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1.
Journal of Clinical Hepatology ; (12): 562-567, 2024.
Article in Chinese | WPRIM | ID: wpr-1013137

ABSTRACT

ObjectiveTo investigate the influencing factors for the clinical outcome of patients with drug-induced liver injury (DILI), and to establish a nomogram prediction model for validation. MethodsA retrospective analysis was performed for the general information and laboratory data of 188 patients with DILI who were admitted to Heilongjiang Provincial Hospital Affiliated to Harbin Institute of Technology from January 2017 to December 2022, and according to their clinical outcome, they were divided into good outcome group with 146 patients and poor outcome group with 42 patients. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate Logistic regression analyses were used to investigate the independent influencing factors for the clinical outcome of DILI patients. R Studio 4.1.2 software was used to establish a nomogram model, and calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to perform internal validation. ResultsThe univariate Logistic regression analysis showed that liver biopsy for the diagnosis of DILI, platelet count, cholinesterase, albumin, prothrombin time activity, IgM, and IgG were associated with adverse outcomes in patients with DILI. The multivariate Logistic regression analysis showed that liver biopsy for the diagnosis of DILI (odds ratio [OR]=0.072, 95% confidence interval [CI]: 0.022‍ ‍—‍ ‍0.213, P<0.001), clinical classification (OR=0.463, 95%CI: 0.213‍ ‍—‍ ‍0.926, P=0.039), alanine aminotransferase (OR=0.999, 95%CI: 0.998‍ ‍—‍ ‍1.000, P=0.025), prothrombin time activity (OR=0.973, 95%CI: 0.952‍ ‍—‍ ‍0.993, P=0.011), and IgM (OR=1.456, 95%CI: 1.082‍ ‍—‍ ‍2.021, P=0.015) were independent influencing factors for clinical outcome in patients with DILI. The nomogram prediction model was established, and after validation, the calibration curve was close to the reference curve. The area under the ROC curve was 0.829, and the DCA curve showed that the model had good net clinical benefit. ConclusionThe nomogram prediction model established in this study has good clinical calibration, discriminative ability, and application value in evaluating the clinical outcome of patients with DILI.

2.
China Pharmacy ; (12): 75-79, 2024.
Article in Chinese | WPRIM | ID: wpr-1005217

ABSTRACT

OBJECTIVE To construct a risk prediction model for bloodstream infection (BSI) induced by carbapenem-resistant Klebsiella pneumoniae (CRKP). METHODS Retrospective analysis was conducted for clinical data from 253 patients with BSI induced by K. pneumoniae in the First Hospital of Qinhuangdao from January 2019 to June 2022. Patients admitted from January 2019 to December 2021 were selected as the model group (n=223), and patients admitted from January 2022 to June 2022 were selected as the validation group (n=30). The model group was divided into the CRKP subgroup (n=56) and the carbapenem- sensitive K. pneumoniae (CSKP) subgroup (n=167) based on whether CRKP was detected or not. The univariate and multivariate Logistic analyses were performed on basic information such as gender, age and comorbid underlying diseases in two subgroups of patients; independent risk factors were screened for CRKP-induced BSI, and a risk prediction model was constructed. The established model was verified with patients in the validation group as the target. RESULTS Admissioning to intensive care unit (ICU), use of immunosuppressants, empirical use of carbapenems and empirical use of antibiotics against Gram-positive coccus were independent risk factors of CRKP-induced BSI (ORs were 3.749, 3.074, 2.909, 9.419, 95%CIs were 1.639-8.572, 1.292- 7.312, 1.180-7.717, 2.877-30.840, P<0.05). Based on this, a risk prediction model was established with a P value of 0.365. The AUC of the receiver operating characteristic (ROC) curve of the model was 0.848 [95%CI (0.779, 0.916), P<0.001], and the critical score was 6.5. In the validation group, the overall accuracy of the prediction under the model was 86.67%, and the AUC of ROC curve was 0.926 [95%CI (0.809, 1.000], P<0.001]. CONCLUSIONS Admission to ICU, use of immunosuppressants, empirical use of carbapenems and empirical use of antibiotics against Gram-positive coccus are independent risk factors of CRKP- induced BSI. The CRKP-induced BSI risk prediction model based on the above factors has good prediction accuracy.

3.
Journal of Sun Yat-sen University(Medical Sciences) ; (6): 712-717, 2023.
Article in Chinese | WPRIM | ID: wpr-979227

ABSTRACT

ObjectiveTo reveal the differences of the related pathogenicity gene mutations between sebaceous adenocarcinoma (SC) of scalp and sebaceous adenoma (SA) of scalp on whole exome level. MethodsWhole exome sequencing was performed on a SC sample and a SA sample by Illumina Hiseq 2500 platform. Suspicious single nucleotide variation sites were selected for mutation conservation and functional analysis. SciClone was used to track subclone evolution and clonal map information was obtained for each tumor sample. The high-frequency significant gene mutations in the tumor sample were screened by MutSigCV software, and compared with the known driver genes. ResultsTwo driver genes TFDP1 and ACVR1B harboring mutations in scalp SC compared to SA were found. ConclusionsThe finding of mutation in driver genes TFDP1 and ACVR1B should be confirmed in a large cohort, which might reveal the mechanism of scalp SC development and find a therapeutic target for SC.

