Objective To evaluate effects of dexmedetomidine on onset ,duration of supraclavicular brachial plexus block induced by levobupivacaine and postoperative analgesia with ultrasound guide .Methods Eighty patients undergoing elective surgeries of distal arm and forearm with class Ⅰ ~ Ⅱ ASA were enrolled ,and the patients were randomly divided into two groups ,one was control group (group C) patients with supraclavicular brachial plexus block by 30 ml of 5% levobupivacaine contained 1 ml normal saline ,the other was dexmedetomidine group patients (group D) with supraclavicular brachial plexus block by 30 ml of 5% levobupivacaine contained 100μg dexmedetomidine .The supraclavicular brachial plexus block was guided with ultrasound .Observation indicators include :sensory and motor onset blocks ,duration of sensory and motor blocks ,time to first rescue analgesia and hemodynamic parameters .Results The differences of sensory block onset between group C and D were not significant .Compared to group C ,motor block onset of group D was significantly shorter (P<0 .01) ,sensory block duration and motor block duration were longer (P<0.001) ,time to first rescue analgesia after the surgeries was longer (P<0 .001) .Mean arterial pressure and mean heart rate of group D were significantly lower than those of group C ,respectively (P<0 .02) .Conclusions Dexmedetomidine can significantly prolong the duration of block and postoperative analgesia of supracla-vicular brachial plexus block induced by levobupivacaine .

With the emergence of technological revolution and industrial transformation in the new era, scientific and technological innovation accelerates development, which has become the leading future force. New technology derived from scientific and technological revolution and the change of the cognition of medicine promote the exploration of modern medicine and help construct a development model of the whole life cycle health care gradually. This medical model marks a new stage with the coexistence of whole life cycle health service and personalized precision diagnosis and treatment. China first proposed the concept of "new medical science" to solve the problems of how to develop medical education in the future and cultivate medical talents in the new era, which are major concerns to medical educators. Therefore, this study analyzed the development trend of medical education in the new era, and explored the reform of medical education and the cultivation of medical talents from the aspects of medical development and scientific research innovation and proposed countermeasures.

Objective:To investigate the current situation of body image and stigma of drug-resistant tuberculosis patients treated with Clofazimine, and analyze the correlation between them.Methods:A cross-sectional study was conducted using convenience sampling method to investigate 150 patients with drug-resistant tuberculosis treated with Clofazimine in tuberculosis ward of Chengdu Public Health Clinical Medical Center from October 2020 to October 2021. The general questionnaire, Body Image Scale (BIS) and Tuberculosis Related Stigma Scale were used to conduct a questionnaire survey.Results:A total of 130 questionnaires were effectively collected. The body image score of 130 patients with drug-resistant tuberculosis treated with Clofazimine was (20.51 ± 6.80) points; the score of stigma was (17.78 ± 6.92) points. There was a positive correlation between the total score of disease shame and the total score of body image ( r=0.544, P<0.05). Conclusions:Patients with drug-resistant tuberculosis treated with Clofazimine have body image disorder and stigma, and the two are positively correlated. Caregivers should carry out psychological assessment and intervention at an early stage to improve the patient′s mental health level.

Epigenetics refers to heritable changes in gene expression independent of DNA nucleotide sequence itself, and the main mechanisms include DNA methylation, histone modifications, noncoding RNAs, and so on. Vascular disease is a chronic disease regulated by the interaction between environmental and genetic factors. In recent years, more and more studies have confirmed that epigenetic regulation plays an important role in the occurrence and development of vascular diseases. This article reviews recent advances in epigenetics in vascular disease.

Obesity, sleep disorders, psychological stress, sedentary are modifiable cardiovascular risk factors. There is growing evidence that these risk factors may accelerate the chronic inflammatory process of atherosclerosis and lead to myocardial infarction. Studies on the role of immune cells and their related immune mechanisms in atherosclerosis have shown that the above modifiable risk factors can affect the hematopoiesis of the bone marrow system, affect the production of immune cells and phenotypes, and then affect the progress of atherosclerosis. This review will focus on the effects of modifiable cardiovascular risk factors on the progression of atherosclerosis through the role of the innate immune system.

The World Health Organization (WHO) released the WHO 2020 guidelines on physical activity and sedentary behaviour in November 2020. Compared with the 2010 WHO guidelines, this guideline has incorporated more extensive medical evidence and made targeted recommendations for special populations. The main content includes physical activity and sedentary behaviour advice for children and adolescents, adults, older adults, pregnant and postpartum women, people with chronic conditions, and disability. This review will interpret the 2020 WHO guidelines in detail.

Objective    To analyze prognostic ability of inflammation-based Glasgow prognostic score (GPS) in patients with ST-segment elevation myocardial infarction (STEMI). Methods    We retrospectively analyzed the clinical data of 289 patients with STEMI admitted to the Department of Emergency in West China Hospital from April 2015 to January 2016. All study subjects were divided into three groups: a group of GPS 0 (190 patients including 150 males and 40 females aged 62.63±12.98 years), a group of GPS 1 (78 patients including 58 males and 20 females aged 66.57±15.25 years), and a group of GPS 2 (21 patients including 16 males and 5 females aged 70.95±9.58 years). Cox regression analysis was conducted to analyze the independent risk factors of predicting long-term mortality of patients with STEMI. Results    There was a statistical difference in long-term mortality (9.5% vs. 23.1% vs. 61.9%, P<0.001) and in-hospital mortality (3.7% vs. 7.7% vs. 23.8%, P<0.001) among the three groups. The Global Registry of Acute Coronary Events (GRACE) scores and Gensini scores increased in patients with higher GPS scores, and the differences were statistically different (P<0.001). Multivariable Cox regression analysis showed that the GPS was independently associated with STEMI long-term all-cause mortality (1 vs. 0, HR: 2.212, P=0.037; 2 vs. 0, HR: 8.286, P<0.001). Conclusion    GPS score is helpful in predicting the long-term and in-hospital prognosis of STEMI patients, and thus may guide clinical precise intervention by early risk stratification.