Biological Activities of Sesquiterpenoids： A Review / 中国实验方剂学杂志

Sesquiterpenoids are natural compounds composed of 15 carbon atoms， which can be divided into sesquiterpene alcohols， ketones， lactones， aldehydes， and carboxylic acids according to oxygen groups. These compounds are widely distributed in nature， and their physiological activities are diverse. For example， many sesquiterpenes with potential anticancer effects have been found for anti-tumor effects， including cytotoxicity， antioxidant， immune regulation， cell proliferation， and so on. In addition， some sesquiterpenoids have good application prospects in antibacterial， anti-inflammatory， and anti-cardiovascular diseases. Malignant tumors， inflammation， bacterial diseases， and cardiovascular diseases are the main diseases that cause human death， and natural products have unique advantages in the treatment of these diseases. Therefore， the development of new drugs that are easy to promote has become a new research hotspot. In this paper， the sesquiterpenes extracted from the natural components of Chinese herbs and plants with anti-tumor， anti-inflammatory， antibacterial， and anti-cardiovascular activities， such as Xanthium， Atractylodes， Convolvulus， Acanthium， Ligularia， Artemisia， Ligularia， Ligularia， Labiaceae Mint， Acanthophyllum， Turmeria， Ginger， and other Chinese herbs and plants， were discussed. The biological activities and related mechanisms of this compound were reviewed， which provided a reference for further research and clinical application of sesquiterpenes.

Analysis of self-assessment on the position competency of residents with completion of residency training in a certain hospital in Beijing / 国际外科学杂志

Objective:To analyze the results of self-assessment on the position competency of residents in a certain hospital, and to provide reference for improving the quality of training.Methods:From June 2021 to October 2021, a whole-group questionnaire survey was conducted among 224 residents who participated in the standardized training in Beijing Friendship Hospital, Capital Medical University. The questionnaire consists of general information questionnaire, position competency questionnaire. The position competency questionnaire contains eight dimensions. Measurement data were expressed as mean ± standard deviation ( ± s), t-test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups. Results:The position competency score of residents was (3.94±1.07) points, among which the scores of interpersonal communication ability was the highest (4.42±0.68) points. The scores of scientific research ability [(3.26±1.30) points] was the lowest among the eight dimensions. There were statistically significant differences among residents of different genders in post competency, disease prevention and health promotion and interpersonal communication ability ( P<0.05). There were statistically significant differences in the scores of medical knowledge and lifelong learning ability and scientific research ability among residents with different identity ( P<0.05). There was statistical significance in the score of scientific research ability among residents with different educational backgrounds ( P<0.05). There were statistically significant differences in the scores of position competency, disease prevention and health promotion, interpersonal communication ability, medical knowledge and lifelong learning ability among residents of different majors ( P<0.05). Conclusions:The position competency of residents should be further improved. To guarantee the quality of training, it was suggested to establish a competence-oriented training mechanism, strengthen the construction of teachers′ training teams, enrich and innovate training contents and methods.

The significance of serum glycocholic acid, total bile acid and glucagon-like peptide-1 in the transformation of fatty liver to liver cancer and its relationship with body glucose and lipid metabolism / 中国医师进修杂志

