Application of Mini-Clinical Evaluation Exercise combined with direct observation of procedural skills in standardized training of emergency medicine guided by professional physician qualification examination / 中华医学教育探索杂志

Objective:To investigate the application effect of Mini-Clinical Evaluation Exercise (Mini-CEX) combined with direct observation of procedural skills (DOPS) in standardized training of emergency medicine guided by professional physician qualification examination.Methods:Based on the time of emergency medicine teaching reform in Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, 32 standardized training residents in Emergency Department before September 2020 were included as control group and were given traditional teaching, and 32 standardized training residents after September 2020 were included as observation group and were given Mini-CEX combined with DOPS teaching under the guidance of professional physician qualification examination. The two groups were compared in terms of Mini-CEX score, DOPS score, assessment score of comprehensive emergency skills, pass rate of professional physician qualification examination, and comprehensive teaching quality. SPSS 25.00 was used to perform the t-test and the chi-square test. Results:Compared with the control group after training, the observation group had significantly higher scores of Mini-CEX, DOPS, and comprehensive emergency skill assessment ( P<0.05). There were no significant differences between the two groups in the pass rates of theoretical and practical examinations in professional physician qualification examination, and the observation group had a significantly higher total pass rate than the control group ( P<0.05). The observation group had significantly higher comprehensive teaching quality scores than the control group ( P<0.05). Conclusion:Mini-CEX combined with DOPS guided by professional physician qualification examination can help to improve the teaching effectiveness of standardized training residents in emergency, enhance their comprehensive skills and emergency professional skills, achieve a relatively high pass rate of professional physician qualification examination, and improve their post competency, and thus it holds promise for clinical application.

Application value of dual-energy CT perfusion imaging in acute pulmonary embolism examination / 中国辐射卫生

Objective To analyze the pulmonary perfusion defect index (PPDI) of dual-energy computed tomography (CT) and pulmonary artery obstruction index (PAOI) of conventional CT angiography, and to investigate the clinical application value of dual-energy CT perfusion imaging in the examination of patients with acute pulmonary embolism. Methods A retrospective study was conducted on 21 patients diagnosed with acute pulmonary embolism in Weifang People's Hospital from January 1, 2022 to December 31, 2022. PPDI, PAOI, and maximum plasma D-dimer concentration (mg/L) were calculated. According to the 2019 ESC Guidelines, the patients were divided into low-risk group (n = 8) and medium-risk group (n = 12). The Mann-Whitney U test was used for between-group comparisons. The Spearman’s rank correlation coefficient was used to analyze the correlations between PAOI, PPDI, and plasma D-dimer concentration. Results The PPDI, PAOI, and D-dimer values in the low-risk group were 3.33 (2.09, 4.58), 5.00 (3.13, 5.00), and 0.67 (0.52, 0.79), respectively. The PPDI, PAOI, and D-dimer values in the middle-risk group were 8.34 (5.42, 12.50), 12.50 (8.13, 15.00), and 1.18 (0.86, 2.87), respectively. The Z-values of comparison between the two groups were −3.092, −3.650, and −3.318, respectively (all P < 0.05). There were significant differences in PPDI, PAOI, and D-dimer between the low-risk and middle-risk groups (P < 0.05). Positive correlations were observed between PPDI and PAOI, between PPDI and D-dimer, and between PAOI and D-dimer (rs = 0.869, 0.918, 0.909, all P < 0.05). Conclusion Both PPDI and PAOI can be used for the clinical examination of patients with acute pulmonary embolism and evaluation of the severity of the disease. Compared with conventional CT, dual-energy CT perfusion imaging is more efficient in the diagnosis of acute pulmonary embolism, and facilitates accurate clinical treatment.

A smart dual-drug nanosystem based on co-assembly of plant and food-derived natural products for synergistic HCC immunotherapy

Nanotechnology has emerged as an ideal approach for achieving the efficient chemo agent delivery. However, the potential toxicity and unclear internal metabolism of most nano-carriers was still a major obstacle for the clinical application. Herein, a novel "core‒shell" co-assembly carrier-free nanosystem was constructed based on natural sources of ursolic acid (UA) and polyphenol (EGCG) with the EpCAM-aptamer modification for hepatocellular carcinoma (HCC) synergistic treatment. As the nature products derived from food-plant, UA and EGCG had good anticancer activities and low toxicity. With the simple and "green" method, the nanodrugs had the advantages of good stability, pH-responsive and strong penetration of tumor tissues, which was expected to increase tumor cellular uptake, long circulation and effectively avoid the potential defects of traditional carriers. The nanocomplex exhibited the low cytotoxicity in the normal cells

Application and discussion of teaching model of Team-based learning teaching integrated with evi-dence-based medicine introduced clinical case in Type 2 diabetes mellitus clinical training / 中华医学教育探索杂志

The knowledge of endocrine metabolic diseases represented by type 2 diabetes mellitus is highly specialized, complicated, and has many clinical guidelines. In this context, team based learning teaching combined with case teaching based on evidence-based medicine was applied in the actual class teaching. The class was divided into several groups and the students were encouraged to discuss and study from each other with the guidance of teachers. Consequently, students' learning interests and spirit of team-work were greatly enhanced, the way of thinking using evidence-based medicine and their ability to solve the practical clinical problems were also improved.

