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Objective:To construct a set of evaluation index system for the core ability of preventive medicine graduates to respond to sudden biological public health events.Methods:Research methods such as in-depth interviews and group discussions were used to determine the core competence structure, the Delphi method was used to conduct two rounds of expert consultation, and the index system and its weights were finally determined based on the consultation results of 21 experts on the system. Excel and SPSS 21.0 were used for data collation and statistical analysis.Results:The positive coefficient of expert consultation was greater than 80%, the authority coefficient was greater than 0.7, and the average was 0.906. The final index system was composed of 4 first-level indicators, 10 second-level indicators, and 39 third-level indicators.Conclusion:The evaluation index system can provide a reference for exploring effective ways to improve the core competence of graduates.
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Caspofungin is the firs t echinocandin antifungal drug approved for serious fungal infections caused by Candida or Aspergillus. Currently ，caspofungin has been recommended as the first-line treatment for invasive Candida and the second-line treatment for invasive Aspergillus，for its safety and tolerability. However ，there are still probability of pharmacokinetic variability and the risk of low exposure in different populations. Herein the population pharmacokinetics-pharmacodynamics studies of caspofungin in children and adults were reviewed. The results indicate that the body surface area was the main factor affecting the distribution and clearance of caspofungin in pediatric patients. In adults ，the two-compartment model fits the caspofungin behavior best in vivo with the primary covariates of body weight and albumin level. The efficacy of caspofungin might be related to pharmacokinetics-pharmacodynamics parameters ，such as the ratio of area under blood concentration time curve to minimum inhibitory concentration （AUC/MIC），the ratio of peak concentration to minimum effective concentration （cmax/MEC）.
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Skin-stretching device as a new treatment method of wound closure has been recognized by many discipline fields. Through continuous improvement and adjustment in clinical application, it has achieved remarkable results in some departments. This article summarizes the basic theory, history, classification, and application of skin-stretching devices.
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Objective@#To design the self-rating scale on basic ability in graduates of preventive medicine major, and test its reliability and validity, providing a reliable tool for evaluating the basic ability of graduates.@*Methods@#On the basis of constructing the Evaluation Index System on Basic Ability in Graduates of Preventive Medicine Major, the three-level indexes were converted to specific questions. Self-evaluation scale including 58 items, 22 sub-dimensions and 8 main dimensions were finally designed after pre-survey and expert argumentation. A total of 205 graduates of preventive medicine major from a medical college and 9 experts in the field of public health were selected to completed the questionnaire. Scale's reliability was tested by applying internal consistency reliability and composite reliability; it's validity was tested by applying content validity and confirmatory factor analysis.@*Results@#Scale's α coefficient of internal consistency reliability was 0.976; α coefficient and combination reliability of eight main dimensions were both higher than 0.8; the content validity index S-CVI of the scale was 0.94, the content validity index I-CVI of the item level was 0.78 to 1.00; the average variance extraction amount (AVE) of the eight main dimensions was higher than 0.50. Fitting of the structural model with the item used as observation indexes was reasonable (χ2/df=1.749, RMR=0.036, RMSEA=0.061, NFI=0.801, IFI=0.904, TLI=0.904, CFI=0.903), and the sub-dimension as used observation indexes was good(χ2/df=1.876, RMR=0.032, RMSEA=0.066, NFI=0.913, IFI=0.958, TLI=0.945, CFI=0.957).@*Conclusion@#This scale is the first self-rating scale on the basic ability in graduates of preventive medicine major on the basis of the National Standards of Teaching Quality on Public Health and Preventive Medicine, with good reliability and validityl. It is able to achieve quantitative evaluation on graduates' basic abilities.
