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Objective:Based on the relevance risk analysis of medical equipment,to formulate process management strategies to improve the clinical operation efficiency of medical equipment.Methods:The risk matrix was evaluated from the perspectives of subject,quality,environment,system and diagnosis and treatment perspective,the comprehensive evaluation model of relevance risk was established,and multiple process management countermeasures were formulated.400 sets of medical equipment in clinical use in Shanghai Eighth People's Hospital from April 2021 to March 2022 were selected and divided into the control group and the observation group by the digital table method,with 200 sets in each group.The control group adopted the individualized risk analysis method for process management,and the observation group adopted the relevance risk analysis method for process management.The risk level and operation benefits of the two groups of medical equipment were compared and analyzed.Results:The high risk rates of medical imaging diagnostic and auxiliary equipment,surgical treatment equipment,life support and first aid equipment,extracorporeal circulation and blood processing equipment,health monitoring and rehabilitation equipment in the observation group were 17.39%(4/23),14.58%(7/28),12.24%(6/49),5.55%(1/18)and5.06%(5/62),respectively,which were lower than those in the control group,the difference was statistically significant(x2=4.132,4.009,6.275,4.833,4.859,P<0.05).The scores of cost benefit,social benefit,diagnosis and treatment benefit and development benefit of medical equipment in the observation group were(91.37±6.15)points,(92.78±3.80)points,(95.25±2.09)points and(90.51±3.82)points,respectively,which were higher than those in the control group,the difference was statistically significant(t=2.392,3.877,4.841,2.504,P<0.05).Conclusion:The relevance risk analysis method can reduce the probability and hazard degree of medical equipment safety risks,improve the clinical operation efficiency of medical equipment,and the process management strategy is in line with the actual needs of the medical equipment lifecycle management.
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Objective:To investigate the efficacy of the nomogram model based on multiparametric MRI combined with clinical features for differential diagnosis of benign and malignant breast imaging reporting and data system (BI-RADS) 4 lesions.Methods:This study was a cross-sectional study. Clinical and imaging data of 56 patients (66 lesions) with pathologically confirmed BI-RADS 4 breast lesions from January 2020 to June 2022 at Second Affiliated Hospital of Shantou University Medical College were retrospectively analyzed. The patients were all females aged 42 (17, 71) years old. All patients underwent the breast MRI, including T 1WI, T 2WI, diffusion-weighted imaging, diffusion kurtosis imaging (DKI), and dynamic-enhanced MRI (DCE-MRI), and the patient clinical characteristics, imaging characteristics as well as relevant MRI quantitative parameters were recorded. Comparisons of the indicators of benign and malignant BI-RADS 4 lesions were performed by sample t-test , Mann-Whitney U, or χ 2 test. The least absolute shrinkage and selection operator regression was utilized to further select indicators with statistically significant differences in univariate analyses, and finally, nomogram models were constructed and reclassified all the lesions. Results:Of the 66 lesions in 56 patients, 24 lesions were found in 24 malignant patients and 42 lesions in 32 benign patients. The differences in age, body mass index, and menopausal status between benign and malignant patients were statistically significant (all P<0.05); the differences in tumor longest diameter, type of lesion enhancement, time-single intensity curve type, mean diffusivity and mean kurtosis (MK) between benign and malignant lesions were statistically significant (all P<0.05). After feature selection, MK ( OR=27.952, 95% CI 1.301-600.348, P=0.033), age ( OR=1.140, 95%CI 1.040-1.249, P=0.005), and the type of lesion enhancement ( OR=0.045, 95%CI 0.006-0.316, P=0.005) were the independent influences in predicting BI-RADS 4 malignant lesions. Using this to construct a nomogram model, its area under the curve for predicting BI-RADS 4 malignant lesions was 0.946, and the accuracy of reclassifying 66 BI-RADS 4 lesions as benign versus malignant was 86.36% (57/66). Conclusion:The nomogram model constructed with MK from DKI parameters, the type of lesion enhancement from DCE-MRI, and age is valuable in diagnosing the benign and malignant nature of BI-RADS 4 lesions.
