Application of situational bilingual teaching in standardized residency training of gynecology / 中华医学教育探索杂志

Objective:To explore the application value of situational bilingual teaching in standardized residency training of gynecology.Methods:The study enrolled 64 gynecological residents of Guangzhou Women and Children's Medical Center, and they were randomized into experimental group and control group, with 32 residents in each group. The control group was taught by the traditional teaching method, using self-compiled teaching materials of our hospital. The experimental group was taught by the situational bilingual teaching mode, and the teaching materials were the same as those of the control group. The training time of the two groups was two months. After teaching, the training effect was evaluated through examination and satisfaction survey. SPSS 22.0 software was used for t test and chi-square test. Results:After training, the scores of theoretical knowledge, operation skills and case analysis in the experimental group were significantly higher than those before training and after training in the control group ( P<0.05). The learning interest, autonomous learning ability, theoretical knowledge mastery, clinical thinking ability and communication ability of the experimental group were significantly better than those of the control group ( P<0.05). The number of residents who were very satisfied with the training was significantly higher than that of the control group, and that of residents who were basically satisfied with the training were less than that of the control group ( P<0.05). Conclusion:The application of situational bilingual teaching in the standardized residency training of gynecology has good teaching effects, which can significantly improve the theoretical performance, clinical operation ability and case analysis ability of the training residents, and also improve the satisfaction of the training residents.

Combination of ultrasound and MRI in the diagnosis of fetal thoracic abnormalities / 实用放射学杂志

Objective To compare and analyze the diagnostic value of prenatal ultrasound and MRI in fetal thoracic abnormalities, as well as the advantages and disadvantages, respectively, and to explore the clinical value of the combined use in diagnosing fetal thoracic abnormalities.Methods The prenatal ultrasound and MRI images of total 94 cases with thoracic abnormalities were analyzed retrospectively.All the patients received MRI exams within 2 days after the preliminary ultrasound diagnosis of abnormalities.All cases were confirmed by autopsy or postnatal follow-ups.Results 94 cases of thoracic abnormalities included 48 cases of cystic adenoma abnormalities, 33 cases of bronchopulmonary sequestration, 10 cases of diaphragmatic hernia and 3 cases of primary pulmonary hypoplasia.The diagnosis coincidence rate of ultrasound was 82.98% (78/94), while the combined use was 93.62% (88/94).There were statistical differences between the combined use and single ultrasound examination in detecting fetal thoracic abnormalities(P<0.05).Conclusion Both ultrasound and MRI could diagnose fetal thoracic abnormalities well and had its own advantages and disadvantages.The combined use of ultrasound and MRI could improve the sensitivity and specificity of prenatal diagnostic accuracy and have a better advantage in diagnosing fetal thoracic abnormalities.

The clinical efficacy of different adding times, treatment courses and doses of probiotics for Helicobacter pylori eradication / 实用医学杂志

Objective To investigate the efficacy of different adding times,treatment courses and doses of bifidobacterium and lactobacillus triple live bacteria in Helicobacter pylori (Hp) eradication.Methods A total of 280 patients Hp-infected were enrolled and randomly assigned to five groups.Group A received lansoprazole 30 mg,clarithromycin 500 mg and amoxicillin 1,000 mg bid for 14 days;group B received bifidobacterium and lactobacillus triple live bacteria 2,000 mg tid for 14 days followed by regimen of group A for another 14 days;group C1 received regimen of group A with addition of bifidobacterium and lactobacillus triple live bacteria 2,000 mg bid for 14 days;group C2:regimen of group A with addition of bifidobacterium and lactobacillus triple livc bacteria 2,000 mg tid for 14 days;and group D received regimen of group C2 followed by bifidobacterium and lactobacillus triple live bacteria 2,000 mg tid for another 14 days.4 weeks after end of treatment,Hp eradication was assessed by 13C-urea breath test.Adverse effects during the courses of treatment were recorded.Results A total of 252 (90.0％) patients completed the treatment.The completion rate in group A,B,C1,C2,and D were 78.6％ (44/56),92.9％ (52/56),87.5％ (49/56),96.4％ (54/56),and 94.6％ (53/56) respectively;the completion rate was significantly higher in group B,C2 and D than in group A (P ＜ 0.05),but there were no differences among groups B,C2 and D (P ＞ 0.05).According to intention-to-trcat (ITT) analysis,the eradication rate was 62.5％,80.4％,69.6％,85.7％,and 87.5％ in groups A,B,C1,C2,and D respectively.The eradication rate in groups B,C2 and D was significantly higher than that in group A (x2 =4.375,P =0.036;x2 =7.864,P =0.005;x2 =9.333,P =0.002),and the eradication rate was higher in group C2 than in group C1 (x2 =4.171,P =0.041),but there were no differences among groups B,C2 and D (P ＞0.05).As for per-protocol (PP) analysis,the eradication rate was 79.5％,86.5％,79.6％,88.9％ and 92.5％ in groups A,B,C1,C2,and D respectively,but no significant statistical differences were found among the five groups (P ＞ 0.05).Adverse effects included nausea,bloating,taste distortion,anorexia and constipation.The rate of adverse effects in groups A,B,C1,C2 and D was 67.9％ (38/56),26.8％ (15/56),35.7％ (20/56),21.4％ (12/56),and 17.9％ (10/56) respectively.The incidence rate was significantly lower in groups B,C2 and D than in group A (P ＜ 0.05),but no significant statistical differences were found among groups B,C2,and D (P ＞ 0.05).Conclusions The triple therapy combined with bifidobacterium and lactobacillus triple live bacteria can obviously decrease the adverse effects and improve patient compliance,thereby increasing the rate of Hp eradication.14-day therapy with probiotics is the best regimen.

