摘要
Comprehensive improvement in course teaching quality is an important link in deepening the reform of undergraduate education and teaching. Since 2018, West China Medical School, Sichuan University, has implemented the collective lesson preparation system of "two meetings, seven decisions, and three preparation sessions" for undergraduate clinical courses, thereby effectively implementing subject cooperation, organizational guidance, and resource integration among clinical teachers and determining the key elements of the course through "teaching, learning, and exam preparations" before class. In the process of course operation, the concept of quality control based on plan-do-check-act cycle is deeply integrated with the collective lesson preparation system, and active implementation of the whole-process quality control loop of planning (plan), organization and implementation (do), inspection of results (check), and treatment and improvement (action) has effectively improved the teaching quality of undergraduate clinical courses.
摘要
AIM: To explore Bland-Altman analysis of corneal curvature and astigmatism measured by new swept-source optical coherence tomography(SS-OCT)and Scheimpflug anterior segment analyzer in patients with age-related cataract.METHODS: A total of 177 patients(282 eyes)with age-related cataract admitted to the hospital between January and December 2021 were enrolled. The steep-axis curvature(Ks), flat-axis curvature(Kf), mean corneal curvature(Km), corneal astigmatism and astigmatism axis of anterior corneal surface, posterior surface and the whole cornea were measured by SS-OCT and Scheimpflug anterior segment analyzer respectively. All parameters were detected by paired sample t-test, intra-group repeatability test, Pearson correlation and Bland-Altman consistency analysis.RESULTS: There was no significant difference in Ks, Kf and Km of anterior corneal surface measured by SS-OCT and Scheimpflug anterior segment analyzer(P>0.05). Ks, Kf and Km of posterior corneal surface and whole cornea measured by Scheimpflug anterior segment analyzer were all greater than those measured by SS-OCT(P<0.05). There was no significant difference in astigmatism and axial values of anterior corneal surface, posterior surface and whole cornea measured by SS-OCT and Scheimpflug anterior segment analyzer(P>0.05). The intraclass correlation coefficient(ICC)of all parameters was greater than 0.88, indicating a good intra-group repeatability. Ks, Kf, Km, astigmatism and axis of anterior corneal surface, posterior surface and whole cornea measured by SS-OCT were positively correlated with those measured by Scheimpflug anterior segment analyzer(P<0.05). Bland-Altman consistency analysis showed that Ks, Kf, Km, corneal astigmatism and axis of anterior corneal surface, posterior surface and whole cornea measured by SS-OCT were highly consistent with those measured by Scheimpflug anterior segment analyzer(P<0.05).CONCLUSION: The corneal curvature and astigmatism parameters measured by new SS-OCT are highly consistent with those measured by Scheimpflug anterior segment analyzer, which can be applied in the diagnosis of corneal curvature and astigmatism in patients with age-related cataract.
摘要
Objective:To investigate the effect of penehyclidine hydrochloride on respiratory mechanics, arterial blood gas, and inflammatory factors in patients undergoing one-lung ventilation during thoracoscopic lobectomy.Methods:A total of 100 patients who underwent thoracoscopic lobectomy with one-lung ventilation at Jinhua Central Hospital from January to November 2022 were included in this randomized controlled study. They were divided into groups A and B ( n = 50 per group) using a random digital number table. Patients in group A received an intravenous infusion of 0.02 mg/kg of pentylenethyclidine hydrochloride 30 minutes before surgery, while patients in group B received an equal amount of 0.9% sodium chloride injection 30 minutes before surgery. Clinical indicators, respiratory mechanical indicators (peak airway pressure, lung compliance), arterial blood gas analysis indicators (blood oxygen saturation, arterial pressure of oxygen, oxygenation index), inflammatory factor levels (interleukin-6, interleukin-8, tumor necrosis factor level-α), and