The introduction of MOOC to medical education in China can greatly promote the development of modern medical education.Using the content analysis method,the paper systemizes the research literatures on MOOC published in 2013-2015 in China.According to the analysis,currently,the research on MOOC in China is still in the initial stage.Therefore,it proposes the focus of domestic research on MOOC and the research development direction in medical education in the future.

Objective To explore the role of flexible fiberoptic bronchoscope(FFB) in the critical patients with severe respiratory diseases of PICU.Methods One hundred and eighty-nine cases of severe respiratory diseases had undergone FFB from Jul 2010 to Jan 2011.One hundred and fifty-seven (83.06％) cases were less than 3 years.FFB examinations were made through nose (226 times) and endotracheal intubation (25 times).Bronchoscopic lavage for bacterial culture was performed by injecting normal saline solution (NSS) via a syringe into the working channel of FFB.Results Of all 189 cases,bacteria were isolated from 80 cases (42.3％) for bacterial culture of bronchoscopic lavage fluid,which included G-bacilli in 51 cases,G + cocci in 21 cases,and fungi in 8 cases.Six cases with tracheobronchial foreign bodies and 31 cases with respiratory tract anatomical abnormalities were found through FFB.Forty cases of severe pneumonia complicated with respiratory failure underwent bronchoscopic lavage,which were effective in 35 cases,and ineffective in 5 cases.In 20 cases of severe pneumonia atelectasis,pulmonary reexpansion were found in 16 cases by bronchoscopic lavage,atomization inhalation,and systemic administration,4 cases improved.Tracheobronchial foreign bodies were removed in all 6 cases by FFB.During FFB,bradycardia was found in 1 cases.There was no FFBrelated death.Conclusion FFB is safe for severe patients with respiratory diseases in PICU.FFB play important role in diagnosis and treatment for children in PICU,including feasible intervention under bronchoscopy.

OBJECTIVETo explore the safety and the efficacy of bronchoscopic argon plasma coagulation (APC) combined with CO2 freezing for the treatment of airway granulation hyperplasia after pediatric airway stenting.

METHODFrom April 2010 to December 2012, APC combined CO2 cryotherapy was performed for granulation tissue hyperplasia in 8 children after airway stenting, their clinical data, complications and postoperative outcomes and follow-up data were analyzed.

RESULTFive of the 8 cases were male and 3 female, when stenting their age was 2 to 17 months, the average age was (8.63 ± 5.50) months. Granulation tissue hyperplasia appears in the range of bracket covering, common to both ends of the stent. The time from stentinging to find hyperplasia of granulation tissue was 20 days to 19 months. As a result, in 30%-100% of children airway narrowing was found. We applied APC treatment when the bronchoscopy found hyperplasia lesions, then we used CO2 cryotherapy, i.e., freezing was persisted for 1 min twice and more, then the probe was moved until the APC burning area was entirely frozen, dyspnea in children were significantly improved and two cases of atelectasis patients' lung were completely re-expanded. Eight patients had varying degrees of postoperative low to moderate fever, three cases had a small amount of active bleeding after APC treatment, hemostasis was achieved after topical application of endoscopic injection of epinephrine or reptilase bleeding and freezing, no complications occurred with CO2 cryotherapy. According to the efficacy criteria in this article, the result was significantly effective in 6 cases, effective in 1 case, and partially effective in 1 case.

CONCLUSIONAPC combined with CO2 cryotherapy may be one of the optional methods that rapidly eliminates granulation tissue and remove the airway obstruction, so it can be used in treatment of pediatric airway' benign lesions.

Anti-Bacterial Agents ; therapeutic use ; Argon Plasma Coagulation ; methods ; Bronchoscopy ; methods ; Carbon Dioxide ; Combined Modality Therapy ; Female ; Freezing ; Granulation Tissue ; pathology ; Humans ; Infant ; Male ; Postoperative Complications ; surgery ; therapy ; Stents ; adverse effects ; Tracheal Stenosis ; surgery ; therapy ; Treatment Outcome

Objective To explore the correlation between TCM constitution and sleep status in escort troops. Methods Standardized TCM Constitution Questionnaire and Pittsburgh Sleep Quality Index (PSQI) were used to investigate escort troops. Factors of PSQI and constitution types were analyzed. Results The results of PSQI showed the number of escort troops who had bad sleeping (PSQI>7) was 64, which accounted for 46%of the escort troops, among which, 45 people (70.3%) were justified as biased constitution, while 19 were normal constitution (29.7%). The top three biased constitution in bad sleeping were:qi deficiency, phlegm-dampness and dampness-heat. PSQI factors such as sleep disorder, daytime dysfunction and total score had positive correlation with qi deficiency, yang deficiency, yin deficiency, dampness-heat and blood stasis, and negative correlation with normal constitution. Conclusion Sleep condition of escort troops has correlation with TCM constitution, which indicates that sleep status could be improved by regulating TCM constitution.

OBJECTIVETo explore the influences of different dosage ferrous sulfate supplements on bone marrow hemopoiesis in rats.

METHODSFemale weaning Wistar rats were fed with an iron deficient diet (< 10 mg/kg diet) until the level of hemoglobin of rats was lower than 100 g/L. Rats (n = 50) were randomly divided into five groups according to the levels of hemoglobin and body weight, iron deficiency control (ID), daily low iron diet supplement (LDs), daily high iron diet supplement (HDs), weekly low iron supplement (LWs), and weekly high iron supplement (HWs).

RESULTSAfter 12 weeks, bone marrow stainable iron was seldom in ID group, and ample in supplement groups. The proportions of iron staining of bone marrow smear in supplement groups were more than 30%. Bone marrow cells in all rats were hyperplastic or active hyperplastic.