Objective:To investigate the significance of serum glycocholic acid (CG), total bile acid (TBA), and glucagon-like peptide-1 (GLP-1) in the transformation of fatty liver to liver cancer and their relationship with the body′s glucose and lipid metabolism.Methods:From May 2018 to August 2020, 96 patients with fatty liver (fatty liver group), 96 patients with liver cirrhosis (cirrhosis group) and 96 patients with liver cancer (liver cancer group) admitted to Jintang Hospital of West China Hospital of Sichuan University were selected. Ninety-six healthy physical examination patients were selected during the same period as the normal control group. Compared the general information, serum CG, TBA, GLP-1, glycosylated hemoglobin (HbA 1c), triacylglycerol (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) levels of each group. The correlation between serum CG, TBA, GLP-1 levels and the body′s glucose and lipid metabolism indicators were analyzed by Pearson correlation. The correlation between serum CG, TBA, GLP-1 and clinical stage were analyzed. Results:The levels of serum CG, TBA, GLP-1, and HbA 1c in the fatty liver group, cirrhosis group, liver cancer group were higher than those in the normal control group: (3.57 ± 1.06), (22.17 ± 8.44),(31.44 ± 9.65) mg/L vs. (1.26 ± 0.78) mg/L; (5.94 ± 1.26), (12.34 ± 4.02), (20.65 ± 5.17) μmol/L vs. (2.87 ± 0.59) μmol/L; (8.34 ± 1.55), (11.69 ± 3.26), (17.84 ± 2.78) pmol/L vs. (6.68 ± 1.24) pmol/L; (5.52 ± 0.31)%, (5.89 ± 0.27)%, (6.11 ± 0.23)% vs. (5.11 ± 0.36)%, and with the progression of the disease, the levels showed a rising trend, and the differences were statistically significant ( P<0.05). The levels of TG, TC, HDL-C, LDL-C in the cirrhosis group and liver cancer group were lower than those in the normal control group and fatty liver group, the differences were statistically significant ( P<0.05). The results of correlation analysis showed that serum CG, TBA, GLP-1 were positively correlated with HbA 1c ( P<0.05), and serum CG, TBA, GLP-1 were negatively correlated with TG, TC, HDL-C, and LDL-C ( P<0.05). With the increase of clinical stage, serum CG and TBA levels showed an increasing trend ( P<0.05). Conclusions:With the transformation of fatty liver to liver cancer, serum CG, TBA, and GLP-1 levels increase, and the change trend is closely related to the body′s glucose and lipid metabolism, which can provide a reference for the clinical improvement of fatty liver outcome evaluation mechanism.

Avian influenza A (H7N9) virus: from low pathogenic to highly pathogenic / 医学前沿

The avian influenza A (H7N9) virus is a zoonotic virus that is closely associated with live poultry markets. It has caused infections in humans in China since 2013. Five waves of the H7N9 influenza epidemic occurred in China between March 2013 and September 2017. H7N9 with low-pathogenicity dominated in the first four waves, whereas highly pathogenic H7N9 influenza emerged in poultry and spread to humans during the fifth wave, causing wide concern. Specialists and officials from China and other countries responded quickly, controlled the epidemic well thus far, and characterized the virus by using new technologies and surveillance tools that were made possible by their preparedness efforts. Here, we review the characteristics of the H7N9 viruses that were identified while controlling the spread of the disease. It was summarized and discussed from the perspectives of molecular epidemiology, clinical features, virulence and pathogenesis, receptor binding, T-cell responses, monoclonal antibody development, vaccine development, and disease burden. These data provide tools for minimizing the future threat of H7N9 and other emerging and re-emerging viruses, such as SARS-CoV-2.

The expression change and clinical value analysis of serum hypersensitive C-reactive protein in patients with non-small cell lung cancer / 中国医师进修杂志

Objective:To investigate the level of hypersensitive C-reactive protein (hs-CRP) in serum of patients with non-small cell lung cancer (NSCLC), and to explore the relationship between hs-CRP level and clinical characteristics and prognosis.Methods:The clinical data of 96 patients with NSCLC (NSCLC group), 50 patients with benign lung disease (benign lung disease group) and 45 normal subjects (control group) from August 2015 to August 2019 were analyzed. The expression of hs-CRP in serum were detected by immunofluorescence immunoassay. The tumor markers carcino-embryonic antigen (CEA), carbohydrate antigen 125(CA125), cytokeratin-19 fragment antigen (Cyfra21-1), neuronspecific enolase (NSE)were measured using automatic biochemical immunoassay. The relationship between hs-CRP and age, gender, tumor pathological type, clinical stage, imaging relief in patients with NSCLC were analyzed. The sensitivity, specificity and accuracy of hs-CRP combined with CEA, CA125, Cyfra21-1 and NSE were calculated.Results:The levels of hs-CRP in NSCLC group and benign lung disease group were higher than that in control group [(14.9 ± 7.5), (26.4 ± 10.2) mg/L vs. (5.1 ± 1.3) mg/L], and the differences were statistically significant ( P<0.05 or <0.01); the level of hs-CRP in NSCLC group was lower than that in benign lung disease group [(14.9 ± 7.5) mg/L vs. (26.4 ± 10.2) mg/L], and the difference was statistically significant ( P<0.05). The levels of CEA, CA125, Cyfra21-1, NSE in NSCLC group were higher than that in benign lung disease group and control group, and there were significant differences ( P<0.01 or<0.05). In 96 patients with NSCLC, there was 49 patients with elevated hs-CRP (hs-CRP elevated group) and 47 patients with normal hs-CRP (hs-CRP normal group). Single factor analysis showed that the level of hs-CRP had no correlation with age, gender and tumor pathological type ( P>0.05), but had correlation with clinical stage ( P<0.05). After detecting the lesions by CT, the rate of solid tumors in hs-CRP elevated group was 66.0%, in hs-CRP normal group was 40.8%, and there was significant difference ( χ2 = 6.089, P<0.05).After followed up for 2 months in NSCLC patients, the disease control rate in hs-CRP elevated group was 59.6%, in hs-CRP normal group was 85.7%, and there was significant difference ( χ2 = 8.300, P<0.01). The ensitivity, specificity and accuracy of hs-CRP combined with CEA, CA125, Cyfra21-1 and NSE was 89.0%, 80.4% and 82.3%. Conclusions:Patients with NSCLC have high expression of hs-CRP, which is correlated with disease progression and clinical treatment. The indicator of hs-CRP combined with CEA, CA125, Cyfra21-1 and NSE may be important for diagnosis and prognosis of NSCLC.

