Comparative Genomic Analysis and Rapid Molecular Detection of Xanthomonas euvesicatoria Using Unique ATP-Dependent DNA Helicase recQ, hrpB1, and hrpB2 Genes Isolated from Physalis pubescens in China.

Ground cherry (Physalis pubescens) is the most prominent species in the Solanaceae family due to its nutritional content, and prospective health advantages. It is grown all over the world, but notably in northern China. In 2019 firstly bacterial leaf spot (BLS) disease was identified on P. pubescens in China that caused by both BLS pathogens Xanthomonas euvesicatoria pv. euvesicatoria resulted in substantial monetary losses. Here, we compared whole genome sequences of X. euvesicatoria to other Xanthomonas species that caused BLS diseases for high similarities and dissimilarities in genomic sequences through average nucleotide identity (ANI) and BLAST comparison. Molecular techniques and phylogenetic trees were adopted to detect X. euvesicatoria on P. pubescens using recQ, hrpB1, and hrpB2 genes for efficient and precise identification. For rapid molecular detection of X. euvesicatoria, loop-mediated isothermal amplification, polymerase chain reaction (PCR), and real-time PCR techniques were used. Whole genome comparison results showed that the genome of X. euvesicatoria was more closely relative to X. perforans than X. vesicatoria, and X. gardneri with 98%, 84%, and 86% ANI, respectively. All infected leaves of P. pubescens found positive amplification, and negative controls did not show amplification. The findings of evolutionary history revealed that isolated strains XeC10RQ, XeH9RQ, XeA10RQ, and XeB10RQ that originated from China were closely relative and highly homologous to the X. euvesicatoria. This research provides information to researchers on genomic variation in BLS pathogens, and further molecular evolution and identification of X. euvesicatoria using the unique target recQ gene through advance molecular approaches.

Effects of 450 nm diode blue laser on the vaporization and incision of renal pelvis tissue ex vivo / 现代泌尿外科杂志

【Objective】 To investigate the effects of 450 nm diode blue laser on the morphological changes and thermal damage of renal pelvis under different conditions. 【Methods】 An ex vivo study was conducted on a fresh porcine pelvis model (7 cm×5 cm×3 cm). The laser fiber was fixed on the mechanical arm perpendicular to the renal pelvis tissue, and the distance between them was 1-2 mm. The renal pelvis tissue was incised at a speed of 1-2 mm/s and power of 5-30 W. After the incised tissue was fixed in formalin (4%), the morphology, depth, width and coagulation thickness were observed with naked eyes and a microscope. 【Results】 The different powers had different vaporization and incision effects. When the operating distance was 2 mm, the speed was 2 mm/s and power was 5 W, the vaporization depth, width and coagulation thickness were approximately 0 9 mm, 0.25 mm and 0.35 mm, respectively. With the increase of power, the vaporization width and depth increased, and the coagulation thickness was 0.35-0.50 mm. When the power was more than 10 W, the renal pelvis tissue was easily penetrated. When the laser power was 20 W, the section of the renal pelvis showed an irregular shape of vaporization. When the operating distance was 1 mm, the whole renal pelvis tissue was easily vaporized. When it was 2 mm, a wide and safe energy treatment window was produced. 【Conclusion】 The 450 nm diode blue laser can vaporize and incise renal pelvis tissue safely and effectively, with high precision and little thermal damage. It is expected to be a new surgical tool in the treatment of renal pelvis lesions.

450 nm diode blue laser vaporescetion of the prostate: a report after 100 BPH procedures / 现代泌尿外科杂志

