Objective　To investigate the causes of death in residents living in the area of industrial pollution in Chongqing. Methods　Mortality rate, sequence of causes of death, years of potential life lost (YPLL) and the valued years of potential life lost (VYPLL) were used to analyze causes of death in 1991-1998. Community not polluted by industry was chosen to serve as control. Results　The annual average mortality rate of the residents was 7.34‰ (standard mortality rate 4.61‰). The sequence of major causes of death was shown as below: malignant tumors (mortality rate 198.07/105, standard mortality rate 126.35/105), cerebrovascular diseases (mortality rate 159.13/105, standard mortality rate 92.66/105), respiratory system diseases (mortality rate 107.33/105, standard mortality rate 84.85/105), cardiac diseases (mortality rate 95.36/105, standard mortality rate 59.37/105) and accidental deaths (mortality rate 47.08/105, standard mortality rate 43.28/105). Among malignant tumors， lung cancer took the lead with a mortality rate of 65.49/105(standard mortality rate 45.27/105). In both sequences of standard rates of YPLL and VYPLL for major causes of deaths, accidental death was always took the first place. Conclusion　In order to reduce mortality rate of the residents in the area, it is necessary to strengthen the administration of natural and social environment of the area.

Objective To analyze the importance of procalcitonin (PCT) and high-sensitivity Creactive protein (hsCRP) in assessing the severity of pneumonia and sepsis patients as well as prognostic evaluation.Methods A total of 77 patients with pneumonia complicated with sepsis were randomly (random number) selected from May 2013 to May 2016 in our hospital and 50 patients with simple pneumonia were enrolled as control group.The sepsis pneumonia patients were divided into three groups,namely sepsis group,severe sepsis group and septic shock group.The sepsis patient were further divided into survival group and death group according to the death of patient within 2 weeks.Statistics was employed to study the roles of PCT and hsCRP in evaluating the severity of pneumonia and sepsis patients as well as prognostic evaluation.Results Compared with control group,the levels of PCT and hsCRP were higher in patients of sepsis groups (P ＜ 0.05).The levels of PCT and hsCRP were gradually increased as the severity of the patient getting worse (P ＜ 0.05).The levels of PCT and hsCRP in the death group were higher than those in the survival group.The areas under ROC curve of PCT and hsCRP for diagnosis of sepsis and septic shock as the optimal cut-off point at ≥ 2 ng/mL and at ≥ 75 mg/L,had the sensitivity of 62.1％ and 81.2％,respectively,and the specificity of 89.2％ and 68.2％,respectively.Conclution PCT and hs CRP levels have a certain value in assessing the severity of pneumonia and sepsis patients as well as prognostic evaluation.

Objective To investigate the efficacy of relaparoscopic common bile duct exploration in choledocholithiasis.Methods 50 patients who underwent LC/OC/LCBDE/OCBDE for biliary surgery with choledocholithiasis were randomized into two groups:Group A (n ＝25) laparoscopic approach and Group B (n =25) open approach.The operation time,hospital stay,cost of hospitalization and postoperative complications were compared.Results There was no significant difference in the operation time,liver functional index,postoperative bile leakage rate and cost of hospitalization between the two groups.The postoperative hospital stay in group A was shorter than that in group B (7.1 ± 1.5 vs 12.4 ±4.3 days,P ＜0.05),as was the volume of intraoperative blood loss (58.3 ± 24.2 ml vs 108.6 ± 35.7 ml,P ＜ 0.05),recovery of gastrointestinal function (26.3 ±3.6 vs 58.2 ±6.3 hours,P ＜0.05),postoperative analgesia (7/25 vs 17/25,P＜0.05) and wound infection rate (1/25 vs 6/25,P＜0.05).Conclusions Relaparoscopic commonbile duct exploration for recurrent choledocholithiasis appeared to be a safe,feasible,and efficacious procedure when carried out by expert laparoscopic surgeons.The procedure is worth promoting.

