Recombinant Schistosoma japonicum egg ribonuclease SjCP1412 inhibits the activation of LX-2 hepatic stellate cells in vitro / 中国血吸虫病防治杂志

Objective To investigate the effect of recombinant Schistosoma japonicum egg ribonuclease SjCP1412 (rSjCP1412) on proliferation, cell cycle, apoptosis and activation of human hepatic stellate cells LX-2 in vitro, and explore the underlying mechanisms. Methods The rSjCP1412 protein was expressed in Escherichia coli BL21 by prokaryotic expression, and the highly purified soluble rSjCP1412 protein was prepared by Ni NTA affinity chromatography and urea gradient refolding dialysis. Yeast RNA was digested using 12.5, 25.0, 50.0 µg rSjCP1412 proteins at 37 °C for 2, 3, 4 h, and the enzymatic products were electrophoresed on 1.5% agarose gel to observe the RNAase activity of rSjCP1412 protein. The proliferation of LX-2 cells stimulated by different doses of rSjCP1412 protein for 48 hours was measured using CCK-8 assay, and the apoptosis of LX-2 cells stimulated by different doses of rSjCP1412 protein for 48 hours was detected using the Annexin V-FITC/PI double staining, while the percentage of LX-2 cells at G0/G1, S and G2/M phases of cell cycle following stimulation with different doses of rSjCP1412 protein for 48 h was detected by DAPI staining. The type I collagen, type III collagen and α-smooth muscle actin (α-SMA) mRNA expression was quantified using quantitative florescent real-time PCR (qPCR) assay and Western blotting at transcriptional and translational levels in LX-2 cells following stimulation with different doses of rSjCP1412 protein for 48 h, while soluble egg antigen (SEA) served a positive control and PBS without rSjCP1412 protein as a normal control in the above experiments. The expression of collagen I, α-SMA and Smad4 protein was determined using Western blotting in LX-2 cells following stimulation with rSjCP1412 protein, transforming growth factor-β1 (TGF-β1) alone or in combination, to examine the signaling for the effect of rSjCP1412 protein on LX-2 cells. Results The rSjCP1412 protein was successfully expressed and the highly purified soluble rSjCP1412 protein was prepared, which had a RNase activity. Compared with the normal group, the survival rates of LX-2 cells significantly decreased post-treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein and SEA for 48 h (F = 22.417 and 20.448, both P values < 0.05). The apoptotic rates of LX-2 cells significantly increased post-treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h (F = 11.350, P < 0.05), and treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h resulted in arrest of LX-2 cells in G0/G1 phase (F = 20.710, P < 0.05). Treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h caused a significant reduction in relative expression levels of collagen I (F = 11.340, P < 0.05), collagen III (F = 456.600, P < 0.05) and α-SMA mRNA (F = 23.100, P < 0.05) in LX-2 cells, and both rSjCP1412 protein and SEA treatment caused a significant reduction in collagen I (F = 1 302.000, P < 0.05), α-SMA (F = 49.750, P < 0.05) and Smad4 protein expression (F = 52.420, P < 0.05) in LX-2 cells. In addition, rSjCP1412 protein treatment inhibited collagen I (F = 66.290, P < 0.05), α-SMA (F = 31.300, P < 0.05) and Smad4 protein expression (F = 27.010, P < 0.05) in LX-2 cells activated by TGF-β1. Conclusion rSjCP1412 protein may induce apoptosis of LX-2 cells and inhibit proliferation, cell cycle and activation of LX-2 cells through down-regulating Smad4 signaling molecules.

Effectiveness of 13-valent pneumococcal conjugate vaccine against invasive disease caused by serotype 19A in children: a meta-analysis / 中华预防医学杂志