Study of the uniformity between MRI and 18F-FDG PET/CT in detection of spinal metastatic tumor / 实用放射学杂志

Objective To compare the uniformity between spine MRI and 18F-FDG PET/CT in detection of spinal metastatic tumor, and to analyze the reasons for the discrepancy between them.Methods Data of 42 malignant tumor patients underwent spine MRI and 18F-FDG PET/CT were analyzed retrospectively.And the two tests were underwent within 30 days.The author censused and analyzed the number of centrums with metastatic tumor detected by spine MRI and 18F-FDG PET/CT,and supposed that 18F-FDG PET/CT was gold standard,to evaluate the sensitivity and specificity of spine MRI.The inconsistent between two tests was analysed.Results The study included 509 centrums of 42 patients.123 positive centrums (24.2%) were detected on spine MRI,and 114 positive centrums (22.4%) on 18F-FDG PET/CT(P=0.22>0.05).The uniformity between two tests was good (Kappa=0.76).Supposing that 18F-FDG PET/CT was gold standard,the sensitivity,specificity,positive predictive value, negative predictive value,false negative rate and false positive rate of spine MRI was 85.1%(97/114),93.4%(369/395),85.1%(97/114),93.4% (369/395),14.9%(17/114) and 6.6%(26/395) respectively.43 centrums of 14 patients were diagnosed inconsistently by spine MRI and 18F-FDG PET/CT.The main reasons for the inconformity were as following: types of primary tumors, insensitivity of spine MRI for diffuse scattered spinal metastatic tumors, the existence of misdiagnosis on spine MRI, misdiagnosis of spine MRI for metastatic lesions located in the vertebral appendix and paramedian vertebral body,misdiagnosis of 18F-FDG PET/CT for metastatic lesions located in the sacral centrum, existence of false positive on 18F-FDG PET/CT and so on.Conclusion The uniformity between spine MRI and 18F-FDG PET/CT is good.The inconformity still existes in some cases.Carefully comparative analysis of them contributes to find metastatic lesions.

Efficacy of Levofloxacin-based Triple Therapy Combined with Probiotics as A Rescue Therapy for Helicobacter pylori Re-eradication / 胃肠病学

Background:With the emergence of bacterial resistance,the efficacy of Helicobacter pylori(Hp)eradication therapy is decreasing in recent years. After the previous failed course of eradication therapy,the possibility of failure of re-eradication therapy is greater. Therefore,choosing the rescue therapy for Hp re-eradication is particularly important. Aims:To investigate the efficacy of levofloxacin-based triple therapy combined with probiotics as a rescue therapy for Hp re-eradication. Methods:A total of 192 patients with a previous failed course of standard triple therapy for Hp eradication were enrolled and randomly assigned into four groups. Group A:lansoprazole 30 mg + amoxicillin 1 000 mg + levofloxacin 200 mg bid for 14 days;group B:regimen of group A with the addition of bismuth potassium citrate 600 mg bid for 14 days;group C:bifidobacterium and lactobacillus triple live bacteria 2 000 mg tid for 14 days followed by regimen of group A for 14 days;group D:regimen of group A with the addition of bifidobacterium and lactobacillus triple live bacteria 2 000 mg tid for 14 days. At 4 weeks after end of treatment,Hp eradication was assessed by 13 C-urea breath test. Adverse effects during the course of treatment were recorded. Results:A total of 177(92. 2% )patients completed the study,the completion rates in group A,B,C and D were 87. 5%(42 / 48),83. 3%(40 / 48),97. 9%(47 / 48)and 100% , respectively;the completion rates in group C and D were significantly higher than those in group A and B(P 0. 05). Adverse effects included constipation,taste distortion,bloating and anorexia,the incidences of adverse effects in group A,B,C and D were 79. 2% ,95. 8% ,29. 2% and 22. 9% ,respectively;the incidences in group C and D were significantly lower than those in group A and B(P < 0. 05). Conclusions:Levofloxacin-based triple therapy combined with bifidobacterium and lactobacillus triple live bacteria can decrease the adverse effects of traditional triple and quadruple therapies and improve the patient compliance,thus increases the efficacy of rescue therapy for Hp re-eradication.