pulmonary complications were compared between the two groups. Results:There were no significant differences in mechanical ventilation time or total infusion volume between the two groups (both P > 0.05). At the end of surgery (T1) and 1 day after surgery (T2), peak airway pressure in group A was (17.43 ± 2.69) cm H 2O and (16.81 ± 2.28) cm H 2O (1 cm H 2O = 0.098 kPa), respectively, which were significantly lower than (19.23 ± 3.40) cm H 2O and (18.29 ± 2.06) cm H 2O in group B, respectively ( t = 2.94, 3.41, P = 0.002, < 0.001). At T1 and T2, lung compliance in group A was (34.67 ± 2.93) cm H 2O and (36.26 ± 3.11) cm H 2O, respectively, which were significantly higher than (32.23 ± 2.85) cm H 2O and (33.84 ± 2.87) cm H 2O in group B, respectively ( t = 4.22, 4.04, P = 0.000, < 0.001). At T1 and T2, blood oxygen saturation, arterial partial pressure of oxygen, and oxygenation index in group A were significantly higher than those in group B ( t = 8.12, 3.07, 10.47, 3.16, 3.81, 4.15, all P < 0.05). At T1 and T2, interleukin-6, interleukin-8, and tumor necrosis factor-α levels in group A were significantly lower than those in group B ( t = 11.67, 13.55, 9.60, 15.71, 6.13, 11.50, all P < 0.001). The incidence of complications in group A was 4% (2/50), which was significantly lower than 16% (8/50) in group B ( χ2 = 4.00, P < 0.05). Conclusion:Penehyclidine hydrochloride has a good effect on respiratory mechanics, arterial blood gas, and inflammatory factors in patients undergoing thoracoscopic lobectomy with one-lung ventilation and thereby deserves clinical promotion.
摘要
OBJECTIVE@#To investigate whether Lingbao Huxin Pill (LBHX) protects against acute myocardial infarction (AMI) at the infarct border zone (IBZ) of myocardial tissue by regulating apoptosis and inflammation through the sirtuin 1 (SIRT1)-mediated forkhead box protein O1 (FOXO1) and nuclear factor-κ B (NF-κ B) signaling pathways.@*METHODS@#Six-week-old Wistar rats with normal diet were randomized into the sham, the model, Betaloc (0.9 mg/kg daily), LBHX-L (0.45 mg/kg daily), LBHX-M (0.9 mg/kg daily), LBHX-H (1.8 mg/kg daily), and LBHX+EX527 (0.9 mg/kg daily) groups according to the method of random number table, 13 in each group. In this study, left anterior descending coronary artery (LADCA) ligation was performed to induce an AMI model in rats. The myocardial infarction area was examined using a 2,3,5-triphenyltetrazolium chloride solution staining assay. A TdT-mediated dUTP nick-end labeling (TUNEL) assay was conducted to assess cardiomyocyte apoptosis in the IBZ. The histopathology of myocardial tissue at the IBZ was assessed with Heidenhain, Masson and hematoxylineosin (HE) staining assays. The expression levels of tumor necrosis factor α (TNF-α), interleukin (IL)-6, IL-1 β, and intercellular adhesion molecule-1 were measured using enzyme-linked immunosorbent assays (ELISAs). The mRNA expressions of SIRT1 and FOXO1 were detected by real-time qPCR (RT-qPCR). The protein expressions of SIRT1, FOXO1, SOD2, BAX and NF- κ B p65 were detected by Western blot analysis.@*RESULTS@#The ligation of the LADCA successfully induced an AMI model. The LBHX pretreatment reduced the infarct size in the AMI rats (P<0.01). The TUNEL assay revealed that LBHX inhibited cardiomyocyte apoptosis at the IBZ. Further, the histological examination showed that the LBHX pretreatment decreased the ischemic area of myocardial tissue (P<0.05), myocardial interstitial collagen deposition (P<0.05) and inflammation at the IBZ. The ELISA results indicated that LBHX decreased the serum levels of inflammatory cytokines in the AMI rats (P<0.05 or P<0.01). Furthermore, Western blot analysis revealed that the LBHX pretreatment upregulated the protein levels of SIRT1, FOXO1 and SOD2 (P<0.05) and downregulated NF- κ B p65 and BAX expressions (P<0.05). The RT-qPCR results showed that LBHX increased the SIRT1 mRNA and FOXO1 mRNA levels (P<0.05). These protective effects, including inhibiting apoptosis and alleviating inflammation in the IBZ, were partially abolished by EX527, an inhibitor of SIRT1.@*CONCLUSION@#LBHX could protect against AMI by suppressing apoptosis and inflammation in AMI rats and the SIRT1-mediated FOXO1 and NF- κ B signaling pathways were involved in the cardioprotection effect of LBHX.
