Application of modified DOPS as formative assessment in clinical skills training for professional graduate students / 中华医学教育探索杂志

Objective:To explore the application effect of modified direct observation of procedural skills (DOPS) as a formative assessment tool in clinical skills training of professional graduate students.Methods:A total of 130 professional graduate students of Batch 2019 were selected as the experimental group, and 127 graduate students of Batch 2018 were selected as the control group. Two groups of students received clinical general skills training after enrollment, the control group adopted the traditional skills teaching method, and the experimental group added DOPS as formative assessment on the basis of traditional teaching. The teaching effect of DOPS was evaluated by means of scores analysis and student self-assessment. SPSS 23.0 was used for t-test. Results:The score of the experimental group (84.35±3.41) was higher than that of the control group (77.58±2.68), which showed a statistically significant difference ( t=2.63, P<0.05). The scores of "skill operation ability" and "communication ability" were the lowest single indexes in the assessment of DOPS. The results of self-assessment showed that the scores of autonomous learning ability, clinical thinking ability, clinical practice ability and professional accomplishment of students in the experimental group were all higher than those in the control group ( P<0.05). Conclusion:Modified DOPS is helpful to improve clinical core ability, which is worth promoting for application.

Trilobatin Induces Apoptosis and Attenuates Stemness Phenotype of Acquired Gefitinib Resistant Lung Cancer Cells via Suppression of NF-κB Pathway.

Trilobatin is a common type of flavonoids compounds derived from Lithocarpus polystachyus Rehd leaves. Previous report suggests that trilobatin was potentially involved in pro-and anticancer, antioxidative and anti-hyperglycemic activities. Here, we investigated the anticancer efficiency of trilobatin on gefitinib resistant lung cancer cells. In this study, MTT assays, EdU incorporation assays, DAPI staining, tumor sphere formation assays, immunofluorescent staining and Western blot analysis were performed to explore the functional role of trilobatin on gefitinib resistant lung cancer cells. The results showed that trilobatin inhibits proliferation of gefitinib resistant lung cancer cells. In addition, the proportions of apoptotic cells were increased along with down-regulated expression levels of Bcl-2 and mitochondrial Cytochrome C while up-regulated Bax, Cleaved Caspase-3, -9, and cytosolic Cytochrome C expression. Moreover, trilobatin decreased tumor sphere formation and expression levels of multiple stemness markers (ALDH1, CD133, Nanog, and ABCG2) in gefitinib resistant lung cancer cells. Furthermore, investigation of the mechanism indicated that trilobatin suppressed activity of NF-κB via decreasing constitutive phosphorylation of NF-κB p65 and IκB-α in gefitinib resistant lung cancer cells. All these results indicate that trilobatin induces apoptosis and attenuates stemness phenotype of gefitinib resistant lung cancer cells, involved with, or partly, the suppression of NF-κB activity.

Acupuncture guided by electrical stimulation can relieve functional ankle instability / 中华物理医学与康复杂志

Objective:To document the clinical efficacy of using electrical stimulation to guide acupuncture on the peroneal longus and the peroneal brevis of patients with functional ankle instability (FAI).Methods:Seventy FAI patients were randomly divided into an observation group and a control group, each of 35. Both groups received routine balance function training, proprioception training and manual activation of the peroneal muscles. The observation group also received acupuncture at the motor points of the peroneal longus and the peroneal brevis muscles under the guidance of electrical stimulation, once a day, for 3 weeks. Before and after the treatment, any curative effect was quantified using the CAIT ankle instability assessment questionnaire, electromyography (iEMG) of the peroneal longus and the peroneal brevis, as well as those muscles′ excitation times during simulated varus walking.Results:All of the measurements after the treatment were significantly better than before the treatment, with the improvements in the observation group significantly greater than in the control group.Conclusions:Acupuncture at the motor points of the peroneal longus and the peroneal brevis under the guidance of electrical stimulation can effectively activate the related muscles and relieve the symptoms of functional ankle instability.

Review of traditional Chinese medicine treatment of stroke sequelae / 国际中医中药杂志

This paper aimed to review the recent literature on the TCM treatment for stroke sequelae. The content summarized and discussed the definition of stroke sequelae, herbalmedicine, TCM patents, acupuncture and so on. Sequelae of stroke’s pathogenesis was mainly caused by deficiency generating stasis, so the treatment principles were to tonifying Qi and blood and promote circulation and remove stasis with the common prescriptions, such asBuyang-Huanwudecoction,Xuefu-Zhuyu decoction andDihuang-Yinzi. Meanwhile, Chinese medicine patents and acupuncture treatment canimprove the brain function and ADL.

Hypoxia and TGF-ß1 lead to endostatin resistance by cooperatively increasing cancer stem cells in A549 transplantation tumors.

