RESUMEN
In vivo confocal microscopy of the cornea is a non-invasive, rapid, and comprehensive technique for real-time, dynamic observation of all layers of the cornea. Confocal microscopy allows the examination of the morphology and cell density in the different layers of the cornea through direct visualization. With the increasing prevalence of diabetes, ocular complications have become common and have garnered more interest and in-depth research from clinical and scientific communities. This paper provides a comprehensive review of research progress made using in vivo confocal microscopy to observe various layers of cornea tissue in diabetic patients.
RESUMEN
Objective:To optimize the clinical nursing pathway, service program and evaluation parameters of percutaneous coronary intervention(PCI), for references for the cost accounting and compensation mechanism of nursing program in public hospitals.Methods:After literature analysis and group discussion, the initial templates were constructed for the PCI clinical nursing pathway, nursing service projects, and their evaluation parameters. 15 experts were consulted by two rounds of Delphi method to optimize PCI nursing path, nursing service items and their evaluation parameters (basic labor consumption, basic time consumption, technical difficulty and risk degree).Results:Two rounds of Delphi method finally determined the PCI clinical nursing path and 27 nursing service items, and adjusted the evaluation parameters of 10 nursing service items. The new projects for PCI clinical nursing services included adjustment and review of dual antiplatelet therapy plans, postoperative rehabilitation nursing, and key project verification. The three nursing service projects with the highest level of technical difficulty and risk were intravenous blood transfusion, gastric catheterization, and gastrointestinal decompression. The two items with the highest importance assigned were high pump assisted arterial/venous infusion (blood) and invasive continuous arterial blood pressure monitoring.Conclusions:The PCI clinical nursing pathway and nursing service project constructed in this study could closely integrate with clinical practice, highlight the integrated nursing service model, and reflect the labor value of nurses.
RESUMEN
As the number of cataract patients with high myopia increases, and the cataract surgery shifts from a rehabilitation procedure to a refractive procedure, achieving a good postoperative visual acuity has been the target of cataract patients with high myopia.Because of inaccurate axial length measurement, unpredictable effective lens position and improper selection of intraocular lens (IOL) calculation formulas, the precision of refractive prediction in cataract patients with high myopia remains low, which affects the visual acuity and satisfaction of patients.With the development of IOL calculation formulas, SRK/T, Holladay1 and other thin-lens vergence formulas have been modified in axial length, corneal curvature and other parameters, and the thick-lens vergence formulas such as Barrett Universal Ⅱ have been widely put into use.Meanwhile, new formulas including artificial intelligence-based formulas such as Hill-RBF, ray tracing formulas such as Olsen and OKULIX, and theoretical formulas such as Kane and EVO formulas have been developed.More choices and guarantees are available for refractive prediction after cataract surgery.This paper summarized the optimization and advance of different types of IOL calculation formulas so as to provide different available choices to improve the accuracy of IOL power calculation in cataract patients with high myopia.
RESUMEN
Objective:To investigate the feasibility of surface-guided hypo-fractionated radiotherapy for intracranial metastasis with open face mask immobilization.Methods:Nineteen patients treated with hypo- fractionated radiotherapy for intracranial metastasis in our hospital were included. Before the start of treatment, each patient underwent simulation with open face mask immobilization. During the treatment, cone-beam CT(CBCT)images were collected for verification each time. Laser-guided positioning was used for the first time in the treatment, and surface images were captured after six-dimensional position correction as the reference images for subsequent treatment. Subsequent treatment was randomly divided into laser-guided positioning group(LG, 85/F)and optical surface-guided positioning group(SG, 101/F). The six-dimensional error data of patients with two positioning methods were compared and expressed as mean ± standard deviation. Meanwhile, the correlation and consistency between the optical surface error data and the gold standard CBCT error data were compared in the laser-guided fraction. GraphPad Prism 6.0 software was used for data processing and mapping, and SPSS 21.software was used for mean analysis and normality test. Pearson correlation analysis was used to analyze the correlation, and Bland-Altman plot analysis was used to test the coincidence between two methods.Results:Compared with the laser-guided positioning, the 3D error of optical surface-guided positioning was reduced from(0.35±0.16)cm to(0.14±0.07)cm. The Pearson coefficient of correlation along all three directions was less than 0.01,R 2 was 0.91,0.70 and 0.78 on Lat, Lng and Vrt, and R 2 was 0.75,0.85 and 0.77 on Pitch, Roll and Rtn(all P<0.01), respectively. The measurement results of two methods were positively correlated. The Bland-Altman plot analysis showed that the 95% limits of agreement were within preset 3 mm tolerance([-0.29 cm, 0.19 cm], [-0.25 cm, 0.25 cm], [-0.27 cm, 0.19 cm]), and the 95% limits of agreement were within preset 3° tolerance(Pitch[-1.76°,1.76°], Roll[-1.54°,1.60°], ROT[-2.18°,1.69°]), indicating agreement between two methods. Conclusions:The optical surface-guided positioning can reduce the setup errors in the hypo-fractionated radiotherapy for intracranial metastasis with open face mask immobilization. The optical surface error and CBCT error have good correlation and agreement.
