OSCE在中医心病科住院医师规范化培训教学中的应用

目的分析客观结构化临床考试(Objective Structured Clinical Examination,OSCE)在中医心病科(心血管内科)住院医师规范化培训(住培)教学应用的效果与价值。方法选取2022年4月—2023年4月在武汉市中医医院进行住培的学生60名,采用随机数字表法分成观察组(30名,采取OSCE考核模式教学)和对照组(30名,采取常规考核模式教学)。比较两组教学效果。结果观察组汇报病史(14.43±0.94)分、理论知识考核(14.17±1.09)分、临床技能考核(22.30±1.09)分、病收集及体格检查(25.70±1.47)分、临床病历书写及分析(14.23±1.30)分、临床临床能力考核总成绩(90.30±4.34)分均高于对照组,差异有统计学意义(t=1.472、0.913、2.686、2.630、2.129、2.694,P均<0.05)。观察组自我导向学习评定得分均高于对照组,差异有统计学意义(P均<0.05)。结论中医心血管内科住院医师规范化培训教学中借助OSCE考核,还可以让学生更好掌握专业知识、临床技能,提高分析、处理临床问题的能力,增加住培生对中医住培教学主观能动性。

Biochanin A attenuates spinal cord injury in rats during early stages by inhibiting oxidative stress and inflammasome activation

Previous studies have shown that Biochanin A,a flavonoid compound with estrogenic effects,can serve as a neuroprotective agent in the context of cerebral ischemia/reperfusion injury;howeve r,its effect on spinal cord injury is still unclea r. In this study,a rat model of spinal cord injury was established using the heavy o bject impact method,and the rats were then treated with Biochanin A(40 mg/kg) via intrape ritoneal injection for 14 consecutive days.The res ults showed that Biochanin A effectively alleviated spinal cord neuronal injury and spinal co rd tissue injury,reduced inflammation and oxidative stress in spinal cord neuro ns,and reduced apoptosis and pyroptosis.In addition,Biochanin A inhibited the expression of inflammasome-related proteins(ASC,NLRP3,and GSDMD)and the Toll-like receptor 4/nuclear factor-κB pathway,activated the Nrf2/heme oxygenase 1 signaling pathway,and increased the expression of the autophagy markers LC3 Ⅱ,Beclin-1,and P62.Moreove r,the therapeutic effects of Biochanin A on early post-s pinal cord injury were similar to those of methylprednisolone.These findings suggest that Biochanin A protected neurons in the injured spinal cord through the Toll-like receptor 4/nuclear factor κB and Nrf2/heme oxygenase 1 signaling pathways.These findings suggest that Biochanin A can alleviate post-spinal cord injury at an early stage.

Development characteristics and controlling factors of fractures in lacustrine shale and their geological significance for evaluating shale oil sweet spots in the third member of the Shahejie Formation in the Qikou Sag, Bohai Bay Basin

Natural fractures are critical for shale oil and gas enrichment and development. Due to the extremely high heterogeneity of shale, the factors controlling the formation of internal fractures, especially horizontal fractures, remain controversial. In this study, we integrate thin section analysis and microcomputed tomography(CT) data from several lacustrine shale samples from the third member(Es3) of the Shahejie Formation, Qikou Sag, Bohai Bay Basin, to assess the fractures in detail. The goal is to reveal the development characteristics, controlling factors, and geological significance for evaluating sweet spots in a shale oil play. The fractures in the Es3contain high-angle structural and horizontal bed-parallel fractures that are mostly shear and extensional. Various factors influence fracture development,including lithofacies, mineral composition, organic matter content, and the number of laminae. Structural fractures occur predominantly in siltstone, whereas bed-parallel fractures are abundant in laminated shale and layered mudstone. A higher quartz content results in higher shale brittleness, causing fractures, whereas the transformation between clay minerals contributes to the development of bedparallel fractures. Excess pore pressure due to hydrocarbon generation and expulsion during thermal advance can cause the formation of bed-parallel fractures. The density of the bed-parallel and structural fractures increases with the lamina density, and the bed-parallel fractures are more sensitive to the number of laminae. The fractures are critical storage spaces and flow conduits and are indicative of sweet spots. The laminated shale in the Es3with a high organic matter content contains natural fractures and is an organic-rich, liquid-rich, self-sourced shale play. Conversely, the siltstone, massive mudstone, and argillaceous carbonate lithofacies contain lower amounts of organic matter and do not have bed-parallel fractures. However, good reservoirs can form in these areas when structural fractures are present and the source, and storage spaces are separated.