Review and analysis on knockout mouse models with cataract / 中华实验眼科杂志

Cataract is the leading cause of blindness worldwide, which is a generally clinical and genetic heterogeneity eye disease.To date, more than 50 genes have been reported to be associated with congenital cataract.While for mouse, parts of human cataract related genes knockout mouse can also resulted cataract.As we know, the model of cataract related gene knockout mice can help us to understand the phenotype, pathogenesis, progress and prognosis of human cataract and it can also help to find unknow genes that not reported in human cataract yet.In this review, knockout mouse models with cataract are summarized, which can help to facilitate identification of cataract genes and clarification of the mechanisms of cataractgenisis.

Application value of barbed suture in reinforcing anastomosis during laparoscopic radical resection of rectal cancer / 中华消化外科杂志

Objective:To investigate the application value of barbed suture in reinforcing anastomosis during laparoscopic radical resection of rectal cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 215 patients with rectal cancer who underwent laparoscopic radical resection in the Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine from March 2016 to December 2018 were collected. There were 122 males and 93 females, aged (62.3±0.7)years, with a range from 20 to 75 years. Of 215 patients, 86 patients undergoing laparoscopic radical resection of rectal cancer with barbed suture for anastomosis were allocated into barbed suture group, and 129 patients undergoing laparoscopic radical resection of rectal cancer without reinforced anastomosis were allocated into traditional group, respectively. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect postoperative complications, anastomotic healing and patency of patients up to May 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Ordinal data were analyzed using the Friedman non-parametric test. Results:(1) Intraoperative situations: patients in the two groups underwent laparoscopic radical resection of rectal cancer successfully, without conversion to open laparotomy. The volume of intraoperative blood loss, operation time, distance between the anastomosis and dentate line, length of auxiliary incision of the barbed suture group were (127±9)mL, (160.2±3.8)minutes, (3.56±0.15)cm, (4.12±0.11)cm, respectively, versus (114±6)mL, (128.9±2.4)minutes, (3.67±0.12)cm, (4.25±0.09)cm of the traditional group. There was a significant difference in the operation time between the two groups ( t=7.33, P<0.05), but no significant difference in the other indicators between the two groups ( t=1.32, 0.61, 0.94, P>0.05). (2) Postoperative situations: the time to first flatus after surgery and duration of postoperative hospital stay of the barbed suture group were (72.5±2.2)hours and (8.1±0.5)days, respectively, versus (76.2±1.7)hours and (8.0±0.5)days of the traditional group, showing no significant difference between the two groups ( t=1.33, 0.87, P>0.05). (3) Follow-up: 215 patients were followed up for 6-12 months, with a median follow-up time of 8 months. In the barbed suture group, 2 patients had postoperative anastomotic leakage, 5 had urinary retention, 6 had incision infection, 4 had intestinal obstruction, 3 had bowel dysfunction in 6 months after operation. In the traditional group, 13 patients had postoperative anastomotic leakage, 15 had urinary retention, 11 had incision infection, 8 had intestinal obstruction, 9 had bowel dysfunction in 6 months after operation. There was a significant difference in the anastomotic leakage between the two groups ( t=4.77, P<0.05), but no significant difference in the urinary retention, incision infection, intestinal obstruction, bowel dysfunction in 6 months after operation between the two groups ( t=2.07, 0.17, 0.22, 1.26, P>0.05). Patients in the two groups showed unobstructed intestinal tract on enteroscopy. Conclusion:The barbed suture for reinforcing anastomosis in radical resection of rectal cancer is safe and feasible, which can reduce the incidence of anastomotic leakage.

