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ObjectiveTo observe the effect of bilateral sequential repetitive transcranial magnetic stimulation on the motor function of upper limbs in stroke patients. MethodsFrom December, 2020 to December, 2022, 62 stroke inpatients in the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were included. They were randomly divided into control group (n = 31) and observation group (n = 31). Both groups accepted conventional medicine and rehabilitation, as well as electroacupuncture antagonistic muscle therapy. Before electroacupuncture, the observation group acceped low-frequency repetitive transcranial magnetic stimulation at primary motor cortex (M1) on the healthy side, followed by intermittent theta burst stimulation at M1 on the affected side, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Barthel Index (MBI) and modified Ashworth Scale (MAS), and motor evoked potential (MEP) latency was compared before and after treatment. ResultsOne patient dropped down in the observation group, and no adverse event happened. After treatment, the scores of FMA-UE and MBI significantly increased (|t| > 9.953, P < 0.001), and the score of MAS and the latency of MEP significantly decreased (|t| > 5.043, P < 0.001) in both groups; while all of them were better in the observation group than in the control group (|t| > 2.237, P < 0.05). ConclusionBilateral sequential repetitive transcranial magnetic stimulation can effectively promote the recovery of upper limb motor function in stroke patients.
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China’s anti-epidemic actions has always adhered to the value of people first and life first, which has profoundly affected the perception of medical humanism by the whole society, especially medical workers. The epidemic prevention and control has put forward new requirements for medical personnel to practice medical humanism, reflecting the unique connotation of the times. In the context of normalized epidemic prevention and control, it is timely to reshape the humanistic spirit of medicine, which has extremely important value of the times. On the basis of explaining the connotation and significance of medical humanism, this paper analyzed the impact and influence of the epidemic on the medical humanism of medical personnel. The value orientation of medical humanism, which is the unity of synergy and innovation, the unity of doctor’s kindness and social responsibility, and the unity of national spirit and human health community, was constructed, and suggestions for reconstructing medical humanism were put forward in terms of improving institutional norms, strengthening education and training, promoting the synergistic development of medical technology and medical humanism, and creating a harmonious humanistic atmosphere.
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Objective To evaluate the imaging features of nigrosome-1 in Parkinson's disease (PD) with a 3 T scanner by susceptibility weighted imaging (SWI),and to explore its clinical relevance.Methods Thirty-two patients with primary PD diagnosed by neurologists were collected.Healthy controls matched to their age and gender were recruited during the same period (n=20).All subjects underwent routine brain magnetic resonance imaging (MRI) and sensitive weighted imaging (SWI).The SWI images of the subjects were evaluated to evaluate nigrosome-1 by blinded investigators.Then,the correlation between imaging features and clinical data was analyzed.Results In the PD group,21 cases of bilateral "absent swallow-tail sign",five cases of bilateral "indecisive swallow-tail sign",five cases of "absent swallow-tail sign" on one side and "indecisive swallow-tail sign" on the other side,and one case of bilateral "clear swallow-tail sign" were found.The course of the "absent swallow-tail sign" group (56 (54) months) was significantly longer than the "non-absent swallow-tail sign" group (18 (18) months;U=-2.47,P=0.01).The Hoehn-Yahr stage was significantly higher in the "absent swallow-tail sign" group (2.0 (0.5)) than in the "non-absent swallow-tail sign" group (1.5 (0.5),U=-2.21,P=0.03).There was also a statistically significant difference in the Unified Parkinson's Disease Rating Scale score (24 (8),13 (14)) between the two groups (U=-2.91,P=0.01).However,there were no statistically significant differences between the two groups in the Hamilton Depression Scale score (5 (2) vs 5 (7),U=-0.10,P=0.94) and the Hamilton Anxiety Scale score (3.0 (2.5) vs 3.0 (3.0),U=-0.02,P=1.00).Conclusion The images of nigrosome-1 by SWI are closely related to the severity of the condition and motor symptoms of patients with PD,which can reflect the severity of the disease.
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Therapeutic plasma exchange can quickly remove the pathogenic macromolecular sub-stance in vivo,and its application is gradually expanded. With the maturity and development of plasma ex-change technology,the effect of high volume plasma exchange in liver failure,thrombotic thrombocytopenic purpura,sepsis and other diseases is obvious. But there is still controversy about the wide use of high volume plasma exchange in ICU. This review aimed to discuss the use of high volume plasma exchange in patients with critical diseases.
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Objective To understand the academic atmosphere current situation of graduate students and put forward relevant countermeasures to protect the academic integrity of graduate students.Methods The graduate student'scientific ethics and academic atmosphere construction situation of graduate students in 10 colleges and universities in Chongqing were investigated by questionnaire survey and analyzed.Results Through 1555 questionnaires,it was found that the average investment of time on scientific research in gruduate students was insufficient,the motivation of learning was complicated,and the situation of preventing academic misconduct was serious.Conclusion This study suggests that colleges and universities should establish an academic integrity security system for graduate students,including establishment of academic integrity system and specializing academic integrity supervision institutions,and strengthing academic integrity education.