RESUMEN
Objective:To explore the risk factors of hypopituitorism after aneurysmal subarachnoid haemorrhage (aSAH) in the acute phase and analysis the effect of hypopituitorism on prognosis.Methods:Patients with aSAH that were diagnosed and treated in China-Japan Union Hospital from Sep. 2017 to Sep. 2018 and undergoing pituitary function evaluation within 3 to 7 days were retrospectively analyzed. 72 patients were enrolled, including 31 males and 41 females. The average age was 50.1 years old (36-71) . The WFNS gradings were Ⅰ, 24; Ⅱ, 20; Ⅲ, 15; Ⅳ, 10; Ⅴ, 3. The Fisher gradings were 2, 21; 3, 38; 4, 13. Acute hydrocephalus happened in 13 cases. Aneurysm located in the Willis circle in 56 cases and not in the Willis circle in 16 cases. 37 cases were treated by microsurgical clipped and 35 cases were treated by embolism. Patients with hypocortisolism were treated by hydrocortisone replacement, and patients with hypothyroidism were given levothyroxine replacement therapy. Patients were followed up at 3 months and their recovery was evaluated by GOS score.Results:Hypopituitorism was detected in 34 patients; the incidence of hypopituitorism was 47.2%. There was no significant correlation between the occurrence of hypopituitorism and age, gender, and hydrocephalus ( P>0.05) . Patients with WFNS grade ≥Ⅳ, Fisher grade 4, aneurysm located in the Willis circle, and treated by clipping were more likely to undergo hypopituitorism. The proportion of patients with good recovery (GOS ≥4) in the hypopituitorism group was smaller than that in the normal pituitary function group at the 3-month follow-up. Conclusions:Patients with WFNS grade ≥Ⅳ, Fisher grade 4, aneurysm located in the Willis circle, and treated by clipping are more likely to undergo hypopituitorism. Hypopituitorism in acute stage affects the prognosis of aSAH patients. Patients with hypocortisolism and hypothyroidism should be treated actively.
RESUMEN
Objective:To evaluate the effect of microsurgery for parafalcine meningioma through contralateral longitudinal fissure approach assisted by 3DSlicer software.Methods:From January 2020 to January 2021, 18 patients with parafalcine meningioma in The second hospital of Hebei Medical University were randomly selected as the observation group.The contralateral longitudinal fissure was treated by microsurgery assisted by 3DSlicer software.Before operation, improve the imaging examinations such as brain CT plain and enhancement, magnetic resonance angiography and magnetic resonance venography, establish the models of tumor, superior sagittal sinus and superior cerebral artery by using 3DSlicer software, analyze the positional relationship between tumor and superior sagittal sinus and superior cerebral vein, and remove the tumor by contralateral longitudinal fissure approach.Nineteen patients with parafalx meningioma treated by traditional ipsilateral longitudinal fissure approach from January to December 2019 were selected as the control group.The differences in operation time, intraoperative bleeding, limb muscle strength recovery rate, headache and dizziness relief rate were compared between the two groups.Results:In the observation group, the positional relationship between the reconstructed tumor and the superior cerebral vein above its base was completely consistent with the actual situation during the operation.All patients underwent Simpson grade I resection, and there was no injury to the superior cerebral vein and venous sinus during the operation.The recovery rate of limb muscle strength in the observation group (75%(9/12)) was higher than that in the control group (23%(3/13))( P=0.009). There was no significant difference in the operation time, intraoperative bleeding and the remission rate of headache and dizziness one week after operation in the observation group ( P>0.05). Conclusion:3DSlicer software was helpful for preoperative evaluation of the positional relationship between parafalcine meningioma and the anatomic structures such as superior cerebral vein and superior sagittal sinus.Under the guiding of 3DSlicer software, surgeon removed the tumor totally through the contralateral longitudinal fissure approach, which effectively reduced the operative side injury of the important structures such as superior cerebral vein and functional cerebral cortex, and contributed highly to the recovery of limb muscle strength of patients.
