Curriculum teaching design of Military Medical Psychology in medical universities / 中华医学教育探索杂志

This study comprehensively analyzes the course of Military Medical Psychology from 7 aspects including the nature and status, teaching objectives, teaching principles, teaching concepts, classroom teaching, practical teaching and lecturing principles, and finally summarizes the characteristics of the course and points out its shortcomings and prospects. The study found that the Military Medical Psychology is an important interdisciplinary course between medical psychology and military science; the teaching objectives include two categories, the overall goals and classified ones; the teaching principle emphasizes the forces of developing practice ability of service orientation; the teaching concept includes combining the theory with practice, focusing on the students, informatization and lectures; the mode of classroom teaching should be cases-introduction, theory-interpretation and case-analysis; the practical teaching should strengthen teaching skills, emphasize connection, stimulate interest and improve the health; lecturing principles emphasize the focus of content. This study has preliminarily completed the teaching design of the course of Military Medical Psychology, which is conducive to the smooth implementation of this course and the cultivation of professional talents of military medical universities.

Analysis of psychological status and influencing factors of medical workers amid COVID-19 pandemic; analysis of influencing factors / 中华健康管理学杂志

Objective:The study seeks to explore the factors influencing the psychological status and sleep quality of medical workers amid the ongoing COVID-19 pandemic, in order to provide data sources and theoretical basis for the development of relevant psychological intervention programs.Methods:Employing the convenience sampling method, general information questionnaire (age, gender, marital status, educational background, job status, etc.), Generalized Anxiety Disorder-7 and Patient Health Questionnaire, epidemic stress index scale, and sleep quality questionnaire were distributed to medical staff between February 18 and April 3, 2020, using the PEM mental health care platform of by ZhongShengKaiXin for medical staff issued. Descriptive, single factor, and correlation analyses, as well as multiple linear regression analysis were used to analyze the data.Results:Overall, 24, 845 questionnaires were collected from 23 provinces, of which 24, 687 were valid, with a recovery rate of 99.36%. The findings showed that the proportion of medical personnel with symptoms of anxiety and depression was 50.58% and 51.37%, respectively; 16.11% had poor or very poor anti-stress ability; and 71.78% reported poor or very poor sleep quality. There was a positive correlation between anxiety, depression, anti-stress ability, and sleep quality ( P<0.05). Anxiety was positively correlated with depression, stress tolerance, and sleep quality( r=0.787, 0.667, and 0.486, all P<0.001); depression was positively correlated with stress tolerance and sleep quality ( r=0.709 and 0.586, both P<0.001); and stress tolerance was positively correlated with sleep quality ( r=0.452, P<0.001). Multiple linear regression analysis results showed that age, gender, marital status, educational background, professional title, job status, and participation influenced the anxiety levels of medical personnel in the backdrop of the pandemic ( P<0.001). Depression levels of medical staff were influenced by gender, educational background, job position, and participation ( P<0.001), while gender, marital status, educational background, job position, and participation influenced the stress tolerance levels ( P<0.001). The sleep quality of medical workers was influenced by age, gender, job position, participation in the fight against the pandemic, and professional title ( P<0.001). Conclusions:Amid the ongoing COVID-19 pandemic, medical staff reported poor mental health status and sleep quality, which can be attributed to diverse factors. The research findings can be useful for assisting medical staff to strengthen their self-cognition, while also providing certain psychological counseling data and theoretical basis for management departments.

A novel "box lesion" minimally invasive totally thoracoscopic surgical ablation for atrial fibrillation

