Objective:To compare the training effect between the laparoscopic simulated uterine model (LSUM) with multi-angle suture and the traditional surgical model and to identify a laparoscopic model more suitable for gynecological resident training.Methods:Forty-eight residents who were trained in Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine from February 2021 to February 2023 were selected. They were trained in batches, with each batch randomly divided into two groups of the same size. The observation group was trained with the traditional surgical model and general surgical videos, while the experimental group was trained with a self-developed LSUM with multi-angle suture and corresponding surgical videos. Finally, the two groups were compared for the assessment results, and a questionnaire survey was conducted in the experimental group. The statistical software SPSS 20.0 was used for t-test or chi-square test of the results. Results:There were no significant differences between the two groups in age, gender distribution, education level, and clinical experience. In theoretical assessment results, no significant difference was shown between the experimental group and the observation group [(82.63±3.93) vs. (85.00±6.15), P>0.05]. In skill assessment results, there was no significant difference between the two groups in the anterior wall assessment [(83.08±4.47) vs. (82.79±3.58), P=0.804]. However, in the assessment of the lateral and posterior walls, the proficiency, accuracy, and degree of coordination between two hands of the experimental group were better than those of the observation group, with the total score being significantly different [(64.13±3.34) vs. (46.75±3.50), (62.25±4.41) vs. (45.00±2.89), P<0.001]. In the questionnaire survey, the experimental group had a high degree of satisfaction with the LSUM and thought that the highly simulated model was beneficial to their training. Conclusions:Compared with the traditional surgical model, the LSUM with multi-angle suture can effectively improve the operation level of residents, which provides a new idea for the laparoscopic simulation training of gynecological residents in the future.

Objective:To investigate the comorbidity status of hypertension, diabetes, and dyslipidemia (the"three diseases") among residents aged≥40 in Liaoning Province, and to explore the correlation between the comorbidity and cardiovascular disease mortality.Methods:This investigation was a prospective cohort study. From February 2017 to March 2019, a multi-stage stratified cluster random sampling method was used to carry out a baseline survey of 18 758 permanent residents aged≥40 years in Liaoning Province. Demographic information and history of hypertension, diabetes, and dyslipidemia were collected and followed up every year. Death was mainly identified by linkage to the Population Death Information Registration Management System. Cox proportional hazard regression model was used to analyze the association between the comorbidity of the "three diseases" and cardiovascular disease mortality risk.Results:A total of 18 758 residents aged≥40 in Liaoning Province were included, with an age of (60.3±9.9) years and 7 325 males (39.1%). The comorbidity rate of hypertension, diabetes, and dyslipidemia was 6.7% (1 256/18 758), and the standardized prevalence rate was 5.4%. The comorbidity rate increased with age (P<0.001), which was higher in women than in men, and more significant in urban areas than in rural areas (all P<0.001). The comorbidity of "three diseases" accounted for 39.3% (1 256/3 198), 18.7% (1 256/6 710), and 11.8% (1 256/10 653) in patients with diabetes, dyslipidemia, and hypertension, respectively. With a follow-up of (4.3±0.6) years, 463 people died of cardiovascular disease. The mortality rate of cardiovascular disease in the comorbidity of hypertension, diabetes, and dyslipidemia was 8.74/1 000 person-years. After adjusting potential confounders, Cox proportional hazard regression model analysis showed that compared with normal individuals, the hazard ratio of cardiovascular disease mortality in patients with the "three diseases" was 2.55 (95% CI: 1.63-3.99). Conclusion:The prevalence of comorbidity of hypertension, diabetes, and dyslipidemia among residents aged≥40 in Liaoning Province was relatively high, and the risk of cardiovascular disease mortality in patients with the "three diseases" was increased.

Objective:To compare the effect of Rain Classroom and traditional teaching model on the academic achievement of domestic medical undergraduates by Meta-analysis.Methods:All literature were retrieved from CNKI, Wanfang Med Online, VIP, and CBM databases, and the retrieval time limited from the establishment of the database to October 2019. Randomized controlled trials (RTCs) for the evaluation of the effects of Rain Classroom method in undergraduate medical education were selected. Literature were screened according to the established inclusion and exclusion criteria. Data was extracted and the quality of the literature was assessed using the Jadad scale. All analyses were performed by Stata 12.0 software.Results:A total of 3 662 medical undergraduates in 20 RCTs were included. Meta-analysis results showed that student's theoretical and practical scores of the Rain Classroom teaching group were significantly higher than those of the traditional teaching group (theoretical scores: WMD = 8.52, 95%CI = 7.30 -9.74, P < 0.001; practical scores: WMD = 8.95, 95%CI = 5.42 -12.49, P < 0.001). Conclusion:The Rain Classroom teaching method can effectively improve the theoretical and practical academic achievement among medical undergraduates and enhance the teaching effect. This study has also provided the evidence -based basis for the promotion and application of the Rain Classroom teaching method in medical undergraduate courses.

