Objective: To study influencing factors on the detection rate of colorectal polyps by repeated examination in colonoscopy. Methods: A total of 900 patients in the digestive endoscopy center of the People′s Hospital of Xinjiang Uygur Autonomous Region received colonoscopy, 300 patients were randomly selected for a second examination and they were selected for three times examination from August 2016 to March 2017. Objective factors for colonoscopy were strictly controlled during the examination, such as endoscopists′ experience, endoscopic operating method, cleansing degree of the intestine and withdrawal time. The characteristics of polyps were recorded, including number, location, shape, size and pathological types of polyps. The characteristics of polyps were compared between the same patient, and between the first-examination group, the second-examination group and the third-examination group. Logistic regression was used to analyze the independent influencing factors of missed diagnosis. Results: A relatively high rate of missed diagnosis could occur in multiple polyps, ascending colon polyps, transverse colon polyps, sigmoid polyps, stepless polyps and small polyps (<5 mm) (All P<0.05), and the pathological type was irrelevant to missed diagnosis (P>0.05). Logistic regression analysis showed that the number, location, shape and size of colorectal polyps were all independent factors influencing the detection rate(all P<0.05). The detection rate of polyps in the two times colonoscopy group was higher than that of the one time colonoscopy group, but there was no statistical difference between the second observation and the third observation (P>0.05). Conclusion The number, location, shape and size of colorectal polyps are all independent factors influencing the detection rate. The detection rate of polyps may be improved by using the second colonoscopy.

Objective To investigate the effects of salidroside(Sal)on mitochondrial autophagy in ischemic cardiomyopathy(ICM)rats by modulating the PTEN-induced kinase 1(PINK1)/E3 ubiquitin ligase(Parkin)signaling pathway.Methods Thirty SD rats were randomly divided into control group,model group,low-dose Sal group,high-dose Sal group,mitochondrial autophagy inhib-itor(Mdivi-1)group and high-dose Sal+Mdivi-1 group,with five rats in each group.The ICM rat model was established.The left ventricular ejection fraction(LVEF),left ventricular fractional short-ening(LVFS),left ventricular end-diastolic diameter(LVIDd)and left ventricular end-systolic diam-eters(LVIDs)were analyzed.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of lactate dehydrogenase(LDH),cardiac troponin Ⅰ(cTnⅠ),creatine kinase(CK)and N-terminal pro-brain natriuretic peptide(NT-proBNP).Hematoxylin and eosin(HE)staining was performed to observe pathological changes in myocardial tissue,and transmission electron microscopy was used to examine mitochondrial structure.The levels of reactive oxygen species(ROS),malondialdehyde(MDA)and superoxide dismutase(SOD)were measured.Western blot analysis was conducted to determine the expression levels of microtubule-associated protein light chain 3(LC3),Beclin1,p62,PINK1 and Parkin in myocardial tissue.Results Compared with the control group,the model group showed more severe myocardial tissue and mitochondrial damage.The LVEF,LVFS,SOD and p62 levels in the model group were significantly lower than those in the control group,while the LVIDd,LVIDs,LDH,cTnⅠ,CK,NT-proBNP,ROS,MDA,LC3Ⅱ/LC3I,Beclin1,PINK1 and Parkin levels were significantly higher(P＜0.05).Compared with the model group,the low-dose and high-dose Sal groups exhibited reduced myocardial and mitochondrial damage.The LVEF,LVFS,SOD,LC3Ⅱ/LC3I,Beclin1,PINK1 and Parkin levels in the low-dose and high-dose Sal groups were significantly higher than those in the model group,while the LVIDd,LVIDs,LDH,cTnⅠ,CK,NT-proBNP,ROS,MDA and p62 levels were significantly lower(P＜0.05).Compared with the model group,the Mdivi-1 group showed more severe myocardial and mitochondrial damage.The LVEF,LVFS,SOD,LC3Ⅱ/LC3I,Beclin1,PINK1 and Parkin levels in the Mdivi-1 group were significantly lower than those in the model group,while the LVIDd,LVIDs,LDH,cTnⅠ,CK,NT-proBNP,ROS,MDA and p62 levels were significantly higher(P＜0.05).Compared with the low-dose Sal group,the high-dose Sal group demonstrated further improvement in myocardial and mitochondrial damage.The LVEF,LVFS,SOD,LC3Ⅱ/LC3I,Beclin1,PINK1 and Parkin levels in the high-dose Sal group were significantly higher than those in the low-dose Sal group,while the LVIDd,LVIDs,LDH,cTnⅠ,CK,NT-proBNP,ROS,MDA and p62 levels were significantly lower(P＜0.05).Mdivi-1 significantly inhibited mitochondrial autophagy and suppressed the activation of the PINK1/Parkin signaling pathway and the improvement in cardiac function induced by Sal(P＜0.05).Conclusion Sal may improve myocardial injury in ICM rats by activating the PINK1/Parkin signaling pathway and promoting mitochondrial autophagy.