Objective To investigate the feasibility and safety of primary closure of common bile duct following laparoscopic common bile duct reexploration and choledocholithotomy for recurrent or residual choledocholithiasis in patients with prior biliary surgery.Methods We retrospectively studied the clinical data of 31 patients who were diagnosed recurrent or residual common bile duct (CBD) stones after prior bile duct surgery.All of 31 patients had undergone primary closure following laparoscopic common bile duct reexploration between Jan 2010 and Jan 2014.Results In all the 31 patients,there was no conversion to open surgery.There were no complications due to port placement,postoperative bleeding and mortality.The operation time was (106 ±32) min; the volume of intraoperative blood loss was (52 ± 16) ml; the time of postoperative gastrointestinal function recovery and postoperative hospital stay were (23 ± 3) h,(5.5 ± 1.5) d respectively.Duodenal injury was found and repaired intraoperatively laparoscopically in one patient.Bile leakage occurred in 2 cases recovered by conservative therapy.No postoperative stricture of bile duct,recurrent or residual stones were observed during a period of 1 month to 1 year (mean follow-up 6 months).Conclusions Primary closure following laparoscopic common bile duct reexploration for patients with a past history of biliary tract operation is safe,feasible,and effective procedure in hands of experienced laparoscopic surgeons.

OBJECTIVE:To establish a method for the determination of related substances in bisacodyl raw material and enteric-coated tablet. METHODS:HPLC was performed on the column of Hibar C18 with mobile phase of acetonitrile-20 mmol/L ammonium acetate (acetic acid adjust pH to 5.0)(55∶45,V/V),detection wavelength was 265 nm,flow rate was 1.0 ml/min, column temperature was 30℃,and the injection volume was 20 μl. RESULTS:The linear range of bisacodyl was 0.25-5.0 mg/ml (r=0.999 9);the limits of detection and quantification were 19-25 ng and 61-68 ng for bisacodyl and impurity A,B,C,D and E;RSDs of precision,stability and reproducibility tests were lower than 2%;recovery was 99.50%-101.00%(RSD=0.5%,n=9). CONCLUSIONS:The method is specific, sensitive and reproducible, and can be used for the determination of related substance in bisacodyl raw material and enteric-coated tablet.

Objective To investigate the health seeking intention and its influencing factors among patients with type 2 diabetes in Chongqing Chronic Disease Management System.Methods Multistage cluster random sampling was used to investigate basic information,diabetes-related treatment situation including first heal seeking and reasons for choosing medical institutions in the last year.Relative risk ratios (RRR) and its influencing factors were analyzed with the method of multi-nominal Logistic regression,as community as a reference.Results Over the past year,38.02％ of type 2 diabetes patients preferred to hospitals above the county level,36.78％ preferred to pharmacy or clinics,and 25.21％ preferred to community health service centers.Univariate analysis showed that different education levels,family income levels,health insurance and therapies were significantly different from health seeking intention.Multi-nominal Logistic regression results indicated that higher educational level (RRR =2.39,95％ CI:1.20-4.78),higher income level (RRR =3.37,95％CI:1.44 -7.88),applying to specific diseases medical insurance (RRR =3.32,95 ％CI:1.72-6.42),the use of insulin and oral hypoglycemic agents (RRR =5.02,95％CI:1.15-22.00) of respondents were more inclined to the hospitals above the county level,rather than community health services.Conclusions Health seeking intention of type 2 diabetes patients preferred to hospital above the county level in Chongqing.Type 2 diabetes was an important disease of non-infectious chronic diseases,while the patients preferred go to utilize hospitals rather than community services.

Objective To evaluate biodistribution and pharmacokinetics pattern of ~(131)I-labeled rch24which is the region-grafted (humanized) anti-carcinoembryonic antigen (CEA) monoclonal antibody in nude mice. Methods Nude mice bearing cancer xenografts received intravenous injections of ~(131)I- rch24, then blood, plasma, heart, liver, spleen, lung, kidney, tumor and other tissues were taken at different time point for determination the concentration of radioactivity and calculate the T/NT value. Nude mice were packeted randomly to four group of high, medium, low dose and continuous administration, blood drug concentration was detected by ELISA method at the different intervals. Then, draw the concentration-time curve and calculate the pharmacokinetics paramete. Results After administration, radioactivity of the tumour was significantly enhanced whereas radioactivity of normal tissues decreased gradually. For single administration, at the dose of low to medium, pharmacokinetics pattern was linearity -kinetics whereas for high dose group,pharmacokinetics paramete shown some behavior of non-linearity-kinetics. Conclusion Our results suggest that the ~(131)I-labeled region-grafted (humanized) anti-CEA monoclonal antibody rch24 exhibit a considerable targeting activity so as to ~(131)I radioisotopes can be concentrated specifically in tumor. The pharmacokinetics pattern of this medicine was different at different dose.

