Research progress of different minimally invasive spinal decompression in lumbar spinal stenosis / 中国修复重建外科杂志

OBJECTIVE@#To review the application and progress of different minimally invasive spinal decompression in the treatment of lumbar spinal stenosis (LSS).@*METHODS@#The domestic and foreign literature on the application of different minimally invasive spinal decompression in the treatment of LSS was extensively reviewed, and the advantages, disadvantages, and complications of different surgical methods were summarized.@*RESULTS@#At present, minimally invasive spinal decompression mainly includes microscopic bilateral decompression, microendoscopic decompression, percutaneous endoscopic lumbar decompression, unilateral biportal endoscopy, and so on. Compared with traditional open surgery, different minimally invasive spinal decompression techniques can reduce the operation time, intraoperative blood loss, and postoperative pain of patients, thereby reducing hospital stay and saving treatment costs.@*CONCLUSION@#The indications of different minimally invasive spinal decompression are different, but there are certain advantages and disadvantages. When patients have clear surgical indications, individualized treatment plans should be formulated according to the symptoms and signs of patients, combined with imaging manifestations.

Research on the construction of teaching quality evaluation index system in medical colleges and universities / 中华医学教育探索杂志

Objective:To construct an evaluation index system of teaching quality in medical schools.Methods:The text entry analysis was used to construct the index entry pool. The thematic group discussions were used to determine the preliminary index system. The Delphi method was used to further select the index. Finally, the analytic hierarchy process was used to determine the index weight and perform consistency test. EpiData 3.2 was used to build database, and MATLAB was used for statistical analysis and solving judgment matrix.Results:The index framework was established by attitude, content, method and effect, which was refined into 10 secondary indicators and 20 tertiary indicators such as passing on knowledge, knowledge mastering, and so on. The consistency test coefficients of each layer was less than 0.1.Conclusion:The method of constructing the indicator system is scientific, and the selection of indicators is in line with the current medical education reform, which has certain feasibility and guiding significance.

Analysis and thinking of the integration of medical curriculum in China: from the perspective of learning theory / 中华医学教育探索杂志

This article starts with the definition of integrated curriculum, analyzes the modes of horizontal, vertical and spiral integration, and summarizes the implementation of integrated curriculum models in North America, Europe and Asian countries. At the same time, we present the implementation of the integrated curriculum teaching model in several domestic universities. Then, we analyze the problems of the domestic integrated curriculum from the aspects of mechanism structure, content connection, teaching ability and assessment and evaluation. Finally, we propose corresponding thoughts and suggestions for the problems from the learning theories view.

Correlation of serum microRNA-15a-5p level with prognosis and neoadjuvant chemotherapy response in patients with locally advanced gastric cancer / 中国医师进修杂志