Objective: Using Meta-analysis to evaluate the vaccine effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13) against invasive Streptococcus pneumoniae disease (IPD) caused by serotype 19A in children <5 years old. Methods: "Streptococcus pneumoniae infection""invasive pneumococcal disease""13-valent pneumococcal polysaccharide conjugate vaccine""PCV13""effectiveness""infant""child" and related terms were searched from China National Knowledge Infrastructure (CNKI), WANFANG DATA, PubMed, SCOPUS and Web of science with no limited on language, region and research institution. The retrieval time was limited from January 2010 to February 2023 and cohort study, case-control study and randomized controlled trial were included. Data were extracted from eligible studies by two independent reviewers, and after study quality assessment by NOS scale, Meta-analysis was completed using Stata 16.0 software. Results: A total of 2 340 related literatures were searched, and 10 literatures were finally included, including 5 case-control studies and 5 indirect cohort studies, which showed good literature quality. The vaccine effectiveness against serotype 19A IPD of PCV13 in children was 83.91% (95%CI: 78.92%-88.89%), and the subgroup analysis (P=0.240) showed there was no significant difference among the case-control study (VE=87.34%, 95%CI:79.74%-94.94%) and the indirect cohort study (VE=81.30%, 95%CI:74.69%-87.92%). The funnel plot and Egger test suggested that the possibility of publication bias was small. Conclusion: The present evidence indicates that PCV13 has a good vaccine effectiveness against serotype 19A IPD in children, and it is recommended to further increase the vaccination rate of PCV13 to reduce the disease burden of IPD in children <5 years old.

Effectiveness of 13-valent pneumococcal conjugate vaccine against invasive disease caused by serotype 19A in children: a meta-analysis / 中华预防医学杂志

Objective: Using Meta-analysis to evaluate the vaccine effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13) against invasive Streptococcus pneumoniae disease (IPD) caused by serotype 19A in children <5 years old. Methods: "Streptococcus pneumoniae infection""invasive pneumococcal disease""13-valent pneumococcal polysaccharide conjugate vaccine""PCV13""effectiveness""infant""child" and related terms were searched from China National Knowledge Infrastructure (CNKI), WANFANG DATA, PubMed, SCOPUS and Web of science with no limited on language, region and research institution. The retrieval time was limited from January 2010 to February 2023 and cohort study, case-control study and randomized controlled trial were included. Data were extracted from eligible studies by two independent reviewers, and after study quality assessment by NOS scale, Meta-analysis was completed using Stata 16.0 software. Results: A total of 2 340 related literatures were searched, and 10 literatures were finally included, including 5 case-control studies and 5 indirect cohort studies, which showed good literature quality. The vaccine effectiveness against serotype 19A IPD of PCV13 in children was 83.91% (95%CI: 78.92%-88.89%), and the subgroup analysis (P=0.240) showed there was no significant difference among the case-control study (VE=87.34%, 95%CI:79.74%-94.94%) and the indirect cohort study (VE=81.30%, 95%CI:74.69%-87.92%). The funnel plot and Egger test suggested that the possibility of publication bias was small. Conclusion: The present evidence indicates that PCV13 has a good vaccine effectiveness against serotype 19A IPD in children, and it is recommended to further increase the vaccination rate of PCV13 to reduce the disease burden of IPD in children <5 years old.

Anthraquinone modifier KA-4c triggers endoplasmic reticulum stress and targets ATF6 against breast cancer cells / 中国药理学通报

Aim To explore the mechanism of the effect of anthraquinone modifier KA-4c on breast cancer cells, and determine its action target by drug affinity reaction target stability technique (DARTS). Methods The cell viability was detected by MTT method. The effect of KA-4c on the morphology of breast cancer cells was studied by HE staining, ER-Tracker Red and electron microscope. The apoptosis rate of breast cancer cells induced by KA-4c was detected by flow cytometry. The expression of apoptotic protein was detected by Western blotting. DARTS and CETSA were used to determine the target of KA-4c. Results KA-4c had the most significant inhibitory effect on the proliferation of triple negative breast cancer MDA-MB231 cells, and could cause endoplasmic reticulum and mitochondrial vacuolation to damage the cells. The apoptosis rate and the expression of apoptosis-related proteins CHOP and caspase-7 increased with the increase of KA-4c concentration. DARTS results showed that KA-4c could activate endoplasmic reticulum protein processing signaling pathway, in which KA-4c bound to ATF6 protein and was resistant to protease hydrolysis. The results of CETSA experiments showed that KA-4c could enhance the expression of ATF6 protein in a concentration-dependent manner. Conclusions KA-4 triggers endoplasmic reticulum stress to induce apoptosis in breast cancer cells. ATF6 may be one of the targets of KA-4c.

