Application of ESA flipped classroom combined with SPOC teaching mode in practice teaching of rehabilitation medicine / 中华医学教育探索杂志

Objective:To explore the application of engage-study-activate (ESA) flipped classroom combined with small private online course (SPOC) teaching in the practice teaching of rehabilitation medicine.Methods:A total of 87 students who practiced in the department of rehabilitation medicine from January 2018 to October 2020 were divided into control group ( n=43) and observation group ( n=44). The control group used routine teaching, and the observation group used ESA flipped classroom combined with SPOC teaching. The individual assessment results and team assessment results of the two groups of interns were compared, and the evaluation of teaching effect and the recognition of interns were analyzed. SPSS 22 0 was performed for chi-square test and t test. Results:The scores of medical history collection, specialized physical examination, treatment methods, individual assessment, humanistic communication, participation and team assessment in the observation group were better than those in the control group ( P<0.05). There was no significant difference in auxiliary examination score, diagnosis score and teamwork score between the two groups ( P>0.05). The scores of learning efficiency, classroom interaction ability, autonomous learning ability, combination of theory and practice, mastery of basic knowledge, clinical innovative thinking ability and teamwork ability in the observation group were higher than those in the control group ( P<0.05). The recognition of teaching in the observation group was 97.73% (43/44), which was higher than 81.40% (35/43) in the control group. Conclusion:ESA flipped classroom combined with SPOC teaching can improve the individual assessment results and group assessment results of interns, improve the educational environment, and its teaching effect is better than conventional teaching methods, which can improve the recognition of interns, so it has important application value in medical teaching.

Progress in the Treatment of Antisense Oligonucleotides in Duchenne Muscular Dystrophy / 罕见病研究

In recent years, antisense oligonucleotide (ASO) has been very active in the field of rare disease research and development, especially in Duchenne muscular dystrophy, where it made a major breakthrough. Duchenne muscular dystrophy (DMD) is a rare childhood myopathy caused by mutations in the dystrophin gene. Currently, the four ASO drugs approved internationally for DMD are all targeted at dystrophin, including eteplirsen, golodirsen, viltolarsen and casimersen. They all belong to phosphorodiamidate morpholino oligomers (PMO) antisense oligonucleotide drugs, so that their pharmacokinetic characteristics are similar. The drugs quickly spread to other tissues after intravenous administration. Because of the electrical neutrality of the PMO, they have a low binding rate to plasma proteins and are quickly metabolized by the kidney and excreted in the urine as archetypes. In addition, the likelihood of drug-drug interactions of ASO is low. Existing clinical studies have shown that they have certain clinical benefits and good tolerability, bringing new options for DMD treatment. This paper mainly discusses the pharmacological effects, pharmacokinetic characteristics, efficacy, and safety of ASO drugs for the treatment of DMD, hoping to provide scientific reference for the rational and safe clinical use of such drugs.

Advances in drug delivery systems for the treatment of liver fibrosis / 中国药科大学学报

Liver fibrosis is a major disease that affects human health. Currently,drugs used for the treatment of hepatic fibrosis have such problems as low drug solubility,lack of liver specificity and possible occurrence of side-effects. In order to improve the anti-fibrosis therapeutic efficacy,various nano-drug delivery systems and targeting strategies are explored in liver fibrosis therapy. This review summarizes the drug delivery systems and targeting strategies that have been applied to liver fibrosis therapy in recent years from the types of carriers and modified ligands,which serve as a basis of designing safe and effective drug delivery systems for liver fibrosis therapy.

Analysis on English Literature of Prescription Refills for Chronic Diseases / 中国药师

Objective:To search the English literatures on prescription refills for chronic diseases for a systemic analysis and to explore the mode and the management measures in order to develop the prescription refill and medication therapy management service for patients with chronic diseases in China .Methods:In the pubmed database , the literatures related to prescription refills published before April 2016 was retrieved.The literatures were analyzed by classification of country or region , the types of drugs and the other in-formation.Results:It was found that the United States , Britain and Sweden were the countries with the most prescription refills .The medications for hypertention , diabetes , hyperlipidemia and other chronic diseases respectively were the most types of medications men -tioned.Age, educational level, race, language, type of medication, and so on.were the factors that affected patient compliance . Pharmacists played a role in auditing , intervention and follow-up in prescription refills programs .Conclusion: The programs of pre-scription refills is well developed in America and Europe , which may be a good way to solve the demand in long-term caremedication therapy for those patients in China .

Enlightenment of Repeat Prescription and Service Mode Continual Improvement in Singapore to China / 中国药师

Repeat prescription is adopted in Singapore as a convenient measure for patients with chronic diseases.On the one hand, it can avoid patients''inconvenience caused by frequent visits to hospitals.On the other hand, it reduces the waste of medical resources.In recent years, Singapore has also been using modern technology and measures to expand the medication refill service actively in order to enhance work efficiency, reduce waiting time and promote drug safety, thus to improve patients'' satisfaction.With the increasing medical pressure and the deepening of medical reform, the repeat prescription model in Singapore shows positive enlightenment to China.

Application of Lipid-modulating Agents in the Dialysis Patients with End-stage Renal Disease / 中国药师

Although dyslipidemia is common in the patients with end-stage renal disease undergoing dialysis, it is still controver-sial in the efficacy and safety of lipid-modulating agents used in the patients. In this paper, current large-scale randomized controlled trials and observational studies were reviewed, and the influence and characteristics of dyslipidemia as well as the application of com-mon lipid-modulating agents in dialysis patients were summarized. The current clinical evidence suggested that the use of statins with or without ezetimibe could effectively reduce the level of blood lipid in dialysis patients without increased risk of adverse events, while it had limited role in cardiovascular protection;fibrates had higher risks in dialysis patients; nicotinic acids had limited use mainly be-cause of their unbearable side effects.

