We learn the advanced philosophy and methods in dermatology residency standardized training program by introducing the residents matching system,periodical training programs and evaluation mechanisms in Taiwan.With the knowledge of current dermatology residency training system in mainland China,we give some recommendations to how to improve dermatology residency standardized training system in mainland China:standardizing and improving dermatology residence recruiting metrics,preparing effective training plan,and implementing better candidate evaluation processes as well as providing a strong faculty team.

Designing of natural product-like compounds using natural products as template structures is an important strategy for the discovery of new drugs. Gambogic acid (GA), which is a Garcinia natural product with a unique caged xanthone scaffold, inhibits potent antitumor activity both in vitro and in vivo. This review summarized the researches on the identification of the antitumor pharmacophore of GA, and the design, structural optimization and structure-activity relationship (SAR) of natural product-like caged xanthones based on it.

Objective To investigate the decisional value of susceptibility weighted imaging(SWI) in intravenous thrombolytic therapy to acute cerebral infarction.Methods According to cerebral microbleeds(CMBs) by SWI, 35 cases of acute cerebral infarction in window-time random were divided into experimental group(14 cases) with CMBs and control group(21 cases) without CMBs.After intravenous thrombolysis, the number of hemorrhagic transformation(HT) was counted by SWI, and statistic difference was compared between the experimental group and the control group(P<0.05).Results After intravenous thrombolytic therapy of acute infarction,12 cases with HT among experimental group, and only 2 cases with HT among control group, there was significant statistically difference between two groups(P<0.05).Conclusion SWI sequence has greater sensitivity in detecting CMBs,and can also assess the state of blood brain barrier(BBB) and vascular wall indirectly.It plays a very important role in giving a decision in the treatment of intravenous thrombolytic with window-time.

Pan-vascular medicine is an emerging discipline focusing on atherosclerotic diseases,with the concept of multidisciplinary integration,emphasizing on exploring the mechanism of disease development from the whole of the organism's structure and function.At present,the basic mechanism system of pan-vascular diseases has yet to be perfected.The pan-vascular concept is highly compatible with the idea of Chinese medicine that focuses on the overall view.Deficiency of all qi is the root cause of pan-vascular diseases,while phlegm,blood stasis,and water-dampness and other tangible evils stagnate in the veins and channels as the symptoms of the disease,therefore,the disease mechanism can be highly summarized as"stagnation due to qi deficiency".Deficiency leads to the stagnation,blocking the veins and channels,and the deficiency worsens due to the stagnation and then damages the veins and channels,thus,it develops into a disease.Based on the theory of"stagnation due to qi deficiency",this paper takes endothelial cell dysfunction as the entry point of pan-vascular diseases,and considers that low endothelial cell immunity is the initiating factor of pan-vascular diseases,and that the widespread persistence of microinflammatory state is the key pathology to pan-vascular diseases.

Objective:To investigate the knowledge, attitude and practice status of ophthalmic nurses on prevention and control of intraocular infection in grade Ⅲ class A hospitals.Methods:A self-made questionnaire was used to investigate the knowledge, attitude and practice of 236 nurses on prevention and control of intraocular infection in the ophthalmology department of 8 grade Ⅲ class A hospitals in Zhengzhou from January to June 2020. The correlation between the knowledge, attitude and practice were analyzed by Pearson correlation analysis and the influencing factors of each term were analyzed by multivariate Logistic regression.Results:The scores of knowledge, attitude, practice of all nurses were (26.08 ± 2.46), (67.45 ± 8.48), (50.31 ± 6.67) points, and the scoring rate were (87.0 ± 8.2)%, (84.3 ± 10.1)%, (83.9 ± 9.8)%, respectively. The scores of each dimension of knowledge, attitude and practice were significantly positively correlated ( r values were 0.26-0.42, all P<0.05), respectively. Multivariate Logistic regression analysis showed that education background, professional title and training experience of infection were the influencing factors of knowledge score ( P<0.05), education background, professional title, training experience of infection and demand were the influencing factors of attitude score ( P<0.05), and nursing age and work post were the influencing factors of practice score ( P<0.05). Conclusions:The level of knowledge, attitude and practice of ophthalmic nurses in grade Ⅲ class A hospitals on prevention and control of intraocular infection is overall good. Hospital management department still needs to make reasonable management countermeasures according to personnel characteristics to improve the knowledge, attitude and practice level of ophthalmic nurses and to reduce post-operative intraocular infection.

Objective This study aims to investigate possible hub genes,associated pathways,and transcription fac-tors between chronic periodontitis(CP)and Parkinson's disease(PD).Methods Gene expression profiles of CP(GSE16134,GSE23586,and GSE10334)and PD(GSE20141 and GSE49036)were downloaded from the gene expres-sion omnibus(GEO)database for differential expression analysis and functional clustering analysis.The protein-protein interaction(PPI)network was constructed,and hub genes were screened by four topological analysis algorithms and modular segmentation.Functional clustering analysis was performed.The hub genes were validated by external datasets of CP and PD,and causal relation was further assessed by Mendelian randomization(MR).Results After merging the data,1 211 differentially expressed genes(DEGs)were screened in the CP datasets;of which,551 were upregulated and 660 were downregulated.A total of 2 407 DEGs were screened in the PD dataset,of which,1 438 were upregulated and 969 were downregulated.The PPI network included 145 nodes and 126 edges.Four hub genes(FCGR3B,PRF1,IL18,and CD33)and three transcription factors(HSF1,HSF2,and HSF4)were finally screened.The relevant pathway was pre-dominantly natural killer(NK)cell-mediated toxic effects.The MR results suggest a possible positive causal relationship between CP and the risk of developing PD.Conclusion This study indicated the probably shared pathophysiology and possible causal relationship between CP and PD and may offer novel concepts and therapeutic targets for future mecha-nistic investigations.