Metformin ameliorates insulin resistance in L6 rat skeletal muscle cells through upregulation of SIRT3 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>SIRT3 is an important regulator in cell metabolism, and recent studies have shown that it may be involved in the pharmacological effects of metformin. However, the molecular mechanisms underlying this process are unclear.</p><p><b>METHODS</b>The effects of SIRT3 on the regulation of oxidative stress and insulin resistance in skeletal muscle were evaluated in vitro. Differentiated L6 skeletal muscle cells were treated with 750 µmol/L palmitic acid to induce insulin resistance. SIRT3 was knocked down and overexpressed in L6 cells. SIRT3, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) p65, c-Jun N-terminal kinase 1 (JNK1), and superoxide dismutase 2 (SOD2) were evaluated by Western blotting.</p><p><b>RESULTS</b>Over expression of SIRT3 increased glucose uptake and decreased ROS production in L6-IR cells as well as in L6 cells. Knock-down of SIRT3 induced increased production of ROS while decreased glucose uptake in both L6 and L6-IR cells, and these effects were reversed by N-acetyl-L-cysteine (NAC). Metformin increased the expression of SIRT3 (1.5-fold) and SOD2 (2-fold) while down regulating NF-κB p65 (1.5-fold) and JNK1 (1.5-fold). Knockdown of SIRT3 (P < 0.05) reversed the metformin-induced decreases in NF-κB p65 and JNK1 and the metformin-induced increase in SOD2 (P < 0.05).</p><p><b>CONCLUSIONS</b>Upregulated SIRT3 is involved in the pharmacological mechanism by which metformin promotes glucose uptake. Additionally, SIRT3 may function as an important regulator of oxidative stress and a new alternative approach for targeting insulin resistance-related diseases.</p>

Endovascular repair of symptomatic penetrating atherosclerotic ulcer of the thoracic aorta / 中华普通外科杂志

ObjectiveTo evaluate endovascular repair(EVAR) of penetrating atherosclerotic ulcer (PAU) of the thoracic aorta.MethodsThere were 12 cases of PAU treated at our department. All the cases had severe acute thoracic pain. Computer tomography angiography (CTA) showed well outlined ulcer in 12 cases, intramural hematoma in 8 cases. EVARs were done under general anaesthesia and 12 stent grafts were used. Two cases received by-pass procedure ahead of EVARs because of main branches involved.Patients were followed up with CTA from 12 months to 4 years( median 36 months).ResultsA total of 12 stent grafts were implanted to 12 patients.The average diameter of stent graft was ( 35.7 ± 2. 5 ) mm(32-40 mm) , length was ( 163 ± 19) mm ( 152-202 mm). There was a very small internal leakage in one case with large size ulcer after implantation of stent graft, other ulcers were excluded completely. Primary technical success rate was 100％. There were no perioperative death and severe complications. All cases were free from symptoms after operation and alive during follow-up. CTA showed satisfactory results without internal leakage.The small leakage in the case disappeared within 3 months.ConclusionsBeing miniinvasive and effective, EVAR is the choice of therapy for symptomatic PAU.

Mechanism of the skin lesions in diabeitic rats / 中华内分泌代谢杂志

Four weeks after SD diabetic rats were induced by streptozotocin,skin thickness was obviously reduced with obscure multilayer epithelium features.Moreover,the thickness of epidermic layers in diabetic rat skin was significantly thinner than that ofnornlal rat skin at the eighth week[(0.016±0.006 vs 0.041±0.007)mm,P<0.01].The percentage of G2/M phase cells in epidermic layers of diabetic group was significantly lower than that in the normal group.At the twelfth week,skin microangiopathy was easily detected in the diabetic group.The blood levels of advanced glycation end products(AGEs)and malonialdehyde were significantly increased and glutathione decreased in diabetic rats compared with control rats(aU P<0.01),along with the increased contents of local glucose and AGEs in the skin of diabetic rats.These results suggest that the local accumulation of glucose and AGEs seems to be one of the important mechanisms in the pathogenesis of diabetic skin lesions.

