Construction of the second classroom system for college students based on the cultivation of innovation and entrepreneurship ability / 中华医学教育探索杂志

Taking medical statistics major in Binzhou Medical University as an example, based on the outcome-based education theory, in order to enhance the innovation ability of university students, we put forward the systematic second classroom training system, including improving the personnel training system, implementing education, experiment teaching reform, and practice teaching reform. It has achieved outstanding results in the discipline competition, improved social service ability and high degree of employer satisfaction. The systematic second-class talent training system based on the outcome-based education theory can provide reference for other medical colleges and related applied majors.

COVID-19 pandemic increased the magnitude of mortality risks associated with cold temperature in Italy: A nationwide time-stratified case-crossover study

Abstract Backgrounds: The coronavirus disease 2019 (COVID-19) pandemic and some containment measures have changed many people lives and behaviours. Whether the pandemic could change the association between cold temperature and mortality remains unknown. Objectives: We aimed to assess whether the association between cold temperature and all-cause mortality in the pandemic period has changed compared to non-COVID-19 period (2015-2019) in Italy. Methods: We collected daily all-cause mortality data and meteorological data for 107 Italian provinces from 1, January 2015 to 31, May 2020. A time-stratified case-crossover design with the distributed lag non-linear model was used to examine the association between cold temperature and all-cause mortality during the first three months (from March to May in 2020) of the COVID-19 outbreak and the same months in 2015-2019. Results: The relative risk (RR) of all-cause mortality at extreme cold temperature (2.5th percentile of temperature at 3 {degrees}C) in comparison with the minimum mortality temperature (24 {degrees}C) was 4.75 [95% confidence interval (CI): 3.90-5.79] in the pandemic period, which is more than triple higher than RR [1.41 (95%CI: 1.33-1.50)] in the same months during 2015-2019. The shift in cold-mortality association was particularly significant for people aged 65-74 years [RR (95%CI): 5.98 (3.78-9.46) in 2020 versus 1.29 (1.10-1.51) in 2015-2019], 75-84 years [5.25 (3.79-7.26) versus 1.40 (1.25-1.56)], and [≥] 85 years [5.03 (3.90-6.51) versus 1.52 (1.39-1.66)], but not significant for those aged 0-64 years [1.95 (1.17-3.24) versus 1.24 (1.05-1.48)]. Conclusion: The findings suggest that the COVID-19 pandemic enhanced the risk of cold temperature on mortality in Italy, particularly among the elderly people. Further studies are warranted to understand the exact mechanism when detailed data are available.

Efficacy of indine of composite Huaihua fructus posraleae combined with fractional CO2 laser on acral stable vitiligo / 中国基层医药

Objective To OvaluatO thO Officacy and safOty of indinO of compositO Huaihua fructus posralOaO combinOd with fractional CO2 lasOr on acral stablO vitiligo.Methods From OctobOr 2014 to August 2017, 79 casOs with acral stablO vitiligo in thO Sixth POoplO′s Hospital of Dongguan wOrO randomly dividOd into trOatmOnt group and control group according to thO digital tablO. ThO trOatmOnt group(51 casOs) was trOatOd with fractional CO2 lasOr onO timO a month for four timOs, and thO sOcond day was givOn topical indinO of compositO Huaihua fructus posralOaO twicO a day. ThO control group(28 casOs) was trOatOd with topical indinO of compositO Huaihua fructus posralOaO twicO a day. ThO trOatmOnt OffOct was obsOrvOd aftOr trOatmOnt for 3 months and 6 months. Results AftOr trOatmOnt for 3 months and 6 months, thO total OffOctivO ratOs of thO trOatmOnt group wOrO 39.22% , 62.75% ,rOspOctivOly, which wOrO significantly highOr than thosO of thO control group(32.14% , 42.86% ) (χ2 =12.557,18.021,all P<0.05). No sOrious advOrsO OvOnt was obsOrvOd in thO two groups.Conclusion IndinO of compositO Huaihua fructus posralOaO combinOd with fractional CO2 lasOr is safO and OffOctivO in thO trOatmOnt of stablO sporadic vitiligo.

Evaluation of the estimated variables for scaling glomerular filtration rate of renal patients: a repeated measures-based method.

OBJECTIVE: Using a best variable to scale glomerular filtration rate (GFR) is important for clinical practice. The variables, estimated by equations regressed from a healthy population, are usually used in scaling GFR of renal patients. However, because the predicted variables may deviate in renal patients, it is necessary to verify whether these variables can be used to reduce the variability of GFR of renal patients. This study was designed to use repeated measures analyses to identify the best variable for scaling GFR of renal patients. METHODS: Patients with non-obstructive renal diseases were enrolled in this study. The absolute GFRs of (99m)Tc-DTPA renography (gGFR) and plasma clearance (pGFR) were measured. The indices relating to between-subjects variability, such as Passing and Bablok regression, intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC) were used to identify the best variable from body surface area (BSA), extracellular fluid volume (ECV), lean body mass (LBM), total body water (TBW), body mass index (BMI), and metabolic rate (MR). RESULTS: For the scaled indices related to between-subjects variability, ICC and CCC identified the same ranking sequence (BMI < LBMB(B; Boer) < LBMJ(J; James) < TBW < ECVB(B; Bird) < ECVS(S; Silva) < BSA < MR). In the Passing and Bablok regression, the ratio of residual standard deviation to pooled standard deviation (RSD/PSD) produced the same ranking sequence as that identified by ICC and CCC. CONCLUSION: The estimated metabolic rate can explain most between-subjects variability of GFR, and seems to be the best variable for scaling GFR of renal patients.

