Focusing our attention on the current situation,we made an investigation of the foreign medical students studying in Chongqing Medical University by way of issuing questionnaires and giving objective interviews,to collect and analyze information including their reasons for studying in China,learning motivations,language skills,study needs,learning difficulties and solutions,evaluation of teaching results, future career options after graduation and interest in Chinese culture. We summarized the relevant issues and proposed improvement plan for future international education.

Objective To investigate the restrictive factors in the development of foreign medical education. Methods From the years 2011 to 2013, 350 foreign students conducted a questionnaire survey in Chongqing Medical University, and recovered 339 valid questionnaires. Results Only 33.0%(112/339) students thought that the teacher's English was fluent and 70.2% (238/339) needed to add Chinese class. Additionally, 69.6% (236/339) and 63.1% (214/339) students considered theoretical knowledge and practi-cal experience were not enough. 92.3%(313/339) students came from developing countries in Southeast Asia. 86.1%(292/339) foreign students considered that university management was insufficient. Conclusion The survey found the restrictive factors included students' demand for English and Chinese, lack of medical ex-pertise and practice, the problem of student sources and daily management difficulties and so on.

Eighteen male Wistar rats aged six weeks were divided equally into Methamphetamine (MA), Placebo and Control group. MA group were injected with 50mg/kg body weight of Methamphetamine hydrochloride (MAHCl) in normal saline, Placebo group were injected with normal saline only, while Control group not injected with anything. Five MA group rats died within four hours of injection and their hearts collected on the same day. Another MA group rat was sacrificed two days after injection. Placebo and control group were sacrificed at similar intervals. Collected hearts were studied for cardiac lesions under light microscopy using special staining and immunohistochemistry. Microscopic examination of the myocardium of the rats that died on the first day of injection showed loss of nuclei in some myocytes, indicating cell death. Some areas in the sub-endocardium region showed internalization and enlargement of myocyte nuclei, consistent with regeneration of cells. There were very few foci of necrosis observed in these samples. The heart samples from the single rat that survived injection for two days showed foci of infiltration of macrophage-like cells that were later revealed to be regenerating myocytes. There were also spindle-like fibroblasts, macrophages and a few leucocytes found within these foci. The overall appearance of the myocardium did not indicate any inflammatory response, and the expected signs of necrosis were not observed. These results suggest a need to re-evaluate the toxic and lethal dosages of MA for use in animals testing. Cause of death was suspected to be due to failure of other major organs from acute administration of MA. Death occurred within a time period where significant changes due to necrosis may not be evident in the myocardium. Further investigations of other organs are necessary to help detect death due to acute dosage of MA.

Background: Various parts of Pandanus foetidus Roxb. are used as traditional medicines. However, scientific reports concerning the effect of this plant on central nervous system (CNS) depression and analgesia are unavailable. This study investigated the CNS depressant and antinociceptive effects of Pandanus foetidus leaf extracts in a rodent model. Methods: The sedative and anxiolytic activities of Pandanus foetidus extract (500 g) were tested using behavioural models of Swiss albino mice, and the analgesic activity was assessed by formalin-induced pain and tail immersion tests at 200 mg/kg body weight of the mice. The data were analysed by a one-way ANOVA, a repeated measure of ANOVA and a non-parametric test (Kruskal-Wallis test) using the SPSS software. Acute toxicity was tested using an established method. Results: Compared with the aqueous fraction, the methanol, petroleum ether and chloroform fractions of the extract exhibited a more significant (P < 0.001) reduction of locomotor activity in the mice in the open field, hole-cross, and elevated plus maze (EPM). The methanol fraction maximized the duration of sleeping time caused by the thiopental sodium induction. The extract produced a significant step-down in pain, as shown by the paw licking time in the early and late phases of the formalin test. In the tail immersion test, the chloroform fraction maximally reduced the heat-induced analgesia. The extract was found to be non toxic. Conclusion: The methanol, petroleum ether, and chloroform fractions of P. foetidus have strong CNS depressant and antinociceptive effects and thus merit further pharmaceutical studies.

