Combining the first class with second class to improve the professional skills of medical students

Medical science is a highly practical subject,which is closely related to human life.Medical institutions take a heavy social responsibility,in addition to the sacred mission of teaching and educating.The professional skills of medical students are one important assessment indicators to become a qualified doctor.Therefore,how to improve the professional skills of medical students in their training process becomes crucial.

Analysis of the Effect of Non-Invasive Positive Pressure Ventilation in Emergency Treatment of Severe Bronchial Asthma with Respiratory Failure

Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance.

Analysis of the Role of Problem-Based Independent Learning Model in Teaching Cerebral Ischemic Stroke First Aid in Emergency Medicine

Objective:To analyze the effect of using a problem-based(PBL)independent learning model in teaching cerebral ischemic stroke(CIS)first aid in emergency medicine.Methods:90 interns in the emergency department of our hospital from May 2022 to May 2023 were selected for the study.They were divided into Group A(45,conventional teaching method)and Group B(45 cases,PBL independent learning model)by randomized numerical table method to compare the effects of the two groups.Results:The teaching effect indicators and student satisfaction scores in Group B were higher than those in Group A(P<0.05).Conclusion:The use of the PBL independent learning model in the teaching of CIS first aid can significantly improve the teaching effect and student satisfaction.

Analysis of the Application Value of Virtual Reality Combined with Flipped Classroom Teaching Mode in Cardiopulmonary Resuscitation Teaching

Objective:To analyze the value of using virtual reality combined with the flipped classroom teaching model in teaching cardiopulmonary resuscitation(CPR).Methods:Two classes of our nursing program were randomly selected for the study from September 2022 to September 2023,Class A(52 students,conventional teaching method)and Class B(52 students,virtual reality combined with flipped classroom teaching mode).The assessment scores and independent learning ability scores of the students in the two classes were compared.Results:CPR theory and operation scores,passing rate,and independent learning ability scores of Class B were higher than those of Class A(P<0.05).Conclusion:the use of virtual reality combined with the flipped classroom teaching mode in CPR teaching is conducive to the improvement of students’assessment scores and independent learning ability.

牛黄千金散抗炎镇痛和免疫抑制作用

目的 :通过对牛黄千金散的消炎、镇痛、免疫抑制作用的研究 ,探讨牛黄千金散的药理作用 ,为临床应用提供理论依据。方法 :抗炎作用应用大白鼠足趾肿胀法、小白鼠耳廓肿胀法 ;镇痛作用运用小白鼠扭体法、大白鼠钾离子皮下透入致痛法 ;免疫抑制作用 ,测定外周血T淋巴细胞百分率、小白鼠脾淋巴细胞转化率、巨噬细胞吞噬功能、迟发性变态反应 (DTH)、血清溶血素和抗体形成细胞的功能。结果 :牛黄千金散有明显的抗炎作用 ,并能加强可待因的镇痛作用及免疫抑制作用 ,与生理盐水对照组比较有非常显著性差异。结论 :牛黄千金散有抗炎。

Change of hs-CRP,sVCAM-1,NT-proBNP levels in patients with pregnancy-induced hypertension after therapy with magnesium sulfate and nifudipine

Objective:To investigate the change of the hs-CRP,sVC AM-1,NT-proBNP levels of the patients with pregnancy-induced hypertension(PIH) syndrome.Methods:A total of 200 patients with PIH were divided into mild,moderate and severe group,and 50 healthy pregnancy patients served as the control group.The serum sVCAM-1 levels were detected by enzyme-linked immunosorbent assay,hs-CRP were detected by immunity transmission turbidity,and NT-proBNP levels were determined by the colloidal gold method.Patients were treated with magnesium sulfate and nifudipine and the contrastive analysis was performed before and after treatment.And the pathological changes in placental of PIH patients were delected by hematoxylin-eosin staining at the same time.Results:The hs-CRP,sVCAM-l,NT-proBNP levels of patients in the mild, moderate and severe PHI group were significantly higher than that in the control group(P<0.05). The hs-CKP,sVCAM-l,NT-proBNP levels in the severe group were significantly higher than the mild group and the moderate group,the difference was statistically significant(P<0.05).The hsCRP,sVCAM-l,NT-proBNP of the moderate group were significantly higher than the mild group(P<0.05).There was a positive correlation between hs-CRP,sVCAM-1,NT-proBNP expression levels and the degree of the PIH.The expression of hs-CRP,sVCAM-1,NT-proBNP levels of the moderate and the severe group were significantly decreased(P<0.05).The number of placental villi and interstitial blood vessel in the moderate and severe PIH group were significantly less than the control group(P<0.05).Conclusions:The increased levels of serum hs-CRP,sVCAM-1, NT-proBNP may be involved in the process of vascular endothelial cell injury of the PIH,and the hs-CRP,sVCAM-1,NT-proBNP can be used as the auxiliary index for diagnosis of PIH and determination of PIH severity.

