Clinical manifestations,diagnosis and long-term prognosis of adult autoimmune enteropathy:Experience from Peking Union Medical College Hospital

BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.

A Brief Overview of the Development and Significance of Modern Scientific Medicine in China:Take Chinese Academy of Medical Science and Peking Union Medical College as an Example

Since the early 20th century,China has gradually established a clinical,educational,and research system centered around modern scientific medicine,which has now become the dominant force in China's medical and health system and services,with the construction and development of the Chinese Academy of Medical Sciences and Peking Union Medical College as the most prominent symbol.The scientific medicine in the new era requires close cooperation across multiple disciplines and fields to build a high-quality and efficient medical and health service system.It also involves combining the excellent traditional Chinese culture with Western medicine to explore a unique path of modern scientific medicine with Chinese characteristics.

Investigation on the Knowledge, Attitude and Practice of Oral Health among Medical College and University Undergraduate

Objectives: This study aims to investigate the status of knowledge, attitude and practice (KAP) of oral health among medical undergraduate students, and provide reference for implementing oral health interventions. Methods: A total of 528 undergraduate students enrolled in Fuzhou Medical College from February 2023 to September 2023 were selected as the research subjects. Their oral health KAP were investigated, and the oral health behavior habits of different types of medical students were compared, and possible influencing factors were analyzed. Results: The total awareness rate of oral health knowledge among medical students is 77.0%, with an average score of 3.85 ± 1.16 points. The overall positive rate of oral health attitudes among medical students is 80.0%, with an average score of 3.19 ± 0.72 points. The total qualified rate of oral health behavior is 65.9%, with an average score of 4.61 ± 1.23 points. The scores of oral health knowledge, attitudes, and behaviors among medical students are related to gender, major, smoking status, and oral health status. The frequency of brushing teeth in the female group was higher than that in the male group, while the habit of brushing teeth before bedtime and the frequency of timely replacement of toothbrushes when deformed were lower, with statistical significance (p 0.05). The frequency of timely replacement of toothbrushes varies among medical students from different majors, and the difference is statistically significant (p 0.05). People who have a habit of eating hot and cold food have a higher frequency of brushing their teeth every day, and the difference is statistically significant (p 0.05). Non smokers have a better habit of brushing their teeth before bedtime and a higher frequency of timely replacement when their toothbrush deforms, with a statistically significant difference (p 0.05). The frequency of using fluoride toothpaste or medicated toothpaste, having a habit of unilateral chewing, and timely replacement of toothbrushes when deformed in patients with existing oral problems is higher than that of those without oral problems, and the difference is statistically significant (p 0.05). Conclusion: The knowledge, attitude, and behavior of oral health among medical students in this school are above average. Students with different genders, dietary and smoking habits, and oral health status have different oral health behavioral habits. It is recommended to include oral health education in mandatory courses for various medical majors.

A Decade of Scien tific and Tech no logical Inno vati on at Chin ese Academy of Medical Sciences&Peking Union Medical College:Retrospect and Prospect

Focusing on the reform initiatives of Chinese Academy of Medical Sciences(CAMS) & Peking Union Medical College(PUMC) in medical scientific and technological innovation from perspectives of deepening the reform and optimizing the ecosystem of science and technology innovation,this article summarizes the highlights of CAMS & PUMC’s efforts in safeguarding people’ s health and promoting the Healthy China 2030 strategy through scientific and technological innovation in the fields including basic research,disease prevention and treatment,and medical technology in the past ten years.These achievements embody the endeavors and responsibility of CAMS& PUMC in realizing self-reliance and self-improvement of Chinese medical science and technology and highlight its contributions to the development of medical science and technology of China.

Job Satisfaction, Engagement and Associated Factors Among Employees Working at Adama Hospital Medical College, Adama, Oromia Regional State, Ethiopia:Institution Based Cross Sectional Study