4.
Acta Pharmaceutica Sinica ; (12): 1577-1585, 2023.
Article in Chinese | WPRIM | ID: wpr-978720

ABSTRACT

In 2015, the United States put forward the concept of precision medicine, which changed medical treatment from "one size fits all" to personalization, and paid more attention to personalization and drug customization. In the same year, Spritam®, the world's first 3D printed tablet, was in the market, marking the emerging pharmaceutical 3D printing technology was recognized by regulatory authorities, and it also provided a new way for drug customization. 3D printing technology has strong interdisciplinary and high flexibility, which puts forward higher requirements for pharmaceutical staffs. With the development of artificial intelligence (AI), modern society can perform various tasks, such as disease diagnosis and robotic surgery, with superhuman speed and intelligence. As a major AI technology, machine learning (ML) has been widely used in many aspects of 3D printing drug, accelerating the research and development, production, and clinical application, and promoting the new process of global personalized medicine and industry 4.0. This paper introduces the basic concepts and main classifications of 3D printing drug, non-AI drug optimization technology and ML. It focuses on the analysis of the research progress of ML in 3D printing drug, and elucidates how AI can empower the intelligent level of 3D printing drug in pre-processing, printing, and post-processing process. It provides a new idea for accelerating the development of 3D printed drug.

5.
China Journal of Orthopaedics and Traumatology ; (12): 12-16, 2023.
Article in Chinese | WPRIM | ID: wpr-970812

ABSTRACT

OBJECTIVE@#To compare the clinical efficacy between visual trephine arthroplasty assisted percutaneous transforaminal endoscopic discectomy (VPTED) and traditional percutaneous transforaminal endoscopic discectomy(PTED) in the treatment of lumbar disc herniation.@*METHODS@#The clinical data of 60 patients with lumbar disc herniation admitted from June 2019 to December, 2020 was retrospectively analyzed. There were 38 males and 22 females, aged from 26 to 58 years old with an average of (43.63±8.48) years, 47 cases were on L4,5 segment and 13 cases were on L5S1 segment. Among them, 32 were treated with VPTED (group A) and 28 were treated with traditional PTED (group B). The general conditions of all the patients were recorded, including intraoperative fluoroscopy times, operation time, hospital stay and surgical complications during follow-up. The arthroplasty area ratio was observed by sagittal CT at the middle level of the intervertebral foramen. Visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score of low back pain, Oswestry disability index (ODI) were used to evaluate the clinical efficacy between two groups.@*RESULTS@#All patients were followed up from 9 to 15 months with an average of (12.10±1.16) months. There was no statistical difference of preoperative general data between two groups. The operation time, fluoroscopy times and hospital stay were (70.47±5.87) min, (13.66±1.34) times and (6.31±0.69) d in group A, and (90.71±7.66) min, (22.82±2.48) times and (6.54±0.92) d in group B. The operation time and intraoperative fluoroscopy times in group A were lower than those in group B(P<0.05). There was no significant difference in hospital stay between two groups (P>0.05). No obvious surgical complications were found during the follow-up in both groups. The arthroplasty area ratio in group A was (29.72±2.84)% and (29.57±2.20)% in group B, respectively, with no significant difference (P>0.05). There was no significant difference in VAS, ODI and JOA score between two groups before operation and at the final follow-up(P>0.05), but the final follow-up was significantly improved(P<0.05).@*CONCLUSION@#The two surgical methods have definite clinical efficacy in the treatment of lumbar disc herniation. Visual trephine arthroplasty assisted percutaneous transforaminal endoscopic discectomy has the advantages of high efficiency and rapidity when establishing the channel, and can significantly reduce the operation time and intraoperative fluoroscopy times.


Subject(s)
Male , Female , Humans , Adult , Middle Aged , Intervertebral Disc Displacement/surgery , Retrospective Studies , Lumbar Vertebrae/surgery , Endoscopy/methods , Diskectomy, Percutaneous/methods , Diskectomy/methods , Treatment Outcome , Arthroplasty
6.
Chinese journal of integrative medicine ; (12): 761-768, 2023.
Article in English | WPRIM | ID: wpr-1010268

ABSTRACT

The current review gives a comprehensive overview of the recent development in Chinese medicine (CM) for treating several kinds of acquired nerve deafness and tinnitus, as well as links the traditional principle to well-established pharmacological mechanisms for future research. To date, about 24 herbal species and 40 related ingredients used in CM to treat hearing loss and tinnitus are reported for the treatment of endocochlear potential, endolymph growth, lowering toxic and provocative substance aggregation, inhibiting sensory cell death, and retaining sensory transfer. However, there are a few herbal species that can be used for medicinal purposes. Nevertheless, clinical studies have been hampered by a limited population sample, a deficiency of a suitable control research group, or contradictory results. Enhanced cochlear blood flow, antiinflammatory antioxidant, neuroprotective effects, and anti-apoptotic, as well as multi-target approach on different auditory sections of the inner ear, are all possible benefits of CM medications. There are numerous unknown natural products for aural ailment and tinnitus identified in CM that are expected to be examined in the future utilizing various aural ailment models and processes.