间充质干细胞的免疫调节作用及其应用

间充质干细胞的免疫调节作用已成为众多学者关注的热点。本文综述了近年来间充质干细胞免疫调节作用的特点、机制及应用研究进展。

Effect of DC-CIK cell on the proliferation,apoptosis and differentiation of leukemia cells

Objective:To observe the effect of co-culture cytokine-induced killer cells(CIK) and homologous dendritic cells(DC) on the proliferative activity and phenotype change of the DCCIK cell and the cell killing activity of leukemia HL-60.Methods:50 mL cord blood sample was obtained from infants delivered by full term healthy woman and the cord blood mononuclear cells were isolated by density gradient centrifugal ion.Non-adherent cells were collectedfor the induction culture of CIK.adherent cells were differentiated into mature DC;cultured mature DC was mixed with and CIK in the proportion of 1:5 for 12 d.killing activity of DC-CIK co-cultured cell on leukemia HL-60 was detected by MTT assay.Results:Compared with CIKs.the cocultured DC-CIKs presented a markedly higher proliferation and killing activity.Conclusions:Co-culture of DC-CIK cells led to a significant increase of the proliferation and cytotoxicity of CIK.

Intestinal T-cell lymphomas:A retrospective analysis of 68 cases in China

AIM: To investigate the clinical features, diagnosis, treatment and prognosis of intestinal T-cell lymphomas (ITCL) by retrospective analysis.

A New Perylenequinone from Hypomyces sp.

A new perylenequinone, named hypomycin A, was isolated from the mycelia of Hypomyces sp.. Its structure was elucidated on the basis of spectroscopic methods.

Human periodontal ligament stem cells repair mental nerve injury

Human periodontal ligament stem cells are easily accessible and can differentiate into Schwann cells. We hypothesized that human periodontal ligament stem cells can be used as an alternative source for the autologous Schwann cells in promoting the regeneration of injured peripheral nerve. To validate this hypothesis, human periodontal ligament stem cells （1 × 106） were injected into the crush-injured left mental nerve in rats. Simultaneously, autologous Schwann cells （1 × 106） and PBS were also injected as controls. Real-time reverse transcriptase polymerase chain reaction showed that at 5 days after injection, mRNA expression of low affinity nerve growth factor receptor was sig-nificantaly increased in the left trigeminal ganglion of rats with mental nerve injury. Sensory tests, histomorphometric evaluation and retrograde labeling demonstrated that at 2 and 4 weeks after in-jection, sensory function was significantly improved, the numbers of retrograde labeled sensory neurons and myelinated axons were significantly increased, and human periodontal ligament stem cells and autologous Schwann cells exhibited similar therapeutic effects. These findings suggest that transplantation of human periodontal ligament stem cells show a potential value in repair of mental nerve injury.

人类免疫缺陷病毒感染的免疫学(英文)

全世界已经有超过二千万人死于获得性免疫缺陷综合征(又称艾滋病)。人类免疫缺陷病毒(HIV)是引起艾滋病的病原体,是由Montagnier在1983年发现的。HIV是一种逆转录病毒,有两条单链RNA组成,在逆转录酶的作用下,转录成前病毒双链DNA。HIV主要通过使CD4T细胞衰竭来破坏免疫系统。当CD4T细胞降至全血200个/mm-3时,免疫系统功能就会发生紊乱,并且会伴随机会性感染如结核杆菌、隐孢子虫等。本文概述了由于HIV感染引起的复杂、多面性的免疫反应,并重点介绍了CD4T细胞衰竭的机制。Th1和Th2辅助细胞的平衡改变也与疾病的进展有关。为了控制此疾病,研究者设计了多种疫苗,并且有些疫苗已经进入了临床试验阶段。

The bothersomeness of female urinary incontinence and its influencing factors: Study from a Chinese city

Purpose:To investigate the bothersomeness of female urinary incontinence(UI)and analyse its influencing factors.Methods:A purposive sample of 506 women with UI from three communities in Jinan was studied using the International Consultation on Incontinence QuestionnaireeUrinary Incontinence Short Form,modified Social Impact Scale,and a coping efficacy questionnaire.The influencing factors of bothersomeness were identified using one-way analysis of variance,χ^(2) test,and logistic regression.Results:Of the participants,33.4%were bothered byUI symptoms;logistic regression indicated that severity of UI,stigma,coping efficacy,and duration of symptoms were independent factors of bothersomeness,which clarified 49.8%of the variation.Conclusion:UI patients should receive individualised intervention.Healthcare workers can provide targeted intervention to patients bothered by UI to alleviate symptoms,decrease the senseof stigma,andincreaseconfidence incopingwithsymptomstodecrease bothersomeness.