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The molecularly imprinted polymers membranes(MIPMs)were prepared for selective adsorption of lamotrigine(LTG)in plasma by surface molecular imprinting technology with polyvinylidenefluoride(PVDF)membranes as supporter,lamotrigine as template molecule,methyl methacrylate as functional monomer,ethylene glycol dimethacrylate as cross-linking agent,azodiisobutyronitrile as initiator and acetonitrile-dimethylformamide(1∶1.5,V/V)as pore-forming agent.The prepared MIPMs were characterized by scanning electron microscope,Fourier transform infrared spectroscopy,Brunaner-emmet-teller measurements,X-ray photoelectron spectroscopy,and thermogravimetric analysis.The adsorption properties of the materials were investigated by kinetic adsorption,isothermal adsorption,selective adsorption,adsorption-desorption and reusability experiments.The results showed that the imprinted layer of LTG was successfully coated on the surface of PVDF,and the materials had uniform particle size.The adsorption capacity and imprinting factor of the MIPMs towards LTG were 3.77 mg/g and 8.97,respectively.The nanomaterials showed fast mass transfer rate(30 min)and good reusability(the adsorption efficiency was 86.66%after 6 cycles),and could be used for the adsorption of LTG in plasma with low matrix interference,recoveries of 86.54%-90.48%and RSD of 1.51%-3.15%(n=5).The proposed LTG MIPMs were demonstrated to be simple and environment friendly,and had high selectivity in rapid separation and extraction of LTG in plasma.
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Small incision lenticule extraction(SMILE)is a flapless femtosecond laser-assisted refractive surgery, which is applied in the treatment of refractive errors. Since the earliest publications about SMILE in 2011, the concept of a refractive surgery performed through a small incision without the complications associated with the flap creation, has led to an increased interest in the ophthalmologic field. Lower impact on corneal biomechanical, less dry eye risk and less stromal layer exposure were some benefits this innovative technique had aroused. It is also stable, safe and effective in treating myopia and myopic astigmatism. Despite of the advantages, the implementation of SMILE is challenging, and various postoperative complications can emerge, including dry eye, infectious keratitis, diffuse lamellar keratitis, transient light sensitivity syndrome, corneal ectasia, pressure induced stromal keratitis, epithelial ingrowth, vision-related changes, etc. Early recognition and proper management of these complications are necessary for optimizing refractive outcomes. This article reviews the risk factors, clinical features, management and prevention of various complications focusing on SMILE.
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ObjectiveTo study the effects of BMI1 on the proliferation and drug resistance of cervical cancer (CC) and endometrial cancer (EC) cells. In addition, the mechanism of paclitaxel (PTX) resistance induced by BMI1 was explored. MethodsIn this study, we utilized the GTEx, Cbioportal, TCGA, and CPTAC databases to comprehensively analyze the mutation rate as well as mRNA and protein expression profiles of BMI1 in CC and EC. Subsequently, immunohistochemistry (IHC) analysis was employed to evaluate the protein expression levels of BMI1 in 40 pairs of CC and 40 pairs of EC tissue samples. Western blot was conducted to investigate alterations in downstream factor protein levels upon BMI1 knockdown in CC and EC cells. Furthermore, functional experiments were performed to elucidate the role of BMI1 in CC and EC cells. Finally, we assessed the synergistic anti-growth effect by combining BMI1 knockdown with paclitaxel treatment in vitro. ResultsThe Cbioportal database revealed that BMI1 amplification, misinterpretation, and splicing occurred in 1.5% of CC patients and 1.9% of EC patients. Mining the data from TCGA and CPTAC databases, high mRNA levels of BMI1 were associated with the pathological type of CC and lower overall survival, and high protein levels of BMI1 were related to EC’s pathological type and tumor grade. Furthermore, the BMI1 protein level is overexpressed in cancer tissues of CC and EC compared with normal tissues, as detected by IHC analysis. Besides, drug sensitivity experiments showed that overexpression of BMI1 resulted in decreased sensitivity of HeLa and HEC-1-A cells to a variety of anticancer drugs, including paclitaxel. In order to further analyze the relationship between BMI1 and paclitaxel resistance, Western blot was used to detect the changes in the protein levels of downstream factors of BMI1 in HeLa and HEC-1-A cells after BMI1 knockdown. The results showed that the level of anti-apoptotic factor Bcl-2 protein decreased, while that of pro-apoptotic factor BAX increased with BMI1 knockdown. Additionally, we showed that high expression of BMI1 promoted the proliferation and migration of CC and EC cells in vitro. Moreover, CC and EC cells with low BMI1 expression were more sensitive to the paclitaxel. ConclusionThe expression of BMI1 is significantly upregulated in tumor tissues from patients with cervical and endometrial cancer, and silencing BMI1 makes CC and EC cells more sensitive to paclitaxel via enhancing pro-apoptotic regulation.