Objective:To investigate the correlation between serum microRNA (miR)-15a-5p and prognosis, neoadjuvant chemotherapy (NAC) response in patients with locally advanced gastric cancer (LAGC).Methods:The clinical data of 122 patients with LAGC who underwent surgery after NAC in Eastern Theater Air Force Hospital of the Chinese People′s Liberation Army from May 2016 to April 2020 were analyzed retrospectively. The general clinical data and laboratory examination results of the patients were recorded. The expression level of serum miR-15a-5p was detected by real-time fluorescence quantitative polymerase chain reaction, and the relationship between the expression of miR-15a-5p and different clinical characteristics in patients with LAGC was analyzed. The pathological response was evaluated by Becker tumor regression grading, in which patients with grade 1a, 1b and 2 were sensitive group and patients with grade 3 were resistant group.Results:The patients with LAGC were divided into high expression (>1.038) and low expression (≤1.038) according to the median miR-15a-5p of 1.038 with 61 cases each. The expression level of serum miR-15a-5p was related to the preference for spicy food, endoscopic ultrasonography (EUS)-T stage and EUS-N stage ( P<0.01 or <0.05). According to the evaluation result of pathological reaction, there were 47 cases in resistance group and 74 cases in sensitive group. The serum miR-15a-5p in resistance group was significantly higher than that in sensitive group: 1.69 (1.39, 1.97) vs. 0.99 (0.96, 1.02), and there was statistical difference ( Z =-8.55, P<0.01). The receiver operating characteristic curve analysis result showed that the area under the curve of serum miR-15a-5p predicting NAC response was 0.959 (95% CI 0.929 to 0.990), the optimal cut-off value was 1.049, the sensitivity was 100.0%, and the specificity was 85.1%. Multivariate Logistic regression analysis result showed that miR-15a-5p was an independent risk factor for NAC response in patients with LAGC ( HR = 1 880.840, 95% CI 123.510 to 28 641.846, P<0.01). Kaplan-Meier survival curve analysis result showed that the median overall survival time and median progression free survival time in patients with high expression of miR-15a-5p were significantly shorter than those in patients with low expression of miR-15a-5p (19 months vs. 62 months and 12 months vs. 51 months), and there were statistical differences (log-rank χ2 = 41.99 and 61.97, P<0.01); the 10-year overall survival rate and 10-year progression free survival rate in patients with high expression of miR-15a-5p were significantly lower than those in patients with low expression of miR-15a-5p (4.9% vs. 52.5% and 24.6% vs. 85.2%), and there were statistical differences (log-rank χ2 = 33.70 and 45.32, P<0.01). Multivariate Cox regression analysis result showed that R 0 resection and miR-15a-5p were the independent risk factors affecting the overall survival time and progression free survival time in patients with LAGC (overall survival time: HR = 1.945 and 3.487, 95% CI 1.033 to 3.660 and 2.112 to 5.759, P<0.05 or <0.01; progression free survival time: HR = 2.427 and 6.335, 95% CI 1.069 to 5.510 and 3.341 to 12.013, P<0.05 or <0.01). Conclusions:The increase of serum miR-15a-5p level is related to NAC response and poor prognosis in patients with LAGC. It can be used as a reliable biomarker to predict the prognosis and NAC response of LAGC.

Effect of FPZ, a total flavonoids ointment topical application from Pouzolzia zeylanica var. microphylla, on mice skin infections

ABSTRACT The present study was designed to investigate the effect of FPZ, a total flavonoids ointment topical application from Pouzolzia zeylanica var. microphylla (Wedd.) Masam, Urticaceae, on skin infections in mice. FPZ ointment anti-infective effect was investigated on Staphylococcus aureus-induced skin abscess and skin ulcers in mice by evaluating the variation in abscess volume, histopathology of skin tissue and healing rate. Secondary, it is topical anti-inflammatory activities on carrageenan-induced hind paw edema in mice was estimated. Besides, FPZ ointment fingerprint was performed by using ultra-performance liquid chromatography and FPZ ointment chemical constituents were isolated and identified by repeated column chromatograph and spectroscopic methods. The results revealed that FPZ ointment topical application at the concentration of 2.5-10% could attenuate skin abscess and ulcers and accelerate wound healing, as compared with control group treated with vehicle (p < 0.05). The histological analysis indicated that FPZ ointment acted via inflammation inhibition, granulation promotion and epidermis formation. Moreover, FPZ ointment effectively inhibited carrageenan-induced paw edema in a dose-dependent manner, especially 10% FPZ which showed superior activities in comparison with dexamethasone used as reference drug. FPZ ointment topical application showed a significant anti-infective effect against pyogenic bacterial skin infection in mice.

Effect of Medicated-catgut Embedding at "Changqiang" (GV 1) on Mechanical Pain Threshold and P 38 MAPK Expression in Spinal Cord Tissue in Anus Incisional Pain Rats / 针刺研究