Investigation on job burnout and depression status of surgical residents / 国际外科学杂志

Objective:To investigate the current situation of job burnout and depression among surgical residents, with a view to reduding or alleviating the burnout and depression of surgical residents.Methods:The job burnout scale and depression scale were used to investigate the burnout and depression of 137 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2016 to January 2019, there were 108 males and 29 females, aged (26.57±1.77) years, and the age ranged from 23 to 28 years. The distribution differences of the incidence of job burnout and depression in gender, time status and the correlation between the three dimensions of job burnout and depression were analyzed. The measurement data were expressed as mean±standard deviation ( Mean± SD). Counting data were expressed as percentage(%). The differences in the distribution of job burnout and depression in gender, time and status were analyzed by chi-square test. Pearson correlation analysis was used to analyze the correlation among the three dimensions of job burnout and depression. Results:Of the 137 surgical residents, 10 (7.3%) had severe job burnout requiring intervention . In the emotional exhaustion dimension, 67 (48.9%) had mild burnout, 53 (38.7%) had moderate burnout, and 17 (12.4%) had severe burnout. In the cynicism dimension, 86 (62.8%) had mild burnout, 37 (27.0%) had moderate burnout, and 14 (10.2%) had severe burnout. In the reduced personal accomplishment dimension, 64(46.7%) had mild burnout, 43(31.4%) had moderate burnout, 30(21.9%) had severe burnout. The results of the depression survey showed that 27 (19.7%) of the 137 surgical residents were depressed. There were no statistically significant differences in the incidence of job burnout in gender, time and status( P>0.05). There were no statistically significant differences in the incidence of depression in gender and status( P>0.05). The incidence of depression was higher among 1-year residents (14, 35.0%) than among 2-year (8, 15.7%) and 3-year(5, 10.9%) residents ( P<0.01). Depression is associated with emotional exhaustion, cynicism and reduced sense of achievement ( r=0.248, r=0.301, r=0.201, respectively, P<0.05). Conclusions:The job burnout and depression of surgical residents are not optimistic. There were differences in the time distribution of depression incidence, among which the incidence of depression is higher among the residents in the first year. The occurrence of depression is positively correlated with three dimensions of job burnout.

Research on satisfaction degree of surgical resident in standardized training / 国际外科学杂志

Objective:To investigate the satisfaction degree of surgical resident in standardized training and to explore the existing problems and influencing factors. It provides references for improving the system and quality of standardized training.Methods:The Self-designed Satisfaction scale was used to investigate the satisfaction degree of 137 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2015 to June 2018. There were 108 males (78.8%) and 29 females (21.2%). The mean age was (26.78±1.83) years. The measurement data of normal distribution were expressed as mean ± standard deviation. Counting data was expressed by frequency and constituent ratio. The differences between groups were analyzed by t test and one-way anova.Results:The overall satisfaction score of the surgical residents to the standardized training was 3.71±0.83, among which the residents scored the highest on the working condition (4.12±0.67), while the training effect (3.53±0.85) was the last in all dimensions. The overall satisfaction of third-year residents was lower than that of first-year and second-year residents, and the differences were statistically significant ( F=3.27, P=0.04). The scores of first-year residents in standardized management was higher than that of second-year and third-year residents, and the difference was statistically significant ( F=3.30, P=0.04). The scores of professional degree postgraduate in overall satisfaction, standardized management and research training were higher than those of enrolled resident, and the differences were statistically significant ( P<0.05). The score in enrolled resident (3.78±0.85) was higher than that of professional degree postgraduate (3.44±0.63)in the dimension of salary, and the difference was statistically significant ( P=0.02). Conclusion:Surgical residents expressed satisfaction with the general condition of standardized training, training condition, research training, training effect and postgraduate salary were still need be strengthen.

Chinese Society of Allergy and Chinese Society of Otorhinolaryngology-Head and Neck Surgery Guideline for Chronic Rhinosinusitis

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.