Objective:To explore the value of blood glucose at different time points in the 7-point peripheral blood glucose spectrum in predicting asymptomatic hypoglycemia at night in elderly patients with type 2 diabetes mellitus (T2DM) based on continuous glucose monitoring system (CGMS) .Methods:From January to October 2019, convenience sampling was used to select 225 elderly T2DM patients who were hospitalized in Xinxiang Central Hospital. We monitored the peripheral blood glucose at 7 time points after admission, and performed 72-hour continuous glucose monitoring (CGM) simultaneously. We investigated the occurrence of night hypoglycemia of patients, and divided patients into night symptomatic hypoglycemia group and night asymptomatic hypoglycemia group according to the results. We compared the hypoglycemia related indicators of two groups, drew the receiver operating characteristic (ROC) curve, calculated the area under the curve (AUC) to determine the best cut-point value of each indicator and the occurrence of asymptomatic hypoglycemia at night.Results:In the CGM of 225 patients, 74 cases had hypoglycemia at night, and the incidence was 32.89%, and 34 cases of them had asymptomatic hypoglycemia at night, accounting for 45.95% (34/74) . The fasting blood glucose, blood glucose after dinner and before bedtime of patients in night asymptomatic hypoglycemia group were lower than those of night symptomatic hypoglycemia group. The best cut-off points of blood glucose before bedtime and fasting blood glucose for predicting asymptomatic hypoglycemia at night were 6.9 mmol/L and 6.0 mmol/L respectively, and the AUC were 0.822 and 0.651 respectively.Conclusions:We should be alert to the occurrence of asymptomatic hypoglycemia at night in elderly patients with T2DM. Blood glucose before bedtime <6.9 mmol/L or fasting blood glucose <6.0 mmol/L indicates an increased risk of asymptomatic hypoglycemia at night.

Tbx18,Wt1,and Tcf21 have been identified as epicardial markers during the early embryonic stage.However,the gene markers of mature epicardial cells remain unclear.Single-cell transcriptomic analysis was performed with the Seurat,Monocle,and CellphoneDB packages in R software with standard pro-cedures.Spatial transcriptomics was performed on chilled Visium Tissue Optimization Slides(10x Genomics)and Visium Spatial Gene Expression Slides(10x Genomics).Spatial transcriptomics analysis was performed with Space Ranger software and R software.Immunofluorescence,whole-mount RNA in situ hybridization and X-gal staining were performed to validate the analysis results.Spatial transcriptomics analysis revealed distinct transcriptional profiles and functions between epicardial tissue and non-epicardial tissue.Several gene markers specific to postnatal epicardial tissue were identified,including Msln,C3,Efemp1,and Upk3b.Single-cell transcriptomic analysis revealed that cardiac cells from wildtype mouse hearts(from embryonic day 9.5 to postnatal day 9)could be categorized into six major cell types,which included epicardial cells.Throughout epicardial development,Wt1,Tbx18,and Upk3b were consistently expressed,whereas genes including Msln,C3,and Efemp1 exhibited increased expression during the mature stages of development.Pseudotime analysis further revealed two epicardial cell fates during maturation.Moreover,Upk3b,Msln,Efemp1,and C3 positive epicardial cells were enriched in extracellular matrix signaling.Our results suggested Upk3b,Efemp1,Msln,C3,and other genes were mature epicardium markers.Extracellular matrix signaling was found to play a critical role in the mature epicardium,thus suggesting potential therapeutic targets for heart regeneration in future clinical practice.

OBJECTIVES: To investigate possible cross-talk genes, associated pathways, and transcription factors between chronic periodontitis (CP) and chronic obstructive pulmonary disease (COPD). METHODS: The gene expression profiles of CP (GSE10334 and GSE16134) and COPD (GSE76925) were downloaded from the GEO database. Differential expression and functional clustering analyses were performed. The protein‑protein interaction (PPI) network was constructed. The core cross-talk genes were filtered using four topological analysis algorithms and modular segmentation. Then, functional clustering analysis was performed again. RESULTS: GSE10334 detected 164 differentially expressed genes (DEGs) (119 upregulated and 45 downregulated). GSE16134 identified 208 DEGs (154 upregulated and 54 downregulated). GSE76925 identified 1 408 DEGs (557 upregulated and 851 downregulated). The PPI network included 21 nodes and 20 edges. The final screening included seven cross-talk genes: CD79A, FCRLA, CD19, IRF4, CD27, SELL, and CXCL13. Relevant pathways included primary immunodeficiency, the B-cell receptor signaling pathway, and cytokine-cytokine receptor interaction. CONCLUSIONS This study indicates the probability of shared pathophysiology between CP and COPD, and their cross-talk genes, associated pathways, and transcription factors may offer novel concepts for future mechanistic investigations.
Humans ; Chronic Periodontitis/genetics* ; Gene Regulatory Networks ; Gene Expression Profiling ; Protein Interaction Maps/genetics* ; Pulmonary Disease, Chronic Obstructive/genetics*

Shared decision-making is a medical model developed in the 1970s where physicians and patients jointly participate in making healthcare decisions. It has been widely adopted in developed countries in Europe and the United States. In recent years, more and more studies have explored the localization of shared decision-making in China, but the clinical application model in Chinese context has not yet been established. This article reviews the basic concept, clinical application, advantages and disadvantages, and future development of the shared decision-making between doctor and patient, in hope of providing ideas for the construction of a shared decision-making model in China.