OBJECTIVE: To observe the olfactory bulb's morphological change after ischemic injury in rats, and explore the role of vascular factor in olfactory disorders. METHOD: Forty adult SD rats (weighting 250-300 g) were used, 30 of which were treated with permanent bilateral occlusion of both common carotid arteries, and the others were served as the control. The olfactory bulbs were carefully taken out on the 1st week, 4th week, 2nd month post operation, respectively, then observed the morphological changes by light microscopy. The ultra structure of cells in olfactory bulbs were also observed by transmission electron microscope. RESULT: In rats with permanent bilateral occlusion of both common carotid arteries, the vascular pattern changed and the cell number decreased in olfactory bulbs by light microscopy. In the 1st week group, the mitral cells' mitochondria injury and metamorphism were found. In the 4th week group, the microvascular paramorphia, lipofuscin in mitral cells and metamorphic nerve fibers were found by transmission electron microscope. CONCLUSION Ischemia could injure the neuron and nerve fiber. This may be one of the reasons of olfactory disorders.
Animals ; Ischemia ; pathology ; Microscopy, Electron, Transmission ; Neurons ; pathology ; ultrastructure ; Olfactory Bulb ; cytology ; pathology ; Rats ; Rats, Sprague-Dawley

Background: ChatGPT is a large language model (LLM) based on artificial intelligence (AI) capable of responding in multiple languages and generating nuanced and highly complex responses. While ChatGPT holds promising applications in medical education, its limitations and potential risks cannot be ignored. Methods: A scoping review was conducted for English articles discussing ChatGPT in the context of medical education published after 2022. A literature search was performed using PubMed/MEDLINE, Embase, and Web of Science databases, and information was extracted from the relevant studies that were ultimately included. Results: ChatGPT exhibits various potential applications in medical education, such as providing personalized learning plans and materials, creating clinical practice simulation scenarios, and assisting in writing articles. However, challenges associated with academic integrity, data accuracy, and potential harm to learning were also highlighted in the literature. The paper emphasizes certain recommendations for using ChatGPT, including the establishment of guidelines. Based on the review, 3 key research areas were proposed: cultivating the ability of medical students to use ChatGPT correctly, integrating ChatGPT into teaching activities and processes, and proposing standards for the use of AI by medical students. Conclusion ChatGPT has the potential to transform medical education, but careful consideration is required for its full integration. To harness the full potential of ChatGPT in medical education, attention should not only be given to the capabilities of AI but also to its impact on students and teachers.

Background: ChatGPT is a large language model (LLM) based on artificial intelligence (AI) capable of responding in multiple languages and generating nuanced and highly complex responses. While ChatGPT holds promising applications in medical education, its limitations and potential risks cannot be ignored. Methods: A scoping review was conducted for English articles discussing ChatGPT in the context of medical education published after 2022. A literature search was performed using PubMed/MEDLINE, Embase, and Web of Science databases, and information was extracted from the relevant studies that were ultimately included. Results: ChatGPT exhibits various potential applications in medical education, such as providing personalized learning plans and materials, creating clinical practice simulation scenarios, and assisting in writing articles. However, challenges associated with academic integrity, data accuracy, and potential harm to learning were also highlighted in the literature. The paper emphasizes certain recommendations for using ChatGPT, including the establishment of guidelines. Based on the review, 3 key research areas were proposed: cultivating the ability of medical students to use ChatGPT correctly, integrating ChatGPT into teaching activities and processes, and proposing standards for the use of AI by medical students. Conclusion ChatGPT has the potential to transform medical education, but careful consideration is required for its full integration. To harness the full potential of ChatGPT in medical education, attention should not only be given to the capabilities of AI but also to its impact on students and teachers.