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By integrating the concept of narrative medicine and relevant models and tools into the Doctor-patient Communication course, this paper expounds the connotation of narrative medicine under the context of “new medicine” and “big health” and the practical significance of the shift to narrative in Doctor-patient Communication course in three aspects: academic frontier, social needs and practical needs. This paper analyzes the four dimensions of innovation that narrative medicine, as the frontier of the discipline, historical accumulation, educational philosophy and professional skills, provides for the Doctor-patient Communication course, and explores the effective path to realize the narrative transformation of the course. It is expected to achieve the purpose of forging students’ humanistic medical skills and literacy through teaching innovation, realizing the coordination of medical education and competency orientation, adapting to the psychological and social increase, the change of people and health, and promoting the reform of the supply side of medical talents.
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The unreasonable use of antibiotics is one of the important causes of antimicrobial resistance (AMR) that poses a huge public health threat. Magnolol is a traditional Chinese medicine exhibiting antibacterial-, antifungal-, anti-inflammatory-, and antioxidant activities. However, it is unclear whether magnolol has an inhibitory effect on mycoplasma. This study found that magnolol showed excellent inhibitory activity against various mycoplasmas. Magnolol showed dose-dependent inhibition of Mycoplasma synoviae growth and biofilm formation in vitro. Magnolol caused severely sunken and wrinkled M. synoviae cell membranes at the minimum inhibitory concentration, and an enlarged cell diameter. The chicken embryo infection model showed that magnolol significantly reduced M. synoviae pathogenicity in vivo. Kyoto Encyclopedia of Genes and Genomes pathway analysis showed that the citrate cycle, glycolysis/gluconeogenesis, and pyruvate metabolism were significantly disturbed at the minimum inhibitory concentration of magnolol. Interestingly, 41% of differential metabolites were in the categories of lipids and lipid-like molecules. Protegenin A was up-regulated 58752-fold after magnolol treatment. It belongs to fatty acyls, and destroys cell membrane integrity and cell activity. Ghosphatidylethanolamine, phosphatidylglycerol, phosphatidic acid, and phosphatidylserine related to membrane maintenance and stress response were widely down-regulated. Collectively, our results illustrate the feasibility of magnolol as a phytochemical compound to treat mycoplasma infection.
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Lignanos , Mycoplasma synoviae , Animales , Embrión de Pollo , Lignanos/farmacología , Lignanos/química , Antibacterianos/farmacología , Compuestos de Bifenilo/farmacología , Compuestos de Bifenilo/química , Mycoplasma synoviae/genéticaRESUMEN
Objective:To detect serum levels of vitamin A (Vit A), vitamin D(Vit D)25-hydroxy vitamin D[25-(OH)D] and vitamin E(Vit E) in children aged 0-6 years in Tibetan Plateau of Garzi Prefecture, thus providing references for physical examinations and prevention of 4 key diseases (rickets, malnutrition anemia, pneumonia and diarrhea) in children in plateau areas by relevant government departments.Methods:A total of 2 122 children who participated in physical examination in 12 townships of Xiangcheng County and 14 townships of Daocheng County, Garzi Tibetan Autonomous Prefecture, Sichuan Province from April 2017 to April 2019 with 0-6 years old were recruited for surveying physical measurements and collection of venous blood.Serum Vit A and Vit E levels were detected by high performance liquid chromatography.Serum levels of 25-(OH)D were detected by high performance liquid chromatography tandem mass spectrometry.The relationship between Vit A, Vit E and 25-(OH)D levels with the gender, age, seasonal change and altitude was analyzed.Results:The serum Vit A level, subclinical Vit A deficiency rate and marginal vitamin A deficiency rate were(1.05±0.27) μmol/L, 8.15%(173/2 122 cases) and 45.99%(976/2 122 cases), respectively in 2 122 children with 0-6 years old.There were significant differences in the serum Vit A level, the subclinical Vit A deficiency rate and the marginal vitamin A deficiency rate in children with different ages, seasons and altitudes (all P<0.05). The serum level of 25-(OH)D and 25-(OH)D deficiency rate insufficient rate were (24.65±6.45) ng/L, 6.03%(128/2 122 cases) and 16.59%(352/2 122 cases), respectively.There were significant differences in the serum level of 25-(OH)D, 25-(OH)D deficiency rate and 25-(OH)D insufficient rate in children with different ages and seasons (all P<0.05). The mean serum Vit E level, Vit E deficiency rate and Vit E insufficient rate were (7.81±1.74) mg/L, 2.78%(59/2 122 cases) and 29.59%(628/2 122 cases), respectively.There were significant differences in serum Vit E level, Vit E deficiency rate