Objective: This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. Methods: Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. Results: The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. Conclusion PMTS is safe and effective in improving insomnia disorders.

Objective:To investigate the standardized construction of critical care departments in different cities and counties of Guizhou province to promote the homogenization development of critical care medicine in Guizhou Province.Methods:Using research methods such as field investigation and data collection, the public hospitals of 88 counties and urban areas in 9 prefectures and cities of Guizhou province were divided into five routes: southeast, northeast, northwest, southwest, and Guiyang. To design the survey form for the standardized construction of ICU, the e-form was sent to the director of ICU or his/her designated personnel by email or wechat 2-3 days in advance. Check the authenticity of data item by item on site, and leave the hospital after checking the receipt form.Results:From April to July 2021, the survey and research data collection was completed for 146 public hospitals (excluding provincial hospitals) with intensive care departments in 88 counties and cities of 9 dizhou cities in Guizhou Province, including 24 Grade-Ⅲ Level A hospitals. 122 Grade-Ⅱ and above hospitals (including 8 Grade-Ⅲ Level B hospitals, 11 Grade-Ⅲ comprehensive hospitals, 97 Level-Ⅱ A hospitals, 3 Level-Ⅱ B hospitals, and 3 Level-Ⅱ comprehensive hospitals). 146 public hospitals have a total of 80 983 beds and 104 017 open beds. The department of Critical Care has 2 035 beds. The ratio of actual beds in ICU to total beds in hospital was 2.51%. From 1999 to 2010, 18 (12.33%) established departments, and from 2011 to 2021, 128 (87.67%) established departments. The total area of the discipline is 113 355.48 m 2, with an average bed area of 55.70 m 2. There were 97 hospitals with 1.5-2.0 m bed spacing, accounting for 66.44%, and 49 hospitals with 2.1- > 2.5 m spacing, accounting for 33.56%. The number of negative pressure wards: 1 in each of 43 hospitals, accounting for 29.45%; 103 hospitals did not have, accounting for 70.55%. The number of single rooms: 288 in 140 hospitals, accounting for 95.89%; 6 hospitals did not have, accounting for 4.11%. Central oxygen supply: 138 hospitals have (94.52%); 8 hospitals did not have, accounting for 5.48%. Natural ventilation: in 129 hospitals with 88.36%; 17 hospitals did not have, accounting for 11.64%. Specialized ICU construction: 66 hospitals, accounting for 45.21%; none in 80 hospitals, accounting for 54.79%. There are 3 712 doctors and nurses in 146 public hospitals. The total number of doctors was 1 041, and the ratio of doctors to beds was 0.51∶1. The total number of nurses was 2 675, and the ratio of nurses to beds was 1.31∶1. Conclusions:All 88 counties and districts in 9 prefectures and cities of Guizhou province have established intensive care medicine departments. The standardization of the discipline construction has been significantly improved. Lack of talents is still an important factor restricting the rapid development of the discipline.

Objective:To discuss the feasibility of offering specialized courses of critical care medicine in undergraduate clinical medicine education, so as to alleviate the shortage of critical care medicine staffs and lay a foundation for improving the success rate for the treatment of critical cases.Methods:The undergraduates majoring in clinical medicine from 2008 to 2011 in Guizhou Medical University (the former Guiyang Medical College) were enrolled. After they had been enrolled in the undergraduate education for 3 years and were ready for Grade four, which meant basic medicine teaching had been completed and clinical medicine teaching was about to start, they were introduced and preached to each discipline, including critical care medicine. The undergraduates were free to choose professional direction of clinical training in Grade four. Students majoring in clinical medicine from 2012 to 2014 were free to choose their major direction when they entered the school.Results:From September 2011 to July 2019, the university had cultivated 246 undergraduates majoring in clinical critical care medicine from 2008 to 2014, and the critical care medicine professional team of affiliated hospital had undertaken 540 teaching hours. By July 2019, all students had graduated on time, with an employment rate of 100%. Forty students took postgraduate programs in our school and other schools, accounting for 16.3%.Conclusions:Professional education of critical care medicine in the undergraduate course of clinical medicine can mobilize students' interest in learning and subjective initiative, which is conducive to career selection. During the clinical training, the students can identify and timely cure critical care cases in the early stage, and partly alleviate the current shortage of critical care medical staffs.