Subject(s)
Humans , Tinnitus/drug therapy , Medicine, Chinese Traditional , Hearing Loss/drug therapy
7.
Journal of Sun Yat-sen University(Medical Sciences) ; (6): 991-998, 2023.
Article in Chinese | WPRIM | ID: wpr-998991

ABSTRACT

ObjectiveTo study the possible correlation between serum osteoprotegerin (OPG)/soluble receptor activator of the nuclear factor κB ligand (sRANKL) levels and the left ventricular diastolic dysfunction (LADD) in patients with type 2 diabetes mellitus (T2DM). MethodsTotally 68 T2DM patients and 37 healthy controls were selected. Serum OPG and sRANKL were determined by solid-phase enzyme-linked immunosorbent assay (ELISA). The left ventricular diastolic function of T2DM patients was measured by transthoracic echocardiography, where E/A < 1 were regarded as LVDD. T2DM patients were further divided into two subgroups according to E/A ratio (E/A≥1.0 and E/A<1). Spearman correlation analysis, logistic regression and ROC curves were used to assess the possible correlation between serum OPG/sRANKL and LADD in T2DM patients. ResultsCompared with the healthy controls, serum OPG level in T2DM patients was higher with statistically significant difference (P <0.01), while serum sRANKL level was lower without statistically significant difference (P =0.32). T2DM patients with E/A<1 had significantly higher OPG level and lower sRANKL level than those with E/A≥1(P <0.01) in subgroup analysis. Spearman correlation analysis showed serum OPG level was negatively correlated with E/A ratio, while sRANKL was positively related with E/A ratio. In single factor logistic regression analyses, serum OPG [OR (95% CI)=1.068 (1.031, 1.106), P<0.001] and sRANKL [OR (95% CI)=0.976 (0.959, 0.992), P=0.003] were significant correlation with LVDD in T2DM patients. ROC curve analysis showed that the sensitivity and specificity of combined OPG and sRANKL in diagnosing T2DM patients LADD were 78.13% and 88.3%, respectively (area under the curve: 0.857; 95% CI=(0.768, 0.946); P<0.001). ConclusionsThe elevated OPG and decreased sRANKL levels may be associated with LADD in T2DM patients.

8.
International Eye Science ; (12): 2021-2025, 2023.
Article in Chinese | WPRIM | ID: wpr-998483

ABSTRACT

In 2004, it was the first time that Wollensak and Spoerl had applied physical and chemical cross-linking methods to scleral tissue. They found that the biomechanical strength of cross-linked sclera, induced by riboflavin/ultraviolet A, glyceraldehyde and glutaraldehyde, could be improved and proposed that scleral collagen cross-linking is expected to be a new method for the treatment of pathologic myopia. In recent years, a series of explorations have been made on the effectiveness and adverse reactions of physical and chemical cross-linking in the prevention and treatment of pathologic myopia, including the establishment of various animal models and different myopia modeling methods, the improvement of cross-linking methods, the amelioration of the measurement of biomechanical strength of scleral tissue and the attention of biological parameters such as the thickness of retinal nerve fiber layer and the amplitude of electroretinogram in vivo. Genipin-crosslinking of the scleral collagen combined with posterior scleral contraction/reinforcement has been applied to clinical research. This review summarizes physical cross-linking and the genipin-crosslinking of scleral collagen to explore the effectiveness and safety of the methods in the prevention and treatment of the pathologic myopia.

9.
Chinese Journal of Rehabilitation Theory and Practice ; (12): 1214-1220, 2023.
Article in Chinese | WPRIM | ID: wpr-998218

