Objective To investigate the effects of a-melanocyte stimulating hormone (?MSH) on serum cytokine levels in rats with acute respiratory distress syndrome (ARDS) induced by acute hemorrhagic shock and intratracheal lipopolysaccharide (LPS) administration (two-hit model) .Methods Thirty male SD rats weighing (337? 25) g were randomly assigned to six groups of five animals in each group: group A normal control; group B ARDS control; group C-F treatment groups in which ?MSH 1.7 mg/kg was given at different time points - Ih before LPS(C), at the time as LPS was administratered (D), 1h after LPS (E) or together with and 3 h and 6 h after LPS (F) . The animals were anesthetized with intravenous thiopental 30 mg?kg-1 and tracheotomized and mechanically ventilated (FiO2 : 0.5, RR 100 bpm, VT12ml, I: E = 1:1.5) . Right common carotid artery was cannulated for BP monitoring, removal of blood and blood sampling. Acute hemorrhagic shock was induced by removal of blood and MAP was maintained at 45 mm Hg for 1 h, then the animals were resuscitated with reinfusion of removed blood and lactated Ringer's solution, then endotoxin (LPS 200 ?g/kg in 500 ?l normal saline). The criterion for ARDS was PaO2/FiO2

Computer selective courses in medical colleges based on C language are facing many problems. First, C language lacks continuity with follow-up courses and well combines with professional courses, which result in loss of interest of students and few students would like choose this selective course. Second, the computer selective courses are miscellaneous and discontinuous, which occupies much time and therefore necessitate integration and optimization. The reformations and implementation schemes are proposed to optimize computer selective courses based on Java language. On the one land, different computer selective courses are optimized, credit hours are compressed, and selective interests of the students are improved. In addition, the practicability and scalability of computer selective courses are enhanced combining the characteristics of medical science specialty.

Nowadays, the new healthcare industry is closely integrated with the new-generation information techniques such as mobile Internet, Internet of things, cloud computing, and big data, which proposes higher requirements for the teaching objectives and contents of the optional course of medical informatics for non-informatics students in medical colleges and universities. Based on the actual teaching demands and the training objectives of clinical medical students, the teaching contents of the optional course of medical informatics were scientifically optimized and allocated. With "small datasets and basic application of electronic medical records/electronic health records" in medical informatics education as the main contents, numeric data, text data, and image data were modularized in medical information processing, and the methods of flipped classroom and case-driven teaching were adopted. The commonly used methods in machine learning (such as regression, classification, and clustering methods) were introduced and applied in task-based case studies, and the comprehensive algorithm case report was used for course assessment and evaluation. The teaching practice has shown that the above exploration not only stimulated the interest in the optional course of medical informatics among students, but also effectively implemented the "five early" mode of early prediction, early adjustment, early identification, early diagnosis, and early treatment among medical students.

Objective:To evaluate the safety and clinical efficacy of hypofractionated radiotherapy (HFRT) at 36.5 Gy in 10 fractions for the chest wall and reginal lymph nodes following modified radical mastectomy for breast cancer.Methods:This was a prospective, single-arm, phase Ⅱ clinical study. A total of 85 patients who received HFRT at 36.5 Gy in 10 fractions to the chest wall ± supraclavicular region following modified radical mastectomy for locally advanced breast cancer from March 2014 to December 2015 were included. The primary endpoint was radiotherapy toxicities. The secondary endpoints were locoregional failure-free survival (LRFFS), disease-free survival (DFS), and overall survival (OS).Results:The median follow-up period was 98 (94.0-109.0) months. Radiotherapy toxicities were mild. The incidence rates of grade 1 acute cutaneous and pulmonary toxicities were 52.9% and 40%, and those of grade 1 late cutaneous, pulmonary, and cardiac toxicities and upper extremity edema were 10.6%, 29.4%, 2.4%, and 21.2%, respectively. Only 1 (1.2%) patient suffered from grade 2 radiation-induced brachial plexus injury. Of the 85 patients, one patient had regional recurrence (supraclavicular lymph nodes), six patients had distant metastasis, and six patients died of breast cancer. The 9-year LRFFS, DFS, and OS were 97.7%, 91.8%, and 92.8%, respectively.Conclusions:HFRT at 36.5 Gy in 10 fractions following modified radical mastectomy for breast cancer is associated with mild toxicities. A phase Ⅲ study is necessary for validating HFRT's clinical efficacy.

Concurrent chemoradiotherapy (CCRT) refers to the simultaneous treatment of chemotherapy and radiotherapy, and the effect of radiotherapy is enhanced with low-dose chemotherapy, which can reduce tumor recurrence and metastasis and improve clinical prognosis of patients. At present, the main factors for the increase of radiosensitivity of concurrent chemotherapy is that concurrent chemotherapy prevents the repair of tumor cells, and chemotherapy and radiotherapy act on different cell cycles and have synergistic effects. However, even for patients with locally advanced cervical cancer (LACC) who have undergone CCRT, the 5-year survival rate is only 60%, which is still not ideal. In order to improve the efficacy, researchers have conducted a series of exploratory studies, which consist of the combination of targeted drugs and immunodrugs, and neoadjuvant regimens before CCRT, etc. Although targeted or immunologic drugs are effective treatment of LACC, in view of the lack of large-scale evidence-based medical evidence, multi-center prospective and randomized phase III clinical trials and high-level articles are needed to improve the level of evidence-based medicine. This consensus summarizes several key evidence-based medical studies published recently, especially the clinical research progress in targeted and immunological therapies, providing reference for domestic peers.

OBJECTIVETo understand the prevalence of myopia in primary and middle school students in 6 provinces and the possible influencing factors.

METHODSPrimary and middle school students were selected through multistage cluster sampling in 60 primary and middle schools in 6 provinces in China. The questionnaire survey and eyesight test were conducted among all the students selected according to the national student's physique and health survey protocol. Pearson chi-square test and binary multivariate logistic regression analysis were done to identify the influencing factors for myopia in students.

RESULTSThe prevalence of myopia among primary and middle school students surveyed was 55.7%, the gender specific difference was statistically significant (59.7% for girls, 51.9% for boys) (P<0.01). The prevalence of myopia increased with age obviously. The prevalence was 35.8% in age group 6-8 years, 58.9% in age group 10-12 years, 73.4% in age group 13-15 years and 81.2% in age group 16-18 years, the differences were statistically significant (P<0.001). Single factor and multivariate analysis showed that parents' myopia, distance between computer screen and eyes, distance less than 30 cm between eyes and book while reading, distance less than 10 cm between chest and the table edge while studying, distance less than 3 cm between fingers and pen tip, sleep time, average outdoor activity time during last week, school sport activities in the afternoon, the size of television set at home, time spent on watching TV and playing computer were the influencing factors for myopia.

CONCLUSIONSThe prevalence of myopia is till high in primary and middle school students. Myopia is associated with both genetic factors and individual eye health related behaviors.

Adolescent ; Child ; China ; epidemiology ; Female ; Health Behavior ; Health Surveys ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Myopia ; epidemiology ; Parents ; Prevalence ; Schools ; Sleep ; Students ; Surveys and Questionnaires