Practice on the characteristic curriculum construction of undergraduate clinical medicine in Sino-foreign cooperative education program / 中华医学教育探索杂志

As one of the first institutions to carry out integrated education in China, the Shanghai Jiao Tong University School of Medicine has carried out a pilot reform of the organ system centered vertical single cycle integrated curriculum in the undergraduate medical education (five-year English stream) based on the Sino-foreign cooperative education program. The curriculum has been formed with multi-disciplinary single cycle integrated courses, longitudinal integrated courses, and three-dimensional specialized expansion electives. The curriculum focuses on the competency training of medical student. The aim is to highlight the teaching concept of early contact with clinic, attach importance to the cultivation and shaping of medical personality, achieve effective connection with post-graduation education, and realize the intersection and deep integration of social, humanities and medical professional courses through the construction of a series of course modules.

Efficacy and safety of laparoscopic versus open radical resection for hilar cholangiocarcinoma: a meta-analysis / 中华肝胆外科杂志

Objective:This article aimed to systematically evaluate the safety, feasibility and short-term outcomes of laparoscopic versus open radical resection for hilar cholangiocarcinoma.Methods:Relevant medical literatures published before November 30, 2021 were searched using PubMed, EMbase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, CBM databases. Based on predetermined inclusion and exclusion criteria, articles were selected, and RevMan5.4 software was used to conduct the meta-analysis of this study.Results:Twelve comparative cohort articles were enrolled, which included 634 patients. There were 275 patients who underwent laparoscopic radical resection for hilar cholangiocarcinoma in the laparoscopic group, and 359 patients who underwent open radical resection for hilar cholangiocarcinoma in the open group. Meta-analysis showed that when compared with the open group, operation time of the laparoscopic group was significantly longer ( MD=58.36, 95% CI:13.54-103.18). However, intraoperative blood loss ( MD=-79.70, 95% CI:-90.01--69.39), hospital stay ( MD=-3.37, 95% CI:-4.29--2.45) and incision-related complications ( OR=0.36, 95% CI:0.16-0.80) were all significantly less (all P<0.05). The number of lymph node harvested, R 0 resection rates, postoperative bile leakage, intraperitoneal infection and effusion, total complication rates, and perioperative mortality and 1-year survival rates after operation between the two groups were not significantly different (all P>0.05). Conclusion:Laparoscopic radical resection for hilar cholangiocarcinoma was feasible and safe in selected patients carried out in an experienced hepatobiliary surgery center.

Introduction and reflection on the curriculum "society, the individual & medicine" in university of Ottawa faculty of medicine / 中华医学教育探索杂志

Taking the curriculum "society, the individual & medicine" in university of Ottawa faculty of medicine as an example, the cultivation models for comprehensive quality of medical students in China and Canada was compared. In University of Ottawa faculty of medicine, the curriculum "society, the individual & medicine" is throughout the whole medical education, including three themes of statistics and epidemiology related knowledge, health related issues and professional development. The varied teaching modes are combined with electronic teaching equipment and students' subjectivity in learning is emphasized. Drawing insights from the medical education in Canada, we should focus on promoting early contact and lifelong study of medical humanities curriculum for medical students, enriching the curriculum content, enhancing the curriculum practicality, diversifying the teaching methods, strengthening the teachers' training, improving the assessment system and establishing the long-term mechanism.

Inspiration of Canadian medical education curriculum system to medical education in China: A case analysis of Ottawa University School of Medicine / 中华医学教育探索杂志

Canada is one of the leading countries in the world with a leading position in medical education and high quality of medical education.Based on the Ottawa-Shanghai joint medical school collaborative program,this article introduces and analyzes the curriculum system of University of Ottawa School of Medicine.The curriculum is designed based on organs and systems,with a focus on the integration of basic and clinical research from the early stage.It adopts a diversified and student-centered teaching method,with practice teaching running through the whole course.Moreover,it attaches importance to family medical education and strengthens the cultivation of medical humanities.Learning from the advanced teaching concepts and methods in North America may help to promote the reform of medical education in China and cultivate high-quality medical talents in line with international standards.

Introduction and reflection on the curriculum "society, the individual & medicine" in university of Ottawa faculty of medicine / 中华医学教育探索杂志

Taking the curriculum "society, the individual & medicine" in university of Ottawa faculty of medicine as an example, the cultivation models for comprehensive quality of medical students in China and Canada was compared. In University of Ottawa faculty of medicine, the curriculum "society, the individual&medicine" is throughout the whole medical education, including three themes of statistics and epidemiology related knowledge, health related issues and professional development. The varied teaching modes are combined with electronic teaching equipment and students' subjectivity in learning is emphasized. Drawing insights from the medical education in Canada, we should focus on promoting early contact and lifelong study of medical humanities curriculum for medical students, enriching the curriculum content, enhancing the curriculum practicality, diversifying the teaching methods, strengthening the teachers' training, improving the assessment system and establishing the long-term mechanism.

