Objective To study the effectiveness of niacinamide in treating maintenance hemodialysis patients with hyperphosphatemia.Methods It was a prospective and randomized controlled trial.Patients with hyperphosphatemia (serum phosphate ＞ 1.45 mmol/L) were randomly assigned into two groups:control group (continue their original phosphate binder and rocaltrol treatment) and niacinamide therapy group (additionally received niacinamide,titrated from 600 mg/d to 1200 mg/d).The treatment lasted for 8 weeks.Serum phosphate and calcium were tested every 2 weeks and normalized protein catabolic rate and other relevant indexes were tested monthly.Results 100 patients were recruited and 93 of them completed the trial,including 44 from the therapy group and 49 from the control group.By the repeated measures analysis of variance,changes of serum phosphate in two groups displayed a statistical significant difference,but the levels of serum calcium in both remained steady.At the end of trial,compared to control group,therapy group appeared decreased serum phosphate levels [(1.59±0.36) mmol/L vs (1.94±0.25) mmol/L,P ＜ 0.001] and increased serum HDL levels [(1.32±0.54) mmol/L vs (1.09±0.41) mmol/L,P=0.02].Meanwhile,two groups showed no significant difference in intact parathyoid hormone and alkaline phosphatase.Adverse reactions including thrombocytopenia and gastrointestinal dysfunction were observed in niacinamide therapy group.Conclusions Niacinamide is effective on controlling hyperphosphatemia along with phosphate binder in maintenance hemodialysis patients.It also increases the serum HDL levels.Nonetheless,it is important to monitor the number of platelet.

Gynecology and obstetrics is a theoretical and practical subject. It is an important goal for the medical students to develop the clinical thinking ability and operating skills and apply them in the diagnosis and treatment of disease. To overcome the limited teaching resources, the rare clinical skills opportunities caused by doctor-patient relationship tension, virtual patient (VP) combined with clinical teaching was applied in clinical teaching, which can reproduce the real, and bring the students to the role of the clinician , enrich the content of the obstetrics and Gynecology clinical teaching. Along with the reform the teaching faculty with high quality was established, their clinical teaching experiences and innovative thinking were improved significantly. The results were evaluated by means of clinical comprehensive ability test. The present study aimed to establish virtual patients of OBGYN (virtual patient, VP) learning to promote learning of basic knowledge, clinic skills, and thinking ability.

Objective To investigate the empathic abilities and the association between empathic abilities and executive function in schizophrenic patients. Methods Empathy with the Interpersonal Reactivity Index-C (IRI-C) and executive function with Wisconsin Card Sorting Test (WCST) , Stroop Color-Word Task (Stroop), Spatial n-back Task (n-back) were applied to 74 schizophrenic patients and 69 healthy controls. Results Compared with healthy controls, schizophrenic patients showed significantly lower total scores ((46. 8 ± 10. 0) vs (51.5 ±9.7), P<0.01),and subscores in Perspective Taking ((9.5 ±4.2) vs (12.2 ±3.9) , P<0. 01), Fantasy ((12.5 ±4.2) vs (15.5 ±3.8), P<0.01) and Empathic Concern((15. 9 ±4.2) vs (17. 3 ±3.4), P< 0.05) ,but higher subscore((8.8 ±5. 1) vs (6.5 ±3.7), P<0.01) in personal distress of IRI-C. A significant difference(P<0.01) were fund on the scores of WCST, Stroop task and n-back task between schizophrenic patients and healthy controls. Pearson correlation analysis showed that the total scores of IRI-C was negatively correlated with the response administered (Ra), the number of responses errors (Re) and non-perseverative errors (nRpe) of WCST (r= -0.293, r= -0.253, r= -0.272, P<0.05) respectively, that empathic concern sub-score of IRI-C was negatively correlated with Ra, Re, perseverative responses (Rp) and perseverative errors (Rpe) of WCST (r= -0.326, r= -0.300, r= -0.294, r= -0.287, P<0.01 -0.05) respectively , but positively correlated with Rfp. of WCST (r=0.279, P<0.05), and that the fantasy subscore of IRI-C was negatively correlated with the reaction time of B part(r= -0.299, P<0.01) and C part (r= -0.322, P<0.01) of the Stroop task. Conclusion Schizophrenics have a general impairment of empathy and executive function,and affective empathy is related to the executive function, suggesting that the impairment of executive function maybe the one of pathological mechanism for the empathic deficit of patients with schizophrenia.

Objective:To explore the efficacy of a flat ground exoskeleton robot in improving the walking ability of stroke survivors.Methods:Fifty-eight stroke survivors with mobility difficulties were randomly divided into a robot group ( n=29) and a control group ( n=29). In addition to routine rehabilitation, the control group received conventional walking training, while the robot group underwent exoskeleton robot-assisted gait training. The 30-minute training sessions were held twice a day, 5 days per week for 5 weeks. Before as well as after 2 and 4 weeks of treatment, everyone′s walking ability was tested using the 6-minute walk test (6MWT) and functional ambulation scale (FAC). General lower limb motor function was quantified using the Fugl-Meyer Lower Extremity assessment (FMA-LE). Moreover, gait analysis was conducted before and after 4 weeks of treatment. Results:After 2 and 4 weeks of treatment, the average 6MWT times of both groups were significantly better than before the treatment, with the improvement of the robot group significantly greater than that of the control group after 2 weeks. After 2 and 4 weeks the average FMA-LE and FAC scores of both groups had improved significantly compared with before treatment. After 4 weeks the stride frequency and gait cycle of both groups had improved significantly.Conclusions:Exoskeleton robot-assisted gait training can improve walking ability and lower limb motor function of stroke survivors about as well as conventional walking training.

Objective To explore the effect of seminar based on case-based learning(CBL)in practical teaching of physical therapy. Methods From July,2021 to June,2022,42 rehabilitation therapy students for internships in Rehabilitation Medicine Center,the First Affiliated Hospital of Nanjing Medical University were non-directionally recruited,and random-ly divided into control group(n = 21)and experimental group(n = 21).The experimental group received instruc-tion using seminar and CBL,while the control group received CBL alone,for three months.The scores of theoret-ical and practical assessments were observed,and the satisfaction was investigated using a self-designed question-naire. Results The scores of both theoretical and practical assessments were better in the experimental group than in the control group(t>2.421,P<0.05);while the satisfaction was better in terms of motivating learning enthusiasm,enhanc-ing learning abilities,cultivating clinical reasoning skills,improving teacher-student communication,promoting teamwork,enhancing overall competence,and satisfying to the teaching in the experimental group than in the control group(χ2>6.667,P<0.05). Conclusion The combination of seminar with CBL would enhance the effect of practical teaching in physical therapy.