Practice and thinking of building active learning general practice team based on learning health system / 中华全科医师杂志

By sorting out the differences and connections between family doctor teams and specialized disease teams, role competency and mutual collaboration, and introducing the learning health system (LHS) mechanism, a comprehensive operating system for community general practice learning organizations based on LHS was constructed, focusing on five single disease types. The system includes a combination of general and specialized medicine that links three levels of medical institutions, thereby opening up the business cooperation process between professionals in different institutions, and establishing a sustainable collaboration mechanism. This allows medical institutions at three levels to continuously tap the potential of their disciplines, achieve their own ability growth and feel higher work value, and also bring better health solutions to residents, guided by the common goal of "health centered, patient centered".

Comparison of CT Features of Omicron and Influenza A-H1N1-Associated Viral Pneumonia:Initial Onset and Follow-Up / 中国医学影像学杂志

Purpose To compare the CT imaging features of the novel coronavirus Omicron variant and influenza A-H1N1-associated viral pneumonia,and to investigate the factors associated with the uptake process of the two pneumonias.Materials and Methods A total of 43 patients with Omicron virus pneumonia(Omicron group)and 30 patients with influenza A(H1N1)virus pneumonia[influenza A(H1N1)group]in Civil Aviation General Hospital from December 2022 to March 2023 were retrospectively collected.The clinical data of the two groups were compared,including age,gender,symptoms(fever or not),duration of symptoms and incidence of complications.White blood cells,monocytes,lymphocytes,neutrophils,C-reactive protein,etc.]and initial and follow-up CT imaging features[lesion density,distribution,signs and qualitative CT severity score(CTSS)].Results The mean age of patients in Omicron group was higher versus that in H1N1 group[(68.61±15.94)years vs.(51.20±16.39)years,P<0.000 1],and the fever rate in Omicron group(58.1%vs.86.7%,P=0.009)and monocyte count[(0.40±0.16)vs.(0.58±0.19),P<0.000 1]were lower than those in the influenza A(H1N1)group.Chest CT showed that the lesions of patients in the Omicron group were mainly distributed under the pleura,and the lesions of patients in the influenza A(H1N1)group were mainly distributed under the pleura and along the bronchovascular bundle(χ2=8.592,P=0.035).Patients in the Omicron group were more likely to have interlobular septal thickening(χ2=11.753,P=0.001),paving pattern(χ2=16.216,P<0.000 1),air bronchogram(χ2=16.216,P<0.000 1),pleural effusion(P=0.039)and pleural thickening(χ2=4.067,P=0.044)than patients in the influenza A(H1N1)group,while patients in the influenza A(H1N1)group were more likely to have nodules than those in the omicron group(χ2=6.971,P=0.008).The CTSS scores of patients in the omicron group were higher than those in the influenza A(H1N1)group at the initial diagnosis(Z=413,P=0.009)and follow-up(Z=107,P=0.027).The correlation between the change of follow-up CTSS and the initial CTSS in the Omicron group was the strongest(r=0.689,P<0.000 1).There was the strongest correlation between the change of follow-up CTSS and the duration of symptoms in influenza A(H1N1)group(r=0.954,P<0.000 1).Conclusion Patients in the Omicron group have a higher range of initial and follow-up lesions than those in influenza A(H1N1)group,and the degree of pneumonia absorption in the omicron group may be related to the initial CTSS,whereas in the influenza A(H1N1)group it may be related to the duration of symptoms.

Training the skills of obstetric forceps delivery for resident doctors by using simulation teaching method / 中华医学教育探索杂志

In this study, 15 second-year resident doctors who had standardized training of OBGYN were taken as research subjects to discuss the effect of training resident doctors with obstetrics forceps by using simulation teaching method. The simulation teaching process includes theoretical study, theoretical examination, simulation teaching of forceps skills and Assessment of forceps skills. In theoretical study section: before learning to use forceps, the students acquired the theoretical knowledge by flipped teaching micro-video mode. In theoretical examination section: the mastery of basic clinical knowledge of using forceps was evaluated through online assessment. In simulation teaching of forceps skills: students who scored 8/10 points were admitted to enter the simulation teaching process, and they had practical training of scenario simulation skills in Clinical Skills Center. In assessment of forceps skills: the mastery of forceps skills was evaluated by standardized forceps delivery procedure items. The results showed that the students in the simulation teaching group had excellent teaching assessment results, and the resident doctors had more confidence in operating forceps independently, and the teaching effect was ideal, which could further promote the simulation teaching of obstetric clinical skills.