Objective To provide decision-making basis for promoting the rapid and healthy development of critical care medicine/intensive care unit (ICU) through discussing the mode of development and construction of the department of ICU.Methods The situations of ICU of Affiliated Hospital of Guizhou Medical University from July 1994 to December 2016 were analyzed and summed up. Data of the situations in different development stages included the location and area of the ward, the number of beds, the number of physicians and nurses, the structure of academic titles and educational levels, the number of patients admitted to ICU per year, the proportion of patients used ventilator per year, the mortality, the mode of the discipline management, the number of medical postgraduates and undergraduates trained in the ICU, the number of teaching hours, the achievements, the number of research projects, the number of published monographs and papers, the number of the multicenter trials that we participated in, the construction of the team, the personal honor, and so on.Results From 1994 to 2016, the department of ICU had three development stages: the initial development stage of the discipline (from July 1994 to March 2005), the standardization development stage of the discipline (from April 2005 to December 2015), the acceleration development stage of the discipline (from December 2015 to December 2016). The scale of the department expanded from an open unit with 6 beds which was shared with the department of cardiothoracic surgery to 6 enclosed units with 90 beds which were managed independently by the intensivists. The area of thedepartment increased from less than 300 m2 to more than 7000 m2. There were 46 beds in the mixed ICU, which covered an area of 4210 m2. There was only one physician in 1994 while the number of the physicians increased to 19 in 2016. The number of nurses increased from 4 in 1994 to 69 in 2016. The proportion of highly educated talents significantly increased. Furthermore, from 1994 to 2016, the number of beds increased from 6 to 46; the number of patients admitted to ICU per year increased from 138 to 1080; and the number of patients used ventilator increased from 24 to 1057. The mean acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was > 24.0 at admission, while < 12.6 at discharge. From 1997 to 2016, a total of 79 postgraduates had studied in the department, and 390 teaching hours we had undertaken. From 2011 to 2016, a total of 250 undergraduates had studied in the department, and 540 teaching hours we had undertaken. From 1994 to 2016, 8 achievements were obtained, 22 projects were undertook, 4 monographs were published, 6 books were edited that the physicians in the ICU as key editors, 104 papers were published, and 8 national multicenter trials that the physicians in the ICU were as key participants, and multiple team and individual honors were obtained.Conclusions The construction of ICU hardware is the basis and prerequisite for the development of the discipline and the construction of ICU software is the soul and motivation of the discipline. The operation indexes of clinical medical treatment, teaching and scientific researches reflect the overall operation status of the discipline and the hospital.

Objective To prepare the Fe3O4-1oaded biodegradable liquid-solid phase inversion poly(lactic-co-glycolic acid) (PLGA) in situ implant for ultrasound-guided injection into nude mouse tumor model,and to investigate its clinical effect in thermomagnetic treatment of nude mice with human liver cancer SMMC-7721 cells in an alternating magnetic field.Methods An in situ implant containing 10％ Fe3O4 was prepared,and 50 μtl Fe3O4-PLGA-NMP gel was injected into the subcutaneous tissue of Kunming mice.The degradation of this material was observed for 2 consecutive months,and the changes in body weight were recorded.HE staining and Prussian blue staining were performed for the heart,liver,spleen,lung,and kidney of Kunming mice.Fresh ex vivo bovine liver was taken and cut into cubes with a dimension of 2 cmu×2 cm×2 cm and then 50 μl Fe3O4-PLGA-NMMP gel was injected;after phase inversion,the cubes ofex vivo bovine liver were heated for 1,2,3,4,and 5 minutes,respectively,and then cut open for observing the range of ablation;HE staining was also performed.Micro-CT scan was performed after ultrasound-guided injection of 50 μl Fe3O4-PLGA gel into the tumors of the nude mice,and then the nude mice were divided into treatment group and control group.The mice in the treatment group were given thermomagnetic treatment for 3 minutes,and tumor growth was observed daily.Results The biodegradation of Fe3O4-PLGA-NMMP implant showed that the subcutaneously injected material was gradually metabolized at 2 weeks after injection and that the nude mice were in good condition.The bovine liver ablation experiment showed that the range of ablation of 50 μl Fe3O4-PLGA implant reached 1.46 ± 0.11 cm.HE staining showed that part of bovine liver had coagulative necrosis.The phase inversion experiment of Fe3O4-PLGA gel showed quick liquid-solid phase inversion of the material after injection into the tumor,and the process of liquid-solid phase inversion could be monitored by ultrasound and CT.The detachment and incrustation of the tumor started at 2 days after treatment,the wound started to heal 15 days later,and the tumor tissue disappeared completely.Conclusion Ultrasound-guided injection of biodegradable Fe3O4-PLGA in situ implant combined with magnetic thermal ablation can effecfively treat human liver cancer SMMC-7721 cells in nude mice.