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Endovascular neurointervention is typically performed with iodinated contrast medium (ICM) under fluoroscopy. However, some patients may be contraindicated to such procedures based on their sensitivity to ICM. In this report, we describe a case of successful coil embolization of a direct carotid cavernous fistula using angiography with gadolinium-based contrast agents in a patient with severe allergic reaction to ICM. The clinical decision-making for this patient was further complicated by comorbidities of renal impairment, drug allergies, and previously severe gastrointestinal bleeding.
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OBJECTIVE@#To evaluate the trend of notified incidence of pulmonary tuberculosis (PTB) in China at different periods by population and region and to explore the effect of TB prevention and control in recent years.@*METHODS@#Using pooled data on TB cases reported by the TB Information Management Reporting System (TBIMS) from 2005 to 2020, we calculated the annual percentage change (APC) using the Joinpoint regression model.@*RESULTS@#From 2005 to 2020, a total of 16.2 million cases of PTB were reported in China, with an average notified incidence of 75.5 per 100,000 population. The age standardization rate (ASR) continued to decline from 116.9 (/100,000) in 2005 to 47.6 (/100,000) in 2020, with an average annual decrease of 5.6% [APC = -5.6, 95% confidence interval ( CI): -7.0 to -4.2]. The smallest decline occurred in 2011-2018 (APC = -3.4, 95% CI: -4.6 to -2.3) and the largest decrease in 2018-2020 (APC = -9.2, 95% CI: -16.4 to -1.3). From 2005 to 2020, the ASR in males (159.8 per 100,000 in 2005, 72.0 per 100,000 in 2020) was higher than that in females (62.2 per 100,000 in 2005, 32.3 per 100,000 in 2020), with an average annual decline of 6.0% for male and 4.9% for female. The average notified incidence was the highest among older adults (65 years and over) (182.3/100,000), with an average annual decline of 6.4%; children (0-14 years) were the lowest (4.8/100,000), with an average annual decline of 7.3%, but a significant increase of 3.3% between 2014 and 2020 (APC = 3.3, 95% CI: 1.4 to 5.2); middle-aged (35-64 years) decreased by 5.8%; and youth (15-34 years) decreased by an average annual rate of 4.2%. The average ASR in rural areas (81.3/100,000) is higher than that in urban areas (76.1/100,000). The average annual decline in rural areas was 4.5% and 6.3% in urban areas. South China had the highest average ASR (103.2/100,000), with an average annual decline of 5.9%, while North China had the lowest (56.5/100,000), with an average annual decline of 5.9%. The average ASR in the southwest was 95.3 (/100,000), with the smallest annual decline (APC = -4.5, 95% CI: -5.5 to -3.5); the average ASR in the Northwest China was 100.1 (/100,000), with the largest annual decline (APC = -6.4, 95% CI: -10.0 to -2.7); Central, Northeastern, and Eastern China declined by an average of 5.2%, 6.2%, and 6.1% per year, respectively.@*CONCLUSIONS@#From 2005 to 2020, the notified incidence of PTB in China continued to decline, falling by 55%. For high-risk groups such as males, older adults, high-burden areas in South, Southwest, and Northwest China, and rural regions, proactive screening should be strengthened to provide timely and effective anti-TB treatment and patient management services for confirmed cases. There is also a necessity to be vigilant about the upward trend of children in recent years, the specific reasons for which need to be further studied.