OBJECTIVE: To observe the effect of medicated-catgut embedding at "Changqiang"(GV 1) on regional pain reaction and expression of p 38 MAPK in the dorsal horn of spinal cord in anus incisional pain rats, so as to explore its analgesic mechanism. METHODS: Forty male SD rats were randomly divided into control, model, GV 1-embedding and sham acupoint embedding groups (n=10 rats in each group). The anus incisional pain model was established by making a radial incision (about 10 mm length) at the left lithotomy position of the anus with a surgical knife, and the mechanical pain threshold (PT) was measured by using a Von Frey before and 4, 8, 12, 24 h after operation. The medicated-catgut (about 12.5 mm length/kg body weight) was implanted in the subcutaneous tissue of GV 1 region. The immunoactivity of p 38 MAPK was determined by immunohistochemistry. RESULTS: Compared with the control group, the mechanical PTs were significantly decreased 4, 8, 12 and 24 h after operation both at the site of incision and about 15 mm proximal to the site of incision in the model group (P<0.05), and the immunoactivity of phosphorylated (p)-p 38 MAPK in the superficial layer of dorsal horns of lumbar spinal cord was significantly increased(24 h)after operation(P<0.05). Compared with the model group, the PTs were significantly increased 8, 12 and 24 h after operation at the site of incision, and 12 h and 24 h at the site about 15 mm proximal to the incision region (P<0.05), and the immunoactivity level of p-p 38 MAPK was significantly down-regulated in the GV 1-embedding group (P<0.05). No significant changes were found in the PT and p-p 38 MAPK immunoactivity levels in the sham acupoint embedding group (P<0.05). CONCLUSIONS: Medicated-catgut embedding at "Changqiang"(GV 1) has an analgesic effect in anus incisional pain model rats, which may be related to its effect in down-regulating the expression of p 38 MAPK in the dorsal horn of lumbar spinal cord.

Effect of longan tablets and levofloxacin on the treatment of chronic nonbacterial inflammatory prostatitis by single or combined application / 中国生化药物杂志

Objective To investigate the clinical efficacy of etoposide and levofloxacin in the treatment of chronic nonbacterial prostatitis(CNP)alone or in combination.Methods A total of 168 patients with CNP in our hospital from August 2014 to January 2016 were enrolled in this study.The patients were divided into A, B and C groups according to the random number table,56 cases in each group.Group A treatment alone, group B was treated with levofloxacin alone, group C was treated with Yongqing Tablet and levofloxacin, and the clinical efficacy and adverse hair loss were compared.Results After a course of treatment, there was no significant difference in the effective rate of treatment between group A and group B.The effective rate of treatment of group C was higher than that of group A and B, the difference was statistically significant (P<0.05).There was no significant differences in the incidence of adverse events between the three groups.Conclusion The clinical effect of Tongueqing and levofloxacin in the treatment of CNP is higher than that of single administration, and it will not increase the adverse reaction.It is worthy to be popularized and applied.

Preparation and cytocompatibility of beta-calcium phosphate scaffolds with tanshinol coating / 中国组织工程研究

BACKGROUND: Revascularization is a challenge for the tissue-engineered bone carrying cells after implanted into human body. Previous studies have found that tanshinol can improve the functions of endothelial progenitor cells and exert vascular protective effects.OBJECTIVE: To prepare the β-calcium phosphate (β-TCP) scaffold with tanshinol coating, and to observe its cytocompatibility.METHODS: The β-TCP scaffolds coated with 10-7, 10-6 and 10-5 mol of tanshinol were constructed by negative pressure absorption method. The distribution of tanshinol coating on the scaffold was observed using scanning electron microscopy,and the inner ingredients were analyzed by infrared spectrum. Human endothelial progenitor cells (hEPCs) were cultured in the extracts of β-TCP and β-TCP scaffolds with 10-7, 10-6, 10-5 mol of tanshinol coatings, respectively. The cell proliferation was detected at 2, 4, 6, 8 and 10 days of culture; the levels of nitric oxide and vascular endothelial growth factor in the supernatants were detected at 1, 7 and 14 days of culture; the lumen formation on the matrigel was observed after 14-day culture. hEPCs were respectively seeded onto the β-TCP and β-TCP scaffolds with different dosages of tanshinol coating,and then the cell growth was observed under scanning electron microscope at 7 days.RESULTS AND CONCLUSION: The tanshinol coating evenly distributed on the inner surface of the pores, and its crystalline structure became dense with dosage increasing. Infrared spectrum analysis revealed no changes in the characteristic absorption peak of tanshinol and TCP in the scaffold. The β-TCP scaffolds with tanshinol coating could promote the proliferation of hEPCs, especially the scaffolds with 10-6 and 10-5 mol tanshinol coating. Compared with the β-TCP scaffold, the scaffolds with 10-6 and 10-5 mol tanshinol coating significantly upregulated the nitric oxide level at 14 days of culture, and significantly increased the level of vascular endothelial growth factor at 7 and 14 days of culture (P <0.05). Although it could be found in all β-TCP scaffolds with tanshinol coating, the lumen formation was the maturest in the scaffold with 10-5 mol tanshinol coating. These results suggest the β-TCP scaffolds with tanshinol coating can promote the proliferation and endothelial differentiation of hEPCs, and hold a good cytocompatibility.

