Objective To explore the development of the research on professional thinking of clinical medicos in China with the purpose of revealing its bibliometric characteristics and rules.Methods With medico and professional thinking taken as the subject terms,relevant literature published in January 2014 was retrieved from CNKI and Wanfang database in reliance on subject retrieval strategy,and then,literature was screened after the enactment of inclusion and exclusion criteria.Finally,all pieces of the included literature were analyzed by bibliometric method.Results Finally,53 papers were included in the paper,among which there were 30 (56.6％) articles published in the year 2007-2014,and priority was given to empirical research;Besides,the research topics were scattered,involving 29 (54.7％) articles of professional attitude,26(49.1％) articles of learning attitude,13 (24.5％) articles of political thought,16 (30.2％) articles of employment and employment,4 (7.5％) articles of medical ethics,12 (22.6％) articles of the idea of professional education,4 (7.5％) articles of the idea of professional,and 21 (39.6％) other topics.Conclusions China hasn't developed a system for the research on the professional thinking of clinical medicos in terms of re-search contents,or elevated the analysis on research result to theoretical level.

Objective To investigate the effects of stellate ganglion block (SGB) on brain injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB). Methods Forty ASA Ⅱ or Ⅲ patients of both sexes aged 22-50 yr weighing 40-64 kg undergoing elective cardiac valve replacement were randomly divided into 2 groups (n = 20 each): control group (group C) and SGB group. Radial artery and right internal jugular vein were cannulated for BP and CVP monitoring. A catheter was inserted into left internal jugular vein under local anesthesia and advanced cephalad until resistance was met for blood sampling. Right SGB was performed with 0.25% ropivacaine 10 ml. Successful block was confirmed by ipsilateral Homer's syndrome.ECG, BP, CVP and SpO2 were monitored. Anesthesia was induced with midazolam 0.2 mg/kg, fentanyl 5-8 μg/kg and vecuronium 0.12 mg/kg and maintained with fentanyl infusion at 8-10 μg· kg- 1· h- 1 and intermittent iv boluses of midazolam and vecuronium. Blood samples were collected for determination of plasma NO, ET-1, S100β protein and NSE concentrations and NOS activity immediately after left internal jugular vein was retrogradely catheterized (T0 ), at 30 min of CPB (T1), 10 min after release of aortic cross clamp (T2 ), 6 and 24 h after operation (T3 ,T4 ). The patients' cognitive function was assessed by using mini-mental state examination (MMSE) the day before operation and on 1st and 7th day after operation. Results The plasma ET-1, S100β protein and NSE concentrations were significantly increased during and after operation at T1-3 as compared with baseline values at T0 in both groups and were significantly lower in group SGB than in group C. Plasma NO concentration was significantly increased during CPB at T1 as compared with the baseline at T0 in both groups but was significant higher after CPB at T2 but lower after operation at T3,4 in gToup SGB than in group C. The NOS activity was significantly higher during operation at T1,2 in group SGB than in group C. The cognitive function was significantly better at 1st postoperative day in group SGB than in group C. Compared with the baseline value,NO/ET-1 ratio was significantly decreased during and after operation in group C,but no significant change in NO/ET-1 ratio was found in group SGB. Conclusion SGB can attenuate brain injury induced by CPB by improving cerebral perfusion through maintenance of relative balance of NO/ET-1.

Objective To discuss the effect of the teaching mode of technological pedagogical and content knowledge in biochemistry theory teaching. Methods 400 students in 8 classes of clinical medicine undergraduate in Grade 2013 were selected and randomly divided into 2 groups. The traditional teaching mode was applied in the control group of 198 students in 1-4 classes, while the technological pedagogical and content knowledge teaching mode was applied in the experimental group of 202 students in 5-8 classes. 385 students in 8 classes of clinical medical undergraduates in Grade 2014 were selected and randomly divided into 2 groups. The control group of 189 students in 1-4 classes adopted the traditional teaching mode, while the experimental group of 196 students in 5-8 classes adopted the technological pedagogical and content knowledge teaching mode, which used the micro-lesson and network platform as learning resource superior to the flipped classroom. Flipped classroom was divided into two major learning links:extracurricular self-study and class digestion. Through the network platform the micro-lesson was presented to the learners. Learners could make self-study according to their own specific circumstances and in the classroom many activities were increased such as the mutual cooperation between the students, the students' PPT teaching, the students' questions and the discussion, and the interaction between teachers and students, etc. The results of the examinations of the two terms students of the same profession and the questionnaire were analyzed. The related data were processed by SPSS 15.0, and the data between groups were compared by t test . Results The test scores analysis showed that the individual test scores in experimental group of Grade 2013 were [(17.94±2.02) vs. (12.28±4.17)], and the individual test scores in experimental group of Grade 2014 were [(18.21 ±1.78) vs. (12.45 ±5.13)], which were obviously higher than the control group, and there was statistical significance. The final exam scores in experimental group of Grade 2013 were [(78.28±11.18) vs. (68.65±12.51)], and the final exam scores in experimental group of Grade 2014 were [(81.73 ±9.12) vs. (74.41 ±11.87)], which were obviously higher than the control group, and there was statistical significance. The results of survey showed that the students thought the teaching mode aroused their study interests while 393 (93.7%), thought the teaching mode developed their self-study ability while 357 (89.7%), thought the teaching mode beneficial to cultivating their ability of solving the problems. Conclusion The teaching mode of technological pedagogical and content knowledge is of certain signifi-cance to break the plight of the traditional teaching, inspire the students interest in learning, improve the teaching quality of biochemistry, and make for the teachers' professional development.

