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Objective:To compare the changes of morphology of pharynx in patients with obstructive sleep apnea hypopnea syndrome （OSAHS） and healthy individuals during oral or nasal breathing, and explore the relevant influencing factors. Methods:Twenty-nine adult patients with OSAHS and 20 non-snoring controls underwent MRI to obtain upper airway structural measurements while the subjects were awake and during mouth breathing with a nasal clip.The following were analyzed. ①The changes of upper airway structure of oral and nasal respiration in non-snoring control/OSAHS patients were observed; ②The differences and influencing factors of upper airway structure changes between OSAHS patients and controls were compared during breathing. Results:The control group consisted of 15 males and 5 females, with an apnea-hypopnea index （AHI）<5 events/h, while the OSAHS group comprised 26 males and 3 females with an AHI of 40.4±23.1 events/h and the mean lowest arterial oxygen saturation （LSaO2） was 79.5% ±10.0%. In the both groups, the vertical distance between the mandible and the posterior pharyngeal wall decreased （P<0.05）; The long axis of tongue body decreased （P<0.05）, and the contact area between tongue and palate decreased. There was no significant change in the total volume of the retropalatine（RP） and retroglossal（RG） airway in the control group （P>0.05）. However, the minimum cross-sectional area and volume of the RP airway in OSAHS decreased （P<0.001）. The lateral diameters of uvula plane in OSAHS decreased during mouth breathing, which was contrary to the trend in the control group （P=0.017）. The AHI of patients was positively correlated with the reduction of the volume of the RP airway during oral breathing （P=0.001）; The reduction of the distance between the mandible and the posterior pharyngeal wall was positively correlated with the length of the airway （P<0.001）. Conclusion:Mouth breathing leads to the shortening of the long axis of the tongue, the reduction of the contact area between the soft palate and the tongue, vertical distance between the mandible and the posterior pharyngeal wall, and the cross-sectional area of the epiglottis plane. These changes vary between OSAHS patients and controls. During mouth breathing, the diameters, areas and volumes of the RP area decreased, and were more significant in severe cases.
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Male , Adult , Female , Humans , Mouth Breathing , Sleep Apnea, Obstructive/surgery , Pharynx/surgery , Palate, Soft , Uvula/surgery , SyndromeABSTRACT
Objective:To investigate the satisfaction of clinical interns to the department and teachers under the merging mode of standardized residency training and clinical practice, and to explore the feasibility to further implement the mode in clinical practice.Methods:Cluster sampling was used to design the scale, which included the importance attached by department to the teaching work, the rationality of the arrangement of practice content, the implementation of teaching activities, the quality of teaching activities, the status of out-department examination, the demonstration of medical ethics of teachers, the teaching attitude and knowledge lecturing of teachers, the revision of medical records and the guidance of skills operation, etc. The questionnaire survey was conducted among clinical interns in a hospital from July 2018 to June 2019. SPSS 22.0 was used to conduct t test or rank sum test of two independent samples, and the analysis of multiple groups of data was performed by means of variance analysis. Results:A total of 1 230 questionnaires were sent out, and 1 195 were returned, with an effective recovery rate of 97.15%. The overall satisfaction of interns was (9.62±0.39). The interns gave the highest evaluation on the medical ethics and medical style of the teacher (9.75±0.78), and the lowest evaluation on the teaching quality of all departments (9.52±1.15). There were significant differences among the evaluations ( F=7.30, P<0.001). Conclusion:Under the merging mode of standardized residency training and clinical practice management, all teaching and research sections and departments have fulfilled various teaching tasks according to the requirements, but the teaching quality and connotation construction need to be further strengthened.