Effect of abnormal expression of miR-141 on malignant biological behav-iors of human hepatocarcinoma cells / 中国病理生理杂志

AIM:To investigate the expression of microRNA-141 (miR-141) in human hepatocellular carcino-ma (HCC) cell line SMMC-7721 and normal hepatocyte line HL-7702, and to analyze the effect of abnormal expression of miR-141 on the malignant biological behaviors of human hepatocarcinoma cells.METHODS:The RNA from SMMC-7721 cells and HL-7702 cells was extracted.SYBR Green real-time PCR was performed to detect the expression of miR-141. Synthetic miR-141 mimic and its negative control were transfected into the SMMC-7721 cells, and miR-141 inhibitor and its negative control were transfected into the HL-7702 cells by the method of Lipofectamine.After transfection, MTS assay and BrdU-ELISA were employed to evaluate the effect of miR-141 on the cell proliferation.Flow cytometry was used to detect cell cycle and apoptosis.The changes of migration ability were investigated by Transwell invasion assay.RESULTS:The expression of miR-141 in the SMMC-7721 cells was significantly lower than that in the HL-7702 cells ( P<0.05 ) .Com-pared with blank group, Lipofectamine group and negative control group, the proliferation of the SMMC-7721 cells trans-fected with 25 nmol/L miR-141 mimic was significantly inhibited in a time-dependent manner (P<0.05).The percenta-ges of G1 phase cells and early apoptotic rate were significantly increased when miR-141 was up-regulated, but the migra-tion ability was inhibited (P<0.05).Compared with blank group, Lipofectamine group and negative control group, the proliferation of HL-7702 cells transfected with 50 nmol/L miR-141 inhibitor was significantly increased in a time-dependent manner (P<0.05).When miR-141 was down-regulated, the percentages of G1 phase cells and early apoptotic rate were significantly decreased, but the migration ability was enhanced (P<0.05).CONCLUSION:miR-141 is down-regulated in human hepatocarcinoma cell line.Up-regulation of miR-141 will not only inhibit cell proliferation and migration ability, but also affect the cell cycle and apoptosis of SMMC-7721 cells.miR-141 may function as a tumor suppressor gene during HCC development.

A comparative study of organ-system based integrated curriculum model and traditional teaching model in medical education / 中华医学教育探索杂志

Objective By comparing the organ system based medical integration teaching mode and traditional teaching mode to evaluate the effect of the integration of curriculum implemen-tation. Methods Through a questionnaire survey of 63 students who implement integrated curriculum and 183 students who are not implementing integrated curriculum as well as 76 teachers, we evaluate students' emotional, cognitive and motor skills, using SPSS statistical analysis, chi-square test. Results In the affective domain, most of the teachers thought the experimental class was superior to the com-mon one in learning interest, lifelong learning and independent learning, critical thinking, the contrast of the two classes were P=0.000, P=0.031 and P=0.001 respectively, all of significant difference. In the cognitive domain, the contrast of the two classes in memory, understanding and application were P=0.000, all of significant difference. The experimental class has high degree of recognition. In the psychomotor domain, more than 55.3%(42/76) of the teachers thought that the experimental class was superior to the common class. According to the students' questionnaire survey, the contrast of the two classes in clinical operation skills, Interpersonal communication skills were P=0.077, P=0.031 respec-tively. There was no statistically significant difference. Conclusions The integrated curriculum teach-ing model can greatly promote students' abilities in most areas such as interest in learning, lifelong learning awareness, clinical thinking ability; interpersonal communication skills etc. In some respects the differences remains to be further studied such as memory of knowledge, systematic knowledge, and clinical operation skills, etc.

