摘要
Objective To explore the application effect of the Mini-CEX evaluation model based on the OBE concept in the clinical Practice teaching of neurology.Methods We Selected 100 students who will Practice in the Department of Neurology from 2022 to 2023 as the research objects,and divided them into the experimental group(n=50)and the control group(n=50).Under the guidance of the OBE concept,the experimental group was guided by learning outcomes,refined the teaching objectives,and applied the Mini-CEX evaluation mode for evaluation and feedback.In contrast,the control group adopted the traditional teaching mode.Combined with the observation data,we analyzed and compared the data of various indicators of the two groups of students at the beginning and end of the internship.Results At the end of the internship,the scores of clinical consultation,Physical examination,humanistic medicine,clinical diagnosis,health consultation,organizational effect,and overall evaluation of the experimental group were significantly improved and were higher than those of the control group.After the Practice,in terms of skill test scores,the experimental group scored higher than the control group,the difference was statistically significant(P<0.05),and the experimental group also scored higher in satisfaction evaluation than the control group.Conclusion The Mini-CEX evaluation teaching model based on the concept of OBE is applied to the clinical practice teaching of the neurology department,which can enhance the training effect of students'clinical practice skills.
摘要
Objective To investigate the role of microRNA-18a (miR-18a) in the pathogenesis of allergic rhinitis in mice. Methods Twenty-two BALB/c mice were randomly divided into a blank group, a model group and a miR-18a group. Mice in the model group and the miR-18a group were injected intraperitoneally with obumin (OVA) suspension to prepare allergic rhinitis models, and mice in the miR-18a group were simultaneously given lentiviral vector plasmid for overexpression of miR-18a. Allergy symptoms were evaluated by the behavioral score and HE staining. The plasma levels of interleukin-1β (IL-1β), IL-6 and tumor necrosis factor α (TNF-α) were measured by ELISA. The distribution of CD45+ cells in nasal mucosa was measured by immunofluorescence histochemistry, and CD45+ cells in nasal lavage fluid were measured by flow cytometry. The mRNA expression levels of IL-1β, IL-6 and TNF-α in nasal mucosa tissues were measured by fluorescence quantitative PCR, and the protein expressions of Toll like receptor 4 (TLR4), nuclear factor κB p65 (NF-κB p65), inhibitor of NF-κB α (IκBα) and phosphorylated IκBα (p-IκBα) in nasal mucosa were measured by Western blot analysis. Results Compared with the blank group, the plasma levels of IL-1β, IL-6, and TNF-α in the model group increased significantly. The number of CD45+ cells in both nasal mucosa tissue and nasal irrigation fluid increased, and the mRNA levels of IL-1β, IL-6 and TNF-α and the protein expression levels of TLR4, NF-κB p65 and p-IκBα in nasal mucosa increased. Compared with the model group, the plasma levels of IL-1β, IL-6 and TNF-α in the miR-18a group decreased significantly. The number of CD45+ cells in both nasal mucosa tissue and nasal lavage fluid decreased, and the mRNA levels of IL-1β, IL-6 and TNF-α and the exprotein expression levels of TLR4, NF-κB p65 and p-IκBα in nasal mucosa decreased. Conclusion miR-18a can inhibit the occurrence and development of allergic rhinitis, and its molecular mechanism is related to the inhibition of TLR4/NF-κB pathway activation.
