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The organic integration of local excellent traditional culture and ideological and political education in medical colleges and universities is an important content of deeply studying and implementing General Secretary Xi Jinping’s important discourse of inheriting and enriching the excellent traditional Chinese culture, and promoting the comprehensive integration of Chinese excellent traditional culture into college education. The integration of them is helpful to improve the effectiveness of ideological and political education, enhance the cultural confidence of medical students, and cultivate their professional spirit. Guided by Marxist theory and the methods of "creative transformation and innovative development", a group of typical ideological concepts, moral norms, and humanistic spirits such as patriotism, basic civic ethics, medical professional ethics, and global health concepts were selected, and then targeted integrate them into ideological and political education through specific paths such as basing on classroom teaching, enhancing campus culture, and strengthening social practice to cultivate medical talents with noble medical ethics and exquisite medical skills in the new era.
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Objective:To evaluate extrathecal vs. intrathecal approach of Glisson's pedicle in laparoscopic hepatectomy of hepatocellular carcinoma (HCC). Methods:Clinical data of 96 HCC patients receiving laparoscopic hepatectomy at the Department of Hepatobiliary Surgery, the 900 Hospital of the United Logistics Force from Jan 2019 to Jun 2022 were retrospectively analyzed. Thrity-six cases were treated with extrathecal approach of Glisson's pedicle and 60 cases were by intrathecal approach.All those 60 undergoing intrathecal approach cases were matched by 1∶1 propensity score matching, and the caliper value was 0.02. The duration of surgery, blocking-time of hepatoduodenal ligament, intraoperative blood loss, indexes of the liver function and the prothrombin time on the 1st day of the postoperative period, rate of the postoperative complications, postoperative hospital stay, postoperative survival and recurrence were compared between the two groups.Results:After propensity score matching, 32 cases in each group were identified. The operation time of the extrathecal group was shorter than that of the intrathecal group [(207.5±77.4) minutes vs. (248.6±74.7) minutes, P=0.03], the intraoperative bleeding volume was less than that of the intrathecal group [(150.0(100.0, 300.0) ml vs. 250.0(150.0, 587.5) ml, P=0.01], and the albumin level was higher on the 1st day after the surgery [(36.5±3.2) g/L vs. (34.3±3.2) g/L, P<0.01]. There was no statistically significant difference in postoperative liver function, coagulation, complications, hospitalization time, all over survival rate between the two groups (all P>0.05). Conclusion:Extrathecal approach for Glisson's pedicle is safe and feasible in laparoscopic hepatectomy for HCC, with simpler surgical procedure, less intraoperative trauma.
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Objective@#To explore the value of magnetic resonance imaging (MRI)-based whole tumor texture analysis in differentiating borderline epithelial ovarian tumors (BEOTs) from FIGO stage I/II malignant epithelial ovarian tumors (MEOTs). @*Materials and Methods@#A total of 88 patients with histopathologically confirmed ovarian epithelial tumors after surgical resection, including 30 BEOT and 58 MEOT patients, were divided into a training group (n = 62) and a test group (n = 26).The clinical and conventional MRI features were retrospectively reviewed. The texture features of tumors, based on T2-weighted imaging, diffusion-weighted imaging, and contrast-enhanced T1-weighted imaging, were extracted using MaZda software and the three top weighted texture features were selected by using the Random Forest algorithm. A non-texture logistic regression model in the training group was built to include those clinical and conventional MRI variables with p value < 0.10. Subsequently, a combined model integrating non-texture information and texture features was built for the training group. The model, evaluated using patients in the training group, was then applied to patients in the test group. Finally, receiver operating characteristic (ROC) curves were used to assess the diagnostic performance of the models. @*Results@#The combined model showed superior performance in categorizing BEOTs and MEOTs (sensitivity, 92.5%; specificity, 86.4%; accuracy, 90.3%; area under the ROC curve [AUC], 0.962) than the non-texture model (sensitivity, 78.3%; specificity, 84.6%; accuracy, 82.3%; AUC, 0.818). The AUCs were statistically different (p value = 0.038). In the test group, the AUCs, sensitivity, specificity, and accuracy were 0.840, 73.3%, 90.1%, and 80.8% when the non-texture model was used and 0.896, 75.0%, 94.0%, and 88.5% when the combined model was used. @*Conclusion@#MRI-based texture features combined with clinical and conventional MRI features may assist in differentitating between BEOT and FIGO stage I/II MEOT patients.