RESUMEN
The application of Toric intraocular lens (IOL) provides an opportunity for patients who want to remove cataract and correct astigmatism at the same time.In order to optimize the postoperative result and minimize the residual astigmatism, the accurate preoperative measurement and calculation of Toric IOL are crucial.To improve the accuracy, different astigmatism measurement devices with various advantages have been introduced into clinical practice one after another.Knowing the principle, advantages and disadvantages of the devices contributes to personalized selection of devices according to the patient's condition.Manual keratometer is still the gold standard tool for measuring curvature, and corneal topography is used to assess whether the corneal astigmatism is regular.Most devices can provide reliable corneal data for Toric IOL calculation, and it is recommended that at least three different devices should be used to enhance the prediction accuracy preoperatively.The posterior corneal astigmatism, which has an effect on the measurement and calculation of Toric IOL, has been attracting more attention of ophthalmologists.With high accuracy and strong applicability, Barrett Toric Calculator is preferred in Toric IOL calculation.Moreover, various Toric calculators and formulas can give stable and accurate results after modification and optimization.In this article, the effects of various corneal curvature measurement devices, posterior corneal astigmatism and Toric calculator on Toric IOL measurement and calculation were reviewed.
RESUMEN
Objective To investigate application value and significance of mixed reality technology in surgical treatment and doctor-patient communication for vestibular schwannoma. Methods We selected randomly 13 vestibular schwannoma patients treated with surgical treatment. After the three-dimensional models were constructed, preoperative surgical planning and doctor-patient communication were performed with mixed reality technology. Craniotomy through retrosigmoid sinus approach, tumor resection and facial nerve protection were achieved intraoperatively with the assistance of mixed reality technology. Questionnaires were collected and facial nerve function of 13 patients was recorded one week after operation. Results Holographic model images of 13 cases were showed successfully using mixed reality technology. The locations of preoperative facial nerves reconstructed were completely consistent with actual locations in 10 cases (84.6%). After preoperative anatomic analysis, it was decided to remove partly the posterior wall of the internal auditory canal in 11 cases. The result of doctor-patient communication questionnaire showed that 13 patients and their family all had a thorough understanding of the condition, operative plan and risks, and expressed satisfaction with the preoperative conversation. With the assistance of mixed reality technology, the tumors were resected totally without injury of vein sinus in 13 cases. The facial nerve function was gradeⅠin 3 cases, gradeⅡin 6 cases, grade Ⅲ in 3 case and grade Ⅳ in 1 case based on House-Brackmann grading one week after surgery. Conclusion Mixed reality technology is quite helpful in individual surgical planning and preoperative doctor-patient communication. It helps reduce the side injuries of surgery and protect the function of facial nerve as a surgical assistant tool intraoperatively.
RESUMEN
Neutralizing antibodies could be antivirals against COVID-19 pandemics. Here, we report the isolation of four human-origin monoclonal antibodies from a convalescent patient in China. All of these isolated antibodies display neutralization abilities in vitro. Two of them (B38 and H4) block the binding between RBD and vial cellular receptor ACE2. Further competition assay indicates that B38 and H4 recognize different epitopes on the RBD, which is ideal for a virus-targeting mAb-pair to avoid immune escape in the future clinical applications. Moreover, therapeutic study on the mouse model validated that these two antibodies can reduce virus titers in the infected mouse lungs. Structure of RBD-B38 complex revealed that most residues on the epitope are overlapped with the RBD-ACE2 binding interface, which explained the blocking efficacy and neutralizing capacity. Our results highlight the promise of antibody-based therapeutics and provide the structural basis of rational vaccine design. One Sentence SummaryA pair of human neutralizing monoclonal antibodies against COVID-19 compete cellular receptor binding but with different epitopes, and with post-exposure viral load reduction activity.
