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As excellent demonstration courses with distinctive teaching characteristics and the first-class teaching level, quality courses can improve the quality and effects of standardized training. Based on years of experience in teaching and training and focusing on the problems in standardized training, we have established a series of quality courses, including targeted short video lessons for systematic and comprehensive learning and module-based training, flipped classroom teaching based on case analysis, and real-time remote teaching and online teaching under the background of "Internet Plus". These courses aim at strengthening students' theoretical basis and practical ability and building their clinical thinking, so as to improve teaching effects and training quality.
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ObjectiveTo describe the characteristics of treatment outcomes of multidrug-resistant tuberculosis (MDR-TB) patients enrolled in second-line treatment in Shanghai from 2017 to 2018, and to analyze the influencing factors of treatment outcomes. MethodsTotally 182 MDR-TB patients were analyzed by using data collected from the China tuberculosis management information system, the hospital's electronic medical record information system, whole genome sequencing results and a questionnaire survey, and logistic regression analysis was used to analyze the factors affecting the success of treatment. ResultsIn 182 MDR-TB patients, the success rate of treatment was 65.4%, the loss to follow-up rate was 8.2%, the mortality rate was 4.9%, the unassessable rate was 13.7%, and the drug withdrawal rate was 7.7%. The factors affecting the success of treatment in MDR-TB patients included age (35‒ years old, OR=5.28, 95%CI: 1.58‒17.59, P=0.007; 55‒ years old, OR=16.30, 95%CI: 4.36‒60.92, P<0.001) and compliance to medication (OR=0.55, 95%CI: 0.42‒0.72, P<0.001). ConclusionThe treatment success rate of MDR-TB patients in Shanghai from 2017 to 2018 is significantly higher than the average level in China. Older patients and patients with less compliant are at higher risk of adverse treatment outcomes.
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Objective:To investigate the relationship between triglyceride glucos (TyG), C-reaction protein/albumin (CRP/Alb), 25-hydroxy vitamin D[25(OH)D] and the prognosis of patients with continous ambulatory peritoneal dialysis (CAPD).Methods:A total of 220 CAPD patients in the Affiliated Hospital of Jining Medical University from January 2017 to March 2020 were prospectively selected and divided into death group and survival group according to the 6-month prognosis. The peritoneal urea clearance index (Kt/V urea), TyG, CRP/Alb, 25(OH)D were compared between the two groups. Logistic regression was used to analyze the prognostic factors of CAPD patients. The predictive value of TyG, CRP/Alb and 25(OH)D on the prognosis of CAPD patients was analyzed by receiver operating characteristic (ROC) curve. Results:After 3 months and 6 months of dialysis, the peritoneal Kt/V urea in the death group [(1.21±0.18)ml/(s·1.73 m 2), (1.02±0.14)ml/(s·1.73 m 2)] was significantly lower than that in the survival group [(1.57±0.40)ml/(s·1.73 m 2), (1.49±0.42)ml/(s·1.73 m 2)] (all P<0.05). After 3 months and 6 months of dialysis, the TyG [(8.79±0.86), (9.24±1.03)] and CRP/Alb [(4.98±0.94)×10 -4, (5.14±1.39)×10 -4] in the death group were higher than those in the survival group [(8.03±0.60), (7.26±0.93), (3.57±1.19)×10 -4, (3.07±0.88)×10 -4], while the 25(OH)D [(19.14±2.29)ng/ml, (17.79±3.17)ng/ml] was lower than that of survival group [(22.67±3.03)ng/ml, (24.31±2.51)ng/ml] (all P<0.05). TyG and CRP/Alb at 3 months and 6 months of dialysis were negatively correlated with Kt/V urea, while the 25(OH)D was positively correlated with Kt/V urea (all P<0.05). Logistic regression analysis showed that Kt/Vurea, TyG, CRP/Alb and 25(OH)D were associated with prognosis in the two groups after 3 and 6 months of dialysis (all P<0.05). The AUC of TyG, CRP/Alb and 25(OH)D at 6 months of dialysis combined to predict the prognosis of CAPD patients was the highest, which was 0.911. Conclusions:TyG, CRP/Alb and 25(OH)D are associated with all-cause mortality in CAPD patients. High TyG and CRP/Alb and low 25(OH)D suggest a higher risk of all-cause mortality. Combined detection of all indicators can effectively predict the prognosis of CAPD, which is convenient for early clinical intervention.
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Objective:To examine the correlations of microRNA-34c(miR-34c) expression in the peripheral blood with the onset of diabetic foot ulcer(DFU)and diabetic foot osteomyelitis(DFO)in patients with type 2 diabetes mellitus(T2DM).Methods:Sixty newly-diagnosed T2DM patients without DFU(T2DM group), 112 T2DM patients with DFU(DFU group), and 60 healthy controls with normal glucose tolerance(NC group)were included. The 112 T2DM patients with DFU were further divided into DFO( n=64)and NDFO( n=48)groups. The levels of miR-34c were determined by quantitative real-time PCR, while clinical features and risk factors of DFU and DFO were explored. Results:A significant increase in the expression level of miR-34c in peripheral blood was observed in T2DM group compared with NC group[2.99(1.45-6.22) vs 1.01(0.89-1.52), P<0.05], and a markedly increased miR-34c expression level was noted in DFU group compared with T2DM group [9.65(6.15-18.63) vs 2.99(1.45-6.22), P<0.01]. Additionally, the expression level of miR-34c in peripheral blood significantly increased in DFO group compared to NDFO group [13.46(8.89-19.11) vs 6.02(5.93-14.72), P<0.01]. Moreover, there was a positive correlation between the expression level of miR-34c in peripheral blood and the amputation rate in patients in DFU group( P=0.030), and a negative correlation in the expression level of miR-34c( P=0.025)with healing rate of DFU after eight weeks. The multivariate logistic regression analysis confirmed that a high expression of miR-34c was an independent risk factor for DFU and DFO( OR=3.52, 4.13; both P<0.01). Conclusion:An increased expression of miR-34c in peripheral blood of T2DM patients might be closely related to the occurrence, development, and prognosis of DFU and DFO.
