The practical teaching system for information management and information system science in higher medical institutions was constructed with job skill training as its target by intruding the concept of competence-based education model into it in order to improve the practical performance of undergraduates majoring in informa-tion management and information system science. The system was designed by taking into consideration the teaching contents, teaching methods and teaching practice, and implemented in the undergraduates of Chengdu Medical College, and the implementation experiences were summarized.

Objective To study the changes of inferior adjacent segmental after different segmental fixation ,and to analyze the accelerating mechanism of the adjacent segment degeneration .Methods Sixty sheep lumbar spine specimens (Waist 1 vertebral body-S5) with pedicle screws were collected ,according to the different fixed section ,they were divided into complete control group(not fixed) ,L6-L7 single segment fixed group ,L5-L7 short segmental fixed group ,L3-L7 long segmental fixed group .The biomechan-ical experiment was measured in the 6 N · m torque loading ,L7-S1 sacral vertebra clearance were measured in different fixed sec-tion .Results Applied in fixed ,beneath the adjacent segment in the stretch direction of angular displacement ,intervertebral disc pressure was increased significantly ,amplitude in creased with the increase of fixed range .The difference between groups was sta-tistically significant(P< 0 .05) .Conclusion After fixing spine in pedicle screws ,the longer the segmentation is fixed ,the more effect it has on subjacent segment degeneration .

Objective To analyze the risk factors of emergence agitation (EA)in the adult patients during the recovery peri-od after general anesthesia in postanesthesia care unit(PACU).Methods 2 056 adult patients undergoing elective surgery under general anesthesia in PACU were selected,aged more than 18 years old,sex unlimited The following factors of age,gender,body mass,ASA grade,preoperative combined disease,education level,premedicatiou,general anesthesia mode,midazolam use for induc-tion,anesthesia time,operation site,operation mode,operation time,intraoperative blood loss,intraoperative fluid replacement,re-covery time in PACU,body temperature,urinary catheter,urine volume,etc.were recorded.According to whether EA occurring during recovery from general anesthesia,the patients were divided into the quiet group and the EA group.The multivariate Logistic regression was performed to analyze and screen the risk factors for the occurrence of EA.Results 127 cases developed EA during recovery from anesthesia.The occurrence rate of EA was 6.18%.The Logistic regression analysis indicated that high grade ASA, large quantity of intraoperative fluid replacement,placing urinary catheter and postoperative pain were the risk factors for EA(P <0.05).Conclusion Highgrade ASA,large quantity of intraoperative fluid replacement,placing urinary catheter and postoperative pain are the risk factors for EA during the recovery period after general anesthesia in PACU.

Chronic kidney disease (CKD) is becoming a global social problem. It is important to slow down the progression of CKD for economic and social concerns. In recent years, it has been found that colon is one of the vital organs which produce uremic toxins. And enterogenous uremic toxins are closely related to the prognosis of CKD. Theory of gut-kidney axis for the slowdown of CKD progression was raised by foreign scholars and became the research hot spot. Colon therapy with traditional Chinese medicine (TCM) has been widely used in clinical practice and is believed to slow down the progression of CKD by numerous clinical reports. However, low re-search quality and ambiguous results limited its further application. Under the guidance of senior TCM Professor Huang Chunlin, who emphasized the method of draining turbidity through bowels in the management of CKD, from the Nephrology Center, Guangdong Provincial Hospital of Chinese Medicine, as well as the modern theory of gut-kidney axis, we had carried out a series of exploratory researches which will provide data and methodology support for further confirmatory studies and improve its effectiveness.

OBJECTIVETo analyze the effects of nicotine on the bone calcium and phosphorus content and alkaline phosphatase (ALP) activity in rat alveolar bone and mandible.

METHODSTwenty health male Wistar rats of five weeks of age were randomly assigned to two groups and received daily intraperitoneal injections for three months as follows: Saline solution for control group, nicotine 0.73 mg.kg-l.d-1 for experimental group. The bone calcium phosphorus content were detected by concentrated acid digestion method and the ALP activity was examined by improved Reddi method.

RESULTSCompared to the control group, bone calcium and phosphorus content was lower in the experimental group (P<0.05), ALP activity had no statistical significance(P>0.05). Bone calcium phosphorus and ALP activity in different parts had no statistical significance (P>0.05).