Study of surgical residents' stressors and job burnout / 国际外科学杂志

Objective To investigate the current situation of stressors and job burnout among surgical residents and to explore the influencing factors,so as to provide evidences for reducing stress and relieving job burnout.Methods The stressor scale and job burnout scale were used to investigate the stress and burnout of 145 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital,Capital Medical University from September 2016 to June 2019,to understand the existence of stress and job burnout in surgical residents,and analyze the linear correlation between each dimension of stressors and each dimension of burnout.There were 132 males and 13 females,who were (26.62 ± 1.45) years old,ranged from 22 to 30 years.SPSS 19.0 software was used for statistical analysis.The measurement data of normal distribution were expressed as Mean ± SD Counting data were expressed by frequency and constituent ratio.Pearson correlation analysis was used to analyze the linear correlation between each dimension of stressors and each dimension of job burnout.Results The total score of surgical resident stress was 2.51 ±0.57.The scores of social factors and workload were higher in each dimension 3.02 ± 0.58 and 3.00 ± 0.62,respectively.The burnout survey showed that 7 residents (4.8％) had severe burnout.In the dimension of emotional exhaustion,there were 14 residents with severe burnout.In the dimension of cynicism,there were 21 residents (14.5％) had severe burnout.In the dimension of reduced personal accomplishment,there were 19 residents (13.1％) of mild burnout and 17 residents (11.7％) of severe burnout.Further analysis of the linear correlation between each dimension of stressors and each dimension of burnout showed that most of them were positively linear correlated.In particular,emotional exhaustion and workload (r =0.411,P ＜ 0.05),reduced personal accomplishment and social factors (r =0.429,P ＜ 0.05) had a relatively large correlation coefficient.Conclusions The stress and burnout of surgical residents were at a high level.In order to reduce the stress and relieve the burnout,it is necessary to strengthen the residents' self-management and improve the social support system.

Study of surgical residents′ stressors and job burnout / 国际外科学杂志

Objective@#To investigate the current situation of stressors and job burnout among surgical residents and to explore the influencing factors, so as to provide evidences for reducing stress and relieving job burnout.@*Methods@#The stressor scale and job burnout scale were used to investigate the stress and burnout of 145 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2016 to June 2019, to understand the existence of stress and job burnout in surgical residents, and analyze the linear correlation between each dimension of stressors and each dimension of burnout. There were 132 males and 13 females, who were (26.62±1.45) years old, ranged from 22 to 30 years. SPSS19.0 software was used for statistical analysis. The measurement data of normal distribution were expressed as Mean±SD Counting data were expressed by frequency and constituent ratio. Pearson correlation analysis was used to analyze the linear correlation between each dimension of stressors and each dimension of job burnout.@*Results@#The total score of surgical resident stress was 2.51±0.57. The scores of social factors and workload were higher in each dimension 3.02±0.58 and 3.00±0.62, respectively. The burnout survey showed that 7 residents (4.8%) had severe burnout. In the dimension of emotional exhaustion, there were 14 residents with severe burnout. In the dimension of cynicism, there were 21 residents (14.5%) had severe burnout. In the dimension of reduced personal accomplishment, there were 19 residents (13.1%) of mild burnout and 17 residents (11.7%) of severe burnout. Further analysis of the linear correlation between each dimension of stressors and each dimension of burnout showed that most of them were positively linear correlated. In particular, emotional exhaustion and workload (r=0.411, P<0.05), reduced personal accomplishment and social factors (r=0.429, P<0.05) had a relatively large correlation coefficient.@*Conclusions@#The stress and burnout of surgical residents were at a high level. In order to reduce the stress and relieve the burnout, it is necessary to strengthen the residents′ self-management and improve the social support system.

Research progress of FYCO1 gene mutation / 中华实验眼科杂志

FYVE and coiled-coil domain containing 1(FYCO1) is an adaptor of cellular autophagy which has RUN domain, coiled coil domain, FYVE domain, GOLD domain and LIR domain.FYCO1 protein is widely expressed and mainly interacts with Atg8 family proteins, microtubule-based kinesins, phosphatidylinositol-3-phosphate (PI3P). The FYCO1 protein involved in the movement of kinesins along microtubules and the microtubule plus end-directed transport of autophagy vesicles and related to the development and transparency maintenance of human lens.FYCO1 mutations are one of the causes inducing autosomal recessive congenital cataract.Mutations of FYCO1 can inhibit the process of autophagosome transport to lysosomes, leading to the failure of mitochondrial and other organelle degradation processes in lens fibroblasts and causing opacity of the lens.Eighteen cataract-related mutations have been identified in FYCO1 currently.In addition, FYCO1 protein plays an important role in life processes, such as cell division, and is associated with various diseases, such as Parkinson's disease, cancer, sporadic inclusion body myositis and keloid.This article reviewed the current research progress of FYCO1 gene mutations.