Objective:To investigate the features of chest computed tomography (CT) imaging and dynamic changes of severe corona virus disease 2019 (COVID-19).Methods:The clinical and CT data of 17 patients diagnosed with severe COVID-19 admitted to Chongqing Public Health Medical Center from January 24 to February 6, 2020 were collected. The first chest CT manifestations and the dynamic changes of imaging during treatment were retrospectively analyzed.Results:The first chest CT manifestations of the 17 patients showed that 16 cases presented with peripheral and subpleural distributions, and two cases presented with three lobes involved, one case with four lobes involved and 14 cases with five lobes involved, and 17 cases presented with ground-glass opacities, ten cases with consolidation, seven cases with subpleural line, nine cases with air bronchogram, three cases with thickened lobular septum, two cases with bronchiectasis, two cases with pleural effusion, three cases with lymphadenopathy with the short diameter of 1.0-1.2 cm.Among 16 patients who underwent repeated CT examination, the lesions of eight patients showed continuous improvement, and those of the other eight patients showed fluctuating changes.Conclusions:The CT findings of severe COVID-19 patients are mainly ground-glass opacities and consolidation, with the peripheral distribution. The range of lesions is wide, with five-lobe involvement mostly. Lymphadenopathy or pleural effusion is rare. Pynamic monitoring chest CT is useful for the evaluation for the therapeutic effects.

Objective: To investigate the features of chest CT imaging and dynamic changes of severe coronavirus disease 2019 (COVID-19). Methods: The clinical and computed tomography (CT) data of 17 patients diagnosed with severe COVID-19 admitted to Chongqing Public Health Medical Center from January 24 to February 6, 2020 were collected. The first chest CT manifestations and the dynamic changes of imaging during treatment were retrospectively analyzed. Results: The first chest CT manifestations of the 17 patients showed that 16 cases presented with peripheral and subpleural distributions, and 2 cases presented with 3 lobes involved, one case with 4 lobes involved and 14 cases with 5 lobes involved, and 17 cases presented with ground-glass opacities, ten cases with consolidation, seven cases with subpleural line, nine cases with air bronchogram, 3 cases with thickened lobular septum, two cases with bronchiectasis, two cases with pleural effusion, two cases with lymphadenopathy with the short diameter of 1.0-1.2cm. Among 16 patients who underwent repeated CT examination, the lesions of 8 patients showed continuous improvement, and those of the other 8 patients showed fluctuating changes. Conclusions The CT findings of severe COVID-19 patients are mainly ground-glass opacities and consolidation, with the peripheral distribution. The range of lesions is wide, with 5-lobe involvement mostly. Lymphadenopathy or pleural effusion is rare. Chest CT is useful for the evaluation for the therapeutic effects.

Objective To develop an instrument for measuring ICU staff′s beliefs and attitudes towards patients′early mobility and to establish the psychometric characteristics of this scale. Methods Based on the ICU medical personnel questionnaire developed by Jolley and a large number of related literature, the item pool was formulated. Preliminary draft was formed through expert consultation and a small sample pre-test. Totally 336 ICU staff were surveyed for investigation to test the validity and reliability. Results ICU staff's beliefs and attitudes of patients′ early mobility scale consisted of 38 items; there were 34 belief scales and 4 attitude scales, the exploratory factor analysis identified five principal factors and explained for 60.50％variance. The item content validity index ranged from 0.667 to 1.000, the scale content validity index was 0.911. The Cronbach α coefficient of the beliefs scale was 0.927 and the attitudes scale was 0.822. The Cronbachαcoefficient of each dimension of the beliefs scale was 0.616-0.906. Conclusions The self-designed ICU staff's beliefs and attitudes of patients′ early mobility scale has good validity, reliability and applicability to ICU staff.