【Objective】 To investigate the clinical efficacy and safety of transurethral blue laser vaporescetion of the prostate in the treatment of benign prostatic hyperplasia (BPH). 【Methods】 The clinical data of 100 BPH patients undergoing the surgery in our hospital during May and Sep.2022 were retrospectively analyzed. The observations included operation time, bladder irrigation duration, postoperative catheter indwelling time, hospital stay, complications, as well as changes in hemoglobin, International Prostate Symptom Score (IPSS), Quality of Life Scale (QoL) score, maximum urinary flow rate (Qmax), bladder residual urine volume (PVR), and other related indicators before and 3 months after surgery. 【Results】 All 100 procedures were successfully completed without turning to transurethral resection of the prostate and/or open surgery. No blood transfusion was needed. The operation time was (37.8±19.6) min, bladder irrigation time (1.3±0.5) d, catheter indwelling time (12.7±0.4) d, hospital stay (3.4±0.7) d, hemoglobin drop (4.1±7.1) g/L. The postoperative IPSS and QoL score were significantly lower than those before surgery (P<0.05); postoperative Qmax was higher than that before surgery (P<0.05); postoperative PVR was smaller than that before surgery (P<0.05). Urinary retention occurred in 4 cases (4%) after removal of the catheter; carnal hematuria and bladder clot formation occurred in 3 cases (3%); mixed urinary incontinence occurred in 2 cases (2%); stenosis of the external urethra occurred in 2 cases (2%). All complications were cured after symptomatic treatment. There were no serious perioperative complications, no intraoperative complications such as ureteral orifice injury or bladder perforation, and no serious postoperative complications such as transurethral resection syndrome (TURS), permanent urinary incontinence or bladder neck contracture. 【Conclusion】 The blue laser surgical system had satisfactory effects of vaporization and hemostasia. Transurethral blue laser vaporesection of the prostate is safe and effective in the treatment of BPH.

Severity and multiple indexes of jaundice in ABO hemolytic disease of fetus and newborn: a comparative analysis / 中国输血杂志

【Objective】 To explore the correlation between the severity of jaundice in ABO hemolytic disease of fetus and newborn (HDFN) and multiple indicators, in order to achieve accurate diagnosis, timely treatment, and prevent complications in ABO HDFN. 【Methods】 From March 2020 to February 2023, a total of 283 ABO HDFN in our hospital were classified into mild, moderate and severe groups based on total bilirubin levels. The differences in basic data, relevant laboratory indicators and the agglutination intensity of the three hemolysis tests were analyzed and compared. 【Results】 In the severe group, 75% (12/16) were male infants, which was significantly higher compared to 37.5% (57/152) in the moderate group (P<0.05). The values (mg/dL) of transcutaneous jaundice in the mild, moderate and severe groups were:forehead 9.88±1.93 vs 12.34±2.01 vs 15.56±2.69, face 10.25±2.27 vs 13.28±2.32 vs 15.99±2.86, chest 9.67±2.16 vs 12.51±2.11 vs 15.33±2.36, respectively. The values(µmol/L) of direct bilirubin (DBIL) and indirect bilirubin (IBIL) were 9.87±2.06 vs 11.90±2.59 vs 16.12±4.73, and 159.36±37.55 vs 252.98±30.52 vs 353.76±55.68, respectively, and the differences between the mild, moderate and severe groups were statistically significant (all P<0.05) . The creatine kinase (CK) values(unit/L) of mild, moderate and severe groups were 664.15±498.26 vs 500.51 ±451.63 vs 402.63±224.27, and the difference between the mild group and the other two groups was statistically significant (P<0.05) . There was no statistically significant difference in the agglutination intensity of the three hemolysis tests among HDFN with different severity of jaundice. 【Conclusion】 Clinicians can predict the severity of jaundice in light of gender, transcutaneous jaundice, DBIL, IBIL and CK of ABO HDFN, for further and graded treatment, so as to avoid the sequelae or even life-threatening consequences caused by ABO HDFN.

Development of comprehensive ability evaluation system for general practice management post in community health service institutions / 中华全科医师杂志

Objective:To develop a comprehensive ability evaluation system for general practice management post in community health service institutions.Methods:Based on the previous studies and literature search on competency of general practitioners in various clinical posts, the first draft of the comprehensive ability indicator system for general management posts was designed. From November 2019 to January 2020, the comprehensive ability indicator system, classification and scoring method and evaluation method for general management posts were determined through three rounds of Delphi consultation.Results:Seventeen experts with administrative management experiences were invited for consultation, including 3 directors in charge and 14 general practice managers. The response rate of valid questionnaires in the three rounds of consultation were all 17/17, the authority of experts were all>0.7, and the coordination coefficients of expert opinions were 0.142, 0.212, and 0.532 (all P<0.01). The 11 evaluation indexes of the comprehensive ability of community general management posts were: achievement orientation, initiative, interpersonal understanding, service consciousness, influence, organization, training others, teamwork, team leadership, professional skills and confidence. Methods suitable for evaluation the ability of psychological test indicators were achievement orientation, interpersonal understanding, service consciousness and self-confident;appropriate indicators for no-leader group discussion were initiation, influence, team work, team leadership;appropriate indicators for in-tray test ability were organized cognition, professional skills;and the appropriate indicator for the ability of the structured interview was training others. Conclusions:The comprehensive ability evaluation system for community general management posts established in this study is scientific and practical, which may provide objective standard basis for the ability evaluation of community health management talents.

