Contemporary medical education not only demands medical students to master knowledge of medical science and to possess good professional ethics and advanced duty, but also possess comprehensive quality, especially nice humane quality. So it is necessity to medical students for growing them into medical talent of advanced quality.

BACKGROUND:The siphon of internal carotid artery is a complex of bending and surrounding structure, which has become a research hot in the field of medical imaging and regional anatomy. There is little research on the hemodynamics of internal carotid artery. Finite element analysis provides the basis for the related dynamics research. OBJECTIVE:To explicit the hemodynamic characteristics of the normal and stenosis internal carotid artery, and to explore the relevant influential factors. METHODS:Finite element model of the siphon of internal carotid artery was built based on 64-slice spiral CT data, and then, three-dimensional models were constructed using Mimics 10.01 software. There were simulations of the normal and post-stenosis blood flows with ANSYS 13.0 CFX software, to observe the changes of hemodynamics, and to analyze their characteristics and differences. RESULTS AND CONCLUSION:The normal blood flow at the siphon of internal carotid artery was in a laminar state, but rotation and turbulent flow formed at the two angle regions. The velocity of external bending zone was slower than that of the internal. The slower was the velocity, the more obvious was the turbulence. The wal shear force decreased at the angle regions, and the wal shear force of external bending zone was smal er than that of the internal. At the region of arterial stenosis, the blood flow was sped, and at the downstream, turbulent flow and low zone of wal shear force were formed. With the increase of stenosis severity, the turbulent flow and low wal shear force area were expanded. Central stenosis showed more obvious effects than the eccentric one. The degree of stenosis and bending at the siphon of internal carotid artery can directly influence the formation of turbulent flow and low wal shear force area, which are more obvious at the external bending zone and central stenosis.

Objective To investigate the influence of Chinese medicine ( CM) treatment on life span of middle-late primary hepatic carcinoma (PHC) patients. Results A multicenter retrospective cohort study was carried out in 489 PHC patients at the stages of Ⅱb, Ⅲa and Ⅲb collected from 15 domestic hospitals. With CM treatment as the exposure factor, the enrolled patients were divided into CM group, western medicine (WM) group and the CM-WM combination group. The main outcomes included median survival time (MST) and survival rate, and the effects of CM treatment and minimally invasive therapy on MST were observed. Results Half-a-year survival rate, one-year survival rate and two-year survival rate were 50%, 9%, 1% in CM group, 70%, 30%, 6% in CM-WM combination group, and 50%, 10%, 0% in WM group, respectively. The survival rates in CM-WM combination group differed from those in CM group and WM group (P<0.01), but the differences of survival rates between CM group and WM group were insignificant (P>0.05) . MST at the stages of Ⅱb, Ⅲa, Ⅲb in CM-WM group was obviously prolonged as compared with the other two groups (P<0.01), and MST at the stages of Ⅲa, Ⅲb in CM group was also obviously prolonged as compared with WM group (P<0.05) . The difference of MST at the stage of Ⅱb was insignificant between CM group and WM group ( P>0.05) . CM treatment and minimally invasive therapy were effective on prolonging the survival time of PHC patients ( P<0.01) . The results of COX regressionanalysis showed that Karnofsky scores, CM treatment and minimally invasive therapy were the preventive factors for the prognosis. Conclusion CM-WM combination group has the best long -term therapeutic effect. CM -WM combination treatment is effective on increasing MST and long-term survival rate, in particular for PHC patients at the stages ofⅡb, Ⅲa and Ⅲb. CM treatment and minimally invasive therapy are helpful for the prolongation of the survival time of PHC patients.

OBJECTIVE To detect genes sul1 and sul2 in Stenotrophomonas maltophilia,and their relationship to drug resistance to trimethoprim-sulfamethoxazole(SXT).METHODS K-B was carried out to detect the drug resistance to SXT of S.maltophilia;minimal inhibitory concentration(MIC) was measured with micro broth dilution method.Genes sul1 and sul2 were amplified by PCR.RESULTS Eight isolates(7.8%) showed resistance to trimethoprim-sulfamethoxazole,sul1 Was positive in four isolates in which one contained sul2 also.Four isolates showed high MIC to SXT.CONCLUSIONS Genes sul1 and sul2 of S.maltophilia are associated with the high drug resistance to SXT.