Total glucosides of paeony inhibits adriamycin-induced nephropathy in rats through blocking TLR4/NF-κB/TGF-β1 signaling / 中国生化药物杂志

Objective To study effect and its possible mechanism of total glucosides of paeony ( TGP ) on adriamycin-induced nephropathy rats.Methods Thirty male SD rats were randomly divided into normal group ( CON) , adriamycin-induced nephropathy group ( ADRN) and TGP-treated ADRN group (TGP).The rat nephropathy model was established by adriamycin injection.At the end of the 8th week after treatment, ELISA was used to detect the level of Cr and BUN.The values of 24 urine protein was determined by urinary protein kit.Masson staining was used to observe the fibrosis.RT-PCR was used to detect the mRNA levels of TLR4/NF-κB/TGF-β1 .Immunohistochemical method was used to detect the content of TLR4/NF-κB/TGF-β1.ResuIts Compared with the CON group, the level of Cr, BUN, 24 urine protein of ADRN group rised(P<0.01), the degree of fibrosis of ADRN group were aggravated(P<0.01), and the expressions of TLR4/NF-κB/TGF-β1 of ADRN group increased significantly.However, compared with ADRN group, the(P<0.01) level of Cr, BUN, 24 urine protein of TGP-treated rats reduced(P<0.01), the degree of fibrosis of TGP-treated rats eased(P<0.05), and the expressions of TLR4/NF-κB/TGF-β1 of TGP-treated rats decreased significantly.ConcIusion TGP retards the process of fibrosis and reduces the pathological damage in adriamycin-induced rats by down-regulating the expression of TLR4/NF-κB/TGF-β1 signaling.

A novel RET proto-oncogene mutation in multiple endocrine neoplasia type 2A / 中华内分泌代谢杂志

Objective To observe the mode of RET proto-oncogene mutation in a pedigree with multiple endocrine neoplasia type 2A (MEN2A).Methods Six members from a MEN2A family,including the proband,were enrolled.Genomic DNAs of these members were extracted from peripheral blood lymphocytes for polymerase chain reaction(PCR),PCR products of 21 exons of the RET proto-oncogene were purified and a direct gene sequence analysis was performed.DNA sequencing was performed on the related exon of the other family members after verifying the mutation site.Results The female proband sufferd from pheochromocytoma and medullary thyroid carcinoma since the age of 45,two missense mutations of TGC(Cys) to TCC(Ser) at codon 634 and CTG(Leu) to TTT(Phe) at codon 633 in exon 11 of the RET proto-oncogene were detected in the proband,while the other members remain unchanged.Conclusions Analysis of the RET proto-oncogene identifies a united mutation of TGC (Cys) to TCC (Ser) at codon 634 and CTG(Leu) to TTT(Phe) at codon 633 in the proband.The former is a proven mutation related to MEN2A,while the latter has never been reported before.

Relationship of social anxiety and parental rearing style and self-esteem among medical freshman students / 中华行为医学与脑科学杂志

Objective To explore the relatianship of social anxiety and parental rearing style and self-es-teem among medical students, and to provide theoretical guidance for students' mental health. Methods 346 medical students were assessed with interaction anxiousness scale(IAS), Egala minnen on bardndosnauppforstran (EMBU) and self-esteem scale (SES). Results Medical students' social anxiety was negatively correlated with emotional warmth and understanding of parents (FF1, MFI) (r=-0.162,-0.150, P<0.01) and self-esteem (r -0.355, P <0.01), and positively correlated with mother's over-interference, over-protection, refusal, rejection and favoring subject(MF2, MF3, MF5) (r=0.137,0.127,0.116, P<0.05). Stepwise regression analysis re-vealed that father's warmth and understanding and father's over-protection and self-esteem enter regression equa-tion and adjusted R square was 0.047 and 0.123. Conclusion The medical students' social anxiety was influ-enced by EMBU and SES, but the level was lower.