Inhibition of silver ion on the frequency of bacterial integron trapping drug resistance gene cassette / 中华微生物学和免疫学杂志

Objective:To analyze the effects of silver ion on the integration frequency of the class 1 integron in Escherichia coli ( E. coli) BL21(DE3) host. Methods:Two recombinant plasmids, pUCINT and pACINAD, were successively transformed into E. coli BL21 (DE3) to construct HS2 strains. Three experimental groups were set up using 0.3 μg/ml, 0.6 μg/ml and 0.8 μg/ml silver ion LB liquid medium, while control group used common LB liquid medium. Silver ion was supplied by silver nitrate and HS2 strains were cultured at 37℃ for 24 h. The copy number of cointegrates and the total copy number of integrons in each group were detected by real-time polymerase chain reaction (qPCR), and the ratio of them was the integration frequency. Changes in the integration frequency were analyzed by three independent phenotypic screening method and the protein expression in HS2 strains was analyzed by mass spectrometry. Results:The integration frequency in HS2 strains in the control group and three experimental groups (0.3 μg/ml, 0.6 μg/ml and 0.8 μg/ml silver ion) was 1.79×10 -5 (1.44×10 -5, 3.13×10 -5), 2.07×10 -5 (1.49×10 -5, 2.67×10 -5), 2.25×10 -6 (1.47×10 -6, 4.54×10 -6) and 1.69×10 -6 (0.22×10 -6, 3.08×10 -6), respectively. The integration frequency in the 0.6 μg/ml and 0.8 μg/ml silver ion groups was significantly lower than that in the control group ( P<0.01), but there was no significant difference between the 0.3 μg/ml silver ion group and the control group. Results of three independent phenotypic screening method were consistent with those obtained by qPCR. Mass spectrometry analysis showed that there were differences in protein expression in HS2 strains between the control group and the experimental groups. Conclusions:Silver ion at a certain concentration had an inhibitory effect on the frequency of drug resistance gene cassette captured by bacterial integron.

Effects of proton pump inhibitors on stress ulcers in elderly patients with acute respiratory distress syndrome / 中华老年医学杂志

Objective:To analyze the effects of proton pump inhibitors(PPIs)on the prevention of stress ulcers(SU)in elderly patients with acute respiratory distress syndrome(ARDS), and to analyze related factors for the risk of short-term death.Methods:This study was a multicenter retrospective cohort study.Two hundred elderly ARDS patients diagnosed and treated at Peking University International Hospital, Anzhen Hospital and Ezhou Central Hospital from November 2017 to December 2019 were continuously included.These patients were treated with PPIs(omeprazole, pantoprazole, rabeprazole, lansoprazole and esomeprazole)within 48 hours after ICU admission to prevent SU and were considered as the PPI group.According to the propensity score matching method, 200 elderly ARDS patients admitted to the hospitals with similar ages, medical history and sequential organ failure assessment(SOFA)scores who did not use PPIs were selected as the control group.All patients were followed up for 30 days.Kaplan-Meier survival analysis and the log-rank test were used to compare the 30-day mortality risk between the two groups.Cox regression analysis was used to analyze the relevant factors affecting the 30-day mortality.The 30-day mortality risk and the incidence of clinically significant gastrointestinal bleeding were evaluated among patients using different PPIs.Results:The average time of PPI use was 8.4±4.4 d in the PPI group.In the control group, 38.0% of patients were treated with H 2 receptor antagonists, and the average time of use was 8.1±5.2 days.There was no significant difference in the 30-day all-cause mortality risk between the two groups(20.5% or 41 cases vs.23.5% or 47 cases, P>0.05). The incidences of clinically significant upper gastrointestinal tract bleeding(2.5% or 5 cases vs.7.0% or 14, P<0.05), gastrointestinal bleeding(5.5% or 11 cases vs.12.5% or 25 cases, P<0.05)and hospital-acquired pneumonia(9.0% or 18 vs.4.0% or 8 cases, P<0.05)had significant differences between the PPI group and the control group.Multivariate Cox regression analysis showed that age>70 years( HR=1.845, 95% CI: 1.131-3.010, P<0.05), arterial oxygen partial pressure <78.0 mmHg(1 mmHg=0.133 kPa, HR=2.143, 95% CI: 1.317-3.487, P<0.01), SOFA score>14( HR=3.603, 95% CI: 1.741-7.456, P<0.01)and blood lactic acid>3.8 mmol/L( HR=2.725, 95% CI: 1.437-5.167, P<0.01)were related factors for the 30-day mortality.Compared with the control group, there was no significant difference in 30-day mortality between the five subgroups taking different PPIs including omeprazole, pantoprazole, rabeprazole, lansoprazole and esomeprazole( P>0.05), and the incidence of clinically significant gastrointestinal bleeding was significantly reduced( P<0.05), but there was no significant difference between the five PPIs subgroups( P>0.05). Conclusions:Although PPIs have no effect on short-term death in elderly ARDS patients, it can increase the risk of hospital acquired pneumonia while reducing the occurrence of gastrointestinal bleeding.With PPI use, advanced age, low arterial oxygen partial pressure, high SOFA score and high blood lactate are risk factors for the 30-day mortality.