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Objective:To explore the best evidence-based nursing plan for the prevention and management of peritonitis associated with peritoneal dialysis, and evaluating the effect of its application.Methods:BMJ Best Practice, Up To Date, Cochrane Library, Joanna Briggs Institute (JBI) Evidence-based Health Care Center database, UK National Clinical Medical Research Guidelines, PubMed, CINAHL, Embase, Web of Science, Physiotherapy Evidence Database, BMJ-Best Practice, SCI, Google Scholar, Europe PMC, Research Gate, NCBI, Yomitong, Mmes, Clinical Practice Guide, CNKI, Wanfang, Chinese Biomedical Literature Database, VIP database involves allguidelines, expert consensus, systematic evaluation and other relevant evidence on the prevention and management of peritoneal diaperis-related peritonitis at home and abroad from establishment to June 2021. The quality of the literature was evaluated and the level of evidence was evaluated. Finally, evidence was extracted and summarized.Results:After repeated check and multiple screening, a total of 13 articles were selected, including 5 guidelines, 2 expert consensus and 6 systematic reviews. At the same time, 19 pieces of best evidence were collected five aspects of peritonitis prevention, peritonitis diagnosis, peritonitis treatment, peritoneal dialysis patient training and management, and healthy quality of life.Conclusions:The prevention and management of peritonitis can effectively reduce the occurrence of peritonitis associated with peritoneal dialysis. According to the clinical situation of the department and the will of patients, standardized nursing procedures are formulated for clinical nurses and personalized nutrition guidance is provided for peritoneal dialysis patients, which is convenient to further improve the quality of life of patients.
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Objective:To explore the effect of problem-originated clinical medical curriculum(PCMC) teaching method combined with PDCA(plan, do, check and action) circulation in the training of craniocerebral ultrasound for neurologically intensive refresher physicians.Methods:Thirty-two refresher physicians who entered the neurosurgery ICU of Henan Provincial People's Hospital from January 2018 to December 2019 were divided into test group ( n=18) and control group ( n=14) according to the time of admission. The test group accepted the teaching mode of PCMC teaching method combined with PDCA circulation, the control group accepted the traditional teaching methods of demonstration, student practice and teacher evaluation. One week before graduation, the differences between two groups in the theoretical assessment, operational skills and questionnaire were compared to evaluate the effectiveness of teaching mode. SPSS 23.0 was used for t-test and chi-square test. Results:Compared with the control group, the individual scores and total scores of the theoretical and operational assessments of craniocerebral ultrasound in the test group were significantly improved, and the questionnaire survey showed that the test group was superior to the control group in all the 7 items of teaching effect and satisfaction with the teaching method, with statistical significance ( P < 0.05). There was no significant difference between the two groups in increasing their interest in learning ( P > 0.05). Conclusion:PCMC teaching method combined with PDCA circulation can improve the training effect and satisfaction of clinical teaching of craniocerebral ultrasound.
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Alcoholic liver disease (ALD) is a common cause of liver dysfunction and death due to liver-related diseases, which brings great harm to human health and social development. Many factors are involved in the development and progression of ALD, such as oxidative stress, change in gut microbiota, genetic variation, autophagy inhibition, and microRNAs. This article summarizes the mechanism of action of these factors in ALD, in order to provide a basis for the treatment of ALD and the discovery of new drug targets.