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Objective To design the self-rating scale on basic ability in graduates of preventive medicine major, and test its reliability and validity, providing a reliable tool for evaluating the basic ability of graduates. Methods On the basis of constructing the Evaluation Index System on Basic Ability in Graduates of Preventive Medicine Major, the three-level indexes were converted to specific questions. Self-evaluation scale including 58 items, 22 sub-dimensions and 8 main dimensions were finally designed after pre-survey and expert argumentation. A total of 205 graduates of preventive medicine major from a medical college and 9 experts in the field of public health were selected to completed the questionnaire. Scale's reliability was tested by applying internal consistency reliability and composite reliability; it's validity was tested by applying content validity and confirmatory factor analysis. Results Scale's αcoefficient of internal consistency reliability was 0.976; α coefficient and combination reliability of eight main dimensions were both higher than 0.8; the content validity index S-CVI of the scale was 0.94, the content validity index I-CVI of the item level was 0.78 to 1.00;the average variance extraction amount (AVE) of the eight main dimensions was higher than 0.50. Fitting of the structural model with the item used as observation indexes was reasonable ( x2/df=1.749, RMR=0.036, RMSEA=0.061, NFI=0.801, IFI=0.904, TLI=0.904, CFI=0.903), and the sub-dimension as used observation indexes was good(x2/df=1.876, RMR=0.032, RMSEA=0.066, NFI=0.913, IFI=0.958, TLI=0.945, CFI=0.957). Conclusion This scale is the first self-rating scale on the basic ability in graduates of preventive medicine major on the basis of the National Standards of Teaching Quality on Public Health and Preventive Medicine, with good reliability and validityl. It is able to achieve quantitative evaluation on graduates' basic abilities.
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Objective@#To explore effects of allogeneic skin fibroblast (Fb) on promoting wound healing of diabetic mice and the mechanism.@*Methods@#(1) Experiment 1. Ten diabetic mice and ten normal mice were chosen and sacrificed to collect back skin tissue. Suspension of the fourth generation of normal skin Fb and diabetic skin Fb were made. Another 27 diabetic mice were collected and divided into phosphate buffered saline (PBS) group, normal skin Fb group, and diabetic skin Fb group with random number table, with 9 mice in each group. Full-thickness skin defect wounds with area of 1 cm×1 cm were made on back of each mouse. Immediately after injury, 4 corners of wound of mice in normal skin Fb group and diabetic skin Fb group were injected with normal skin Fb and diabetic skin Fb suspension of 200 μL, respectively. Mice in PBS group were injected with the same amount of PBS at the same position. On post injury day (PID) 3, 7, 10, 14, and 17, surviving mice in the three groups were collected for gross wound observation and wound healing rate was calculated. On PID 7 and 14, 3 mice in each group were taken after gross wound observation to collect wound skin tissue. Percentage of Ki67 positive cell in wound tissue was detected by immunofluorescence method. Microvessel density (MVD) of wound tissue was detected by immunohistochemistry. Collagen fiber deposition of wound tissue was detected by Masson staining. (2) Experiment 2. Ten diabetic mice and ten normal mice were collected to make primary and the fourth generation normal skin Fb, and primary and the fourth generation diabetic skin Fb with the same method as in experiment 1. Apoptosis rate of Fb was detected by flow cytometry. The mRNA expressions and protein expressions of transforming growth factor β1 (TGF-β1), advanced glycation end products (AGE), matrix metalloproteinase 9 (MMP-9), and neurokinin 1 (NK-1) of Fb were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction and Western blotting, respectively. Data were processed with analysis of variance of factorial design, one-way analysis of variance, and LSD-t test.