After years of respiratory medicine clinical practice teaching , we have discovered that there exist some problems such as teachers' job burnout, teachers' lowprofessional knowledge level of clinical teaching and lack of teaching ability, medical students' fear, low self-esteem, psycho-logi-cal fear and emotional weariness breeding as well as the patients and their family members ' refusal of practice because of their worrying about being a test and so on. To solve these problems , we have put forward some proposals such as recognizing and rewarding teachers to affirm their teaching levels , organizing teachers to participate in academic conferences, seminars, etc. to expand their professional knowledge in order to improve their overall quality. And at the same time, we have adopted PBL teaching method, applied multimedia technology and network platforms, put emphasis on basic skills training, the improvementof departmental rotation assessment, the establishment of teaching files and doctor-patient communication and other ways to improve clinical teaching quality and develop interns' clinical thinking ability to help them transitto clinicians.

Objective: To understand the relationship between eye strain and eye health behavior in college students learning at home during the period of COVID-19 epidemic, and to provide a scientific reference for improving the hygiene of using eyes among the college students. Methods: A cross sectional study and stratified cluster sampling was used to select 2 671 college students from 8 colleges in Anhui Province during the March 1st to July 1st in 2020, and an online questionnaire was survey included general information,eye strain,and daily eye health behavior. Results: The prevalence of eye strain in college students was 69.64%. Multivariable Logistic regression analysis showed that eye strain was correlated with gender, myopia, siesta habit, staying up until 2:00 am, and the use of eye liquid, with OR values(95% CI ) were 0.64(0.53-0.76), 1.77(1.42- 2.20 ),0.71(0.59-0.86), 1.39(1.17-1.65), and 2.18(1.71-2.79), respectively. There was no correlation among daily outdoor activity time, daytime reading time and the occurrence of eye strain( P >0.05). Conclusion During the period of COVID-19 epidemic, eye strain among college students is common. The daily eye health behavior is related to the occurrence of eye strain. Under the special learning context, eye care measures should be encouraged specifically.

The link between nonresolving inflammation and cancer is well documented. On the one hand, epidemiologic evidence supports that approximately 25% of all human cancer worldwide is caused by nonresolving inflammation. On the other hand, inflammatory cells are found in the microenvironment of most, if not all, tumors. In the tumor micro-environment, inflammatory cells and molecules influence almost every aspect of cancer. MicroRNAs (miRNAs) participate in the initiation and progression of nonresolving inflammation-related cancer by regulating the key genes and related signaling pathways. Further investigation into the molecular mechanisms by which miRNAs carry out their functions will be of great value in the prevention, early diagnosis, and treatment of tumors.
Chronic Disease ; Humans ; Inflammation ; complications ; genetics ; immunology ; Inflammation Mediators ; immunology ; MicroRNAs ; genetics ; Neoplasms ; etiology ; genetics ; Tumor Microenvironment

Background: Acne vulgaris (AV) is a common adolescent skin condition which is mainly caused by Cutibacterium acnes overcolonization and subsequent inflammation. Objective: Our previous studies demonstrated that ethanol extracts of Meconopsis quintuplinervia Regel (EMQ) possess significant antimicrobial properties. However, their protective effects and potential mechanisms against AV remain unclear. Methods: In the present study, the EMQ treatment potential for AV was evaluated in a C.acnes-induced mouse ear edema model, and the EMQ anti-inflammatory mechanism was evaluated in lipopolysaccharide (LPS)-induced RAW264.7 macrophage cells. Results: The results showed that EMQ alleviated edema formation and inflammatory cell infiltration in an acne mouse model by suppressing inflammatory cytokines interleukin (IL)-6, IL-1β, and tumor necrosis factor α expression. Moreover, EMQ inhibited the phosphorylation of MAP kinases (MAPKs) such as p38, JNK, and ERK, the phosphorylation and degradation of IκB-α and the nuclear translocation of nuclear factor kappa B (NF-κB) p65 in LPS-induced RAW264.7 cells. Conclusion These findings suggest the potent anti-inflammatory activity of EMQ is possibly through the regulation of the MAPKs and NF-κB signaling pathways. Inhibition of C. acnes activity combined with a powerful anti-inflammatory effect of EMQ indicated its potential as a novel therapeutic option for AV.