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Objective:To evaluate the diagnostic value of endoscopic ultrasonography (EUS) in colorectal submucosal lesions, and provide evidence for clinical diagnosis and treatment strategies.Methods:A retrospective analysis was performed on data of 229 patients with colorectal submucosal lesions discovered by electronic colonoscopy and EUS. The diagnosis was confirmed by pathology. The location, type, EUS features of lesions and the coincidence rate of EUS and histopathological diagnosis were analyzed.Results:Colorectal submucosal lesions were common in the rectum (44.98%, 103/229) and ascending colon (15.28%, 35/229). Lipoma was the most common pathological type of colorectal submucosal lesions (34.93%, 80/229), which was commonly located in transverse colon (22.50%, 18/80) and ascending colon (20.00%, 16/80). Neuroendocrine tumor was the second one, accounting for 33.63% (77/229), and was commonly located in rectum (96.10%, 74/77), followed by cyst (18.78%, 43/229). Under EUS, 229 cases of lesions originated from submucosa in 215 cases, muscularis mucosa in 11 cases, and muscularis propria in 3 cases. The overall coincidence rate of EUS and pathological diagnosis was 89.08% (204/229). The coincidence rate of EUS diagnosis was 100.00% (80/80) for lipoma, 5/5 for air-cyst, 3/3 for intestinal stromal tumor, 81.82% (72/88) for neuroendocrine tumor, 89.13% (41/46) for cyst, 1/4 for leiomyoma, 2/5 for lymphangioma, and granulosa cell tumor and neurofibroma were both 0.Conclusion:EUS has a more accurate diagnosis of the origin, echogenicity and pathological properties of colorectal submucosal lesions, but it has certain limitations for the diagnosis of rare tumors such as granulosa cell tumor and neurofibroma.
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Objective@#To investigate the effect of genioglossus (GG) activation at sleep onset on the outcome of velopharyngeal surgery in obstructive sleep apnea hypopnea syndrome (OSAHS) patients.@*Methods@#Thirty-five patients between April 2014 and February 2015 in Beijing Tongren Hospital with OSAHS underwent overnight polysomnography with synchronous genioglossus electromyography (GGEMG) using intraoral electrodes. The upper airway (UA) anatomy was evaluated by three-dimensional computer tomography (3D-CT) in OSAHS patients. Then, all of the patients received velopharyngeal surgery, including revised uvulopalatopharyngoplasty (UPPP) with uvula preservation or UPPP combined transpalatal advancement pharyngoplasty. All patients were followed-up using polysomnography 3-6 months after surgery. T-test or Wilcoxon test were used to compare the variables between groups, and Spearman correlation analysis was used to test the correlation between parameters.@*Results@#Thirty-five patients received velopharyngeal surgery. Twenty-two patients (62.86%) were responders, and 13 patients (37.14%) were non-responders. Responders had a higher mean GGEMG during sleep onset (15.31±3.74 vs. 9.92±2.93, t=4.504, P=0.001). The decreased AHI was significantly positively related to the sleep onset mean GGEMG (r=0.541, P=0.004) and the change in GGEMG (r=0.422, P=0.028). The decreased AHI was significantly negatively related to the minimal cross sectional airway area (mCSA,ρ=0.629,P=0.000) and the minimal lateral airway dimension (mLAT, ρ=0.484, P=0.009) at velopharynx.@*Conclusions@#The outcome of velopharyngeal surgery was affected by the mean GGEMG during sleep onset. We speculated that the patient with higher GGEMG at sleep onset and narrower velopharynx were more suitable candidates for velopharyngeal surgery.
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Objective@#To investigated the effect of long-term low-concentration mixed benzene exposure on peripheral blood of male workers.@*Methods@#A case-control study was conducted to select 452 male workers exposed to mixed benzene (benzene, toluene, xylene) for five consecutive years from January 2012 to December 2016 in an automobile manufacturer as case group, and 438 male administrative and logistic managers who underwent physical examination during the same period as control group. The peripheral blood of the two groups was tested and compared, and the occupational hazards in the workplace were detected.@*Results@#There were low dose exposure to mixed benzene in the enterprise, but the test results met the occupational exposure limit requirements. During the five years from 2010 to 2016, between the two groups of workers, the mean values of WBC, NEUT, RBC and Hb were statistically different (P<0.05). There was no statistical difference (P>0.05) in the mean value of PLT. The abnormal rate of main peripheral blood indexes in the control group was higher than that in the exposed group. There were significant differences in NEUT, RBC and Hb (P< 0.05), but no significant differences in WBC and PLT (P>0.05).@*Conclusion@#It can not be concluded that long-term low-concentration mixed benzene exposure can cause the change of peripheral blood index.