<p><b>INTRODUCTION</b>Minimally invasive surgical ablation is an emerging alternative method to catheter ablation and the full surgical maze procedure for nonpharmacologic treatment of atrial fibrillation (AF). We present a totally thoracoscopic "box lesion" radiofrequency ablation procedure in patients with paroxysmal or persistent AF.</p><p><b>MATERIALS AND METHODS</b>From June 2011 to October 2012, 14 patients with lone paroxysmal (n = 7) or persistent AF (n = 7) were enrolled in this study. Procedures were performed through 3 5-12 mm holes on each side of the chest wall. A bipolar ablation device was used to create a box lesion in the posterior wall of the left atrium that encircled the 4 pulmonary veins (achieving bilateral pulmonary vein/posterior left atrial wall isolation). Perioperative complications were recorded for all patients. Freedom from AF was assessed by 24-hour Holter monitoring every 3 months or during symptoms of arrhythmia.</p><p><b>RESULTS</b>The ablation was successfully performed in all patients, with median operation time of 128 minutes (range, 45 to 180 minutes). No operative mortality or morbidity were noted during the study period. Freedom from AF was achieved in 12 patients (85.7%) during follow-up (median follow-up 9 months). One patient with persistent AF was shifted to paroxysmal AF. No atrial flutter or atrial tachycardia was noted during the follow-up.</p><p><b>CONCLUSION</b>These early results show that totally thoracoscopic surgical ablation using a unique "box lesion" procedure for persistent or paroxysmal AF is a feasible and effective method with good short-term results. Further study is necessary to validate this result.</p>

Expressions of hypoxia inducible factor 1 alpha and P53 in the epididymis of varicocele rats / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the mechanism of epididymal hypofunction of rats with varicocele (VC) by observing the changes in the epididymal index, motility of epididymal sperm, expressions of hypoxia-inducible factor 1 alpha (HIF-1 alpha) and the tumor suppressor protein p53, and epididymal epithelial cells.</p><p><b>METHODS</b>Ninety SD rats were equally randomized to a VC model (A), a sham operation (B), and a normal control group (C). At 49 days after surgery, all the rats were executed after weighing. Then the volume of the left epididymis was obtained, the epididymal sperm motility was detected by computer-assisted sperm analysis (CASA), the expressions of HIF-1 alpha and p53 in the epididymal tissue were determined by Western-blot, and the epididymal epithelial cells were observed by HE staining.</p><p><b>RESULTS</b>VC models were successfully established in 27 of the rats. One-way ANOVA test showed no statistically significant differences in the epididymis index among groups A ([40.53 +/- 1.76] x 10 (-5)) , B ([43.31 1.58] x 10( -5)) , and C ( [44. 10 +/- 2.62] x 10 -5) (P > 0.05). Sperm motility and the percentage of progressively motile sperm were significantly lower in group A ([71.86 +/- 5.07]% and [42. 26 +/-4.45]%) than in B ([78.51 4.50]% and [49.08 +/-4. 19]% ) and C ( [79.24 +/- 2.70] % and [52. 23+/- 2. 23] % ) (both P <0.05) , while the expressions of HTF-1 a and p53 were remarkably higher in A (1.74 +/- 0. 16 and 1.71 +/- 0. 11) than in B (0.32 +/- 0. 08 and 0.56 +/- 0.13) and C (0.12 +/- 0. 03 and 0.25 +/-0.06) (both P < 0.05). The epididymal epithelial cells in group A were obviously decreased in number and arranged in loose and disorderly patterns as compared with those in B and C.</p><p><b>CONCLUSION</b>Varicocele can cause hypoxia in the epididymal tissue, which in turn may lead to epididymal hypofunction.</p>

Case-control study on locking titanium plate in treating comminuted proximal humeral fracture in elderly / 中国骨伤

<p><b>OBJECTIVE</b>To observe therapeutic effects of locking titanium plate for the treatment of comminuted proximal humeral fracture in elderly.</p><p><b>METHODS</b>From June 2011 to May 2013, 72 elderly patients with comminuted proximal humeral- fractures were divided into locking titanium plate group and anatomical plate group, 36 cases in each group. In locking titanium plate group, there were 16 males and 20 females aged from 60 to 79 years old with an average of (69.55±5.62) years old; 10 cases were type Neer II, 18 were type Neer III and 8 cases were type Neer IV in accordance with Neer classification; treated with locking titanium plate. In anatomical plate group, there were 15 males and 21 females aged from 60 to 81 years old with an average of (69.76±5.70) years old; 9 cases were type Neer II, 20 were type Neer III and 7 cases were type Neer IV; and treated with anatomical plate. Clinical effects, preoperative and postoperative Neer scoring, operative time, bone healing time and incidence of complications between two groups were compared.</p><p><b>RESULTS</b>All patients were followed up from 1 to 3 years with an average of 15 months. The excellent and good rate of locking titanium plate group (91.7%) was significantly higher than anatomical plate group (75.0%). Postoperative Neer score of two groups were improved obviously, but locking titanium plate group (92.51±7.85) was higher than anatomical plate group (83.64±8.56); there was no significant differences between two groups in operative time (P>0.05); bone healing time in locking titanium plate was (18.6±3.4) weeks, and shorter than anatomical plate group (24.3±3.9) weeks; incidence of complications in locking titanium plate was (5.6%) shorter than anatomical plate group (22.2%), and had obviously differences between two groups.</p><p><b>CONCLUSION</b>Locking titanium plate for the treatment of comminuted proximal humeral fracture in elderly plays an important role in good rate, bone healing time and Neer score. It has advantages of early rehabilitation exercise, less shoulder pain, rapid recovery of shoulder joint, less complications, safe and effective, and be worthy of clinical application, especially for senile osteoporosis patients.</p>