Clinical characteristics of imported and second-generation COVID-19 cases outside Wuhan, China: A multicenter retrospective study

BackgroundThe mortality of COVID-19 differs between countries and regions. By now, reports on COVID-19 are largely focused on first-generation cases. This study aimed to clarify the clinical characteristics of imported and second-generation cases. MethodsThis retrospective, multicenter cohort study included 134 confirmed COVID-19 cases from 9 cities outside Wuhan. Epidemiological, clinical and outcome data were extracted from medical records and were compared between severe and non-severe cases. We further profiled the dynamic laboratory findings of some patients. Results34.3% of the 134 patients were severe cases, and 11.2% had complications. As of March 7, 2020, 91.8% patients were discharged and one patient (0.7%) died. The median age was 46 years. The median interval from symptom onset to hospital admission was 4.5 (IQR 3-7) days. The median lymphocyte count was 1.1x109/L. Age, lymphocyte count, CRP, ESR, DBIL, LDH, HBDH showed difference between severe and no-severe cases (all P<0.05). Baseline lymphocyte count was higher in the survived patients than in the non-survivor case, and it increased as the condition improved, but declined sharply when death occurred. The IL-6 level displayed a downtrend in survivors, but rose very high in the death case. Pulmonary fibrosis was found on later chest CT images in 51.5% of the pneumonia cases. ConclusionImported and second-generation cases outside Wuhan had a better prognosis than initial cases in Wuhan. Lymphocyte count and IL-6 level could be used for evaluating prognosis. Pulmonary fibrosis as the sequelae of COVID-19 should be taken into account. SummaryImported and second-generation cases manifested less complications, lower fatality, and higher discharge rate than initial cases, which may be related to the shorter interval from symptom onset to hospital admission, younger age, and higher lymphocyte count of the imported and second-generation patients. Lymphocyte count and IL-6 level could be used as indicators for evaluating prognosis. Pulmonary fibrosis was found in later chest CT images in more than half of the pneumonia cases and should be taken into account.

Innovation and application of case-based PBL teaching model in the teaching of medical genetics / 中华医学教育探索杂志

Since 2008, we have carried out a systematic exploration of case-based PBL teaching model in clinical medical undergraduates. The questionnaire results show that the students are highly satisfied with the course setting and the teaching quality of teachers, and have a strong sense of gain in the cultivation of learning interest and the improvement of learning capacity. The analysis of the examination results in the past ten years also reveals that the excellent student rate of the class with case-based PBL seminars have been significantly improved. The retrospective analysis also shows that the students' knowledge level, professional background, class size, and the curriculum system settings have significant influences on the teaching effect. Therefore, for students with different academic systems and majors, PBL teaching mode should be designed differently to achieve better teaching effect.