Rrelationship between liver volume atrophy rate,liver stiffness measurements and Child-Turcotte-Pugh value with Laennec histopathological classification in patients with hepatitis B cirrhosis / 重庆医学

Objective To explore the relationship between the liver volume atrophy rate,liver stiffness measurements(LSM) and Child-Turcotte-Pugh(CTP) value with the Laennec histopathological classification in the patients with hepatitis B cirrhosis and its value in the quantitative diagnosis of liver cirrhosis degree.Methods The clinicopathological data of liver biopsy tissue pathological slides,FibroScan,CT examination and hematological detection in 32 cases of hepatitis B cirrhosis were retrospectively analyzed.Liver cirrhosis was divided into mild,moderate and severe according to the Laennec liver cirrhosis histopathological classification.Then the relationship between the liver volume atrophy rate,LSM and CTP score with liver cirrhosis histopathological.Results Among 32 cases,9 cases(28.12％) were mild,12 cases(37.50％) were moderate and 11 cases(34.38％) were severe.The liver volume atrophy rates of mild,moderate and severe groups were (16.75±2.20)％,(23.11±6.67)％ and(35.55±5.70)％ respectively;LSM were(14.96±3.36),(20.21± 3.07),(37.03 ± 16.44) kPa respectively,the difference among 3 groups was statistically significant (P＜ 0.01).The CTP scores had no statistical difference among the 3 groups were(P＞0.05).The cirrhosis histopathological grade had the positive correlation with the liver volume atrophy rate and LSM(r=0.93,0.74,P＜0.01),however had no obvious correlation with the CTP scores(r=0.27,P＞0.05);the liver volume atrophy rate was positively correlated with LSM and CTP score(r=0.90,0.91,P＜0.01);while LSM had no obvious correlation with CTP score (r =0.15,P ＞ 0.05).Conclusion The more severe the cirrhosis histoathological grade,the bigger the liver volume atrophy rate and the higher the FibroScan detection value;the liver volume atrophy rate and LSM may serve as the quantitative diagnosis indicators of liver fibrosis histopathological severity.

Therapeutic effect and safety of cilostazol combined clopidogrel and aspirin on aged patients after PCI / 心血管康复医学杂志

Objective:To explore therapeutic effect and safety of cilostazol combined clopidogrel +aspirin on aged pa‐tients after percutaneous coronary intervention (PCI) .Methods :A total of 100 aged patients with coronary heart disease undergoing PCI were randomly divided into routine treatment group (n=52 ,received aspirin and clopidogrel antiplatelet therapy) and cilostazol group (n= 48 ,received cilostazol therapy based on routine treatment group ) . Turbidimetry was used to measure platelet aggregation rate (PAR );PAR and mean platelet volume (MPV ) were compared between two groups before ,one week and one month after PCI .All subjects were followed up for six months ,incidence rates of major adverse cardiovascular events (MACE) and hemorrhage events were compared be‐tween two groups .Results:There were no significant difference in MPV and PAR between two groups before PCI . Compared with routine treatment group ,PAR significantly reduced [one week after PCI :(48.7 ± 6.3)% vs .(43.5 ± 5.7)% ,one month after PCI :(46.8 ± 5.8)% vs .(42.4 ± 5.4)% ] in cilostazol group , P0.05;incidence rate of hemorrhage in cilostazol group was significantly lower than that of routine treatment group (6.25% vs .19.23% , P< 0.01) .Conclusion:Compared with clopidogrel+aspirin therapy ,cilostazol combined clopidogrel+aspirin can more significantly inhibit platelet ag‐gregation ,and significantly reduce hemorrhage events ,so they are safe and effective in aged patients with coronary heart disease undergoing PCI .