Co-integration relation between residents’ health and economic development in China / 中国卫生政策研究

Objective:This paper aims to explore the relationship between the residents’ health and economic de-velopment to provide a scientific basis which will promote the coordinated economy and health development. Methods:Adopting the entropy method, we could calculate the comprehensive health evaluation index. In combining the co-inte-gration and error correction models, we could analyze the long-term and short-term relationships between our country residents’ level of health since 2000 and the national macro-economic development information. The Granger causality test served as a good method used in testing the casual relationships. Results: The health and economic development has a co-integration relationship which is -0. 6216 in the short-term correction. The economic development extent is the Granger cause of residents’ health status. Conclusion:There is not only a long-term equilibrium, but also a short-term relationship between the residents’ health and economic development in our country. The economic growth pro-motes residents’ health status while the promotion of residents’ health to economic growth is not obvious.

Changes of filaggrin and its gene in patients with ichthyosis vulgaris / 中华皮肤科杂志

Objective To detect mutations in the filaggrin (FLG) gene and expressions of FLG and loricrin in patients with ichthyosis vulgaris (Ⅳ),and to investigate their clinical significance.Methods Tissue specimens were resected from the skin lesions of 10 patients with Ⅳ and normal skin of 14 healthy human controls,and immunohistochemical SP method was used to detect the expressions of filaggrin and loricrin.The expression intensity was determined by the Image-Pro Plus (IPP) software,and expressed as positive units (PU).Blood samples were collected from 10 patients of Han nationality with Ⅳ and 100 healthy human controls followed by DNA extraction.PCR and DNA sequencing were performed to detect the presence of 13 mutations (3321delA,441delA,1249insG,E1795X,S3296X,R501X,2282de14,R2447X,S2889X,7945delA,3702delG,Q2417X,R4307X) in the FLG gene.Results FLG was mainly expressed in the cytoplasm of keratinocytes in the stratum corneum,granular layer,prickle layer and basal layer,and loricrin was observed in the cytoplasm and nuclei of keratinocytes in the granular layer,prickle layer and basal layer,in both the lesional and normal skin.Compared with the normal skin,the lesional skin showed significantly weaker expressions of FLG (0.208 2 ± 0.008 0 vs.0.230 0 ± 0.0228,t =3.30,P ＜ 0.01) and loricrin (0.137 0 ± 0.011 2 vs.0.149 3 ± 0.007 3,t =3.07,P ＜ 0.01).Sequencing analysis identified two mutations,including 3321delA in 7 patients and 441delA in 2 patients.No mutations were detected in the healthy controls.Conclusions The 3321delA and 441delA mutations in the FLG gene may represent the most frequent genetic cause of Ⅳ in patients of Han nationality.The low expressions of FLG and loricrin may be associated with the impairment of skin barrier function in patients with Ⅳ.

Clinical analysis of 62 cases of symmetric acral keratoderma / 中华皮肤科杂志

Objective To analyze the clinical,demographic and pathologic features of symmetric acral keratoderma.Methods Totally,62 outpatients with symmetric acral keratoderma were collected at the Dongguan Hospital for Chronic Disease Prevention and Control from May 2003 to June 2012.Data on these patients,including demographic information,family history,physical and pathological examination findings,were reviewed.Results There were 55 males and 7 females among these patients.The age at onset and disease duration varied from 4 to 53 years (average: 24.02 years) and from 15 days to 10 years (average: 26.65 years) respectively.Characterized manifestation was brown keratinized patches on the dorsum of hands and digits,wrists,elbows,knees,ankles,and along the lateral margin of palms,which became white 3 to 6 minutes after immersing in water.Lesions usually resolved spontaneously in winter.Microscopic examination of lesions for fungal elements was negative.Histopathology revealed epidermal hyperkeratosis,acanthosis and mild papillomatous hyperplasia as well as dermal infiltrates with a few lymphocytes.Conclusion Symmetric acral keratoderma is a skin disease characterized by symmetric acral keratosis with apparent seasonality.

The Assay of Fibrinolytic Function in the Patients with SLE and its Significance / 中华皮肤科杂志

The fibrinolytic function of 98 patients with SLE were determined by spectrophotometric assay and immunodiffusion, 19 patients were observed before treatment, 1 month after treatment and 3 months after the disappearance of clinical symptoms. The results showed that the low level of fibrinolytic function correlated to the severity and the refractoriness of the disease, the activity of plasminogen activator inhibitor (PAI) was significantly increased in all patients. The activity ratio of tissue-type plasminogen activator (t-PA): PAI was significantly lower than normal level in the patients with lupus nephritis, not only the activity of PAI increased significantly, but also the activity of t-PA was significantly decreased, so the activity ratio of t-PA: PAI became much lower, the result suggested that it was related to the refractoriness of the disease. In patients in clinical remission, although the activity of PAI was still higher than normal level, the activity of t-PA was also significantly increased, therefore, the activity ratio of t-PA: PAI was nearly normal.