Application of Raman Spectroscopy in the Diagnosis of Oral Cancer / 中国医学科学院学报

Oral cancer is a common and deadly malignancy.While multidisciplinary treatment(mainly surgery)has been applied in the treatment of cancer treatment,early diagnosis and complete removal of the primary lesion are essential for a better prognosis.Raman spectroscopy is an optical technique that detects inelastic scattered light generated by the interaction of light and matter.It can detect the vibrational spectra of biochemical and biomolecular structures and tissue conformations,and can provide the "molecular fingerprint" for cells,tissues,and biological fluids.With the development of related technologies and optical instruments,Raman spectroscopy has been widely applied in medical fields.This article reviews the research advances and application of Raman spectroscopy in the diagnosis of oral cancer.

Clinical value of p16 and geminin in the progress of patients with low?grade squamous intraepithelial lesions / 中国综合临床

Objective To analyze the positive expression levels of p16 ( p16ink4a), cell cycle factor geminin and Ki-67 in low-grade squamous intraepithelial lesions ( LSIL),and to further explore the ability of these indicators to evaluate the progression of LSIL patients. Methods From January 2015 to June 2018,276 cervical specimens from Jiading District Central Hospital of Shanghai were retrospectively studied, and 148 LSIL patients were selected. According to the results of the second examination,LSIL patients were divided into three groups: (1) no lesion (natural regression) group 90 cases; (2) LSIL persistent group 38 cases; (3) high-grade Squamous Intraepithelial Lesion (HSIL) group 20 cases. Immunohistochemistry was performed on the first biopsy tissues and the relative positive ratios of p16, geminin and Ki-67 were calculated. Spearman correlation analysis identified the correlation between the above indicators and the progress of the disease; ROC curve was used to calculate the best diagnostic value of each indicator,and multivariate logistic regression analysis was included to explore the ability of the above indicators to assess the risk of patients progressing to HSIL. Results In the HSIL group, p16 ( 51. 26 ± 17. 15)%, geminin relative positive ratio ( 45. 92 ± 15. 70)% was higher than those in the LSIL group(( 43. 71 ± 11. 84)%, (21. 68± 14. 47)%) and regression group (( 17. 92 ± 9. 60)%, ( 0. 16 ± 0. 03)%) . The difference were statistically significant ( F＝2. 922, 2. 751, all P＜0. 05) . Spearman correlation analysis showed that the relative positive ratio of p16 ( r＝0. 27,P＝0. 014) and geminin ( r＝0. 44,P＜0. 001) presented a notable positive correlation with the progression of the disease. Under the ROC curve,the best diagnostic values of p16, geminin and Ki-67 were 38. 9%, 32. 5% and 18. 6%, respectively. Multivariate logistic regression analysis showed that the relative positive ratio of p16 was higher than 38. 9%(OR＝4. 366,P＝0. 006),and geminin was higher than 32. 5%( OR ＝ 5. 392, P ＝ 0. 011 ) had a higher risk of progression to HSIL. Conclusion p16 and geminin may be effective biomarkers for identifying patients with advanced LSIL.

Clinical value of Bristol stool form scale for bowel preparation in pediatric patients undergoing colonoscopy / 中华消化内镜杂志

Objective To evaluate the clinical value of Bristol stool form scale(BSFS) for bowel preparation in pediatric patients. Methods Data of 202 pediatric patients undergoing colonoscopy were collected from May 2016 to December 2016 at Children's Hospital of Fudan University. All patients received polyethylene glycol ( PEG)-4000 with clear fluid diet for bowel preparation. BSFS was used to record the stool form, and Boston bowel preparation scale ( BBPS) was used to evaluate the quality of bowel cleansing.Differences in BBPS score between the enema group with BSFS 6 and the no enema group with BSFS 7 were studied. Based on the data types, t ( or t') test and chi-square test were used to analyze the influencing factors for colon preparation respectively. Those factors of statistical significance were studied with multivariate logistic regression analysis. Results The mean defecation time of pediatric patients during bowel preparation was 14. 4±6. 8. One hundred and sixty-five (81. 7％) patients were assessed as 7 points in BSFS, 37 ( 18. 3％) were 6 points in BSFS with supplemented enema, and 154( 76. 2％) patients achieved adequate bowel preparation. No significant differences were observed between the no enema group and enema group in the BBPS scores [75. 2％(124/165) VS 81. 1％(30/37), χ2=0. 587, P=0. 526]. Significant factors for inadequate colon preparation were constipation history (χ2=32. 588, P=0. 000 ) , total time of defecation(t=3. 432,P=0. 001) and total time of BSFS 7 (t'=2. 877,P=0. 005). Multivariate logistic regression analysis showed constipation history ( P = 0. 000, OR = 12. 620, 95％CI:4. 850-32. 800 ) was independent risk factor for inadequate colon preparation. Conclusion Patients of BSFS 6 points could receive warm saline enema as a remedy. Patients with total time of defecation less than 15 and total time of BSFS ( 7 points) less than 8 are liable for the possibility of inadequate bowel preparation. It is also suggested that for patients with constipation history, the time of bowel preparation should be prolonged for microscopic visual field clarity.