Effects of coriaria lactone-activated,astrocyte-conditioned medium on estrogen receptor and progesterone receptor expression in rat cortical and hippocampal neurons

BACKGROUND： Coriaria lactone-activated astrocytes released bioactive substances that eventually caused epilepsy. OBJECTIVE： It has been suggested that activated astrocytes alter the expression of the estrogen receptor and progesterone receptor by releasing bioactive substances during epilepsy, thereby affecting neuronal activity in the brain. This study was designed to observe the expression of the estrogen receptor and the progesterone receptor in rat brain following lateral ventricle injection of coriaria lactone-activated, astrocyte-conditioned medium. DESIGN AND SETTING： This immunohistochemical, randomized, controlled, animal study was conducted at the Department of Pathology, Hospital Affiliated to Binzhou Medical College, China. MATERIAL： Coriaria lactone was provided by Huaxi Pharmaceutical Factory, China. METHODS： Forty adult, healthy, male, Sprague Dawley rats were randomly assigned into two groups. Astrocyte-conditioned medium （10 μ L） was injected into rat lateral ventricle in the control group （n = 8）. Coriaria lactone-activated, astrocyte-conditioned medium （10 μL） was infused into the rat lateral ventricle in the coriaria lactone group （n = 32）. At 2, 4, 8 and 12 hours following injection, rats were sacrificed and subjected to immunohistochemistry. Eight rats were studied at each time point. MAIN OUTCOME MEASURES： Behavioral changes were observed in rats of both groups. Expression of the estrogen receptor and the progesterone receptor in rat cortical and hippocampal neurons was measured using immunohistochemistry. RESULTS： Four hours after injection, estrogen receptor levels in rat cortical and hippocampal neurons were significantly higher in the coriaria lactone group than in the control group （P 〈 0.05）. Progesterone receptor levels were significantly lower in the coriaria lactone group than in the control group （P 〈 0.05）. Seizures were not observed in the control group. In the coriaria lactone group, convulsions appeared 30 minutes after injection; seizures reached grade Ⅲ at 45 minutes rat behavior was nearly normal at 2 hours. CONCLUSION： Activated astrocytes can induce seizures in the rat by enhancing estrogen receptor expression and decreasing progesterone receptor expression in cerebral cortical and hippocampal neurons.

Pericryptal Fibroblast Sheath in Intestinal Metaplasia,Dysplasia and Carcinoma of the Stomach

Objective： To investigate the existence of pericryptal fibroblasts sheath （PCFS） in normal gastric mucosa, intestinal metaplasia （IM）, indefinite for dysplasia （I-Dys）, low grade dysplasia （L-Dys）, high grade dysplasia （H-Dys） and gastric cancer （GC）, and its association with gastric carcinogenesis. Methods： In this study, we examined the existence of PCFS in normal gastric mucosa （N=10）, IM （N=26）, I-Dys （N=16）, L-Dys （N=13）, H-Dys （N=21） and GC （N=145） using immunohistochemical staining for two smooth muscle markers, alpha smooth muscle actin（α-SMA） and high molecular weight caldesmon （h-CD）. The significance of PCFS was discussed, especially in association with gastric carcinogenesis. Results： The PCFS was recognized in 65.4%（17/26） of IM, 62.5%（10/16） of I-Dys and 23.1% （3/13） of L-Dys respectively. No PCFS was detected in H-Dys and GC. The PCFS was gradually reduced in IM, Dys and GC in sequence （P〈0.0001）. Conclusion： The PCFS is associated with the differentiation of epithelium and involved in gastric carcinogenesis via epithelial-mesenchymal interaction.

The effect and significance on Akt and PTEN expression in melanoma B16 cells with chamaejasme extract

Objective: The aim of this study was to investigate the effect on Akt and PTEN expression and the mechanism of proliferation and apoptosis of melanoma B16 cells treated with chamaejasme extract. Methods: The expressions of Akt and PTEN of B16 cells treated with different concentrations of chamaejasme extract were detected with immunohistochemical method, cell apoptosis index(AI) was calculated with in situ labeling method. Results: Akt expressions of B16 cells treated with different concentrations of chamaejasme extract were significantly lower than the control group, while the PTEN expressions significantly up-regulated, and the effects appeared to be dose-related(P < 0.05). The Akt/AI of B16 cells treated with different concentrations of chamaejasme extract was significantly lower than the control group, all the parameters had extremely difference(F = 24.58, P < 0.05). Conclusion: Chamaejasme extract can inhibit proliferation and induce apoptosis of malignant melanoma B16 cells by down-regulating the expression of Akt and up-regulating the expression of PTEN.