Research progress on the incidence and economic burden of herpes zoster disease in immunocompromised population / 中华预防医学杂志

With the increase of age or the impairment of immune function, the specific cellular immune level against varicella zoster virus (VZV) in the body decreases, and the latent VZV in the ganglion can be reactivated to cause herpes zoster (HZ). HZ and its main complication postherpetic neuralgia (PHN) can seriously affect the quality of life of patients. The immunocompromised (IC) population is more prone to HZ than the immunocompetent population due to diseases and therapeutic drugs. This paper reviews the incidence, risk factor and economic burden of HZ in IC population with special health status, to provide ideas for research and adjustment of immunization strategies in the future.

Effects of a simulation-based blended training model on nurses’ treatment decision-related knowledge about oral cancer in Taiwan: a pilot survey / 보건의료교육평가

The present study aimed to evaluate the effects of virtual reality (VR) simulations combined with bedside assignments on nurses’ self-efficacy in providing pre-treatment educational services. Between March 2019 and November 2020, we conducted a study of VR educational materials that were developed to cover information about the treatment of oral cancers. The effects of the VR simulation, the thinking-path tracking map method, and bedside assignments on the nurses’ treatment decision-related knowledge were evaluated in a ward for oral cancer patients at Taipei Veterans General Hospital, Taipei, Taiwan. The blended training model significantly increased nurses’ familiarity (P<0.01) and confidence (P<0.03) regarding their knowledge of treatments and treatment decision-related knowledge. This model also significantly increased their confidence in their skills in bedside pre-treatment education for admitted oral cancer patients (P<0.002). Oral cancer-specific VR materials enhanced the effectiveness of skills training among nurses in the oral cancer ward.

Effects of a simulation-based blended training model on nurses’ treatment decision-related knowledge about oral cancer in Taiwan: a pilot survey / 보건의료교육평가

The present study aimed to evaluate the effects of virtual reality (VR) simulations combined with bedside assignments on nurses’ self-efficacy in providing pre-treatment educational services. Between March 2019 and November 2020, we conducted a study of VR educational materials that were developed to cover information about the treatment of oral cancers. The effects of the VR simulation, the thinking-path tracking map method, and bedside assignments on the nurses’ treatment decision-related knowledge were evaluated in a ward for oral cancer patients at Taipei Veterans General Hospital, Taipei, Taiwan. The blended training model significantly increased nurses’ familiarity (P<0.01) and confidence (P<0.03) regarding their knowledge of treatments and treatment decision-related knowledge. This model also significantly increased their confidence in their skills in bedside pre-treatment education for admitted oral cancer patients (P<0.002). Oral cancer-specific VR materials enhanced the effectiveness of skills training among nurses in the oral cancer ward.

Application Value of Transrectal Shear Wave Elastography Mode Combined with Elastic Modulus in the Diagnosis of Prostate Cancer / 中国医学科学院学报

To explore the value of trans-rectal shear wave elastic mode combined with elastic modulus in the diagnosis of prostate cancer and establish a new method for the evaluation of prostate with trans-rectal shear wave elastography(SWE). The typical findings of trans-rectal ultrasound(US)and SWE in 79 patients with prostate cancer(=41)and benign prostatic hyperplasia(BPH)(=38)confirmed by surgery or US-guided biopsy were analyzed retrospectively.Their diagnostic value were evaluated with the pathological results as the golden standards. Three or more malignant features detected by conventional trans-rectal US(=42.5,<0.001)and asymmetrical SWE mode(=54.2,<0.001)showed statistically significant difference in prostate cancer and BPH groups.The elastic modulus of Emean and Emax in the prostate cancer group were(92.8±21.5)and(114.2±29.8)kPa,which were significantly higher than those in the BPH group [(56.7±14.0)(=-8.8,<0.001)and(68.4±17.2)kPa(=-8.3,<0.001)].The receiver-operating characteristic(ROC)curve with Logistic regression showed that the elastic model combined elastic modulus had the largest area under ROC curve and the highest diagnosis efficiency of prostate cancer,with the cutoff value of 0.45.The diagnosis sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of the combination were 95.1%,89.5%,90.7%,94.4%,and 92.4%,respectively. Combination of SWE mode and elastic modulus is more valuable than elastic modulus alone in the diagnosis of prostate cancer.