CONCLUSIONThe nicotine reduces calcium phosphorus deposition of jaw bone, but has no obvious influence to ALP activity.

Objective:To study the interaction effects between intestinal microflora features with serum inflammatory factors and homeostatic model assessment insulin resistance (HOMA-IR) in patients with first-episode untreated schizophrenia (SCZ).Methods:A total of 79 SCZ patients admitted to Suining Central Hospital from August 2016 to August 2019 were selected as observation group, and 60 healthy examiners were set as control group. The intestinal microflora, serum inflammatory factors and glucose metabolism indexes of the two groups were detected and compared. The correlation between intestinal microflora and inflammatory factors and HOMA-IR was analyzed.Results:The content of bifidobacteria in the observation group was lower than that in the control group while the content of bacteroides was higher than that in control group; the levels of serum inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and IL-6] and in the observation group were higher than those in the control group ( P<0.05); the level of HOMA-IR in the observation group was higher than that in control group ( P<0.05). The TNF-α, IL-1β, IL-6 and HOMA-IR in SCZ patients were significantly negatively correlated with intestinal bifidobacteria content ( P<0.05), and were obviously positively correlated with bacteroides content ( P<0.05). Conclusions:In first-episode untreated SCZ, the content of bifidobacteria decreased and the content of bacteroides increased, and there was a significant correlation with inflammatory factors and HOMA-IR, which may lead to the disorder of glucose and lipid metabolism and induce the occurrence of metabolic diseases such as diabetes.

At present,in medical academic circle there is no consensus on the optimal diameter of the stent used in transjugular intrahepatic portosystemic shunt(TIPS).In 2021,the Advancing Liver Therapeutic Approaches Consortium(ALTAC)recommended the use of controllable diameter TIPS covered stent system in the performance of TIPS,the stent diameter of this system can be adjusted within the range of 8 mm to 10 mm,and its stability can be maintained for a long time.This system carries several advantages such as accurately regulating portal venous pressure gradient(PPG),optimizing hemodynamic target,protecting liver blood perfusion,reducing shunt-related complications,etc.,indicating that this system has a promising clinical application prospect.Through reviewing the relevant literature,this paper summarizes the research progress of controllable diameter TIPS covered stent system,aiming to better help clinicians engaged in related fields to gain a further understanding of this new technology.

BACKGROUND:Mechanical stimulation has been confirmed to promote osteogenic differentiation of bone marrow stromal stem cells,but the mechanism is unknown.Primary cilia are important mechanoreceptors and regulate various signaling pathways such as TGF-β1/BMP-2/SMAD.They are likely to be important targets for mechanical regulation of bone marrow stromal stem cells. OBJECTIVE:To investigate the effect and mechanism of fluid shear stress on osteogenic differentiation of bone marrow stromal stem cells. METHODS:Rat bone marrow stromal stem cells were divided into control group,mechanical stimulation group(fluid shear mechanics intervention by shaking table),mechanical stimulation + IFT88 silencing group(mechanical stimulation + silencing IFT88 expression with siRNA).After 24 hours of intervention,qRT-PCR was utilized to determine the expression of transforming growth factor β1 and bone morphogenetic protein 2.Western blot assay was used to detect the expression of phosphorylated SMAD2/3 protein.Immunofluorescent staining of primary cilia was conducted and morphology was analyzed. RESULTS AND CONCLUSION:Shear stress stimulation could promote the transcriptional activity of transforming growth factor β1 and bone morphogenetic protein 2 genes,and increase the expression of phosphorylated SMAD2/3 protein.After siRNA interfered with primary cilia,this mechanical response effect was significantly reduced.There was a Spearman correlation between the change ratio of the primary cilium area of bone marrow stromal stem cells and the increased ratio of transforming growth factor β1 and bone morphogenetic protein 2 gene transcription.These findings indicate that primary cilia/intraflagellar transport mediates the activation of fluid shear stress-responsive transforming growth factor β1/bone morphogenetic protein 2/SMAD signaling pathway and promotes osteogenic differentiation of bone marrow stromal stem cells.

