Competition of teaching skills is regarded as an effective means to develop teacher's ability in teaching.This article briefly described a teaching competition at a medical school from participant identification,requirement clarification,training before competition,evaluation index screening and interviewer selection.Meanwhile the article further analyzed and analyzed the problems arising from the competition and proposed measures to promote teachers' awareness and ability of teaching.

107 copies/mi group. Conclusion: The presence of high amount of HBVDNA in serum is associated with suppressed co-stimulatory and regulatory effect of IL-12 to Th1/Th2 profilation

To explore the relationship between the serum vascular endothelial growth factor (VEGF) level and the severity of obstructive sleep apnea hypopnea syndrome (OSAHS), the concentrations of serum VEGF in 40 OSAHS patients and 9 healthy controls were measured by using ELISA method. Meanwhile the correlation between the concentration of VEGF and parameters of polysomnography (PSG) was examined. Our results showed that the concentrations of VEGF were significantly higher in OSAHS patients with severe hypoxia (536.8+/-334.7 pg/mL) than in those with mild hypoxia (329.2+/-174.7 pg/mL) and healthy controls (272. 8+/-211.0 pg/mL) (P<0.05 for both). The concentrations of VEGF were also significantly higher in OSAHS patients with hypertension (484.5+/-261.4 pg/mL) than in those without hypertension (311.0+/-158.4 pg/mL) and healthy controls (272. 8+/-211.0 pg/mL) (P<0.05 for both). There was a positive correlation between the concentration of VEGF and the apnea hypopnea index (AHI) (r=0.34, P<0.05). It is concluded that the concentration of the serum VEGF is positively related to the severity of OSAHS. The elevated serum VEGF level may be involved in the pathogenesis of the complications of obstructive sleep apnea hypopnea syndrome.

Objective To evaluate the efficacy and safety of frequently nebulized hypertonic saline(HS) in different concentration with Terbutaline in infants with moderate to severe bronchiolitis.Methods A total of 195 infants were randomly enrolled to either Group A(5% HS 4ml+Terbutaline 2.5mg,n=65),Group B(3% HS 4ml + Terbutaline 2.5mg,n=65) or Group C[0.9% normal saline(NS) 4ml + Terbutaline 2.5mg,n=65].All the infants were given inhalation treatment q6h after admission for 4 times,and then q8h till the remission of wheezing.The primary outcome was the hospital length of stay(LOS),and the secondary outcomes were the clinical severity score(CSS),remission time of wheezing,cost and side effects.

Objective To determine whether recombinant adeno-associated virus serotyoe 9 with CaMEK gene transfected on myocardial cells leads to reduce I/R-induced apoptosis.Methods Establish an ischemic/reperfusion(I/R) model of myocardial cells in vitro and the cells were divided into four experimental groups:(1) control group;(2) I/R group;(3) I/R+rAAV9-CBA-CaMEK group;(4) I/R+rAAV9-CBACaMEK+PD98059 group,respectively.The P-ERK1/2 and the Caspase-3,Bax were quqntitated by Western blot.Results These data clearly demonstrate that AAV9-mediated CaMEK gene transfected lead to active ERK1/2 and reduce I/R-induced apoptosis notablely.Conclusion rAAV9-mediated CaMEK gene transfected on myocardial cells can reduce I/R-induced apoptosis.

Objective To analyze the relationship between genotype and phenotype in 3 pedigrees with Stargardt disease.Methods Three pedigrees with Stargardt disease were included in Ningxia Eye Hospital from January 2017 to September 2017.The clinical features of patients and other family members were evaluated by ophthalmic examinations,including visual acuity,best corrected visual acuity (BCVA),fundus examination,optical coherence tomography (OCT),fundus fluorescein angiography (FFA) and electroretinogram (ERG).The periphery blood sample of 5 ml from patients and 1 family member with normal phonotye in each family were collected.The next generation sequencing,PCR and direct sequencing were used to confirm the disease-causing mutation.The relationship between genotype and phenotype was analyzed.This study was approved by Ethic Committee of Ningxia Eye Hospital and informed consent was obtained from each subject.Results In 3 Stargardt pedigrees,2 pedigrees showed autosomal recessive inheritance,and 1 pedigree was pseudodominant inheritance.Five mutations on ABCA4 gene were detected and p.F2188S and p.Y345C were novel muations.All pedigrees carried two heterozygous mutation.The onset age of the patients were adolescence except just one patient who suffered at the age of 50 years old.The visual acuity was severely affected and the OCT indicated different degrees of macular atrophy.The results of the ocular fundus photography and the FFA were variable.Conclusions The patients with stargardt disease often carry heterozygous mutation on ABCA4 gene and available characteristics,including early onset age,varying ocular fundus and severe visual impairment.Next generation sequencing technique shows the advantages of rapid and high efficiency in the diagnosis of Stargardt disease.