Objective This study aimed to estimate the impact of the threshold of Autocapture algorithm on the pacemaker's service life.Methods Seventy-four patients implanted with VVI pacemaker were retrospectively evaluated.Among them,48 were implanted with pacemaker of autocapture function.Diagnostic data were retrieved from device memory.Pacemaker's service life was estimated according to the working flow and voltage.Results (1) The average working voltage of the control group and the observation group was (2.8 ± 0.4) V and (1.1 ± 0.4)V respectively.The difference was statistically significant;(2) The battery life in the observation group was (12.59 ± 0.55) a,significantly longer than that in the control group (6.74 ± 1.12) a,with an 86.8％ increase of the device's estimated service life (P＜0.05).Conclusion The Autocapture function results in a significant service life of cardiac pacemaker and represents valuable clinical technology.

Objective:To summarize the experience of blood glucose management and nursing for a newborn with repeated hypoglycemia in Beckwith-Wiedemann syndrome.Method:A multidisciplinary team was formed, and formulated an individualized care plan for a large infant with Beckwith-Wiedemann syndrome. A dynamic blood glucose monitoring system was used to closely monitor blood glucose fluctuations for this children, dynamically adjusted the amount of infusion and milk according to the blood sugar situation, detected and dealed with hypoglycemia in time, strengthened the skin care of child and implemented psychological care for the family.Results:After refined treatment and care, the child′s vital signs were stable, and his blood sugar could maintain within a normal range before being discharged from the hospital.Conclusions:The use of dynamic blood glucose monitoring system under the guidance of a multidisciplinary team can effectively monitor and control the blood glucose fluctuations of children with BWS syndrome, which can provide a basis for further treatment of children.

OBJECTIVE: To determine the composition and distribution of beta-thalassemia-associated genotypes in Liuzhou area of Guangxi, China. METHODS: From January to December 2017, 13 847 individuals who came for premarital examination, maternity examination or health check were recruited with informed consent. The subjects were analyzed by reverse dot blotting (RDB) for 17 common beta-thalassemia-associated variants among the Chinese population. Individuals with inconsistent results by blood test, electrophoresis, and RDB were subjected to Sanger sequencing to detect rare variants of the beta globin gene. RESULTS: In total 2098 individuals were found to harbor beta-thalassemia-associated variants, which included 2075 heterozygotes (98.90%), 12 compound heterozygotes (0.57%) and 11 homozygotes (0.52%). CD41-42 (48.43%) and CD17 (31.45%) were the most common variants. Three hundred and thirty eight-individuals were found to also carry heterozygous variants of the alpha globin gene, with the most common types being --SEA/aa, -a3.7/aa, aCSa/aa, -a4.2/aa. Through Sanger sequencing, rare genotypes such as beta-32/betaN, betaCD41-42/betaIVS-II-5 and betaCD30/betaN were detected. CONCLUSION Liuzhou area has a high incidence of beta-thalassemia, but with a complex variant spectrum and clinical phenotypes different from other regions. Genetic counseling and prenatal diagnosis for the carrier population is crucial for the reduction of the related birth defects. Our result may provide valuable information for the prevention and control of beta-thalassemia in this area.
China ; Female ; Genetic Counseling ; Genetic Variation ; Genotype ; Humans ; Mutation ; Pregnancy ; Prenatal Diagnosis ; alpha-Globins ; genetics ; beta-Globins ; genetics ; beta-Thalassemia ; diagnosis ; genetics

