Acute Disease ; Humans ; Pulmonary Embolism ; therapy

Animals ; Atherosclerosis ; etiology ; metabolism ; Gene Expression Regulation ; Humans ; Lipase ; analysis ; genetics ; physiology ; Lipoproteins ; metabolism ; Lipoproteins, HDL ; metabolism ; Lipoproteins, LDL ; metabolism ; Polymorphism, Genetic ; Tissue Distribution

The application of MOOCs (massive open online courses) in internal medicine education is feasible with the construction of MOOCs in internal medicine, internet and mobile terminal availability, and the improvement of college student quality. We reviewed the progress of MOOCs in the medical teach-ing. The chapter of coronary heart disease was exemplified to illustrate how to apply MOOCs in internal medicine teaching. The MOOCs was carried out with the following steps: the share of MOOCs courses, self-guided learning, online question and answer section, in-class teaching and exams post MOOCs, which achieved good teaching effect, enhanced students' subjectivity, and promoted the sharing of high-quality medi-cal teaching resources. At the same time, in view of the limited nature of MOOCs in internal medicine, we need to overcome it in the development of teaching practice.

Anemia, Aplastic ; therapy ; Child ; Female ; HLA Antigens ; genetics ; immunology ; Humans ; Mesenchymal Stem Cell Transplantation ; Peripheral Blood Stem Cell Transplantation

OBJECTIVE:To compare the efficacy and safety of ferrous succinate or Shengxuening in the adjuvant treatment of renal anemia in patients with diabetic nephropathy peritoneal dialysis (CAPD). METHODS:64 diatetic nephropathy CAPD pa-tients with renal anemia were randomly divided into observation group (32 cases) and control group (32 cases). All patients re-ceived subcutaneous injection of insulin for blood glucose control (adjusted the insulin dosage based on fasting blood glucose lev-els),hypertension patients actively controlled blood pressure,corrected acid-base and electrolyte balance disorders,orally received fo-lic acid and vitamin B12,ambulant CAPD,then rhEPO was subcutaneously injected with initial dose of 100-150 U/(kg·week) for 2-3 times and other conventional treatment. Based on it,observation group received 1 g of Shengxuening tablet,3 times a day;control group received 0.2 g Ferrous succinate tablet,3 times a day. The treatment course for both groups was 16 weeks. The rhEPO dose was monthly adjusted to make Hb 100-120 g/L. Clinical efficacy,serum iron,serum ferritin,total iron binding capacity,transfer-rin saturation before and after treatment,Hb,Hct,hs-CRP,rhEPO dose before treatment and after 4,8,12 and 16 weeks of treat-ment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:There was no significant difference in the total effective rate between 2 groups (P>0.05). After treatment,serumiron,total iron binding capacity,transferrin saturation,Hb and Hct in 2 groups were significantly higher than before,and it gradually increased by treatment time,serum ferritin,hs-CRP was sig-nificantly lower than before,and it gradually decreased by treatment time,the differences were statistically significant(P<0.05);but there was no significant difference between 2 groups(P>0.05). The rhRPO dose in observation group 8,16 and 16 weeks af-ter treatment and in control group 8 weeks after treatment were significantly lower than 4 weeks after treatment,and 12 and 16 weeks after treatment in observation group were lower than control group,the differences were statistically significant (P<0.05). The incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). CONCLUSIONS:Based on conventional treatment,both ferrous succinate and Shengxuening show good ef-ficacy in the adjuvant treatment of renal anemia with diabetic nephropathy CAPD,both can improve anemia and iron metabolism, while Shengxuening is superior to ferrous succinate in terms of improving microinflammatory state and reducing rhEPO dose,with better safety.

OBJECTIVETo evaluate the application of two-dimensional ultrasound speckle tracking imaging (STI) in assessment of myocardial torsion and left ventricular function for patients with chronic pulmonary heart disease (CPHD).

METHODSThirty six patients with CPHD and 38 normal subjects were enrolled in the study,and STI examinations were performed. The left ventricular short-axis views (mitral level,apical level) were observed,the rotation angles of the standardized time point were measured at each short-axis views and the corresponding left ventricular torsion angles were calculated. Simultaneously, the basal rotation peak, apical rotation peak, left ventricular twist peak, end-systolic basal rotation value, end-systolic apical rotation value and end-systolic left ventricular twist value were recorded. The correlations of left ventricular ejection fraction (LVEF) with left ventricular torsion peak, end-systolic left ventricular twist value in patients were analyzed.

RESULTSCompared to normal controls, the basal rotation peak, apical rotation peak, left ventricular twist peak, end-systolic basal rotation value, end-systolic apical rotation value and end-systolic left ventricular twist value were significantly lower (P<0.01) in CPHD patients. The LVEF was highly correlated with left ventricular twist peak and end-systolic left ventricular twist value in CPHD patients (r=0.967, 0.952,P<0.001).

