摘要
Objective To analyze the relationship between expression level of protein O-fucosyltransferase 1(POFUT1)and tumor immune infiltration level and prognosis of patients,and explore the value of POFUT1 in tumor immunotherapy.Methods Based on the pan-cancer data,R software was used to analyze the changes in POFUT1 expression levels of various tumor tissues and their correlation with the risk ratio of various tumor patients,and screen for tumor types related to patient prognosis and POFUT1 expression.Through the String database,a protein interaction network was constructed,POFUT1-associated genes were screened,and functional enrichment analysis was performed.The estimate software package was used to analyze the correlation between POFUT1 expression and immune infiltration score in selected tumor tissues.The TIMER database was used to analyze the correlation between the expression level of POFUT1 and various levels of immune cell infiltration,and the correlation between the infiltration level of immune cells and the prognosis of patients.Results The expression levels of POFUT1 were significantly high in 14 types of tumors(P<0.05),and were associated with poor prognosis of low-grade gliomas,lung adenocarcinoma,and thyroid cancer(Hazard Ratio>1,P<0.05).POFUT1 and its associated genes were highly involved in Notch signaling pathway,lymphocyte activation and immune regulation processes.The expression level of POFUT1 was positively correlated with the infiltration degree of B cells,CD8+T cells,CD4+T cells,macrophages,neutrophils and dendritic cells in low-grade gliomas,as well as positively associated with the infiltration level of neutrophils in LUAD,and B cells,CD4+ T cells and macrophages in thyroid cancer(|r|>0.2,P<0.05).The high infiltration levels of the above 6 types of immune cells were correlated with the poor prognosis of patients with low-grade glioma(Hazard Ratio>1,P<0.05).Conclusion POFUT1 was highly involved in the process of immune regulation,affecting the immune infiltration level of some tumors and further influencing patient prognosis.It may have the potential to become a target for tumor immunotherapy.
摘要
The basic task of the integrated construction of ideological and political education through curriculum of medical colleges and universities is to establish morality and cultivate people. The integrated construction requires all medical colleges and universities, all medical specialties, all medical courses and all teaching links to be fully promoted and implemented, at the same time, the construction of ideological and political education through curriculum in medical colleges and universities should deal with such problems as the presentation of the connotation of the construction of ideological and political education through curriculum, the orientation of the ideological and political education through curriculum and the ideological and political curriculums, the professional and ideological and political construction of the curriculum, the integration of undergraduate and graduate students, etc.. From the organization and leadership guarantee, the evaluation mechanism system, key points of curriculum classification, the curriculum teaching actuality and the talented teacher team to improve and strengthen the integrated construction of ideological and political education through curriculum.
摘要
The red doctor’s culture is a cultural system with strong vitality and excellent genes created by the people under the leadership of the Communist Party of China in the process of creating health undertakings, and is the unity of the red revolutionary culture, the culture of medical care and health, and the culture of medical education.Its interpretation is from the perspective of historical logic, theoretical logic, practical logic, value logic and overall logic,in the meantime it is of great educational significance to the cultivation of red doctor’s in the new era, the way of practice can be explored from the following aspects: the excavation of red doctor’s cultural history, the refinement of red doctor’s cultural value, the practice of red doctor’s cultural spirit, the improvement of red doctor’s cultural literacy, the innovation of red doctor’s cultural scene, and the construction of red doctor’s cultural curriculum system.
摘要
Ideological and political education in medical discipline is the integration of "medical discipline" and "ideological and political education", the deepening of "ideological and political theories teaching in all courses" and "professional ideological and political education", and an important part of discipline construction and ideological and political education in medical colleges. This paper analyzed the value and inevitability of ideological and political education in medical discipline from the perspective of medical discipline, "three-all education" and medical personnel training, and expounded the connotation system and practical dimension of "ideological and political education in medical discipline" in the framework of subject form, object form, mediator form, theory form, practice form and system form.