and Vit E insufficient rate in children with different ages and seasons (all P<0.05). The mean serum levels of Vit A and Vit D remained the lowest before the age of 1 year, and their deficiencies at this age were the most significant.The mean serum level of Vit E remained the lowest in >1-2 years old, and its deficiency and insufficient at this age were the most significant.Vit A, D and E levels were significantly affected by seasonal changes, which were significantly higher in the summer than in the spring, autumn and winter.In addition, Vit A and 25-(OH)D were significantly affected by the altitude, which were the lowest above 4 km altitude. Conclusions:The overall serum levels of Vit A, 25-(OH) D and E in children with 0-6 years old in Tibetan Plateau areas of Ganzi Prefecture are lower than those in plain areas.Vit A, 25-(OH) D and Vit E levels significantly differed in the age, season and altitude, which are related to the lack of local resources, insufficient maternal nutrition during pregnancy and insufficient intake after birth, as well as temperature and light caused by changes in local seasons and altitude.Therefore, it is necessary to make reasonable supplements during pregnancy to prevent vitamin deficiency.
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H9N2 is the most prevalent low pathogenic avian influenza virus (LPAIV) in domestic poultry in the world. Two distinct H9N2 poultry lineages, G1-like (A/quail/Hong Kong/G1/97) and Y280-like (A/Duck/Hong Kong/Y280/1997) viruses, are usually associated with binding affinity for both α 2,3 and α 2,6 sialic acid receptors (avian and human receptors), raising concern whether these viruses possess pandemic potential. To explore the impact of mouse adaptation on the transmissibility of a Y280-like virus A/Chicken/Hubei/214/2017(H9N2) (abbreviated as WT), we performed serial lung-to-lung passages of the WT virus in mice. The mouse-adapted variant (MA) exhibited enhanced pathogenicity and advantaged transmissibility after passaging in mice. Sequence analysis of the complete genomes of the MA virus revealed a total of 16 amino acid substitutions. These mutations distributed across 7 segments including PB2, PB1, PA, NP, HA, NA and NS1 genes. Furthermore, we generated a panel of recombinant or mutant H9N2 viruses using reverse genetics technology and confirmed that the PB2 gene governing the increased pathogenicity and transmissibility. The combinations of 340 K and 588 V in PB2 were important in determining the altered features. Our findings elucidate the specific mutations in PB2 contribute to the phenotype differences and emphasize the importance of monitoring the identified amino acid substitutions due to their potential threat to human health.
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Subtipo H9N2 del Virus de la Influenza A , Mutación Missense , Infecciones por Orthomyxoviridae , Sustitución de Aminoácidos , Animales , Perros , Femenino , Cobayas , Subtipo H9N2 del Virus de la Influenza A/genética , Subtipo H9N2 del Virus de la Influenza A/metabolismo , Células de Riñón Canino Madin Darby , Ratones , Ratones Endogámicos BALB C , Infecciones por Orthomyxoviridae/genética , Infecciones por Orthomyxoviridae/metabolismo , Infecciones por Orthomyxoviridae/transmisiónRESUMEN
Objective To observe the clinical efficacy of acupuncture at the six mind-calming points plus the four gate points in treating migraine.Method Totally 128 eligible migraine patients were randomized into a treatment group and a control group, 64 cases in each group. The treatment group was intervened by acupuncture at the six mind-calming points plus the four gate points, while the control group was by ordinary acupuncture. The Numerical Rating Scale (NRS), headache attack frequency, headache duration, headache intensity, complicated symptoms, Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS) were observed before and after treatment and in the follow-up study.Result The NRS scores and the headache symptoms and functions scores were significantly changed respectively after 2-week and 4-week treatment in both groups (P<0.01,P<0.05). The NRS score, headache duration, and headache intensity in the treatment group were significantly different from that in the control group after 4-week treatment and in the follow-up study (P<0.05,P<0.01). The SDS and SAS scores were significantly changed after 2-week and 4-week treatments as well as in the follow-up study in the treatment group (P<0.01). The SDS and SAS scores were significantly changed after 4-week treatment in the control group (P<0.01). There were significant differences in comparing the SDS and SAS scores between the two groups after 2-week and 4-week treatment as well as in the follow-up study (P<0.05,P<0.01). In the treatment group, the SDS and SAS scores in the follow-up study were significantly different from that after 2-week treatment (P<0.01).Conclusion Acupuncture at the six mind-calming points plus the four gate points is an effective method in treating migraine, and it can reduce headache intensity, and improve the anxiety and depression state.