BACKGROUND: Lung cancer is the leading cause of cancer-related deaths worldwide, and treatments for lung cancer have a high failure rate. Anti-angiogenic therapy is also often ineffective because of refractory disease. Endostatin (ES) is one of the most widely-used anti-angiogenic drugs for lung cancer in China, and resistance to it is a barrier that needs to be resolved. It has been shown that myeloid-derived suppressor cells (MDSCs) are involved in resistance to ES. Whether other cells and/or cell factors in the tumor microenvironment that have been shown to be related to resistance to other anti-cancer drugs are also involved in ES resistance is unknown. RESULTS: In this study, we showed that after continuously treatment with ES for 12 days, volumes of A549 transplantation tumors of mice reached the sizes of tumors which were borne by mice that were treated with normal saline and this meant that resistance to ES appeared. Cancer stem cells (CSCs), which have been widely accepted as one of reasons responsible for resistance to many anti-tumor drugs were also being discovered increased proportionally in A549 transplantation tumors after ES treatment for 12 days. During further exploration of reasons for this increase, we discovered that after ES treatment, microvessel density and vascular endothelial growth factor level was decreased in tumors, whereas transforming growth factor (TGF)-ß1 level was elevated, and MDSCs, one of the sources of TGF-ß1, were also increased. We speculate that hypoxia and TGF-ß1 are responsible for the increased CSC number in A549 transplantation tumors. By using cobalt chloride to mimic hypoxia and human recombinant TGF-ß1 in vitro, we found that hypoxia and TGF-ß1can indeed enhance the stemness of A549 cells. In addition, the inductive effect of hypoxia is stronger than TGF-ß1, and the combination of both is stronger than either alone, which is first report of such a finding, to our knowledge. CONCLUSIONS: Increased TGF-ß1 and strengthened hypoxia in A549 transplantation tumors, as a result of ES therapy, cooperatively increase proportion of CSCs that are involved in ES resistance which was revealed by failure of tumor volume repression after continuously treatment with ES for 12 days.

The predictive value of heart rate variability to, and its correlation with ventricular arrhythmias in patients with structural heart disease / 中华老年医学杂志

Objective To investigate the predictive value of heart rate variability to,and its correlation with ventricular arrhythmias in patients with structural heart disease.Methods 24 hours ambulatory electrocardiogram monitoring was administered during March 2012 and October 2013,and standard deviation of the NN interval (SDNN) in the time-domain analysis and sympathetic/vagal ratio in the frequency domain analysis were collected and retrospectively analyzed in 300 patients.Results The incidence rate of ventricular arrhythmias was higher in patients with structural heart disease in SDNN ＜100 ms group than in control group [4.1％ (3/74) vs.39.5％ (45/114),P＜0.01].The sympathetic/vagal ratio was significantly higher in group with structural heart disease and ventricular arrhythmia than in control group(19.9 ±2.3 vs.10.1 ±1.7,P＜0.01)The time-domain index SDNN was negatively correlated with the frequency domain index (sympathetic/vagal ratio) (r=-0.819,P ＜0.01).Conclusions SDNN ＜100ms and the increased sympathetic/vagal ratio can be considered as the predictors of ventricular arrhythmias in patients with structural heart disease.

Reform on training mode of clinical medicine postgraduates with professional degree / 中华医学教育探索杂志

The enrollment scale of clinical medicine postgraduates with professional degree was expanded each year in order to meet the needs of the society.How to train high quality medical talents in line with modem medical education and people's health needs was the problem we were confronted with.The affiliated hospital of Inner Mongolia medical university lunched reform on training mode of clinical medicine postgraduates with professional degree; the concrete measures included increasing postgraduate pre-service training,implementing tutor responsible system,applying PBL teaching and focusing on the overall quality training.Students' clinical competence was improved after the reform.

Effects of intrathecal gabapentin on analgesic efficacy of morphine in a rat model of incisional pain / 中华麻醉学杂志

Objective To investigate the effects of intrathecal (IT) gabapentin on the analgesic efficacy of morphine in a rat model of incisional pain. Methods Forty-eight male SD rats in which IT catheters were successly inserted according to the method described by Yaksh were randomly divided into 6 groups ( n = 8 each): Ⅰ sham operation group, Ⅱ incisional pain group, Ⅲ GBP 50 μg group, Ⅳ morphine 2.5 μg group, Ⅴ morphine 5 μg group, and Ⅵ morphine 2.5 μg + gabapentin 50 μg group. In group Ⅰ , IT artificial cerebrospinal fluid (ACSF)10 μl was injected and then 1.4% isoflurane was inhaled for 5 min. IT ACSF 10 μl, gabapentin 50μg and morphine 2.5 and 5 μg were injected 30 min before the establishement of the model in group Ⅱ -Ⅴ respectively. Paw withdrawl threshold (PWT) to mechanical stimulation and paw withdrawal latency (PWL) to a thermal nociceptive stimulus were measured at 2 h after the establishement of the model. Results Compared with group Ⅰ , MWT was significantly decreased and TWL was significantly shortened in group Ⅱ , Ⅲ and Ⅳ ( P ＜ 0.05), but no significant change in MWT and TWL was found in group Ⅴ and Ⅵ (P＞0.05). Compared with group Ⅱ , MWT was significantly increased and TWL was significantly prolonged in group Ⅴ and Ⅵ (P ＜ 0.05), but no significant change in MWT and TWL was found in group Ⅲ and Ⅳ/ ( P ＞ 0.05). MWT was significantly decreased and TWL was significantly shortened in group Ⅲ and Ⅳ compared with group Ⅵ ( P ＜ 0.05). Conclusion IT gabapentin enhances the analgesic efficacy of morphine in a rat model of incisional pain.

Mechanism of a cardiovascular automatic feedback control instrument and animal experiments / 中华急诊医学杂志

Objective To design and develop a cardiovascular automatic feedback control instrument for rescuing the critical patients.Methods Ten dogs used this kind instrument and the effects were obserred.Resuts The experiment of the dogs showed:the computer collected samples promptly,accurately and rapidly,and the instrument could help us to reach the expected goal.Conclusion In animal experiments,it showed that the whole cycle,from obtaining blood pressure to adjusting the amounts of medicine through feedback,was shortened.The calculating was accuratel and curative effect was reliable.This instrument is wait to be apprnsed by clinic.