Subject(s)
Animals , Mice , Disease Models, Animal , Inflammation , Interleukin-6/genetics , MicroRNAs/genetics , NF-kappa B/metabolism , NF-KappaB Inhibitor alpha , Rhinitis, Allergic , RNA, Messenger , Toll-Like Receptor 4/metabolism , Tumor Necrosis Factor-alpha/genetics摘要
Objective:Standardized sample resources and high-quality clinical big data are important resources for medical research, only through resource sharing can maximize its utilization.Which can be utilized to the max only through resource sharing.Methods:This paper attempts to explore the sharing mechanism of the resource sharing platform and proposes some aspects such as the platform construction background, management regulations, legal ethical system, data sharing principles, benefit distribution, etc.This article attempts to explore the sharing mechanism based on the resource sharing platform of the respiratory disease biobank, proposes the contents that should be included in the sharing mode.Detailed information including the platform construction background, management procedures, legal and ethical system, data sharing principles and benefit distribution should take into consideration in the operating mechanism of the platform.Results:Establishing a resource sharing platform matches the development of clinical research in China.The tailored sharing model which is suitable for the field of respiratory diseases will also guide the rapid development of clinical research.Conclusions:The construction of a respiratory disease biobank sharing platform is conducive to promoting the opening and sharing of biological samples and information resources in the context of big data.
摘要
Objective:To analyze the correlation between 1H-MRS in hippocampus and peripheral blood cytokines and T lymphocyte subsets in patients with temporal lobe epilepsy, and to explore the relationship between immune dysfunction and the degree of neuronal injury. Methods:Fifty patients with temporal lobe epilepsy were selected from Affiliated Hospital of Xuzhou Medical University from October 2020 to July 2021.Clinical data of all patients were collected and they were divided into two groups according to MRI results of epileptic sequence: abnormal hippocampal MRI group ( n=20) and normal hippocampal MRI group ( n=30). Bilateral 1H-MRS scanning of hippocampal and detection of T lymphocyte subsets and cytokines in peripheral blood during interictal period were performed in both groups. The levels of hippocampal metabolites NAA, NAA/(Cr+ Cho), T lymphocyte subsets and cytokines in peripheral blood of the two groups were compared.At the same time, the levels of NAA and NAA/ (Cr+ Cho) in the hippocampus on the abnormal side and the normal side in the abnormal hippocampal MRI group were compared within the group. Finally, the correlation between the levels of metabolites NAA, NAA/ (Cr+ Cho) in the hippocampus on the abnormal side obtained by 1H-MRS scanning and T lymphocyte subsets and cytokines in the abnormal group of MRI was analyzed. The data were statistically analyzed by SPSS 26.0 software. Independent sample t-test or Mann-Whitney U test was used for comparison between the two groups. Paired sample t-test was used for intra group comparison of different sides. Spearman correlation analysis was used to analyze the correlation between each index. Results:The NAA and NAA/(Cr+ Cho) values of the abnormal MRI group(normal side NAA: (1.22±0.37), NAA/(Cr+ Cho): (0.56±0.15). abnormal side NAA: (1.02±0.34), NAA/(Cr+ Cho): (0.48±0.13)) were significantly lower than those of the normal MRI group (NAA: (1.51±0.36), NAA/(Cr+ Cho): (0.73±0.19))(NAA: t=2.705, 4.800, both P<0 05; NAA/(Cr+ Cho): t=3.394, 4.914, both P<0 05). The values of NAA and NAA/(Cr+ Cho) in the abnormal side in the MRI abnormal group were significantly lower than those in the normal side( t=6.467, P<0 05). The levels of IL-1β(11.19(3.56, 20.98)pg/ml), IL-5 (3.12(1.86, 6.41)pg/ml), TNF-α(2.55(1.19, 8.28)pg/ml), CD4+ T lymphocytes((43.13±6.82)%) and Th/Ts((1.96±0.66)) in the hippocampal MRI abnormal group were significantly higher than those in normal MRI group (IL-1β: 3.27(1.63, 6.17)pg/ml, IL-5: 1.15(0.96, 2.96)pg/ml, TNF-α: 1.34(1.02, 2.36)pg/ml, CD4+ T: (38.01±7.21)%, Th/Ts: (1.48±0.53))( Z=-3.041, -2.516, -2.496, all P<0.05; t=2.511, 2.810, both P<0 05). The level of CD8+ T ((23.48±5.33)%) in peripheral blood of abnormal MRI group was significantly lower than that of normal group CD8+ T((27.18±6.08)%)( t=2.210, P<0.05). In the abnormal MRI group, the levels of NAA and NAA/ (Cr+ Cho) in the abnormal hippocampus were negatively correlated with the levels of IL-1β, IL-5 and TNF- α ( r=-0.612--0.463, all P<0.05), and positively correlated with CD8+ T lymphocytes ( r=0.537, 0.478, P<0.05). Conclusion:There is neuronal damage and dysfunction in the abnormal hippocampal region of patients with temporal lobe epilepsy with abnormal hippocampal formation, and the degree of neuronal damage is highly correlated with CD8+ T lymphocytes, IL-5, IL-1β and TNF-α in peripheral blood. The imbalance of interictal lymphocyte subsets and chronic inflammatory response may play an important role in the pathogenesis of epilepsy and neuronal injury .