ABSTRACT

ObjectiveTo investigate the association between serum 25-hydroxy vitamin D [25(OH)D] and the occurrence and outcome of stroke-associated pneumonia (SAP) in patients with acute ischemic stroke (AIS) in emergency ward. MethodsThe clinical data of 256 patients with AIS from January, 2019 to December, 2021 were collected in the emergency department of Beijing Bo'ai Hospital. Blood routine, biochemical indicators and serum concentration of 25(OH)D were detected within 24 hours after enrollment; meanwhile, National Institute of Health Stroke Scale (NIHSS) and A2DS2 score were evaluated. The patients were divided into non-SAP group (n = 164) and SAP group (n = 92) according to whether pneumonia occurred during hospitalization. Multivariable logistic regression model was used to analyze the influencing factors of SAP. The predictive ability of serum 25(OH)D and A2DS2 for SAP were evaluated by receiver operating characteristic (ROC) curves. The 28-day survival of patients with SAP was followed up. Multivariable Cox proportional hazard regression model was used to investigate the association between vitamin D nutritional status and 28-day all-cause mortality. ResultsSerum 25(OH)D was significantly lower in the SAP group than that in the non-SAP group (Z = 6.896, P < 0.001). After adjusting age, sex, infarct volume, A2DS2 score and other factors, lower serum 25(OH)D level (OR = 0.934, 95%CI 0.884 to 0.986, P = 0.014) was an independent risk factor for SAP. The areas under curve (95%CI) of serum 25(OH)D, A2DS2 score and their combined model for predicting SAP were 0.774 (0.718 to 0.824), 0.832 (0.781 to 0.876) and 0.851 (0.802 to 0.893) (P < 0.001), respectively; and the optimum cut-off values were 25(OH)D < 10.2 ng/mL, A2DS2 score > 5 points, combined prediction > 0.207, and the Youden index were 0.493, 0.662 and 0.616, respectively. A2DS2 score could improve the prediction efficiency of serum 25(OH)D (Z = 2.106, P = 0.035). After adjusting age, sex, infarct volume and NIHSS score, vitamin D deficiency was an independent risk factor for all-cause mortality after 28 days of SAP (HR = 2.871, 95%CI 1.004 to 8.208, P = 0.049) . ConclusionSerum 25(OH)D is independently associated with the occurrence and outcome of SAP in patients with AIS in emergency ward, which could serve as an independent predictor for SAP.

10.
Chinese Journal of Physical Medicine and Rehabilitation ; (12): 18-23, 2023.
Article in Chinese | WPRIM | ID: wpr-995173

ABSTRACT

Objective:To explore the risk factors for cognitive impairment 3 months after an ischemic stroke and their predictive value.Methods:A retrospective case-control study considered the records of 856 elderly patients who had survived an ischemic stroke. All had been evaluated using the Montreal Cognitive Assessment scale (MoCA). They were divided according to their MoCA scores into a group without cognitive impairment (the PSNCI group) and an impaired (PSCI) group. The subjects′ demographic and clinical laboratory data were compiled. All had been assessed using the National Institutes of Health stroke scale (NIHSS), the Barthel Index (BI), and the Hamilton depression scale (HAMD). Univariate and multivariate logistic regressions were evaluated and a receiver operator characteristics (ROC) curve was computed.Results:There were significant differences between the two groups in terms of gender distribution, age, hypertension and heart disease history, family history of dementia and education level. Moreover, significant differences were observed in the groups′ average total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), urinary neurofilament protein (AD7c-NTP), NIHSS scores, BIs and ADL scores. Logistic regression showed that a history of heart disease, urinary AD7C-NTP level and HAMD score were significant independent predictors of cognitive impairment 3 months after a stroke. A high BI was an independent protective factor. The area under the ROC curve for urinary AD7C-NTP was the largest (0.875) and had significant predictive value with a cut-off value of 2.43, sensitivity of 0.94 and specificity of 0.75.Conclusion:Age, sex, education, smoking, drinking, body mass index, a history of heart disease or stroke, a family history of dementia and elevated AD7C-NTP, TC or TG are risk factors for cognitive impairment after a stroke. A high BI suggests a better prognosis. Urinary AD7c-NTP is a useful predictor of PSCI 3 months after a stroke.

11.
Chinese Journal of Geriatrics ; (12): 645-649, 2023.
Article in Chinese | WPRIM | ID: wpr-993868

ABSTRACT

Objective:To investigate the impact of group-based rehabilitation exercise on motor and non-movement symptoms of Parkinson's disease(PD).Methods:A total of 88 patients from out-patient and in-patient services at our hospital were randomly assigned to an early exercise group(E-EG), a late exercise group(L-EG), and a control group(CG)using a randomized delayed-start design.Patients in the E-EG carried out a rigorous, formal group exercise program, one hour per session, twice per week, for 18 months(May 2018-November 2019). Patients in the L-EG took part in the exercise program in the final 6-12 months of the study.We assessed outcomes using the Unified Parkinson's Disease Rating Scale(UPDRS), Parkinson's disease questionnaire-39(PDQ-39 Q), trail-making test part A & B, nine-hole peg test(9-HPT), 30 second sit to stand test(30s SST), 10 m walk test(10 m W), mini-balance evaluation systems test(Mini-BEST), Fullerton Advanced Balance(FAB)Scale and time up and go(TUG)test.Results:Compared with pre-exercise levels, patients with PD in the E-EG had lower performance in UPDRS(17.5±8.3 vs.20.0±8.6, t=-2.2, P=0.02)and lower performance in PDQ-39(27.2±2.1 vs.29.0±9.8, t=-2.6, P=0.001)after exercise.Moreover, compared with pre-exercise levels, patients with PD in the E-EG showed decreased post-exercise performance in trail-making test part B(114.2±25.5 vs.129.8±28.4, t=-2.3, P=0.02)and in 9-HPT(33.7±7.3 vs.39.6±9.3, t=-2.6, P=0.001). Conclusions:The practice of group-based rehabilitation exercise can improve movement abilities and quality of life in PD patients, especially if implemented early.Targeted rehabilitation exercise should be taken as part of the treatment strategy for PD patients as early as possible to deliver the best benefits.