摘要
Red doctor's stories have functions such as red narrative and medical narrative,political narrative and value narrative,historical narrative and realistic narrative,scientific narrative and humanistic narrative,and have become the unique advantage and characteristic resource for"reasoning"in medical students'ideological and political courses.Red doctor's stories are stories that highlight"red",identify"medicine",are based on"truth",promote"beauty",and revolve around"education".In the teaching process,it is necessary to focus on the essence of"reasoning"ideological and political courses,follow the logical requirements of"explaining deeply,thoroughly,and vividly",and grasp the basic principles of the combination of history and reality,textbooks and students,content and process,leading and subject,diversity and unity,tradition and innovation.The unique characteristics of the red doctor's stories are conducive to clarifying the principles of politics,profession,value and the times.In practice,it is necessary to explain principles by emotions,describe principles by events,practice principles by practical action,debate principles by asking,bear principles by literature,and clarify principles by history.
摘要
Abstract Background The development of rosacea is suggested to be closely associated with lipid metabolism, inflammation, and anxiety/depression. Gamma linolenic acid (GLA) is a key factor participating in lipid metabolism, which is also confirmed to regulate the inflammatory response. However, the associations of serum GLA levels with rosacea severity and psychological status still remain unclear. Objective and limitations of the study The present study aimed to investigate the associations of gamma linolenic acid (GLA), a key factor participating in lipid metabolism and the inflammatory response, with rosacea severity and psychological status. The present study still had some limitations. First, this study is a cross-sectional study and does not provide longitudinal evidence about the relationship between GLA and rosacea; Second, the cohort in this study is also relatively small, and a larger cohort is needed in further investigation to reveal the potential role of lipid metabolism in the pathogenesis of rosacea. Methods A total of 62 rosacea patients were consecutively recruited. Patient's Self-Assessment (PSA) scale and Clinician Erythema Assessment (CEA) as well as 7-item Generalized Anxiety Disorder (GAD-7) and 9-item Patient Health Questionnaire (PHQ-9) were conducted to evaluate the degree of erythema severity and anxiety/depression, respectively. Serum GLA levels were determined by gas chromatography mass. Results Lower levels of serum GLA in rosacea patients were observed (p < 0.001), and subgroup analysis revealed that patients with higher-level GLA had lower scores of PSA, CEA, GAD-7 and PHQ-9. Moreover, Spearman correlation analysis uncovered that serum GLA levels were negatively associated with PSA, CEA, GAD-7 as well and PHQ-9 scores, respectively. Linear regression model found that serum GLA levels at baseline were a predictive factor for prognosis of clinical outcomes after 1-month conventional treatment. Conclusion The present study indicates that lower levels of serum GLA in rosacea patients are negatively associated with the degree of erythema and anxiety/depression status.
摘要
Objective:To analyze the operation data of inter-provincial direct settlement of patients with chronic diseases and special diseases in outpatient service, explore the effect of policy implementation and put forward corresponding suggestions.Methods:The descriptive analysis method was used to analyze the real-time settlement data of outpatients with chronic disease and special disease of a grade A tertiary cancer hospital in Beijing in 2022, including changing trend in medical visits, age distribution of the medical population, disease distribution of the medical population, medical departments, cost structure, and payment of medical insurance benefits.Results:In 2022, the hospital admitted a total of 12 812 outpatient patients with chronic and special diseases from 28 provinces and Xinjiang Production and Construction Corps, with an increase from 53 in January to 1 957 in December. The age of the patients was 11 to 88 years old, most of whom were 51 to 70 years old. The main disease was lung cancer, and the main visiting departments were internal medicine(chemotherapy) and radiotherapy(radiotherapy). The cost of diagnosis and treatment was relatively high, and the average proportion of medical insurance fund payment was 79.94%.Conclusions:The inter-provincial direct settlement policy for outpatients with chronic diseases and special diseases could further release the demand for medical treatment, greatly reduce the economic burden of cancer patients, and help to solve the problem of " difficult and expensive medical treatment" for patients with cancer and other major diseases.