Objective:To evaluate the therapeutic effect of CXCL1 monoclonal antibody on dextra sulfate sodium (DSS)-induced acute ulcerative colitis (UC) in mice,and to elucidate its effect on the expressions ofTNF-α,IFN-γ,,IL-17 and IL-10 as well as neutrophil infiltration.Methods:Female BALB/c mice were randomly divided into a normal group (DSS-),a disease group (DSS+saline),an anti-CXCL1 antibody group (DSS+anti-CXCL1 Ab) and a treatment control group (DSS+IgG Ab).The DSS+saline,DSS+anti-CXCL1 Ab and DSS+anti-CXCL1 Ab groups were given 3.5％ DSS solution as drinking water to induce acute intestinal inflammation,while the normal control was given distilled water freely.The DSS+anti-CXCL1 Ab mice were intraperitoneal injected with anti-CXCL1 Ab (4 mg/kg) on the 3rd and 6th day.Same amount of rat IgG Ab was given in the DSS+IgG Ab group.The normal group and the disease group were injected with 0.9％ sodium chloride solution.The value of disease activity index (DAI) and the injury of colorectal tissue were measured.The levels of TNF-α,IFN-γ,IL-10 and IL-17 in colonic tissues of mice were detected by RT-PCR.Myeloperoxidase (MPO),a specific marker of neutrophils was measured by immunohistochemistry.Results:Compared with the normal control group,DAI score and colorectal injury score in the disease group were significantly increased,but the DAI and colorectal in the mice with acute ulcerative colitis tissue damage score were significantly reduced after anti-CXCL1 Ab intervention.Compared with the normal control group,mRNA levels of TNF-α,IFN-γ and IL-17 in the colorectal tissues were significantly elevated (P＜0.05) in the disease group while the IL-10 was decreased;these effects were attenuated by anti-CXCL1 Ab intervention (P＜0.05).Immunohistochemistry showed that the infiltration of neutrophils (MPO+) in the colon tissue was significantly increased in the disease group,while the anti-CXCL1 Ab treatment could significantly reduce the neutrophil infiltration in colon tissue (P＜0.05).Conclusion:Anti-CXCL1 Ab relieves the progression of DSS-induced acute ulcerative colitis by suppressing proinflammatory expression and neutrophil infiltration.

Liver transplantation has become the most effective treatment of end-stage liver disease. Nursing care for enhanced recovery is safe and effective in the management after liver transplantation, which is conducive to the early recovery of body function of the recipients. In this article, relevant literature review was conducted to summarize the standard operation procedure (SOP) of nursing care for enhanced recovery after liver transplantation from the postoperative vital signs and fluid temperature management, gastrointestinal function and nutrition management, early grading activities, sedation, analgesia and sleep management, infection prevention and control, etc.

Toll-like receptors (TLRs) is a type of pattern recognition receptors (PRRs), which are singular, non-catalytic and highly homologous. TLRs not only play significant roles in natural immunity, but also act as a bridge between innate immunity and adaptive immunity. Recent studies have revealed that TLRs play critical roles in the development of non-resolving inflammation-related cancer,including the formation of tumor microenvironment, invasion and metastasis, immune escape, etc. Further investigation into the mechanisms responsible for the function of TLRs will be of great value in tumor prevention, early diagnosis and therapy.
Humans ; Inflammation ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasms ; Toll-Like Receptors ; Tumor Microenvironment