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Objective@#To summarize the nursing experience of postoperative infection of hip joint replacement combined with gaucher′s disease.@*Methods@#According to the characteristics of the disease, nursing intervention and symptomatic treatment were given, including infection control, nursing of complications, nursing of joint puncture, medical treatment and nursing, and strengthening psychological nursing and safety nursing.@*Results@#Through targeted nursing, the patient′s infection was controlled, the condition was stable, the symptoms were relieved, and the patient was discharged.@*Conclusions@#In view of the patient′s condition, the development and implementation of comprehensive and integrated targeted nursing measures can effectively reduce the complications, alleviate the progress of the disease, improve the understanding of gaucher′s disease and the quality and effect of the disease nursing.
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Objective@#To understand the prevalence of gynecologic diseases among married female workers.@*Methods@#The data of married female workers who underwent occupational health examination in a physical examination center from January to December 2017 were collected. The relationship between the detection of common gynecological diseases, age and occupational types examined by gynecological routine, TCT, breast B-mode ultrasound, uterus and appendix B-mode ultrasound were analyzed.@*Results@#Among the 1142 female workers, the total detection rate of reproductive tract infections was 67.25% (768/1142), the total detection rate of breast-related diseases was 75.22% (859/1142) ; the total detection rate of gynecological tumors and benign lesions was 14.71% (168/1142). The detection rate of breast hyperplasia was the highest 67.08% (766/1142), followed by vaginitis 51.66% (590/1142). Among the abnormalities detected in breast-related diseases, gynecological tumors and benign lesions, the highest detection rate was found in public institutions (85.66% and 27.13%), and the lowest was found in factory workers (70.24% and 7.89%). With the increase of age, the detection rate of breastrelated diseases (breast hyperplasia, breast cyst), gynecological tumors, benign lesions (uterine myoma), and Nessler's cyst abnormalities in married female workers increased (χ2trend=7.647、21.653、107.411、53.802, P<0.05), while the detection rate of columnar epithelium of cervix decreased (χ2trend=7.404, P<0.05). There was no significant difference in the total detection rate of reproductive tract infectious diseases (vaginitis, cervical polyps, cervical hypertrophy) among married famale workers of different ages (P<0.05) .@*Conclusion@#The common gynecological diseases of married female workers are affected by many factors such as age and occupation. Health examination and health education should be carried out regularly to reduce the incidence of gynecological diseases among female workers according to different ages and occupations.
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OBJECTIVE： To screen and characterize effective components of immunopotentiating activity in Senecionis cannabifolii Herba. METHODS： The polysaccharide components were obtained by water extraction and alcohol precipitation method to yield 50％ alcohol precipitation sample （SCHE-1） and 80％ alcohol precipitation sample （SCHE-2）. The cells from mice mononuclear macrophage line RAW264.7 were divided into blank group （medium without serum）， negative control group （medium with serum）， lipopolysaccharide group （LPS， positive control drug， 1 μg/mL）， SCHE-1 and SCHE-2 low-dose and high-dose groups （0.5， 1 mg/mL）. The cell viability of RAW264.7 cells was detected by MTT assay. The levels of IL-1β， IL-6 and TNF-α in RAW264.7 were detected by ELISA. These were used to investigate the effects of SCHE-1 and SCHE-2 on the immunological enhancing activity of RAW264.7 cells. The molecular weight and distribution of SCHE-1 were determined by size exclusion chromatography； the monosaccharide composition of SCHE-1 was determined by HPLC pre-column derivatization. Methylation analysis of SCHE-1 was conducted by NaOH method. RESULTS： Compared with negative control group， the activity of RAW264.7 cells was enhanced significantly in SCHE-1 groups and LPS group， which also significantly increased the levels of IL-1β， IL-6 and TNF-α in cell culture fluids （P＜0.01）. SCHE-1 was an effective component with immunopotentiating activity. The neutral sugar content of SCHE-1 was 40.05％， the uronic acid was 35.62％， and the protein was 8.89％. SCHE-1 was a mixture， molecular weight of which was 62-6 119 Da； monosaccharide was mainly composed of galacturonic acid， arabinose （Ara） and galactose （Gal）. The results of methylation analysis showed that the backbone was composed of 1→3， 1→4 and 1→6 linked Gal， and branches were on the O-6 position of the 1→3 linked Gal， and the non-reducing terminals were Ara. CONCLUSIONS： SCHE-1 may be the effective component of immuno potentiating activity， and main component of SCHE-1 is polysaccharide. SCHE-1 may regulate the immune function by activating macrophages to release IL-1β， IL-6 and TNF-α.