Public practice，attitude and knowledge of coronavirus disease / 热带医学杂志

@#Objective To analyze the status of knowledge，attitude and practice of the coronavirus disease（COVID ⁃19）among the adults of 18⁃59 years old in China，and to provide scientific basis for corresponding health education strategies. Methods In the rapid development phrase of COVID ⁃ 19，subjects from all provinces or municipalities of China were invited to participate in a quick questionnaire online survey on January 29th，2020. Results The effective response rate of completing questionnaire was 97.41%（3 083/3 165）. 98.54% of the subjects reported that they were very terrified. The main reasons included the high contagion（64.71%）and lack of effective treatments（19.92%）；94.45% of the subjects were concerned that they and their family members would be infected by the novel coronavirus. 99.42% knew that the virus could be transmitted from person to person；97.89% and 93.87% knew that it could spread through respiratory tract and contact respectively，97.73% knew that patients without symptom could also be contagious，96.37% knew that persons in close contact to COVID⁃19 patient were required to be quarantined for at least 14 days of medical observation. 99.09% knew that the pathogen of this disease was novel coronavirus. 65.46% knew that both medical protective masks and surgical masks could prevent COVID⁃19 effectively. 99.68% had confidence in defeating COVID⁃19，and 85.86% believed that COVID⁃19 would be controlled within the next 3 months. Study subjects mainly obtained health information through WeChat（88.97%）or websites（82.06%）. The proportions of the subjects who can cover mouth and nose when coughing or sneezing，avoid hand contacting with eyes，mouth or nose，practice hand hygiene，wear masks outside，avoid exposure to respiratory patients，and avoid the crowded were 89.85%，85.44%，95.13%，96.89%，92.18% and 96.27%，respectively. Multivariate Logistic analysis showed that gender（OR=0.544，95%CI：0.440⁃0.673，P<0.001），age（OR=1.844，95%CI：1.466⁃2.320，P<0.001），recognition （OR=2.200，95% CI：1.780 ⁃ 2.718，P<0.001） were associated with those good behaviors. Conclusion After the happened，the government and society′s vigorous publicity to the public achieved good results. The public are highly concerned and have a high awareness of the knowledge of COVID ⁃ 19. They adopt protective measures proactively. Females，middle⁃aged，and individuals with insufficient recognition are likely under⁃protected. In the different epidemic stages of the emerging infectious disease，health education should be carried out to the public based on scientific evidences.

Effects of virtual reality training on decreasing the rates of needlestick or sharp injury in new-coming medical and nursing interns in Taiwan / 보건의료교육평가

Purpose@#Senior nursing and medical interns’ lack of familiarity and confidence with respect to practicing universal precaution for the prevention of occupational needlestick or sharp injuries may harm themselves. Trainees’ self-reported needlestick or sharp injury rate was known to be especially high during the first 2 months of internship in Taiwan. This prospective cohort study aimed to assess the effect of newly developed virtual reality (VR) game, which uses Gagne’s learning model to improve universal precaution for needlestick or sharp injury prevention and decrease the rates of needle stick or sharp injuries in new-coming medical and nursing interns in Taiwan. @*Methods@#From 2017 to 2019, the VR system was developed and applied in training of 59 new-coming nursing and 50 medical interns. Occupational needlestick or sharp injury prevention was sought to be achieved through a game of right and wrong choices for safe or unsafe universal precaution behaviors. @*Results@#In comparison with medical interns, a higher proportion of nursing interns had past experiences of deep occupational needlestick or sharp injury. Before VR training, the familiarity and confidence for needlestick or sharp injury prevention were higher among nursing interns than medical interns. Trainees with past experiences of deep needlestick or sharp injury exhibited better performance on the accuracy rate and time needed to complete 20 decisions than those without past experiences in VR practice. All trainees showed an improved performance after VR training. A high proportion of trainees reported that the VR-based training significantly decreased their anxiety about needlestick or sharp injury prevention. @*Conclusion@#This self-developed VR game system using Gagne’s flow improved universal precaution for needlestick or sharp injury prevention and reduced the needlestick or sharp injury rates in the first 2 months of nursing and medical internship.