Objective To analyze the relevant factors influencing 18F-FDG uptake in the primary lesion of breast invasive ductal carcinoma (BIDC).Methods A total of 160 female patients underwent 18 F-FDG PET/CT examination from 2010 to 2015 and breast lesions were revealed.Lesions were divided into benign group (n =118) and malignant group (n =49,BIDC) according to pathological results.KruskalWallis H test and Mann-Whitney u test were performed to compare SUVmax of the two groups,and to investigate the relationship between the SUVmax of breast malignant lesion and patients' age as well as clinical pathological parameters including T stage,lymphatic vessel invasion,nuclear grade,route of metastasis,ER,PR,HER2 and Ki-67 expression,and subtype of breast cancer.The diagnostic efficiency of 18F-FDG PET/ CT in differentiating benign and malignant breast lesions was analyzed using ROC curve analysis.Results The SUVmax of BIDC was 6.09(3.88,9.26),higher than that of breast benign lesion (1.35 (0.95,2.35);u=341.0,P＜0.05).The SUVmax of BIDC showed statistically significant difference between groups with different T stage,with or without lymphatic vessel invasion,with different nuclear grade,different routes of metastasis and different Ki-67 expression (u:117.5-209.5,H=7.70,P＜0.01 or 0.05).For all breast lesions,lesions with the maximum diameter ≤ 2.0 cm and lesions with the maximum diameter ＞2.0 cm,the optimum cutoff values of SUVmax were ＞2.60,＞ 1.71 and ＞3.97,respectively.When the optimum cutoff values of SUVmax for breast lesions with the maximum diameter ≤2.0 cm were selected as ＞ 1.71 and ＞2.60,the Youden indexes were 0.66 and 0.61(z=0.566,P＞0.05).When the optimum cutoff values of SUVmax for breast lesions with the maximum diamter ＞2.0 cm were selected as ＞3.97 and ＞2.60,the Youden indexes were 0.89 and 0.81(z=0.748,P＞0.05).Conclusions T stage,lymphatic vessel invasion,nuclear grade,route of metastasis and Ki-67 expression of BIDC influence the uptake of 18F-FDG by tumor tissues.The SUVmax of the primary lesion of BIDC is related to the size of lesion,and thus the diagnostic threshold of SUVmax should be decreased appropriately for small lesions.

Fluorescent carbon quantum dots ( CQDs) were synthesized by one-step hydrothermal treatment of apple juice. Experiments showed that Hg2+could quench the fluorescence of the CQDs with specificity. Based on this phenomenon, a selective and sensitive sensor was constructed for Hg2+ detection. In a NaH2 PO4-Na2HPO4 buffer solution (pH 7. 0), their fluorescence intensity showed good linear relationship with the concentrations of Hg2+ from 5 to 100 nmol/L and 1 to 50 μmol/L, respectively, with the detection limit of 2. 3 nmol/L (S/N=3). Its practical application was further demonstrated by the detection of Hg2+ in real water samples.

