Objective To discuss the accuracy and objectivity of student standardized patients (SSP) in objective structured clinical examination(OSCE). Methods On March 30 and 31, 2013, 168 seven-year program medical students of class 2006 and 2007 took part in OSCE. Differences in as-sessment results between SPP and those given by professional doctors at 3 SP sites(angina pectoris SSP station, acute cholecystitis SSP station, depression SSP station) were analyzed. Each site had 4 items for assessment, with a total score of 100. Scores were given in strict accordance with a set of unified scoring rules. Counting data were presented as x±s. Data were verified using t test. P<0.05 was considered statis-tically considerable. Results At angina pectoris station, respective scores of SSP and professional physi-cians were 85.2±7.1 and 85.5±6.6, P=0.688. At acute cholecystitis station, respective score of SSP and professional physicians were 89.1±5.2 and 88.2±6.2, P=0.150. At depression station, respec-tive score of SSP and professional physicians were 79.8±7.5 and 78.2±7.0, P=0.078. Conclusion There is no statistical difference between scores given by SSP and those given by the physicians in OSCE. This proves that SSP who received standardized training delivers fair and accurate results in OSCE , and therefore is recommended for future application.

Objective: To evaluate the impact of food advertising on childhood obesity by reviewing relevant literatures, and to provide evidence support for childhood obesity prevention and control strategies in China. Methods: A systematic review method was used to search relevant literatures published to November 30，2020 from 8 databases including CNKI, VIP, Wanfang Data, PubMed, Medline, SpringerLink, Web of Science, Science Direct. The high quality systematic reviews published since 2016 were included directly, and those published before 2016 were rereviewed after combined with other literatures. Results: A total of 13 articles were included for evaluation, including systematic reviews, cohort studies, randomized controlled trials and cross sectional studies. Children s exposure to food advertisements could increase energy intake. Television food advertising could influence children s food choices and increase the consumption of unhealthy foods such as sweets and sugary drinks. Children s exposure to unhealthy food advertisements could increase the risk of obesity. Conclusion Regulating the food advertisement can help reduce the risk of childhood obesity.

Objective: To evaluate the impact of sugar sweetened beverages (SSBs) tax on childhood obesity by literatures reveiew, and to provide evidence support for childhood obesity prevention and control strategies in China. Methods: A systematic review method was used to search relevant literatures published to November 30，2020 from 8 databases including CNKI, VIP, Wanfang Data, PubMed, Medline, SpringerLink, Web of Science, and Science Direct. The high quality system reviews published since 2016 were included directly, and those published before 2016 were rereviewed before combined with other literatures. Results: Twelve studies including 5 systematic reviews (or Meta analysis), 1 cohort study and 6 cross sectional studies were included. Comprehensive analysis showed that the prevention effect on childhood obesity was small or even ineffective if the tax on SSBs lower than 5%, a certain protective effect on childhood obesity could be shown if the tax on SSBs increased to 20%. From the perspective of cost benefit analysis, the implementation of SSBs tax showed certain net benefits. Conclusion SSBs tax can help reduce the risk of childhood obesity.

Objective: To evaluate the impact of community built environment and the distribution of fast food restaurants on childhood obesity, and to provide evidence support for childhood obesity prevention and control strategies in China. Methods: A systematic review method was used to search relevant literatures published to November 30，2020 from 8 databases including CNKI, VIP, Wanfang Data, PubMed, SpringerLink, Web of Science, Science Direct. The high quality system reviews published since 2016 were included directly, and those published before 2016 were reviewed before combined with other literatures. Results: A total of 20 articles were included for evaluation, including systematic reviews, cohort studies, randomized controlled trials and cross sectional studies. High walkability near the living area could increase children s physical activity levels and reduce the risk of obesity. The fast food sales environment increased the risk of obesity; while large supermarkets or health food sales environment could reduce the risk of obesity. Conclusion Improving walking suitability in residential areas and reducing the density of unhealthy fast food sales could help decrease the risk of childhood obesity.