CONCLUSIONSDaily high iron supplement or once weekly high iron supplement were safe to bone marrow hemopoiesis in rats.

Anemia, Iron-Deficiency ; drug therapy ; Animals ; Bone Marrow ; drug effects ; Disease Models, Animal ; Female ; Ferrous Compounds ; pharmacology ; Hematopoiesis ; drug effects ; Rats ; Rats, Wistar

OBJECTIVETo understand the infantile nocturnal sleep-wake pattern developmental trajectory with Actiwatch, which would benefit the clinical assessment of infantile sleep.

METHODThis study was a longitudinal study conducted between 7 Oct, 2009-30 Oct, 2011 in 10 hospitals of 9 cities of China ( Beijing, Xi'an, Qingdao, Wuhan, Changsha, Chongqing, Huzhou, Xiamen and Liuzhou). Actiwatch was used to track the sleep-wake pattern development trajectory of healthy infants in the first year of life in the home setting. Participating infants were followed up at 10th day and 28th day during the first month, and then monthly from the second to the sixth month after birth, and then at ninth and twelve months of age respectively. Meanwhile, infantile sleep was observed continuously for about 60 hours at each visit. According to the characteristics of repeated measurement data of this study, two-level random effect model was adopted to analyze the trend of infantile nocturnal sleep-wake parameters changing with age, and the gender difference.

RESULTA total of 473 healthy infants were included in this study, among whom 246 (52.0%) were boys, and 227 (48.0%) were girls; 355 (75.1%) infants completed the whole year follow-up survey. With infants' age increasing, the latency of infants' nighttime sleep onset decreased from 66.8 minutes on 10th day to 15.5-18.7 minutes at 6-12 months of age. The number of night wakes also decreased with age, while uninterrupted sleep periods lengthened with age. On the 10th day, there were 3.0 times of nightwaking on average, and the longest continuous sleeping interval lasted for 227.6 minutes on average. At 12-month of age, infants could sleep continuously for 350.9 minutes at most on average, while the number of nightwaking decreased to 1.6 times per night on average. Generally, nighttime sleep efficiency increased from 66.3% on the 10th day to 86.3% at 12-month of age. The differences of sleep-wake patterns between boys and girls presented as boys' nocturnal longest uninterrupted sleep period was 19 minutes shorter(266.6 vs. 285.6 min), and the average nighttime sleep efficiency was 2.2% lower (74.2% vs. 76.4%) compared with girls respectively. And the differences of sleep efficiency between boys and girls reduced gradually along with the growth.

CONCLUSIONDuring the first 6 months after birth, infantile sleep-wake pattern undergo obvious change. The capability of sleep-onset and uninterrupted sleep improved with age, and the sleep efficiency increased.

China ; Female ; Humans ; Infant ; Infant, Newborn ; Longitudinal Studies ; Male ; Sleep ; physiology ; Surveys and Questionnaires

To study the role of the activity in reducing the incidence of water leakage in digestive endoscopy, through the activity of the quality control circle (QCC), the reasons for water leakage and high maintenance cost are analyzed deeply. Then, the author formulated and implemented targeted measures to intervene in the non-standard aspects of daily management of endoscopy. Then targeted measures has been taken to improve the nonstandard daily management.Results demonstrate that the application of the quality control circle can significantly reduce the incidence of water leakage in the digestive endoscope and control the other faults caused by the leakage. This not only reduces the high maintenance cost of endoscopy, improves the utilization rate and turnover rate of endoscopy, but also fully explores personal potential, enhances team cohesion, and improves quality management awareness.

Odontogenic keratocysts (OKCs) are common cystic lesions of odontogenic epithelial origin that can occur sporadically or in association with naevoid basal cell carcinoma syndrome (NBCCS). OKCs are locally aggressive, cause marked destruction of the jaw bones and have a propensity to recur. PTCH1 mutations (at ∼80%) are frequently detected in the epithelia of both NBCCS-related and sporadic OKCs, suggesting that PTCH1 inactivation might constitutively activate sonic hedgehog (SHH) signalling and play a major role in disease pathogenesis. Thus, small molecule inhibitors of SHH signalling might represent a new treatment strategy for OKCs. However, studies on the molecular mechanisms associated with OKCs have been hampered by limited epithelial cell yields during OKC explant culture. Here, we constructed an isogenic PTCH1 cellular model of PTCH1 inactivation by introducing a heterozygous mutation, namely, c.403C>T (p.R135X), which has been identified in OKC patients, into a human embryonic stem cell line using the clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated 9 (Cas9) system. This was followed by the induction of epithelial differentiation. Using this in vitro isogenic cellular model, we verified that the PTCH1 heterozygous mutation causes ligand-independent activation of SHH signalling due to PTCH1 haploinsufficiency. This activation was found to be downregulated in a dose-dependent manner by the SHH pathway inhibitor GDC-0449. In addition, through inhibition of activated SHH signalling, the enhanced proliferation observed in these induced cells was suppressed, suggesting that GDC-0449 might represent an effective inhibitor of the SHH pathway for use during OKC treatment.
Anilides ; pharmacology ; Basal Cell Nevus Syndrome ; Hedgehog Proteins ; genetics ; pharmacology ; Humans ; Molecular Targeted Therapy ; Odontogenic Cysts ; genetics ; physiopathology ; therapy ; Odontogenic Tumors ; genetics ; physiopathology ; therapy ; Pyridines ; pharmacology

Humans ; COVID-19 ; Quarantine ; Renal Dialysis ; SARS-CoV-2 ; Hospitals