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The application of antiglaucoma drugs is the main treatment for glaucoma,but there are differences in the response of patients to antiglaucoma drugs.Different races have different reactivities to prostaglandins;the same patient may has different reactivity to different prostaglandins;with the prolonged use of prostaglandins,the status of some patients have changed from being unresponsive to being reactive.The reasons for individual difference of drug response are complex.Drug receptor and metabolism gene polymorphisms are deemed as the cause of individual difference.Studying the relationship between drug responses and gene differences can realize individual therapy.This review summarized the response to antiglaucoma drugs and influence factors leading to individual difference of drug response,which may provide help for clinical individualized and precise treatment.
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In this study, HRP or FeCl3were used as the catalysts in MTT, TMB and Mino reaction system, the effects of carnosine on the oxidation reaction were evaluated respectively. Indeed, carnosine was a pro-oxidant in luminol reaction, however an anti-oxidant in MTT assay. Once TMB was its substrate, carnosine was neutral in oxi-dation. Thus, it is supposed that the oxidative property of carnosine depends on the substrates.
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The application of antiglaucoma drugs is the main treatment for glaucoma,but there are differences in the response of patients to antiglaucoma drugs. Different races have different reactivities to prostaglandins;the same patient may has different reactivity to different prostaglandins;with the prolonged use of prostaglandins,the status of some patients have changed from being unresponsive to being reactive. The reasons for individual difference of drug response are complex. Drug receptor and metabolism gene polymorphisms are deemed as the cause of individual difference. Studying the relationship between drug responses and gene differences can realize individual therapy. This review summarized the response to antiglaucoma drugs and influence factors leading to individual difference of drug response,which may provide help for clinical individualized and precise treatment.
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Objective To investigate the pathogenesis,diagnosis,treatment and prognosis of aort-oesophageal fistula(AEF).Methods Retropective analysis was performed on 6 patients presenting with AEF between January 2002 and December 2014,and relative literature was reviewed on its pathogenesis,di-agnosis,prognosis and treatment.Results Five men and 1 woman with a mean age of 49 (range,27-71 years)were recruited to the study.One case of AEF was caused by esophageal foreign body,2 cases were caused by aneurysm while the other 3 patients presented AEF after aortic surgery.All 6 patients showed he-matemesis,among whom 3 presented sentinel hemorrhage,1 presented exsanguination after sentinel hemor-rhage,2 presented sudden exsanguination.Among 4 patients with sentinel hemorrhage,2 accompanied with chest pain,1 with dysphagia and 1 with fever.Two patients had a history of hypertension.Diagnostic rate was nearly 100% by gastroscopy or CT/CTA.Four patients died from hemorrhagic shock and 2 patients re-covered from surgery.Conclusion AEF should be seriously considered for patients with a history of hyper-tension,aortic disease or esophageal foreign body presenting sentinel hemorrhage,chest pain,dysphagia,fa-tal exsanguination followed by symptom-free interval.Prompt examinations and aggressive surgery are of great significance for survival.
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BACKGROUND:With the deepen understanding on the biological function of Rho/ROCK pathway, new ROCK inhibitors continue to be discovered, and ROCK inhibitors show good promoting effects on the survival, proliferation and migration of keratocytes. Research on ROCK inhibitors wil provide more donor materials or seed cels for regenerative medicine and clinical cel transplantation. OBJECTIVE:To summarize and explore the progress in the treatment and application of corneal disease using the ROCK inhibitors Y-27632 and Y-39983. METHODS:The PubMed database and CNKI database were retrieved by computer to search the relevant literature published between 2008 to 2015 using the key words of “corneal endothelial cel, corneal epithelial cel, ROCK inhibitor, Y-39983, Y-27632” in English and Chinese, respectively. Relevant articles in line with the theme were screened and analyzed. RESULTS AND CONCLUSION:Totaly 264 papers were initialy searched. At last, 45 papers were selected. Currently there are two main ROCK inhibitors: Y-27632 and Y-39983, but both of which are stil in basic research stage and clinical testing stage. Y-27632 promotes the proliferation and activity of corneal epithelial stem cel after resuscitation; Y-39983 as a novel ROCK inhibitor can be better to inhibit Rho kinases activity than Y-27632, thereby more effectively promoting the healing of the corneal endothelium. There are many studies on the application of ROCK inhibitors in corneal treatment, but not a stable method established to obtain seed cels. Each method has its own advantages and disadvantages, and how to overcome these disadvantages and to find fast and stable access to seed cels is the future direction of development.