12.
Chinese Journal of Clinical Infectious Diseases ; (6): 128-133, 2023.
Article in Chinese | WPRIM | ID: wpr-993725

ABSTRACT

Objective:To explore the risk factors of mortality in patients with Klebsiella pneumoniae bloodstream infection, and to construct a predictive model. Methods:The clinical data of 234 patients with Klebsiella pneumoniae bloodstream infection admitted in the First Hospital of Qinhuangdao from January 2020 to December 2022 were retrospectively analyzed, including 202 cases admitted during January 2020 to June 2022 (model set), and 32 cases admitted during July to December 2022 (validation set). There were 64 cases died (fatal group) and 138 cases survived (survival group) within 28 d after admission in model set. Multivariate Logistic regression was used to analyze the risk factors of death in patients with Klebsiella pneumoniae bloodstream infection and a mortality prediction model was constructed. The constructed model was applied in validation set, and the consistency between predicted mortality and real mortality was analyzed. Results:Multivariate Logistic regression analysis showed that male sex ( OR=2.598, 95% CI 1.179-5.725, P=0.018), age≥65 years ( OR=4.420, 95% CI 2.029-9.627, P<0.001), admitted to intensive care unit (ICU) ( OR=10.299, 95% CI 4.752-22.321, P<0.001), and the empirical use of quinolones antibiotics ( OR=4.288, 95% CI 1.127-16.317, P=0.033) were independent risk factors for 28-day mortality in Klebsiella pneumoniae bloodstream infection patients. The regression equation for predicting the risk of death was -3.469+ male × 0.955+ age ≥ 65 years × 1.486+ admitted to ICU × 2.332+ empirical use of quinolone antibiotics × 1.456. The area under the ROC curve (AUC) for predicting death in the model set was 0.831, with sensitivity and specificity of 71.9% and 80.4%, respectively. The AUC for predicting death in the validation set was 0.881, with sensitivity and specificity of 91.7% and 75.0%, respectively. Conclusion:The constructed mortality prediction model in the study has good application value for the prognosis of patients with Klebsiella pneumoniae bloodstream infection.

13.
Chinese Journal of Nuclear Medicine and Molecular Imaging ; (6): 518-522, 2023.
Article in Chinese | WPRIM | ID: wpr-993628

ABSTRACT

Objective:To investigate predictive value of model based on pre-surgical 18F-FDG PET/CT metabolic parameters for mediastinal lymph node metastasis (LNM) in lung adenocarcinoma. Methods:A total of 288 patients with lung adenocarcinoma (135 males, 153 females, age (61.6±8.5) years) who diagnosed and treated in the Fourth Hospital of Hebei Medical University from January 2016 to February 2021 were enrolled retrospectively. All patients underwent 18F-FDG PET/CT examination within 1 month before operation, and underwent complete resection of primary lung tumor and standard lymph node dissection. PET/CT parameters were extracted (PET metabolic parameters: minimum SUV(SUV min), SUV max, SUV mean, SUV standard deviation (SUV std), metabolic tumor volume (MTV) and total lesion glycolysis (TLG); CT parameters: minimum CT value (HU min), maximum CT value (HU max), mean CT value (HU mean), CT value standard deviation (HU std)). Multivariate logistic regression analysis was used for screening parameters and establishing model to predict LNM. ROC curves analyses were used to evaluate the predictive performance of models. Results:Among 288 patients, 90 had LNM, and 361 metastatic lymph nodes (N1: 186, N2: 175) were reported by pathology. SUV min (odds ratio ( OR)=1.859, 95% CI: 1.074-3.220, P=0.027), SUV max ( OR=2.255, 95% CI: 1.306-3.893, P=0.004), SUV mean ( OR=0.277, 95% CI: 0.115-0.665, P=0.004) were predictors of LNM. The AUC of PET/CT model was 0.849 (95% CI: 0.804-0.893), and the sensitivity, specificity, accuracy, and positive and negative predictive values were 87.8%(79/90), 72.2%(143/198), 77.1%(222/288), 59.0%(79/134) and 92.9%(143/154), respectively. Conclusion:The model based on 18F-FDG PET/CT metabolic parameters can improve the accuracy of pre-surgical N-staging in patients with lung adenocarcinoma.