Subject(s)
Animals , Rats , Apoptosis , Drugs, Chinese Herbal , Inflammation/metabolism , Myocardial Infarction/pathology , NF-kappa B/metabolism , Nerve Tissue Proteins , Rats, Wistar , Sirtuin 1/genetics摘要
Objective@#The purpose of this study was to test the hypothesis that a significant temporal relationship exists between asthma and attention deficit hyperactivity disorder (ADHD). @*Methods@#The population dataset consisted of 95,846,511 physician diagnoses for 768,460 (46% male) individuals spanning 1993–2010. Four groups were labeled as having neither Asthma nor ADHD, Asthma only, ADHD only, or both Asthma and ADHD and formed the basis of calculating the odds ratios for each sex describing the association of Asthma and ADHD by age, and, in addition, a prospective sample age (<5 years) between 1993 and 1996 was utilized to evaluate the temporal association between Asthma and ADHD. @*Results@#There was a significant relationship between ADHD and Asthma within the age strata of the sample, one from the cohort and two from the whole sample. When both ADHD and Asthma were diagnosed in the same patients, the age was younger in both cross-sectional and prospective cohort samples. ADHD arose significantly more often after Asthma in the cross-sectional samples stratified on age and in the prospective cohort sample. @*Conclusion@#The results are consistent with previous literature where ADHD has been linked to allergic diseases, such as asthma.
摘要
In response to the major national strategic needs of "Healthy China" and "Innovation-Driven Development", Sichuan University, as a pilot university of "Excellent Doctor Education and Training Plan-Top Innovative Medical Personnel Training", has been exploring the training strategies since 2012. On the basis of the international theory of "The Third Generation of Medical Education based on Health System", we have innovatively put forward the new era of "Med+" education theory based on research-oriented hospitals (with medical/research/translational facility) and the two-level training paradigm from "cultivating professionalism" to "notch up to top" by planting three cultures. We have also developed a competency training system of "Five Integrated Curricula and Five Teaching & Learning Strategies". We have shifted from "didactic teaching" to "formative learning", edifying excellent doctors with "professionalism culture". We have initiated two kinds of top-notch plans, constructed a "1+2+3" innovation and entrepreneurship education system, explored "transformative learning" to incubate compound top-notch personnel with "innovative culture", opened up a "school-hospital unified" administrative system, built a PDCA closed-loop of quality control supported by mobile technology, and recast the "quality culture" to ensure shifting from "cultivating professionalism" to "notch up to top".
摘要
Objective To approach new and simple method in treatment of ear cerumen. Methods Retrospective analysis of 110 cases of cerumen embolization from March 2015 to March 2017. Results The outer ear canal cerumen was removed in one time without perforation of the eardrum. 12 cases of external auditory canal injury. Conclusion Cerumen under the hard ear endoscope is a safe, simple and effective method.