An expert-led and artificial intelligence system-assisted tutoring course to improve the confidence of Chinese medical interns in suturing and ligature skills: a prospective pilot study / 보건의료교육평가

PURPOSE@#Lack of confidence in suturing/ligature skills due to insufficient practice and assessments is common among novice Chinese medical interns. This study aimed to improve the skill acquisition of medical interns through a new intervention program.@*METHODS@#In addition to regular clinical training, expert-led or expert-led plus artificial intelligence (AI) system tutoring courses were implemented during the first 2 weeks of the surgical block. Interns could voluntarily join the regular (no additional tutoring), expert-led tutoring, or expert-led+AI tutoring groups freely. In the regular group, interns (n=25) did not receive additional tutoring. The expert-led group received 3-hour expert-led tutoring and in-training formative assessments after 2 practice sessions. After a similar expert-led course, the expert-led+AI group (n=23) practiced and assessed their skills on an AI system. Through a comparison with the internal standard, the system automatically recorded and evaluated every intern's suturing/ligature skills. In the expert-led+AI group, performance and confidence were compared between interns who participated in 1, 2, or 3 AI practice sessions.@*RESULTS@#The end-of-surgical block objective structured clinical examination (OSCE) performance and self-assessed confidence in suturing/ligature skills were highest in the expert-led+AI group. In comparison with the expert-led group, the expert-led+AI group showed similar performance in the in-training assessment and greater improvement in the end-of-surgical block OSCE. In the expert-led+AI group, the best performance and highest post-OSCE confidence were noted in those who engaged in 3 AI practice sessions.@*CONCLUSION@#This pilot study demonstrated the potential value of incorporating an additional expert-led+AI system–assisted tutoring course into the regular surgical curriculum.

Roles of transforming growth factor - β1 and heat shock protein 47 in progression of Schistosoma japonicum-induced hepatic fibrosis / 中国血吸虫病防治杂志

Objective To investigate the dynamic expression of transforming growth factor-β1 (TGF-β1) and heat shock protein 47 (HSP47) and explore their roles in the progression of hepatic fibrosis induced by Schistosoma japonicum infection. Methods Fifty female mice of the ICR strain were randomly divided into the infection group and the normal control group, of 25 mice in each group. Each mouse in the infection group was infected with 20 ± 1 cercariae of S. japonicum via the abdominal skin, while uninfected animals served as normal control. Five mice were sacrificed 4, 6, 8, 10 and 12 weeks post-infection and liver tissues were sampled. Serum HSP47 and TGF-β1 was determined using enzyme-linked immunosorbent assay (ELISA), and the pathological changes of liver specimens were observed with hematoxylin & eosin (HE) staining. In addition, the synthesis of alpha 1 chain of type I collagen (COL1A1) was measured using Masson staining, and the mRNA expression of TGF-β1, HSP47 and COL1A1 was determined using real-time fluorescent quantitative PCR (qPCR) assay. Results During the period of S. japonicum-induced hepatic fibrosis, the serum HSP47 and TGF-β1 levels and the mRNA expression of TGF - β1, HSP47 and COL1A1 gradually increased with the progression of hepatic fibrosis. The serum levels of HSP47 and TGF-β1 were (179.26 ± 29.87) pg/mL and (22.37 ± 5.21) ng/mL 6 weeks post-infection, respectively, which were significantly greater than those [(150.29 ± 34.91) pg/mL and (18.54 ± 7.78) ng/mL, respectively] in the normal control group (both P values < 0.05). In addition, the mRNA expression of HSP47, COL1A1 and TGF-β1 was (0.86 ± 0.04), (1.17 ± 0.06) and (0.64 ± 0.13) in mouse liver specimens, which was significantly higher than that (0.23 ± 0.03, 0.20 ± 0.02 and 0.38 ± 0.02) in the normal control group (all P values < 0.01). Conclusions The expression of TGF-β1 and HSP47 during the period of S. japonicum-induced hepatic fibrosis is consistent with the progression of the hepatic fibrosis, and exhibits the same tendency with type I collagen expression. HSP47 is a novel promising diagnosis marker and therapeutic target for S. japonicum-induced hepatic fibrosis.