14.
Chinese Journal of Medical Education Research ; (12): 961-967, 2023.
Article in Chinese | WPRIM | ID: wpr-991449

ABSTRACT

This study summarizes related studies on readiness for online teaching in China and globally and constructs an online teaching readiness scale for higher education teachers with reference to related studies on online teaching competency, blended teaching readiness, and influencing factors for online teaching. This scale includes five dimensions, i.e., belief, teaching readiness, technical readiness, online communication readiness, and institutional support. A questionnaire survey and statistical analyses were performed to investigate the rationality of the scale, and then the scale was modified. The results show that the indicators of the scale have a good degree of fitting, and this study provides a necessary standard for examining the online teaching readiness of higher education teachers and new ideas for online teaching in colleges and universities.

15.
Chinese Journal of Medical Education Research ; (12): 791-795, 2023.
Article in Chinese | WPRIM | ID: wpr-991412

ABSTRACT

The objectives of the paper is to more accurate understand the use demands of wise classrooms for medical students, and provide scientific basis for wise classroom managers when formulating wise classroom environment optimization strategies. In the paper, the questionnaire survey method was used to investigate 23 indicators in 4 dimensions of hardware facilities, information technology, teaching methods and medical wise classroom features. And the data of 1 074 questionnaires were analyzed using KANO model analysis technology and satisfaction importance quadrant chart. Among the 23 demand indicators, there are 6 required attributes, 7 expected attributes, 9 charm attributes and 1 non-differential attribute. According to the theoretical importance ranking of the KANO model, wise classroom managers should first improve the quality of indicators related to necessary attributes, give priority to the quality of indicators related to expected attributes, and finally meet the requirements of indicators related to charm attributes. Relevant policies and construction suggestions for smart classrooms are put forward from the three levels of school top-level design, teachers and managers in the paper.

16.
Chinese Journal of Medical Education Research ; (12): 606-612, 2023.
Article in Chinese | WPRIM | ID: wpr-991373

ABSTRACT

Objective:To explore the intervention effect of humanistic management on anxiety and depression tendency of visiting physicians.Methods:The visiting physicians who began to further study in Beijing Anzhen Hospital, Capital Medical University from January 2016 to December 2018 were selected for humanistic management, and the visiting physicians from April 2013 to December 2015 were set as reference to conduct a questionnaire survey before and after the refresher training with the Hospital Anxiety and Depression Scale. Therefore, the visiting doctors all had the conventional refresher study management mode. On this basis, the intervention group established an individualized refresher study schedule, equipped the doctors with tutors, regularly visited the doctors and organized symposiums for them, assisted them to join the academic groups of the department, organized and coordinated the doctors to participate in the multi-disciplinary academic ward rounds, conducted negative emotional relief through the Balint groups, and integrated the cultural life of the refresher doctors into the cultural construction of the hospital and follow up the refresher doctors after the refresher training. SPSS 16.0 was used to perform t-test and variance analysis. Results:There was no difference in anxiety and depression scores between the two groups according to gender, type of refresher department, level of source hospital and length of study ( P > 0.05). Compared with the two evaluations in the intervention group, the second scores of anxiety for men and women [(5.90±1.37) vs . (6.48±1.87), (5.92±1.45) vs . (6.73±2.12)], doctors in each department [(5.50±1.23) vs . (6.76±2.35), (6.03±1.36) vs . (6.64±1.75), (5.98±1.50) vs . (6.64±2.15)], doctors from secondary and tertiary hospitals [(5.85±1.29) vs . (6.64±2.02), (6.00±1.50) vs . (6.78± 2.14)], the total score of doctors [(5.92±1.37) vs . (6.64±2.15), (5.92±1.47) vs . (6.68±1.98)] and the total score [(5.92±1.42) vs. (6.66±2.05)] were lower than the first evaluation score ( P<0.05). The second scores of depression for female doctors [(6.15±1.37) vs . (6.68±2.06)], doctors in medical laboratory department [(6.02±1.40) vs . (6.69±1.88)], doctors from tertiary hospital [(6.13±1.41) vs. (6.51±1.90)], doctor with different training durations [(6.04±1.42) vs . (6.50±2.02), (6.12±1.34) vs . (6.57±1.97)] and the total score of doctors [(6.09±1.37) vs . (6.54±1.99)] were lower than those of the first evaluation ( P < 0.05). The anxiety score of the second evaluation in the control group was higher in male physicians [(6.63±1.15) vs . (6.11±1.76)] than the first evaluation ( P < 0.05). Compared with the second evaluation data of doctors in the two groups, in terms of anxiety scores, the scores of doctors at all levels and total scores in the intervention group were lower than those in the control group ( P < 0.05); in terms of depression score, the scores of female visiting doctors, doctors from tertiary hospitals, doctors with refresher training duration of 6 months and total score were lower than those of the control group ( P < 0.05). Conclusion:The application of humanistic management to strengthen the management of refresher physicians can improve the psychological state of refresher doctors to a certain extent, especially alleviate the anxiety state, which is a worthy promotion of refresher management mode.

