Application of situational simulation combined with video feedback in cardiopulmonary and abdominal probation of diagnostics / 中华医学教育探索杂志

Objective:To investigate the effect of situational simulation combined with video feedback in cardiopulmonary and abdominal clinical probation of diagnostics.Methods:Two hundred and twenty-four clinical undergraduates from the second affiliated hospital of Guangxi Medical University were randomized into the experimental group ( n=112) and the control group ( n=112). The experimental group applied situational simulation combined with video feedback methods in the cardiopulmonary and abdominal clinical probation. In other words, according to the assignment of diseases, two students played the role of "physician and patient" and conducted corresponding consultation and physical examination, in which the positive and negative video feedback were integrated to standardize students' physical examination skills. The control group adopted conventional teaching method. The teaching effect of the two groups was evaluated through unified and standardized scores of theoretical tests, cases analysis, and clinical skills operation, and the experimental group was conducted anonymous questionnaires to 112 students. SPSS 22.0 was used to perform the t test. Results:The evaluation results show that the average scores of theoretical tests (90.12±0.94), cases analysis (9.30±0.10) and physical examination (93.50±0.72) in the experimental group are higher than those of the control group, (83.20±1.66), (8.10±0.11), (85.00±1.75), respectively, with statistical significance ( P<0.05). All 112 questionnaires were collected, with an effective rate of 100%. The percentage of "yes" respondents is as follows, 91.1% of "Enhancing the mastery and application of knowledge"; 97.3% of "Cultivating clinical thinking"; 87.5% of "Improving doctor-patient communication skills"; however, there are 93.8% students believe that this new teaching approach takes more time to prepare before class, consequently, their initiative and enthusiasm of study and learning interest have slid into decline, with percentage of 80.4% and 83.0%, respectively. Conclusion:The teaching method of situational simulation and video feedback in cardiopulmonary and abdominal clinical probation of diagnostics is beneficial to enhance students' understanding and mastery of theoretical knowledge, standardize physical examinations, cultivate clinical thinking ability and improve the doctor-patient communication skills. However, it takes a lot of time for students to prepare before class. If they fail to make reasonable arrangements, the teaching effect will be half the effort and students' initiative and enthusiasm of learning will be reduced.

Cognitive status of professionalism among medical students: a case study of two universities in China / 中华医学教育探索杂志

Objective:To investigate the cognitive status of professionalism among medical college students and ways to cultivate physician professionalism.Methods:According to the literature and interview, we made the questionnaire on the cognition of physician professionalism among medical students. A total of 512 valid questionnaires (including e-questionnaires) were collected from medical students of Shantou University Medical College and Qingdao University Medical College of Shandong Province from May to September, 2017. SPSS 20.0 software was used to perform the normality and single-sample t-test on physician professionalism, professional cognition, professional emotion and professional willingness. Quantitative data was analyzed by cross-table chi-square test and mean-standard deviation. Results:The professional cognition scored lowest (3.62±0.50) in the three dimensions, the professional willingness scored the highest (4.35±0.58), and the professional emotional scored in the middle (4.05±0.48). There was significant difference in physician professionalism among medical students with different family background ( P<0.05), but no statistical difference in gender and school system. Conclusion:The results demonstrate a low-to-medium level of physician professionalism in medical students. We suggest to cultivate and promote physician professionalism from the aspects of emphasis on objectivity, and cultivation of humanism and service consciousness.

Expression changes and their clinical significance of triggering receptors of myeloid cells-1 after severe thoracic trauma / 中华创伤杂志