Inhibitory effects of IBI302 on experimental choroidal neovascularization / 中华眼底病杂志

Objective To investigate the inhibitory effects of IBI302 on experimental choroidal neovascularization (CNV).Methods Affinity of IBI302 to vascular endothelial growth factor (VEGF) family cytokines (including VEGF-A165,VEGF-A121 and placental growth factor PlGF) and complements (C3b,C4b) was determined by enzyme-linked immunosorbent assay (ELISA).The antagonist effect of IBI302 on VEGF was measured by proliferation,migration and tube formation tests of human umbilical vein endothelial cells (HUVEC).The anti-complement activity of IBI302 was measured by hemolysis test mediated by complement classical pathway and alternative pathway.Rhesus laser-induced CNV model was divided into 5 groups including model control group,bevacizumab group,IBI302 0.25 mg group,IBI302 0.50 mg group and IBI302 1.25 mg group.Fluorescein angiography and optical coherence tomography were performed on these monkeys at 14 and 28 days after drug delivery to observe the fluorescein leakage area and retinal thickness.The aqueous VEGF concentration was measured at 29 days after drug delivery.Results IBI302 showed good affinity to VEGF-A165,VEGF-A121 and PlGF,as well as C3b and C4b.IBI302 significantly inhibited the proliferation,migration and tube formation of HUVEC induced by VEGF-A165.IBI302 inhibited the hemolysis induced by complements obviously.At 14 and 28 days after drug delivery,the area of fluorescein leakage and retinal thickness in IBI302 0.25 mg group,IBI302 0.50 mg group,IBI302 1.25 mg group were reduced.The differences of the area of fluorescein leakage and retinal thickness in three IBI302 groups were not significant (P＞0.05).At 29 days after drug delivery,the VEGF concentration in the aqueous of rhesus monkey in bevacizumab group [(38.644 ± 6.521) pg/ml] was decreased than that in model control group [(94.203± 17.360) pg/ml],the difference was significant (P＜ 0.05).The VEGF concentration in the aqueous of rhesus monkey in three IBI302 groups were less than 31.300 pg/ml.Conclusion IBI302 inhibited experimental CNV through blocking the activity of VEGF and complement.

Clinical profile and characteristics of serum GP73 in cirrhotic patients with chronic hepatitis B infections / 国际检验医学杂志

Objective To explore clinical profile and significance of serum golgi protein 73 (GP73) in cirrhotic patients with chronic hepatitis B virus (HBV) infection .Methods A total of 109 cirrhotic patients with HBV infection were included ,in which 60 patients were compensated cirrhosis ,and 49 patients were decompensated cirrhosis .The receiver operating characteristic curve (ROC) analysis were used to evaluate the clinical significance of GP73 for diagnosing decompensated cirrhosis in cirrhotic popula-tion .Results Serum GP73 level in cirrhotic patients was correlated with alanine aminotransferase (ALT ) and HBV DNA ,but neg-atively correlated with albumin levels .Serum GP73 levels in patients with decompensated cirrhosis was (215 .9 ± 96 .56)ng/mL , which was significant higher than (113 .7 ± 68 .95)ng/mL in patients with compensated cirrhosis .The area under ROC was 0 .82 (95% CI :0 .74 ~ 0 .90 ,P< 0 .05) .The sensitivity and specificity of GP73 diagnosing decompensated cirrhosis in cirrhotic population with chronic HBV infection were 77 .55% and 75 .00% respectively ,when the cut-off was set at 140 .5 ng/mL .Conclusion Serum GP73 level is related with liver injury and HBV replication .GP73 might be an useful marker for diagnosing decompensated cirrhosis in cirrhotic population with chronic HBV infections .

The Challenge and Countermeasure of Pharmacy Automation Construction in Public Hospital / 中国药房

OBJECTIVE:To demonstrate challenges of pharmacy automation reconstruction so as to set solutions. METHODS:Based on literature review,analysis of pharmacy automation setting and features,this paper gave the suggestions and solutions on construction cost,management model change,equipment maintenance and emergency response,etc. according to the practice of the hospital. RESULTS&CONCLUSIONS:Pharmacy automation construction should be stick to the requirements of new health re-form to lower the cost by using the out resources and interior optimal allocation,to improve efficiency by unified planning and proper design,and to ensure the system running efficiently by sufficient maintenance and contingency plan.

Comparative study on the medical education training model in China and Australia / 中华医学教育探索杂志

With the significant reformation of the health care system in China, medical edu-cation has also been adjusted rapidly in order to meet the needs of health services and development of medical and health undertakings. However, as a result of the adjustment of medical education system and the different schooling system in different regions around the country, medical education system and academic degree in China can hardly be comparedaround the world, and the education institutions such as universities in foreign countries can't understand clearly our country's medical education system and degree very well. Based on the medical education theory and practice of Australia, this paper de-scribes and analyses the difference of medical education system between the two countries, so as to provide some idea on perfecting the medical educationtralning model in China as well as lay a founda-tion for the comparison between Chinese medical education system and mature systems of foreign countriessuch as Australia.