Investigation and analysis of effect of teaching competition on young teachers' teaching ability / 中华医学教育探索杂志

Objective To investigate current situation of teaching competition and to put forward some feasible suggestions for improving the teaching competition of theoretical course for young teachers. Methods Questionnaire survey was conducted for 126 teachers including the effect of teaching competi-tion on effective teaching atmosphere,comprehensive teaching results,teaching ability and recommenda-tions for improvement. SPSS software was used to do statistical analysis andχ22 test was applied. P<0 . 05 stands for statistically significant difference. Results Investigation results demonstrated that teaching competition of theoretical course was conducive to forming effective teaching atmosphere,achieving better teaching effect and improving teaching ability of teachers . A χ22 test was performed on the cognition of the cultivating of classroom management ability;results demonstrated that there were significant differ-ences between teachers with more than 10 years education age and those with less than 10 years education age(χ22=4.375,P=0.0365). Conclusions Teaching competition of theoretical course is an effective way to cultivate young teachers teaching ability. Teaching competition should be combined with training and feedback and evaluation should be more scientific and objective in order to improve young teachers' teaching ability.

Postoperative pain of hemorrhoid treated with thread embedding at Changqiang (GV 1) / 中国针灸

<p><b>OBJECTIVE</b>To compare the therapeutic effect of postoperative pain of hemorrhoid treated with thread embedding at Changqiang (GV 1) and Indometacin suppository.</p><p><b>METHODS</b>Eighty cases were randomly divided into an acupoint catgut-embedding group (group A) and an Indometacin group (group B), forty case in each group. In group A, thread embedding at Changqiang (GV 1) was applied, and Indometacin suppository was put into rectum in group B. The pain intensity after 6, 12, 24, 72 hours of treatment and the the maximum scores of VAS in 24 hours (T24max VAS) of 1-3 days of postopration were evaluated with pain Visual Analogue Scale (VAS); the quantity demanded of analgesic and the adverse reaction were observed.</p><p><b>RESULTS</b>The scores of VAS after 6, 12, 24, 72 hours of treatment in group A were obviously lower than those in group B (all P < 0.05); the T24max VAS scores in group A were obviously lower than those in group B (all P < 0.05). Six cases in group A and 14 cases in group B were treated with non-steroidal anti-inflammatory drug as well. The total effective rate of 87.5% (35/40) in group A was superior to that of 62.5% (25/40) in group B, indicating the statistically significant differences between two groups (P < 0.05). There was no obvious adverse reaction in group A; in group B, headache, dizziness, nausea, vomiting, distention of chest and palpitation appeared, accounting for 11 cases.</p><p><b>CONCLUSION</b>The therapeutic effect of postoperative pain of hemorrhoid treated with thread embedding at Changqiang (GV 1) is favorable, it can reduce the quantity of analgesic, the adverse reaction, its effect is better than that of Indometacin suppository.</p>

Practice and thinking of clinical skills competition for medical students in medical colleges and universities in China / 中华医学教育探索杂志

This paper analyzed the system,methods,content,scope and standards of last two competition in order to further improve the clinical skills competition for national medical students in China.According to the characteristics of medical education,the paper proposed several opinions and suggestions as follows:repechage should be cancelled in competition system and objective structured clinical examination should be used in competition; the content,scope and criteria of the competition should take the actual ability of the medical students at graduation into consideration.

The explore of curriculum integration during Eight-year-term medical education / 中华医学教育探索杂志

Objective To research the affection and problem of Curriculum integration teaching method in eight-year term Medical Education.Methods Combination teaching and tradition teaching methods were employed in 100 students (Eight-year-term) and 127 students (Seven-year-term) respectively.A questionnaire survey and teaching effect were analyzed at last (employx2 analysis).Results Currculum integration is more acceptable(x2 =3.92,P ＜ 0.05),effective (x2 =11.07,P ＜0.01 ),systematic (x2 =11.82,P ＜ 0.01 ) and improve self-study ability better(x2 =8.51,P ＜ 0.01 ).But it's not helpful for the study enthusiasm(x2 =0.90,P ＞0.05).Conclusion Combination teaching method is more acceptable and effective than tradition method.However,the enthusiasm of study is not improved obviously.Combination Curriculum integration teaching method is a good one and worth popularizing.