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Child , Middle Aged , Adolescent , Humans , Female , Male , Aged , Incidence , Tuberculosis, Pulmonary/epidemiology , China/epidemiology , Population GroupsABSTRACT
BACKGROUND@#Epidemiological surveys on heart failure (HF) in Chinese community are relatively lacking. This study aimed to estimate the prevalence and incidence of HF among community residents in southern China.@*METHODS@#Baseline data of this prospective study was collected from 2015 to 2017 among 12,013 permanent residents aged ≥ 35 years in Guangzhou, China. The same survey process was carried out for individuals aged ≥ 65 years after a three-year follow-up.@*RESULTS@#The overall prevalence of HF in community residents aged ≥ 35 years was 1.06%. Male had significantly higher risk of HF prevalence [odds ratio (OR) = 1.50, P = 0.027]. The gender-adjusted risk of HF was 1.48 times higher per 10 years aging. HF prevalence was statistically associated with atrial fibrillation, valvular heart disease, hypertension and chronic obstructive pulmonary disease after adjusting for age and gender (OR = 8.30, 5.17, 1.11, 2.28, respectively; all P < 0.05). HF incidence in individuals aged ≥ 65 years were 847 per 100,000 person-years. Baseline atrial fibrillation, valvular heart disease, and diabetes mellitus were risk factors for HF incidence for individuals aged ≥ 65 years adjusting for age and gender (OR = 5.05, 3.99, 2.11, respectively; all P < 0.05). Besides, residents with new-onset atrial fibrillation and myocardial infarction were at significantly higher risk of progression to HF (OR = 14.41, 8.54, respectively; all P < 0.05).@*CONCLUSIONS@#Both pre-existing and new-onset cardiovascular diseases were associated with HF incidence in southern China. Management of related cardiovascular diseases may be helpful to reduce the incidence of HF.
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Effective treatments for neuropathic pain are lacking due to our limited understanding of the mechanisms. The circRNAs are mainly enriched in the central nervous system. However, their function in various physiological and pathological conditions have yet to be determined. Here, we identified circFhit, an exon-intron circRNA expressed in GABAergic neurons, which reduced the inhibitory synaptic transmission in the spinal dorsal horn to mediate spared nerve injury-induced neuropathic pain. Moreover, we found that circFhit decreased the expression of GAD65 and induced hyperexcitation in NK1R+ neurons by promoting the expression of its parental gene Fhit in cis. Mechanistically, circFhit was directly bound to the intronic region of Fhit, and formed a circFhit/HNRNPK complex to promote Pol II phosphorylation and H2B monoubiquitination by recruiting CDK9 and RNF40 to the Fhit intron. In summary, we revealed that the exon-intron circFhit contributes to GABAergic neuron-mediated NK1R+ neuronal hyperexcitation and neuropathic pain via regulating Fhit in cis.
