Curriculum construction and application effect evaluation of MOOCs in pediatrics teaching / 中华医学教育探索杂志

The First Affiliated Hospital of Xi'an Jiaotong University has established pediatric MOOCs courses, including the formation of excellent MOOC teachers, the curriculum planning and design of MOOCs, making MOOCs videos, and using MOOCs for teaching activities. The MOOCs for teaching is intuitive, the courses are interesting, and the learning time is flexible. Besides, it is open and resources-sharing, and it also can increase the educational equity. At the same time, it can reduce teachers' burden, improve teaching ability, and improve learning ability of students. Most students and teachers agree that MOOCs are worthy of promotion and application.

Omnibearing reform and practice of medical education based-on integrated organ system-based curriculum and PBL / 中华医学教育探索杂志

Xi'an Jiaotong University has proposed the concept of "less teaching and more learning, interaction between guiding and learning" in medical education, based on its sedimentary deposits, and carried out reform for all clinical medical students since 2001. After more than ten years of educational reform, we have built brand new management framework, and established integrated organ system-based curriculum and PBL teaching pattern. This pattern involves eight aspects of comprehensive reform, including training program, curriculum model, textbook, teaching method, learning style, assessment and evaluation, teaching organization, teaching conditions and guarantee. It will provide paradigm for the integrated curriculum reform in peer colleges, and will be a milestone in the history of medical education in China.

Influence of acute pancreatitis in pregnancy on pregnancy outcomes and neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the influence of acute pancreatitis in pregnancy (APIP) on pregnancy outcomes and neonates.</p><p><b>METHODS</b>A retrospective analysis was performed for 33 APIP patients and 31 neonates born alive.</p><p><b>RESULTS</b>Of the 33 APIP patients, 26 (79%) developed APIP in the late pregnancy. Fourteen (45%) patients had hyperlipidemic APIP, 13 (42%) had biliary APIP, and 4 (13%) had other types of APIP. According to the severity, 22 (67%) were mild APIP, 5 (15%) were moderate APIP, and 6 were severe APIP. None of the 33 APIP patients died. Among the 20 patients with term delivery, 11 underwent termination of pregnancy; among the 10 patients with preterm delivery, 9 underwent termination of pregnancy; two patients experienced intrauterine fetal death, and one experienced abortion during the second trimester. Among the 31 neonates born alive (two of them were twins), 1 (3%) died, 12 (39%) experienced neonatal hyperbilirubinemia, 8 (26%) had neonatal hypoglycemia, 6 (19%) had neonatal respiratory distress syndrome, 5 (16%) experienced infectious diseases, and 2 (6%) experienced intracranial hemorrhage. The hyperlipidemic APIP group had a higher percentage of patients undergoing termination of pregnancy than the biliary APIP and other types of APIP groups (P<0.05). The incidence rate of preterm infants in the moderate APIP was higher than in the mild and severe APIP groups (P<0.05). The mean birth weights of neonates were the lowest in the moderate APIP group. The incidence rates of neonatal respiratory distress syndrome, intracranial hemorrhage, and infectious disease were the lowest in the mild APIP group (P<0.05).</p><p><b>CONCLUSIONS</b>APIP can lead to adverse pregnancy outcomes and neonatal diseases, which are associated with the severity of pancreatitis.</p>

Research on the expression of aquaporin 9 gene and efficacy of mannitol in neonatal rats with hypoxia-ischemic brain edema / 中国新生儿科杂志