Objective To investigate the expression change and their clinical role of triggering receptor expressed on myeloid cells-1 (TREM-1) in patients with severe thoracic trauma.Methods A prospective cohort study was conducted to analyze the clinical data of 52 patients with severe thoracic trauma (trauma group) hospitalized from October 2016 to May 2017.The peripheral anticoagulant blood samples were collected at days 1,3,5,7 and 14 after trauma.Meanwhile,10 healthy volunteers were enrolled in control group and their blood samples were collected once.According to injury severity score (ISS),the patients were divided into ISS low-score group (＜ 20 points,n =15) and high-score group (≥20 points,n =37).The patients were assigned to traumatic non-sepsis group (n =34) and traumatic sepsis group (n =18) by the latest definition and standard of sepsis 3.0 issued by the Society of Critical Care Medicine (SCCM)/European Society of Intensive Care Medicine (ESICM).The expressions of TREM-1 on neutrophils and monocytes were measured by flow cytometry.Pairwise comparisons were done between trauma group and healthy volunteers,ISS low-score group and ISS high-score group,and traumatic sepsis group and non-sepsis group,respectively.The accuracy of traumatic sepsis prediagnosis by TREM-1 was evaluated by the area under receiver operating characteristic curve (AUC).Results Trauma group had 41 males and 11 females,with age of (45.9 ± 12.4) years,Abbreviated Injury Scale (AIS) of (3.5 ± 0.6) points and Injury Severity Score (ISS) of (23.6 ± 8.5) points.Control group had eight males and two females,with the age of(29.1 ± 2.8) years.Compared to control group,trauma group had slightly lower TREM-1 expressions in neutrophils and significantly higher expressions in monocytes at days 1 to 14 (all P ＜ 0.01).ISS high-score group had slightly lower TREM-1 expressions in neutrophils than ISS low-score group at days 1 to 7,with significant difference at day 1 (P ＜ 0.05).ISS high-score group had slightly higher TREM-1 expressions in monocytes than ISS lowscore group at days 1 to 14,with significant difference at day 14 (P ＜ 0.05).Compared to traumatic non-sepsis group,traumatic sepsis group had significantly lower TREM-1 expressions in neutrophils at days 1 to 14 (all P ＜ 0.05).Traumatic sepsis group had slightly lower expressions in monocytes than traumatic non-sepsis group at days 1 to 7,with significant difference at day 3 (P ＜ 0.05).AUC and 95％ CI evaluating the role of neutrophils TREM-1 in traumatic sepsis prediagnosis were 0.852 (0.738,0.966) at day 1,0.835 (0.721,0.948) at day 3,0.797 (0.654,0.939) at day 5,0.756 (0.599,0.914) at day 7,and 0.707 (0.525,0.888) at day 14,respectively.Conclusions After severe thoracic trauma,the expressions of TREM-1 are decreased in neutrophils but increased in monocytes.TREM-1 might be used to assess the injury severity and has certain value in prediagnosis for traumatic sepsis.

Serotypes and antimicrobial resistance profile of the Group B Streptococcus isolates in perinatal pregnant women during the period from 2013 to 2014 / 中国感染与化疗杂志

Objective To analyze the serotypes and antimicrobial susceptibility profile of Group B Streptococcus (GBS) in perinatal pregnant women.Methods The vaginal and rectal specimens were collected from pregnant women at 35 to 37 weeks of pregnancy for culture and identification.The serotypes were analyzed using agglutination assay.Antimicrobial susceptibility testing was conducted by using Kirby-Bauer method,and interpreted according to 2009 CLSI breakpoints.The data were analyzed via WHONET 5.6 software.Results The prevalence of GBS was 10.4％ (264/2 533) in the 2 533 perinatal pregnant women.Serotype Ⅲ,Ⅰa and Ⅰb was identified in 54.9％ (84/153),17.6％ (27/153) and 13.1％ (20/153) of the GBS,respectively.All the GBS isolates were susceptible to penicillin,cefiriaxone and vancomycin.But 32.9％,68.1％ and 62.1％ of the isolates were resistant to levofloxacin,erythromycin and clindamycin,respectively.The antibiotic resistance rate of serotype Ⅲ isolates to the above three antibiotics was significantly higher than the other serotypes.Conclusions GBS may colonize both vagina and rectum of pregnant women.Vaginal and rectal secretions should be sampled simultaneously for better screening GBS.GBS serotype Ⅲ was the predominant serotype.Penicillin can be used as the first-choice treatment for GBS infections in pregnant women and newborns.GBS-positive pregnant women should be given the intervention treatment immediately to ensure the health of perinatal infants.