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Objective@#To understand the status of blood-borne occupational exposure and protection among health care workers (HCWs) in dental practice, and provide evidence for making effective prevention.@*Methods@#From April 1 to 15, 2019, a stratified random sampling method was conducted to investigate the data of blood-borne occupational exposure among 221 dental HCWs in 2018, and Chi-squared Test was used to evaluate the differences of status on occupational exposure and protection among different professionals, such as nurses, doctors and trainees, and among different-grade hospitals.@*Results@#A total of 166 HCWs were exposed to occupational exposure 269 times, with the annual incidence of 75.11% (166/221) , and 37.55% (101/269) of exposures were reported. However, all source patients of exposures had failed to be traced. 89.59% (241/269) of exposures were sharp injuries. The top three instruments caused injuries were syringe/bilan needles, suture needles and vehicle needles, accounting for 35.68% (86/241) 、16.60% (40/241) and 16.18% (39/241) , respectively; and the top three exposure operations were removal/disposal of needles or instruments, suture/assisting suture and injection of anesthetic, accounting for 37.17% (100/269) 、22.30% (60/269) and 17.84% (48/269) , respectively. There were statistically significant differences among different professionals in occupational exposure frequency, reporting rate, the types of instruments caused injuries, exposure operations and hepatitis B vaccinated time (P<0.01) . The compliance rate of standard precautions, safe operation, post-exposure reporting and prevention, and training on occupational protection were generally poor among HCWs, with significant differences in different-grade hospitals (P<0.01) .@*Conclusion@#There is a high incidence, low reporting rate and poor self-protection of blood-borne occupational exposure among dental HCWs. Strongly suggesting that standard precautions, safe use and disposal of oral instruments, active post-exposure report and prevention must be improved for everyone.
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Objective:To assess the diagnostic and prognostic value of lymphocyte subtyping for invasive candidiasis infection (ICI) in critically ill patients with non-neutropenic sepsis.Methods:A prospective observational cohort study was performed at Peking Union Medical College Hospital (PUMCH), 377 patients with non-neutropenic sepsis admitted to Department of Critical Care Medicine from January 2017 to November 2019 were enrolled. There were 9.0% (34/377) patients diagnosed as ICI. Vital signs, supportive care therapy and microbiological specimens were collected. Peripheral blood lymphocyte subtypes, serum globulin, complements, inflammatory factors such as interleukin(IL)-6, IL-8, IL-10 and tumor necrosis factor were detected within 24 hours after sepsis was diagnosed. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value and prognostic significance of immunological indicators for ICI. Multiple logistic regression was used to analyze the independent risk factors for ICI. Kaplan-Meier analysis was used to analyze survival.Results:The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was 17.0 (13.0, 21.0) in all 377 patients. The sequential organ failure score (SOFA) was 11.0 (8.0, 13.0), and the 28-day mortality rate was 27.6% (104/377). Peripheral blood CD8 +absolute T lymphocyte count≤177 cells/μl, CD28 +CD8 +T-cell count≤81 cells/μl and 1, 3-β-D-glucan (BDG) ≥88.20 ng/L were closely correlated with the diagnosis of ICI (AUC=0.793,95 %CI 0.749-0.833, P<0.000 1;AUC=0.892,95 %CI 0.856-0.921, P<0.000 1;AUC=0.761, 95 %CI 0.715-0.803, P<0.000 1, respectively), with sensitivity of diagnosis 94.12%, 100.00%, and 88.24%; the specificity of diagnosis 81.34%, 62.39%, 63.56% respectively. Multivariate logistic regression analysis identified CD8 +T-cell count≤139 cells/μl ( OR=7.463, 95 %CI 1.300-42.831, P=0.024) and CD28 +CD8 +T-cell counts≤52 cells/μl ( OR=57.494, 95 %CI 3.986-829.359, P=0.003) as independent risk factors for higher mortality. Kaplan-Meier survival analysis suggested that CD8 +T-cell count ≤139 cells/μl ( P=0.0159) and CD28 +CD8 +T-cell count≤52 cells/μl ( P=0.000 1) were associated with higher mortality within 28 days (68.8%, 91.7%). Conclusions:Low CD28 +CD8 +T cell count in peripheral blood is closely related to the development and clinical outcome of ICI in sepsis patients, which could be used as an effective indicator for the diagnosis and prognosis prediction of ICI.