摘要
Objective:To investigate the value of stereo-electroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC) in patients with focal epilepsy.Methods:Eighteen patients with focal epilepsy admitted to and treated by SEEG-guided RFTC in our hospital from April 2019 to December 2020 were chosen. The clinical data of these patients were retrospectively analyzed, and follow up was performed monthly by telephone and outpatient subsequent visit. The treatment efficacies of these patients were evaluated by Engel grading.Results:(1) The number of electrodes accurately implanted into the intended target in these 18 patients was 4-11 (6.56±2.15 on average); unilateral implantation was noted in 6 patients, and bilateral implantation was noted in 12 patients. SEEG monitoring showed that 7 patients were with frontal lobe epilepsy, 8 were with temporal lobe epilepsy, 2 were with frontotemporal junction epilepsy, and one was with temporal occipital junction epilepsy. (2) Two-9 RFTC electrodes (3.43±1.47 on average), and 9-42 RFTC contacts (17.38±9.20 on average) were given in these 18 patients. One patient developed seizures during the course of RFTC, one had temporary mental symptoms after RFTC, one had diffuse brain edema with intracranial hypertension, and one had asymptomatic regional brain edema. The total complication incidence was 22.2% (4/18) and no permanent neurological impairment occurred. (3) Eleven patients (61.1%) had recurred seizure within 1 year of RFTC: 3 (27.3%) recurred within 1 month, 3 (27.3%) recurred within 1-3 months, 3 (27.3%) recurred within 3-6 months, and 2 (18.2%) recurred within 6-12 months; however, the duration and frequency of seizure were obviously decreased as compared with those before RFTC. Seven patients (38.9%) received craniotomy after RFTC; follow up for 5-24 months showed that 12 patients were with Engel grading I, 4 were with Engel grading II, 2 were with Engel III, and no one was with Engel grading IV.Conclusions:SEEG-guided RFTC has enabled patients with focal epilepsy to achieve complete remission of their seizures with varying durations, and some patients have achieved long-term remission of their seizures. For patients with recurrent epilepsy after SEEG-guided RFTC, further craniotomy of the epileptogenic area is still effective.
摘要
The novel coronavirus pneumonia (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is pandemic globally. The progress and evolution of the disease is closely related to the immune defense function. The host immune promotes virus clearance. The dysfunction of immune compromises virus clearance, and incurs uncontrolled inflammatory response which causes immune pathological injury and makes the disease worse. Therefore, the application of immunotherapy for immune disorders caused by SARS-CoV-2 infection is expected to be an effective strategy for the treatment of COVID-19.