High level of professional satisfaction among healthcare workers earns high dividends such as higher worker force retention and patients satisfaction.The aim of this study is to assess level of employees satisfaction and associated factors among employees working in Adama hospital medical college town from January to March 2019.Institution based cross-sectional study design was employed.About 389 employees were interviewed.Multi variable logistic regression analysis was used to identify the relationship among predictors and outcome variable.Variables with P-value<0.25 at bivariate logistic regression analysis were entered into multi variable logistic regression.P-value<0.05 and adjusted odds ratio at 95%level of significance was be used to declare predictors of employees satisfaction.A total of 389 study participant responded to the questionnaires with response rate of 92.20%.More than half 212(54.5%)were male and the mean age of study participants were 32.24 years(SD±7.87).The overall level of job satisfaction was 185(47.6%)(95%CI:1.43,1.53).Factors like shisha smoking(AOR,0.4;95%CI:0.01,0.44),co-workers relationship(AOR,2.85;95%CI:1.21,6.72),working environment(AOR,4.08;95%CI:1.98,8.41),autonomy at their working(AOR,4.40;95%CI:1.89,11.19),commitment for their organization(AOR,2.48;95%CI:1.20,5.10),performance evaluation(AOR,5.69;95%CI:2.53,12.80),promotion or growth opportunity(AOR,9.58;95%CI:4.11,22.32)and relationship with immediate supervisor(AOR,4.59;95%CI:1.89,11.19)shows significant association with employees’job satisfaction.The overall level of employees satisfaction is low.The organization should work on factors associated with employees’job satisfaction in order to increase satisfaction levels of employees.

Management of Adult Growth Hormone Deficiency at Peking Union Medical College Hospital:A Survey among Physicians

Objective To evaluate physicians' attitude and knowledge about the management of adult growth hormone deficiency(AGHD) at Peking Union Medical College Hospital and impact factors associated with better decision-making.Methods A 21-question anonymous survey was distributed and collected at Peking Union Medical College Hospital,a major teaching hospital in Chinese Academy of Medical Sciences.Data of physicians' educational background,clinical training,patient workload per year and continuing medical education in AGHD were collected.Factors associated with appropriate answers were further analyzed by multivariate regression models.Results One hundred and eighteen internal medicine residents,endocrine fellows,attending physicians and visiting physicians responded to the survey.Among them,44.9% thought that AGHD patients should accept recombinant human growth hormone replacement therapy.Moreover,56.8% selected insulin tolerance test and growth hormone-releasing hormone-arginine test for the diagnosis of AGHD.Logistic regression analysis of physician demographic data,educational background,and work experience found no consistent independent factors associated with better decision-making,other than continued medical education,that were associated with treatment choice.Conclusions The physicians' reported management of AGHD in this major academic healthcare center in Beijing was inconsistent with current evidence.High quality continued medical education is required to improve Chinese physician management of AGHD.

Positive Rate of Different Hepatitis B Virus Serological Markers in Peking Union Medical College Hospital,a General Tertiary Hospital in Beijing

Objectives To investigate the positive rate of different hepatitis B virus （HBV） serological markers, and the demographic factors related to HBV infection. Methods We enrolled all patients tested for HBV serological markers, such as HBV surface antigen （HBsAg）, HBV surface antibody （HBsAb）, hepatitis B e antigen （HBeAg）, hepatitis B e antibody （HBeAb）, HBV core antibody （HBcAb）, and HBV-DNA from July 2008 to July 2009 in Peking Union Medical College Hospital. The positive rate of each HBV serological marker was calculated according to gender, age, and department, respectively. The positive rates of HBV-DNA among patients with positive HBsAg were also analyzed. Results Among 27 409 samples included, 2681 （9.8%） were HBsAg positive. When patients were divided into 9 age groups, the age-specific positive rate of HBsAg was 1.2%, 9.6%, 12.3%, 10.9%, 10.3%, 9.7%, 8.0%, 5.8%, and 4.3%, respectively. The positive rate of HBsAg in non-surgical department, surgical department, and health examination center was 16.2%, 5.8%, and 4.7%, respectively. The positive rate of HBsAg of males （13.3%） was higher than that of females （7.3%, P=0.000）. Among the 2681 HBsAg （＋） patients, 1230 （45.9%） had HBV-DNA test, of whom 564 （45.9%） were positive. Patients with HBsAg （＋）, HBeAg （＋）, and HBcAg （＋） result usually had high positive rate of HBV-DNA results （71.8%, P=0.000）. Conclusions Among this group of patients in our hospital, the positive rate of HBsAg was relatively high. Age group of 20-29, males, and patients in non-surgical departments were factors associated with high positive rate of HBsAg.