摘要
Stevens-Johnson syndrome (SJS), also known as the multifactorial erythematous drug eruption, is a class of adverse reactions of the skin and mucous membranes primarily caused by drug allergy often involving the oral cavity, eyes, and external genital mucosa, generally accompanied by fever, and can be life-threatening in severe cases. In February 2022, the Department of Stomatology, the First Affiliated Hospital of Zhengzhou University admitted a patient with huge inflammatory hyperplasia of bilateral lingual margins secondary to SJS. Upon admission, no other obvious symptoms were observed except for tongue hyperplasia. The patient suffered from a severe adverse drug reaction caused by acetaminophen 2 months ago and was complicated by liver dysfunction and pulmonary infection. After 1 month of treatment and rehabilitation, he developed a secondary tongue mass and was subsequently admitted to Dept. of Oral and Maxillofacial Surgery Ward 2, the First Affiliated Hospital of Zhengzhou University. After completing the examination, the tongue mass was surgically removed. After a follow-up of 11 months, the patient's condition was satisfactory and no temporary discomfort was observed. The case of tongue mass secondary to SJS is extremely rare. If a stomatologist encounters a similar case, we should carefully inquire about the drug allergy history and recent medication history, and be alert to whether or not they had adverse drug reactions recently.
Subject(s)
Male , Humans , Stevens-Johnson Syndrome/drug therapy , Hyperplasia/pathology , Skin , Drug Hypersensitivity/pathology , Tongue摘要
As one of the key components of clinical trials, blinding, if successfully implemented, can help to mitigate the risks of implementation bias and measurement bias, consequently improving the validity and reliability of the trial results. However, successful blinding in clinical trials of traditional Chinese medicine (TCM) is hard to achieve, and the evaluation of blinding success through blinding assessment lacks established guidelines. Taking into account the challenges associated with blinding in the TCM field, here we present a framework for assessing blinding. Further, this study proposes a blinding assessment protocol for TCM clinical trials, building upon the framework and the existing methods. An assessment report checklist and an approach for evaluating the assessment results are presented based on the proposed protocol. It is anticipated that these improvements to blinding assessment will generate greater awareness among researchers, facilitate the standardization of blinding, and augment the blinding effectiveness. The use of this blinding assessment may further advance the quality and precision of TCM clinical trials and improve the accuracy of the trial results. The blinding assessment protocol will undergo continued optimization and refinement, drawing upon expert consensus and experience derived from clinical trials. Please cite this article as: Wang XC, Liu XY, Shi KL, Meng QG, Yu YF, Wang SY, Wang J, Qu C, Lei C, Yu XP. Blinding assessment in clinical trials of traditional Chinese medicine: Exploratory principles and protocol. J Integr Med. 2023; 21(6): 528-536.
Subject(s)
Drugs, Chinese Herbal/therapeutic use , Medicine, Chinese Traditional/methods , Outcome Assessment, Health Care , Reference Standards , Reproducibility of Results , Research Design , Clinical Trials as Topic摘要
The vaginal microbiota is a complex and dynamic environment that plays an important role in the healthy reproduction of women. The mechanism of unexplained infertility is not yet clear, and the imbalance and low stability of vaginal microbiota may be related to unexplained infertility. Taking probiotic composite preparations to restore normal vaginal microbiota may be a safe and natural method for treating unexplained infertility. This article reviews the probiotic composite preparations used in the treatment of unexplained infertility both domestically and internationally, including the isolation site of the bacterial species, the use method of the composite preparation, the course of treatment, and the final therapeutic effect, aiming to provide a basis for the clinical application of probiotic composite preparations in the treatment of unexplained infertility.
Subject(s)
Female , Humans , Infertility, Female/microbiology , Vagina/microbiology , Microbiota摘要
The vaginal microbiota is a complex and dynamic environment that plays an important role in the healthy reproduction of women. The mechanism of unexplained infertility is not yet clear, and the imbalance and low stability of vaginal microbiota may be related to unexplained infertility. Taking probiotic composite preparations to restore normal vaginal microbiota may be a safe and natural method for treating unexplained infertility. This article reviews the probiotic composite preparations used in the treatment of unexplained infertility both domestically and internationally, including the isolation site of the bacterial species, the use method of the composite preparation, the course of treatment, and the final therapeutic effect, aiming to provide a basis for the clinical application of probiotic composite preparations in the treatment of unexplained infertility.