Objective To study the relationship between aquaporin 9 (AQP 9) gene and brain edema in neonatal rats of hypoxic-ischemic brain damage (HIBD) and the therapeutic mechanism of mannitol.Method Healthy and 7-day-old SD rats were randomly assigned into three groups:sham-operated group,HIBD group and mannitol group.Both HIBD and mannitol group were established on HIBD model.The mannitol group was given mannitol intraperitoneally at 0,24,48 h of HIBD.2 ml/kg of 2％ Evans blue (EB) were injected intraperitoneally before sacrifice.0,6,12,24,48 and 72 h after HIBD,the outcomes were analyzed including the brain water content,the expression of AQP 9 mRNA measured using RT-PCR and immunofluorescence staining methods,and the permeability of blood-brain barrier (BBB) measured with EB.Result In HIBD group,the brain water content was higher comparing with sham-operated group at 0 h after HIBD(P ＜ 0.05),and gradually increased over time,reaching peak at 48 h (89.3％ ± 1.9％) and then decreased.In mannitol group,brain water content started to decrease from 1 h after mannitol administration to the bottom at 12 h (86.5％ ±0.6％),then increased to peak at 72 h (87.2％ ± 1.7％),and brain water content were decreased during 0 ～ 48 h comparing with HIBD group.HIBD group's EB were higher than sham-operated group (P ＜ 0.05);Mannitol group's EB were decreased comparing with HIBD group (except 0 h,P ＜ 0.05).AQP 9 mRNA expression in the HIBD group was decreased at 0 h,and reached the bottom at 48 h (0.09 ± 0.07).Comparing with sham-operated group,it was higher in the HIBD group at0,6,72 h,and lower (P＜ 0.05) at 12,24,48 h.Higher AQP 9 mRNA expression were detected in mannitol group than HIBD group and sham-operated group at each time point (with the exception of 48 h) (P ＜ 0.05).AQP 9,which was closely related to water metabolism,were widely found in the pia mater and ependyma using immunofluorescence staining.After ischemia and hypoxia insult,an increasedecrease-increase pattern of AQP 9 expression was found.Conclusion AQP 9 is widely existed in various parts of the brain,influencing brain edema through a variety of pathways.AQP 9 also plays a role in alleviating brain edema in mannitol therapy.

Comparison of the Clinical Effect and Safety of Three Dosage Regimens in the Treatment of Children with Severe Pneumonia / 现代生物医学进展

Objective:To compare the clinical effect and safety of three different regimens treating children with severe pneumonia.Methods:120 cases treated in our hospital from January,2012 to January,2016 were randomly divided into the observation group 1 (dopamine combined with dobutamine,42 cases),observation group 2 (dopamine combined with phentolamine,40 cases),control group (38 cases).The clinical effect and levels of inflammatory cytokine were compared between the three groups.Results:The total effective rate in the observation group 1 was 90.48％ and that of observation group 2 was 87.5％,which were significantly higher than that of the control group (63.16％).The disappearance time of pulmonary rales,cough,dyspnea,pyretolysis and length of stay in the observation group (both 1,2) were significantly shorter than those of the control group (p ＜0.05).After therapy,the level of serum IL-6,IL-8,CRP and TNF-α in all the three groups were obviously decreased compared with those of before therapy (p＜0.05),and those of the observation group were significantly lower than the control group (p ＜ 0.05).Conclusion:Dopamine combined with dobutamine as well as dopamine combined with phentolamine were both effective methods in treating children with severe pneumonia,which were significantly better than conventional therapy.

The effect of lactobacillus vaginal capsules and Kangfuxin liquid in the treatment of senile vaginitis and the influence on vaginal environment / 中国基层医药

Objective To observe the effect of lactobacillus vaginal capsules and Kangfuxin liquid in the treatment of senile vaginitis and the influence on vaginal environment,thus to guide rational and effective treatment. Methods 80 patients with senile vaginitis were randomly divided into observation group and control group.40 cases in the control group were given ornidazole suppository,40 cases in the observation group were given lactobacillus vagi-nal capsules and Kangfuxin liquid on the basis of the control group.Both two groups had been treated for 7d.The symptoms and signs were observed before and after treatment.The vaginal secretions were taken for measuring vaginal lactobacilli by smear method.The pH in vaginal was detected,adverse events were recorded.All the patients were fol-lowed up for six months,the recurrence was observed.Results The total effective rate,the recurrence rate of 2 months after treatment,the recurrence rate of 4 months after treatment,the recurrence rate of 6 months after treat-ment of the observation group and control group were 97.5% vs 75.0%,0.0% vs 10.0%,2.5% vs 17.5% and 2.5% vs 22.5%,the differences were statistically significant(χ2 =4.211,5.000,7.314,all P <0.05).The improve-ment of genital itching,increased vaginal discharge,dysuria,vaginal congestion in the observation group were better than the control group(χ2 =5.00,4.872,5.475,5.333,all P <0.05).The pH values of vagina in the observation group and control group were (4.4 ±1.8),(5.5 ±2.1),there was statistically significant difference(t =5.386,P <0.01).The vaginal lactobacilli positive rate of the control group after treatment was 57.5%(23 /40),which of the observation group was 87.5% (35 /40 ),the difference was statistically significant (χ2 =9.028,P <0.01 ). Conclusion The method contained lactobacillus vaginal capsules and Kangfuxin liquid can balance the vaginal envi-ronment,improve symptoms and signs,reduce the rate of disease recurrence.