Effect of Angiotensin Receptor-Neprilysin Inhibitor versus Valsartan on Cardiac Status in Patients with Chronic Heart Failure with Reduced Ejection Fraction: A Randomized Clinical Trial in Rangpur Medical College Hospital, Bangladesh

Background: Heart failure with reduced ejection fraction has a significant association with considerable morbidity and mortality, but there is still inadequacy in appropriate treatment to prevent this condition. We observed the effect of angiotensin receptor neprilysin inhibitor (ARNi) with such disorder compared to valsartan. Methods: In this single-blind trial, the patients were enrolled with chronic HF aged on or above 40 years, symptomatic NYHA class II - IV, an elevated NT-proBNP above 400 pg/ml level and a reduced LVEF of 40% or less. The patients were randomly assigned 1:1 to the treatment arms either ARNi (50 mg titrated to 100 mg twice a day) or valsartan (40 mg titrated to 80 mg twice a day) and followed for a median of 88 days. The primary outcome was mode of cardiovascular death and re-hospitalization for heart failure. Changes in the level of NT-proBNP and rate of ejection fraction were also measured. Results: Cardiovascular deaths occurred 4 (8%) in the ARNi treatment arm, while 11 (22%) in the valsartan treatment arm with significant hazard ratio in the ARNi group [Hazard Ratio = 0.37;95% CI: 0.34, 0.64;p = 0.042] during a median of 88 days of follow up period and 2 (4%) of the patients from the ARNi treatment arm were hospitalized due to HF, while in the valsartan treatment arm, 10 (20%) patients were hospitalized due to HF followed by receiving treatment respectively with hazard ratio in the ARNi group [Hazard Ratio = 0.80;95% CI: 0.57, 0.92;p Conclusion: Chronic treatment with the angiotensin receptor neprilysin inhibitor (ARNi) strongly decreases the NT-proBNP as well as morbidity and mortality and increases LVEF in patients with heart failure compared to valsartan.

Investigation and application of educational method in pathophysiology at medical college

This article explores and applies the methodology of the education in pathophysiology for dealing with the problems:(1)how the professors at the medical college could expand the training of thought,renew the conception and emphasize the innovation with the clin-ical experience;(2)how they could get the new clinical knowledge,optimize the intellectual structure and improve the ability of clinical practice of pathophysiology through the investigation and application of the method of education;(3)how they could direct the students to learn the pathophysiological knowledge correctly,to master the details of the examination of the mediastinus enlistment and to raise effectively their pass rate in the examination depending on training strictly.It is for discussion and communication with all the colleagues.

An Analysis of War Weaponry Trauma Victims from a Medical College Setting in Kashmir Valley

Background: Kashmir valley, being a known conflict zone keeps on receiving war victims due to scuffles between civilians and the government forces. Such upsurges have been noted in the recent past in 2008 and 2010;however, a new face of upheaval took place in the month of July 2016. Herein, we present an analysis of 500 abdominal trauma victims reported to our department at Government Medical College Srinagar, Kashmir, India. Methods: Government Medical College Srinagar Kashmir is a tertiary care teaching hospital situated in the heart of Kashmir valley. Being one of the referral hospitals, for trauma, we received a total figure of 6149 trauma victims out of which 500 were purely of abdominal in nature managed by the department of surgery. The study conducted was a short analysis of these abdominal trauma patients that reported from 8th July to 8th November 2016. Results: The result of analysis of 500 abdominal trauma patients is reported herein. The male female ratio of patients was 19.8:1 (male = 95.2%, female = 4.8%). The age range was from 5 years to 65 years with majority reported in the age range of 15 - 30 years. The number of bullet injuries was =85 and the pellet injuries were =349. The commonest organs involved were small intestines, spleen, large bowel and liver in descending order. Penetrating injuries were seen in =60.4%, non-penetrating were seen in =39.6%. The patients were grouped into conservative, non operative and operative group. The commonest morbidity observed was wound sepsis and a total mortality reached to a figure of 2%. Conclusion: This short study of analysis of trauma victims has explored the newer horizons of trauma management and we believe and conclude that specialized trauma hospitals with skilled manpower and modern gadgets of handling trauma is need of an hour especially in developing countries like ours.