Objective To evaluate the association between retinol-binding protein 4 (RBP4) and coronary artery disease (CAD) in Chinese.Methods A document retrieval was conducted by using retrieval systems,such as PubMed,Web of Science,Cochrane Library,Chinese National Knowledge Infrastructure (CNKI),CBM,VIP and WanFang Database,to collect the published papers of case-control studies on association between RBP4 and CAD in Chinese up to February,2015.Data collection and quality assessment were completed by two authors respectively.All the analyses were conducted with software RevMan 5.2.Results A total of 10 qualified studies were included in our meta-analysis.The pooled analysis showed that RBP4 might be associated with CAD in Chinese [WMD=7.17 (95％CI:3.56-10.78) μg/ml,P＜0.05].Clinical subtype specific subgroup analysis showed RBP4 might be also associated with both stable angina pectoris [WMD=4.81 (95％ CI:1.25-8.37) μg/ml,P＜0.05] and acute myocardial infarction [WMD=13.96(95％CI:6.12-21.80) μg/ml,P＜0.05].Age specific subgroup analysis showed the significant association between RBP4 and CAD was only found in patients aged ≤65 years [WMD=7.26(95％CI:2.73-11.79)μg/ml,P＜0.05].Sensitivity and publication bias analyses indicated that our results were stable and reliable.Conclusion The meta-analysis suggests that RBP4 might be associated with CAD in Chinese.

[ABSTRACT]AIM:ToinvestigatetheeffectofmiR-155-specificsiRNAaloneorincombinationwithcytosinear-abinoside (Ara-C) on the growth and apoptosis of Burkitt lymphoma Raji cells .METHODS: miR-155-specific siRNA and/or Ara-C were used to treat the cells .Quantitative real-time polymerase chain reaction was used to detect the expres-sion of miR-155.The growth of the cells was analyzed by CKK-8 assay.The cell apoptosis was determined by flow cytome-try.RESULTS:The miR-155 expression level of the cells transfected with miR-155 siRNA was significantly lower than that in the 2 control groups .Ara-C or miR-155 siRNA alone inhibited the growth of Raji cells in a dose-depend manner . miR-155 siRNA combined with Ara-C produced more inhibition of cell proliferation (P<0.05).After treatment for 48 h, the apoptotic rate of Raji cells in miR-155 siRNA+Ara-C group [(38.4 ±1.4)%] was higher than that in Ara-C group [(16.5 ±0.3)%] and miR-155 siRNA group [(14.6 ±0.3)%], with statistically significant difference (P<0.05). The expression of caspase-3 in Ara-C+miR-155 siRNA group was increased significantly as compared with Ara-C group and miR-155 siRNA group.CONCLUSION:miR-155-specific siRNA enhances the chemosensitivity of Raji cells to Ara-C by inducing apoptosis through the caspase-3 pathway .

ObjectiveLoss-of-function mutation of p53,a tumor suppressor gene,is an important mechanism for the development of human cancers.In this study we tried to transfect p53N15-based fusion peptide into H1299,a lung cancer cell line,and evaluate the anti-tumor effects of the fusion peptide.MethodsAdeno-associated virus ( AAV) vectors were used for transfecting p53N15 fusion peptide into p53-null lung adenocarcinoma H1299 cells.The anti-replication effects of p53N15 fusion peptide were evaluated with inverted microscopy,MTT test for cell viability and flow cytometry.ResultsFusion peptides in H1299 cells was highly expressed and had detectable suppressive effects on cell proliferation.A large amount of dead cells were seen under microscope after the transfection of recombinant viruses for 72 hours.Cells activity was reduced significantly in the virus-transfecting groups as demonstrated by MTT test.The flow cytometry showed that a large number of dead cells were present in the virus-transfecting groups.ConclusionThe growth of H1299 lung adenocarcinoma cells could be inhibited in vitro by being transfected with p53N15 fusion peptide,which may be a potential gene therapy alone or as an adjuvant option in the treatment of lung cancer.

Psychostimulant is a type of psychoactive substances that stimulate central and peripheral nervous system as well as induce drug dependence.A series of studies indicate that monoamine especially dopamine plays an important role in behavior and drug dependence,moreover,dopamine transporter(DAT)controls homeostasis of dopamine in neuron and transmission of dopamine pathways.Thus DAT might play an important role in the reward and behavioral stimulation of psychostimulant.