A 51-year-old male patient was presented to our hospital for inspection of right renal space-occupying lesions. CT revealed soft tissue density in the right renal pelvis and renal pelvis ureter transitional crumb, for which a clinical diagnosis of right renal cancer was made. After laparoscopic radical resection of the right kidney, pathological examination supported the diagnosis of idiopathic retroperitoneal fibrosis. With an unclear pathogenesis, idiopathic retroperitoneal fibrosis presents with atypical clinical manifestations but shows specific features in imaging examination. Its treatment is individualized according to the specific condition for which conservative medical or surgical treatment can be considered. Retroperitoneal fibrosis has a low incidence and a high misdiagnosis rate, and imaging examinations remain currently the primary modality for diagnosis with specific findings.
Diagnostic Errors ; Humans ; Kidney Neoplasms ; Kidney Pelvis ; pathology ; Male ; Middle Aged ; Retroperitoneal Fibrosis ; diagnosis ; Ureter ; pathology

Objective:To investigate the incidence of delayed onset of lactogenesis Ⅱ (DOL Ⅱ) in mothers of preterm infants and its influencing factors.Methods:This retrospective cohort study involved women who delivered prematurely at the Department of Obstetrics of the First Affiliated Hospital of Zhengzhou University from September 2021 to March 2022. Demographic and perinatal data of the subjects were collected. According to lactation outcome on the third day after delivery, these women were divided into DOL Ⅱ and non-DOL Ⅱ groups. The two groups' differences in general conditions were compared, and the potential factors influencing DOL Ⅱ were also analyzed. Chi-square test, two independent samples t-test, Mann-Whitney U test, and logistic regression analysis were used for statistical analysis. Results:There were 286 mothers of premature infants enrolled in this study, and 73 (25.5%) of them experienced DOL Ⅱ. The other 213 cases without DOL Ⅱwere included as the non-DOL Ⅱ group. Univariate analysis showed significant differences between the DOL Ⅱ and non-DOL Ⅱ groups in the following aspects: the proportion of women with adverse pregnancy history [28.8% (21/73) vs 41.8% (89/213), χ2=3.89], the proportion of primiparas [60.3% (44/73) vs 38.0% (81/213), χ2=10.93], the incidence of hypertensive disorders of pregnancy [35.6% (26/73) vs 16.4% (35/213), χ2=11.92], the time to initiate breastfeeding after birth[5.0 h (3.0-7.0 h) vs 4.0 h (2.0-5.0 h), Z=－4.27], and the frequency of breastfeeding or pumping within 48 h after delivery [7.0 times (6.0-9.0 times) vs 9.0 times (7.0-11.0 times), Z=－3.62] (all P<0.05). Multivariate logistic regression showed that primipara ( OR=2.720, 95% CI: 1.485-4.982), hypertensive disorders of pregnancy ( OR=3.178, 95% CI: 1.609-6.274), the time to initiate breastfeeding ( OR=1.394, 95% CI: 1.211-1.604) and the frequency of breastfeeding/pumping within 48 h after delivery ( OR=0.861, 95% CI: 0.772-0.962) were independent influencing factors for DOL Ⅱ (all P<0.05). Conclusions:?The factors that influence the occurrence of DOL Ⅱ in preterm mothers are primipara hypertensive disorders of pregnancy, breastfeeding initiation time after delivery, and the frequency of breastfeeding or pumping within 48 h postpartum.