Pregnancy Outcomes of Repeat Cesarean Section in Peking Union Medical College Hospital

Objective To evaluate the effect of elective repeat cesarean section on the maternal and neonatal outcomes. Methods A retrospective clinic- and hospital-based survey was designed for comparing the maternal and neonatal outcomes of elective repeat cesarean section [RCS group （one previous cesarean section） and MRCS group （two or more previous cesarean sections）] and primary cesarean section （FCS group） at Peking Union Medical College Hospital from January 1998 to December 2007. Results The incidence of repeat cesarean section increased from 1.26% to 7.32%. The mean gestational age at delivery in RCS group （38.1±1.8 weeks） and MRCS group （37.3±2.5 weeks） were significantly shorter than that in FCS group （38.9±2.1 weeks, all P〈0.01）. The incidence of complication was 33.8% and 33.3% in RCS group and MRCS group respectively, and was significantly higher than that in FCS group （7.9%, P〈0.05）. Dense adhesion （13.5% vs. 0.4%, OR=7.156, 95% CI： 1.7-30.7, P〈0.01） and uterine rupture （1.0% vs. O,P〈0.05） were commoner in RCS group compared with FCS group. Neonatal morbidity was similar among three groups （P〉0.05）. Conclusions Repeat cesarean section is associated with more complicated surgery technique and increased frequency of maternal morbidity. However, the incidence of neonatal morbidity is similar to primary cesarean section.

Medical colleges summary of biomedical engineering profession<br>—Luzhou Medical College in the perspective of biomedical engineering profession<br>

This paper expounds professional characteristics of biomedical engineering in our school, and analyses some problems lying in it, emphatically discusses advantages and the problems combining biomedical engineering with the medical courses in order to offer targeted solutions. It summarizes the results and problems so as to provide reference value to a new major.

Evaluation of Lipid Profile in Obese and Non-Obese Hypertensive Adult Patients Attended in Medicine Department of a Medical College Hospital of Bangladesh

Background: By the dawn of this modern era of science, the prime challenge of physician is cardiovascular disease (CVD). The most important modifiable risk factors of CVDs are unhealthy diet, physical inactivity and tobacco use. The effects of unhealthy diet and physical inactivity include abnormal blood lipid, obesity and hypertension. We tried to evaluate and correlate the pattern of lipid profile in obese and non-obese hypertensive patients. Objectives: This study was conducted at medicine department of Cumilla Medical College Hospital. The principal aim was to evaluate the lipid profile in obese and non-obese adult hypertensive patients. Methodology: During this cross sectional analytical study, a total of 100 adult hypertensive patients were taken by purposive sampling. Among them 50 (group 1) patients were taken those were obese and 50 (group 2) patients taken those were non-obese according to BMI measurement on operational definition. Diagnosis of hypertension would be established with the help of ambulatory BP measurements two occasions few minutes apart. The staging of hypertension was done according to JNC7 Criteria. Morning blood samples were taken after 8 - 12 hours of fasting and lipid profiles were done on authentic laboratories. The laboratory values were interpreted according to the operational definition of dyslipidaemia. The ethical research and review committee approved the study protocol and signed informed consent was obtained from the participants. The statistics was analyzed using the IBM SPSS software of version 19.0. Statistical significance was set at p < 0.05. Results: Among the two groups, there were 56 (56%) males and 44 (44%) females. The mean age of group 1 (46.10 ± 11.09) was compared to that of group 2 (45.5 ± 10.6). Lipid profile abnormalities were significantly higher in the stage 2 hypertension (59.62%) and stage 3 hypertension (66.66%), higher in class 2 obese (100%) and class 3 obese subjects (100%), female hypertensive patients had significantly higher BMI than their male counterparts (27.24 ± 3.63 kg/m2 versus 29.29 ± 3.99 kg/m2), lipid profiles were higher in the female than male hypertensive patients (63.33% vs 55.35%) but only TC was statistically significant (4.45 ± 1.19 mmol/l versus 4.86 ± 1.29 mmol/l, p < 0.05). Those who were obese had significant high TG (p < 0.001), high TC (p < 0.001) and high LDL-C (p < 0.001). 38 (76%) of the obese hypertensive patients had dyslipidaemia whereas 21 (42%) of non-obese hypertensive patients had dyslipidaemia. In multivariate regression, TG was significantly and directly associated with BMI of subjects. Dyslipidaemia was more prevalent in the age group 30 - 59 of adult hypertensive patients. It showed that obese hypertensive patients had significantly higher SBP (p < 0.001), DBP (p < 0.001) than non-obese subjects. The mean TC (4.83 ± 0.95 mmol/l versus 4.15 ± 0.57 mmol/l, t = -9.70, p < 0.001), TG (2.64 ± 0.67 mmol/l versus 2.10 ± 0.45 mmol/l, t = -5.37, p < 0.001) and LDL-C (3.00 ± 0.82 mmol/l versus 2.44 ± 0.53 mmol/l, t = -9.11, p < 0.001) were also significantly higher among the hypertensive obese subjects. The mean HDL-C was however comparable in the two groups (1.25 ± 0.27 mmol/l versus 1.24 ± 0.57 mmol/l, t = -0.25, p = 0.08)...