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Objective To summarize the nursing experience of postoperative infection of hip joint replacement combined with gaucher′s disease. Methods According to the characteristics of the disease, nursing intervention and symptomatic treatment were given, including infection control, nursing of complications, nursing of joint puncture, medical treatment and nursing, and strengthening psychological nursing and safety nursing. Results Through targeted nursing, the patient′s infection was controlled, the condition was stable, the symptoms were relieved, and the patient was discharged. Conclusions In view of the patient′s condition, the development and implementation of comprehensive and integrated targeted nursing measures can effectively reduce the complications, alleviate the progress of the disease, improve the understanding of gaucher′s disease and the quality and effect of the disease nursing.
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Objective To analyze the relationship between onset of myocardial infarction(MI)to bivalent antibiotics therapy and outcome in elderly female MI patients.Methods One hundred and fourteen elderly MI patients admitted to our hospital from January 2016to January 2018were divided intoΔT≤188min group(n=57)andΔT＞188min group(n=57)according to the onset of MI to bivalent antibiotics therapy.The major adverse cardiac events(MACE),arrhythmia,angina pectoris,heart failure and death were compared between the two groups.Results MACE occurred in 44out of the 144MI patients included in this study.Of the 44MI patients,17died,6 were diagnosed with arrhythmia,16were diagnosed with angina pectoris,5were diagnosed with heart failure.The incidence of arrhythmia,heart failure and the mortality were significantly higher while the incidence of angina pectoris was significantly lower inΔT≤188min group than inΔT＞ 188min group(7.0％vs 3.5％,7.0％vs 1.8％,15.8％vs 14.0％,7.0％vs 21.1％,P＜0.05).Age,diabetes,ΔT,hyperlipidemia,hypertension and coronary artery disease were the independent influencing factors for the poor outcome in MI patients(P＜0.05,P＜0.01).Conclusion TheΔT should be shortened,the MI patients should be timely treated,the criminal blood vessels should be opened,and the ischemic myocardium should be saved in order to prevent the occurrence of severe cardiovascular events and reduce the mortality in elderly MI patients.
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OBJECTIVE: To explore the 2014 edition of the diagnostic criteria of occupational noise-induced deafness on the assessment of hearing loss in occupational health examination. METHODS: A total of 835 noise-exposed workers were selected as study subjects by cluster sampling method. The hearing threshold results were compared through two different editions of criteria: GBZ 49-2007 Diagnostic Criteria of Occupational Noise-induced Deafness( GBZ 49-2007) and GBZ 49-2014 Diagnosis of Occupational Boise-induced Deafness( GBZ 49-2014). RESULTS: The binaural high frequency threshold average calculated by GBZ 49-2007 was lower than that of GBZ 49-2014 [( 46. 8 ± 8. 1) vs( 49. 2 ± 8. 0) d B,P < 0. 01].The speech frequency threshold average of the good ear calculated by GBZ 49-2007 was lower than the monaural threshold of weighted value of the good ear of GBZ 49-2014 [( 18. 8 ± 3. 6) vs( 22. 0 ± 3. 3),P < 0. 01]. The speech frequency threshold average of the good ear and the monaural threshold of weighted value of the good ear calculated after age and sex correction using GBZ 49-2007 were lower than that calculated by using GBZ 49-2014 [( 18. 8 ± 3. 6) vs( 19. 4 ± 3. 6),( 21. 5 ±3. 4) vs( 22.0 ±3.3),P <0.05]. The detection rate of suspected occupational noise-induced deafness GBZ 49-2014 was higher than that of GBZ 49-2007( 6. 35% vs 2. 87%,P < 0. 01). CONCLUSION: In occupational health examination,the diagnostic criteria of GBZ 49-2014 can diagnose patients as suspected occupational noise-induced deafness easier than that of GBZ 49-2007.