摘要
Objective To investigate the prevalence and endoscopic detection rate of proximal serrated polyps and to screen the risk factors. Methods The data of 9010 colonoscopies performed by 22 endoscopists between September 2016 and September 2017 were reviewed. The adenoma detection rate (ADR) and proximal serrated polyp detection rate (PSDR) were calculated, and the correlation between ADR and PSDR was estimated by Pearson correlation coefficients. Multivariate logistic regression was used to analyze PSDR among endoscopists. Results For all subjects, the mean ADR was 30. 07% ( ranged from 20. 00% to 40. 78%) and mean PSDR was 4. 70% ( ranged from 1. 52% to 9. 28%) . PSDR of males was 1. 38 times of that of females ( OR=1. 38, 95%CI:1. 13-1. 69, P<0. 01) . For 3560 cases ( 39. 51%) of 50 years and older subjects, the mean ADR was 45. 01% ( 28. 99%-57. 78%) and mean PSDR was 6. 08%(2. 07%-10. 56%). PSDR was moderately correlated with ADR (r=0. 48, P=0. 02). PSDR of males was 1. 36 times of that of females (OR=1. 36, 95%CI: 1. 04-1. 80, P=0. 03). Endoscopist was a significant risk factor for detection of proximal serrated polyps ( P<0. 01) . Compared with endoscopist with the highest PSDR, odds ratio of other endoscopists ranged from 0. 16 (95%CI:0. 06-0. 40, P<0. 01) to 0. 83 (95%CI:0. 53-1. 32, P=0. 44) . Conclusion Proximal serrated polyps are more common in males, who are over 50 years old. The PSDR is highly variable and dependent on endoscopists. It is possible that a certain proportion of proximal serrated polyps are missed during colonoscopy.
摘要
Objective·To analyze the choice of smoking cessation methods and its influencing factors in moderate-to-severe nicotine-dependent population.Methods·A retrospective clinical analysis was conducted for170 moderate-to-severe nicotine-dependent smoking-quitters (Fagerstr(o)m scale ≥ 4).Different smoking cessation methods (pharmacotherapy and non-pharmacotherapy) and abstinence rates of the selected population (7 d point prevalence abstinence rates and sustained abstinence rates 1,3,and 6 months after treatment) were compared and possible influencing factors were analyzed.Results·The differences in choosing the smoking cessation method in moderate-to-severe nicotine-dependent population with different ages,levels of education,and employment status were statistically significant (P=0.000).The Logistics regression analysis showed that the level of education was the major factor for choosing the smoking cessation method (P=0.006).The 7 d prevalence abstinence rate was much lower for pharmacotherapy than for non-pharmacotherapy 1 month after treatment (P=0.000) and was much higher for pharmacotherapy than for non-pharmacotherapy 3 and 6 months after treatment (P=0.000).The sustained abstinence rate was much higher for pharmacotherapy than for non-pharmacotherapy 3 and 6 months after treatment (P=0.002,P=0.000).Conclusion·For moderate-to-severe nicotine-dependent smoking-quitters,attention should be paid to the formulation and implementation of personalized strategies.The choice of smoking cessation methods depends on the age,level of education,and employment status.Reasonable pharmacotherapies can significantly increase the abstinence rate.
摘要
Objective:To realize Tangshan City’s medical institutions of health and human resources. Methods: Using gray predict model to prognosis Tangshan City’s main medical human resources, and find out the phenomena of lacking of medical administrative staff, disproportional of nursing staff, and shorting of assistant departments staff, such as pharmacy and medical laboratory.Results: In the next few years, we should focus on strengthening the ability of the health technical personnel, except practicing(assistant)doctors.Conclusion:Through increasing the orientation training and recruitment, improving treatment, changing ideas, etc, to achieve the rationalization of health personnel allocation. In order to coping with health care reform, we should complete the allocation and reserve of health human resources.
摘要
Reduced sulfur compounds ( RSCs) are one of the main pollutant species in the atmosphere, so it is of great significance to develop a rapid and on-line approaches for their detection. In this study, a portable time-of-flight mass spectrometer ( TOF-MS) with magnetic field enhanced photoelectron ionization source was designed to detect RSCs. The photoelectron ionization source was induced from vacuum ultraviolet photons which generated from vacuum ultraviolet (VUV) lamp with energy of 10. 6 eV. The energy of photoelectrons was controlled by adjusting the extraction voltage to produce the photoelectron ionization, and an annular magnet was used in the ionization region to improve the ionization efficiency of photoelectrons. From the simulation result by SIMION software, it was found that the introduction of magnet field made the motion trajectroies of electrons in the helical motion increase and the convergence of electron at the ionization source was achieved. Experimental results showed that after introducing the magnet filed, the sensitivity of H2 S, SO2 and CS2 was improved by a factor of 5. 3, 9. 4 and 6. 9, respectively. With a detection time of 50 s, the limits of detection for H2S, SO2 and CS2 were 0. 14, 0. 52 and 0. 31 mg/m3(S/N=3), respectively. It could be concluded that the portable TOF-MS with magnetic field enhanced photoelectron ionization source has great potential to be applied for on-line monitoring of volatile sulfides at the emission source.