Expression change of SH2B1, SOCS3, PTP1B and NPY in mice hypothalamus and its relation with obesity / 中南大学学报(医学版)

OBJECTIVE@#To investigate the expression pattern of adapter protein with a Src-homology 2 domain (SH2B1), the suppressor of cytokine signaling-3 (SOCS3), protein-tyrosine phosphatase 1B (PTP1B) and neturopetide Y (NPY) in obese and normal mice hypothalamus and its relation with serum leptin and insulin levels.@*METHODS@#The obesity animal model was prepared with healthy C57/bl6 mice. Lee's index and Homeostasis model assessment-insulin resistance (HOMA-IR) were calculated. The mRNA levels of SH2B1, SOCS3, PTP1B and NPY were measured by fluorescent quantitation RT-PCR. The SH2B1 and NPY protein expressions were detected by Western blot.@*RESULTS@#Compared with the normal mice of the same age, SH2B1 mRNA expression in the obese mice hypothalamus decreased. SOCS3 and PTP1B mRNA expression increased. Western blot showed that SH2B1 protein expression decreased, while NPY protein expression increased in the obese mice. Linear correlation analysis showed that the serum leptin and fasting insulin levels were negatively correlated with SH2B1mRNA expression and positively correlated with SOCS3 and PTP1B mRNA expression.@*CONCLUSION@#SH2B1, SOCS3, PTP1B and NPY are key factors for obesity development.

Mental health states of patients with recurrent chest pain after percutaneous coronary intervention and coronary artery bypass grafting / 中国组织工程研究

BACKGROUND:Many researchers appealed that coronary atherosclerotic heart disease patients were medical treated while special psychological intervention should be integrated into the rehabilitation plans (biology-psychology-social treatment) for coronary atherosclerotic heart disease patients.Pertinence psychological intervention would be processed after finding out mental health state of coronary atherosclerotic heart disease patients.OBJECTIVE:To make principal component analysis for mental health state of coronary atherosclerotic heart disease patients with relapsing pain in chest after percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) by questionnaire investigation,and to find out the primary factors.METHODS:A total of 40 coronary atherosclerotic heart disease patients with relapsing pain in chest after PCI and CABG were selected,(25 males and 15 females),mean age of (60±10) years old.It was used that the mental health section of the integrative system for diagnosing and assessing health state in Chinese population,including body symptoms,positive emotion,negative emotion,cognitive ability,behavior trouble,self-evaluation and social adapting problem.RESULTS AND CONCLUSION:Totally 4 principle component factors which the accumulative contribution rate reached to 83.89% were extracted.The first principle component factors which the contribution rate reached to 40% mainly demonstrated behavior trouble and social adapting problem.The second one mainly demonstrated positive emotion and negative emotion,the third for cognitive ability and self-evaluation,and the fourth for body symptoms.The behavior trouble and social adapting problem of coronary atheroscleroticheart disease patients with relapsing pain in chest after PCI and CABG must be paid great attention,and positive emotion would be leaded,negative emotion would be lowered.

Association of PTP1B gene polymorphism with obesity in Chinese children / 中南大学学报(医学版)

Objective To investigate the distribution characteristics of protein tyrosine phosphatase 1B (PTP1B) gene IVS6+G82A and Pro303Pro polymorphisms in Chinese children and determine the effect of PTP1B gene IVS6+G82A and Pro303Pro polymorphisms on the pathogenesis of childhood obesity. Methods A total of 147 Chinese obese and 118 healthy children were randomly selected and enrolled to identify IVS6+G82A and Pro303Pro genotypes by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assay. Waist circumference (WC), waist to hip ratio (WHR), percentage of body fat (%BF),systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), serum triglycerides (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), plasma fasting insulin (FINS), homeostasis model assessment for insulin resistance (HOMA-IR), and plasma leptin were examined. Results The allele frequencies of IVS6+G82A and Pro303Pro were 59.5% and 19.4% in obese children, and 53.4% and 11.0% in healthy children, respectively. There were significant differences in allele frequencies of Pro303Pro polymorphism between the obese and the control group. Pro303Pro polymorphism was associated with body mass index, WC, TG, and LDL C in the obese subjects. There was not di fference in the genotype distributions or allele frequencies of IVS6+G82A polymorphism between the obese and the control group. Further analysis showed no association between the genotypes of IVS6+G82A and clinical characteristics in the obese subjects. The linkage disequilibrium analysis for IVS6+G82A and Pro303Pro (D′: 0.441, r2: 0.027) was weak.Conclusion PTP1B gene Pro303Pro polymorphism might be associated with the pathogenesis of obesity in children and could affect the lipid metabolism in Chinese obese children.