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In the context of a healthy China, strengthening humanistic literacy education for general medical students reflects the demands of the times, promotes the transformation of medical models, and has important practical significance in reducing the work burnout of general practitioners in practice. Integrating narrative medicine into general practice student education is conducive to implement the patient-centered concept of general practice, provide continuous and systematic medical services, and further improve the humanistic literacy of general practitioners. Based on these, this paper proposed the relevant paths of integrating narrative medicine into student education in general medicine, including changing educational concepts and integrating educational resources, boldly carrying out curriculum reforms and innovating educational methods, fully utilizing parallel medical records and reflective writing, as well as cultivating the habit of lifelong learning.
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Objective To evaluate the effect of applying sitting posture corrector on improving reading and writing posture of elementary school students， and provide scientific evidence for prevention and control of myopia in children and adolescents. Methods One elementary school each in urban and suburban areas of Shanghai was selected using a convenience sampling strategy. Furthermore， two classes each in Grade 3 and 4 were selected as the intervention group （282 students were included in the study）， and the other two classes each in Grades 3 and 4 were selected as the control group （294 students were included in the study）. Students in the intervention group used the sitting posture corrector in the classrooms for 4 months （from September 2020 to January 2021）， while those in the control group did not use the sitting posture corrector. Relevant data were collected before and after the intervention through a self-administered questionnaire and visual examination. Statistical analysis was performed using chi-square test and generalized estimating equation. Results Before the intervention， 13.5% （38/282） of students in the intervention group and 12.2% （36/294） in the control group had good reading and writing posture （ χ 2 = 0.195， P >0.659）. After the intervention， 18.4% （52/282） of students in the intervention group had good reading and writing posture， which was higher than that （11.2%， 33/294） in the control group （ χ 2=5.957， P =0.015）. Before and after the intervention， there was no significant differences in the prevalence of myopia between students in the intervention and control groups （all P >0.05）. Generalized estimating equation analysis showed that students in the intervention group were 1.502 times more likely to have good reading and writing posture than those in the control group after the intervention （ P =0.043）. Conclusion Applying sitting posture corrector in schools could improve students' reading and writing posture.
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Objective To evaluate the effect of applying sitting posture corrector on improving reading and writing posture of elementary school students， and provide scientific evidence for prevention and control of myopia in children and adolescents. Methods One elementary school each in urban and suburban areas of Shanghai was selected using a convenience sampling strategy. Furthermore， two classes each in Grade 3 and 4 were selected as the intervention group （282 students were included in the study）， and the other two classes each in Grades 3 and 4 were selected as the control group （294 students were included in the study）. Students in the intervention group used the sitting posture corrector in the classrooms for 4 months （from September 2020 to January 2021）， while those in the control group did not use the sitting posture corrector. Relevant data were collected before and after the intervention through a self-administered questionnaire and visual examination. Statistical analysis was performed using chi-square test and generalized estimating equation. Results Before the intervention， 13.5% （38/282） of students in the intervention group and 12.2% （36/294） in the control group had good reading and writing posture （ χ 2 = 0.195， P >0.659）. After the intervention， 18.4% （52/282） of students in the intervention group had good reading and writing posture， which was higher than that （11.2%， 33/294） in the control group （ χ 2=5.957， P =0.015）. Before and after the intervention， there was no significant differences in the prevalence of myopia between students in the intervention and control groups （all P >0.05）. Generalized estimating equation analysis showed that students in the intervention group were 1.502 times more likely to have good reading and writing posture than those in the control group after the intervention （ P =0.043）. Conclusion Applying sitting posture corrector in schools could improve students' reading and writing posture.
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Objective:To analyze the related factors affecting the use of autogenous arteriovenous fistula (AVF), and provide a theoretical basis for prolonging the service life of AVF in hemodialysis patients.Methods:This was a retrospective study. The patients undergoing AVF and using it to maintain hemodialysis (MHD) in the First Affiliated Hospital of Nanchang University from October 2004 to June 2017 were selected as study subjects to discuss the relevant factors affecting the service life of AVF. The data of general information, dialysis and laboratory examinations were collected through questionnaire surveys, hospital case system and hemodialysis record sheets. The patients were divided into the patency group and the dysfunction group according to the status of AVF, and the related factors were compared. Multivariate Cox proportional hazard model was used to analyze the influencing factors, and Kaplan-Meier survival curve was used to determine the service life of AVF, respectively.Results:A total of 187 subjects were included in the study. The patency group had 140 cases and the dysfunction group had 47 cases. There were statistically significant differences in the proportion of diabetes, the level of serum albumin, uric acid and parathyroid hormone (PTH) between the two groups (all P<0.05). Multivariate Cox proportional hazard regression analysis showed that diabetes ( HR=9.348, 95% CI 3.507-24.918, P<0.001) and hypoalbuminemia ( HR=12.650, 95% CI 2.925-54.714, P=0.001) were risk factors for the short service life of AVF. The results of Kaplan-Meier analysis showed that the service life of AVF in patients with diabetes was significantly shorter than that in MHD patients without diabetes (Log-rank χ2=13.191, P<0.001); the service life of AVF in patients with hypoalbuminemia was significantly shorter than that without hypoalbuminemia (Log-rank χ2=13.591, P<0.001). Conclusions:Diabetes mellitus and hypoalbuminemia are risk factors for the short service life of AVF. Therefore, intervention programs should be formulated to extend the service life of AVF.