An Early Experience of Stapled Hemorrhoidectomy in a Medical College Setting

Background: Stapled hemorrhoidectomy, popularly known as Longo technique is in use for the treatment of hemorrhoids since its first description to surgical fraternity in the world congress of endoscopic surgeons in 1998. Objectives: To evaluate the feasibility, patient acceptance, recurrence and results of stapled haemorrhoidectomy in our early experience. Methods: Between Jan 2012 and Dec 2013, 42 patients with symptomatic GRADE III and IV hemorrhoids were operated by stapled hemorrhoidectomy by a single surgeon at our surgery department. The evaluation of this technique was done by assessing the feasibility of the surgery;and recording operative time, postoperative pain, complications, hospital stay, return to work and recurrence. Results: All the procedures were completed successfully. The mean (range) operative time was 30 (20 - 45) min. The blood loss was minimal. Mean (range) length of hospitalization for the entire group was 1 (1 - 3) days. Only 3 patients required more than 1 injection of diclofenac (75 mg) while as rest of the patients were quite happy switching over to oral diclofenac (50 mg) just after a single parenteral dose. All the patients returned to their routine work in less than a week’s time. The mean (range) follow-up was 6 (4 - 12) months. There were no major intraoperative or postoperative complications except for retention of urine in 8 patients. The patients are still on regular follow-up and have not had recurrence as yet. Conclusion: Stapled hemorrhoidectomy technique is a safe alternative to the traditional Milligan-Morgan technique. It can be performed as an office procedure, is well tolerated by patients and is cost effective than conventional surgical therapy.

Laparoscopic Transabdominal Preperitoneal Mesh Hernioplasty: A Medical College Experience

Objectives: To determine the feasibility and patient’s outcome of laparoscopic transabdominal preperitoneal mesh hernioplasty for inguinal hernias. Patients and Methods: This study was carried out from March 2011 to April 2014. A total of 130 patients underwent laparoscopic transabdominal preperitoneal mesh hernioplasty (TAPP) for uncomplicated inguinal hernia. Of this, 10 patients presenting with bilateral inguinal hernias were operated in the single sitting. A 15 cm × 12 cm polypropylene mesh was used in all cases. Operative morbidity, postoperative pain, seroma formation, evidence of superficial infection, chronic groin pain and hernia recurrence were noted. The majority of the patients were discharged within 24 hours and follow-up was done at 1 week, 1 month, and 6 months. Results: 130 patients presenting with uncomplicated inguinal hernias were operated over a period of three years in the department of surgery, Govt. Medical College Srinagar. The mean age of the patients was 39.18 years (range: 18 - 70 years). The median duration of operation was 48.5 minutes (range: 18 - 120 minutes). None of the procedure was converted to open inguinal hernia repair. Postoperative pain was observed in 9.23% of the cases and was easily controlled by oral analgesics. Six patients (4.62%) developed seroma, out of which one required aspiration while others settled conservatively. Two patients (1.54%) developed wound infection and one patient (0.77%) had recurrence. None of the patients developed scrotal hematoma or neuralgia. Return to normal activity after TAPP repair was found to be after a median of 16.1 days. Conclusion: Transabdominal preperitoneal repair for inguinal hernia using proline mesh may be a safe and effective procedure with low morbidity, early return to normal activity and with a very low recurrence after six months follow-up.

Improving the delivery of medical education in rural medical colleges

It is a fact that in most of the rural settings,especially in low-and middle-income nations,the access to health care services and facilities is quite difficult.The primary reason for origin of this problem lies in the fact that a major proportion of medical professionals are not willing to serve in rural areas.This is in turn can be linked with the obvious geographical disparity in distribution of medical colleges in both rural and urban settings,with most of them being present in urban locations.In order to accomplish the vision to create a cadre of competent medical professionals,who are fit to work in the capacity of a primary health care physician,it is an indispensable requirement to sensitize and give adequate number of learning experiences pertaining to rural medical education.The process of planning and execution of rural medical education needs careful and systematic consideration,otherwise we will find ourselves short in achieving the intended learning outcomes.To conclude,rural medical education is an important aspect of the medical training.It is high time that all the stakeholders join their hands and work together to improve the competence level of medical students and play our part in the making of a community health physician.