Sampling Analysis of the Use of Precursor Drugs in the Outpatients of Our Hospital / 中国药师

Objective:To understand the application status of precursor drugs in the outpatients of our hospital. Methods:Totally 12 kinds of precursor drugs were included in the management. The data of prescriptions in HIS were collected from July 1 to September 30 in 2015. The defined daily dose (DDD), frequency of drug use (DDDs), drug utilization index (DUI) and the other parameters were calculated and the influencing factors were analyzed by the Pareto method. Results: Among the twelve precursor drugs, DUI of seven kinds was less than or equal to 1. Paracetamol tablets, pseudoephedrine hydrochloride tablets, dextromethorphan hydrobromide and chlorphenamine maleate tablets, nicergoline tablets and compound dextromethorphan hydrobromide tablets II displayed lower DUI, indicating their clinic application was more reasonable. Conclusion:The data showed that the use of precursor drugs in our hospital is basically reasonable.

Influence of unilateral mandibular first molar loss on the activities of masticatory muscles / 安徽医科大学学报

Objective To investigate the electromyographic changes in the anterior temporal and masseter muscles of patients with long-term unilateral mandibular first molar loss. Methods Eighteen patients with one-year or more than one-year loss of unilateral mandibular first molar were selected as experimental group,and eighteen volunteers from similar places,had similar dietary habits in the same age and gender with normal occlusion were recruited as control group. Surface electromyography was used for the evaluation of the electrical activities of bilateral anterior temporal and masseter muscles in mandibular postural position ( MPP ) , maximal clenching in intercuspal position ( ICP) and masticating situations. The data were analyzed using SPSS 17. 0 software package to compare the differ-ences among groups. Results The average electrical activities of anterior temporal and masseter muscles in MPP of experimental group were significantly higher than the contral group,and the missing side was higher than the non-missing side ( P <0. 05 ) . The average electrical activities of anterior temporal and masseter muscles in maximal clenching and masticating were significantly lower than the control group,especially in the masticating situation( P<0. 05 ) . The asymmetry index of anterior temporal muscles and masseter muscles in MPP and maximal clenching were significantly different(P<0. 05). Conclusion Long-term loss of unilateral mandibular first molar can affect the electrical activities of the anterior temporal muscles and masseter muscles in the experimental group,especially for the missing side and in the masticating situation. These results also suggest that it might be one of the potential factors on mastication system disorders.

Expression Profile and Bioinformatics Studies of Long Noncoding RNA in Mouse Embryonic Fibroblasts under Endoplasmic Reticulum / 医学研究杂志

Objective To explore the potential significance of long noncoding RNA (lncRNA) expressed in endoplasmic reticulum stress response also known as unfolded protein response ( UPR) .Methods Mouse embryonic fibroblasts ( MEFs) were isolated from 13 day mouse embryo , cultured and treated with tunicamycin for 16 hours to induce UPR .The untreated MEFs were used as negative control .The lncRNA expression profile was examined by a customized lncRNA array. The results of array assay were validated by real-time PCR and further analyzed by bioinformatics. Results There were 411 lncRNAs whose expression was signficantly up-regulated in MEFs treated with tunicamycin as compared with the controls ,while 790 lncRNAs were significantly down-regulated. A number of significantly alter lncRNAs were validated by real-time PCR. A further bioinformatics analysis of lncRNA profile suggested that many cold be in-volved in multiple cellular pathways. Conclusion Our lncRNA expression profile and bioinformatics studies srongly suggest that many lncRNAs can be regulated in the cells under UPR and could also in turn regulate UPR and other cellular processes.

The changes of maxillary sinus membrane thickeness after maxillary sinus floor elevation surgery / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the success rate of dental implants and the changes of sinus membrane thickness after sinus lift in cases of thickened sinus membrane.</p><p><b>METHODS</b>Sixteen patients without maxillary sinusitis and with 5-8 mm residual alveolar bone heights were included in this study. The sinus membrane thickeness of these patients were more than 2 mm. All patients received sinus lift surgery and dental implants insertion. The changes of sinus membrane was evaluated by cone-beam CT (CBCT) pre-surgery and 6 months after sinus lift surgery, and the short term success rate of dental implants was also evaluated.</p><p><b>RESULTS</b>A total of 18 implants from 16 subjects were inserted. The thickness of membrane was decreased in 14 cases after sinus lift and increased in 2 cases. All the orifice of maxillary sinus was unobstructed before surgery, one case was obstructed after surgery without inflammation. All the dental implants succeeded.</p><p><b>CONCLUSIONS</b>Sinus augmentation with thickened sinus membrane is not contraindication of sinus lift.</p>

Synthesis and antitumor effect of novel andrographolide derivatives / 中国药科大学学报

A series of andrographolide derivatives with the structure of 12-N-substituted-14-deoxyandrographolide were synthesized from the parent compound andrographolide.Their antitumor activities were preliminarily evaluated on various cancer cell lines and compound 4d stood out due to its potent growth inhibitory effect in comparison with andrographolide.Compound 4d also demonstrated significant antitumor effect on human hepatoma HepG2cells in vitro and on sarcoma 180 (S180) and hepatoma 22(H22)-bearing mice in vivo.Then,the apoptosis induced by compound 4d in HepG2cells was detected by Annexin V/PI double staining assay.Further mechanic study showed that the expression of p53 and Bax was significantly elevated and that of Bcl-2was downregulated in 4d-treated HepG2cells.Collectively,these data suggested that compound 4d had remarkable antitumor effect both in vitro and in vivo and could effectively induce apoptosis via a p53-dependent pathway in HepG2 cells,thus deserving further investigation.