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Rats , Animals , Posterior Horn Cells/pathology , Spinal Cord Dorsal Horn/metabolism , Neuralgia , Synaptic TransmissionABSTRACT
Objective: To investigate the clinicopathologic features of progressively transformed germinal center-like follicular T-cell lymphoma (PTGC-like FTCL). Methods: The clinicopathologic data of 14 PTGC-like FTCL cases that were diagnosed at the Beijing Friendship Hospital Affiliated to the Capital Medical University from January 2017 to January 2022 were retrospectively collected. Clinicopathological features, immunophenotype, and Epstein-Barr virus (EBV) infection status were analyzed in these cases. Polymerase chain reaction (PCR) was performed to detect the clonal gene rearrangements of T cell receptor (TCR) and the immunoglobulin (Ig) in 10 and 8 cases, respectively. Results: The male to female ratio was 5∶2. The median age was 61 years (range 32-70 years). All patients had lymphadenopathy at the time of diagnosis. By using the Ann Arbor system staging, seven cases were classified as stage Ⅰ-Ⅱ, and seven cases as stage Ⅲ-Ⅳ. Seven cases had B symptoms, four cases had splenomegaly, and two cases had skin rash and pruritus. Previously, three cases were diagnosed as classic Hodgkin's lymphoma, three cases as small B-cell lymphoma, two cases as atypical lymphoid hyperplasia unable to exclude angioimmunoblastic T-cell lymphoma (AITL), one case as EBV-associated lymphoproliferative disorder, and one case as peripheral T-cell lymphoma (PTCL) associated with the proliferation of B cells. All the 14 cases showed that the large nodules were composed of mature CD20+, IgD+B lymphocytes admixed with small aggregates of neoplastic cells with pale to clear cytoplasm. Moreover, hyperplastic germinal centers (GCs) and Hodgkin/Reed-Sternberg-like (HRS-like) cells were seen within these nodules in two and five cases, respectively. The neoplastic cells expressed CD3 (14/14), CD4 (14/14), PD1 (14/14), ICOS (14/14), CD10 (9/14), bcl-6 (12/14), CXCL13 (10/14), and CD30 (10/14). The HRS-like cells in five cases expressed CD20 (2/5), PAX5 (5/5), CD30 (5/5), CD15 (2/5), LCA (0/5), OCT2 (5/5) and BOB1 (2/5). Moreover, neoplastic T cells formed rosettes around HRS-like cells. EBV-encoded RNA (EBER) in situ hybridization showed scattered, small, positive bystander B lymphocytes in 8/14 cases, including 3/5 cases containing HRS-like cells. All tested cases (including five with HRS-like cells) showed monoclonal TCR gene rearrangement and polyclonal Ig gene rearrangement. Conclusions: PTGC-like FTCL is a rare tumor originated from T-follicular helper cells. It could be distinguished from angioimmunoblastic T-cell lymphoma by the formation of follicular structure, and lack of follicular dendritic cell proliferation outside the follicles and the polymorphous inflammatory background. In addition, it should be differentiated from lymphocyte-rich classical Hodgkin's lymphoma and low-grade B cell lymphoma.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Lymphoma, T-Cell, Peripheral/pathology , Reed-Sternberg Cells/pathology , Epstein-Barr Virus Infections , Hyperplasia/pathology , Retrospective Studies , Herpesvirus 4, Human/genetics , Immunoblastic Lymphadenopathy/pathology , Hodgkin Disease/pathology , Germinal Center/pathology , Receptors, Antigen, T-CellABSTRACT
Objective:To compare the application of GLIM and SGA in diagnosing malnutrition among severe neurosurgery patients.Methods:According to random sampling,42 patients admitted to the intensive care unit of Department of Neurotrauma in a Grade-A hospital in Guangzhou from January 2023 to April 2023 were screened.The nutritional status was assessed using GLIM standard and SGA scale,respectively.GLIM criteria and SGA scale were compared in the diagnosis of malnutrition.Results:The patients'NRS 2002 score was(3.90±1.10),and the positive rate of nutritional screening risk was 100％(42/42).13 patients were diagnosed as malnutrition by GLIM criteria,with a positive rate of 30.95％.29 cases were diagnosed as malnutrition by SGA,and the positive rate was 69.05％.The Kappa value of GLIM standard and SGA scale for malnutrition was 0.372,and the difference between the two nutritional status assessment tools was statistically significant(P＜0.05).Conclusion:Patients receiving neurocritical surgery had high nutritional risk and had a low incidence of malnutrition under GLIM criteria,while a high incidence of malnutrition under SGA criteria.Moreover,the results of GLIM criteria and SGA were not consistent in the assessment of malnutrition.