@*Results@#(1) The drying and scab growing speeds of wounds of mice in normal skin Fb group and diabetic skin Fb group at each time point post injury were faster than those of mice in PBS group. On PID 17, wound healing rate of mice in normal skin Fb group was close to that of mice in PBS group (t=3.45, P>0.05). At other time points, wound healing rate of mice in normal skin Fb group and diabetic skin Fb group was significantly higher than that of mice in PBS group, respectively (t=9.15, 10.25, 35.28, 6.79, 8.37, 10.69, 22.53, 6.70, 4.47, P<0.05 or P<0.01). On PID 7 and 14, wound healing rate of mice in normal skin Fb group was significantly higher than that of mice in diabetic skin Fb group (t=4.41, 4.16, P<0.05). On PID 7 and 14, percentages of Ki67 positive cells in wound tissue of mice in normal skin Fb group and diabetic skin Fb group were significantly higher than that of mice in PBS group (t=20.89, 31.82, 4.86, 29.53, P<0.05 or P<0.01); percentages of Ki67 positive cells in wound tissue of mice in normal skin Fb group were significantly higher than those of mice in diabetic skin Fb group (t=8.78, 13.51, P<0.05 or P<0.01). On PID 7 and 14, MVD of wound tissue of mice in normal skin Fb group and diabetic skin Fb group was significantly higher than that of mice in PBS group (t=26.92, 56.42, 10.36, 26.85, P<0.01). On PID 14, MVD of wound tissue of mice in normal skin Fb group was significantly higher than that of mice in diabetic skin Fb group (t=8.61, P<0.01). On PID 7 and 14, the amount of collagen fiber deposition of wound tissue of mice in normal skin Fb group was significantly higher than that of mice in diabetic skin Fb group and PBS group, respectively (t=10.09, 5.48, 4.77, 3.14, P<0.05 or P<0.01). (2) Apoptosis rate of primary normal skin Fb was (5.61±0.18)%, which was close to that of normal skin Fb of the fourth generation [(6.48±0.16)%, t=1.44, P=0.06]. Apoptosis rate of primary diabetic skin Fb was (26.25±0.56)%, which was significantly higher than that of primary normal skin Fb (t=36.61, P<0.01) and close to that of diabetic skin Fb of the fourth generation [(25.68±0.93)%, t=0.91, P=0.41]. The mRNA expressions of TGF-β1 and NK-1 of primary normal skin Fb were significantly higher than those of primary diabetic skin Fb (t=25.25, 273.30, P<0.01). The mRNA expressions of AGE and MMP-9 of primary normal skin Fb were significantly lower than those of primary diabetic skin Fb (t=23.01, 8.84, P<0.05 or P<0.01). The mRNA expressions of TGF-β1, AGE, and NK-1 in primary diabetic skin Fb were significantly higher than those of diabetic skin Fb of the fourth generation (t=4.34, 22.84, 12.10, P<0.05 or P<0.01). The protein expression of TGF-β1 and NK-1 of primary normal skin Fb were significantly higher than those of primary diabetic skin Fb (t=4.61, 8.53, P<0.05). The protein expressions of AGE and MMP-9 of primary normal skin Fb were significantly lower than those of primary diabetic skin Fb (t=10.22, 29.90, P<0.01). The protein expressions of AGE and NK-1 of primary diabetic skin Fb were significantly higher than those of diabetic skin Fb of the fourth generation (t=8.09, 4.36, P<0.05 or P<0.01).@*Conclusions@#Allogeneic skin Fb can promote wound healing through promoting Fb proliferation, angiogenesis, collagen fiber deposition in wound of diabetic mice. When diabetic skin Fb of mice is cultured in vitro away from diabetic microenvironment, cell activity can′t return to normal levels, and the effects of diabetic skin Fb on promoting wound healing is not as good as normal skin Fb.
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Skin is the largest organ in the body, with a variety of functions, such as thermoregulation, physical barriers, and sensory transmission, etc. Therefore, to restore the function after injury as soon as possible is particularly important. Mesenchymal stem cells (MSCs) are derived from mesoderm, and can differentiate into a variety of tissues, such as cartilaginous tissue, myoideum, and adipose tissue. Weak immunogenicity of MSCs make them become the ideal seed cells of tissue engineering. MSCs have a wide range of sources, including known sources of bone marrow, skin, placenta, and adipose tissue, etc. MSCs from different sources also have many different mechanisms in wound repair. This article reviews the recent researches on MSCs in the treatment of chronic wounds, so as to explore new ideas for the clinical treatment of chronic wounds.