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With the development and application of abdominal imaging technology,the concept of treatment of liver trauma has been changed over time,and nearly 80％ of patients with liver trauma prefer non-surgical treatment.In non-surgical treatment,hepatic artery vascular embolization plays an important role.This article will discuss the application,process and complications of hepatic artery interventional embolization in hepatic trauma.
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The gastrointestinal flora is composed of a large number of microorganisms with complex structure,which participates in the process of decomposition,digestion and absorption of nutrients,promotes the development of the body's immune system,inhibits the colonization of pathogenic bacteria,and affects the health and disease of the body.In recent years,with the advancement of sequencing technology,the relationship between gastrointestinal flora and gastrointestinal neoplasms has became a research hotspot.This article reviews the carcinogenic pathways of the gastrointestinal flora and the possible carcinogenic mechanisms of the gastrointestinal flora.
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Objective To evaluate the efficacy and safety of TurboHawk plaque resection system in the treatment of lower extremity arteriosclerosis obliterans.Methods Clinical data of 36 patients with atherosclerotic occlusion of lower extremity treated with TurboHawk from January 2016 to August 2017 were retrospectively collected.The characteristics of lesion,improvement of symptoms,ankle brachial index (ABI) and postoperative complications were analyzed.The measurement data were expressed as ((x) ± s),All patients were reviewed every 3 months after operation,followed up for 3-18 months,with an average of (9 ± 0.5) months.And the ABI comparison before and after treatment were performed by paired t test;the counting data were expressed as rate (％),and the comparison of different stages was performed by chi-square test.Results In 36 patients,the technical success rate was 100％,and the symptoms of lower limbs were significantly improved.The ABI (0.85 ±0.07) and ABI (0.75 ±0.10) were significantly better in 3 days and in 3 months after operation than before operation (0.29 ±0.10)(t =37.76,P ＜0.001).Postoperative complications occurred in 2 cases,in one case,the artery dissection was covered with a bare scaffold,and in the other case,the blood vessel was ruptured after resection,and was closured by using balloon angioplasty.Conclusion TurboHawk plaque resection system is an effective,less traumatic and safer option for the treatment of lower extremity arteriosclerosis obliterans.
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Objective To introduce the construction of clinical research information system of a tertiary grade A comprehensive hospital in Shanghai.Methods Based on the database construction,the structured inpatient medical records,surgical records and ancillary diagnostic report are designed and the application terminal is developed.Results A full-link normalized clinical research information system for research-based cases covering all aspects of clinical research is developed,which can provide customized and structured data.Conclusions The clinical research information system provides convenience for clinical medical research,and its practice has certain reference significance.
