Objective To investigate whether the effect of PBL is better than LBL when used in a new type of three phases labor trainee teaching. Methods 216 medical students of the five-year and seven-year program who took part in labor trainee in the 2013-2014 school year were chosen and divided into two groups:PBL group and LBL group. Both the two groups' labor trainee were performed as three phases: trainee preparation, delivery room trainee, and discussion-class after trainee. Ques-tionnaire investigations were used to evaluate the effect of the delivery room trainee and discussion-class in PBL group and LBL group. A quiz after the third phase was used to examine whether the teaching effect of the two groups is different or not. Statistical analysis was performed using SPSS 16.0 software. Count data between sample rates were compared by chi square test, mean data between the two groups were compared by t test, the inspection level is α=0.05. Results Both in the delivery room trainee and discussion-class after trainee, questionnaire score in PBL group was significantly higher than that in LBL group (P<0.05). The average of quiz score in PBL group was 25.7±2.1, which was significantly higher than that in LBL group (19.3±3.6) (P<0.05). The excellent rate in PBL group was 82.6%, which was also higher than that in LBL group (P<0.05). Conclusion PBL teaching method elevates learning initiative of medical students and increases the teaching effect, and it can be promoted in labor trainee teaching.

Objective To analyze the diagnostic value of serum procalcitonin ( PCT ) for early postoperative bacterial infection after pediatric living donor liver transplantation.Methods A retrospective study was conducted in pediatric patients after living donor liver transplantation recipients admitted to department of critical care medicine of Beijing Friendship Hospital affiliated to Capital Medical University during June 2013 to October 2015.According to the clinical data , all pediatric patients were divided into infection group(n=60) and non-infection group (n=100).Primary disease, PCT post operation day 1 to day 5 for non-infection group and day 1 to day 9 for infection group , temperature , white blood cell , cold ischemia time, warm ischemia time, operation time, volume of blood loss during operation were recorded.All parameters above were compared between groups.Receiver operating characteristic ( ROC) curve was plotted, and the diagnostic value of PCT was evaluated.Results PCT of both groups were elevated after liver transplantation , there was a markedly resolution in non-infection group within 48 to 72 hours.PCT of pediatric patients with bacterial infection was significantly higher than that of non-infected patients , and the difference was of greatly significant (4.62 ±1.39) ng/ml vs (0.85 ±0.19) ng/ml,t=26.56,P=0.00.ROC curve showed that the peak level of PCT might be valuable in the diagnosis of bacterial infection ( AUC=0.985).There was no significant difference of cold ischemia time [(109.92 ±19.22) min vs (108.04 ± 13.20) min, t=1.05, P=0.29], warm ischemia time[(1.49 ±0.17) min vs (1.52 ±0.12) min, t=1.08, P=0.28], operation time[(8.01 ±0.77)vs (8.00 ±1.05) h, t=0.06, P=0.94], WBC[(8.95 ±1.69) ×109/L vs (8.98 ±2.00) ×109/L,t=-0.08, P=0.93]and body temperature[(37.5 ±0.7) vs (37.5 ±0.8) ℃,t=-0.05, P=0.96] on the first day after surgery between infection and non-infection groups.Amount of bleeding in infection group was higher than that of non infection group [ ( 650.87 ± 90.36) ml vs (240.29 ±67.67) ml, t=32.33, P=0.00], there was longer length of ICU stay in the infection group[(11.01 ±1.81)d vs (6.03 ±1.65)d, t=17.78, P=0.00].Conclusion Peak PCT level was a valuable indicator for early postoperative bacterial infection after pediatric living donor liver transplantation.

Objective To investigate the epidemiological characteristics and mortality risk factors of severe sepsis patients admitted into intensive care unit (ICU).Methods The clinical data of 419 severe sepsis patients admitted to an adult ICU of Beijing Friendship Hospital from January 2009 to December 2012 were retrospectively analyzed and evaluated.Logistic regression analysis was employed to identify independent risk factors for the death of patients with severe sepsis during ICU stay.Results Overall ICU mortality was 43.9％ (184/419),and the respiratory tract was the most common site of infection (50.8％),followed by infection of the gastrointestinal tract and abdominal cavity (27.8％),and hematogenous infection (4.3％).Gram-negative bacteria were the most common pathogens [46.0％ (214/465)].Iatrogenic infections accounted for 53.7％ (225/419) of the enrolled patients.Logistic regression analysis showed that age [odds ratio (OR)=0.003,95％ confidence interval (95％CI) 1.015-1.056,P=0.O00],vasoactive drug application (OR=3.251,95％CI 1.562-6.768,P=0.002),failure of 3 or more organs (OR=2.452,95％ CI 1.015-5.924,P=0.046),and iatrogenic infection (OR =1.775,95％ CI 0.981-3.221,P=0.046) were independent risk factors for ICU mortality.Conclusions Severe sepsis is a common cause of ICU admission.Patients with risk factors for high mortality should be carefully monitored,and aggressive treatment should be administered.