The oxidative damage on the proliferation of oral cancer SCC-25 cells / 实用口腔医学杂志

Objective:To study the exogenous oxidative stimuli on the mtDNA damage and proliferation of oral cancer SCC-25 cells.Methods:SCC-25 cells and fibroblast cell line BJ cells were treated by H2O2 at 0 (the control),120,240,480 and 960 μmol/L respectively for 15 m-24 h respectively,mtDNA damage was measured by a supercoiling-sensitive qPCR method(ss-qPCR),cell proliferation was tested by MTT assay.Results:Dose-dependent mtDNA damage was observed in SCC-25 cells treated by H2O2 at 120 μmol/L or above,and in BJ cells by H2O2 at 240 μmol/L or above,the mtDNA damage rate of both cells decreased 2-24 h after H2O2 treatment,in the 120 μmol/L group the damage rate reached to the control group.BJ cells showed less reaction to H2O2 stimulation than SCC-25 cells.Conclusion:Oxidative stress may be related to the development of oral cancer.

Inducing effect of IL-1βabout the release of HMGB1 in human bronchial epithelial cells / 重庆医学

Objective To investigate the effect of IL‐1βon the expression and release of high mobility group box 1 (HMGB1) from normal human bronchiolar epithelial cell (HBE) .Methods HBE135‐E6E7 was developed and methyltetrazolium (MTT) as‐say was used to assess the viability of HBE cell line under different concentration of IL‐1β.The mRNA expression of HMGB1 in HBE after stimulating with IL‐1βwere determined by Real‐time PCR;the level and location of HMGB1 in the cytoplasm ,nucleus and culture medium of HBE after stimulating with IL‐1β were detected by Western blot and ELISA assay .The expression and translocation of HMGB1 of HBE after stimulating with IL‐1β were detected by Immunofluorescence .Results 0 .1 ,1 .0 ,10 .0 ng/mL IL‐1βdid not influence the cell viability of HBE ;IL‐1β increased the mRNA expression of HMGB1 in HBE in does‐and time‐dependent manner and increased the protein expression of HMGB1 in HBE .In comparison with control group ,the levels of HMGB1 in the culture medium significantly increased after stimulation with IL‐1βat 1 .0 ,10 .0 ng/mL for 24 h(P<0 .05)in the dose dependent experiments;and in time dependent experiments ,10 .0 ng/mL IL‐1βsignificantly increased HMGB1 level in the cul‐ture medium after stimulation for both 12 h and 24 h (P< 0 .05) .After stimulation with IL‐1β (10 .0 ng/mL ) for 24 h ,the HMGB1 expression in cytoplasm significantly increased in plasmosin and decreased in nucleus .HMGB1 translocated from nuclei to cytoplasm after stimulation with IL‐1β(10 .0 ng/mL ) for 24 h .Conclusion IL‐1βcould induce HMGB1 expression and release in human bronchial epithelial cells ,which indicates that HMGB1 may involve in IL‐1β‐mediated chronic airway inflammation .

Study on the course reformation of medical laboratory science after changing five-year system to four-year system / 中华医学教育探索杂志

To adapt to the system reformation of medical laboratory science from five academic years to four academic years and to meet the new professional technology-oriented requirements, the medical laboratory science institute of Guangdong Medical College has carried out a comprehensive reform of curriculum system. This paper has analyzed the current problems in the school medical ex-amination and explored the curriculum system reform from three respects such as adjusting curriculum by restructuring and integrating programs, implementing modular teaching to build its characteristics and strengthening practice teaching.And it has also explored the full assessment mode by optimizing the traditional one-stop assessment.