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Objective To explore the correlation between depressive symptoms and frailty,in order to provide evidence for prevention and relief of depressive symptoms in elderly inpatients.Methods A cross-sectional survey and comprehensive geriatric assessment(CGA)were conducted with 248 eligible elderly inpatients from December 2015 to February 2017 in our hospital.Depressive symptoms were assessed by the 5-Item Geriatric Depression Scale(GDS-5),and frailty was identified by the frailty phenotype method.Results In all respondents,50 (20.2 ％)patients showed depressive symptoms,93(37.5 ％)patients had pre-frailty and 39 (15.7 ％)patients had frailty.Correlation analysis showed that frailty degree,low grip strength,slow gait speed,low physical activity,fatigue,and weakness were all positively correlated with depressive symptoms in elderly inpatients (r =0.441,0.315,0.426,0.316,0.395 and 0.151,respectively,P ＜ 0.05).Logistic regression analysis showed that patients who had more severe frailty faced a much higher risk of developing depressive symptoms (OR=2.608,P＜0.05).Of the 5 indicators of frailty,slow gait speed and frailty also increased the risk of having depressive symptoms (OR =2.801 and 3.484,P ＜ 0.05).Conclusions Frailty degree,gait speed and fatigue are associated with increased risk of depression in the elderly.Depressive symptoms can be reduced in elderly inpatients with prevention and intervention of pre-frailty and frailty.
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Objective@#To investigate the expression of marker proteins in vocal cord leukoplakia, and to find markers for the early stage of diagnosis and prognosis of precancerous lesions.@*Methods@#The study included 119 cases, 68 cases of vocal cord leukoplakia (22 cases with epithelial simple hyperplasia, 46 cases with epithelial dysplasia), and 51 cases of vocal cords benign lesions(31 cases of vocal cord polyps, 20 cases of Reinke′s edema). The expression of p53, Ki-67, p21, Survivin, p16, p27, PTEN, c-Myc and vascular endothelial growth factor (VEGF) in vocal cords leukoplakia were detected, vocal cord benign lesions (vocal cord polyps and Reinke′s edema) acted as controls, comparing the expression differences of different pathological tissue. Data was analyzed by SPSS 22.0 software.@*Results@#The expression of p53, p16, Ki-67, VEGF in vocal cord benign lesions and vocal cords leukoplakia with epithelial simple hyperplasia did not show significant differences. There was a grading increase in the positive expression of p53, Ki-67 in the vocal cord leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions and vocal cords leukoplakia with epithelial simple hyperplasia (p53: χ2=13.340, P=0.002, Ki-67: χ2=53.386, P=0.000). The expression of p27, PTEN, c-Myc in vocal cord benign lesions and vocal cords leukoplakia with epithelial dysplasia did not show significant differences. There was a grading increase in the positive expression of p21 Survivin in vocal cords leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions (P<0.05). Expression of Survivin in vocal cords leukoplakia with mild-moderate epithelial dysplasia showed a significant increase than those in vocal cord benign lesions (P<0.05). The positive expression grade of p21 showed a rising trend (P=0.073) between the different grades of dysplasia.@*Conclusion@#The positive expression grade of p53, Ki-67, p21 Survivin showed an increase in vocal cords leukoplakia with epithelial dysplasia contrasting to those in vocal cord benign lesions, which might be an implication for evaluating the diagnosis and prognosis of precancerous lesions. Expression of p21 was correlated to the degrees of dysplasia and expression of Survivin showed a significant difference in early stage of epithelial dysplasia contrasting to benign lesions.