摘要
In this article, an acetone-enhanced negative photoionization (AENP) source based on a 10. 6 eV vacuum ultraviolet ( VUV) lamp was developed and coupled to a home-made time-of-flight mass spectrometer for rapid detection of trace explosives. In the AENP source, acetone molecules absorbed 10. 6 eV photons and were ionized by single photon ionization to emit photoelectrons. The photoelectrons reacted with O2 , CO2 , etc. in the atmosphere to produce mainly CO-3 negative reactant ions. With this ionization source, common explosives, N-nitrobiz ( 2-hyolorolroxy ethyl )-amine dinitrate ( DINA ) , Tetryl, trinitrotoluene ( TNT ) and hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX), could be detected sensitively, and the limit of detection of 2 pg ( TNT) with a linear range of 3 orders of magnitude was achieved. The simple structure, high sensitivity characteristics make the AENP source as a promising ionization source for mass spectrometry.
摘要
OBJECTIVE To observe the curative effect of external dacryocystorhinostomy(EDCR) and intranasal endoscopic dacryocystorhinostomy(IEDCR)for chronic dacryocystitis, and to evaluatethe postoperative satisfaction of the patients.METHODS According to randomized controlled design, 108 chronic dacryocystitis patients were divided into the intranasal endoscopic dacryocystorhinostomy group and control group, both groups underwent intranasal dacryocystorhinostomy and external dacryocystorhinostomy respectively.The changes of symptom and clinical sign, operation time, hospital day, cost of hospitalization were recorded.All patients were followed up for 1-5years, and the postoperative satisfaction of the patients were investigated by interval satisfaction scale.RESULTS ①There were no significant difference between the groups at the curative effect, operation time and hospital day, the hospitalization cost of the intranasal endoscopic dacryocystorhinostomy group was higher than that of the control group;②The recurrence rate of the intranasal endoscopic dacryocystorhinostomy group and control group were 12.82% and 15.56% respectively after 5 years, Log Rank test ?2=0.394, P=0.530;③ The postoperative satisfaction of the patients in both groups were(81.70?10.242)and(75.72?10.653) score respectively, which were similar to normal distribution, t=-2.974, P=0.004.CONCLUSION The effect of intranasal endoscopic dacryocystorhinostomy for chronic dacryocystitis is similar to external dacryocystorhinostomy.But intranasal endoscopic dacryocystorhinostomy is a more ideal method, because it is minimal invasive technique and doesn't affect the face cosmetology.
摘要
Objective:To apply electropalatography(EPG) in speech training for the patients with misarticulations caused by abnormal palatolingual contact, such as palatalized misarticulation(PM) and lateral misarticulation(LM) because of cleft lip and palate. Methods: Four patients with cleft lip and palate averagely aged 12.5 years old were enrolled in this study. PM was found in all the patients with or without LM. Misarticulations of these patients were corrected by visual feedback of EPG in speech training. Speech intelligibility and electropalatogram before and after therapy were compared. Results: It was convenient for the patients to check their pronaciation by the visual feedback of EPG.Their speech intelligibility was improved and palatolingual contact were more anterior after speech training. Conclusion: EPG is a valuable instrument in speech training for patients with misarticulation
摘要
The amygdalin content in Runing Granules has been determined on the column RP-C_(15), using acetonitrile:water(1:6)as mobile phase and detection wavelength at 240nm.This method showed a high sensitivity,simple operation,good reproducibility and reliable result.It provide a certain base for the quality control of Chinesemateria medica and traditional Chi- nese patent medicine with amygdalin.