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Objective To evaluate the effectiveness of comprehensive prevention and control measures on coal-burning-borne endemic tluorosis in Xishui,on residents healthy behavior and situation of the disease.Methods In 2013,five towns were selected according to their location of east,south,west,north and centre.Three villages and one elementary school in each town were chosen,and 20 families' related behavior and fluorine prevention knowledge questionnaire in each village were surveyed.All the students from one class aged 8-12 of grade 3-6 in each school were selected,according to the Diagnosis of Dental Fluorosis,dental fluorosis was examined and fluorine knowledge questionnaire was surveyed.At the same time,the detection rate of dental fluorosis of children aged 8-12,information of the knowledge about prevention and cure of fluorosis and related behavior of target groups in 2007,and the urinary fluoride contents of children aged 8-12 in 2000 were collected.Analysis and comparison of the data in 2000,2007 and 2013 were done.Results After the intervention,the witting rates of students and family householders 90.95% (11 773/12 945),84.27% (3 792/4 500),were significantly higher than those of before the intervention [19.29% (1 039/5 385),26.27% (394/1 500),x2 =9 279.14,1 794.22,all P < 0.01].Proper utilization rate of cooking stove was 100.00% (37/37),iron stove utilization rate was 99.64% (279/280),dry chili correct rate was 100.00% (299/299) and before the intervention,these values were 3.20% (43/1 345),90.28% (1 207/1 337)and 62.14% (855/1 376),respectively,and the differences were statistically significant (x2 =601.12,27.28,27.28,all P < 0.01).Children's dental fluorosis detection rate was 24.21% (206/851),compared with that of before the intervention,61.62% (2 150/3 489),the difference was statistically significant (x2 =385.93,P < 0.01).Children's urine fluoride was (0.51 ± 0.29) mg/L,and before the intervention [(1.55± 1.59) mg/L],the difference was statistically significant (t'=10.25,P < 0.01).Conclusions The effect of comprehensive prevention and control measures against coal-burning-borne endemic fluorosis in Xishui are remarkable.The residents health related behavior has been formed and the condition is reduced markedly.
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Objective To investigate the clinical effects of tendon sheath laceration by syringe needle under the guidance of ultrasonography in the treatment of stenosing tenosynovitis. Methods A retrospective comparison was made on the curative efficacy in 78 patients with stenosing tenosynovitis of the hand. The patients were divided into two groups: the treatment group (n=39) was given tendon sheath laceration by 20-gauge syringe needle under the guidance of 10 MHz ultrasonography, while the control group ( n= 39) received the conventional puncture and laceration without the ultrasound guidance. Results At the fourth postoperative week, complete pain relief was achieved in 32 patients in the treatment group (82.1%) and in 20 patients in the control group (51.3%), respectively, with a significant difference ( ? 2 =8.34, P =0.004). The visual analogue score (VAS) was 8.9~3.5 (mean, 6.7?2.0) lower than before operation in the treatment group and 8.5~0.5 (mean, 5.2?2.9) in the control group. The pain relief in the treatment group is significantly superior to that in the control group ( t =2.659, P =0.010). Conclusions Ultrasound-guided laceration of the stenotic tendon sheath by syringe needle is a simple, minimally invasive and effective option for the management of stenosing tenosynovitis of the hand.