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Objective@#To investigate the sleep-related deglutition in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and its correlation with sleep stage and cortical arousals. @*Methods@#From December 2015 to September 2017, simultaneous polysomnography and pharyngeal pressure monitoring were performed in 23 adult patients with OSAHS, Mann-Whitney U test were employed to analyze the following parameters: (1) the relationship between arousal and deglutition; (2) the effect of sleep stage on deglutition; (3) The relationship between the frequency of deglutition and the severity of OSAHS. @*Results@#The subjects in this study aged (43±12) years, and the mean apnea-hypopnea index (AHI) was (49.2±27.7) times/hour. A total of 1 382 deglutition were recorded during sleep, with a median of 9.2[5.8, 13.8]times/person. There was a positive correlation between deglutition frequency and AHI(r=0.570, P=0.005) and negatively correlated with oxygen saturation (r=-0.639, P=0.001). The majority of the deglutition (73.7%) occurred after the respiratory event and in association with respiratory arousal. Deglutition occurred more in Non-rapid eye movement sleep stage 1 (N1) than N2, N3 and REM sleep (Z=-3.680, P<0.001; Z=-2.746, P=0.006; Z=- 3.490, P<0.001). @*Conclusions@#The occurrence of deglutition in patients with OSAHS is associated with cortical arousals. Deglutition frequency increased with the severity of apnea and affected by sleep staging.
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Objective:To observe the morphological features of liver injury induced by hydrodynamic injection, and to explore the procedure and mechanism of liver repair. Methods:Twenty-five female Balb/c mice were intravenously injected with large volume of saline solution(1.8-2.0 mL)in 3 s. The mice were divided into 30 min,8 h,1 d,3 d,and 7 d groups according to the post-injection time.Each group contained 5 mice.Six non-injected mice were used as control group.The blood samples from angular vein of the mice were collected to detect the levels of alanine transaminase(ALT).The morphological features of liver tissue of the mice in various groups were observed with HE staining.The proliferating cell nuclear antigen(PCNA)protein expressions in liver tissue of the mice in various groups were detected by immunohistochemical saining.The expression levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),epidermal growth factor(EGF),hepatocyte growth factor (HGF),transforming growth factor-α(TGF-α),Cyclin D1,vascular endothelial growth factor(VEGF),Bax and Bcl-2 mRNA were determined by Real-time PCR.Results:Compared with control group,the ratio of liver weight/original body weight in 8 h group was significantly decreased(P<0.05),but there was no significant difference in 7 d group(P>0.05).Compared with control group,the serum ALT level in 1 d group was significantly elevated (P<0.01),but there was no significant difference in 7 d group(P>0.05).Compared with control group,the liver tissue of the mice in 30 min group showed hepatocyte swollen and small hemorrhagic area,and the number of hepatocytes per high power field was significantly declined(q=4.760,P<0.05)under microscope.Compared with 30 min group,the number of swollen cells was decreased in 8 h group,the hemorrhagic and necrotic area enlarged, both of the hepatocyte number and binuclear hepatocyte number per high power field were significantly increased (q=7.310,P<0.01;q=7.200,P<0.01).Compared with 8 h group,the hemorrhagic and necrotic areas in 1 d group were reduced,both of the hepatocyte number and binuclear hepatocyte number per high power field were significantly decreased(q=4.966,P<0.05;q=6.596,P<0.01);there were no significant differences compared with control group(P>0.05).The hemorrhagic and necrotic areas almost disappeared in 3 d group.The histological appearance of liver tissue of the mice in 7 d group was same as control group.Compared with control group,the PCNA indexes