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Objective To investigate the protective effects and mechanism of insulin(INS) on brain in septic rats,and explore the possible role of uncoupling protein 2 (UCP2) in these effects.Methods Fifty male specific pathogen free(SPF) Sprague-Dawley rats were randomly divided into normal control (CN) group(n=10),lipopolysaccharide(LPS) group(n=20) and INS group (n=20) according to random number table.The septic rat model was established through an intraperitoneal injection of 15 mg/kg LPS of gram-negative bacteria.The rats in the INS group received a 1 U/kg INS injection subcutaneously 30 minutes before the injection of LPS,and the rats in the CN group were given equivalent 9 g/L saline in the same way.Eight rats in each group were killed,and their cerebral cortex were collected after the injection of LPS for 24 h.Pathological change of cerebral cortex was detected by Hematoxylin-Eosin(HE) staining.The cerebral cortex mitochondia were extracted for detecting the levels of reactive oxygen species(ROS),malondialdehyde (MDA) and the activity of superoxide dismutase(SOD).Neuronal apoptosis was detected by terminal dexynucleotidyl transferase(TdT)-mediated dUTP nick end labeling staining.UCP2 mRNA expression was detected by quantitative real-time(RT)-PCR.Apoptosis-associated protein B lymphocyte tumor-2(Bcl-2),Bcl-2 associated X protein(Bax),cleaved cysteinyl aspartate specific protease(cleaved Caspase-9) and UCP2 protein expression were determined by Western blot.Results (1)Compared with the CN group,obvious abnormal pathological change was revealed by HE staining in cerebral cortex of rats in the LPS group and the INS group,but the pathological change was attenuated in the INS group compared with the LPS group.(2)Compared with the CN group,the levels of mitochondrial ROS[(210.01±14.09) RFU vs.(49.06±7.28) RFU] and MDA[(2.19±0.18) nmol/mg pro vs.(1.25±0.11)nmol/mg pro]in the LPS group significantly increased,whereas SOD activity significantly decreased [(238.49±35.60) U/g pro vs.(446.66±24.90)U/g pro],and the differences were significant(all P<0.05).Compared with the LPS group,the levels of ROS [(152.69±15.83) RFU vs.(210.01±14.09) RFU] and MDA[(1.55±0.14) nmol/mg pro vs.(2.19±0.18) nmol/mg pro] in the INS group decreased,while SOD activity increased[(327.8±23.26) U/g pro vs.(238.49± 35.60) U/g pro],and the differences were significant(all P<0.05).(3)Compared with the CN group,the neuronal apoptosis index of cortex in the LPS group was elevated[(54.16±6.84)% vs.(5.45±1.43)%],while the expression of Bcl-2 decreased (627±0.018 vs.0.739±0.020),but the expressions of Bax(0.768±0.019 vs.0.520±0.010) and cleaved Caspase-9(0.739±0.016 vs.0.467±0.030) increased,and the differences were significant(all P<0.05).Compared with the LPS group,the neuronal apoptosis index of cortex in the INS group decreased [(33.30±3.07)% vs.(54.16±6.84)%],but the Bcl-2 expression increased (0.743±0.022 vs.0.627±0.018),and Bax (0.687±0.034 vs.0.768±0.019) and cleaved Caspase-9(0.551±0.013 vs.0.739±0.016) were reduced,and the differences were significant (all P<0.05).(4)Compared with the CN group,the mRNA (2.248±0.155 vs.1.000±0.100) and protein expression of UCP2 (0.659±0.016 vs.0.599±0.018) were elevated in the LPS group.Compared with the LPS group,the UCP2 mRNA (2.944±0.117 vs.2.248±0.155) and UCP2 protein (0.719±0.018 vs.0.659±0.016) increased,and the differences were significant(all P<0.05).Conclusions INS can protect the brain of septic rats through alleviating mitochondrial oxidative stress and inhibiting the mitochondrial-initiated apoptotic pathway to reduce neuronal apoptosis.INS upregulates UCP2 expression in the brain of septic rats,which may play a role in the protective effects mentioned above.
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Uncoupling protein 2(UCP2)is a proton transporter which presents in the mitochondrial inner membrane. Recent studies have found that UCP2 plays important roles in protecting mitochondria functions,re-ducing mitochondrial ROS generation by inducing proton leak across the inner mitochondrial membrane and pro-moting mild uncoupling which leading to a decrease in the mitochondrial inner membrane′s potential. Because of its antioxidant function,UCP2 has been studied in several domains. This review provides novel insights into the molecular mechanisms,by which the activity of UCP2 is regulated and describe novel findings concerning basical experiments of UCP2.