摘要
Objective: To explore the diagnostic value and efficiency of using whole body bone scintigraphy (WBS) combined with the levels of tumor markers to evaluate non-small cell lung cancer (NSCLC) patients with bone metastases. Methods: One-hundred and eighty-five cases of NSCLC, confirmed by pathology or cytological examination from January 2014 to June 2016, were emrolled from the Affiliated Tumor Hospital of Guangxi Medical University. WBS and test results of tumor markers, such as serum carcinoembryonic antigen (CEA), serum carbohydrate antigen (CA125), and cytokeratin CK19 (CYFRA21-1), were analyzed. WBS results were assessed by the Soloway classification criteria and divided into four grades: Correlations between WBS classification and the levels of tumor mark-ers were determined with Spearman correlation analyses. Results: Seventy-eight of the 185 NSCLC patients had bone metastases (a rate of 42.16%). The sensitivity and specificity of WBS were 91.02%(71/78) and 85.98%(92/107), respectively. The CEA, CA125, and CYFRA21-1 levels in bone metastases patients were higher than those in NSCLC patients without bone metastases (P＜0.05). In the 78 patients with bone metastases, there were seven cases of EOD0 (8.98%), 39 cases of EOD1 (50%), 17 cases of EOD2 (21.8%), and 15 cases of EOD3 (19.2%). The correlations between WBS grade and CEA, CA125, and CYFRA21-1 levels were: rs=0.579, 0.274, and 0.327, respectively (P＜0.05). The combined WBS and tumor marker diagnostic performance was significantly better than either alone (AUC=0.922), and their sensitivity and specificity increased (92.3%and 86.0%, respectively). Conclusions: WBS shows high clinical efficacy in the diagnosis of NSCLC with bone metastases. Furthermore, it can be used as a screening test for bone metastases of NSCLC, which has important clinical implications. WBS combined with CEA, CA125, and CYFRA21-1 examination improves the detection rate of NSCLC bone metastases, thereby enhancing its clinical utility.
摘要
Objective To prepare tamsulosin hydrochloride sustained-release pellet by coating with acrylic copolymers. Methods EUDRAGIT® NE 30 D was used as the main sustained-release material, EUDRAGIT® L 30 D-55 and Methocel® E3 were used as release adjust agent; a one layer sustained-release coating was done for tamsulosin hydrochloride-loaded pellet in bottom spray fluid bed. A three factor, three-level Box-Behnken design was used to optimize the percentages of EUDRAGIT® L 30 D-55 and Methocel® E3 in the total dry polymers and the weight gain of total dry polymers as the three nonlinear factors, which mainly influenced drug release of the pellets in the formula of sustained-release coating layer. In-vitro cumulative drug release after 2 h, 3 h and 5 h was tested and the following target range:2 h 12%-39%, 3 h 44%-70% and 5 h>70% were set for optimization. Results The formulation and process of one layer sustained-release coating, which was synergistically controlled by the three materials based on acrylic copolymers, was determined after optimization:the total dry polymers were applied with a weight gain of 12% on drug pellets, with EUDRAGIT® L 30 D-55 dry polymers and Methocel® E3 being 7% and 2% of the total dry polymers, respectively. The sustained-release pellets coated with the optimized formulation provided a release profile that was close to the predicted value and similar to that of the commercial product Harnal® capsule pellets by f2 similarity factor comparison (f2 values of three batches were 71,73 and 80). Conclusion The established formulation and process is a simple and reproducible method to prepare tamsulosin hydrochloride sustained-release pellets with good stability.
摘要
The successful suppression of clutter arising from stationary or slowly moving tissue is one of the key issues in medical ultrasound color blood imaging. Remaining clutter may cause bias in the mean blood frequency estimation and results in a potentially misleading description of blood-flow. In this paper, based on the principle of general wall-filter, the design process of three classes of filters, infinitely impulse response with projection initialization (Prj-IIR), polynomials regression (Pol-Reg), and eigen-based filters are previewed and analyzed. The performance of the filters was assessed by calculating the bias and variance of a mean blood velocity using a standard autocorrelation estimator. Simulation results show that the performance of Pol-Reg filter is similar to Prj-IIR filters. Both of them can offer accurate estimation of mean blood flow speed under steady clutter conditions, and the clutter rejection ability can be enhanced by increasing the ensemble size of Doppler vector. Eigen-based filters can effectively remove the non-stationary clutter component, and further improve the estimation accuracy for low speed blood flow signals. There is also no significant increase in computation complexity for eigen-based filters when the ensemble size is less than 10.
Subject(s)
Humans , Blood Flow Velocity , Color , Signal Processing, Computer-Assisted , Ultrasonography摘要
The paper makes a brief introduction to the application of natural language processing in Traditional Chinese Medicine (TCM).Through research and analysis of relevant literatures , it describes the features and application directions of such methods as the association rule mining , clustering analysis , information extraction , machine learning , etc.It also summarizes methods related to the es-tablishment of knowledge networks on TCM and proposes new ideas for future researches of natural language processing in TCM based on the establishment of knowledge networks .