in hepatocytes in 8 h and 1 d groups were significantly increased(t=4.458,P<0.01;t=15.557,P<0.01);there was no significant difference in 7 d group(P>0.05).Compared with control group, the PCNA index in cholangiocytes in 30 min group was increased significantly(t=3.985,P<0.01);there was no significant difference in 7 d group(P>0.05).The mRNA expression levels of TNF-α,IL-6,EGF,and VEGF in liver tissue of the mice in 30 min group were significantly higher than those in 8 h group(q=4.952,P<0.05;q=14.750,P<0.01;q=14.750,P<0.01;q=13.551,P<0.01).The HGF mRNA expression level in liver tissue of the mice in 3 d group was significantly higher than those in 30 min group and 8 h group(q=5.031,P<0.05;q=4.631,P<0.05).The TGF-αmRNA expression levels in liver tissue of the mice in 8 h group and 1 d group were higher than that in 30 min group(q=4.592,P<0.05;q=8.137,P<0.01).The Cyclin D1 mRNA expression levels in liver tissue of the mice in 8 h group and 1 d group were higher than that in 7 d group(q=4.736, q=5.213,P<0.05).The Bax/Bcl-2 ratio of the mice in 1 d group was higher than that in 30 min group(q=5.731,P<0.01).Conclusion:Acute liver injury induced by hydrodynamic injection mainly shows the hepatocyte swelling and hemorrhagic necrosis.The injury could be repaired naturally in a week.The various cytokines and growth factors related with liver regeneration are involved in the repair procedure.
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Objective To investigate the effect and feasibility of problem-based learning teaching model in case discussion and its influence on the cultivation of medical students' practical ability in primary hospitals under the guidance of the synergy of medical education. Methods Interns from this hospital of the year 2017 were chosen as subjects. Those who were organized by science and teaching department with PBL model in case discussion were observation group, while those who were organized in traditional case discussion by clinical departments were control group. Questionnaires were filled in and effects between two groups were compared. Results In both the cognitive and affective domain, PBL teaching group scored higher compared with traditional teaching group (P=0.000). Conclusion Under the current situation, carry-ing out PBL teaching model has certain feasibility and practical significance in primary hospitals and is more suitable for the development of medical cooperation between colleges and hospitals.
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OBJECTIVE We hypothesized that unstable ventilatory control(high loop gain, LG) could predict the short-term efficacy of positive airway pressure therapy in patients with obstructive sleep apnea(OSA). METHODS 42 adult patients with OSA, M/F=39/3, were studied. The stability of the ventilatory control system(LG) was quantified by fitting a simplified mathematical model to the spontaneous ventilatory pattern obtained via polysomnography. LG, pulmonary function test results, and other PSG parameters were analyzed in patients who had post-treatment AHI≥10 events/hr(non-responders) using auto-positive airway pressure therapy. RESULTS The subjects aged(40±8) years, apnea-hypopnea index(AHI) were 68.2[42.9,81.0]events/hr). Nine patients(34.6％) were non-responders. Twenty pat ients(47.6％) had residual AHI＜5 events/hr. Loop gain and pre-treatment mixed apnea index were higher in the non-responders versus responders(0.74 [0.62, 0.82] vs 0.49[0.37, 0.77], P =0.035) and(11.0[4.3, 22.9] vs 2.0[0.2, 5.3], P =0.004). In the 26 patients with LG＞0.6, nine(34.9％) had posttreatment 5 events/hr≤AHI＜10 events/hr. And all of the non-responders had LG(n=9, 34.9％). The difference was signif icant between the LG＞0.6 a nd LG＜0.6 group(P =0.007). CONCLUSION Loop gain and mixed apnea index was higher in patients with residual AHI＞10 events/hr after short-term auto-PAP therapy. Ventilatory control stability evaluation might have predictive value for PAP treatment efficacy in OSA patients.