17.
Chinese Journal of Medical Education Research ; (12): 481-485, 2023.
Article in Chinese | WPRIM | ID: wpr-991345

ABSTRACT

The medical massive open online course (MOOC) quality certification standard is the reference for the implementation of medical MOOC quality monitoring. This thesis utilizes data mining, quantitative analysis, qualitative analysis and other methods, taking the comment text of the Chinese medicine courses on the Ai Course (MOOC of China Universities) platform as the data source out of which to extract certain potential indicators for the medical MOOC quality certification standard. Based on the analysis of the existing research results on MOOC quality evaluation domestic and abroad as well as the relevant policies of the Ministry of Education, a medical MOOC quality accreditation standard including 6 first-level indicators are formed, including course content, teaching design and so on. Expert scores and AHP method were used to calculate the weight coefficient of the quality certification standard. Finally, this paper explains the procedure of medical MOOC quality certification in college. This certification system can be used to conduct self-assessment and quality monitoring of medical MOOC in colleges and universities.

18.
Chinese Journal of Postgraduates of Medicine ; (36): 758-762, 2023.
Article in Chinese | WPRIM | ID: wpr-991093

ABSTRACT

Objective:To investigate the changes and clinical significance of high mobility group protein B1 (HMGB1) in condyloma acuminatum (CA).Methods:Sixty four patients with initial CA(initial group) and 48 patients with recurrent CA(recurrent goup) treated in the Second Affiliated Hospital of PLA Air Force Military Medical University Hospital from January 2019 to November 2020 were included. In the same period, 31 patients who underwent circumcision and 19 female underwent sexual organ cosmetic plastic surgery were taken as the control group, and the normal foreskin and healthy vulva were collected. The expression of HMGB1 in wart was detected by real-time quantitative polymerase chain reaction(RT-PCR), and the expression of soluble apoptosis related factor ligand (sFasL), cell lymphoma-2 gene (Bcl-2), soluble apoptosis related factor (SFAS) and Survivin, caspase-3 were detected. At the same time, serum interleukin (IL) - 6, IL-17, IL-23 and tumor necrosis factor - α (TNF- α) were detected by enzyme-linked immunosorbent assay(ELISA).Results:The expression of HMGB1 mRNA in the warts of patients in the initial group, recurrence group and control group were 1.96 ± 0.20, 1.53 ± 0.14, 1.05 ± 0.11, there was statistical difference ( F = 15.20, P<0.05) ; the expression of HMGB1 mRNA in the warts of patients in the initial group was significantly higher than that in the recurrence group and the control group ( P<0.05), and the recurrence group was also significantly higher than that in the control group ( P<0.05). The mRNA expressions of sFas, Bcl-2, sFasL and caspase-3 in the warts of patients in the initial group were significantly lower than those in the recurrence group and the control group: 0.52 ± 0.08 vs. 0.82 ± 0.16, 1.10 ± 0.19; 0.50 ± 0.05 vs. 0.79 ± 0.13, 1.08 ± 0.21; 0.47 ± 0.06 vs. 0.81 ± 0.15, 1.01 ± 0.19; 0.35 ± 0.04 vs. 0.68 ± 0.09, 0.91 ± 0.16, P<0.05; and the recurrence group were also significantly lower than those in the control group ( P<0.05). The expression of Survivin mRNA in the warts of patients in the initial group was significantly higher than those in the recurrence group and the control group: 2.14 ± 0.40 vs. 1.60 ± 0.27, 0.99 ± 0.18, P<0.05, and the recurrence group was also significantly higher than that in the control group ( P<0.05). The serum levels of TNF-α and IL-6 in the initial group were significantly lower than that in the recurrence group and the control group: (20.08 ± 1.95) μg/L vs. (26.93 ± 2.74), (37.65 ± 3.83) μg/L; (31.05 ± 3.24) μg/L vs. (38.13 ± 3.76), (45.98 ± 4.69) μg/L, P<0.05; and the recurrence group were also significantly lower than those in the control group ( P<0.05). The serum levels of IL-17 and IL-23 in the primary group were significantly higher than those in the recurrence group and the control group: (423.71 ± 28.68) ng/L vs. (384.26 ± 21.70) and (335.43 ± 19.65) ng/L; (289.50 ± 18.53) ng/L vs. (251.07 ± 15.96) and (214.67 ± 13.20) ng/L, P<0.05; and the recurrence group were also significantly higher than those in the control group ( P<0.05). The results of correlation analysis showed that the mRNA expression of HMGB1 in the warts of CA patients were negatively correlated with the mRNA expression of caspase-3, sFas, Bcl-2 and sFasL in the warts ( r = - 0.602, - 0.734, - 0.692, - 0.717, P<0.05), and was positive correlation with Survivin mRNA expression ( r = 0.645, P<0.05); and were positive correlation with the contents of IL-17 and IL-23 in serum ( r = 0.673, 0.685, P<0.05), and negatively correlated with the contents of TNF-α and IL-6 ( r = - 0.698, - 0.764, P<0.05). Conclusions:HMGB1 is obviously abnormal in the warts of patients with condyloma acuminatum, and is closely related to apoptosis, immune and inflammation-related factors, and may be jointly involved in the occurrence and recurrence of CA.