Objective To study the inhibitory action of docetaxel (DOC) on the proliferation of HeLa and SiHa cells. Methods Cell morphological changes were observed with inverted phase contrast microscope. MTT was adopted to test and calculate the cell inhibition ratio. Flow cytometry was used to detect cell cycle. Results DOC had an obvious concentration-dependent inhibitory effect on the proliferation of both HeLa and SiHa cells. The inhibition ratio of DOC on SiHa was significantly higher than that on HeLa (P<0.05). DOC blocked HeLa at G2/M phase. Under the effect of DOC, the cell cycle of SiHa was not changed much. Conclusion DOC has an obvious inhibitory action on both HeLa and SiHa cells, which shows a promising prospect of DOC in clinical treatment of cervical cancer.

Objective: To investigate the influence of depression symtoms and related occupational stress on workers in chip manufacturing industry. Methods: By using cluster sampling method, 2 251workers in electronic manufacturing industry were selected as study subjects in July-December 2016. The simple Occupational Stress Questionnnaire and The Chinese version of Effort-reword imbalance questionnaire (ERI) Questionnnaire were used to investigate and evaluate their job demand-control-support questionnaire (JDC) and ERI Occupational stress stiuation respctively. Depression symptoms were measured by the depression module of the patient health questionnaire (PHQ-9) . Results: Among the 2 251 workers, 77.03% workers were found high level of depression symptom.486 workers were the highest level depression.1 248 workers were the higher level depression. The scores of depression symptoms in the related influceing factors JDC and ERI occupational stress were different (P<0.05) . The multivariate logistic analysis results indicated the main positve factors of depression were above college degree, more than 1 years of working age and high input (P<0.05) . The main protective factors of depression were non migrant workers and high return (P<0.05) . Conclusion The rate of depression of workers is relatively higher in chip manufacturing factory. Enterprises should pay special attention to workers who were above college degree, more than 1 years of working age and high input, ERI occupational stress.

Objective: To clarify the association between occupational exposure to wood dust and chronic obstructive pulmonary disease risk by a meta-analysis. Methods: A systematic search of the studies was conducted using 3 English databases (Pubmed, Embase, and Cochrane library) and 3 Chinese databases (CNKI, WanFang, and VIP) before March 2019. The following key words was used: 1) wood, 2) hardwood, 3) softwood, 4) saw, 5) dust, 6) chronic obstructive pulmonary disease, 7) chronic obstructive airway disease, 8) lung function. A quality score was evaluated by Newcastle-Ottawa Scale, NOS (Wells, 2012). Pooled effect value with 95% confidence interval (CI) was calculated using fixed-effect model (Heterogeneity test I²<25%) or random-effect model (Heterogeneity test I²≥25%). Meta-regression was used to explore heterogeneous source. Sensitivity analysis was used to verify the stability of the results. Publication bias was assessed by Egger＇s test. Fill and trim method was used to correct the pool effect value with 95%CI for studies which wit publication bias. The TSA threshold was calculated by the O＇Brien-Fleming loss function in the TSA data. The studies were evaluated based on the accrued information size (AIS) . Results: A total of 9 studies were included in the analysis. The occupational exposure to wood dust was not significantly associated with increased chronic obstructive pulmonary disease risk (ES=1.01, 95%CI: 0.856-1.194). TSA showed that the cumulative Z-value curve neither gone beyond the traditional (Z=1.96) threshold line, nor exceed the TSA threshold, but has reached the expected amount of information. This result was consistent with the meta-analysis. Conclusion This study does not yet consider that COPD is associated with occupational wood dust exposure.

Objective: To analyze the characteristics and influencing factors of new occupational diseases in Tianjin from 2008 to 2017, and to provide scientific basis for the formulation of prevention and control measures for occupational diseases in Tianjin. Methods: In 2018, data on the new occupational disease in Tianjin from 2008 to 2017 were collected from the China Disease Prevention and Control Information System. Statistical analysis was performed on the basic situation, the nature of the company, and the distribution of the industry. Results: A total of 5201 cases of occupational diseases were reported in Tianjin from 2008 to 2017, mainly including pneumoconiosis (92.37%) , followed by occupational poisoning (2.88%) , and the third occupational ENT disease (2.31%) . The male cases were higher than females, with a median age of 56 years and a median of 20 years of service. The most reported area was Hedong District (26.86%) . The economic type and scale of the cases belonged to state-owned large and medium-sized enterprises. The industry is mainly composed of non-metallic mineral products, and there are significant differences in the composition ratios of its economic type (χ²=19240.00, P<0.01) , enterprise size (χ²=3883.00, P<0.01) and industry (χ²=52050.00, P<0.01) . Conclusion Pneumoconiosis, occupational poisoning and occupational ENT diseases are the key prevention and control occupational diseases in Tianjin city. It is necessary to strengthen the prevention and control of occupational diseases in large and medium-sized state-owned enterprises, and to respond to occupational disease hazards in such key industries as the manufacturing industry so as to protect the health of occupational groups.