Dreyfus scale-based feedback increased medical students’ satisfaction with the complex cluster part of a interviewing and physical examination course and improved skills readiness in Taiwan / 보건의료교육평가

Purpose@#In contrast to the core part of the clinical interviewing and physical examination (PE) skills course, corresponding to the basic, head-to-toe, and thoracic systems, learners need structured feedback in the cluster part of the course, which includes the abdominal, neuromuscular, and musculoskeletal systems. This study evaluated the effects of using Dreyfus scale-based feedback, which has elements of continuous professional development, instead of Likert scale-based feedback in the cluster part of training in Taiwan. @*Methods@#Instructors and final-year medical students in the 2015–2016 classes of National Yang-Ming University, Taiwan comprised the regular cohort, whereas those in the 2017–2018 classes formed the intervention cohort. In the intervention cohort, Dreyfus scale-based feedback, rather than Likert scale-based feedback, was used in the cluster part of the course. @*Results@#In the cluster part of the course in the regular cohort, pre-trained standardized patients rated the class climate as poor, and students expressed low satisfaction with the instructors and course and low self-assessed readiness. In comparison with the regular cohort, improved end-of-course group objective structured clinical examination scores after the cluster part were noted in the intervention cohort. In other words, the implementation of Dreyfus scale-based feedback in the intervention cohort for the cluster part improved the deficit in this section of the course. @*Conclusion@#The implementation of Dreyfus scale-based feedback helped instructors to create a good class climate in the cluster part of the clinical interviewing and PE skills course. Simultaneously, this new intervention achieved the goal of promoting medical students’ readiness for interviewing, PE, and self-directed learning.

Roles of transforming growth factor - β1 and heat shock protein 47 in progression of Schistosoma japonicum-induced hepatic fibrosis / 中国血吸虫病防治杂志

Objective To investigate the dynamic expression of transforming growth factor-β1 (TGF-β1) and heat shock protein 47 (HSP47) and explore their roles in the progression of hepatic fibrosis induced by Schistosoma japonicum infection. Methods Fifty female mice of the ICR strain were randomly divided into the infection group and the normal control group, of 25 mice in each group. Each mouse in the infection group was infected with 20 ± 1 cercariae of S. japonicum via the abdominal skin, while uninfected animals served as normal control. Five mice were sacrificed 4, 6, 8, 10 and 12 weeks post-infection and liver tissues were sampled. Serum HSP47 and TGF-β1 was determined using enzyme-linked immunosorbent assay (ELISA), and the pathological changes of liver specimens were observed with hematoxylin & eosin (HE) staining. In addition, the synthesis of alpha 1 chain of type I collagen (COL1A1) was measured using Masson staining, and the mRNA expression of TGF-β1, HSP47 and COL1A1 was determined using real-time fluorescent quantitative PCR (qPCR) assay. Results During the period of S. japonicum-induced hepatic fibrosis, the serum HSP47 and TGF-β1 levels and the mRNA expression of TGF - β1, HSP47 and COL1A1 gradually increased with the progression of hepatic fibrosis. The serum levels of HSP47 and TGF-β1 were (179.26 ± 29.87) pg/mL and (22.37 ± 5.21) ng/mL 6 weeks post-infection, respectively, which were significantly greater than those [(150.29 ± 34.91) pg/mL and (18.54 ± 7.78) ng/mL, respectively] in the normal control group (both P values < 0.05). In addition, the mRNA expression of HSP47, COL1A1 and TGF-β1 was (0.86 ± 0.04), (1.17 ± 0.06) and (0.64 ± 0.13) in mouse liver specimens, which was significantly higher than that (0.23 ± 0.03, 0.20 ± 0.02 and 0.38 ± 0.02) in the normal control group (all P values < 0.01). Conclusions The expression of TGF-β1 and HSP47 during the period of S. japonicum-induced hepatic fibrosis is consistent with the progression of the hepatic fibrosis, and exhibits the same tendency with type I collagen expression. HSP47 is a novel promising diagnosis marker and therapeutic target for S. japonicum-induced hepatic fibrosis.