打造教师教学发展共同体,多校共上一堂课——“大学化学实验课程群虚拟教研室”教研活动初探及成效

介绍“大学化学实验课程群虚拟教研室”在创新教研形态、加强教学研究、共建优质资源以及开展教师培训等方面开展的一系列工作及取得的初步实效。重点阐明了“多校共上一堂课,共享教学云资源”的示范教学直播课活动的教研形式以及教学内容的选取原则。

Lacustrine shale oiliness influenced by diabase intrusions in the Paleogene Funing Formation,Subei Basin,China

The research on the correlation between hydrocarbon accumulations and magmatic activities has always attracted aroused much wide attention.Existing research has primarily the hydrocarbon generations capability of source rocks and the quality of reservoirs by diabase intrusions.whereas,rare systematic research has been conducted on the oiliness and enrichment mechanism.To be specific,the diabase intrusive zone,the contact metamorphic zone and the normal shale zone of the Funing Formation in the Gaoyou Sag,Subei Basin were taken as the object of this study.Moreover,in this study,the hydrocarbon generation quality,reservoir quality,and oil-bearing quality of diabase-metamorphic zone-normal shale were evaluated using X-ray diffractions,argon ion polishing-field emission scanning electron microscope,energy spectrum,rock slice/light-sheet microscopic observations,organic geochemical tests,N_(2) gas adsorption and 2D NMR tests.The results indicated that the intrusive zone,the metamorphic zone,and the normal zone were formed in order by the degree of effect of diabase intrusions.Secondly,the oil content of different parts exhibited significant heterogeneity due to the baking effect of diabase,and the metamorphic zone had the significantly better oil-bearing nature than the intrusive zone.Lastly,a distribution model was proposed for the diabase intrusive zone-metamorphic zone-normal surrounding rock zone.

Upregulation of UBAP2L in Bone Marrow Mesenchymal Stem Cells Promotes Functional Recovery in Rats with Spinal Cord Injury

Post-translational modifications of cellular proteins with ubiquitin or ubiquitin-like proteins regulate many cellular processes,such as cell proliferation,differentiation,apoptosis, signal transduction,intercellular immune recognition,inflammatory response,stress response,and DNA repair.Nice4/UBAP2L is an important member in the family of ubiquitin-like proteins,and its biological function remains unknown.This study aimed to investigate the effect of UBAP2L on spinal cord injury (SCI).At first,rat bone marrow mesenchymal stem cells (BMSCs)were infected with adeno-associated virus to induce over-expression of Nice4.Subsequently,the infected BMSCs were transplanted into rats suffering from semi-sectioned SCI.The results showed that the over-expression of Nice4 significantly promoted the proliferation and differentiation of BMSCs. In addition,the transplantation of infected BMSCs into the injured area of SCI rats improved the function repair of SCI.Importantly,the immunohistochemical and hematoxylin-eosin staining and RT-PCR results showed that the number of neuronal cells,oligodendrocytes,and astrocytes was significantly increased in the injured area,along with significantly upregulated expression ofcyclin D1 and p38 mitogen-activated protein kinase (MAPK).Meanwhile,the expression of caspase 3 protein was significantly down-regulated.In conclusion,the over-expression of Nice4 gene can promote the functional recovery in SCI rats by promoting cell proliferation and inhibiting apoptosis. The results of this study indicate an alternative option for the clinical treatment of SCI.

Formation and distribution characteristics of Proterozoic–Lower Paleozoic marine giant oil and gas fields worldwide

There are rich oil and gas resources in marine carbonate strata worldwide.Although most of the oil and gas reserves discovered so far are mainly distributed in Mesozoic,Cenozoic,and upper Paleozoic strata,oil and gas exploration in the Proterozoic–Lower Paleozoic（PLP）strata—the oldest marine strata—has been very limited.To more clearly understand the oil and gas formation conditions and distributions in the PLP marine carbonate strata,we analyzed and characterized the petroleum geological conditions,oil and gas reservoir types,and their distributions in thirteen giant oil and gas fields worldwide.This study reveals the main factors controlling their formation and distribution.Our analyses show that the source rocks for these giant oil and gas fields are mainly shale with a great abundance of type I–II organic matter and a high thermal evolution extent.The reservoirs are mainly gas reservoirs,and the reservoir rocks are dominated by dolomite.The reservoir types are mainly karst and reef–shoal bodies with well-developed dissolved pores and cavities,intercrystalline pores,and fractures.These reservoirs arehighly heterogeneous.The burial depth of the reservoirs is highly variable and somewhat negatively correlated to the porosity.The cap rocks are mainly thick evaporites and shales,with the thickness of the cap rocks positively correlated to the oil and gas reserves.The development of high-quality evaporite cap rock is highly favorable for oil and gas preservation.We identified four hydrocarbon generation models,and that the major source rocks have undergone a long period of burial and thermal evolution and are characterized by early and long periods of hydrocarbon generation.These giant oil and gas fields have diverse types of reservoirs and are mainly distributed in paleo-uplifts,slope zones,and platform margin reef-shoal bodies.The main factors that control their formation and distribution were identified,enabling the prediction of new favorable areas for oil and gas exploration.