PURPOSE: To compare the expression of survivin and its association with clinicopathological criteria in major types of urinary bladder carcinoma, specifically, transitional cell carcinoma with and without squamous differentiation and squamous cell carcinoma. MATERIALS AND METHODS: Immunohistochemical staining for survivin and Ki67 was performed on paraffin-embedded sections of 104 carcinomas: 52 transitional cell carcinoma, 20 transitional cell carcinoma with squamous differentiation, and 32 squamous cell carcinoma. Expression of survivin in >10% of tumor cells was described as altered survivin status. Ki67 staining in >20% of tumor cells was described as a high proliferation index. RESULTS: Altered survivin expression was detected in 60/104 specimens (58%) and was significantly more frequent in transitional cell carcinoma (78%) than in squamous cell carcinoma (38%) or transitional cell carcinoma with squamous differentiation (40%) (p<0.0001). In transitional cell carcinoma but not in squamous cell carcinoma, altered survivin status was associated with higher tumor grade, higher proliferation index, and recurrence. In the whole specimens, altered survivin expression was significantly associated with advanced stage (p<0.001), recurrence (p=0.005), distant metastasis (p<0.001), and death (p=0.001). In the multivariate analysis, altered survivin was an independent poor prognostic factor for recurrence. CONCLUSIONS: Unlike in transitional cell carcinoma, alteration of survivin expression in squamous cell carcinoma occurs less frequently and is not associated with features of tumor aggression or patient outcome. These findings raise a question: are urinary bladder carcinoma patients with squamous cell carcinoma type suitable candidates for survivin vaccine? This is an important question to be answered before approving the vaccine in management.
Carcinoma, Squamous Cell/*genetics ; Carcinoma, Transitional Cell/*genetics ; Female ; Humans ; Inhibitor of Apoptosis Proteins/genetics/*metabolism ; Ki-67 Antigen/metabolism ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Grading ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Treatment Outcome ; Tumor Markers, Biological ; Urinary Bladder/pathology ; Urinary Bladder Neoplasms/*genetics

Objective: To evaluate the nutritional composition, including major minerals, essential trace elements and toxic heavy metals of five different wild vegetables Dhekishak (Dryopteris filix-mas), Helencha (Enhydra fluctuans), Kalmishak (Ipomoea aquatica), Patshak (Corchorus capsularis) and Shapla stem (Nymphaea stellata) and their safety aspects. Methods: Proximate parameters moisture, ash, fat, fiber, protein, carbohydrate and energy; major minerals Na, K, Ca and Mg; trace elements Fe, Zn and Cu; and toxic heavy metals Pb, Cd, Cr, Ni and Hg were evaluated in the selected wild vegetables using the standard food analysis techniques. Results: The results from nutritional analysis showed that all the wild vegetables used in this study had a low content of crude fat and high content of moisture, ash, crude protein, crude fiber, carbohydrate and energy having the recommended dietary allowances. The vegetables were also rich in major minerals Na, K, Ca and Mg, sufficient in essential trace elements Fe, Cu and Zn while the heavy metals Pb, Cr and Ni were detected higher in amount in all the vegetables except Patshak than the limits recommended by Food and Agriculture Organization/World Health Organization. The heavy metals Cd and Hg were not detected in any vegetable. Conclusions: The outcome of this study suggests that the wild vegetables have very good nutritional potential to meet the recommended dietary allowances, but special awareness should be taken for public health concern about the high level of Pb, Cr and Ni which exceed the Food and Agriculture Organization/World Health Organization recommended limits for the metals in vegetables.