Effects of myocardial platelet rich plasma injection on rats with acute myocardial infarction:(99)Tc(m)-MIBI gated SPECT imaging evaluation results / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the effect of direct myocardial injection of platelet rich plasma (PRP) on cardiac function, ventricular remodeling and myocardial perfusion.</p><p><b>METHODS</b>Myocardial infarction was induced in 30 Fisher rats by left anterior descending coronary artery (LAD) ligation. One week after LAD ligation, rats in control group (n = 15) received 0.5 ml saline myocardial injection and rats in PRP group (n = 11) received 0.5 ml PRP myocardial injection.(99)Tc(m)-methoxyisobutylisonitrile (MIBI) gated single photon-emission computed tomography (SPECT) imaging was applied at 1 week post LAD ligation and prior myocardial saline/PRP injection and repeated at 4 week post LAD ligation to assess myocardial perfusion and ejection fraction (EF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and the number of infarct segments.</p><p><b>RESULTS</b>EF remained unchanged between 1 and 4 weeks post LAD ligation in control group and was significantly higher at 4 weeks post LAD ligation than at 1 week post LAD ligation in PRP group (P < 0.05). LVESV was significantly increased in the control group (P < 0.05) while remained unchanged in the PAP group (P < 0.05) at 4 weeks post LAD ligation compared that at 1 week post LAD ligation. LVEDV remained unchanged in the control group (P > 0.05) and significantly increased in the PRP group (P < 0.05) from 1 week to 4 weeks post LAD ligation. Myocardial perfusion remained unchanged in the control group and significantly improved in the PRP group at 4 week post LAD ligations. Histological examination also confirmed that PRP treatment can decrease infarct size [from (47 ± 19)% to (36 ± 11)%], increase ventricular wall thickness [from (3.1 ± 0.9) mm to(4.6 ± 1.8) mm] (P < 0.05).</p><p><b>CONCLUSION</b>Myocardial PRP injection could improve cardiac function and reperfusion in this rat model of acute myocardial infarction.</p>

Challenges for rear hospital care of Wenchuan earthquake casualties: experience from West China Hospital / 中华创伤杂志(英文版)

To review the challenges and countermeasures in the hospital care for Wenchuan earthquake casualties and draw lessons for the protective response in the future. Medical records and laboratory findings of the victims admitted in West China Hospital (WCH) were retrospectively analyzed. Related data were compared between beforemath and aftermath of the earthquake and between WCH and frontier county hospitals. One thousand and thirty-one earthquake survivors were hospitalized, 1 358 victims underwent surgery and 142 victims were transferred to intensive care unit. The incidence of infection, crush syndrome and multiple organ dysfunction syndrome (MODS) was 39.6%, 20.7% and 2.3% respectively. Wound classification showed that the incidence of extremity damage was 72%, while the incidence of chest trauma, abdominal trauma and brain trauma was less than 10% respectively. Isolating rates of environmental pathogens were increased in the aftermath of earthquake, and the spectrum of the pathogens and related antibiotic sensitivities were quite different from those in the beforemath of earthquake. The social economic and population conditions in the earthquake-stricken areas affected the composition of the victims and the geographic features restricted the efficiency of rescue. Trauma-induced MODS, crush syndrome and severe infections all constituted the dilemma for the hospital care, to resolve whether the multidiscipline team work was proved to be an optimizing choice. For a more effective disaster protective response in the future, the study on rescue plan and the ladder therapies for massive casualties should be potentiated.