摘要
<p><b>OBJECTIVE</b>To observe the impacts on the muscle strength in the patients of stroke-induced acroparalysis treated with Xunjingcuiqi needling technique.</p><p><b>METHODS</b>One hundred patients were randomized into a Xunjingcuiqi group and a routine acupuncture group, 50 cases in each group. In the routine acupuncture group, the routine acupuncture technique was adopted at the main acupoints, such as Shangxing (GV 23), Baihui (GV 20), Dicang (ST 4), Quchi (LI 11), Huantiao (GB 30) and Zusanli (ST 36), etc. In Xunjingcuiqi group, on the basis of the routine acupuncture technique, Xunjingcuiqi needling technique (pricking technique was quickly applied with the filiform needle along the running course of meridian to promote the conduction of meridian qi) was added. For the patients being hard to feel the needling sensation and with the muscle strength of 0 to 1 degree, Dongzhencuiqi technique was supplemented at shu-stream points of yang meridians (after qi arrival, the needling manipulation with limb movement was given to promote the conduction of meridian qi). The treatment was given once every day in the two groups. Ten treatments made one session. Three sessions of treatment were required. At the end of each session treatment, the muscle strength and clinical efficacy were assessed.</p><p><b>RESULTS</b>In the 1st, 2nd and 3rd sessions of treatment, 20, 24 and 36 cases achieved the 3 to 5 degrees muscle strength in Xunjingcuiqi group, respectively; and 6, 10 and 15 cases achieved the 3 to 5 degrees muscle strength in the routine acupuncture group. The differences were significant statistically in comparison of the two groups (P < 0.01, P < 0.05). The markably effective rates were 60.0% (30/50), 64.0% (32/50) and 70.0% (35/50) after the 1st, 2nd and 3rd sessions of treatment in Xunjingcuiqi group, respectively; and those were 38.0% (19/50), 44.0% (22/50) and 46.0% (23/50) in the routine acupuncture group, respectively. The differences were significant in the 1st and 3rd sessions of treatment between the two groups (both P < 0.05).</p><p><b>CONCLUSION</b>Xunjingcuiqi needling technique combined with routine acupuncture achieves the apparent superior efficacy on acroparalysis induced by ischemic stroke as compared with the simple routine acupuncture. Xunjingcuiqi needling technique obviously improves muscle strength and shortens the duration of sickness.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Acupuncture Points , Acupuncture Therapy , Methods , Paralysis , Therapeutics , Qi , Stroke , Treatment Outcome摘要
<p><b>OBJECTIVE</b>To observe clinical effect of acupuncture combined with medicine therapy for elderly women in Britain with lymphedema syndrome.</p><p><b>METHODS</b>Twenty-seven cases were classified according to syndrome differentiation of TCM into cold congealing and dampness obstruction type (11 cases), qi-blood stagnation type (12 cases) and downward attack of damp-heat type (4 cases). They were treated with acupuncture at main points Zusanli (ST 36), Yanglingquan (GB 34), Yinglingquan (SP 9), Sanyinjiao (SP 6), Taichong (LR 3), Fenglong (ST 40), Xuehai (SP 10), Fengshi (GB 31), Futu (ST 32), Liangqiu (ST 34), Weizhong (BL 40), etc., twice each week and oral administration of modified Duhuojisheng Decoction, Huangqiwuwu Decoction and Simiao San Decoction, respectively, meanwhile washing the affected limb with again decoction of remaining gruffs one medicament each day. They were treated for 12 weeks.</p><p><b>RESULTS</b>Twelve cases were clinically cured, accounting for 44.4%, 14 cases were effective, accounting for 51.9%; and 1 case was ineffective, accounting for 3.7%.</p><p><b>CONCLUSION</b>Acupuncture combined with medicine has a good therapeutic effect on lymphedema syndrome.</p>
Subject(s)