Objective:To explore the risk factors of delayed onset of lactogenesis stage Ⅱ(DOL Ⅱ) after cesarean section, and to establish a risk prediction model.Methods:This study involved 330 women who underwent cesarean section in the First Affiliated Hospital of Zhengzhou University from September 2021 to January 2022 and were further divided into DOL Ⅱ group ( n=104) or non-DOL Ⅱ group ( n=226). All clinical data were compared. Univariate analysis and multivariate logistic regression were used to analyze the independent risk factors of DOL Ⅱ after cesarean section to establish the risk prediction model and draw nomogram. The predictive validity of the model was evaluated by the area under the receiver operating curve (AUC) and the goodness of fit was verified by Hosmer-Lemeshow test. Another 129 women who underwent cesarean section in our hospital from February to March 2022 were recruited for external validation. Results:The incidence of DOL Ⅱ in the model development and validation cohort were 31.5%(104/330) and 31.0%(40/129), respectively . In the model developing cohort, significant differences were shown in the constituent ratio of different groups of pre-pregnant body mass index {lean:[9.7%(22/226) vs 3.8%(4/104)]; fit: [66.8%(151/226) vs 62.5%(65/104)]; overweight or obsess:[23.5%(53/226) vs 33.7%(35/104)]}, the proportion of primiparas [50.4%(114/226) vs 61.5%(64/104)], breastfeeding education during pregnancy [64.2%(145/226) vs 40.4%(42/104)] and maternal separation [36.3%(82/226) vs 50.0%(52/104)], and the gestational age at delivery[38.0(36.0-39.0) vs 37.0(35.0-38.5) weeks] and frequency of breastfeeding within 48 h post-delivery [6.0(3.0-9.0) vs 2.0(0.5-5.0)] between the DOL Ⅱ and non-DOI Ⅱ group (all P<0.05). The predictors included in the model were pre-pregnancy overweight or obese ( OR=4.040, 95% CI:1.196-13.651), primipara ( OR=1.866, 95% CI:1.079-3.227), breastfeeding education during pregnancy ( OR=0.582, 95% CI:0.339-1.000), and frequency of breastfeeding within 48 h after delivery ( OR=0.791, 95% CI:0.720-0.857). The Hosmer-Lemeshow test showed that P=0.814 and the AUC was 0.784(95% CI:0.731-0.837). The Youden index was 1.504 with a sensitivity of 0.769 and a specificity of 0.735. While for the external validation, Hosmer-Lemeshow test showed that P=0.260 and the AUC was 0.751(95% CI:0.661-0.840). The Youden index was 1.460 with a sensitivity of 0.775 and a specificity of 0.685. Conclusion:The risk prediction model for DOL Ⅱ developed in this study has a good consistency and predictive performance, which can provide a reference for clinical screening of mothers at high risk of DOL Ⅱ following cesarean section.

This study compared the efficacy and safety of tiotropium bromide inhalation powder (spiriva) and doxofylline oral tablet (doxofylline) in the treatment of chronic obstructive pulmonary disease (COPD). A multi-center, randomized, double-blind, double-dummy, parallel-controlled study involved 127 eligible stable moderate to severe COPD patients treated with inhaled tiotropium dry powder (18 μg/day) or oral doxofylline tablets (0.2 g/time, 2 times a day) for 12 and 24 weeks. Before and after treatment for 12 weeks and 24 weeks, respectively, pulmonary function, 6-min walking distance and dyspnea index were recorded. The results showed that in both tiotropium group and doxofylline groups, after 12-week treatment, FEV(1), FEV(1)/FVC% and 6-min walk distance were significantly higher than those before the medication, while dyspnea index decreased as compared with that before treatment. After 24-week treatment, a slight improvement in the measures was observed as compared with that of 12-weeks treatment, but the difference was not statistically significant. With both 12-week and 24-week treatment, the effect of tiotropium was slightly better than that of doxofylline tablets, with the difference being statistically insignificant. The major adverse events in the tiotropium group and doxofylline group were observed in 9 cases (9.9%) and 12 cases (12.9%), respectively, and no statistically significant difference was found between them. We are led to conclude that both tiotropium at 18 μg a day and doxofylline tablets at 0.2 g/day (two times a day) are effective and safe for the treatment of COPD.