RESUMEN
Objective:To explore the clinical features, diagnosis and treatment of hypopituitorism after severe traumatic brain injury (TBI) in acute phase.Methods:Twenty-four patients with hypopituitorism after severe TBI that were diagnosed and treated in China-Japan Union Hospital from Jan. 2017 to Sep. 2018 were retrospectively analyzed.Results:Pituitary function was evaluated between 3 to 7 days after TBI, and hypopituitorism was detected in 15.2% (24/158) of patients with severe TBI. The average age of the 24 patients was 35.8 (range from 18 to 65) years, and the median GCS score on admission was 5.6 (range from 3 to 8) . The pituitary endocrine axis was involved as follows: hypofunction of pituitary-adrenal in 9 cases, hypofunction of pituitary-thyroid axis in 7 cases, hypofunction of pituitary-thyroid axis and pituitary-adrenal axis in 6 cases, hypofunction of growth hormone axis in 1 case and pituitary-gonad axis in 1 case. Hydrocortisone replacement was carried out in patients with hypofunction of pituitary-adrenocortical axis, and patients with hypofunction of pituitary-thyroid axis were given levothyroxine replacement therapy. All patients were followed up at 3 months after injury. Among the patients with pituitary-thyroid axis hypofunction, 61.5% (8/13) returned to normal. The pituitary-adrenocortical axis function returned to normal in 40% (6/15) patients with pituitary-adrenocortical axis hypofunction. Both the function of the growth hormone axis and the pituitary-gonad axis returned to normal.Conclusions:It is not uncommon for severe TBI patients to be complicated with hypopituitorism at early stage, which should be paid enough attention. Assessment of pituitary function at early stage can help to screen out the patients with severe adrenocortical hypofunction and hypothyroidism. Hormone replacement treatment should be carried out as early as possible, which has important significance for improving the prognosis of severe TBI patients.
RESUMEN
Hypopituitorism is not uncommon in patients with aneurysmal subarachnoid hemorrhage (aSAH) . It can happen both in acute and chronic stages of aSAH. There are different clinical features of hypopituitorism happened in acute and chronic stages. In the acute stage, pituitary-adrenocortical axis dysfunction is of the most clinically significant, which can cause adrenal crisis. Growth hormone deficiency and pituitary-adrenocortical axis dysfunction are the two most common endocrine deficits in the chronic stage, symptoms include fatigue, decreased exercise capacity, cognitive impairment and decreased libido et al. The mechanism and risk factors of hypopituitorism are still unclear. The function of pituitary-adrenal axis should be paid attention for patients with aSAH during the acute phase. If patients manifest symptoms related to hypopituitorism during the chronic stage, comprehensive evaluation of pituitary function should be carried out. The diagnosis of hypopituitorism should be based on basic hormone level and corresponding stimulation test. Hypocortisolism in the acute phase of aSAH should be treated with glucocorticoid because of its potential contribution to the morbidity and mortality. Hypopituitorism occurred in the chronic phase of aSAH may have lasting effect on cognition and life quality, and hormone replacement should be carried out once the diagnosis be confirmed.