An expert-led and artificial intelligence system-assisted tutoring course to improve the confidence of Chinese medical interns in suturing and ligature skills: a prospective pilot study / 보건의료교육평가

PURPOSE: Lack of confidence in suturing/ligature skills due to insufficient practice and assessments is common among novice Chinese medical interns. This study aimed to improve the skill acquisition of medical interns through a new intervention program. METHODS: In addition to regular clinical training, expert-led or expert-led plus artificial intelligence (AI) system tutoring courses were implemented during the first 2 weeks of the surgical block. Interns could voluntarily join the regular (no additional tutoring), expert-led tutoring, or expert-led+AI tutoring groups freely. In the regular group, interns (n=25) did not receive additional tutoring. The expert-led group received 3-hour expert-led tutoring and in-training formative assessments after 2 practice sessions. After a similar expert-led course, the expert-led+AI group (n=23) practiced and assessed their skills on an AI system. Through a comparison with the internal standard, the system automatically recorded and evaluated every intern's suturing/ligature skills. In the expert-led+AI group, performance and confidence were compared between interns who participated in 1, 2, or 3 AI practice sessions. RESULTS: The end-of-surgical block objective structured clinical examination (OSCE) performance and self-assessed confidence in suturing/ligature skills were highest in the expert-led+AI group. In comparison with the expert-led group, the expert-led+AI group showed similar performance in the in-training assessment and greater improvement in the end-of-surgical block OSCE. In the expert-led+AI group, the best performance and highest post-OSCE confidence were noted in those who engaged in 3 AI practice sessions. CONCLUSION: This pilot study demonstrated the potential value of incorporating an additional expert-led+AI system–assisted tutoring course into the regular surgical curriculum.

Clinical efficacy of visual function training in the late stage of ametropic amblyopia treatment / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the clinical efficacy of visual function training in the late stage of ametropic amblyopia treatment. <p>METHODS: One hundred and twenty two children patients and 244 eyes with ametropic amblyopia, which were ranged from January 2016 to December 2016, were enrolled in the prospective case control study. Patient inclusion criteria: spherical power≤ ±3.00D, absolute value of astigmatism(hereinafter referred to as the degree of astigmatism)≥2.00D, binocular spherical lens difference ≤1.50D, binocular cylinder difference ≤1.00D. All patients received preliminary treatment. After routine optometry and amblyopia treatment, visual acuity in amblyopic eyes improved to more than 0.6 and visual acuity difference between two eyes should be less than 2 lines in visual chart testing. Enrolled patients were randomly assigned into a training group(62 cases 124 eyes)and a control group(60 cases 120 eyes). All patients had routine glasses with a combination of both family and clinic training. Treatments in the control group included: amblyopia training instrument(light brush, red flash and grating etc.)and fine stimulation training through computer software. In addition to similar treatments in control group, patients in training group also received following treatments including monocular adjustment function training, binocular adjustment function training, binocular integration and fusion function training. After 6mo, visual acuity, near stereopsis, adjustment amplitude, adjustment sensitivity and adjustment response tests were compared and statistically analyzed in patients of both control and training groups. <p>RESULTS: Our data demonstrated that the overall visual acuity was significantly improved in training group(<i>P</i><0.05). Additionally, results of near stereopsis function, adjustment amplitude, adjustment sensitivity and adjustment response examination, also displayed significant difference between the two groups(<i>P</i><0.05). <p>CONCLUSION: Binocular visual function training has a certain effect in the improvement of successful cure rate, shortening treatment course and establishing a sound stereo vision function in the late stage of children patients receiving a comprehensive therapy.

Clinical efficacy of disinhibition and visual function training in children patients with anisometropic amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the clinical efficacy of treatment <i>via</i> disinhibition and visual function training in children patients with anisometropic amblyopia. <p>METHODS: Eighty-three children patients with anisometropic amblyopia were enrolled in the prospective case control study. All patients were monocular amblyopia, which were randomly classified into 2 groups as a training group(44 cases)and a control group(39 cases). All patients had routine glasses and quantitative coverage, and were treated by the combination of both family and clinic training. Patients in both control and training groups were treated by amblyopia training instrument(light brush, red flash, grating, etc.)and fine stimulation training <i>via</i> computer software. Additionally, patients in the training group, whose corrected vision improved more than 0.6, were also exposed to other treatments including monocular adjustment function training, disinhibition training, binocular adjustment function training, binocular integration and fusion function training. Visual acuity and outcomes were statistically analyzed after 6mo. <p>RESULTS: No significant difference in the total effective rate of vision improvement between the two groups. However, the overall visual acuity difference between the two groups was statistically significant(<i>P</i><0.05). After disinhibition and visual function training, the number of patients with improvement in both far and near stereopsis in the training group was significantly greater than that in the control group(<i>P</i><0.05). <p>CONCLUSION: Combinational treatment with disinhibition and binocular visual function training enhances the competitiveness of amblyopic eyes and eliminate inhibition, which is accompanied by improved visual acuity and ameliorated visual function in children patients with anisometropic amblyopia.