Ethical Boundary for the Application of the Next-generation Sequencing in Genetic Counseling / 中国医学伦理学

The next-generation sequencing technology has been widely used in genetic counseling, but there are two major problems in the application of new technology, namely, the lack of unified technical specifications and clear ethical boundary, which would limit industry development and impaired public rights and interests. The solution of the former problem depends on technological progress, while the latter requires the delineation of ethical boundary.Genetic counseling should follow WHO's recommendations and guidelines. Four basic principles of medical ethics, namely, no harm, good deeds, autonomy and impartiality, constitute the principle boundary of genetic counseling ethics. Informed consent in practice is the rigid red line of the ethical principle boundary of next-generation sequencing.There are many problems in the implementation of informed consent in China. Five types and 15 notification points of informed consent in the application of next-generation sequencing were proposed from the technical point of view in this article.

An investigation of recognition and needs of policies of science and technology achievement transformation a-mong the medical personnel in 21 tertiary hospitals in Shanghai / 中华医学科研管理杂志

Objective To understand the cognition ,attitudes and needs of the science and technology achievement trans-formation policies among the medical personnel of 21 tertiary hospitals in Shanghai .Methods Convenient sampling method was used .The self-designed questionnaires were used to survey 420 personals in 21 tertiary hospitals in Shanghai ,and 411 valid questionnaires were responded with a valid rate of 97 .86％ .Results The cognition of science and technology achievement transformation policies of the respondents was low ,and the degree of cognition was related to the professional titles ( P<0 .05) .While the recognition degree of some policies was high ;40 .47％ agreed that enterprises could be the decision-maker during the transformation process ;85 .99％ agreed that it is OK to hire the Technology intermediary service agencies to evalu-ate the achievements value ,confirmed that need such agencies to provide the services of information collection and screening . Conclusions More Policy publicity should be enhanced among the medical personnel ,communications about their needs and suggestions on the science and technology achievement transformation should be carried out to further update related policies , as well as improve the transformation of science and technology achievements in health system .

[Current therapy of atrophic edentulous mandibular fractures among elderly people].

The cases of mandible fractures among elderly people, especially those with atrophic mandibles, are increasing. Atrophic mandibular fractures among elderly people require specific treatment because of the differences between the anatomicophysiologies of elderly people and those of normal adults. This paper serves as a literature review on the characteristics, selection of the treatment method, and complication of atrophic edentulous mandibular fractures among elderly people.

Application of clinical cases related problem-based-learning in critical care medical education / 中华医学教育探索杂志

Objective To evaluate the application of clinical cases related problem-based-learning (PBL) method in critical care medical standardized resident training program. Methods 84 residents were randomly divided into experimental group (n=42) and control group (n=42) by lottery way. The experimental group received PBL process during clinical case analysis while the control group learned completely through traditional teaching method . The residents' clinical competence were assessed by multiple scale mixed method including question bank examination (QBE), case-based discussion (CBD), direct observation of procedural skills (DOPS), simulation etc, and Likert-type scale questionnaire was used to evaluate the feedback of training residents. SPSS 17.0 was used to do line t test to the data of both groups. Results Finally 84 residents finished the study. There were no difference in the general conditions in two groups. The PBL group achieved higher examination score during QBE [(80.26 ±8.89) vs. (86.10 ±9.32)], CBD [(84.83±5.43) vs. (75.36±6.06)], DOPS [(88.81±6.68) vs. (82.70±6.98)], simulation [(79.86±10.09) vs.(72.71±9.30)]. Except two groups residents all gave high scores in enhancing cross connection in clinical knowledge [(4.786±0.470) vs. (4.571±0.859), P=0.16], and the questionnaire results showed that the resi-dents of PBL group gave higher points in exciting autonomous learning, improving clin-ical analysis ability, accelerating clinical thinking establish, developing independent thinking habits, improving the clinical communication skills and teamwork ability (P<0.05). Conclusion The clinical cases related PBL method can improve the training effects during critical care medical standardized resident training program. It can be used broadly after adapting modification in critical care medical education.