Objective To observe the effectiveness and safety of Kang′ai injection combined with docetaxel or gemcitabine chemotherapy in treatment of elderly patients with advanced non-small cell lung cancer(NSCLC). Methods A multi-center,randomized and parallel control study was carried out in 150 elderly patients with ad-vanced NSCLC treated in 3 hospitals during the period from June 2013 to August 2014.The patients were randomly divided into platinum-based group(platinum-based doublet chemotherapy)and Kang′ai group(Kang′ai injection combined with single agent chemotherapy). The clinical efficacy,quality of life and adverse reactions were ob-served and compared between the two groups. Results There was no significant difference in the disease control rate between the two groups group(79.66% vs 81.82%)(χ2=0.101,P=0.751)while the effective rate of Kang′ai group was significantly higher than that of platinum-based group(30.51% vs 14.29%)(χ2=5.240,P=0.022). The effective rate of clinical symptom relief in Kang′ai group after treatment was significantly higher than that in platinum-based group(69.49% vs 48.05%)(χ2=6.278,P=0.012),and the increase rate of PS score in Kang′ai group after the treatment was also significantly higher than that in platinum-based group(18.64% vs 3.90%)(χ2=7.868,P=0.005).There was no significant difference in quality of life between two groups(P>0.05).The quali-ty of life score of Kang′ai group was significantly higher than that of platinum-based group at the second course of treatment(P<0.05).The incidence of adverse reactions in Kang′ai group was significantly lower than that in the platinum-based group(47.46% vs 71.42%)(χ2= 8.070,P < 0.05). Conclusion Kang′ai injection combined with single agent chemotherapy can effectively relieve clinical symptoms and reduce the tumor size in elderly patients with advanced NSCLC,with high safety.

Aim To investigate the effeot of Shenqi Fuzheng injection on the prevention of immune myocarditis induced by anti-PD-1 antibody by reducing the production of inflammatory factors and the expression of myocardial injury markers. Methods Thirty-two maie PD-1 humanized mice with C57BL/6 genetic background were randomly divided into control group, myocarditis model group, anti-PD-1 antibody group and Shenqi Fuzheng injection group (n = 8). Except the control group, mice in other groups were intraperitoneally injected with myocardial myosin heavy chain peptide (5 mg • kg

Objective:To summarize the clinical manifestations and gene mutation features of patients with nucleotide excision repair (NER) disorders.Methods:A retrospective analysis was made on clinical data of patients with NER disorders who were admitted to the Chinese People′s Liberation Army General Hospital from October 2008 to February 2022 and diagnosed in the Outpatient Department of Beijing Children′s Hospital, Capital Medical University from October 2015 to February 2022.Literature on previously reported Chinese patients with NER disorders was reviewed.Results:(1)A total of 16 patients with NER disorders were enrolled, including 6 males and 10 females.The onset age was 7.5 (4.0, 12.0) months and the age at diagnosis was 42.0 (21.5, 77.0) months.There were 3 types of NER disorders: Cockayne syndrome (CS) in 13 cases, Xeroderma Pigmentosum (XP) in 2 cases and Cerebro-Oculo-Facio-Skeletal syndrome (COFS) in 1 case.Four disease-causing genes were detected: CSA gene in 11 cases, CSB gene in 3 cases, XPG gene in 1 case, and XPD gene in 1 case.The first symptoms of the 16 patients were photosensitivity and developmental delay, and neurological symptoms were observed in all the 3 NER disorder types.XP and CS patients had skin symptoms.CS patients presented typical facial features, visual and auditory impairment, microcephaly and changes in neuroimaging features.COFS patients showed intrauterine growth retardation.(2)Results of literature review: a total of 96 Chinese patients reported were retrieved, involving 6 disease types, including CS in 45 cases, XP in 44 cases, trichothiodystrophy in 4 cases, COFS in 1 case, XP-CS in 1 case, and ultraviolet sensitive syndrome in 1 case.Nine mutated genes were identified: CSA in 33 cases, XPA in 15 cases, CSB in 13 cases, XPV in 10 cases, XPC in 9 cases, XPG in 7 cases, XPD in 7 cases, XPF in 1 case, and MPLKIP in 1 case.The common symptoms were growth failure (62 cases), skin photosensitivity (61 cases), typical facial features (52 cases), mental retardation (49 cases) and microcephaly (48 cases). Among 36 cases had imaging data 33 cases(91.7%)had calcification of basal nucleus or globus pallidus.Three cases had intrauterine growth retardation and microcephaly during pregnancy. Conclusions:Patients with such prenatal manifestations as intrauterine growth retardation and microcephaly or with typical symptoms like skin photosensitivity, typical facial features, growth failure, mental retardation, hypertonia, and calcifications of basal ganglia should be suspected of NER disorders.Early genetic testing is recommended to confirm the diagnosis.