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Objective To investigate the differential expression of microRNA - 30e in sepsis - induced acute lung injury(ALI)and its correlation with interleukin(IL)- 1β and tumor necrosis factor(TNF)- α from two aspects of in vivo and in vitro. Methods Thirty SD male rats were randomly divided into 5 groups:normal control group,3 - hour sepsis group,6 - hour sepsis group,12 - hour sepsis group and 24 - hour sepsis group in equal number. Sepsis - in-duced ALI model was induced by intraperitoneal injection of lipopolysaccharide(LPS,10 mg/ kg). The rat alveolar mac-rophages NR8383 were divided into blank control group and LPS(1 mg/ L)stimulated 3,6,12,24 hour groups. Inverse transcription - polymerase chain reaction was used to assay the production changes of IL - 1β,TNF - α and miRNA - 30e in lungs and cells. The injury of lung tissue was evaluated through histopathology. Results The levels of IL - 1β and TNF - α in lung tissues of rats in sepsis groups were obviously up - regulated when compared with those in normal control groups(all P ﹤ 0. 01). The lung tissue hematoxylin - eosin staining indicated ALI in the sepsis group. The relative expression of miR - 30e in rat lung tissue in sepsis 3,6,12,24 hour groups were respectively 0. 26 ± 0. 02, 0. 41 ± 0. 08,0. 29 ± 0. 05 and 0. 18 ± 0. 05,which were significantly lower than those in normal control group(1. 23 ± 0. 24,all P ﹤ 0. 01). The levels of IL - 1β and TNF - α in LPS stimulated NR8383 cells at different time points were obviously up - regulated when compared with those in blank control groups(all P ﹤ 0. 01). The relative expression of miR - 30e in LPS stimulated 3,6,12,24 hour groups were respectively 0. 27 ± 0. 04,0. 55 ± 0. 05,0. 65 ± 0. 02 and 0. 41 ± 0. 10,which were significantly lower than those in blank control group(1. 17 ± 0. 21,all P ﹤ 0. 01). The expres-sion of miR - 30e in lung tissues of groups showed significantly negative correlations with those of IL - 1β and TNF - α(IL - 1β:r = - 0. 417,P = 0. 022;TNF - α:r = - 0. 437,P = 0. 016). The expression of miR - 30e in LPS stimulated NR8383 cells of groups also showed significantly negative correlations with those of IL - 1β and TNF - α(IL - 1β :r =- 0. 713,P = 0. 003;TNF - α:r = - 0. 712,P = 0. 002). Conclusions The expression level of miR - 30e was signifi-cantly down - regulated in sepsis - induced ALI,and had a significantly negative correlation with IL - 1β and TNF - α, which may be used as a new biomarker of diagnostic,prognosis evaluation and therapy of sepsis - induced ALI.
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Since the implementation of synergy of medical education, the education of clinical medi-cal postgraduate of academic degree inevitably has faced problems such as the decrease quality of the source of students, unclear training objectives and confused training model, and bad job prospects. Can these problems be solved effectively or not, which is directly related to the coordinated development of clinical medicine professional degree and academic degree. This study analyzes the problems faced by the graduate education of clinical medicine after the synergy of medical education and puts forward the corresponding countermeasures:firstly, to attract excellent clinical medical undergraduates and encourage medical students of related subjects or clinical doctors having working experience to apply for academic degree;secondly, the university, supervisors and graduates need to clear the training target and ensure the quality of graduate education; thirdly, employment guidance should be carried out throughout all the study stage of graduates, and the school should guide the graduates to form correct opinion of employment and to plan their career reasonably.
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Curriculum study is a major phase for medical postgraduate education,however,the patterns of the curriculum system are not uniform among domestic medical colleges,not to mention the uniformed patterns for scientific degree and professional degree.Hence,our school has reformed the curriculum system to set up different curriculum systems for both scientific degree and professional degree according to their different educational goals in an aim to improve the quality of education.
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Strengthening the construction of supervisor team has great effects on the improvement of the quality of postgraduate education.Some problems exist in China's current situation of the construction of supervisor team.For example,the quality of supervisors needs to be improved,the quantitative evaluation system is not scientific,the quantity of professional degree supervisors is not enough,and the dynamic evaluation mechanism is imperfect and so on.Strengthening the construction of supervisor team from the development of scientific and rational quantitative evaluation index system,the selection of professional degree supervisors,the enhancement of supervisor training and some other aspects,can effectively improve the quality of postgraduate education.
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It introduced the standardized management of graduate students' experimental records. On the basis of experimental records standardization, 3 level inspection system including tutors, departments and graduate school plays a very important role in setting up the good habit, getting more reliable experimental results and preventing the happening of misconduct in scientific research.
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With the size of graduate education continues to expand,deepening the reform of graduate education to improve the quality of graduate education has become the core of graduate education.This paper introduces the common problems and solution of graduate education in cilinical medicine professional degree.
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The important sign of scaling graduate culture quality is the quality of doctor degree papers.By strengthening the doctor degree management and carrying out the system of outside university experts' double blind judge,the doctor degree papers can be appraised scientifically,reasonably,impersonally and justly so as to achieve the aim of promoting the quality of doctor degree thesis.
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The clinic ability training is the important tache of cultivating postgraduates with the degree of clinical medicine and the clinic ability training's quality control is the important issue.This paper analyzed the existent problems in cultivation at present and expatiated the steps and countermeasure we ought to adopt in light of the actual condition of our university.