is an oncologic emergency that seriously threatens the lives of pa-tients. Prevention of tumor lysis syndrome is more important than treatment. According to the risk classifica-tion,identifying high risk patients and effective preventive measures can improve the prognosis of patients. Patients with tumor lysis syndrome should receive hydration, rasburicase, diuretics, correction of electrolyte imbalances and appropriate renal replacement therapy.
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OBJECTIVE@#To explore long-term following-up clinical effects of lateral closed high tibial osteotomy for the treatment of knee osteoarthritis.@*METHODS@#Twenty patients with medial unicompartmental knee osteoarthritis were treated with lateral closed high tibial osteotomy and screw fixation from June 2005 to December 2015. Among them, including 17 females and 3 males, aged from 43 to 76 years old with an average of (57.80±8.05) years old. VAS score and KSS score were applied to evaluate recovery degree of pain and function before operation and after operation at 1, 5 and 10 years, and postoperative complications were observed.@*RESULTS@#Sixteen patients were followed-up, the time ranged from 9 to 11(10.0±0.8) years, 4 patients were loss to follow-up. Preoperative VAS score was 7.88±1.15 and decreased to 3.19±0.91, 3.44±0.96, 3.69±1.20 at 1, 5 and 10 years after operation, and there were statistical differences in VAS score between before and after operation at different time points (<0.05). Clinical score of KSS increased from 61.94±5.74 before opertaion to 75.50±4.62, 80.13±3.97, 77.38±6.40 at 1, 5 and 10 years after operation, and there were statistical differences in clinical score of KSS between before and after operation at different time points(<0.05); functional score of KSS increased from 62.81±13.03 before operation to 77.50±8.56, 81.88±6.55, 76.88±10.78, and there were statistical differences in functional score of KSS between before and after operation at different time points(<0.05). All incisions healed well without complications such as fibula nerve injury and fracture nonunion.@*CONCLUSIONS@#Lateral closed high tibial osteotomy and screw fixation for knee osteoarthritis could receive good clinical results, stop and delay progress of knee osteoarthritis, and long-term following-up could achieve the same effect as total knee arthroplasty.