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AIM To optimize the supercritical CO2 extraction of sauchinone and to evaluate the in vitro antitumor activity of Saururi Herba supercritical extract.METHODS With extraction pressure,extraction temperature,extraction time,entrainer (ethanol) concentration and entrainer amount as influencing factors,together with extraction rate of sauchinone as an evaluation index,orthogonal test was used for optimizing the extraction.Then MTT was applied to determining the extract's inhibitory effect on human multidrug-resistant hepatocellular carcinoma cell line (7721/Adm).RESULTS The optimal conditions were determined to be 30 MPa for extraction pressure,50 ℃ for extraction temperature,2 h for extraction time,95％ for ethanol concentration,and one time for ethanol amount,the average extraction rate of sauchinone was 0.173％.The obtained extract significantly inhibited the proliferation of 7721/Adm cells (IC50 =50.08 μg/mL),demonstrating a stronger activity than that of ethanol extract (ICs0 =150.59 μg/mL).CONCLUSION This stable and feasible method is appropriate for sauchinone extraction,and the supercritical CO2 extract from Saururi Herba shows a strong in vitro antitumor activity.
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Objective To explore the therapeutic effects of pure collagenase injection and collagenase combined with herniation injection of ozone on the treatment of lumbar disc herniation(LDH).Methods According to the principle of randomized controlled double blind, 100 patients with LDH were divided into 2 groups:pure collagenase group and combined treatment group.Changes of NRS value and Macnab score were observed and recorded at multiple time points after operation.The difference of the effect of the two kinds of operation was analyzed.Results Among the 50 patients in the simple treatment group,3 patients were lost to follow-up.Among the 50 patients in the combined treatment group,2 patients were lost to follow-up,and open surgery in 2 patients because of poor efficacy after the injection of 3 months and 6 months respectively.By analyzing the change of NRS value and Macnab score of 2 groups patients,there was no significant difference in the short-term and long-term efficacy between the 2 groups(P>0.05);The symptoms of the 2 groups were improved after operation.The curative effect was positively correlated with the recovery time, and the difference was statistically significant (P<0.05).Conclusion The curative effect of pure collagenase injection and the combined with herniation injection of ozone are both significant, and there is no significant difference in the clinical efficacy between the 2 kinds of operations.
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AIM To study the chemical constituents from Securidaca inappendiculata Hassk..METHODS The dichloromethane and ethyl acetate fractions of S.inappendiculata 95％ ethanol extract were isolated and purified by silica,gel column and recrystallization,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Ten compounds were isolated and identified as 8-hydroxy-1,3,4-trimethoxyxanthone (1),1,2,7-trimethoxyxanth-one (2),4-hydroxy-3,5-dimethoxybenzaldehyde (3),sesamin (4),2-methoxy-3,4-methylenedioxybenzophenone (5),1,3,7-trihydroxy-4-methoxyxanthone (6),1,3,7-t-rihydroxy-2-methoxyxanthone (7),2-hydroxy-1,7-dimethoxyxanthone (8),3,8-dih-ydroxy-1,4-dimethoxyxanthone (9),oα-spinasterol (10).CONCLUSION Compound 1 is first found in the form of natural product,compounds 2-4 are isolated from genus Securidaca for the first time.