Research status of scientific research ability of professional surgical postgraduates under the standardized training mode of residents / 国际外科学杂志

Objective@#To explore the status quo and countermeasures of the scientific research ability of professional surgical postgraduates under the standardized training mode of residents.@*Methods@#Fifty-five students in Beijing Friendship Hospital, Capital Medical University during September 2015 to December 2017 were enrolled in the present study. Questionnaire was used to collection the data in order to evaluate the current research abilities and provide feedbacks for the adoption of improvement measures of research skill. The results of the survey were entered into the computer using EpiData 3.0 software, and descriptive analysis of the data were performed using Excel 2010 and SPSS 20.0 to calculate the percentage of each indicator.@*Results@#The results showed that 38(69.1%) graduate students were able to assist the instructor in basic research work, and 17(30.9%) graduate students showed low enthusiasm for independent design and writing of the paper. In addition, 23(41.8%) graduate students hoped to improve their research capabilities and added more training courses. 10(18.2%) students hoped to strengthen the training of the clinical subject tutors, and thought that the communication and contact with the tutor was not enough.@*Conclusions@#The professional postgraduates overvalue clinical practice and undervalued scientific research. This article introduces ways of strengthening the cultivation of scientific research awareness, optimizing curriculum system, playing the core role of mentors, establishing incentive system and scientific research platform to enhance scientific research capacity.

Tutor evaluation on the scoring criterion for non-technical skills in surgeons / 中华医学教育探索杂志

Objective@#Non-technical skills (NTS) are necessary to evaluate the comprehensive quality of surgeons. In this study, we proposed the concept of C-NTS, a scoring criterion for NTS based on real scenarios (for example, history taking) and video recording, and verified its practical application effects.@*Methods@#Study objects were divided into the tutor group and the student group. The tutor group contained four senior attending physicians in gastrointestinal surgery department of one tertiary hospital (all male with doctor degree). The student group had four rotating surgeons who were randomly selected from the same department in 2018 (two males and two females). Before and after the training, the tutor rated the same anonymous video by C-NTS. One-factor analysis of variance was used to compare the differences between and within the groups, and Kendall concordant coefficient was used to test the consistency by SPSS 22.0.@*Results@#After the tutor receiving training, Kendall concordant coefficient was increased from 0.425 to 0.853 and the latter suggested the difference had statistical significance (P=0.017), which confirmed the effectiveness of the training.@*Conclusion@#C-NTS has preliminarily solved the difficulty of homogenization of NTS assessment. Relevant C-NTS discussions and trainings for clinical tutors may be beneficial to save time and manpower in clinical teaching and evaluation.

Tutor evaluation on the scoring criterion for non-technical skills in surgeons / 中华医学教育探索杂志

Objective Non-technical skills (NTS) are necessary to evaluate the comprehensive quality of surgeons.In this study,we proposed the concept of C-NTS,a scoring criterion for NTS based on real scenarios (for example,history taking) and video recording,and verified its practical application effects.Methods Study objects were divided into the tutor group and the student group.The tutor group contained four senior attending physicians in gastrointestinal surgery department of one tertiary hospital (all male with doctor degree).The student group had four rotating surgeons who were randomly selected from the same department in 2018 (two males and two females).Before and after the training,the tutor rated the same anonymous video by C-NTS.One-factor analysis of variance was used to compare the differences between and within the groups,and Kendall concordant coefficient was used to test the consistency by SPSS 22.0.Results After the tutor receiving training,Kendall concordant coefficient was increased from 0.425 to 0.853 and the latter suggested the difference had statistical significance (P=0.017),which confirmed the effectiveness of the training.Conclusion C-NTS has preliminarily solved the difficulty of homogenization of NTS assessment.Relevant C-NTS discussions and trainings for clinical tutors may be beneficial to save time and manpower in clinical teaching and evaluation.

Research status of scientific research ability of professional surgical postgraduates under the standardized training mode of residents / 国际外科学杂志

Objective To explore the status quo and countermeasures of the scientific research ability of professional surgical postgraduates under the standardized training mode of residents.Methods Fifty-five students in Beijing Friendship Hospital,Capital Medical University during September 2015 to December 2017 were enrolled in the present study.Questionnaire was used to collection the data in order to evaluate the current research abilities and provide feedbacks for the adoption of improvement measures of research skill.The results of the survey were entered into the computer using EpiData 3.0 software,and descriptive analysis of the data were performed using Excel 2010 and SPSS 20.0 to calculate the percentage of each indicator.Results The results showed that 38(69.1％) graduate students were able to assist the instructor in basic research work,and 17 (30.9％) graduate students showed low enthusiasm for independent design and writing of the paper.In addition,23 (41.8％) graduate students hoped to improve their research capabilities and added more training courses.10 (18.2％) students hoped to strengthen the training of the clinical subject tutors,and thought that the communication and contact with the tutor was not enough.Conclusions The professional postgraduates overvalue clinical practice and undervalued scientific research.This article introduces ways of strengthening the cultivation of scientific research awareness,optimizing curriculum system,playing the core role of mentors,establishing incentive system and scientific research platform to enhance scientific research capacity.