Ethanolic extract of propolis induces apoptosis of HL-60 cells in vitro

Objective The aim of the study was to investigate whether ethanolic extract of propolis inhibits the growth and induces apoptosis of HL-60 cel s. Methods HL-60 cel s were treated for 24, 48, 72 h with various concentrations ethanolic extracts of prop-olis （0, 50, 100, and 200 μg/mL）. The proliferation of HL-60 cels was determined using the 3-（4,5-dimeth-ylthiazol-2-yl）-2,5-diphenyltetrazolium bromide （MTT） assay. Subsequently, Hochest 33258 staining and terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） were used to test the apoptosis of HL-60 cel s. We observed the expression levels of Bax and Bcl-2 in HL-60 cel s by immunohistochemistry. Results MTT assay showed that various concentrations of ethanolic extract of propolis had significant inhibitory efect on HL-60 cel proliferation （P〈 0.05）. Typical morphologic changes could be observed by fluorescence microscope and TUNEL. By immunohistochemistry, we found the expression level of Bax was up-regulated, whereas that of Bc1-2 was down-regulated （P 〈 0.05）.Conclusion Ethanolic extract of propolis inhibits leukemia cel proliferation and induces apoptosis in vitro. Its mechanism may be related to the regulation of Bax and Bcl-2 expression and up-regulation of Bcl-2/Bax ratio.

Efficacy and safety of early oral feeding in postoperative patients with upper gastrointestinal tumor:A systematic review and metaanalysis

BACKGROUND Early oral feeding(EOF)is an important measure for early recovery of patients with gastrointestinal tumors after surgery,which has emerged as a safe and effective postoperative strategy for improving clinical outcomes.AIM To determine the safety and efficacy of early oral feeding in postoperative patients with upper gastrointestinal tumor.METHODS This meta-analysis was analyzed using Review Manager version 5.3 and Stata version 14.All clinical studies that analyzed efficacy and safety of EOF for postoperative patients with upper gastrointestinal tumor were included.RESULTS Fifteen studies comprising 2100 adult patients met all the inclusion criteria.A significantly lower risk of pneumonia was presented in the EOF compared with TOF group[relative risk(RR)=0.63,95%confidence interval(CI):0.44-0.89,P=0.01].Length of hospital stay was significantly shorter in the EOF group than in the TOF group[weighted mean difference(WMD)=-1.91,95%CI:-2.42 to-1.40;P<0.01].Cost of hospitalization was significantly lower(WMD=-4.16,95%CI:-5.72 to-2.61;P<0.01),and CD4 cell count and CD4/CD8 cell ratio on postoperative day 7 were significantly higher in the EOF group than in the TOF group:CD4 count(WMD=7.17,95%CI:6.48-7.85;P<0.01),CD4/CD8 ratio(WMD=0.29,95%CI:0.23-0.35;P<0.01).There was no significant difference in risk of anastomotic leak and total postoperative complications.CONCLUSION EOF as compared with TOF was associated with lower risk of pneumonia,shorter hospital length of stay,lower cost of hospitalization,and significantly improved postoperative immune function of patients.

Clinical Study on the Effects of Electroacupuncture Combined with Extracorporeal Shock Wave in the Treatment of Periarthritis of Shoulder

Objective:To investigate the clinical effects of electroacupuncture combined with extracorporeal shock wave in the treatment of periarthritis of shoulder.Methods:136 patients with periarthritis of shoulder admitted to our hospital from September 2018 to September 2019 were randomly divided into two groups by double-blind method.68 patients in the control group were treated with extracorporeal shock wave;68 patients in the observation group were treated with electroacupuncture combined with extracorporeal shock wave.The shoulder joint pain,joint function and activities of daily living were compared between the two groups.Results:The VAS score of shoulder joint pain in the observation group after treatment(1.92±0.24)was lower than that in the control group(3.51±0.32),and the UCLA score of shoulder joint function(31.28±1.96)was higher than that of the control group(27.42±2.36),the differences were statistically significant(P<0.05).After treatment,the active degree of forward flexion and extension of shoulder joint in the observation group was higher than those of the control group,and the activities of daily living was higher than that of the control group,with statistically significant differences(P<0.05)Conclusion:Electroacupuncture combined with extracorporeal shock wave treatment for periarthritis of shoulder has achieved ideal effects,safety and non-invasiveness,and can quickly restore the functions of shoulder joints.