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OBJECTIVE:To analyze fatty oil and volatile oil in seed of Metaplexis japonica. METHODS:Fatty oil and vola-tile oil in seed of M. japonica were analyzed by GC-MS:HP-5MS quartz capillary column,high purity nitrogen as carrier gas, flow rate of 1 mL/min,injector temperature of 220 ℃,primary column temperature of 120 ℃(temperature programmed),column pressure of 80 kPa,split sampling,split ratio of 20:1,sample size of 1 μL. Mass condition:electron bombardment ion source, electron energy of 70 eV,interface temperature of 250 ℃,mass scanning range of m/z 50-550,scanning interval of 1.0 s. The dif-ference of volatile components in seed of M. japonica before and after processing was analyzed by HSGC-MS:HP-5MS quartz cap-illary column,high purity nitrogen as carrier gas,flow rate of 1 mL/min,headspace heating temperature of 90 ℃,heating time of 30 min,primary column temperature of 80 ℃(temperature programmed),column pressure of 80 kPa,split sampling,split ratio of 20:1,sample size of 1 μL. Mass condition:electron bombardment ion source,electron energy of 70 eV,interface temperature of 210 ℃,mass scanning range of m/z 50-550,scanning interval of 1.0 s. RESULTS:A totall of 30 components were identified in fatty oil,among which relative contents of linoleic acid,oleic acid,palmitic acid were in high level;54 components were identi-fied in volatile oil,main components were terpenes,among which relative contents of cananga oil diene,thujopsene,dehydro aro-madendrene were in high level. Terpinen-4-ol was found and dihydrocarveol increased 100% after frying,compared with before fry-ing. CONCLUSIONS:The study basically confirm main component of fatty oil and volatile oil in seed of M. japonica;there is dif-ference of volatile components in seed of M. japonica before and after frying.
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Objective To analyze the clinical curative effect of inferior vena cava filter placement and catheter direct thrombolytic therapy combined with anticoagulant therapy with Rivaroxaban for deep venous thrombus (DVT) of the lower extremity.Methods 40 patients with acute lower extremity DVT were collected,after the inferior vena cava filter placement,thrombolytic catheter were placed in femoral and iliac vein occlusion,and urokinase was continuously infused through the catheter 24 h.Anticoagulant therapy with Rivaroxaban tablets started when the patient was diagnosed with the disease.We evaluated the short-term and long-term efficacy of the treatment from the iliac femoral vein patency,limb circumference and complications.Results 40 patients were successfully implanted the filter,38 patients were successfully removed the filter after 21 days.The clinical symptoms were relieved after 7 days of treatment,and the iliac femoral vein blood flow was basically recovered.Before and after treatment,the limb circumference was significantly reduced (P＜0.05).No serious complications occurred during the treatment period.Following up in 6 months,the rate of iliac vein occlusion and pigmentation were 2.5 ％ (1/40)and 2.5 ％ (1/40)respectively.Following up in 12 months,the rate of iliac vein occlusion and pigmentation were 7.5 ％ (3/40) and 5.0 ％ (2/40)respectively.Conclusion For treatment of acute DVT of the lower extremity,inferior vena cava filter placement and catheter direct thrombolytic therapy combined with anticoagulant therapy with Rivaroxaban can achieve satisfactory clinical curative effect,which is clinically safe and feasible.
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AIM To establish an HPLC method for the simultaneous content determination of five constituents in Jiangzhi Granules (Salviae miltiorrhizae Radix et Rhizoma,Polygoni cuspidati Rhizoma et Radix,Artemisiae scopariae Herba,etc.).METHODS The analysis of methanol extract of this drug was performed on a 30 ℃ thermostatic Hanbon-C18 column (4.6 mm × 250 mm,5 μm),with the mobile phase comprising of acetonitrile (A) 0.1％ phosphoric acid (B) flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelengths were set at 286 nm (0-30,40-50 min) and 203 nm (30-40 min).RESULTS Gypenoside A,chlorogenic acid,polydatin,salvianolic acid B and emodin showed good linear relationships within the ranges of 0.176-2.46,0.056-0.84,0.36-5.40,0.192-2.88 and 0.12-1.80 μg (r ＞0.999 0),respectively,whose average recoveries were 97.17％-102.59％ with the RSDs of 1.9％-2.9％.CONCLUSION This accurate and simple method can be used for the quality control of Jiangzhi Granules.
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Objective To explore the clinical application of a new laryngeal mask in implantation of tracheal stent.Methods The new laryngeal masks were implanted under general anesthesia for 20 patients with tracheal or primary bronchus stenosis.The oxygen was continuously supplied from its side hole,and the stents were subsequently implanted from the tail hole.Results By using the new laryngeal masks under general anesthesia,all of 20 patients were successfully and leisurely implanted the tracheal stent.After the operation,the dyspnea symptoms were significantly improved,and there was no complication.Conclusion Stent implantation by using the new laryngeal mask under general anesthesia will provide a safe and effective treatment for tracheal stenosis.