Alterations of CaM pathway in the brains of scrapie infected mice / 中华实验和临床病毒学杂志

Objective@#To analysis the alterations of CaM and its downstream factors in the brains of scrapie infected mice.@*Methods@#Using the methods of Western blot and immunohistochemistry assay to detect the levels and distributions of CaM, as well as the expressing alterations of the downstream substrates of CaM in the brains of mice infected with scrapie.@*Results@#Compared with the normal controls, the levels of CaM are significantly increased in the brains of scrapie-infected mice and particularly distributing in the regions of cortex, thamalus and cerebellum. Remarkable high levels of CaMKII, p-CaMKII and p-CaMKIV are observed in the brain homogenates of scrapie-infected mice. The regulatory protein of cAMP response element binding protein (CREB) and p-CERB are also increased, while the levels of BDNF which is regulated by p-CREB are obeviously downregulated.@*Conclusions@#The synthesis of BDNF may be influenced by the prion replication in neuron and further attenuates its neuronal protective features.

Current therapy of atrophic edentulous mandibular fractures among elderly people / 华西口腔医学杂志

The cases of mandible fractures among elderly people, especially those with atrophic mandibles, are increasing. Atrophic mandibular fractures among elderly people require specific treatment because of the differences between the anatomicophysiologies of elderly people and those of normal adults. This paper serves as a literature review on the characteristics, selection of the treatment method, and complication of atrophic edentulous mandibular fractures among elderly people.

Protocol optimization and quality control of large-scale acupuncture clinical trial for infertility / 中国针灸

The design of research protocol and quality control are the key to ensure the quality of clinical trial. A randomized clinical trial regarding the effects of medication combined with acupuncture on live birth rate in polycystic ovary syndrome (PCOS), which was initially designed as a comparative effectiveness research, then added with an acupuncture control group and finally became a factorial analysis, is taken as an example to explain the protocol design and optimization process, demonstrating the high level of methodology design and international recognization. By a series of measurements, such as unified purchase of acupuncture equipment, multiple trainings and assessments for acupuncturists' knowledge and operation standardization, in-site supervision of local center experts, the standard operation of acupuncture could be ensured and the credibility and scientificity of research results could be improved.

Comparison of headless compression screw and interlocking compression plate fixation in ankle fusion / 中国组织工程研究

BACKGROUND:The ankle fusion is an important treating means of end-stage ankle joint disease. Internal fixation of implant has become the preferred way of fixation, but fixation of different implants has different effects. OBJECTIVE:To explore the value of different internal fixation methods in ankle fusion. METHODS:A retrospective analysis was performed in 64 cases of ankle fusion from September 2012 to March 2015. They were divided into the observation group (32 cases) and control group (32 cases) according to the way of internal fixation of implant. The observation group underwent headless compression screw fixation. The control group underwent interlocking compression plate fixation. Length of incision, operation time, postoperative drainage volume, postoperative complications, healing time of bone and functional recovery of ankle-hindfoot were observed and compared between the two groups. RESULTS AND CONCLUSION:(1) There was no statistical significance in operation time and healing time of bone between the two groups (P>0.05). (2) Length of incision and postoperative drainage volume were significantly greater in the control group than in the observation group. The incidence of postoperative complications was significantly higher in the control group than in the observation group (P0.05), but the score was significantly higher in the observation group than in the control group in final fol ow-up (P<0.05). (4) These findings suggest that compared with the interlocking compression plate, headless compression screw treatment for ankle fusion can obtain better effect, smal trauma, less postoperative complications, fixed firmly, more in line with the physiological and biomechanical requirements.