Predictive Value of Combination Scores of Leukocyte and Platelet Counts for Mortality in Patients With Acute ST Segment Elevation Myocardial Infarction After PCI Treatment / 中国循环杂志

Objective: To study the predictive value of combination scores of leukocyte and platelet counts (COL-P) for in-hospital mortality in patients with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) treatment. Methods: A total of 660 STEMI patients with emergent PCI in our hospital from 2009-11 to 2013-08 were retrospectively studied. The patients were divided into 3 groups according to COL-P scores: COL-P0 group,n=283, COL-P1 group,n=319 and COL-P3 group,n=58. The relationship between the in-hospital mortality and COL-P scores was analyzed among different groups. Results: There were 88/660 in-hospital death. The patients in death group had the higher white blood cell count and lower platelet count than those in survival group, bothP<0.01. Logistic regression analysis indicated that compared with COL-P0 group, the COL-P scores at COL-P1 level (OR 4.346, 95% CI 2.134-8.850,P<0.001) and COL-P2 level (OR 10.126, 95% CI 4.061-25.250,P<0.001) were the independent risk factors for in-hospital death in STEMI patients after emergent PCI. The in-hospital mortality in COL-P0, COL-P1 and COL-P2 groups were at 4.9%, 15.4% and 43.1% respectively, allP<0.001. Conclusion: COL-P score was useful for predicting the in-hospital mortality in STEMI patients after emergent PCI, while the long term mortality estimation should be further studied.

Evaluation on implementing postgraduate psychological mentor scheme in clinical hospitals of ;colleges and universities / 中华医学教育探索杂志

Objective To analyze the psychological condition of postgraduates in clinical hos-pitals of colleges and universities before and after the implementation of psychological mentor scheme so as to evaluate the effect. Methods Quantitative questionnaire (SCL-90 scale) and qualitative fo-cus interview were used to compare psychological condition of postgraduates. Totally 182 copies of questionnaires were sent to two hospitals (A and B) respectively. Then, psychological mentor scheme was carried out in A hospital. Afterwards, 206 and 140 copies of questionnaires were sent again to the hospitals respectively to compare the results. Eight student psychological consultants, 12 postgraduates and 5 postgraduate management staff were enrolled in qualitative focus interview. Excell2003 software was adopted to establish the database and SPSS 11.0 software was used for statistical analysis. Descrip-tive analysis, frequency analysis, t test, chi-square test and variance analysis were adopted for data analysis. P<0.05 signifies for statistically significant difference. Results Mental health status of both groups was better than the national level before the implementation (total SCL score: A hospital=118 . 08 ±36.20; B hospital =100.33 ±22.90). However, SCL-90 score of A hospital was decreased (total SCL score: 102.58 ±25.23) and that of B hospital (total SCL score:134.01 ±38.92) was in-creased (part of items higher than the adult national norm) at one year after conducting psychological mentor scheme. Conclusions Psychological mentor scheme can effectively relieve stress and interper-sonal stress so as to reduce the general psychological problems and can help to improve mental health of the students.

Evaluation preparation technology of Xiaochaihu granules using fingerprint-peak pattern matching / 药物分析学报

An approach was proposed to evaluate preparation technology by means of fingerprint-peak matching technology of high performance liquid chromatography with diode array detector (HPLC-DAD).Similarity and hierarchical clustering analysis (HCA) were applied to identify the 15 batches of Xiaochaihu granules from different manufacturers and our laboratory,and peak pattern matching between the composite formulae and Radix Bupleuri Chinensis,which was one of the main ingredients of Xiaochaihu granules,was utilized to evaluate the preparation technology of Xiaochaihu granules via the indexes of the relative deviation of retention time (RT) and UV spectrum feature similarity of their corresponding peaks.Eleven matching peaks were found between Xiaochalhu granules and Radix Bupleuri Chinensis.However,the saikosaponin A and saikosaponin D,which are the important active components in Radix Bupleuri Chinensis,were not found in Xiaochaihu granules from any manufacturers.The peak areas of 11 characteristic peaks of Xiaochaihu granules samples formed a matrix of 11 × 15.The result of HCA showed that Xiaochaihu granules samples were divided into four kinds of category.Xiaochaihu granules samples from the same manufacturer were basically clustered of the same category.The results suggested that the saikosaponin A and saikosaponin D are prone to structural transformation under the condition of decoction and in the presence of the organic acidic components.These active components,existing in raw herb,might transform to a series of non-active secondary saikosaponin due to unfavourable preparation technology.So the conventional decoction-based preparation technology of Xiaochaihu granules might greatly affect its quality and therapeutic effectiveness. This study demonstrates that fingerprint-peak matching technology can not only be used for quality control of this composite formulae,but also provide some guidance for preparation technology of Xiaochaihu granules.