The role of memory T cells in acute rejection of heart transplantation following skin transplantation / 中华器官移植杂志

Objective The presence of alloreactive memory T cells in recipient is a critical handicap to achieve transplantation tolerance.To make a mouse model which mimics the present transplant patient is important for research at this subject.Thus,we developed a novel re-transplant model and compared the alloresponse in this model with that in the conventional memory T cellstransfer model (transfer control).Methods The re-transplant model was established via microsurgery and vessel cannula techniques,and the experiment was composed of three groups:the re- transplant group,memory T cell-transfer group (transfer control) and the conventional blank group (blank control).The research indexes included survival time of donor heart,rejection score of allograft,and detection of proliferation and differentiation of the alloreactive memory/effector T cells by by flow cytometry (FCM) and in vitro mixed lymphocyte reaction (MLR).Results The median survival time of allograft in re-transplant recipients was significantly shortened compared to that of transfer control,but there was no significant difference in rejection score of graft between them (the score in retransplant group was the most intense of the three groups). Moreover, proliferation and differentiation of the alloreactive effector T cells were more intensive in re- transplant recipients than in the transfer control,which was confirmed by in vitro MLR and by FCM of the splenocytes for detecting CD44highCD62L-memory/effector phenotype cells.Conclusion The recall alloresponse in retransplantation is more intensive than that in memory-transfer setting and this re-transplant model is more close to the clinic situation than the memory-transfer model in rodents.

Surgical treatment of cardiac myxoma / 中国综合临床

Objective To review and sum up the experience of diagnosis and surgical treatment of cardiac myxoma. Methods 133 patients with cardiac myxoma of different locations from January 1990 to May 2007 admitted in Qilu Hospital of Shandong University and Department of Cardivovascular Affdiafed Zhong shan Hospital of Xiamen Unversity were clearly diagnosed by two dimensional echecardiography. The tumors of 109 patients were located in left atrium ,22 in right atrium and 2 in both cardiac atria. All the patients underwent tumor extirpation under extracor-poreal circulation. Atrioventricular valve plasty was performed when necessary. 11 underwent bicuspid valvuloplasty and 6 underwent tricuspid valvuloplasty at the same time. All the minors were sent to histopathology examination. Re-suits Two patients died of low cardiac output syndrome in early postoperative period. Cerebral embolism happened in 6 cases,left lower extremity embolism and pulmonary embolism in 1 ease respectively. Other patients' symptoms were improved and the physical sign disappeared. All the tumors were demonstrated to be benign cardiac myxoma. Conclusions Most cardiac myxoma is benign but its clinical consequence is severe. So tumor extirpation should be performed as soon as possible and the following-up is important after operation. Prevention of tumor defluvium is im-portant. Two dimensional echocardiography is preferred in the diagnosis of cardiac myxoma.

The Annotation and Application of the Several Main Resources in Clinical Practice / 中华医学教育探索杂志

To adapt to the variety of environment,the teaching of clinical practice must face some innovations and reformations in the contents and methods.The article discusses the specialties and applications of the several main resources,such as clinical teachers(the resource of manpower)?the training center of clinical skills(the resource of methods) ?the SP(the resource of carriers),then,provides some useful information for the teaching innovations in clinical practice.

Discussion on the Development of the HigherEducation in Medical Science after Joining with the Synthetic University / 中华医学教育探索杂志

In the last few years, Many medical colleges have been joined with synthetic universities because of creat-ing the international and well-known and high level universities. In the article the author expounds the exploitation'sadvantage of synthetic university respectively from the foundational mode, the humanities and agency science, the cal-culator technique and the knowledge diversification. He also discusses the problems arising from the united universityand the correlative plan to the effect of the problems from the contradiction of resources` division,the managing mode ofthe medical education, the phenomena of "Teaching is heavier than Researching" and the popularization of highereducation, hoping to draw lessons from the advanced experience abroad extensively to enhance and perfect the newmode of our higher medical education.[

Evaluation on the Effect and Safety of Point Injection and Embedding The rapy on Postoperative Pain of Hemorrhoid Patients / 中医杂志

Objective To evaluate the effect and safety of point injection and em bedding therapy on postoperative pain of hemorrhoid patients. Me thods Totally 105 hemorrhoid patients were rand omized into a treatment group (54 cases) and a control group (51 cases). The tre atment group was treated by point injec tion and embedding therapy at Changqiang point (GV 1) under the local anesthesia . The control group was treated by Indometacin Suppository after operation. On the fir st, second, four th and seventh day of the treatment, the pain occurrence, pain severity, and com prehensive effect scores were recorded for the evaluation of therapeutic effect and safety. Results On all interview periods, the compr ehensive effect score, pain occurrence, pain severity, patient satisfaction, occurrence of untoward eff ect, complications, and analgesics combination in the treatment group were all superior to those in the control group (P