Mechanism of α-lipoic acid in reducing the injury of kidneys in diabetic rats / 中华内分泌代谢杂志

The effect and mechanism of α-lipoic acid(ALA)on the injury of kidneys in diabetic rats induced by streptozotocin were investigated.Results showed that ALA decreased the level of oxidative stress,the production of advanced glycation end products(AGE)[(0.087±0.003 vs 0.103 4±0.014)pg/mg protein,P<0.05],and the expression of AGE receptor protein(1.8I±0.04 vs 2.67±0.01,P<0.01)and transforming growth factor-β(TGF-β)mRNA(1.51 4±0.20 vs 2.04±0.08,P<0.05)in renal cortex of diabetie rats,resulting in reduced kidney injury and improved renal function in diabetic rats.

Protective effects of alpha-lipoic acid against beta-cell damage in streptozotocin induced diabetes In rats / 中华胰腺病杂志

Objective To investigate the protective effects of alpha-lipoie acid (ALA) against beta-cell damage in streptozotocin (STZ)-induced diabetes in rats. Methods Thirty SD rats were randomly divided into three groups: normal control (NC) group, STZ group and ALA + STZ group, with 10 rats in each group. mg/kg, intraperitoneal injection), till the end of the study (4 weeks later). Blood glucose were measured every 3 days after STZ injection. Malondialdehyde (MDA) and reduced glutathione (GSH) levels were measured in pancreatic homogenates. Pancreatic beta-cells were examined by immunohistocbemical methods, Results STZ induced a significant increase of the level of blood glucose. Body weight of rats in ALA + STZ group was (341±26)g, which significantly lower than (368±3)g in NC group, and high than (301±2)g in STZ group with stas(P < 0. 05). Meanwhile the MDA levels in STZ group and NC group were(1.22 ± 0. 14) and(0.57 ± 0.04)nmoL/mg prot, respectively, and there was significant difference between the two groups (P < 0.05) ; the GSH levels in STZ group and NC group were(16.54 ± 1.10) and(25.46 ± 0.62) mg/g prot (P < 0.05), respectively; degeneration of islet cells and decreased blood glucose were observed in STZ + ALA-pretreated rats; MDA level in pancreatic homogenates was(0.72 ± 0. 23)nmoL/mg prot, which was significantly lower than that in STZ group (P < 0.05) ; the GSH level was (35.33 ± 2.66) mg/g prot, which was significantly higher than that in STZ group (P < 0.05) ; increased staining of insulin and preservation of islet ceils functions were more obvious in the STZ + ALA-pretreated rats. Conclusions ALA exerted its protective effect through reducing the oxidative stress and preserving pancreatic beta-cell integrity.

Estimation of the effects of local drug injection on the benign thyroid tumour / 中国实用内科杂志

0.05)in sex,age and volume of lesions.Over a course of treatment the average volume of thyroid adenomas of each group significantly(P

Carotid endarterectomy for patients with atherosclerotic occlusive diseases / 中国普通外科杂志

Objective To evaluate carotid endarterectomy for patients with atherosclerotic occlusive diseases. Method Surgical experience of endarterectomy in 32 patients with atherosclerotic occlusive diseases was retrospectively analyzed. Internal carotid artery stem pressure was measured during operation. Shunting was used routinely. Patching was used electively. Anti-platelet agents and agents reducing plasma fibrinogen were given perioperatively. Result There was no perioperative mortality, nor ischemic cerebral stroke. Patients were followed-up from 5 months to 20 months with no occurrence of ischemic cerebral stroke during the follow-up. One case presented dysfunction of hypoglossal nerve. Two cases presented dilation of carotid artery on ultrasound scan. There were no restenosis (≥50%) and thrombosis. Conclusion Carotid endarterectomy for patients with atherosclerotic occlusive diseases of carotid artery is effective and safe. Careful performance, shunting, patching and the correct order of clamps removing are the keys of preventing complications.

Investigation of androgen receptor gene expression in human peripheral leukocytes / 第二军医大学学报

Objective: To investigate androgen receptor (AR) mRNA expression in human peripheral leukocytes. Methods: Total RNA was isolated from peripheral leukocytes of healthy men and women, AR mRNA was determined by RT PCR and Northern blot. Results: An AR cDNA fragment of the expected size of 390 bp was determined by RT PCR. 9.4 kb AR mRNA was detected by Northern blot, which was consistent with AR mRNA in human prostate reported by Lubahn et al . Conclusion:AR mRNA expresses in human peripheral leukocytes, this provides basis for studying the effect of androgen on the function of the human peripheral leukocytes and the changes of AR in pathological stages. [

Construction and identification of rat vascular endothelial growth factor recombinant adenovirus-mediated gene transfer system / 中国普通外科杂志