Objective:To explore the teaching effect of individualized teaching based on problem-based learning (PBL) that applied in gynecology practice teaching under the background of conflicts between postgraduate examination preparation and clinical internship for medical undergraduates.Methods:A total of 157 medical students of the five-year program who started gynecology internship and meanwhile prepared for the postgraduate entrance examination in 2018 were enrolled in the study and divided into two groups randomly. One group received traditional teaching (control group), and the other group received individualized teaching mode based on PBL (observation group). After the internship, the two groups of students were assessed for their theoretical and clinical skills, and the students' evaluation of the teaching effect was acquired through a questionnaire survey. SPSS 22.0 was used to perform chi-square test.Results:The students in observation group had statistically significant higher scores in theory and skill tests than those in the control group ( P<0.001). The evaluation of boosting their enthusiasm for internship, advancing self-learning ability, conducing to improving learning methods in the future, and enhancing clinical skills and thinking ability in the observation group was significantly better than that in the control group ( P<0.05). Conclusion:The individualized teaching model based on PBL could efficiently alleviate the conflicts between internship and postgraduate entrance examination preparation and improve the effect of gynecology practice teaching.

Objective:To analyze the incidence and risk factors of acute kidney injury in children with biliary atresia after liver transplantation.Methods:The retrospective case-control study was conducted.The clinical data of 115 children with biliary atresia who received liver transplantation for the first time in Beijing Friendship Hospital Affiliated to Capital Medical University from December 2018 to November 2020 were collected.The patients were divided into AKI group ( n=39) and non-AKI group ( n=76) according to the diagnostic criteria of the Kidney Disease Improving Global Outcomes(KDIGO). The differences of clinical indicators between the two groups were compared, and multivariate logistic regression analysis was performed for statistically significant variables ( P<0.05) to further determine the independent risk factors for AKI after liver transplantation. The measurement data of normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for comparison between groups.Measurement data with non-normal distribution were represented by M( Q1, Q3), and Mann-Whitney U test was used for comparison between groups.Count data were expressed as cases and percentage, and comparisons between groups were made using Chi-square test or Fisher′s exact test. Results:The incidence of AKI in biliary atresia patients after liver transplantation was 33.9%. Univariate analysis showed that there were statistically significant differences in age ( OR=0.721, 95% CI: 0.553-0.938, P=0.014), preoperative infection ( OR=3.307, 95% CI: 1.294-8.468, P=0.013), PELD score ( OR=1.065, 95% CI: 1.031-1.101, P<0.001), serum creatinine numerical value ( OR=0.745, 95% CI: 0.657-0.858, P<0.001), intraoperative red blood cell transfusion ( OR=1.034, 95% CI: 1.028-1.051, P<0.001) and intraoperative plasma transfusion ( OR=1.055, 95% CI: 1.025-1.086, P=0.002) between the AKI group and the non-AKI group ( P< 0.05). Multivariate logistic regression analysis was performed on the selected indicators by univariate analysis, and the results showed that preoperative infection ( OR=3.763, 95% CI: 1.185-11.945, P=0.025) and low serum creatinine ( OR=0.685, 95% CI: 0.570-0.823, P<0.001), intraoperative red blood cell transfusion ( OR=1.033, 95% CI: 1.015-1.056, P=0.028) was independently associated with postoperative AKI ( P<0.05). The inpatient treatment time in ICU and in hospital between the two groups were statistically significant ( P<0.05). Conclusions:Preoperative infection, low creatinine numerical value and intraoperative red blood cell transfusion are independent risk factors for postoperative AKI in children with biliary atresia. AKI may prolong the time in ICU and in hospital.

Objective:To assess the application effect of "internet + mobile medicine" on the process management of standardized residency training of obstetrics and gynecology.Methods:A total of 43 teachers including 14 administrators and 29 instructors who were not directly responsible for management, and 41 residents who participated in the standardized training in our base were enrolled as research objects. The data of process management were sorted by internet technology, and combined with personal wishes and casting lots, the residents were divided into two groups: the control group ( n=21) adopted traditional way while the observation group ( n=20) used mobile medicine for process management. By conducting multi-dimensional questionnaire and data comparison, we analyzed the evaluation of teachers and residents, the scores of different stage of residents, and the satisfaction of cervical cancer postoperative patients to medical care under different process management mode. SPSS 22.0 software was used for t test and chi-square test. Results:The application of "internet + mobile medicine" in standardized residency training obtained positive evaluation both by teachers and residents, and the ratio of considering "necessary" to reform the traditional residency training management mode in residents [95.1%(39/41)] and administrators [92.9%(13/14)] were both higher than that in instructors [62.1%(18/29)]. And 78.6%(11/14) of the administrators believed that cloud data management took less time. After 6 months of process management by different modes, the clinical diagnosis and treatment ability and skill operation ability scores of observation group were higher than those of control group [(93.6±5.6) vs. (89.4±5.7); (89.6±8.8) vs. (84.0±8.7)]. The "overall medical satisfaction rate" of cervical cancer patients was relatively high in both groups [100%(30/30) vs. 93.3%(28/30)], and the "very satisfied rate" of patients in the mobile medical group was higher than that in the traditional group [86.7%(26/30) vs. 63.3%(19/30)].Conclusion:The application of "internet + mobile medicine" is conducive to strengthening the process management and optimizing the quality of standardized residency training management of obstetrics and gynecology.