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Objective:To explore the correlation between serum level of matrix metalloproteinase 2 (MMP-2)and se-verity of coronary artery disease in aged patients with acute coronary syndrome (ACS)complicated hyperhomocys-teinemia (HHCY).Methods:According to serum level of homocysteine (Hcy),a total of 105 aged ACS patients were selected and divided into ACS+HHCY group (n=56)and pure ACS patients (n=49),another 65 healthy in-dividuals were enrolled as healthy control group.The severity of coronary artery disease was showed by Gensini score ;enzyme linked immunosorbent assay was used to measure serum MMP-2 level in each group.Results:Com-pared with healthy control group,there were significant rise in MMP-2 level [(140.8±50.1)ng/ml vs.(442.5± 98.2)ng/ml,(297.9±86.3)ng/ml]in ACS+HHCY group and pure ACS group,P <0.01. Gensini score in ACS+HHCY group was significantly higher than that of pure ACS group [(1.9±0.2)scores vs.(1.1±0.3)scores,P<0.01].Pearson correlation analysis indicated that Gensini score was positively correlated with MMP-2 level in ACS+HHCY group (r =0.424,P <0.05).Conclusion:The serum MMP-2 level is significantly positively correla-ted with severity of coronary artery disease in aged patients with ACS complicated HHCY.
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Objective To observe the expression of toll like receptor 4(TLR4) Signaling and the release of inflammation factors in rat tubular epithelial cell(NRK-52E) under high glucose condition after TLR4-siRNA transfection.Methods Three TLR4-siRNA sequences were designed and synthesized.The transfection efficiency was observed by fluorescence microscope after transfection,and the expression of TLR4 mRNA was detected by real time PCR.The most effective siRNA was selected to be used for forward experiments.After transfection for 24 h,cells were stimulated with 25 mmol/L glucose and/or 10-7 mmol/L Angiotension Ⅱ (Ang Ⅱ) for 12 h,24 h; cells without stimulation were as normal control.Real-time PCR was used to analyze TLR4 and myeloid differentiation factor 88 (MyD88) mRNA expression; Western blot was used to observe TLR4/MyD88 and NF-κB protein expression.ELISA assay was used to detect the concentration of monocyte chemoattractant protein-1 (MCP-1),interleukin-6(IL-6) in cell supernatant after cells were stimulated for 24 h.Results TLR4/ MyD88 mRNA and TLR4/MyD88/NF-κB protein were highly expressed under high glucose or Ang Ⅱ co -incubated NRK-52E(P ＜ 0.01),the MCP-1 and IL-6 levels were also increased markedly compared with normal control group (P ＜ 0.01).TLR4/MyD88 mRNA and TLR4/MyD88/NF-kB protein expressions were obviously inhibited in cells that were transfected with TLR4-siRNA compared with high glucose group(P ＜ 0.01),MCP-1 and IL-6 production decreased remarkably compared with high glucose or Ang Ⅱ co-stimulated group(P ＜ 0.01).Conclusions High glucose can lead to the activation of TLR4/ MyD88/NF-kB signaling and the secretion of inflammation factors in NRK-52E,Ang Ⅱ further augments these effects.The effect can be blocked efficiently by specific siRNA gene silence.TLR4 signaling plays a pivotal role in the innate-immune inflammatory reaction in NRK-52E.
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BACKGROUND:The glass ionomer cement has good biological stability and can sustain the release of fluoride, which has been used as dental repair materials. But because of its low mechanical strength, the glass ionomer cement is confined to the front teeth and other parts with smal er force. OBJECTIVE:To analyze the compressive strength, microleakage and other physical performances of Fuji IX glass ionomer cement after the addition of 8%modified nano-hydroxyapatite. METHODS:(1) Universal testing machine was applied to detect the compressive strength of Fuji IX glass ionomer cement, Fuji IX glass ionomer cement added with 8%modified nano-hydroxyapatite, and super glass ionomer to fil the stainless steel cylinder. (2) Fuji IX glass ionomer cement, Fuji IX glass ionomer cement with 8%modified nano-hydroxyapatite and super glass ionomer were used to fil the tooth cavity;then, the microleakage was detected. (3) Fuji IX glass ionomer cement, Fuji IX glass ionomer cement added with 8%modified nano-hydroxyapatite, and super glass ionomer were used to fil stainless steel rectangular specimens. Then, universal material testing machine was applied to detect the bending strength value. RESULTS AND CONCLUSION:The compressive strength, microleakage, and bending strength of specimens fil ed with Fuji IX glass ionomer cement the addition of 8%modified nano-hydroxyapatite were better than the other two groups, and Fuji IX glass ionomer cement was superior to the super glass ionomer in the compressive strength, microleakage and bending strength of fil ed specimens. It is shown that Fuji IX glass ionomer cement after addition of 8%improved nano-hydroxyapatite can improve the compressive strength and microleakage.
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Objective To analyze the outcome and prognosis-related factors of MA (mitoxantrone+cytarabine) regimen for acute myeloid leukemia(AML). Methods 102 untreated AML patients were treated with MA. All patients were divided into two groups according to age, blood white cell count(WBC), FrenchAmerican-British (FAB) morphology, level of lactate dehydrogenase (LDH) and immunophynotype respectively.Analyze the prognosis-related factors. Results The complete remission (CR), partial remission (PR), nonresponse (NR) rate, and remission rate (CR+PR) of all the 102 cases were 63.73 % (65/102), 17.65 % (18/102), 18.62 % (419/102)and 81.38 % (83/102) respectively. The patients younger than 60 years old, WBC＜100×109/L, LDH≤600 U/L, FAB-M2 morphology group had higher CR and remission rate. The CR rate of patients with CD7 positive had statistical difference from that of patients with CD7 negative (P ＜0.05), but the remission rate not. However, the CR and remission rate of patients with CD19 positive had no statistical difference from that of patients with CD19 negative (P ＞0.05). Conclusion These results suggest that use of MA regimen was effective and safe for AML. Age, WBC, FAB morphology, level of LDH and CD7 expression are prognosis-related factors for clinical outcome.