Epidemiologic study on thyroid nodules in community population of Jiangsu / 中华内分泌代谢杂志

The residents who had lived for at least 5 years and aged over 20 years old were sampled from urban to rural districts of Jiangsu Province with a stratified cluster sampling technique. B mode ultrasonography and thyroid function determination were carried out in 6 128 persons. The location, diameter, number, boundary, and calcification in thyroid nodules were described by using 7.5 MHz/50 mm transducer of thyroid ultrasonography. TSH was measured by chemiluminescence immunoassay. Free triiodothyronine(FT3)and free thyroxin(FT4)were measured when TSH was abnormal. The crude prevalence of thyroid nodules was 21.12% in total population, 14.55% in male, and 25.24% in female. The standardized prevalence was 15.69%, 11.20%, and 20.40%, respectively. The prevalence was lower in male than in female, and increased with age(P＜0.05). Thyroid nodules in Jiangsu Province were highly prevalent and more attention should be paid to the follow-up, early diagnosis, and treatment.

Serum Vaspin level in type 2 diabete patients and its clinical significance / 中国综合临床

Objective To detect serum Vaspin level in subjects with normal glucose regulation(NGR)and newly-diagnosed type 2 diabetes mellitus (T2DM) ,and to investigate the association between serum Vaspin and body mass index (BMI), age, gender, glycometabolism and lipemetabolism and insulin sensitivity index. Methods The fasting serum levels of Vaspin were measured in 48 normal controls and 66 T2DM patients using enzyme linked immunosorbent assay ( ELISA ). BMI, waist-hip ratio (WHR) and % body fat were measured,as well as fasting blood glucose (FBG), HBA1C, lipids and insulin levels. Results The fast serum Vaspin concentrations in the obese T2DM patients was ( 1.13 ±0. 25 ) μg/L,which were significantly higher than that in the non-obese T2DM patients (0. 65 ± 0. 13 ) μg/L (P ＜ 0. 01 ). In the NGR group, the fast serum Vaspin concentrations in the obese was (0. 95 ± 0. 11 ) μg/L, which were significantly higher than that in the non-obese (0. 38 ± 0. 18) μg/L( P ＜ 0. 01 ). In the T2DM group, serum Vaspin concentration in females ( [0. 92 ± 0. 35]μg/L) was higher than in males ([0.76 ± 0. 22] μg/L) (P ＜ 0.01 ). In the NGR group, serum Vaspin concentration in females was also higher than that in males ( [1.05 ± 0. 21] μg/L vs [0. 48 ± 0. 14] μg/L) )(P＜0. 01 ). Serum Vaspin level was positively correlated with BMI,WHR,% Body Fat,fasting insulin(FINS)and insulin sensitivity index (ISI) (r = 0. 365,0. 214,0. 238,0. 183 and 0. 147, respectively, Ps ＜ 0. 05 ). The multiple stepwise regression analysis showed that gender( R2 = 0. 161, P ＜ 0. 01 ), ISI ( R2 = 0. 183, P ＜ 0. 01 )and WHR( R2 = 0. 216, P ＜ 0. 01 ) were independent variables associated with Vaspin. Conclusion Serum vaspin level significantly increases in subjects with obesity, and independently associated with gender, ISI,WHR. These findings suggest that serum Vaspin may be involved in the pathophysiology of insulin resistance syndrome.

Epidemiologic study of hypothyroidism in Jiangsu province / 中华内分泌代谢杂志

Objective To investigate the prevalence and epidemiologic characteristics of hypothyroidism among community population in Jiangsu province. Methods The residents who had lived for at least five years and aged more than 20 years old were sampled from six layers in urban and rural districts of Jiangsu province by a stratified cluster sampling technique. Serum was sampled from 7 122 subjects and sTSH was measured by chemiluminescence immunoassay, and FT3 and FT4 were determined in the subjects with abnormal sTSH level. Results (1) The crude prevalences of overt hypothyroidism and subclinical hypothyroidism were 0.66% and 7.53% respectively in total population, with the respective standardized rates of 0.43% and 6.28%. (2)The prevalences of hypothyroidism and subclinical hypothyroidism were significantly higher in females than in males (both P <0.05). (3) The prevalence of subclinical hypothyroidism was significantly increased with advancing age in both female and males (P<0.05). Conclusion Comparing with hypothyroidism, subclinical hypothyroidism shows higher prevalence in Jiangsu province, and more attention should be paid to the follow-up and diagnosis of subclinical hypothyroidism.