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Objective To investigate the effect of different delivery methods on the levator ani muscle of the pelvic floor by transperineal three-dimensional ultrasound and TUI imaging. Methods 200 cases of pregnant women from August2014 to August 2016 in our hospital were divided into selective cesarean section group (n = 85) and vaginal delivery group (n= 115). The vaginal group, according to the intraoperative lateral segmentation, was further divided into vaginal lateral incision group (n = 65) and vaginal delivery without lateral incision group (n = 50). At the same time, select 80 cases of nulliparous women (volunteers) as control group, relevant indicators by three-dimensional imaging and TUI imaging technique. Results The vaginal delivery without lateral incision group, lateral incision group vaginal delivery and cesarean section group levator hiatus diameter, anteroposterior diameter, perimeter and area were significantly higher than the control group(P＜0.05), and vaginal delivery side cut was significantly higher than the other three groups (P＜0.05), vaginal delivery in two sub-group and cesarean section group of levator ani muscle thickness were significantly lower than the control group(P＜0.05), vaginal delivery in two sub groups were significantly lower than that in the cesarean section group (P＜0. 05); vaginal delivery group of levator ani muscle injury rate was significantly higher than that in the cesarean section group (P＜0. 05); There was no significant difference in the rate of levator ani muscle injury in vaginal delivery group (P＞0.05). Conclusion Compared with cesarean section, vaginal delivery is more obvious in changing the morphology and integrity of levator ani muscle, and vaginal delivery is more obvious than that of vaginal incision.
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ObjectiveTo summarize the clinical significance of ultrasonic screening of fetal structural anomalies at 11-13+6 weeks.Methods We conducted a retrospective study of 4853 cases of nuchal translucency screening at 11-13+6 weeks in Maternal and Child Health Hospital of Bao?an of Shenzhen City from September 2011 to May 2014. The screening ultrasound planes included the median sagittal plane, neck sagittal section, cerebral transverse section, cardiac four-chamber view, three-vessel-trachea view, abdominal transverse section, bladder section, upper limb section and lower limb section of the fetuses. All the cases then underwent the ultrasonic structural screening in the second trimester (20-24 weeks) and the third (28-32 weeks) trimester and were followed up until 6 weeks after birth or the biopsy after abortion.Results Eighty-ifve fetal structural anomalies were detected among the 4853 pregnant women at 11-13+6 weeks of gestation with the detection rate of 1.75% (85/4853), including central nervous system abnormalities (28 cases), anterior abdominal wall anomalies (9 cases), cardiac anomalies (6 cases), urinary system malformation (3 cases), skeletal system malformation (2 cases), multilocular cystic tumor and dropsy embryo (35 cases), and abnormal twins (2 cases). Among above abnormal fetuses, 6 cases showed normal structure in the screening after 14 weeks and were born without malformations, while the rest 79 cases were taken artiifcial abortion (73 cases in the ifrst trimester and 6 cases in the second trimester). Only 9 cases were taken chorionic puncture or amniocentesis, including normal karyotypes (3 cases), 47, XN, +18 (3 cases) and 45, X (3 cases). The False negative rate in the ifrst trimester was 23% (25/110). Supplementary detection of fetal structural abnormalities in the second and third trimester were found in 22 cases (20%, 22/110). Two cases of VSD and 1 case of microtia were identiifed after birth.ConclusionsThe fetal malformation can be detected in the earlier gestation with the ultrasonic screening at 11-13+6 weeks, which provide the earlier termination to the abnormal fetus. It has important clinical signiifcance in effectively reducing fetal births with structural abnormalities.
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Objective To evaluate the effect of rehabilitation training on rats with spinal cord injuries by Meta-analysis. Methods Ar-ticles were searched from PubMed( ~2013),CNKI(1989~2013), WanFang Data( ~2013),VIP(1989~2013),quality of included article was assessed with Jadad scale,and available data was analyzed with RevMan 5. 0 software. Results 287 related articles were identified,but only 11 eligible articles were included. The Meta-analysis of BBB score indicated that the rehabilitation training groups were better than con-trol groups. The BBB score[weighted mean difference(WMD) =1. 87,95%CI(1. 50,2. 33),Z=10. 02,P<0. 01]. There was significant diffence between two groups. Conclusion Rehabilitation training can improve the recover of hindlimb function.