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Objective:To explore the role of mindfulness and negative cognitive bias between behavioral inhibition system and social anxiety among college students.Methods:From October 12th to November 8th of 2012, a total of 747 college students from a university in Tianjin were sampled and assessed using the behavioral inhibition system scale (BIS), the mindful attention awareness scale (MAAS), the negative cognitive processing bias questionnaire (NCPBQ), and the social avoidance and distress scale (SAD). Descriptive statistics, correlation analysis, and tests for mediating effects were performed by SPSS 20.0 and Mplus 8.0.Results:The scores of behavioral inhibition system, social anxiety, mindfulness and negative cognitive bias were (15.3±2.4), (12.7±7.2), (3.4±0.8) and (45.6±11.5), respectively. The scores of BIS, NCPBQ, and SAD were positively correlated with each other ( r=0.27-0.49, all P<0.001). The scores of MAAS were negatively correlated with the scores of BIS, NCBPQ, and SAD ( r=-0.33--0.28, all P<0.001). The behavioral inhibition system exerted its influence on social anxiety through three pathways. The mediating effect size of mindfulness was 0.04, accounting for 16.0% of the total effect. The mediating effect size of negative cognitive bias was 0.17, accounting for 68.0% of the total effect. And the chain mediating effect size of mindfulness and negative cognitive bias was 0.04, accounting for 16.0% of the total effect. Conclusion:The effects of behavioral inhibition system on social anxiety in college students are individually mediated by mindfulness and negative cognitive biases, as well as their chain mediating effects.
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A large number of data show that the prevalence rate of alcoholic liver injury （ALI） is increasing year by year， and it has become one of the main causes of death due to chronic liver diseases such as liver cancer and liver cirrhosis. Quitting drinking is the main method for the prevention of ALI in modern medicine， and the main treatment methods include Western medicine with antioxidant and anti－fibrotic effects and nutritional support. However， Western medicine tends to have an unsatisfactory treatment effect and can only alleviate initial symptoms， and severe ALI still requires surgical treatment. Studies have shown that the monomers extracted from natural drugs and foods have obvious preventive and therapeutic effects on ALI， with high safety and easy access. Therefore， this article systematically summarizes the main natural drug and food monomers used for the prevention and treatment of ALI and proposes the idea of the combination of drug and food for the prevention and treatment of ALI from the perspective of paying attention to the whole process of health， in order to explore more effective prevention， health care， and treatment methods and provide ideas for research on the prevention and control of ALI.
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Objective @#To evaluate the effect of maternal hypothyroidism on lipid metabolism in the early life of emale offspring by constructing a murine model during pregnancy．@*Methods @# Female mice C57BL /6J were ran- domly divided into normal control group ( NC0 ) ，hypothyroidism complicated with pregnancy group ( PH0 ) and pregnancy complicated with hypothyroidism group ( GH0) ．Firstly，PH0 group was given 0．15% propylthiouracil di- et for 28 days，while NC0 and GH0 groups were given normal diet．After the successful modeling of PH0 was con- firmed，female mice in GH0 and PH0 groups were given 0．15% propylthiouracil diet during pregnancy，and NC0 group was still given normal diet．After delivery，the levels of free triiodothyronine ( FT3) ，free thyroxine ( FT4) ， thyroid stimulating hormone (TSH) and total cholesterol (TC) ，triglyceride (TG) in each group were detected at 3 weeks of age for female offspring．The pathological changes of thyroid and liver were observed by HE staining．West- ern blot detected the levels of proteins associated with lipid metabolism.@*Results @#Compared with the NC0 group， the levels of serum FT3 and FT4 decreased，the levels of serum TSH，serum TC，hepatic TC and TG increased in the female offspring of the PH0 and GH0 groups，and lipid deposition was observed in their livers．The expression levels of HMGCR , FAS and CD36 related to lipid metabolism in livers increased，while the expressions of CPT1A and LDL-R were down-regulated.@*Conclusion @# Hypothyroidism during pregnancy may lead to the disturbance of lipid metabolism in the early life of female offspring mice.