Objective To evaluate the effect of individualized rehabilitation extended nursing on activities of daily living (ADL) in children with cerebral palsy. Methods A total of 156 cases of non-operative children with severe disorder of cerebral palsy from January to December 2017 in Sichuan 81 Rehabilitation Center, of 101 males and 55 females, aged 2-7 years with weighting 9 to 21 kg, were divided into 2 groups according to the time sequence, of which 70 cases of January to June 2017 before extension nursing as control group and 86 cases of July to December 2017 after extension nursing as observation group. The control group was received routine nursing according to the ADL rating scale, and the observation group was adopted the extended nursing method, according to the ADL rating scale to evaluate and judge the barrier grade, and chosen the suitable measures for rehabilitation nursing according to the individualized principle.The rehabilitation assessment was carried out before extended nursing (W0), the second week after extended nursing (W2), fourth week (W4), sixth week (W6), eighth week (W8), tenth week (W10), and twelfth week (W12) respectively. Results There was no significant difference in gender, age, weight and ADL scores at the time point of W0between the two groups (P>0.05). The ADL scores of the two groups were increased with the treatment time, and the increase of the observation group was greater than that of the control group. Compared with the control group, the ADL scores of the observation group were increased significantly at the time of W4to W12(P<0.01).After 12 weeks of treatment, there were 25 cases of mild disorders (29% ), 46 cases of moderate disorder (53.5% ) and 15 cases of severe disorder (17.5% ) in the observation group, and 3 cases of mild disorders (4.3% ), 38 cases of moderate disorder (54.3% ) and 29 cases of severe disorder (41.4% ) in the control group, and the observation group was obviously better than that of the control group (χ2＝21.083,P＜0.01). Conclusion Individualized rehabilitation extended nursing can improve ADL in children with cerebral palsy.

Objective:To explore the exfoliative value of multi-slice CT (MSCT) on conversion therapy of gastric cancer patients with positive evaluation cytology (P 0CY 1) . Methods:A total of 36 P 0CY 1 gastric cancer patients receiving conversion therapy in a prospective, single-center, phase Ⅱ clinical trial were enrolled. MSCT examinations were performed before and after conversion therapy. Its solid tumor efficacy evaluation criteria (response evaluation criteria in solid tumors, Recist) 1.1 score and tumor volume reduction rate were evaluated. The Spearman correlation test was used to analyze the correlation between Recist 1.1 score and tumor volume reduction rate and the results of conversion therapy. The ROC curve was used to determine the defined value of the volume reduction rate to identify the effectiveness of conversion therapy, and formulate new grading standards. Results:According to the conversion of free cancer cells in the abdominal cavity , 15 of 36 patients had successful conversion therapy and 21 had failed. The rate of tumor volume reduction in the successful and failed conversion groups was 44.38%±37.86% and -54.96%±156.92%, respectively( P=0.016). The Recist 1.1 score was moderate correlated with the results of conversion therapy ( R=0.540, P=0.001), and the rate of tumor volume reduction was significantly correlated with the results of conversion therapy ( R=0.657, P<0.001). When the tumor volume reduction rate of 26.27% was used as the effective threshold for evaluating conversion therapy, the AUC under the ROC curve was the largest, and the sensitivity and specificity were 80.0% and 85.7%, respectively. Conclusion:Both the MSCT-measured Recist 1.1 score and the tumor volume reduction rate can be used to evaluate the efficacy of conversion therapy in patients with pure exfoliated cytology-positive gastric cancer, and CT tumor volume measurement significantly correlates with conversion therapy results.

Objective: To determine the most influential data features and to develop machine learning approaches that best predict hospital readmissions among patients with diabetes. Methods: In this retrospective cohort study, we surveyed patient statistics and performed feature analysis to identify the most influential data features associated with readmissions. Classification of all-cause, 30-day readmission outcomes were modeled using logistic regression, artificial neural network, and EasyEnsemble. F1 statistic, sensitivity, and positive predictive value were used to evaluate the model performance. Results: We identified 14 most influential data features (4 numeric features and 10 categorical features) and evaluated 3 machine learning models with numerous sampling methods (oversampling, undersampling, and hybrid techniques). The deep learning model offered no improvement over traditional models (logistic regression and EasyEnsemble) for predicting readmission, whereas the other two algorithms led to much smaller differences between the training and testing datasets. Conclusions: Machine learning approaches to record electronic health data offer a promising method for improving readmission prediction in patients with diabetes. But more work is needed to construct datasets with more clinical variables beyond the standard risk factors and to fine-tune and optimize machine learning models.