Practice of strengthening students' identity as a‘trainee doctor’in pediatric practice teaching / 中华医学教育探索杂志

Objective Through the practice of new practice teaching methods, to observe whether it can help students to strengthen their self-identity as ‘trainee doctors’. Methods By sim-ulating interrogation, building simulation medical environment and increasing operation project, the practice operation abilities and sense of identity were improved,The questionnaire were required to fill in at the beginning and at the end of the term, and the differences between two teaching methods in advantages, characteristics and the identity of ‘trainee doctors’by their own pairing were compared. Data were analyzed by software SPSS 18.0. Results The new teaching model, to a certain extent, alleviated the present situation of having relatively more students and insufficient source, which was superior to traditional teaching mode in improving students' initiative, enthusiasm, learning ability, practical ability, analysis of the problems, comprehensive ability and so on. It also enabled students to master some of doctor-patient communication skills(P<0.001), to realize the identity of‘trainee doctors’ (Z=-7.671, P<0.001). Conclusion The new practice teaching mode has solved the problems such as insufficient source in clinical teaching. It has also increased the initiative and enthusiasm of students' clinical learning, so that students can think, analyze and deal with the problems from the point of view of doctors, and implement the identity of a‘trainee doctor’.

Sclerotherapic effects of different concentrations of lauromacrogol on endometrial cyst models in rats in two retention ways / 中华超声影像学杂志

Objective To compare the sclerotherapic effects of different concentrations of lauromacrogol on endometrial cyst models in rats in two ways :10 minutes retention with extraction and retention without extraction .Methods Ninety SD rats after modeling were randomly divided into three groups :group A ,10 minutes retention with extraction;group B ,retention without extraction;group C , normal saline .While both A and B group were randomly divided into four subgroups with different concentrations :1% ,0 5.% ,0 2.5% ,and 0 1.25% . Seven days after treatment the cure rates and histopathological changes were observed .Results Cure rates in group A were 86 7.% ,71 4.% ,50% and 20% ;in group B were 100% ,100% ,87 5.% and 37 5.% .In both A and B groups ,the cure rates were not significantly different between 1% ,0 5.% and 0 2.5% concentration subgroups ( P >0 0.5) ,the cure rates of these subgroups in group B had statistical significance with 0 1.25% concentration subgroups and the saline control group( P 0 0.5) , but between 0 5.% and 0 2.5% concentration subgroups ,it had statistical significance( P <0 0.5) .Conclusions It will be conductive to enhancing the sclerotherapic effect if the lauromacrogol concentration remains above 0 2.5% and does not be extracted from the cyst models .

Scope and method of image registration and clinical target volume margin for central-type non-small cell lung cancer in image-guided radiotherapy / 中南大学学报(医学版)

OBJECTIVE@#To determine the influence of different registration scopes and methods on kilo-voltage cone beam CT (kVCBCT) image and CT image and to estimate the appropriate clinical target volume (CTV)-to-planned target volume (PTV) margin for central-type non-small cell lung cancer in image-guided radiation therapy (IGRT).@*METHODS@#Twenty-six patients with central-type non-small cell lung cancer (NSCLC) who received IGRT were enrolled in this study and totally 104 flames of kVCBCT scanning acquired before radiotherapy were analyzed. First, registrations were performed by gray plus manual match and were compared among different registration scopes of tumor and tumor plus vertebra. Then, the results of registration as well as time cost using tumor plus vertebra as registration scope were compared among different registration methods of gray plus manual match and bone plus manual match. At last, 200 registrations using tumor plus vertebra as the registration scope performed by bone plus manual match were recorded and the CTV-to-PTV margin was calculated.@*RESULTS@#There was no significant difference in X, Y and Z translational and rotational movements between the registration scopes of tumor and tumor plus vertebra when gray plus manual match was used as the registration method (P>0.05). The registration results of gray plus manual match and bone plus manual match were equal when tumor plus vertebra was used as the registration scope (P>0.05), but the time cost of bone plus manual match [(1.9±0.3) min] was shorter than that of gray plus manual match [(3.1±0.2) min]. The CTV-to-PTV margins were 5.3, 4.9 and 5.7 mm in X, Y, and Z directions respectively.@*CONCLUSION@#For central-type NSCLC, tumor and vertebra can be used as registration scope and the bone plus manual match is suggested in IGRT. To avoid errors, we suggest a CTV-to-PTV margin of 6 mm.