BACKGROUND:Cervical neutral position magnetic resonance imaging is widely used for the diagnosis and treatment of cervical spondylotic myelopathy.However,it is not possible for patients to maintain the exact same position of the head and neck during repeated cervical magnetic resonance imaging examinations.The cervical spine undergoes minor flexion and extension movements in the sagittal plane,and the head may have a certain degree of variation in flexion and extension.Whether these changes in the neutral position of the cervical spine affect the volume of cervical discs herniation and cervical curvature is unclear. OBJECTIVE:Using artificial intelligence-assisted measurement,this study aimed to analyze the accuracy and reliability of magnetic resonance imaging examinations for measuring the volume of cervical discs herniation and cervical curvature in patients with cervical spondylotic myelopathy undergoing two consecutive cervical neutral positions in the short term. METHODS:A retrospective study was conducted on patients with cervical spondylotic myelopathy who underwent conservative treatment and underwent two consecutive cervical magnetic resonance imaging examinations within three months between June 2012 and June 2023.We proposed the use of occipital-thoracic distance and occipital-thoracic angle to evaluate the variation in flexion and extension of the head in the neutral position of the cervical spine.Based on the changes in occipital-thoracic angle,patients were divided into occipital-thoracic angle increase group and occipital-thoracic angle decrease group.Cervical discs herniation volume,C2-6 Cobb angle,and cervical(C3-C7)curvature were measured using artificial intelligence-assisted measurement software.Normal distribution data were represented by mean±SD,while non-normal distribution data were represented by the median(interquartile range).Spearman's rank correlation coefficient was used to analyze the correlation between changes in Cobb angle,cervical(C3-C7)curvature,and cervical discs herniation volume. RESULTS AND CONCLUSION:(1)A total of 104 patients and 326 cervical discs herniation were included in the study.There were 47 patients in the occipital-thoracic angle increase group and 57 patients in the occipital-thoracic angle decrease group.(2)Extension and flexion index of the head:There were no significant differences in occipital-thoracic distance and occipital-thoracic angle during the initial diagnosis and follow-up examination.The variation of occipital-thoracic distance was 0.035(3.23)mm,and the variation of occipital-thoracic angle was-0.31(3.28)°.The deviation range of occipital-thoracic distance and occipital-thoracic angle was small,and there was no significant correlation.(3)Cervical curvature index:There were no significant differences in C2-6 Cobb angle and C3-C7 curvature during the initial diagnosis and follow-up examination.There were no significant differences in C2-6 Cobb angle and C3-C7 curvature between the occipital-thoracic angle increase group and occipital-thoracic angle decrease group.(4)There was no significant difference in volume of cervical discs herniation during the initial diagnosis and follow-up examination.There was no significant difference in volume of cervical discs herniation between the occipital-thoracic angle increase group and occipital-thoracic angle decrease group.There was no significant correlation between the change of cervical discs herniation volume and the change of C2-6 Cobb angle and the cervical(C3-C7)curvature.(5)These results indicate that in the neutral position of the cervical spine,there were negligible minor flexion and extension movements in the sagittal plane,and the head was limited to a specific position.Although the head has a certain range of flexion and extension variation,it does not affect the accuracy and reliability of parameters including cervical discs herniation volume,C2-6 Cobb angle,and cervical(C3-C7)curvature.

Objective To investigate the prevalence of physical state of HPV-l6 DNA in cervical cancer and cervical precancerous carcinoma. Methods Multiplex PCR was adopted to detect the physical state of HPV in samples from 252 patients with cervical carcinoma, including 48 samples of cervical cancer, 204 cervical intraepithelial neoplasia (CIN ) (125 CIN I, 46 CIN II and 33 CIN III) and 20 normal samples from the subjects with hysteromyoma undergoing hysterectomy, respectively. Results Among 48 patients with cervical cancer, 31 (65.6%) were infected with HPV-16. Eighteen among 31 (58.1%) HPV-16 infected patients with cervical cancer were found to have integrated infection of HPV-16. The positive rates of HPV-16 infection in the patients with CIN I, CIN II and CIN III were 19.2%, 34.8%and 42.4%, and the integrated infection rates of HPV-16 were 16.7%, 18.8%and 35.7%, respectively. Compared with patients with different grades of CIN, the integrated rate of HPV-16 infection in those with cervical cancer was significantly elevated. Conclusion Among the patients with HPV-16 infection, the integrated state of HPV-16 is positively correlated with the severity of cervical lesions. Combined HPV typing test and detection of integrated viral state contribute to predicting the prognosis of patients with cervical precancerous lesions and increasing the accuracy of screening cervical cancer on the basis of HPV DNA detection.