Simultaneous determination of five active components in compound preparation of Dangguishuan by high-performance liquid chromatography / 中国中药杂志

<p><b>OBJECTIVE</b>To develop a HPLC method for determination of matrine, oxymatrine; ferulic acid, L-shikonin and beta, beta-dimethylacrylshikonin in compound preparatioti of Dangguishuan.</p><p><b>METHOD</b>The chromatogtaphic separation was performed on a Kromasil ODS C18 column (4.6 mm x 250 mm, 5 microm) maintaining at 30 degrees C during the whole process. The mobile phase consisted of methanol and 0.1% triethylamine aqueous solution (adjusted with phosphoric acid, pH 3) at a flow rate of 1.0 mL x min(-1). The detection wavelength was set at 220 nm for matririne and oxymatrine, 316 nm for ferulic acid, 516 nm for L-shikonin and beta, beta-dimethylacrylshikonin, respectively.</p><p><b>RESULT</b>All the compounds showed good linearity (r > 0.9996) in the range of the test concentrations, and the average recoveries of the method is betwuen 96.92% and 102.22%, RSD < 3.1%.</p><p><b>CONCLUSION</b>The method is proved to be credible, sensitive, accurate and repeatable. It can be applied to determine of matrine, oxymatrine, ferulic acid, L-shikonin and beta, beta-dimethylacrylshikonin in compound preparation of Dangguishuan simultaneously, and provide a basal method of quality control to this preparation and other relative preparations.</p>

How does the traction force affect the intervertebral disc:a three dimensional finite element analysis / 中华物理医学与康复杂志

Objective To identify the effective traction conditions by comparing the effects of traction forces on the intervertebral disc under various mechanical conditions. Methods A three dimensional finite element model was used to carry out mechanical analysis of the traction under conditions with different forces and angles, then to carry out the comparative analysis of the stress distribution and the change of the volume of the intervertebral disc. Results In general, the stress distribution on the intervertebral disc was not even under different traction forces, The maximum stresses appeared at the back rim of the intervertebral disc. With the increase of the traction force and angle, the enlargement of the intervertebral disc volume increased, and the enlargement rate was more significant. Conclusion The volume of the intervertebral disc can be most effectively enlarged at the condition of 30?forward bending of the neck when a force of 90N was applied. This is the most effective traction condition.

Chitosan inhibits high glucose-induced peroxidation and monocytes adhesion to vascular endothelial cells / 中国药理学通报

Aim To study the inhibitory effect of chitosan on peroxidation and monocytes adhesion to vascular endothelial cells induced by high concentration of glucose. Methods Human umbilical vascular endothelial cells (HUVEC) were treated with high glucose, and high glucose with different concentrations of chitosan for 24 h. Hydroxyl radicals (OH?) and malon-dialdehyde (MDA) were measured. Monocytes Raw 264.7 were pre-incubated with Rhodamin123, and then co-cultured with HUVEC for 30 min, followed bymicroscope observation and determination of the monocytes adhesion. Finally, the mRNA expression of vascular cell adhesion molecular-1 (VCAM-1) was evaluated by reverse transcription polymerase chain reaction (RT-PCR). Results Concentrations of OH? and MDA in HUVEC increased after incubation with high glucose. Both of the amount of adhesive monocytes and mRNA expression level of VCAM-1 in HUVEC were induced by high glucose. Inversely, chitosan inhibited these changes in a dose-dependent manner without any cytotoxicity to cells. Conclusion Chitosan can scavenge free radicals and prevent peroxidative injury on vascular endothelial cells, which further down-regulates the expression of VCAM-1 and consequently inhibits the adhesion of monocytes to endothlial cells.

Investigation of Underpotential Deposition of Lead on Rotating Silver Disk Electrode by Chronocoulometry / 分析化学

The monolayer charge of lead underpotential deposition (UPD) was studied by chronocoulometry. On the rotating silver disk electrode (Ag-RDE), the monolayer charge of UPD lead could reaches steady state at different Pb2+ concentration levels by changing reduction time of UPD Pb2+ . A supporting electrolyte solution of 0.01 mol/L HNO3 + 0.01 mol/L NaCl was used. The steady state charge measured was 393.3 μC/cm2, which corresponded to a surface cover of 2 × 10-9 mol/cm2 Pb2+ on the electrode surface.