Analysis of the electromyographic characteristics on shoulder fatigue caused by lifting load / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To analyze and evaluate the fatigue of shoulder skeletal muscle caused by different lifting loads with surface electromyography (sEMG).</p><p><b>METHODS</b>According to the loading standard of1 Repetition Maximum (1RM), ten male volunteers performed 3 tasks of upper limb flexion, i.e. 10%, 50% and 90%-1RM. During action process, the signals of Upper Trapezius (UT), Lower Trapezius (LT), Serratus Anterior (SA) and Anterior Deltoid (AD) were recorded by sEMG. The Mean Amplitude (MA) served as an index to evaluate the changes in skeletal muscle fatigue.</p><p><b>RESULTS</b>The scores of Borg were 15.6, 15.9 and 15.2 for 3 loads of 10%-1RM, 50%-1RM and 90%-1RM, respectively (P > 0.05). The mean amplitudes (MAs) of Upper Trapezius, Lower Trapezius, Anterior Deltoid and Serratus Anterior in shoulders increased obviously. Under the load intensity of 10%-1RM, the MAs of Upper Trapezius and Anterior Deltoid increased significantly (P < 0.05), which were 0.898 and 0.736, respectively. After the exhaustion, the contribution of mean amplitude in shoulder muscle did not change significantly (P > 0.05).</p><p><b>CONCLUSION</b>The low-load action for long time can induce easily the fatigue of upper trapezius and anterior deltoid.</p>

Concurrent chemoradiotherapy followed by consolidation chemotherapy and sequential chemoradiotherapy for stage III non-small cell lung cancer: comparison in 93 patients / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the efficacy and toxicity of concurrent chemoradiotherapy followed by consolidation chemotherapy (CCRT-CT) and sequential chemoradiotherapy (SCRT) in the treatment of stage III non-small cell lung cancer.</p><p><b>METHODS</b>From February, 2007 to June, 2010, 93 patients with unresectable stage III non-small cell lung cancer were treated with SCRT or CCRT-CT. SCRT group (50 cases) received radiotherapy after 2-6 cycles of chemotherapy (median 2 cycles) followed by 0-4 cycles (median 2 cycles) of chemotherapy. CCRT-CT group (43 cases) received 2 cycles of chemotherapy every 3 weeks with concurrent radiotherapy followed by 2-4 cycles (median 2 cycles) of chemotherapy with the same drugs. The chemotherapy consisted of cisplatin plus gemcitabine, docetaxel or vinorelbine. Radiotherapy was administered using two-dimensional conformal irradiation (36-40 Gy/18-20f) followed by three-dimensional conformal boost to 56-70 Gy/28-35f (median DT64Gy) or using three-dimensional conformal irradiation 50-74 Gy/25-37f (median DT62Gy).</p><p><b>RESULTS</b>The response rates were 76.7% and 54.0% in CCRT-CT and SCRT group, respectively (P<0.05). The median progression-free time in the two groups was 16.0 and 10.0 months, with the overall survival time of 18.0 and 12.5 months, respectively. The 1-, 2- and 3-year overall survival rates were 83.7%, 48.8% and 20.9% in CCRT-CT group and 52.0%, 20.0%, and 2.0% in SCRT group, respectively (P<0.05). CCRT-CT group showed a significantly lower rate of distant metastasis than SCRT group (P<0.05), but the local recurrence rate was similar between the two groups. The main side effects included radiation pneumonitis, radiation esophagitis, nausea/vomiting and anemia/leucopenia/thrombocytopenia. CCRT-CT group had a significantly higher rate of III-IV grade nausea/vomiting and anemia/leucopenia/thrombocytopenia than SCRT group.</p><p><b>CONCLUSION</b>Compared to SCRT, CCRT-CT can improve the response rate, progression free survival and overall survival and decrease the rate of distant metastasis, but is associated with a higher toxicity.</p>

1,3,4-tri-O-galloyl-6-O-caffeoyl-β-D-glucopyranose, a new anti-proliferative ellagitannin, regulates the expression of microRNAs in HepG(2) cancer cells / 南方医科大学学报