Objective To study the effects of ganoderma applanatum polysaccharides(GAPS) on cell morphology, proliferation and PDGFR -?expression in cell lines MGC - 803 , and to explore its potential mechanisms of anti - tumor of GAPS. Methods Cell morphology was observed by inverting microscope. MTT assay was used to investigate the inhibitory effect of GAPS on MGC -803.Expressions of PDGFR -?was analyzed by flow cytometry (FCW). The fluorescence intensity of expressions of PDGFR -?was observed by fluorescence microscope. Results Cells of GAPS group were irregular shaped and grew poorly. GAPS inhibited the proliferation of MGC -803 cells in dose - dependent and time - dependent manners . After MGC - 803 cells were treated with GAPS for 72h, GAPS could down - regulate expression of PDGFR -?observed by fluorescence microscope which was consistented with the results of FCW with statistic significance difference as compared with control group (P

BACKGROUND: After the damage of central nervous system, F-waves of electromyography is the valuable way for detecting tendon reflex and muscular tension below injured segment. The increase of spasm, stiffness and muscular tension induced by upper motor neuron injury can revoke change of F-waves.However, change of F-waves after spinal injury, and relationship between Fwaves and spasm of lower limb after injury are still unclear at present.OBJECTIVE: To analyze the correlation of minimal latency, occurrence rate and every index of dispersion-time degree of F-waves with post-injured spinal cord spasm in patients with spinal injury.DESIGN: Case-control observation.SETTING: Department of Rehabilitative Medicine, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology.PARTICIPANTS: Totally 29 patients with traumatic spinal cord injury,who were hospitalized at Department of Rehabilitative Medicine, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology between June 2002 and March 2004, were selected as spinal injury group. Another 29 normal healthy volunteers were enrolled as normal control group in the same period. METHODS: Spasm level of both lower extremities in patients with spinal injury was graded with Ashworth scale to assess flexion of both coax, flexion of knee joint and Ashworth grade of dorsiflexion of ankle. F-waves was detected with Kepoint1.5 type EMG instrument produced by Denmark.Minimal latency, maximal latency and occurrence rate of F-waves of tibial nerve of both lower extremities were recorded. The discrete-time degree (difference value of maximal latency of F-waves and minimal latency of Fwaves) and mean occurrence rate of F-waves were calculated.MAIN OUTCOME MEASURES: The difference of each index between patients with spinal injury and normal persons was compared and the correlation of spasm with discrete-time degree, occurrence rate and minimal latency of F-waves in patients with spinal injury was analyzed.RESULTS: A total of 29 patients and 29 normal persons were involved in the result analysis. ①The discrete-time degree of F-waves in patients with spinal injury was higher than that in the normal persons, which had significant difference [(9.2±1.9), (6.7±1.0) ms, P ＜ 0.000 1]. ②The occurrence rate of F-waves in patients with spinal injury was lower than that in normal persons, which had significant difference [(84.5±6.2)%, (89.5 ±5.7)%, P ＜ 0.05]. ③The minimal latency of F-waves in patients with spinal injury was higher than that in normal persons, which had insignificant difference ( P ＞ 0.05). ④The discrete-time degree of F-waves in patients with spinal injury had positive correlation linearly with score of spasm Ashworth (r=0.790 31, P＜ 0.000 1). The occurrence rate of Fwaves in patients with spinal injury had positive correlation linearly with score of spasm Ashworth (r=0.742 03, P ＜ 0.000 1 ). The minimal latency of F-waves in patients with spinal injury had insignificant correlation with score of spasm Ashworth (r=0.081 68, P ＞ 0.05).CONCLUSION: The discrete-time degree and occurrence rate of F-waves can be used as sensitive index to evaluate electrophysiology in patients with spinal injury so as to assess the level of spasm in patients with spinal injury.

Objective To investigate the value of gastrointestinal tract preparation with oral racean?isodamine tablets and isotonic mannitol in 18 F?FDG PET/CT imaging. Methods From July to September 2013, 129 patients with confirmed or suspected tumors who were referred for 18 F?FDG PET/CT imaging were divided into 2 groups. In the study group (30 males, 37 females, age (53.4±13.9) years), raceanisodam?ine tablets (10 mg) and 1 000-1 200 ml isotonic mannitol solution (2.5%) were orally taken at 10 min after in?jection of 18F?FDG;while in the control group (37 males, 25 females, age (60.0±12.8) years), 1 000-1 200 ml water was given. Mann?Whitney u test was used to compare the difference between the 2 groups in the filling degree of gastrointestinal lumen, delineation of tube wall, physiological uptake, matching degree of PET and CT images, delineation of mesentery, and the influence of gastrointestinal uptake on the identification of ab?dominal and pelvic lesions. χ2 test was used to compare the difference between the 2 groups in the uptake pattern of gastrointestinal tract and the incidence of side effects. Spearman correlation analysis was used to study the correlation between gastrointestinal lumen filling and PET/CT image matching. Results The gas?trointestinal lumen filling, delineation of tube wall, PET/CT image matching in the stomach, small intestine and colon (z: -5.096 to -2.665, all P<0.01),and delineation of mesentery (z=-2.781,P<0.01) were better in the study group than those in the control group. The filling degree of gastrointestinal lumen correla?ted with the corresponding PET/CT image matching (rs:0.521, 0.755, 0.239, all P<0.01). The physio?logical uptake of small intestine and colon was significantly higher in control group than that in the study group( z=-4.131, -3.095, both P<0.01) . But uptake in the stomach between the 2 groups was not signifi?cantly different(z=-0.776, P>0.05). There was statistically significant difference in the uptake pattern of small intestine between the two groups(χ2=12.884, P<0.01) , but not in the stomach and colon (χ2=0.559, 1.083,both P>0.05). The incidence of transient diarrhea (20?9%, 14/67) was higher in the study group than that in the control group (4.8%, 3/62;χ2=7.256,P<0.01). Conclusions The abdominal PET/CT image quality is improved by gastrointestinal preparation with oral raceanisodamine tablets (10 mg) and 1 000-1 200 ml isoton?ic mannitol solution (2.5%).

