Objective To investigate the different characteristics of gastrointestinal migrating myoelectrical complex (MMC) of different origin in fasting state and the effects of motilin (MTL) and ursodeoxycholic acid (UDCA) on the MMC of the gastrointestinal tract of different origin in rats. Methods Three bipolar silver electrodes were chronically implanted on the antrum, duodenum and jejunum. Seven days later twenty-four experimental rats were divided into two groups. One group were injected with porcine MTL via sublingual vein, while the other group was perfused with UDCA into the stomach. The gastrointestinal myoelectrical activity was recorded one hour before and two hours after the test substances infusions on these conscious fasting rats. Results Among the total sixty-eight MMCs recorded in fasting rats under control, 67% started in the duodenum, and 33% started in the antrum. The MMC cycle duration and duration of phase Ⅲ of antral origin were longer than those of duodenal origin. Administration of porcine MTL could induce a premature antral phase Ⅲ of antral origin. However, perfusion into the stomach with UDCA resulted in a shorter MMC cycle duration and longer duration of phase Ⅲ of duodenal origin. Conclusion In fasting rats, MMC may originate from the antrum and duodenum, respectively. The different characteristics of MMC of different origin may contribute to the large variations within subjects. Pocrine MTL and UDCA can affect the MMC of different origin of the gastrointestinal tract in fasting state.

To explore the long-term effects of L-T4 treatment on physical and intellectual development in neonatal congenital hypothyroidism(CH) patients during adolescence and adulthood.14 out of 15 patients,aged 15-31 years old,including 9 males and 6 females,were diagnosed by neonatal screening for congenital hypothyroidism.(1) By treatment for 10 years until adolescence,return visit ages were 12.6-18.1 years old,the height of patients were normal in 14 cases,weight normal in 8 cases,and overweight in 6 cases.Only the first patient of neonatal screening for congenital hypothyroidism height 154 cm,weight of 43.5 kg,which were below the standard.Bone age by X-ray showed 9 normal,1 case of rapid development,4 cases with left wrist bone age retardation.IQ combined Raven's test(CRT) showed 3 cases excellent,7 cases normal,3 cases borderline,and 2 cases low.(2)Treatment for more than 20 years to adulthood,9 cases of return visits (8 cases were screened out) by 23-31 years of age,with 5 males and 4 females,height and bone age were all normal,normal weight,only 2 cases BMI slightly overweight.As to IQ,good were in 7 cases,mild retardation in 2 cases.7 patients received above average education;they were all employed except one.The employed patients were all capable for their jobs.In summary,screening out of 8 patients,1 case were of mild mental retardation (12.5％);while 7 patients(87.5％),both in physical and intellectual levels were as those of the normal population.

Objective To investigate the influential factors for the outcome of the first 131I therapy in patients with PTC after total thyroidectomy.Methods One hundred and fifty-nine patients (45 males,114 females,average age (43.4± 12.2) years) with PTC after total thyroidectomy who underwent 131I therapy from July 2014 to December 2015 were retrospectively analyzed.Curative efficacy was evaluated 6 months after 131I therapy.Therapeutic outcome was evaluated according to TSH stimulated Tg (sTg) level,Dx-WBS and evidences of other imaging modalities.Twelve possible factors affecting therapeutic outcome of 131I therapy,including patients' age,gender,time interval between thyroidectomy and 131I therapy,primary tumors size and extrathyroidal extension,number and range of primary tumor lesions,lymph node metastases in surgery,status of thyroid remnant in 99TcmO4-imaging,pre-treatment laboratory measurements (TSH,sTg and TgAb),131I therapeutic dose,results of Rx-WBS and SPECT after 131I therapy,were analyzed with univariate and multivariate logistic regression.ROC curve and diagnostic critical point were analyzed to evaluate the predictive value of influential factors for the outcome of 131I therapy.Results The cure rate of the first 131I therapy was 64.2％ (102/159).Univariate logistic regression analysis showed that age,gender,lymph node metastases,sTg and 131I therapeutic dose (all P＜0.01) were the influential factors for the outcome of 131I therapy.Multivariate logistic regression analysis showed that lymph node metastases (regression coefficient:1.118) and sTg (regression coefficient:0.314) were influential factors (both P＜0.05).The regression equation was:Logit P =-4.155+ 1.118×lymph node metastases+0.314×sTg (x2 =93.7,P＜0.001).Taking sTg as a predictive factor for the outcome of 131I therapy,the AUC of ROC curve was 0.926 (95％ CI:0.888-0.963).The cut-off value of sTg was 2.97 μg/L with a sensitivity of 94.7％ (54/57) and a specificity of 76.5％ (78/102).Conclusions PTC patients with low sTg levels and few lymph node metastases after total thyroidectomy are more likely to be cured in the first 131I therapy.