19.
Chinese Journal of Practical Nursing ; (36): 1628-1635, 2023.
Article in Chinese | WPRIM | ID: wpr-990383

ABSTRACT

Objective:To analyze the influencing factors of delayed nausea and vomiting in patients with primary liver cancer after transarterial chemoembolization based on Logistic regression model and decision tree model.Methods:This was a cross-sectional study. A total of 236 patients with primary liver cancer after transarterial chemoembolization in The Second Affiliated Hospital of Air Force Military Medical University from March 2021 to June 2022 were conveniently selected as the research subjects. The factors related to delayed nausea and vomiting were collected, and Logistic regression and decision tree models were established, respectively, and the differences between the two models were compared.Results:The incidence of delayed nausea and vomiting of patients with primary liver cancer after transarterial chemoembolization was 45.34% (107/236). Logistic regression model showed that age, anxiety, sleep disorder, emetic risk level of chemotherapeutic drugs, embolic agent type, and pain 24 hours after surgery were the influencing factors of delayed nausea and vomiting in patients with primary liver cancer after transarterial chemoembolization(all P<0.05). Decision tree model showed that age, sleep disorder, emetic risk level of chemotherapeutic drugs, embolic agent type, and pain 24 hours after surgery were the influencing factors of delayed nausea and vomiting in patients with primary liver cancer after transarterial chemoembolization (all P<0.05). The classification accuracy rates of Logistic regression, decision tree model and combined diagnosis of two models were 72.9%, 71.2% and 72.0% respectively; the areas under the ROC curve were 0.778, 0.781 and 0.806 respectively, with no significant difference (all P>0.05). Conclusions:The analysis results of Logistic regression and decision tree model on the influencing factors of delayed nausea and vomiting in patients with primary liver cancer after transarterial chemoembolization are highly consistent, which can be combined to provide a more comprehensive reference for the evaluation and intervention of medical staff.

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Chinese Journal of Emergency Medicine ; (12): 174-179, 2023.
Article in Chinese | WPRIM | ID: wpr-989796

ABSTRACT

Objective:To explore the predictive value and prognosis effect of calprotectin on acute kidney injury (AKI) in patients with sepsis.Methods:A prospective observational study was conducted. From December 2018 to November 2020, patients with sepsis admitted to the Emergency Department of China Rehabilitation Research Center were enrolled. General clinical data of patients were collected continuously, and the acute physiology and chronic health evaluationⅡ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score and calprotectin were evaluated in 24 h after admission. The patients were divided into the AKI group and non-AKI group according to the occurrence of AKI within 7 days after admission. Calprotectin level and other clinical data were compared between the two groups. Logistic regression was used to analyze the risk factors for AKI in patients with sepsis, and receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of calprotectin for AKI in patients with sepsis. The patients with AKI were further divided into the survival group and death group according to the 28-day outcome, and the calprotectin levels between the two groups were compared.Results:A total of 207 patients with sepsis were enrolled, and the incidence of AKI was 68.12% (141/207). The level of calprotectin in patients with AKI was higher than that in patients without AKI [4.65 (3.25, 5.61) μg/mL vs. 3.42 (2.29, 4.09) μg/mL, P < 0.001]. Multivariable Logistic regression analysis showed that APACHEⅡ score ( OR=1.090, 95% CI: 1.043-1.139), C-reactive protein ( OR=1.004, 95% CI: 1.001-1.008) and calprotectin ( OR=1.590, 95% CI: 1.269-1.991) were independent risk factors for AKI in patients with sepsis. The area under ROC curve (AUC) of calprotectin for predicting AKI was 0.716 (95% CI: 0.643-0.788). The cutoff value of prediction was 4.63 μg/mL with the Yoden index of 0.405, which yielded a sensitivity of 0.511 and a specificity of 0.894. When calprotectin was combined with APACHE II score and SOFA score respectively, the predictive ability was significantly improved with the AUC of 0.768 (95% CI: 0.701-0.834) and 0.769 (95% CI: 0.701-0.837), respectively. We further divided patients with AKI into the survival group and non-survival group according to the 28-day outcome and there was no significant difference in calprotectin between the two groups [4.80 (3.40, 5.76) μg/mL vs. 4.19 (2.89, 5.29) μg/mL, P < 0.05]. Conclusions:The level of calprotectin in the AKI group is higher than that in the non-AKI group. Calprotectin can be regarded as an effective predictor of AKI in patients with sepsis, and the combination with APACHEⅡ score or SOFA score will improve its predictive efficacy. However, there is no significant difference in the concentration of calprotectin for patients with sepsis associated AKI with different prognosis.

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