Aged , Female , Humans , Middle Aged , Acupuncture Points , Acupuncture Therapy , Combined Modality Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Lymphedema , Drug Therapy , Therapeutics , Treatment Outcome , United Kingdom摘要
<p><b>OBJECTIVE</b>To evaluate the therapeutic effect and safety of acupuncture and moxibustion for treatment of acne, and to analyze the current situation of clinical studies at present.</p><p><b>METHODS</b>Retrieve PubMed, Cochrane library, CBM databank, CNKI databank, etc., and collect the randomized and controlled trials of treatment of acne with acupuncture and moxibustion, and select clinical trials conforming with the enrolled criteria, and conduct evaluation of quality with Cochrane systematic manual 5.0, and RevMan 4.2.8 was used for statistical analysis.</p><p><b>RESULTS</b>Seventeen papers, including 1,613 cases, conformed with the enrolled criteria. Seventeen studies adopted the cured rate as the evaluation index, Meta-analysis showed treatment of acne by acupuncture and moxibustion with routine western medicine as control, significant difference for inter-group comparison [combined RR (random efficacy model) = 2.96, 95% CI (1.63, 4.91), Z=4.08. P<0.0001]; comprehensive acupuncture and moxibustion therapy was controlled with single acupuncture moxibustion therapy, significant difference for inter-group comparison [combined RR (fixed efficacy model) = 2.51, 95% CI (1.76, 3.57), Z=5.11, P<0.00001].</p><p><b>CONCLUSION</b>Acupuncture-mox ibustion is safe and effective for treatment of acne, and it is possibly better than routine western medicine, and the comprehensive acupuncture-moxibustion therapy is better than single acupuncture-moxibustion therapy. The conclusion has not been determined yet, because lower quality of a part of literature enrolled.</p>
Subject(s)
Humans , Acne Vulgaris , Therapeutics , Acupuncture Therapy , Meta-Analysis as Topic , Moxibustion , Randomized Controlled Trials as Topic摘要
<p><b>OBJECTIVE</b>To study apoptosis and gene FasL expression induced by carbon disulfide in sertoli cells of male rats.</p><p><b>METHODS</b>Sertoli cells were exposed to different concentrations of CS(2) (0, 0.36, 0.72, 1.44 micromol/ml) for 24 hours. Survival rate, apoptosis rate, expression level of gene FasL were measured using MTT, FCM, and RT-PCR methods respectively.</p><p><b>RESULTS</b>Sertoli cell survival rate decreased as the concentration of CS(2) increased. The survival rate (73.34% +/- 1.39%) was significantly lower than the control group (99.98% +/- 5.48%) when the concentration of CS(2) > or = 1.44 micromol/ml (P < 0.05). Apoptosis rate increased as the CS(2) concentration increased. Apoptosis rate (7.93% +/- 0.43%) was significantly higher when the concentration of CS(2) > or = 1.44 micromol/ml (P < 0.05). Expression level of the FasL significantly increased as the concentrations of CS(2) (P < 0.05).</p><p><b>CONCLUSION</b>CS(2) is cytotoxic to sertoli cells. It could cause apoptosis of sertoli cells.</p>
Subject(s)
Animals , Male , Rats , Apoptosis , Carbon Disulfide , Toxicity , Cell Line , Cell Survival , Fas Ligand Protein , Metabolism , Sertoli Cells , Metabolism , Testis , Cell Biology摘要
Objective: To explore the effect of Fuzheng granules on immune function activities in animal models.Methods: The effects of Fuzheng granules were investigated in normal mice and immunosuppressive mice by macrophage englobement rate and index of phagocytosis,leucocyte quantity,lymphocyte conversion ratio induced by adhesin,serum hemolysin,content of serum con-complement.Results: Fuzheng granules could significantly elevate the macrophage englobement rate,index of phagocytosis,leucocyte quantity,lymphocyte conversion ratio induced by adhesin,serum hemolysin,content of serum con-complement in above mice.Conclusion: Fuzheng granules had the effect of improving immune function activities.