Objective:To explore the effects of small-group collaborative stratified teaching in critical care medicine training for professional postgraduate students.Methods:We randomly assigned 71 professional postgraduate students who entered the Intensive Care Unit of The Affiliated Hospital of Qingdao University for standardized training between June 2020 and November 2020 into experimental group and control group. An entrance examination was taken after one week of unified training. Then the experimental group adopted small-group collaborative stratified teaching, while the control group adopted traditional teaching for training. After two months of training, the Mini-Clinical Evaluation Exercise (Mini-CEX) assessment, post competency assessment, exit examination, and teaching satisfaction evaluation were conducted. SPSS 25.0 was used for the t test and chi-square test. Results:In the Mini-CEX assessment, the experimental group had significantly higher scores in history-taking skills [(7.42±0.60) vs. (7.00±0.55)], physical examination [(7.47±0.56) vs. (6.94±0.24)], communication skills [(7.56±0.50）vs.(7.24±0.49)], clinical dialectical thinking [(7.53±0.56) vs. (7.03±0.39)], clinical judgement [(7.50±0.51) vs.(6.90±0.42)], organization/efficiency [(7.58±0.50) vs. (7.15±0.44)], and overall clinical competence [(7.64±0.49) vs. (7.17±0.39); all P<0.05] than the control group. In the post competency assessment, the experimental group had significantly better performance in clinical basic competence [(89.15±9.12) vs. (86.24±10.23)], medical knowledge application [(48.37±5.87) vs. (46.98±3.68)], teamwork [(48.10±3.55) vs. (45.96±4.83)], information and management [(68.52±7.61) vs. (66.38±5.54)], and academic research [(22.18±0.95) vs. (20.87±1.22); all P<0.05] than the control group. The experimental group was also significantly superior to the control group in terms of the exit examination score and teaching satisfaction (both P<0.05). Conclusions:Small-group collaborative stratified teaching can improve the quality of critical care medicine training for professional postgraduate students, and strengthen their clinical comprehensive abilities and post competencies.

OBJECTIVETo explore the function of nucleotide-binding domain (NOD)-like receptor protein 3 (NLRP3) inflammsomes in liver damage after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODSThe study presented a murine (BALB/c-based) model of allo-HSCT. Chimera rate was measured by flow cytometry. The hematoxylin-eosin, Masson's trichrome, immunohistochemistry staining were used to observe the pathology changes in liver, then measured the degree of liver damage. Inflammation cells and NLRP3 were measured by Western blot, cytokines IL-1β, IL-18 and NLRP3 related genes were tested with real-time quantitative polymerase chain reaction (q-PCR).

RESULTSHematopoietic stem cells had been successfully transplanted, the chimera rate was geater than 97% on the 10th day. Liver damage occurred after allo-HSCT and suffered infiltration of inflammation cells, which reached the peak on day 15, then moved to moderate; the cytokines IL-1β, IL-18 had the similar trend with liver injury, and reached the highest level on day 15, their mRNA expressions increased by (1.19 ± 0.40) fold and (1.64 ± 0.76) fold, respectively; Meanwhile, caspase-1 had the similar trend, its mRNA expression increased by (3.51 ± 0.46) fold on day 15; the inflammasomes NLRP1, NLRP3, NLRC4 and NLRP5 expressed in liver on day 15 of post-allo-HSCT, and NLRP3 inflammasome expressed highest among them. The mRNA and protein level of NLRP3 inflammasomes were kept with the serious degree of the liver damage, its mRNA expression increased by (2.91 ± 0.41) fold on day 15.

CONCLUSIONNLRP3 inflammsome expressed in liver injury during allo-HSCT in mice, and may be one of the important factors contributed to liver injury.

Animals ; Carrier Proteins ; metabolism ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Inflammasomes ; metabolism ; Liver ; metabolism ; pathology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; NLR Family, Pyrin Domain-Containing 3 Protein ; Postoperative Period