Subject(s)
Female , Humans , Infertility, Female/microbiology , Vagina/microbiology , Microbiota摘要
The λ pattern is a rare electrocardiogram feature in clinical practice,which often indicates the occurrence of impending fatal ventricular tachyarrhythmias or sudden cardiac death.In this case,Holter monitoring recorded a progressive evolution of the λ pattern followed by advanced atrioventricular blocks in a patient with chest pain accompanied by syncope.λ sign occurred at the time of chest pain,and advanced atrioventricular blocks were recorded at the time of subsequent syncope.Coronary stenosis was detected in the left circumflex by coronary angiography.The patient recovered after stent implantation in the culprit vessel and related medications to prevent coronary spasm.Our case indicate that the λ pattern could occur prior advanced atrioventricular blocks-induced syncope in patient with ischemic heart disease.
摘要
@#Objective To compare the pain relief and rehabilitation effect of intercostal nerve block and conventional postoperative analgesia in patients undergoing thoracoscopic surgery. Methods China National Repository, Wanfang Database, VIP, China Biomedical Literature Database, Web of Science, Clinicaltrials.gov, Cochrane Library, EMbase and PubMed were searched from establishment of each database to 10 Febraray, 2022. Relevant randomized controlled trials (RCTs) of intercostal nerve block in thoracoscopic surgery were collected, and meta-analysis was conducted after data extraction and quality evaluation of the studies meeting the inclusion criteria. Results A total of 21 RCTs and one semi-randomized study were identified, including 1 542 patients. Performance bias was the main bias risk. Intercostal nerve block had a significant effect on postoperative analgesia in patients undergoing thoracoscopic surgery. The visual analogue scale (VAS) score at 12 h after surgery (MD=–1.45, 95%CI –1.88 to –1.02, P<0.000 01), VAS score at 24 h after surgery (MD=–1.28, 95%CI –1.67 to –0.89, P<0.000 01), and VAS score at 48 h after surgery significantly decreased (MD=–0.90, 95%CI –1.22 to –0.58, P<0.000 01). In exercise or cough state, VAS score at 24 h after surgery (MD=–2.40, 95%CI –2.66 to –2.14, P<0.000 01) and at 48 h after surgery decreased significantly (MD=–1.89, 95%CI –2.09 to –1.69, P<0.000 01). In the intercostal nerve block group, the number of compression of the intravenous analgesic automatic pump on the second day after surgery significantly reduced (SMD=–0.78, 95%CI –1.29 to –0.27, P=0.003). In addition to the analgesic pump, the amount of additional opioids significantly reduced (SMD=–2.05, 95%CI –3.65 to –0.45, P=0.01). Postoperative patient-controlled intravenous analgesia was reduced (SMD=–3.23, 95%CI –6.44 to –0.01, P=0.05). Patient satisfaction was significantly improved (RR=1.31, 95%CI 1.17 to 1.46, P<0.01). Chest tube indwelling time was significantly shortened (SMD=–0.64, 95%CI –0.84 to –0.45, P<0.001). The incidence of analgesia-related adverse reactions was significantly reduced (RR=0.43, 95%CI 0.33 to 0.56, P<0.000 01). Postoperative complications were significantly reduced (RR=0.28, 95%CI 0.18 to 0.44, P<0.000 01). Two studies showed that the length of hospital stay was significantly shortened in the intercostal nerve block group, which was statistically different (P≤0.05), and there was no statistical difference in one report. Conclusion The relief of acute postoperative pain and pain in the movement state is more prominent after intercostal nerve block. Intercostal nerve block is relatively safe and conforms to the concept of enhanced recovery after surgery, which can be extensively utilized in clinical practice.
摘要
The basic task of the integrated construction of ideological and political education through curriculum of medical colleges and universities is to establish morality and cultivate people. The integrated construction requires all medical colleges and universities, all medical specialties, all medical courses and all teaching links to be fully promoted and implemented, at the same time, the construction of ideological and political education through curriculum in medical colleges and universities should deal with such problems as the presentation of the connotation of the construction of ideological and political education through curriculum, the orientation of the ideological and political education through curriculum and the ideological and political curriculums, the professional and ideological and political construction of the curriculum, the integration of undergraduate and graduate students, etc.. From the organization and leadership guarantee, the evaluation mechanism system, key points of curriculum classification, the curriculum teaching actuality and the talented teacher team to improve and strengthen the integrated construction of ideological and political education through curriculum.