Pore structure evolution of lacustrine organic-rich shale from the second member of the Kongdian formation in the Cangdong Sag,Bohai Bay Basin,China

Pyrolysis experiments were conducted on lacustrine organic-rich shale from Cangdong Sag in Bohai Bay Basin,China,to investigate the impact of hydrocarbon generation on shale pore structure evolution.Thermal evolution is found to control the transformation of organic matter,hydrocarbon products characteristics,and pore structure changes.Furthermore,pore volume and specific surface area increase with increasing maturity.In low-mature stage,the retained oil content begins to increase,pore volumes show slight changes,and primary pores are occluded by the generated crude oil of high molecular weight and density.In the oil-window stage,the retained oil content rapidly increases and reaches maximum,and pore volumes gradually increase with increasing thermal maturity.At high mature stage,the retained oil content begins to decrease,and the pore volume increases considerably owing to the expulsion of liquid hydrocarbon.In over mature stage,natural gas content significantly increases and kerogen transforms to asphalt.Numerous organic pores are formed and the pore size gradually increases,resulting from the connection of organic pores caused the increasing thermal stress.This study lays a foundation for understanding variation of hydrocarbon products during the thermal evolution of lacustrine shales and its relationship with the evolution of shale reservoirs.

Ethnic Difference of Disease Prevalence in Rural China: Examples and Explanations

Ethnic difference of disease prevalence has attracted great attentions in recent years in China, but few researches have summarized analysis available on ethnic difference of disease prevalence in rural China. The PubMed Central, Wiley Inter science, Science direct, Biomed central, CNKI and Springer-link were searched to identify studies published between January 1984 and October 2014 on ethnic inequality of health status in rural China. Distinct ethnic differences of disease prevalence exist in rural China. Results across disciplines put different explanations on the ethnic differences from ethnicity, infant feeding, and inequality in maternal health services utilization angles. The ethnic inequality of health status in rural China can be reduced by policy makers to allocate more resources towards health service in ethnic rural China.

Marital distress and disease progression: A systematic review

Objective: To review the state of research on the association between marital distress and disease progression. Methods: The PubMed Central, Wiley Interscience, Sciencedirect, Biomed central and Springer-link were searched to identify studies published between January 1984 and October 2012 on disease progression. Articles meeting the following criteria were selected for review: 1) study subjects were spouses, 2) the article was published within the past 28 years in a peer-reviewed journal, and 3) the research included at least one of the following outcomes-marital distress or disease progression. Articles were different on time span, the number of surveys, and the definition of disease. Results: Out of 72 screened articles, 18 met our criteria. Research demonstrates that marital distress and disease progression appear to have bidirectional influence on each other. Conclusion: Marital distress has a significant effect on disease progression. This article summarizes what is known about the association of marital distress on disease progression among spouses with disease. The authors speculate that associations between marital distress and disease progression will motivate policy makers in developing countries to allocate more resources towards spousal service.

The characteristics of cerebrospinal fluid tumor microenvironment in a patient with leptomeningeal metastases from cancer of unknown primary

Cancer of unknown primary(CUP)is a rare disease characterized by metastases in which the primary tumor is of unknown origin.The cerebrospinal fluid(CSF)tumor microenvironment of CUP is still unknown.A Chinese male was diagnosed with leptomeningeal metastases from CUP(CUP-LM)based on the following medical examination results:partial leptomeningeal enhancement by brain magnetic resonance imaging,few malignant cells of diverse morphology in CSF,and no abnormalities or lymphadenopathy by systemic examination.