Risk Factors for Wound Infection Following Caesarean Section: A Case Control Study from Sir Salimullah Medical College &Mitford Hospital in Dhaka, Bangladesh

Background: Post caesarean section (CS) wound infection or surgical site infection is a leading cause of prolonged hospital stay or readmission. An understanding of its risk factors is important. Methods: A case control study was conducted in the Department of Obstetrics and Gynecology of Sir Salimullah Medical College & Mitford Hospital, in Dhaka, Bangladesh from January to June 2014 to evaluate the risk factors of postoperative surgical site infection following CS. One hundred patients were studied. Results: Fifty patients of post CS wound infection (surgical site infection: SSI) were selected as cases. Body mass index > 25 (kg/m2), anemia (p = 0.001), prolonged rupture of membrane (p = 0.005), prolonged operation time (p = 0.019), and junior surgeons performing the operation (p = 0.011) were the risk factors for CS-SSI. Conclusions: Pre- and postoperative care and surgical training of junior doctors should be directed to these risk factors.

Clinical Outcomes of 67 Patients Treated with Chemoradiotherapy for Primary Thyroid Non-Hodgkin’s Lymphoma in Osaka Medical College

Background: The reports of clinical outcomes of patients treated with chemoradiotherapy for primary thyroid non-Hodgkin’s lymphoma are rare. We report our results of chemoradiotherapy for primary thyroid non-Hodgkin’s lymphoma. Materials and Methods: The subjects were 67 patients with thyroid non-Hodgkin’s lymphoma among 269 patients with malignant lymphoma who received radiotherapy in our hospital during a period between May 1990 and June 2005. The patients included 16 men and 51 women, with a mean age of 66.2 ± 10.7 years (30 - 84 years). The disease stage was stage I in 42 patients, stage II in 24, and unclear in 1. The histologic type was B-cell lymphoma in 66 patients, MALT in 9, diffuse type in 52, follicular type in 5, and diffuse and follicular type in 1. CHOP chemotherapy regimen for malignant lymphoma patients was as follows. Intravenous drip infusion of cyclophosphamide 750 mg/m2, (drip) infusion of doxorubicin 50 mg/m2, and intravenous injection of vincristine 1.4 mg/m2 were administered on day 1, followed by 5 consecutive days of oral prednisolone 100 mg/m2. This regimen was repeated every 3 weeks (21 days) in 6 to 8 courses. Modified CHOP chemotherapy regimen was as follows. Intravenous drip infusion of cyclophosphamide 600 mg/m2, intravenous (drip) infusion of doxorubicin 40 mg/m2, intravenous infusion of vindesine 3 mg/m2, and intravenous drip infusion of prednisolone 60 mg/body were administered on day 1, and intravenous prednisolone was changed to oral prednisolone with the dose tapered gradually. After completing one course of this regimen, two courses of radiotherapy (a total of 36 Gy) were performed, followed by 6 courses of the chemotherapy regimen at lower doses (80% of the initial doses) repeated once a month. Results: Results of chemoradiotherapy in all patients were excellent. The 15-year survival rate was over 80%. Although there were no significant differences in the results of chemoradiotherapy among different histologic types of thyroid malignant lymphoma, the survival rate was 100% for MALT type, as compared with poor results for diffuse large type or diffuse mixed type. The analysis of the results of chemoradiotherapy according to the stage of malignant thyroid lymphomas revealed that therapeutic results were significantly better in stage I than in stage II. Conclusion: The CHOP chemoradiotherapy regimen and modified CHOP chemoradiotherapy regimen were excellent for primary thyroid non-Hodgkin’s lymphoma.

Results and Discussion——A Study on Pragmatic Competence in Using Apologies by Medical College Students

The author elaborates usage of“I’m sorry”and“Excuse me”,mistakes in using“I’m sorry”and“Excuse me”to reveal the development of students’pragmatic competence and causes for differences of using apologies among the subjects.

Development,growth,and future of the Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences&Peking Union Medical College:65 years tackling medical research paradigms

The Institute of Basic Medical Sciences(IBMS)is a global leader in biomedical research and advanced medical education.This year(2023)marks the 65^(th)anniversary of its foundation at the Chinese Academy of Medical Sciences(CAMS)and School of Basic Medicine(SBM)of the Peking Union Medical College(PUMC).In the beginning,the IBMS and SBM incorporated the premedical departments of the PUMC,which was established by the Rockefeller Foundation in 1917.Since then,these departments have been committed to undertakingrstrate medical science research in China.