Objective:To explore the value of three-dimensional speckle tracking imaging (3D-STI) in the diagnosis of immunoglobulin light-chain cardiac amyloidosis(AL-CA) patients with normal left ventricular ejection fraction (LVEF).Methods:A total of 92 consecutive patients diagnosed with systemic immunoglobulin light chain amyloidosis(sAL) and with normal LVEF from October 2014 to January 2018 in Xijing Hospital were enrolled.Based on the diagnostic criteria of cardiac involvement, the patients were divided into AL-CA group (52 cases) and immunoglobulin light chain amyloidosis (AL) group (40 cases). The clinical data and serological markers of the patients were collected, the conventional echocardiography and full-volume three dimensional dynamic images were acquired, left ventricular global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) were analyzed using off-line TomTec software. The differences between the two groups were compared.Results:Compared with the AL group, the NT-proBNP of AL-CA group was significantly higher ( P<0.05) and there were no significant differences of the other serological indexes between the two groups(all P>0.05). Compared with the AL group, the maximal left ventricular wall thickness, left ventricular mass index, left atrial volume index, and E/e′ in the AL-CA group were significantly increased (all P<0.05). There were no significant differences of other conventional echocardiographic measurements between the two groups(all P>0.05). Compared with the AL group, GLS, GAS, and GRS were significantly lower in AL-CA group (all P<0.05); but there was no significant difference of GCS between the two groups( P>0.05). The ROC curve analysis showed that the cut-off values discriminating cardiac involvement were 16.09% for GLS, 36.54% for GAS and 31.90% for GRS. Conclusions:3D-STI measurements of left ventricular myocardial mechanics could detect cardiac involvement in patients with sAL amyloidosis, and provides a new method for diagnosis of AL-CA.

OBJECTIVE: To explore the pathogenesis of two fetuses from one family affected with Joubert syndrome (JS). METHODS: Whole exome sequencing was employed to screen potential mutations in both fetuses. Suspected mutations were verified by Sanger sequencing. Impact of intronic mutations on DNA transcription was validated by cDNA analysis. RESULTS: Two novel TCTN1 mutations, c.342-8A>G and c.1494+1G>A, were identified in exons 2 and 12, respectively.cDNA analysis confirmed the pathogenic nature of both mutations with interference of normal splicing resulting in production of truncated proteins. CONCLUSION The genetic etiology of the family affected with JS has been identified.Above findings have enriched the mutation spectrum of TCTN1gene and facilitated understanding of the genotype-phenotype correlation of JS.
Abnormalities, Multiple ; diagnosis ; genetics ; Cerebellum ; abnormalities ; Eye Abnormalities ; diagnosis ; genetics ; Humans ; Kidney Diseases, Cystic ; diagnosis ; genetics ; Membrane Proteins ; genetics ; Mutation ; Pedigree ; Retina ; abnormalities ; Whole Exome Sequencing

Objective:To preliminarily investigate the effect of circIGF2BP3 on autophagy in photoaged dermal fibroblasts.Methods:Human dermal fibroblasts were isolated from circumcised foreskin tissues from 6 children in the Department of Urological Surgery, Third Affiliated Hospital of Sun Yat-sen University. An ultraviolet A (UVA) -induced photoaged human dermal fibroblast model (UVA radiation group) was established by repeated UVA radiation at a dose of 10 J/cm 2 for 14 consecutive days, and human dermal fibroblasts receiving no treatment served as control group. The photoaged cell model was verified by β-galactosidase staining, Western blot analysis for determining P21 protein expression, and cell counting kit-8 (CCK8) assay for evaluating cell viability. Moreover, Western blot analysis was performed to determine the protein expression of autophagy-related proteins P62, microtubule-associated protein 1 light chain 3 (LC3) -Ⅰand LC3-Ⅱ in photoaged human dermal fibroblasts, and real-time quantitative RCR (qRT-PCR) to verify the differential expression of circIGF2BP3 between photoaged and normal human dermal fibroblasts. Furthermore, circIGF2BP3 was biologically annotated. Some cultured primary human dermal fibroblasts were divided into 4 groups: empty vector group transfected with an empty vector, UVA + empty vector group transfected with an empty vector followed by repeated UVA radiation, circIGF2BP3 group transfected with a circIGF2BP3-overexpressing lentiviral vector, UVA + circIGF2BP3 group transfected with a circIGF2BP3-overexpressing lentiviral vector followed by repeated UVA radiation. Western blot analysis was performed to determine the expression of autophagy-related proteins. Statistical analysis was carried out by using t test, one-way analysis of variance and least significant difference- t test. Results:Compared with the control group, the UVA radiation group showed significantly increased proportions of β-galactosidase-positive cells (61.33% ± 5.78% vs. 6.37% ± 0.32%, t = 9.49, P < 0.01) and P21 expression (1.25 ± 0.03 vs. 1.00 ± 0.05, t = 4.26, P < 0.05), but significantly decreased cell viability (74.33% ± 3.48% vs. 100%, t = 7.38, P < 0.01). Moreover, the P62 expression and LC3-Ⅱ/Ⅰ ratio were significantly higher in the UVA radiation group than in the control group (both P < 0.05). The relative expression of circIGF2BP3 was 0.72 ± 0.04 in the photoaged human dermal fibroblasts, which was significantly lower than that in the normal human dermal fibroblasts (1.00 ± 0.03, t = 5.46, P < 0.01). The P62 expression and LC3-Ⅱ/Ⅰ ratio were significantly lower in the circIGF2BP3 group (0.60 ± 0.01, 0.71 ± 0.01, respectively) than in the empty vector group (1.00 ± 0.02, 1.00 ± 0.01, t = 16.25, 2.75, P < 0.01, < 0.05, respectively), and lower in the UVA + circIGF2BP3 group (1.05 ± 0.02, 2.04 ± 0.05, respectively) than in the UVA + empty vector group (1.31 ± 0.02, 2.72 ± 0.14, t = 10.493, 6.472, respectively, both P < 0.01) . Conclusion:circIGF2BP3 can regulate autophagy in UVA-induced photoaged dermal fibroblasts, which provides a new potential therapeutic target for the prevention and treatment of skin photoaging.