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The scientific setting and standardized management of adult vaccination clinics will improve the accessibility of vaccination services, thereby increasing the vaccination rate. Currently, some provinces and cities in China have been exploring the construction of adult vaccination systems for many years, effectively improving the level of vaccination services, and forming some useful experiences and models. However, the construction of China's adult vaccination system is not yet perfect, and the service mode needs to be optimized. In the future, we should continue to improve the guarantee measures for adult vaccination, scientifically lay out the network, optimize the service mode, and improve the overall quality of immunization services over the life course.
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Adult , Humans , Life Change Events , Immunization , Vaccination , China , CitiesABSTRACT
The scientific setting and standardized management of adult vaccination clinics will improve the accessibility of vaccination services, thereby increasing the vaccination rate. Currently, some provinces and cities in China have been exploring the construction of adult vaccination systems for many years, effectively improving the level of vaccination services, and forming some useful experiences and models. However, the construction of China's adult vaccination system is not yet perfect, and the service mode needs to be optimized. In the future, we should continue to improve the guarantee measures for adult vaccination, scientifically lay out the network, optimize the service mode, and improve the overall quality of immunization services over the life course.
Subject(s)
Adult , Humans , Life Change Events , Immunization , Vaccination , China , CitiesABSTRACT
Objective:Under the background of "new medical science", to construct a whole-process education path with "education as the driving force - moral cultivation as the core", and to provide a decision-making basis for the reform, innovation, and development of humanistic quality education in medical colleges.Methods:Five-year clinical medical students (freshman to fifth graders) from Qiqihar Medical University were selected as the research objects. The evaluation model and questionnaire of humanistic quality of clinical medical students were constructed by literature analysis. The Questionnaire Star platform was used to investigate and collect data by random sampling of clinical medical undergraduates, and the data results were analyzed by SPSS 26.0 to explore the path of building the whole-process education.Results:The empirical research on the cultivation of humanistic quality of medical students showed that the average humanistic attitude score of medical students was (3.47±0.75) points. From the perspective of gender, the scores of humanistic cognition, attitude, and behavior of male students were 2.81, 3.68, and 3.22 points, respectively, which were all significantly higher than those of female students (2.52, 3.22, and 2.95 points, respectively) ( P<0.05). The data from freshmen to the fifth graders showed that humanistic cognition, attitude, and behavior scores all presented an increasing trend with the grade. Using the "Knowledge, Attitude/Belief, Practice" model, it was found that the cognitive rate of humanistic quality of medical students was relatively ideal, and the awareness rate of medical students in different grades was different. The cross analysis showed that the effect of ideological morality and political literacy education on medical students in medical colleges had a significant cross-relationship with multiple choice questions. Conclusion:The humanistic quality of clinical medical students needs to be improved, and the cultivation of medical humanistic quality should run through the whole process from the first year to the fifth year, so as to improve the comprehensive training of professional ability and promote the all-round development of medical students.
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Diabetic retinopathy(DR)has been traditionally considered a purely microvascular disease in the retina. Currently, mainstream therapies focus only on advanced vascular complications and a single molecular target-vascular endothelial growth factor(VEGF). However, the research is shifting towards a more comprehensive view that DR is a neurovascular disease caused by neurovascular unit(NVU)injury. In the early stage of DR, diabetic retinal neurodegeneration(DRN)dominates and may precede the retinal microvascular abnormalities. Moreover, neuronal apoptosis can further lead to microvascular injury and blood-retinal barrier(BRB)disruption. Therefore, it makes sense to develop new therapeutic strategies to prevent or reverse DRN. However, no drug targeting DRN has been approved for clinical use. In recent years, it has become a trend to study the protective effect of traditional Chinese medicine on the retina. The primary research focuses on Chinese herb monomers. This article reviews the research status of representative monomers in DRN to provide references for the early treatment of DR and development of new drugs.