Tricuspid valve replacement and anticoagulation therapy: a report of 70 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the operative indication, the choice of valve prostheses, and the method of anticoagulation therapy of tricuspid valve replacement (TVR).</p><p><b>METHODS</b>From May 1998 to January 2008, 70 patients underwent TVR. There were 59 cases of rheumatic heart diseases. The operations included mitral and tricuspid valve replacement for 37 cases, triple valve replacement for 18 cases, isolated TVR for 13 cases, and tricuspid and aortic valve replacement for 2 cases. All the patients received oral anticoagulant therapy (warfarin) 2 d after the operations.</p><p><b>RESULTS</b>There were 3 in-hospital deaths (4.3%) and 1 late death (0.4%). The follow-up rate was 88.1%, and the cumulative follow-up was 243.5 patient-years (pty). The anticoagulation-related event rate was 2.9% pty, and the mean INR value of 643 out-patient samples was 1.87 +/- 0.68. Post-operative heart function NYHA classification: 52 cases in class I to II, and 7 cases in class III.</p><p><b>CONCLUSIONS</b>TVR should be indicated for severely damaged and deformed tricuspid valve of rheumatic heart diseases. Bileaflet mechanical valve is a suitable prosthesis for TVR. The optimal anticoagulation therapy intensity of TVR needs to be investigated.</p>

Chemosensitivity of mdr1 gene overexpressed multidrug resistant cancer cells to lidamycin / 药学学报

<p><b>AIM</b>To investigate the chemosensitivity to lidamycin (C-1027) in mdr1 gene overexpressing cancer cell lines established by drug induction and by gene-transfection.</p><p><b>METHODS</b>DNA was cloned by RT-PCR and then eukaryotic expressing recombinant plasmid pcDNA3. 1/mdrl was constructed. Using Lipofectamine 2000, a strain of stably transfected human hepatoma cancer cells, HepG2/mdrl, was obtained. The mdr1 mRNA level, P-glycoprotein (P-gp) level and the activity of P-gp to extrude drugs in cancer cells were determined by RT-PCR, immunofluorescence analysis and rhodamine 123 efflux assay. The chemosensitivity of cancer cells with low or high mdr1 expression to lidamycin and other antitumor drugs was tested by MTT assay.</p><p><b>RESULTS</b>The mdr1 mRNA and P-gp levels in KBv200, MCF-7/ADR, and stably transfected HepG2/mdr1 cells were much higher than that in respective parent KB, MCF-7 and HepG2 cells. The IC50 values of lidamycin for KBv200, MCF-7/ADR and HepG2/mdrl cells were (0.24 +/- 0.20) nmol x L(-1), (0.028 +/- 0.011) nmol x L(-1), and (0.020 +/- 0.011) nmol x L(-1), respectively. Compared with parental cells, the values of resistant fold for KBv200, MCF-7/ADR and HepG2/mdr1 cells to lidamycin were 6.8, 1.6 and 1.3 fold; to adriamycin were 37.2, 181.3 and 8.8 fold; to taxol were 336.8, 49.2 and 40.3 fold, respectively.</p><p><b>CONCLUSION</b>Lidamycin is highly active to multidrug resistant cancer cells. The chemosensitivity of those resistant cancer cells to lidamycin is approximately at the similar level as that of parent cancer cells.</p>

Alpha-blockers and bioflavonoids in men with chronic nonbacterial prostatitis (NIH-IIIa): a prospective, placebo-controlled trial / 中华流行病学杂志