RESUMEN
Objective:To assess the changes in IOL-Master 700 parameters after administering sodium hyaluronate eye drops to moderate and severe dry eye and non-dry eye patients.Methods:Non-randomized controlled clinical research was performed.Patients with moderate and severe dry eye and non dry eye were enrolled in this study, with 40 patients in each group.All patients underwent IOL-Master 700 bioassay before and 5, 10 and 15 minutes after the administration of 0.1% sodium hyaluronate eye drops.The differences in axial length (AL), central corneal thickness (CCT), corneal curvature, and intraocular lens (IOL) were compared before and after the administration.All subjects signed informed consent.Results:In the dry eye group, the AL, CCT and IOL power were increased and the K1 were decreased at 5 and 10 minutes after administering sodium hyaluronate eye drops (P<0.05/3). IOL power of 17.5% increased by 0.5 D at 5 minutes after administering sodium hyaluronate eye drops.Further, 22.5% IOL power increased by 0.5 D or 1.0 D at 10 minutes after administering sodium hyalruonate eye drops.At 15 minutes after the administration, the IOL-Master parameters returned to the pre-intervention level.For the non-dry eye group, the AL and CCT were increased at 5 minutes after administering sodium hyalruonate eye drops, and the IOL power was decreased (P<0.01). The IOL power was decreased by a maximum of 0.5 D. At 10 and 15 minutes after administering sodium hyalruonate eye drops, the AL and CCT were significantly higher than those before the administration (all at P<0.05/3), but there was no significant change in IOL power (P>0.05).Conclusions:The IOL power of moderate and severe dry eye patients is increased at 5-10 minutes after administering sodium hyaluronate eye drops, and the IOL power of non-dry eye patients is decreased within 5 minutes after the administration.
RESUMEN
Hypopituitorism is a common complication of traumatic brain injury (TBI),which can happen both at acute and chronic stages after TBI.There are different clinical features of hypopituitorism happened at acute and chronic stages.At acute stage,dysfunction of pituitary-adrenal cortical axis is of the most clinical significance,which can cause hypotension,hypoglycemia,hyponatremia and lead to life-threatening complications.Growth hormone deficiency and hypogonadotropic hypogonadism are the two most common endocrine deficits at chronic stage.Symptoms of hypopituitorism at chronic stage include fatigue,cognitive impairment,decreased exercise capacity,decreased libido and so on.Assessment of pituitary function should be carried out for patients with moderate to severe TBI during the acute phase,focusing on the function of pituitary-adrenal axis.If patients manifest symptoms related to hypopituitorism during chronic stage,comprehensive evaluation of pituitary function should be carried out.The diagnosis of hypopituitorism should be based on basic hormone level and corresponding stimulation test.Hypofunction of pituitary-adrenal cortical axis in the acute phase of TBI should be treated with glucocorticoid immediately because of its potential contribution to the acute morbidity and mortality.Severe hypofunction of pituitary-thyroid axis should also be treated with thyroxine replacement.Most growth hormone deficiency and hypofunction of pituitary-gonadal axis occurred in the acute phase could be improved by themselves with time migration,so there is no need to be treated in this phase.Hypopituitorism occurred in the chronic phase of TBI may have lasting effect on cognition and life quality.Hormone replacement should be carried out once the diagnosis is confirmed.
RESUMEN
Objective To retrospectively analyze the effects of nerve block anesthesia versus general anesthesia on intertrochanteric fracture in the elderly. Methods The 104 elderly inpatients undergoing closed reduction and intramedullary nailing for the treatment of femoral intertrochanteric fractures were recruited into this study at Department of Orthopedics ,Xiangya Hospital ,Central South University from January 2015 to June 2017.Medical records were collected and analyzed by SPSS 16.0 or GraphPad Prism 6.0 software. Results A total of 104 patients were divided into general anesthesia group(n= 48 )and nerve block anesthesia group (n= 56 ). There was no statistical difference in the demographic characteristics between the two groups. The changes in heart rate ,maximum changes of systolic/diastolic blood pressures ,and infusion volume during surgery were lower in the nerve block anesthesia group than in the general anesthesia group [(12.7 ± 7.3)vs. (18.1 ± 7.8)beats/min ,(22.5 ± 8.8/12.2 ± 7.5)mmHg vs. (34.3 ± 7.9/21.6 ± 6.6)mmHg ,(792.9 ± 387.0)ml vs. (1 083.0 ± 445.5)ml ,respectively ,t=3.64 ,7.14 ,6.73 ,5.16 ,all P<0.01]. There was no statistically significant difference between two groups in other perioperative data and the number of deaths at three months and one year after surgery. Conclusions As compared with the general anesthesia ,the nerve block anesthesia has less effects on the heart rate ,less maximum changes of systolic and diastolic blood pressures ,and less infusion volume during surgery ,and has no significant increase in postoperative mortality ,which is safe and worthy of further promotion.