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Lung cancer remains the leading cause of cancer-related deaths in men and women worldwide, and 85% of these patients have non-small cell lung cancer. In recent years, the clinical use of targeted drug therapy and immune checkpoint inhibitors has dramatically changed the treatment landscape for advanced NSCLC. The mechanism and the value of targeted therapies have been a hot topic of research, as KRAS is one of the earliest discovered and most frequently mutated oncogenes, which is activated by binding to GTP and triggers a series of cascade reactions in cell proliferation and mitosis. The KRAS protein acts as a molecular switch and is activated by binding to GTP, triggering a series of cascade responses in cell proliferation and mitosis. Clinically, patients with KRAS mutated NSCLC have poor response to systemic medical therapy and poor prognosis. Since the first report of KRAS gene in 1982, research on KRAS targeted therapeutics has been slow, and previous studies such as farnesyltransferase inhibitors and downstream protein inhibitors of KRAS signaling pathway have not achieved the expected results, making KRAS long defined as a "non-druggable target". The deeper understanding of the crystal structure of KRAS has led to the discovery of potential therapeutic sites for KRAS and the development of several drugs directly targeting KRAS, especially KRAS G12C inhibitors such as AMG510 (sotorasib) and MRTX849 (adagrasib), which have shown encouraging results in clinical trials. In recent years, studies on the therapeutic efficacy of immune checkpoint inhibitors for KRAS-mutated NSCLC have made some progress. In this review, we systematically introduce the basic understanding of RAS gene and clinical characteristics of KRAS mutated NSCLC patients, summarize the medical treatments for KRAS mutated NSCLC, including chemotherapy, anti-vascular drug therapy and tumor immunotherapy, and focus on the review and outlook of the research progress of KRAS targeted therapy.
Subject(s)
Male , Humans , Female , Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/genetics , Proto-Oncogene Proteins p21(ras)/therapeutic use , Genes, ras , Immune Checkpoint Inhibitors/therapeutic use , Guanosine Triphosphate/therapeutic use , MutationABSTRACT
Objective: To examine the association of greenness exposure with waist circumference (WC) and central obesity in older adults in China. Methods: Based on the cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey in 2017-2018, 14 056 participants aged 65 years and over were included. Demographic characteristics, lifestyle, WC, and other information were collected through a questionnaire and physical examination. Based on the satellite monitoring data of moderate-resolution imaging spectroradiometer (MODIS) provided by NASA, the annual mean of normalized difference vegetation index (NDVI) within a radius of 1 000 meters was obtained as the measurement value of greenness exposure. Multivariate linear regression model, multivariate logistic regression model, and restricted cubic splines (RCS) model were used to analyze the association and dose-response relationship between greenness exposure and WC and central obesity in older adults in China. Results: A total of 14 056 participants were enrolled with a median age of 84.0 years [IQR: 75.0-94.0 years]. About 45.0% (6 330) of them were male and 48.6% (5 853) were illiterate. There were 10 964 (78.0%) participants from rural. The mean of WC was (84.4±10.8) cm. Central obesity accounted for 60.2% (8 465), and the NDVI range was (-0.06, 0.78). After adjusting for confounding factors, the multivariate linear regression model showed that the change value of WC in the urban group [β (95%CI):-0.49 (-0.93, -0.06)] was smaller than that in the rural [-0.78 (-0.98, -0.58)] for every 0.1 unit increase in NDVI (Pinteraction=0.022). Compared with the Q1 group in NDVI, WC of Q2 and Q3 groups in rural decreased, and the β (95%CI) values were-1.74 (-2.5, -0.98) and-2.78 (-3.55, -2.00), respectively. The multivariate logistic regression model showed that after adjusting for confounding factors, the risk of central obesity decreased for urban and rural older adults with an increase of 0.1 unit in NDVI, and the OR (95%CI) values were 0.87 (0.80, 0.95) and 0.86 (0.82, 0.89), respectively (Pinteraction=0.284). Compared with the Q1 group in NDVI, the risk of central obesity in the Q2 and Q3 groups in rural was lower, and the OR (95%CI) values were 0.68 (0.58, 0.80) and 0.57 (0.49, 0.68), respectively. The results of the multivariate regression model with RCS showed that there was a non-linear association of NDVI with WC (Pnonlinear=0.006) and central obesity (Pnonlinear=0.025). Conclusion: Greenness exposure is negatively associated with WC and central obesity in older adults in China.