<p><b>OBJECTIVE</b>MicroRNAs (miRNAs) play important roles in cell proliferation, differentiation and apoptosis. 1, 3, 4-tri-O-galloyl-6-O-caffeoyl-β-D-glucopyranose (BJA32515) is a new natural ellagitannin compound extracted from Balanophora Japonica MAKINO. The effect of BJA32515 on the expression of miRNAs in cancer cells has not yet been explored. Objective The present study was carried out to examine the changes in miRNA expression profiles in human HepG(2) hepatocarcinoma cells following BJA32515 exposure.</p><p><b>METHODS</b>The proliferation of BJA32515-exposed HepG(2) cells was assessed using a colorimetric assay (cell counting kit-8). The miRNA expression profile of the cancer cells was analyzed using a miRNA array and quantitative real-time PCR. Apoptosis was assessed by annexin V and propidium iodide staining.</p><p><b>RESULTS</b>BJA32515 inhibited the cell proliferation and increased apoptosis in HepG(2) cancer cells. The exposure to BJA32515 also caused alterations in the miRNA expression profile in the cells, with 33 miRNAs upregulated and 59 down-regulated. The up-regulation of let-7a and miR-29a and the down-regulation of miR-373 and miR-197 were verified by quantitative real-time PCR. CONCLSION: BJA32515-modifed miRNA expression may mediate the antiproliferative effect of this compound in HepG(2) cancer cells.</p>

Detection of epidermal growth factor receptor and c-Met gene copies for prognostic evaluation of non-small cell lung cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the role of epidermal growth factor receptor (EGFR) and c-Met in the oncogenesis, development and prognosis of non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>The relative copy numbers of EGFR and c-Met mRNA were detected in 61 cases of NSCLC by fluorescent RT-PCR, and the correlation between EGFR and c-Met as well as their correlation to the clinicopathological data of the patients were analyzed. A survival analysis was also performed in relation to EGFR and c-Met expressions.</p><p><b>RESULTS</b>The relative copy numbers of EGFR and c-Met were positively correlated (r=0.352, P=0.005). The levels of these two genes in smokers were 0.15 and 0.14, respectively, significantly higher than those in non-smokers (P<0.05); their levels were 0.16 and 0.14 in adenocarcinoma, respectively, significantly higher than those in squamous carcinomas (P<0.05). In patients with squamous carcinomas, a higher level of EGFR and c-Met DNA copies was associated with poorer prognosis, and Log Rank analysis indicated a survival difference in relation to EGFR and c-Met DNA copies (P=0.015, P=0.046).</p><p><b>CONCLUSIONS</b>EGFR and c-Met may interact in a synergistic manner in the oncogenesis and development of NSCLC, and may help in the prognostic evaluation of squamous carcinomas.</p>

Clinicopathological features and prognostic implications of EGFR/c-Met gene copy number and protein expression in non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the gene copy number and protein expression of EGFR/c-Met, so as to explore the relationship between them and the clinicopathological features and prognosis in non-small cell lung cancer (NSCLC) patients.</p><p><b>METHODS</b>The expression of EGFR/c-Met protein was detected by immunohistochemical staining in NSCLC tissues of 61 cases. The level of EGFR/c-Met gene copy number was detected by fluorescent RT-PCR.</p><p><b>RESULTS</b>The positive rates of EGFR and c-Met protein expression were 77.5% and 57.4%, respectively. These rates in well/moderately differentiated NSCLC tissues were 61.5% and 38.5%, all significantly lower than the data in poorly differentiated tissues (P < 0.05). The relative EGFR and c-Met gene copy number was 0.22 ± 0.22 and 0.20 ± 0.21 in smokers, respectively, all significantly higher than that in non-smokers (P < 0.05). The gene copy number of EGFR and c-Met in adenocarcinoma was 0.24 ± 0.26 and 0.23 ± 0.25, respectively, all higher than the data in squamous cell carcinoma (P < 0.05). There was a significant correlation in regard to the EGFR and c-Met protein expression, EGFR and c-Met gene copy number, and the protein expression vs. the gene copy number only in EGFR (P < 0.05). But there was no significant correlation between the c-Met protein expression and gene copy number (P = 0.259). There was a statistical significance between the postoperational median survival times (MST) of low EGFR gene copy number (48 months) and the high EGFR gene copy number (36 months) patients (P = 0.039). Similarly, there was also a significant difference between the MST of the low and high c-Met gene copy number patients (44 and 31 months, P = 0.022).</p><p><b>CONCLUSION</b>There is a correlation between the EGFR and c-Met protein expression and the differentiation of NSCLC. The relative gene copy number is correlated with pathologic types and smoking of NSCLC patients, and it can be used in the prediction of prognosis.</p>