Objective To construct the recombinant adenovirus vector carrying rat vascular endothelial growth factor(VEGF) as preparation for later use for genetic transfection.Methods Rat VEGF was obtained by using RT-PCR amplification and then cloned into the shutter plasmid pDC316.Subsequently,this newly constructed plasmid pDC316-VEGF,after identification by nuclease digestion analysis and sequencing analysis,was transfected into human embryonic kidney cells HEK293 by lipofectamine 2000 mediation,together with adenovirus-packaging plasmid pBHGE3.Based on the homologous recombination of the two plasmids within HEK293 cells,the recombinant adenovirus vector carrying VEGF,VDC316-VEGF,was created.VDC316-VEGF was subsequently identified using PCR,purified using repeated plaque passages,proliferated using freezing and melting within HEK293 cells,and titrated using 50% Tissue Culture Infective Dose(TCID50) assay.Results The newly constructed recombinant adenovirus was confirmed carrying rat VEGF by PCR,and its titration value determined based on TCID50 assay was 3?109pfu/ml.Conclusions The recombinant adenovirus carrying rat VEGF was successfully constructed.The newly constructed adenovirus can produce a sufficiently high titration value within HEK293 cells,providing a reliable tool for genetic transfection in further gene therapy researches.

Surgical management for ruptured abdomnial aortic aneurysm:a report of twelve cases / 中国普通外科杂志

Objective To explore the diagnosis and management of ruptured abdominal aortic aneurysm(RAAA).Methods Twelve patients with RAAA treated in past 7 years were revienled retrospectively.The main clinical manifestations were abdominal pain and / or back pain,low blood pressure or shock,and pulsating abdominal mass.All cases were accurately diagnosed with CT and 7 were treated by conventional operation,one by EVAR,and the other 4 did not receive surgical treatment.Results Perioperative death occurred in 5 cases(mortality rate was 62.5%) in 8 surgical treated patients,including circulatory failure in 2 cases,renal failure in 1 case,and multiple organ failure in 2 cases.All the 4 patients treated with nonoperative method were dead.Conclusions Surgical operation in RAAA cases still carried a high mortality.Early dignosis,appropriate resuscitation,urgent surgical repair,reduction of operative time,and infrarenal clamping are measures conducive to lowering the mortality rate of RAAA.EVAR has the potential to reduce the mortality rate from RAAA.

Study on growth inhibitory effect of chemotherapeutic drugs on the pancreatic cancer cell line-Aspc-1 and Bxpc-3 / 介入放射学杂志

Objective To study the growth inhibitory effect of chemotherapeutic drugs on the pancreatic cancer cell line Aspc-1 and Bxpc-3, and the relations to the varied concentration and exposere time of chemotherapeutic drugs administrated in single or in combination. Methods Four chemotherapeutic drugs included 5-fluorouracil (5-FU), epirubicin (E-ADM), mitomycin(MMC) or cisplatin (DDP) administrating in single or in combination and using varied concentrations(d1、d2、d3 and d4) and exposure times(24、28 and 72 hours); and then the growth inhibitory effect on the two cell lines. resulted from these drugs were assayed by MTT colorimetry and analysed by “ t ” test. Results The growth inhibitory rate of two cell lines was increased, with the increment of drug concentration and/or the prolongation of exposure time ( P

CHANGES OF MELATONIN RECEPTOR IN RATS OF MALNUTRITION AND ITS SIGNIFICANCE / 解放军医学杂志

To investigate the role of malnutrition on expression of thymus melatonin receptor(MR), rats were fed with low protein diet to induce an experimental animal model of malnutrition. MR was detected by radioligand binding assay. In malnourished rats before pregnancy and those during pregnancy, the thymus development in their offsprings was retarded, and the expression of MR was lower than that of the controls. After fed with standard diet,the development of the thymus and the MR in the infant rats improved significantly. The results suggest that malnutrition can retard the development of thymus, so the production of MR in thymus is lowered, and this may affect the physiological role of melatonin.

INVESTIGATION OF MELATONIN ON SEX HORMONES AND OVULATION / 解放军医学杂志

To investigate the effect of melatonin(Mel) on follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E 2) and ovulation, 100 healthy women were divided into 5 groups to take 0mg, 12mg, 30mg, 75mg, and 300mg Mel per day, respectively, for 3 months. The levels of FSH, LH, E 2 were determined by enzyme-linked immunosorbent assay(ELISA) before and after medication, the development of dominant follicle was detected by ultrasound. We have found that the levels of FSH, LH and E 2 were all lower and the dominant follicle was smaller than those of the control (0mg) group at 3 months. In this study we demonstrated the direct involvement of melatonin in modulation of the female reproductive system in a dose-dependent manner, and it may be put into effect through melatonin receptors in human hypothalamus-pitutary-ovary cells.