Objective To investigate the effects of salidroside(Sal)on mitochondrial autophagy in ischemic cardiomyopathy(ICM)rats by modulating the PTEN-induced kinase 1(PINK1)/E3 ubiquitin ligase(Parkin)signaling pathway.Methods Thirty SD rats were randomly divided into control group,model group,low-dose Sal group,high-dose Sal group,mitochondrial autophagy inhib-itor(Mdivi-1)group and high-dose Sal+Mdivi-1 group,with five rats in each group.The ICM rat model was established.The left ventricular ejection fraction(LVEF),left ventricular fractional short-ening(LVFS),left ventricular end-diastolic diameter(LVIDd)and left ventricular end-systolic diam-eters(LVIDs)were analyzed.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of lactate dehydrogenase(LDH),cardiac troponin Ⅰ(cTnⅠ),creatine kinase(CK)and N-terminal pro-brain natriuretic peptide(NT-proBNP).Hematoxylin and eosin(HE)staining was performed to observe pathological changes in myocardial tissue,and transmission electron microscopy was used to examine mitochondrial structure.The levels of reactive oxygen species(ROS),malondialdehyde(MDA)and superoxide dismutase(SOD)were measured.Western blot analysis was conducted to determine the expression levels of microtubule-associated protein light chain 3(LC3),Beclin1,p62,PINK1 and Parkin in myocardial tissue.Results Compared with the control group,the model group showed more severe myocardial tissue and mitochondrial damage.The LVEF,LVFS,SOD and p62 levels in the model group were significantly lower than those in the control group,while the LVIDd,LVIDs,LDH,cTnⅠ,CK,NT-proBNP,ROS,MDA,LC3Ⅱ/LC3I,Beclin1,PINK1 and Parkin levels were significantly higher(P＜0.05).Compared with the model group,the low-dose and high-dose Sal groups exhibited reduced myocardial and mitochondrial damage.The LVEF,LVFS,SOD,LC3Ⅱ/LC3I,Beclin1,PINK1 and Parkin levels in the low-dose and high-dose Sal groups were significantly higher than those in the model group,while the LVIDd,LVIDs,LDH,cTnⅠ,CK,NT-proBNP,ROS,MDA and p62 levels were significantly lower(P＜0.05).Compared with the model group,the Mdivi-1 group showed more severe myocardial and mitochondrial damage.The LVEF,LVFS,SOD,LC3Ⅱ/LC3I,Beclin1,PINK1 and Parkin levels in the Mdivi-1 group were significantly lower than those in the model group,while the LVIDd,LVIDs,LDH,cTnⅠ,CK,NT-proBNP,ROS,MDA and p62 levels were significantly higher(P＜0.05).Compared with the low-dose Sal group,the high-dose Sal group demonstrated further improvement in myocardial and mitochondrial damage.The LVEF,LVFS,SOD,LC3Ⅱ/LC3I,Beclin1,PINK1 and Parkin levels in the high-dose Sal group were significantly higher than those in the low-dose Sal group,while the LVIDd,LVIDs,LDH,cTnⅠ,CK,NT-proBNP,ROS,MDA and p62 levels were significantly lower(P＜0.05).Mdivi-1 significantly inhibited mitochondrial autophagy and suppressed the activation of the PINK1/Parkin signaling pathway and the improvement in cardiac function induced by Sal(P＜0.05).Conclusion Sal may improve myocardial injury in ICM rats by activating the PINK1/Parkin signaling pathway and promoting mitochondrial autophagy.

Objective:To explore the application of the early clinical exposure concept-guided question-answer teaching model combined with the ORTCC (objectives, rules, training, check, and culture) model in endocrine teaching reform.Methods:Sixty-two students who interned at Beijing Anzhen Hospital of Capital Medical University from August 2022 to August 2023 were divided into control group and observation group according to the order of student number, with 31 students in each group. The control group received traditional teaching, while the observation group received early clinical exposure concept-guided question-answer teaching combined with the ORTCC model. At the end of the internship, the two groups were compared in terms of theoretical and practical assessment scores and comprehensive competency assessment scores. SPSS 22.0 was used to perform the t-test. Results:The theoretical assessment score of the control group was (87.00±3.86) points, while that of the observation group was (91.26±4.34) points, with a statistically significant difference between the two groups ( t=4.09, P<0.001). The observation group also showed significantly higher scores of clinical practice assessment and comprehensive competency assessment than the control group ( P<0.05). Conclusions:The combination of question-answer teaching guided by the early clinical exposure concept and the ORTCC model is helpful for endocrine interns to master theoretical knowledge and acquire clinical practical skills and comprehensive abilities, effectively improving the quality of internship teaching.