Objective To investigate the effects of hyperbaric oxygen (HBO) combined with neural stem cell (NSC) transplantation on functional recovery after spinal cord injury (SCI).Methods Forty healthy adult Sprague-Dawley rats were randomly divided into a sham group,an SCI group,an NSC group and an HBO+NSC group.In the latter three groups,complete spinal cord transection was performed at T10.The rats of the HBO+NSC group were treated with HBO therapy after NSC transplantation.Hindlimb motor function was assessed with the BassoBeattie-Bresnahan (BBB) scale and tilt table testing.Motor evoked potentials (MEPs) were measured to evaluate the rats'nerve conduction function.The amount of surviving transplanted NSCs at the injured site was counted using Hoechst dyeing.Results The average BBB scores and tilt table test results in the HBO+NSCs group were significantly better than in the SCI and NSC groups from the 2nd week post-SCI.By the 4th week the average latency period and MEP amplitude in the HBO+NSC group were significantly better than in the NSC group,while MEPs in the SCI group still had not re-appeared.The surviving amount of transplanted NSCs in the HBO+NSC group was also significantly greater than in the NSC group.Conclusion HBO combined with NSC transplantation has synergistic effects and can improve functional recovery after SCI.This may be explained by the important role of HBO in promoting the survival of transplanted NSCs.

Objective:To evaluate the value of 18F-FDG PET/CT in the diagnosis and treatment of primary breast lymphoma (PBL). Methods:Clinical data and 18F-FDG PET/CT imaging data of 6 patients (all females, age 46-79 years) with pathologically diagnosed primary breast diffuse large B cell lymphoma (PB-DLBCL) in Xishan People′s Hospital of Wuxi City and Affiliated Hospital of Jiangnan University from July 2015 to October 2021 were analyzed retrospectively. A total of 10 18F-FDG PET/CT scans were done for primary staging (6 scans of 6 patients), evaluation of treatment response (3 scans of 2 patients), and recurrence detection (1 scan of 1 patient). 18F-FDG PET/CT image analysis was performed qualitatively (visually) and semi-quantitatively (SUV max). Treatment response was evaluated by Deauville scores. Results:All 6 patients were diagnosed pathologically as PB-DLBCL (3 patients by core needle biopsy, 3 patients by biopsy after lumpectomy). All 6 patients were staged using baseline 18F-FDG PET/CT before chemotherapy. For 3 patients diagnosed by core needle biopsy, baseline 18F-FDG PET/CT showed unilateral breast lesion with high FDG uptake (SUV max: 23.0, 52.9, and 33.6). For 3 postoperative patients, baseline 18F-FDG PET/CT showed flocculent soft tissue density in the operative area with low FDG uptake (SUV max: 3.4, 2.2 and 2.0). Patient No.2 showed a large left breast mass with left axillary lymph node involvement by baseline PET/CT, and multiple nodular uptakes in bilateral breast (Deauville score of 4) after 4 courses of chemotherapy and negative result (Deauville score of 1) after 3 courses of new chemotherapy regimens by PET/CT. Patient No.4 showed right breast lesion and right axillary lymph nodes by routine preoperative imaging examination, but left breast lesion by postoperative PET/CT. According to the results of 18F-FDG PET/CT, patient No.4 was with complete response (Deauville score of 1) after treatment, but recurrence (Deauville score of 5) occurred after 7 months follow-up. Conclusion:18F-FDG PET/CT can play an important role in every step of management (diagnosis and staging, treatment response evaluation and detection of recurrence) in patients with PB-DLBCL.