Chinese Society of Allergy Guidelines for Diagnosis and Treatment of Allergic Rhinitis

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.

Clinical efficacy of laparoscopic and open total proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis / 中华消化外科杂志

Objective To compare the short-term and long-term outcomes between laparoscopic and open total proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC).Methods The retrospective cohort study was conducted.The clinical data of 150 UC patients who underwent total proctocolectomy with IPAA in the Renji Hospital of Shanghai Jiaotong University between January 2003 and December 2016 were collected.Among 150 patients,87 undergoing laparoscopic total proctocolectomy with IPAA and 63 undergoing open total proctocolectomy with IPAA were respectively allocated into the laparoscopy group and open group.Observation indicators:(1) comparisons of intra-and post-operative situations;(2) postoperative complications;(3) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect postoperative recovery and complications up to December 2017.Measurement data with normal distribution were represented as x-±s and comparison between groups was analyzed using the t test.Comparison between groups of count data was analyzed using the chi-square test.Results (1) Comparisons of intra-and post-operative situations:operation time,volume of intraoperative blood loss,time of initial intestinal stoma exsufflation and duration of hospital stay were respectively (306±3) minutes,(197± 12) mL,(62.1±1.8) hours,(8.2±0.4) days in the laparoscopy group and (224±4) minutes,(308±24) mL,(75.6±2.0) hours,(10.1±0.6) days in the open group,with statistically significant difference between groups (t =16.23,4.33,5.03,2.61,P＜ 0.05).All patients discharged successfully from hospital.All the 150 patients underwent stoma reversion of ileum at 3-12 months postoperatively,and the average time in the laparoscopy group and open group was respectively (6.0±5.6) months and (6.0±4.6)months,with no statistically significant difference between groups (t =0.01,P＞ 0.05).(2) Postoperative complications:cases with postoperative wound infection,retention of urine and frequency of defecation ＞ 4 times / day were respectively 2,8,21 in the laparoscopy group and 8,15,29 in the open group,with statistically significant differences between groups (x2 =5.25,4.37,0.96,P＜0.05).The cases with postoperative intestinal obstruction,anastomotic leakage,pelvic infection,pouch infection,pouch-related Crohn's disease and hyperplasia of ileal pouch were respectively 3,10,5,23,2,1 in the laparoscopy group and 8,7,4,24,1,0 in the open group,with no statistically significant differences between groups (x2=3.65,0.11,0.01,0.96,0.17,0.82,P＞0.05).Patients with postoperative complications were improved by acid suppression,fasting,anti-infection and fluid infusion.(3) Follow-up situation:150 patients were followed up for 12-60 months,with a median time of 48 months.There was no abnormality of postoperative anastomotic stoma and intestinal mucosa through comparison of colonoscopy results between pre-operation and 5 year postoperatively.During the follow-up,50 patients had shapeless stool and irregular defecation (times ＞ 4 times / day) at 3 years after stoma reversion of small intestine bypass,including 21 in the laparoscopy group and 29 in the open group,with a statistically significant differences between groups (x2 =4.72,P＜0.05).Eleven and 10 patients in the laparoscopy group and open group had shapeless stool and irregular defecation at 5 years postoperatively,but status were improved compared with the preoperative status,with no statistically significant difference between groups (x2=0.32,P ＞ 0.05).Conclusion The security of laparoscopic total proctocolectomy with IPAA for UC is equivalent to that of open total proctocolectomy,with the better short-term and long-term outcomes.