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Objective To explore the clinical application of a new laryngeal mask in implantation of tracheal stent.Methods The new laryngeal masks were implanted under general anesthesia for 20 patients with tracheal or primary bronchus stenosis.The oxygen was continuously supplied from its side hole,and the stents were subsequently implanted from the tail hole.Results By using the new laryngeal masks under general anesthesia,all of 20 patients were successfully and leisurely implanted the tracheal stent.After the operation,the dyspnea symptoms were significantly improved,and there was no complication.Conclusion Stent implantation by using the new laryngeal mask under general anesthesia will provide a safe and effective treatment for tracheal stenosis.
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OBJECTIVE:To establish a method for simultaneous determination of puerarin,berberine hydrochloride and ba-icalin in Erxieting syrup. METHODS:HPLC was performed on the column of Kromasil-C18 with mobile phase of methanol-0.2%Phosphoric acid solution (gradient elution) at flow rate of 1.0 ml/min,column temperature was 30 ℃,detection wavelength was 275 nm,and the volume injection was 10 μl. RESULTS:The linear was 10.43-83.44 μg/ml for puerarin,10.71-85.68 μg/ml for ber-berine hydrochloride and 12.58-100.64 μg/ml for baicalin(r≥0.999 3);RSDs of precision,stability and reproduciblity tests were lower than 2%;recoveries were 98.25%-100.87%(RSD=0.92%,n=6),99.41%-101.40%(RSD=0.68%,n=6)and 98.13%-99.76%(RSD=0.57%,n=6),respectively. CONCLUSIONS:The method is simple,reliable,can be used for the quality control of Erxiet-ing syrup.
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BACKGROUND: Pedicle screw fixation is a common repair method for thoracolumbar fractures. Of them, pedicle screw placement into the injured vertebra is an important method. However, the long-term effects and the related biomechanical properties deserve further analysis. OBJECTIVE: To analyze the long-term effect and biomechanical characteristics of the internal fixation of thoracolumbar fractures by pedicle screw implantation. METHODS: A retrospective analysis was performed in 126 cases of thoracolumbar fractures. The patients were treated with pedicle screw implantation and the treatment was fol owed up regularly. Ten specimens of fresh calf chest and lumbar spines were obtained. Five specimens served as an experimental group to prepare models of anterior middle column fractures, and these specimens received pedicle screw fixation into the injured vertebra. The other five specimens served as the control group, and did not receive any treatment. In the two groups, along the sagittal axis, axial compression displacement, anterior flexion displacement, posterior extension displacement, torsion angle and pul -out strength were measured and recorded. RESULTS AND CONCLUSION: (1) Clinical trial results: 126 patients were fol owed up for 10-36 months. Compared with pre-treatment, compression ratio of the injured vertebra, the height of intervertebral space, vertebral slip distance, visual analogue score and Cobb angle were significantly improved at 1 month after treatment and during final fol ow-up (al P 0.05). At the end of fol ow-up, Frankel spinal cord injury grade was significantly improved (Z=-4.127, P 0.05). (3) Above findings showed that pedicle screw fixation into the injured vertebra for thoracolumbar fractures obtained good long-term effects, and had good biomechanical properties.
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Molecular targeted therapy is a treatment bed emerging recent years for the treatment of malignant tumors,imatinib mesylate in the treatment of gastrointestinal stromal tumor (GIST) is a successful example ofmolecular targeted therapy.Imatinib mesylate can inhibit tyrosine kinase andinhibition of cell proliferation by treatment of gastrointestinal stromal tumor.With the positive effect of imatinib in the treatment of GIST,the related adverse reactions and the prevention and treatment strategies are worth to be discussed.