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Objective To explore the causes of respiratory tract obstruction during resuscitation of general anesthesia and nursing strategy.Method The clinical data of 13 patients with respiratory tract obstruction during resuscitation of general anesthesia after extubation were reviewed.Results The causes of respiratory tract obstruction included glossocoma,laryngismus,bronchial spasm,airway blockage with secretions and tracheal compression.The respiratory tract obstruction was cured by way of pertinent treatment.Conclusion The critical measures for the treatment of respiratory tract obstruction include careful observation and prompt detection of abnormal symptoms of hypoxia and respiratory index,and effective treatment.
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Objective To investigate the pathological features of blood vessel inflammation in facioscapulohumeral muscular dystrophy ( FSHD ) and the role of vasculitis on the pathogenesis of FSHD. Methods The clinical manifestations and myopathological features of 26 FSHD patients were retrospectively analyzed and summarized. All of the patients were divided into 2 groups; inflammatory infiltration group and non-inflammatory infiltration group. The latter was further divided into 3 subgroups;endomysial inflammation subgroup, perivasculitis subgroup and transmural vasculitis subgroup.Immunohistochemical staining were carried out in inflammatory infiltration group with anti-CD3, anti-CD4,anti-CD8,anti-CD20 and anti-SMA antibody. The control group was composed of 10 dermatomyositis ( DM)cases and 10 polymyositis ( PM) cases. Results The age of onset was (25. 2 ± 12. 6) years old and the average course was (7. 8 ±7. 3) years. The sex ratio of male to female was 1.6: 1. Five of them had family history. The main clinical features were progressive weakness and atrophy of facial, shoulder girdles and proximal upper limbs muscles. The lower distal limbs and (or) lower distal limbs and pelvic girdle muscles were involved in 18 cases. The main pathological features were shown as followed. Seventeen of them had focal inflammatory cell infiltration, including endomysial inflammation (4/17) , perivasculitis (7/17) , and transmural vasculitis (6/17). Immunohistochemical staining confirmed the major types of inflammatory cells were CD4* T lymphocytes and CD20B lymphocytes, which was familiar with DM. While in PM, CD8+ T lymphocytes were dominant The proportionality of residual muscle fibers obviously decreased in inflammatory infiltration group ( 48. 0% ± 23. 6% ) than non-inflammatory infiltration group ( 94. 3% ±3. 1% , T = 198. 000, P = 0. 000). As to CK levels, there were no significant deviation. Conclusions Obvious inflammatory cell infiltration can be seen in FSHD, the locations of inflammatory cells are endomyosium inflammation, perivasculitis and transmural vasculitis. Transmural vasculitis indicates vascular pathological factor may have something to do with pathogenesis of FSHD.
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Objective To investigate the effect of applying core competence training for grading nursing in ICU.Methods The nurses in ICU were divided into high qualification nurses group and low qualification nurses group according to professional ability;make clear the post responsibility, clinical educational training and management were performed according to grades.The nursing department and head nurse evaluated the training;the scores were analyzed and fed back.Results After applying core competence training for grading nursing the satisfaction of patients and nurses and the operational standard-reaching rate were significantly higher (p<0.05).Conclusion The core competence training for grading nursing could give full play to nurses at all levels, provide basis and ladder of sustainable development for nurse's career, deserve the clinical expansion.
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Objective To explore the effect of erythropoietin (EPO) on caspase-9 mRNA expression after globe ischemia-reperfusion in rats.Methods The globe ischemia-reperfusion models of rats were divided randomly into three groups: group A, group B and group C. Both group A and group B included 5 subgroups according to different reperfusion time (6 h, 12 h, 24 h, 48 h and 72 h). The rats of group B were treated with EPO after globe ischemia-reperfusion. Brain tissues were taken out after execution at different time point. The expression of caspase-9 mRNA was detected with reverse transcription PCR (RT-PCR) technique.Results (1) After ischemia-reperfusion, the expressions of caspase-9 mRNA in group A were significantly higher than those in group B and group C (all P