Effects and risk factors of low ligation of the inferior mesenteric artery on the third station lymph node dissection and metastasis in laparoscopic radical resection of rectal cancer / 中华消化外科杂志

Objective To explore the effects of low ligation of the inferior mesenteric artery (IMA) on the third station lymph node dissection in laparoscopic radical resection of rectal cancer (RC),and analyze the risk factors affecting the third station lymph node metastasis.Methods The retrospective cohort study was conducted.The clinical data of 380 RC patients who were admitted to Renji Hospital of Shanghai Jiaotong University School of Medicine from June 2014 to June 2016 were collected.Of 380 patients,177 with preservation of left colic artery (LCA) and 203 without preservation of LCA were respectively allocated into the low ligation group and high ligation group.All the patients received laparoscopic radical resection of RC based on the principle of total mesorectal excision (TME).Observation indicators:(1) intra-and post-operative recovery situations;(2) results of postoperative pathological examination;(3) follow-up and survival;(4) risk factors analysis affecting the third station lymph node metastasis.Follow-up using outpatient examination and telephone interview was performed to detect postoperative disease-free survival and tumor recurrence or metastasis up to May 31,2017.Measurement data with normal distribution were represented as x ± s,and comparisons between groups were evaluated with the t test.Comparisons of count data and ordinal data were respectively analyzed using the chisquare test and U test.The survival curve and survival rate were respectively drawn and analyzed using the KaplanMeier method,and the survival analysis was done by the Log-rank test.Results (1) Intra-and post-operative recovery situations:all the patients underwent successful surgery.The operation time,time to initial exsufflation and cases with anastomotic leakage were respectively (147.2±3.0) minutes,(72.8± 1.4)hours,20 in the low ligation group and (137.2±2.8) minutes,(76.6± 1.1) hours,38 in the high ligation group,with statistically significant differences between groups (t =2.463,2.073,x2 =4.025,P＜0.05).Volume of intraoperative blood loss,cases with temporary stoma,vascular injury (injury of inferior mesenteric vessels and presacral vein injury),urinary retention and duration of postoperative hospital stay were respectively (119±6)mL,25,29,24,(10.7± 0.5)days in the low ligation group and (108±5)mL,32,27,30,(9.6±0.4)days in the high ligation group,with no statistically significant difference between groups (t=1.524,x2 =0.235,0.716,1.115,t=1.780,P＞ 0.05).Of 58 patients with anastomotic leakage,31 received previously terminal loop ileostomy,13 received conservative treatment and 14 received postoperatively terminal loop ileostomy.Fifty-four patients with urinary retention received urethral catheterization.All the patients with complications were improved by treatment and then were discharged.(2) Results of postoperative pathological examination:number of lymph node dissected in the low ligation group and high ligation group was respectively 12.8±0.4 and 12.0±0.3;cases with depths of tumor invading to intestinal wall in stage pT1-T2 and pT3-T4,with tubular adenocarcinoma and non-tubular adenocarcinoma,with high-differentiated,moderate-differentiated and low-differentiated tumors,with lymph node metastasis in stage N0,N 1 and N2,with and without the third station lymph node metastasis,with TNM staging in stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ were respectively 53,124,150,27,81,63,33,73,66,38,16,161,17,54,93,13 in the low ligation group and 59,144,176,27,99,59,45,79,78,46,24,179,32,47,105,19 in the high ligation group,with no statistically significant difference in above indicators between groups (t =1.556,x2 =0.035,0.296,U=2.002,0.220,x2 =0.778,U=5.557,P＞0.05).(3) Follow-up and survival:338 of 380 patients were followed up for 6-36 months,with an average time of 28 months,including 164 in the low ligation group and 174 in the high ligation group.The 1-and 3-year disease-free survival rates and cases with postoperative tumor recurrence or metastasis were respectively 93.9％,76.4％,39 in the low ligation group and 94.8％,79.3％,36 in the high ligation group,with no statistically significant difference between groups (x2=0.861,P＞0.05).(4) Risk factors analysis affecting the third station lymph node metastasis:results of univariate analysis showed that tumor location and diameter,depth of tumor invading to intestinal wall and tumor histopathological type were related factors affecting the third station lymph node metastasis of RC patients (x2 =9.957,9.921,6.196,6.576,P＜0.05).Results of multivariate analysis showed that tumor diameter ＞ 5 cm and non-tubular adenocarcinoma were independent risk factors affecting the third station lymph node metastasis of RC patients (Odds ratio=2.561,2.296,95％ confidence interval:1.280-5.123,1.037-5.083,P＜0.05).Conclusions The low ligation of the IMA is safe and feasible in laparoscopic radical resection of RC,meanwhile,it has the same radical effect in lymph node dissection and doesn't affect the third station lymph node metastasis and shortterm disease-free survival compared with high ligation of the IMA.Tumor diameter ＞ 5 cm and non-tubular adenocarcinoma are independent risk factors affecting the third station lymph node metastasis of RC.