RESUMEN
Objective To evaluate the effectiveness and safety of transarterial ehemoembolization(TACE) combined with radiofrequency ablation(RFA) and surgical resection(SR) in the treatment of early stage hepatocellular carcinoma(HCC).Methods PubMed,Medline,Embase,China biomedical database,Wanfang database,CQVIP database and Chinese Journal Full-text database were retrieved by computer.Prospective or retrospective studies of TACE combined with RFA and SR for treating early HCC published from January 2000 to March 2016 were collected.Results Four randomized or non-randomized concurrent controlled trials were included,involving 697 patients.The 1-year and 3-year overall survival(OS) rates in the TACE-RFA group were[94.40%(337/357) and 59.94%(214/357),which in the SR group were 92.35%(314/340) and 68.24% (232/340),the difference between the two groups was not statistically significant(OR=1.43,95%CI:0.79-2.60,P=0.24,I2 =0%;OR=0.77,95%CI:0.56-1.07,P=0.12,I2 =45%).The 1-year relapse-free survival(RFS) rate of the TACE-RFA group and the SR group was similar [81.5%(291/357) vs.80.3%(273/340),OR=1.07,95%CI:0.73-1.57,P=0.74,I2=0%],while the 3-year RFSrate of the TACE-RFA group was obviously lower than that of the SR group(29.97% vs.44.41%,OR=0.56,95%CI:0.40-0.77,P=0.000 5,I2 =0%).The incidence rate of severe complications in the TACE-RFA group was evidently lower than that in the SR group(1.43% vs.5.07%,OR=0.23,95%CI:0.10-0.54,P=0.000 7,I2 =10%).Conclusion Compared with TACE-RFA,SR can significantly reduce the long term recurrence rate of early stage HCC,but the occurrence rate of severe complications in SR is higher than that in TACE-RFA.
RESUMEN
Objective To investigate the clinical characteristics of neonatal inflammatory bowel disease (IBD). Methods The clinical data of two neonates diagnosed with IBD. Clinical manifestation, laboratory examination, imaging, endoscopy and histopathological findings, treatment plan and prognosis were included. Results The clinical manifestations were fever, diarrhea, oral ulcer in two cases of neonatal IBD in this study. Laboratory findings showed inflammatory indicators (such as white blood cells, C-reactive protein) increased mainly accompanied by decreased hemoglobin, platelet, plasma albumin and other indicators. Endoscopic and pathological manifestations were significantly different in ulcerative colitis (UC) and Crohn disease (CD) children. The lesions range of UC patients were mainly sigmoid colon, and CD patients ileocecal. Conclusions For neonates with highly suspected IBD, positive endoscopy and gene detection are recommended. Early diagnosis and standard treatment are important. For children with refractory IBD with IL-10 and IL-10 receptor gene mutations, hematopoietic stem cell transplantation is feasible and could improve its prognosis.
RESUMEN
Objective To observe the effect of oral massage combined with trial feeding on dysphagia in neonates with hypoxic- ischemic encephalopathy (HIE). Methods We enrolled 30 hospitalized newborns who were diagnosed moderate to severe HIE with dysphagia in the NICU of our hospital from January 2016 to December 2017. According to the random number table method, these newborns was divided into control group and study group. Oral massage combined with trial feeding were given in the study group, nasogastric feeding in the control group and family participatory care and the treatment of nutritional neurodrugs were also given in two groups. To campare the oral milk remnant, feeding time and sucking action after the flow of milk and swallowing, oral feeding time, gastric tube indwelling time and length of stay in two groups. Results After 5 days intervention, the clinical manifestations of dysphagia in two groups were compared, and there were 6 cases, (8.50 ± 1.05)ml, (36.40 ± 2.87)min and 10 cases of oral milk remnant, feeding time and sucking action after the flow of milk and swallowing respectively in the study group, and 15 cases were 15 cases, (10.80 ± 0.39 )ml, (42.29 ± 1.60) min, 3 cases in the control group, respectively. The difference between the two groups was statistically significant ( χ2=12.86, t=7.52, 6.93, χ2=6.66, P<0.05). The oral feeding time, gastric tube indwelling time and hospitalization time of the study group were (15.60±1.35) d, (11.73±1.39) d, and (21.47±2.03)d, and the control group were (17.00±0.65) d , (14.13±0.99) d, (23.27 ± 1.16) d, respectively. The difference between the two groups was statistically significant (t=3.61, 5.45, 2.98, P<0.05). Conclusions For children with dysphagia, oral massage and combined feeding before each feeding can promote the improvement of oral motor nerves in children, and improve feeding effect, and promote rehabilitation of children.