摘要
Ideological and political education in medical discipline is the integration of "medical discipline" and "ideological and political education", the deepening of "ideological and political theories teaching in all courses" and "professional ideological and political education", and an important part of discipline construction and ideological and political education in medical colleges. This paper analyzed the value and inevitability of ideological and political education in medical discipline from the perspective of medical discipline, "three-all education" and medical personnel training, and expounded the connotation system and practical dimension of "ideological and political education in medical discipline" in the framework of subject form, object form, mediator form, theory form, practice form and system form.
摘要
The red doctor’s culture is a cultural system with strong vitality and excellent genes created by the people under the leadership of the Communist Party of China in the process of creating health undertakings, and is the unity of the red revolutionary culture, the culture of medical care and health, and the culture of medical education.Its interpretation is from the perspective of historical logic, theoretical logic, practical logic, value logic and overall logic,in the meantime it is of great educational significance to the cultivation of red doctor’s in the new era, the way of practice can be explored from the following aspects: the excavation of red doctor’s cultural history, the refinement of red doctor’s cultural value, the practice of red doctor’s cultural spirit, the improvement of red doctor’s cultural literacy, the innovation of red doctor’s cultural scene, and the construction of red doctor’s cultural curriculum system.
摘要
BACKGROUND@#Pre-operative non-invasive histological evaluation of hepatocellular carcinoma (HCC) remains a challenge. Tumor perfusion is significantly associated with the development and aggressiveness of HCC. The purpose of the study was to evaluate the clinical value of quantitative liver perfusion parameters and corresponding histogram parameters derived from traditional triphasic enhanced computed tomography (CT) scans in predicting histological grade of HCC.@*METHODS@#Totally, 52 patients with HCC were enrolled in this retrospective study and underwent triple-phase enhanced CT imaging. The blood perfusion parameters were derived from triple-phase CT scans. The relationship of liver perfusion parameters and corresponding histogram parameters with the histological grade of HCC was analyzed. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal ability of the parameters to predict the tumor histological grade.@*RESULTS@#The variance of arterial enhancement fraction (AEF) was significantly higher in HCCs without poorly differentiated components (NP-HCCs) than in HCCs with poorly differentiated components (P-HCCs). The difference in hepatic blood flow (HF) between total tumor and total liver flow (ΔHF = HFtumor - HFliver) and relative flow (rHF = ΔHF/HFliver) were significantly higher in NP-HCCs than in P-HCCs. The difference in portal vein blood supply perfusion (PVP) between tumor and liver tissue (ΔPVP) and the ΔPVP/liver PVP ratio (rPVP) were significantly higher in patients with NP-HCCs than in patients with P-HCCs. The area under ROC (AUC) of ΔPVP and rPVP were both 0.697 with a high sensitivity of 84.2% and specificity of only 56.2%. The ΔHF and rHF had a higher specificity of 87.5% with an AUC of 0.681 and 0.673, respectively. The combination of rHF and rPVP showed the highest AUC of 0.732 with a sensitivity of 57.9% and specificity of 93.8%. The combined parameter of ΔHF and rPVP, rHF and rPVP had the highest positive predictive value of 0.903, and that of rPVP and ΔPVP had the highest negative predictive value of 0.781.@*CONCLUSION@#Liver perfusion parameters and corresponding histogram parameters (including ΔHF, rHF, ΔPVP, rPVP, and AEFvariance) in patients with HCC derived from traditional triphasic CT scans may be helpful to non-invasively and pre-operatively predict the degree of the differentiation of HCC.