CONCLUSIONSTI is sensitive to detect left ventricular myocardial torsion change; left ventricular torsion peak and end-systolic left ventricular twist value can be used to assess the left ventricular function in patients with CPHD.

Aged ; Echocardiography ; Female ; Heart Ventricles ; diagnostic imaging ; physiopathology ; Humans ; Male ; Middle Aged ; Pulmonary Heart Disease ; diagnostic imaging ; Torsion Abnormality ; diagnostic imaging

OBJECTIVE: To investigate the signal transduction mechanism of curcumin in inhibiting the proliferation of bovine lens epithelial cell (LEC) induced by recombinant human epidermal growth factor (rhEGF). METHODS: There were three groups in this experiment, which were normal control group, untreated group and curcumin-treated group. Proliferation of LEC was induced by rhEGF (50 microg/L). The concentration of intracellular Ca(2+) ([Ca(2+)](i)) in LEC was measured with Fura-2/AM by spectrofluorimetry. The contents of intracellular cAMP and cGMP were assayed by radioimmunoassay. RESULTS: The [Ca(2+)]i in LEC was obviously increased in the untrated group as compared with that in the normal control group (P<0.01), and the [Ca(2+)](i) in LEC in the curcumin-treated group was highest among three groups (P<0.01). The content of intracellular cAMP in LEC was decreased while the content of intracellular cGMP was obviously increased in the untreated group as compared with those in the normal control group (P<0.01). The content of intracellular cAMP in LEC was higher in the curcumin-treated group than that in the untreated group, while the content of intracellular cGMP was lower than that in the untreated group (P<0.01). CONCLUSION: The antiproliferation effects of curcumin on LEC may relate to the regulations of multiple processes of signal transduction.

AIM:To investigate the effect of intense pulsed light on the meibomian gland dysfunction ( MGD) , and to observe whether the intense pulsed light can improve the symptoms and objective indexes of the patients with meibomian gland dysfunction. · METHODS: A retrospective noncomparative interventional case series was conducted. Totally 21 MGD patients (42 eyes) were selected from November 2016 to February 2017 in Renmin Hospital of Wuhan University, the results of the following tests is recorded:OSDI score, corneal fluorescein staining, tear break-up time, ocular surface analyzer, scanning confocal microscopy, all patients respectively were received intense pulsed light treatment 3 times at 3wk intervals, and followed up after 1mo. Paired sample t test was used to analyze the difference in outcome. ·RESULTS: In the 21 cases ( 42 eyes ) , the OSDI score decreased, the mean value before treatment was 30. 18 ± 4. 07, and the mean value after treatment was 24. 87±4. 32. The first tear film break-up time ( first, BUT) increased, the mean value before treatment was 5. 37 ± 0. 82s, the mean value after treatment was 7. 12 ± 0. 74s. The mean value of meibomian gland secretion scores before the treatment was 1. 57 ± 0. 52,the mean value after treatment was 1. 22 ± 0. 52. The mean value of corneal fluorescence staining before treatment was 0. 82 ± 0. 41, and the mean value after treatment was 0. 51 ± 0. 53, the difference was statistically significant (t=11. 2, 2. 68, 3. 31, 2. 78, 2. 61;P<0. 05). · CONCLUSION: Intense pulsed light can effectively improve the subjective symptoms of patients with MGD and alleviate the obstruction of meibomian glands. It is an important method for MGD treatment.

Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Tyrosinemias ; diagnosis ; therapy

Objective To determine the usefulness of tricuspid annular displacement(TAD),based on twodimensional speckle tracking imaging, for assessment of right ventricular(RV)systolic function.Methods Eighteen patientswith dilated cardiomyopathy and 20 age-matched healthy volunteers were in volved. Twodimensional and real-time three-dimensional(RT3D)imaging were obtained in all patients at apical four-chamber view.The parameters of TAD were derived from off-line QLAB software.RT3D-RV ejection fraction(RVEF)was calculated by using 4D RV function software.Results TAD data were acquired in all 38 cases, while RT3D-RVEF was done in 30 out of 38.The parameters of TAD correlated well with RVEF(P<0.01).The parameters of TAD in dilated cardiomyopathy group were significantly lower than the corresponding values in healthy subjects (P<0.01).The intra-and interobserver variabilities for measurement of TAD were(0.49±2.69)mm and(0.21± 0.60)mm, respectively.Conclusions TAD,based on two-dimensional speckle tracking imaging,proved to be a rapid and reproducible method in determining RV global systolic function.