Objective:To investigate how medical staff recognize and understand the nursing quality evaluation in robot-assisted arthroplasty so as to provide reference and evidence for construction of a nursing quality evaluation system for robot-assisted arthroplasty.Methods:The descriptive phenomenological research method was used for this qualitative research. From May to October, 2021, 6 doctors and 9 nurses from Operating Room, Laoshan Campus, Hospital Affiliated to Qingdao University were interviewed in a semi-structured way about the nursing quality evaluation for robot-assisted arthroplasty. The data were sorted out by Nvivo12.0 qualitative analysis software, and the interview data were analyzed while the themes and topics refined according to the Colaizzi seven-step analysis of phenomenological data.Results:Three themes were extracted. ① The first theme was related to the quality evaluation of nursing structure, including 2 topics: nursing staff allocation and nursing quality management in operating room. ② The second theme was related to the quality evaluation of nursing process, including 4 topics: environment and facilities, nosocomial infection control, management of patients' operative safety, and specialized operative nursing. ③ The third theme was related to the quality evaluation of nursing outcomes, including 3 topics: satisfaction for operating room nursing, incidence of adverse events and patients' benefits.Conclusion:The themes and topics for nursing quality evaluation in robot-assisted arthroplasty extracted from the perspective of medical staff can provide reference for construction of a reasonable, scientific, efficient and comprehensive nursing quality evaluation index system.

Objective To investigate the independent influences on the occurrence of ICU Acquired Weakness(ICU-AW)in elderly patients undergoing third-and fourth-level surgeries,to construct a prediction model and draw a column-line diagram,and to internally validate the model.Methods A convenience sampling method was used to select 186 elderly patients undergoing tertiary and quaternary surgeries who were hospitalized in 3 tertiary A hospitals in Beijing from May to December 2022 as the study subjects.Single-factor and multifactor logistic regression were used to analyze the risk factors for ICU-AW in elderly patients undergoing third-and fourth-degree surgeries.A risk prediction model was established and the model was visualized by drawing a column-line diagram,and the receiver operator characteristic curve(ROC)and the Hosmer-Lemeshow tests were applied to verify the predictive effect of the model.Results ICU-AW occurred in 40 of 186 cases in the modeling group,with an incidence rate of 21.5％.The results of univariate analysis showed that the 2 groups of preoperative physiology score and surgical severity score included in the physiology and surgical severity scoring system,age,presence of cardiac disease,hemoglobin(within 24 h of admission to the ICU),blood urea nitrogen(within 24 h of admission to the ICU),blood creatinine(within 24 h of admission to the ICU),presence of braking,mode of establishment of mechanical ventilation,presence of nutritional therapy,number of sedative or analgesic drugs used,whether vasoactive drugs were used,whether diuretics were used,and the level of hemoglobin,blood urea nitrogen and blood creatinine within 24 h after admission to ICU the difference is statistically significant(P＜0.05).The results of multifactorial logistic regression analysis showed that preoperative physiology scores included in the physiology and surgical severity scoring system,the presence of cardiac disease,the presence of braking,the presence of nutritional therapy,and the number of sedative or analgesic medications used were the predictors of the occurrence of ICU-AW in elderly patients undergoing third-and fourth-degree surgeries(OR were 1.364,2.344,5.568,5.823,1.109,all P＜0.05).The above 5 factors were plotted as independent variables in a column-line graph,and the area under the ROC curve of the model was 0.859(95％CI 0.793～0.924),with an optimal critical value of 0.156,a sensitivity of 0.875,a specificity of 0.705,and a Hosmer-Lemeshow goodness-of-fit test of x2=3.906,P=0.865,Brier score of 0.109,and a decision analysis curve indicating that patients could benefit.Conclusion The predictive effect of the constructed model is good,and it can be used as a reference for early and rapid identification of the risk of ICU-AW in elderly patients undergoing third-and fourth-degree surgeries by clinical staff,and timely provision of preventive intervention programs.