PURPOSE: Combined anterior and posterior ring (APR) fixation is classically performed in Tile B2 and C1 injuries to achieve superior biomechanical stability. However, the posterior ring (PR) is the main weight bearing portion that is responsible for weight transmission from the upper parts of the body to the lower limbs through the sacrum and the linea terminalis. It is hypothesized that isolated PR fixation can achieve comparable radiological and clinical outcomes to APR fixation. Therefore, we conducted this study to compare the two fixation principles in managing Tile B2 and C1 injuries. METHODS: Our study included 20 patients with Tile B2 injuries and 20 patients with Tile C1 injuries. This study was a randomized control single-blinded study via computerized random numbers with a 1:1 allocation by using random block method. The study was performed at a level one trauma center. A total of 40 patients with Tile B2 and C1 injuries underwent combined APR or isolated PR fixation (Group A and B, respectively). Matta & Tornetta radiological principles and Majeed pelvic scoring system were used for the assessment of primary outcomes and postoperative complications. Secondary outcomes included operative time, amount of blood loss, intraoperative assessment of reduction, need of another operation, length of hospital stay, ability to weight bear postoperatively and pain control metrics. We used student t-test to compare the difference in means between two groups, and Chi-square test to compare proportions between two qualitative parameters. We set the confidence interval to 95% and the margin of error accepted to 5%. So, p ≤ 0.05 was considered statistically significant. RESULTS: The mean follow-up duration was 18 months. The operative time (mean difference 0.575 h) and the intraoperative blood loss (mean difference 97.5 mL) were lower in Group B. Also, despite the higher frequency of rami displacement before union in the same group, there were no significant differences in terms of radiological outcome (excellent outcome with OR = 2.357), clinical outcome (excellent outcome with OR = 2.852) and postoperative complications assessment (OR = 1.556) at last follow-up. CONCLUSION The authors concluded that isolated PR fixation could favorably manage Tile B2 and C1 pelvic ring injuries with Nakatani zone II pubic rami fractures and intact inguinal ligament. Its final radiological and clinical outcomes and postoperative complications were comparable to combined APR fixation, but with less morbidity (shorter operation time, lower amount of blood, and no records of postoperative wound infection).
Humans ; Fracture Fixation, Internal/methods* ; Pelvic Bones/injuries* ; Bone Screws ; Retrospective Studies ; Fractures, Bone/surgery* ; Spinal Fractures ; Treatment Outcome

Introduction: Community clinics provide one-stop healthcare services that is vital in primary healthcare. Measuring users' contentment is imperative to improving the quality of care at the doorsteps of the people. This article focuses on community clinics' importance and overall client satisfaction in Bangladesh. Methods: A cross-sectional survey was conducted from March to April 2019. Sixteen Upazilas from eight districts in Bangladesh were randomly selected for conducting interviews. The survey compiled local data regarding client satisfaction with the health care service of community clinics in Bangladesh. Results: A total of 760 female participants provided data. The majority (41%) were in the age group 18-24 years. This group showed more satisfaction than others (Odds Ratio 1.44). Childless married women were also more satisfied with the community clinic services than others (Odds Ratio 1.64). Furthermore, gender, education, and economic perspective were positive aspects of getting service from community clinics. Conclusion Although there is a challenge balancing psychosocial and medical care, promoting client-oriented care with a focus on overall comfort concerning the culture of the area is vital. This can be done with community-focused training and explaining written prescriptions better, including signs, symptoms, treatment, and referral points. Government backing has also been shown to be a strengthening source regarding primary healthcare services.

Introduction: Hajj is a unique religious mass gathering among Muslims hosted by Kingdom of Saudi Arabia (KSA) annually. It is a fifth pillar that is compulsory to be carried among muslim. Infections due to Neisseria meningitidis, Streptococcus Pneumoniae and Influenza virus are very high among Hajj pilgrims in KSA. Study shows knowledge and attitude towards vaccine preventable disease and vaccination which is very important for the prevention of these infectious diseases. This study aims to determine knowledge and attitude among the prospective Malaysian hajj pilgrims on vaccine preventable disease and vaccination. Method: A cross sectional study was conducted among prospective hajj pilgrims in June 2019. Self-administered questionnaires were given to the respondents through simple random sampling. The socio-demographic characteristics were described using descriptive analysis. Chi-square test was used to analyse the association between the socio-demographic and Malaysian hajj pilgrims’ knowledge and attitude towards the vaccine preventable diseases and vaccination. Results: A total of 135 respondents were recruited in the study. There were statistically significant associations between the knowledge and the highest education level (p=0.01), and also between the knowledge and the occupation (p=0.02) on vaccine preventable disease and vaccination. Conclusion: There is a lack of knowledge among the Malaysian hajj pilgrims about these vaccine preventable diseases and vaccination, especially those who have lower education level and also unemployed. Tabung Haji are highly advised to focus on these group and prepare a special course that focused on these vaccine preventable diseases so that Malaysian Hajj pilgrims will be protected.