Content design and development model of medical microlecture platform based on Internet / 基础医学与临床

Microlectures have great advantages in improving the enthusiasm of medical students in self -learning be-cause of its short period and brief content,breaking through the limitations of time and space and realizing the share of educational resources.WeChat, QQ, Weibo and other communication software make daily use of micro-course possible in the education.This paper presents the content design and development model of electronic medical mi -cro-course platform,providing a theoretical basis and a model reference for the construction of electronic platform.

Correlation of the Serum bFGF Level with MDS Typing, Serum IL-32 Level and Prognosis / 中国实验血液学杂志

OBJECTIVE@#To investigate the correlation of serum bFGF level with MDS typing, serum IL-32 and prognosis.@*METHODS@#A total of 62 patients with myelodysplastic syndromes admitted in our hospital from April of 2014 to April of 2017 were enrolled in MDS group. And 50 healthy people who received healthy physical examination in our hospital were selected as the control group at the same period. According to the type of disease, the MDS group was divided into 4 subgroups: A, B, C, D. the serum levels of bFGF, and IL-32 were detected, and the prognosis of patients with different MDS types was evaluated.@*RESULTS@#The serum levels of bFGF and IL-32 in 4 subgroups of MDS were higher than those in the control group (P0.05), and the serum levels bFGF and IL-32 also was no significantly different between subgroup C and D (P>0.05), but the serum levels of bFGF and IL-32 in subgroup C and D were significantly higher than those in subgroup A and B (P0.05),but significantly higher than that in the other 2 subgroups (P<0.05).@*CONCLUSION@#The serum levels of bFGF and IL-32 in MDS patients were significantly higher than that in the normal controls, while the serum levels of bFGF and IL-32 in RAEB and RAEB-t subtypes were significantly higher than that in RA and RAS. The changes of serum bFGF and IL-32 levels are positively correlative.

Effects of corrective surgery on the ocular surface and refractive in children with congenital ptosis / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate the ocular surface and refractive change after the surgery of levator resection and frontalis suspension. ·METHODS:One hundred and twenty-one patients (146 eyes) for corrective surgery of congenital ptosis were selected in our department from July 2014 to June 2016. According to the severity of congenital ptosis, all the children divided into mild group (47 eyes), moderate group (68 eyes) and severe group(31 eyes). All the children were divided into group of less than 5 years old (104 eyes) and group of more than or equal to 5 years old (42 eyes) according to the age. According to the surgical approach, all the children divided into group of levator resection (62 eyes) and group of frontalis suspension(84 eyes). The effects of the two surgeries on the ocular surface and refractive were compared. The relationship between age, severity of postoperative ptosis and postoperative ocular surface, refractive of children were analyzed. ·RESULTS: There were no significant differences in break-up time (BUT), keratometry (Km) and corneal astigmatism (Ast) in the levator resection group and frontalis suspension group (P > 0. 05). There was significant difference between the mild, moderate and severe group on the proportion of excellent corrected to uncorrected (Z=-2.936, P=0.003). The proportion of excellent correction in mild group was higher than that of moderate and severe group(93.6%, 83.8% and 67.7%). The indexes of BUT (F=9.793, P=0.041) and Km (F=11.657,P=0.037) in the three groups decreased with the increase of severity. While the Ast (F=28.417, P<0.01) showed an increasing trend, the difference was significant. In addition, the proportion of excellent correction in <5 year old group was significantly more than≥5 years old group(x2=4.082,P=0.043). The index of Km (t= 2.813, P= 0.006) was higher and Ast (t=-7.741, P<0.01) was lower in the <5 year old group. There was no significant difference in the index of BUT between the two groups after surgery (P>0.05). · CONCLUSION: The corneal refractive power and astigmatism can be improved similarly after treated with levator resection and frontalis suspension surgery. And there is some damage of corneal epithelial in the initial postoperation, but the function of ocular surface can return to normal after a period of time. The less severity of ptosis before surgery,the better improvement of ocular surface and refractive after sugery. There is no correlation between the age and postoperative ocular surface, but earlier surgical treatment may improve the children's refractive power and astigmatism and achieve greater benefits.