RESUMEN
"Si Sheng",including postgraduates,advanced study students,standardized training students and interns,is the main part of teaching work in hospital and department.This article is for meeting the requirement of students and emphasizing all-round preparation of the teaching work and teaching in accordance with their aptitude;pays attention to the combination of various teaching methods,such as training of new technology and new affairs,case discussion,multidisciplinary discussion,standardized teaching rounds and so on;pays attention to collect feedback from students.Those practical works effectively improve teaching quality and standard.
RESUMEN
Objective:To explain the present status of licensed pharmacists in China, and put forward suggestions for perfecting the system by a problem-focused method. Methods: The data from Certification Center for Licensed Pharmacists of CFDA and 2535 pieces of questionnaire from nationwide were reviewed, and the practice registration, distribution, educational background, qualifica-tions and the other status were analyzed. Results:Generally, the development of licensed pharmacists in China was promising. Howev-er, there were still some problems existing in China such as the lower registration rate compared with some countries abroad, the une-ven distribution inside, and the unclear duty understanding. Conclusion:It is proposed to formulate relevant policies to strengthen re-gional guidance, improve registration rate, distinguish the content of continuing education and so on in order to promote the quality of licensed pharmacists in China.
RESUMEN
Objective To explore the relationship and the clinical significance of homeobox gene B1 (HOXB1 )and microRNA-31 75 (miR-31 75)expressions in human glioma.Methods The expression levels of HOXB1 and miR-31 75 in 60 glioma tissues and 1 5 normal brain tissues were analyzed by real-time fluores-cent quantitative PCR (qRT-PCR).Spearman rank correlation analysis was performed to explore the relation-ship between HOXB1 and miR-31 75 in human glioma tissues.The relationship between HOXB1 (or miR-31 75)and clinical pathological characteristics of glioma patients was analyzed.The correlation of HOXB1 (or miR-31 75)and survival rate was calculated by Kaplan-Meier.And COX regression models were used to assess the prognostic factors.Results Compared with normal brain tissues,the expression of HOXB1 was significant-ly decreased in glioma tissues (1 .498 ±0.323 vs.0.946 ±0.588,t =-5.680,P =0.000);and the expre-ssion of miR-31 75 was obviously increased in glioma tissues (1 .008 ±0.355 vs.2.076 ±0.841 ,t =4.274, P =0.000),and HOXB1 expression was negatively correlated with miR-31 75 expression in glioma tissues (r =-0.601 ,P =0.000).HOXB1 expression was related with histologic grade (χ2 =4.848,P =0.028), and miR-31 75 expression was related with histologic grade (χ2 =5.640,P =0.01 8)and Karnofsky score (χ2 =4.785,P =0.029).The results of Kaplan-Meier revealed that there were significant differences in median survival time between HOXB1 (or miR-31 75)high-expression group and HOXB1 (or miR-31 75)low-expression group [HOXB1 :(21 .0 ±4.0)months vs.(7.0 ±0.8)months;χ2 =7.495,P =0.006;miR-31 75:(6.0 ±0.6)months vs.(1 6.0 ±5.8)months;χ2 =9.591 ,P =0.002].COX regression models showed that tumor degree (RR =6.556,95% CI:1 .1 96-35.952,P =0.002),HOXB1 (RR =0.01 8, 95%CI:0.001 -0.31 2,P =0.006)and miR-31 75 (RR =2.098,95%CI:1 .663-7.51 3,P =0.037)were independent prognostic factors for prognosis.Conclusion The HOXB1 expression may be negatively correlated with miR-31 75 in human glioma tissues,and the expression levels of HOXB1 and miR-31 75 are associated with the glioma malignant degree,survival time and prognosis of glioma patients.