Subject(s)
Humans , Carcinoma, Hepatocellular/diagnostic imaging , Contrast Media , Liver Neoplasms/diagnostic imaging , Perfusion , Retrospective Studies , Sensitivity and Specificity , Tomography, X-Ray Computed摘要
Objective:To explore sagittal parameters change of upper cervical spine after anterior cervical decompression and fusion (ACDF) and analyze the influential factors by comparison between single-, double- and multi-level surgery.Methods:In this retrospective study, 126 patients (include 60 patients with radiculopathy, 41 patients with myelopathy and 25 patients with myeloradiculopathy) who underwent ACDF between December 2016 and December 2018, were followed up at least 1year ranged from14 to 38 months, with the average of 25.6±7.2 months. 20 patients were operated by single-level ACDF, 45 patients were operated by double-level ACDF and 61 patients were operated by 3- or 4-level ACDF. Standing radiographs of cervical spine and the flexion and extension cervical X-rays were obtained in all patients at 1week before, 3 months after and 1year after operation. The Japanese Orthopaedic Association (JOA) Scores, visual analogue scale (VAS) and neck disability index (NDI) were used to evaluate the clinical effectiveness. Cervical sagittal parameters were assessed with the following parameters: the platform angle of axis (C2Slope), the cobb angle and the range of motion (ROM) of C2-7, C0-1 and C1-2.Results:All the patients obtained satisfactory clinical effects. The mean operative time of single-, double- and multi-level group were 86.4±15.5 min, 117.6±15.6 min and 170.2±28.7 min, respectively. The intraoperative blood loss of 3 groups were 16.5±5.2 ml, 37.2±30.5 ml and 63.4±41.5 ml, respectively. There was statistically significant difference between the 3 groups ( P<0.05). In the single- and double-level groups, the changes of the cobb angle and ROM of upper cervical spine between 1 week before operation and 1 year after operation was no significant difference ( P>0.05). In the multi-level group, the ROM of atlantooccipital joint (C0-1) increased significantly from 11.5°±6.1° before operation to 16.1°±13.9° 3 months and 15.3°±4.8° 1 year after operation ( P<0.05). The cobb angle of upper cervical spine and C2Slpoe was decreased significantly from 21.0°±7.6°, 6.1°±6.7° before operation to 18.6°±7.7°, 4.3°±6.9° 3 months and 19.7°±7.2°, 5.6°±6.3° 1 year after operation respectively ( P<0.05). However, there was no significant difference of cobb angle ofatlantooccipital joint between 1 week before operation and 1 year after operation ( P>0.05). Conclusion:Single- and double-level surgery makes a better ability of preserving the restoration of cervical lordosis, with little impact on the upper cervical spine, meanwhile multi-level fusion shows a negative influence on the restoration and limits the range of motion, also increases risk of surgical operation and degeneration of the atlantooccipital joint, with the increased stress distribution and range of motion.
摘要
@#（正）食管癌位于我国恶性肿瘤发病率第 5 位及死亡率第 4 位，每年大约有 10 万新增病例，占全球50% 以上。食管癌病因复杂，发病隐匿，目前公认的治疗方案是以手术为主、放化疗为辅的综合治疗。而传统开胸手术治疗创伤大，并发症多，恢复时间长，预后较差。经过多年的不断探索与发展以及腔镜技术的日益成熟，以三野清扫为目的的胸腹腔镜联合食管癌切除已成为一种趋势，其在切除范围、淋巴结清扫程度、切口疼痛程度、快速康复以及预后等方面较传统术式有明显优势，同时并发症发生率并未增加[1]。本视频旨在展示胸腹腔镜食管癌切除术的手术入路、操作要点及术后情况。
摘要
Immunoglobulin Y (IgY) is an effective orally administered antibody used to protect against various intestinal pathogens, but which cannot tolerate the acidic gastric environment. In this study, IgY was microencapsulated by alginate (ALG) and coated with chitooligosaccharide (COS). A response surface methodology was used to optimize the formulation, and a simulated gastrointestinal (GI) digestion (SGID) system to evaluate the controlled release of microencapsulated IgY. The microcapsule formulation was optimized as an ALG concentration of 1.56% (15.6 g/L), COS level of 0.61% (6.1 g/L), and IgY/ALG ratio of 62.44% (mass ratio). The microcapsules prepared following this formulation had an encapsulation efficiency of 65.19%, a loading capacity of 33.75%, and an average particle size of 588.75 μm. Under this optimum formulation, the coating of COS provided a less porous and more continuous microstructure by filling the cracks on the surface, and thus the GI release rate of encapsulated IgY was significantly reduced. The release of encapsulated IgY during simulated gastric and intestinal digestion well fitted the zero-order and first-order kinetics functions, respectively. The microcapsule also allowed the IgY to retain 84.37% immune-activity after 4 h simulated GI digestion, significantly higher than that for unprotected IgY (5.33%). This approach could provide an efficient way to preserve IgY and improve its performance in the GI tract.