<p><b>OBJECTIVE</b>The National Institutes of Health (NIH) category IIIa chronic prostatitis syndromes (non bacterial chronic prostatitis) were common disorders but with few effective therapies. Alpha-blockers and bioflavonoids had recently been reported in randomized controlled trials to improve the symptom of these disorders in a significant proportion of men. The aim of this study was to confirm these findings in a prospective randomized, placebo-controlled trial.</p><p><b>METHODS</b>Forty-five men with category IIIa chronic non bacterial protatitis were randomized into three groups as follows: (1) placebo; (2) phenoxybenzamine-hydrochloride:10 mg two times a day for one month; (3) flavoxate HCI-neptumus: 200 mg three times a day for one month. The NIH chronic prostatitis symptom score was used to grade symptoms at the beginning and conclusion of the study.</p><p><b>RESULTS</b>All the patients in three groups completed the study except three dropout patients in placebo group because of sever symptoms. The three groups were similar in age, duration of symptoms and initial symptom score. Patients taking placebo had a mean improvement in NIH-CPSI from 21.85 to 19.55 (not significant), while the phenoxybenzamine-hydrochloride group had a mean improvement from 21.95 to 13.75 (P < 0.01), and those taking flavoxate HCI-neptumus had a mean improvement from 21.75 to 16.95 (P < 0.05). The decrease in NIH-CPSI was associated with significant improvement in patients' clinical manifestations.</p><p><b>CONCLUSION</b>Therapy with alpha-blockers was well tolerated with significant symptomatic improvement in most men having chronic non-bacterial chronic protatitis while the bioflavonoids group had no significant improvement. Mechanism of both medicines needs further study.</p>

A study on biomarkers of styrene / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the biomarkers of styrene and to provide theoretical basis for bio-monitoring of styrene.</p><p><b>METHODS</b>Urinary mandalic acid (MA), phenylglyoxalic acid (PGA) and mercapturic acid (MUA) of styrene were examined by high performance liquid chromatography (HPLC).</p><p><b>RESULTS</b>The correlation regression equations between exposure dose and MA, PGA and MUA level in morning urinary samples were: ŷ = 2.58x + 70.82; ŷ = 1.66x + 37.42; ŷ = 0.05x + 0.55 respectively. The correlation regression equations between exposure dose and MA, PGA and MUA level in post-shift urinary samples were: ŷ = 1.85x + 89.02; ŷ = 1.33x + 4.32; ŷ = 0.04x + 0.68 respectively. All showed close dose-response relationship.</p><p><b>CONCLUSIONS</b>The level of MA, PGA and MUA in morning or post-shift urinary samples may be used as bio-monitoring indexes of styrene.</p>

Low intensity anticoagulation therapy after mechanical heart valve replacement / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the proper anticoagulation intensity in patients after mechanical heart valve replacement in china.</p><p><b>METHODS</b>The anticoagulation therapy intensity and the complications in 480 patients after mechanical heart valve replacement were studied.</p><p><b>RESULTS</b>The follow-up rate was 89.17%, the total patient-years (Pty) was 2,110.04 years, the mean oral import warfarin dosage was (2.81 +/- 0.95) mg/day, and native warfarin dosage (2.38 +/- 0.46) mg/day. The mean PTR value of 2 116 samples was 1.43 +/- 0.26, and the INR value of 1 195 samples was 1.63 +/- 0.49. The total hemorrhage rate was 4.60% Pty, and the hemorrhage death rate was 0.38% Pty. The PTR and INR values were higher in the hemorrhage group than in the no-hemorrhage group. (t = 1.816, P < 0.05; t = 2.407, P < 0.01). The thromboembolism rate was 0.66% Pty, and the thromboembolism death rate was 0.05% Pty. There were 15 pregnancies in 14 women patients and no malformed newborns were found.</p><p><b>CONCLUSIONS</b>The most important complication of anticoagulation therapy after mechanical heart valve replacement is hemorrhage in china; The proper anticoagulation intensities of this group are INR 1.5-2.0 and PTR 1.3-1.5. It is beneficial to adopt the low intensity anticoagulation therapy for decreasing the death rate from hemorrhage, protecting pregnant women and newborns from hemorrhage and malformation, and improving the life qualities of the patients.</p>

Sensing scheme of minim liquid density based on Lamb-wave / 中国医疗器械杂志

This paper presents and discusses the liquid density sensing potential of a delay line Lamb-wave sensor configuration, where Lamb wave is excited only by interdigital transducer (IDT), without membrane when fabricated. An optimized cut orientation and the normalized thickness of substrate by using genetic algorithm is presented to improve the sensitivity of the sensor and to get low noise. Experimental measurements performed on Lamb-wave device fabricated from Y-Z LiNbO3 in a delay line configuration are found to be in agreement with theoretical calculations.