非小细胞肺癌组织miR-1179、miR-1182表达水平与Notch信号通路、临床病理特征和预后的关系

目的:探讨非小细胞肺癌(NSCLC)组织微小核糖核酸(miRNA)-1179、miR-1182表达与缺口(Notch)信号通路、临床病理特征和预后的关系。方法:选取2018年1月~2019年12月武汉市中医医院收治的118例NSCLC患者,收集手术切除的癌组织和癌旁组织标本,采用实时荧光定量聚合酶链式反应检测miR-1179、miR-1182和Notch信号通路相关分子表达。分析miR-1179、miR-1182表达与Notch信号通路相关分子和NSCLC患者临床病理特征的关系。根据NSCLC组织中miR-1179、miR-1182表达均值分为高、低表达组,采用K-M法绘制不同miR-1179、miR-1182表达NSCLC患者生存曲线,多因素Cox回归分析NSCLC患者预后的影响因素。结果:与癌旁组织比较,NSCLC组织中miR-1179、miR-1182表达降低,Notch受体1(Notch1)信使核糖核酸(mRNA)、Notch2 mRNA、Notch3 mRNA、Notch4 mRNA表达升高(P<0.05)。Pearson相关性分析显示,NSCLC组织中miR-1179、miR-1182表达与Notch1 mRNA、Notch2 mRNA、Notch3 mRNA、Notch4 mRNA表达均呈负相关(P<0.05)。不同分化程度、TNM分期、淋巴结转移NSCLC患者miR-1179、miR-1182表达比较有统计学差异(P<0.05)。118例NSCLC患者随访3年,失访5例,3年总生存率为55.75%。K-M生存曲线分析显示,miR-1179、miR-1182高表达组总生存率高于低表达组(P<0.05)。多因素Cox回归分析显示,低分化、TNM分期Ⅲ期、淋巴结转移为NSCLC患者预后的独立危险因素,miR-1179、miR-1182升高为其独立保护因素(P<0.05)。结论:NSCLC组织中miR-1179、miR-1182低表达,与Notch信号通路、分化程度、TNM分期、淋巴结转移和预后有关,miR-1179、miR-1182表达可能通过抑制Notch信号通路发挥抑癌作用。

植物氮形态利用策略及对外来植物入侵性的影响

氮是影响外来植物入侵性的重要因素之一,但相关研究多关注土壤氮水平的效应,较少考虑氮形态的作用。为从土壤氮形态利用的角度阐释外来植物的入侵机制,本文在植物氮形态利用策略分析的基础上,综述了外来植物氮形态利用的偏好性及其对入侵性的影响。植物的氮形态利用策略有偏好性和可塑性两种,这可能与植物对土壤氮形态特性的长期适应有关;植物不仅可以对土壤氮形态做出响应,而且还能改造土壤氮形态,并对改变后的土壤氮形态做出反馈响应。很多外来植物入侵硝态氮占优势的干扰生境,偏好硝态氮的外来植物与本地植物竞争硝态氮;而偏好铵态氮的外来植物通过抑制土壤硝化作用,营造铵态氮环境,促进自身生长,同时抑制偏好硝态氮的本地植物生长。然而,植物氮形态利用策略不是一成不变的,而是受多种生物和非生物因素共同作用影响的复杂过程,今后应加强多因素交互作用对外来入侵植物氮形态利用策略的影响及机制研究,更好地揭示氮形态利用策略,尤其是氮形态利用的可塑性与外来植物入侵性的关系。

Porous graphene decorated silica as a new stationary phase for separation of sulfanilamide compounds in hydrophilic interaction chromatography

Porous graphene(PG) has potential applications in numerous fields because of the existence of nanopores in the plane. In this study, porous graphene decorated silica microspheres(Sil-PG) were successfully fabricated by assembling PG onto the silica particles surface in deep eutectic solvents(DESs).Experimental results demonstrate that this new stationary phase can facilitate the separation of six sulfonamides compounds in hydrophilic chromatographic conditions. The successful synthesis of the SilPG stationary phase provides a basis for the application of porous graphene-modified materials as the stationary phase for liquid chromatography, and offers the possibility to broaden the application of PG in the field of chromatography.

Preparation of Silica-Based Superfi cially Porous Silica and its Application in Enantiomer Separations: a Review

Chromatographic substrate material,as a carrier of chromatographic stationary phases,plays a vital role in defining its chromatographic characteristics,including column efficiency,stability,peak capacity and so on.In recent years,superficially porous silica(SPS)was widely valued for its excellent performance in improving the column efficiency due to its special structural properties,which was considered as a real substitute for fully porous SiO_(2)(FPS)and had been used to develop a new generation of highly efficient stationary phase.To help researchers better understand the SPS and further promote its application and development in the field of chromatography,the rapid separation mechanism,preparation method and its applications in the rapid separation and analysis of enantiomers were systematically introduced,and the development prospects of SPS were also prospected in this paper.