Objective To investigate the feasibility and superiority of the lecture based learning (LBL)combined problem-based learning (PBL)for endocrinology teaching practice. Methods Totally 150 clinic medical undergraduates were randomly divided into three groups:LBL group (n=50),PBL group (n=50)and LBL+PBL group (n=50). Questionnaires,written and oral tests were employed to evaluate the teaching effect. ANOVA was used to compare the indicator scores and chi-square test was used to compare grades and passing rate. Results Teaching efficiency,mater of knowledge,capabilities of analysis,teaming and collaboration ability and medical diagnosis thinking cultivation were better in LBL and PBL group than in the other two groups. There were statistical differences in total score(F=4.69, P=0.010)and passing rate(χ2=8.94,P=0.030)among three groups. Conclusions LBL+PBL guarantee the teaching quality and cultivate the comprehensive quality of students; therefore it is superior to LBL and PBL.

This study was aimed to explore the method to improve the purity of primary myocardial cells from neonatal rats. The myocardial tissues of rats which were born 1-3 days were repeated digested by 0.08% myocardial cells digestive juices. And then, cells were neutralized with DMEM medium which containing 10% fetal bovine serum. The cells were separated with differential sidewall ion. The red blood cell cracking liquid was added to remove the red blood cells. Bromine deoxidization uracil (Brdu) was added to purify the myocardial cells. Then, cells were incubated in the CO2 incubator for two days. The serum-free synchronization was performed for one day. The results showed that the output of myocardial cells from one rat was about 1.2 × 106. The dynamic myocardial cells occupied more than 90%. The purity of myocardial cells was more than 90%. After 3 to 4 days, the cell fusion of myocardial cells was formed with spontaneous rhythm beats. It was concluded that the method can ensure the yield and the activity of the myocardial cells. At the same time, the purity of myocardial cells can also be improved greatly.

This paper reviews the assessment tools for childbirth readiness of pregnant and puerperal women and their applications, analyzes the advantages and disadvantages of these tools, and puts forward suggestions, in order to provide reference for research on the readiness for childbirth in pregnant and puerperal women.

OBJECTIVETo explore the mechanism of lumen loss of the left circumflex ostium after main vessel stent implantation.

METHODSTwenty-eight patients undergoing provisional T technique were enrolled in this study. Intravascular ultrasound (IVUS) examination was performed before and after main vessel stenting and kissing balloon post-dilatation to evaluate the geometrical changes of the vessels.

RESULTSThe CSA of LCX ostium lumen decreased significantly from 5.9∓2 mm(2) to 4.9∓1.9 mm(2) (P<0.01) after the procedure, and the CSA of LCX ostium P and M increased from 5.4∓2.9 mmmm(2) to 5.7∓2.9 mm(2) (P=0.21) after the main vessel stenting. The changes in LCX ostium lumen CSA was correlated with the changes of LCX ostium EEM CSA but not the LCX ostium P and M CSA. After kissing balloon post-dilatation, the CSA of LCX ostium lumen increased from 4.9∓1.9 mm(2) to 5.5∓1.9 mm(2) (P<0.01) , and the CSA of LCX ostium P and M showed no obvious changes (5.7∓2.9 mmmm(2) vs 5.7∓2.6 mmmm(2), P=0.89). The changes of LCX ostium lumen CSA were correlated with the those of the LCX ostium EEM CSA (R=0.432, P=0.02).

CONCLUSIONAfter stent implantation from the LMCA to the LAD, most of lumen losses of the LCX are due to carina shift, and in occasional cases, plaque shift occurs from the distal LMCA to the ostium of the LCX. Kissing balloon technique can adjust carina shift but can not improve plaque shift.

Aged ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; diagnostic imaging ; therapy ; Coronary Stenosis ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome ; Ultrasonography, Interventional

Objective:To study the role of myocardial work parameters in early identification of myocardial injury in neonatal asphyxia.Methods:From July 2020 to December 2021, neonates diagnosed with mild neonatal asphyxia admitted to the Department of Neonatology of our hospital within 24 h after birth were prospectively enrolled into the asphyxia group. Neonates without asphyxia during the same period were selected as the control group and matched with the asphyxia group for gender, gestational age and birth weight at a ratio of 1:1~1:2. The asphyxia group was subgrouped into preterm asphyxia group and term asphyxia group. All neonates received echocardiography within 24 h after birth. Multiple parameters were measured including M-mode, two-dimensional image, Doppler image, global longitudinal strain (GLS) and myocardial work parameters [global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE)]. The level of serum N-terminal pro brain natriuretic peptide (NT-proBNP) was recorded in the asphyxia group. The data were compared between the asphyxia group and the control group. Correlations between myocardial work parameters and other parameters were analyzed.Results:A total of 33 cases were in the asphyxia group and 43 cases were in the control group. The preterm asphyxia group (18 cases) showed significantly lower GWI and GCW than the preterm control group (18 cases) [GWI: (702±153) mmHg vs. (879±205) mmHg, GCW: (1 016±221) mmHg vs. (1 200±271) mmHg] ( P<0.05). No differences existed in GLS, GWW and GWE. The term asphyxia group (15 cases) showed significantly lower GWW than the term control group (25 cases) [45.0 (30.0, 65.0) mmHg vs. 71.0 (35.5,85.5) mmHg] ( P<0.05). No differences existed in GLS, GWI, GCW and GWE. GWI was negatively correlated with serum NT-proBNP level ( r=-0.327, P<0.05). Conclusions:GWI and GCW may indicate myocardial injury in preterm neonates with mild asphyxia.

Myocardial fibrosis is featured by excessive proliferation of cardiac fibroblast and collagen deposition. There is close relationship between myocardial fibrosis and various cardiovascular disease, and it is potential risk factor for sudden death. At present the precise mechanism remains unclear.Myocardial fibrosis has been found to relate with renin-angiotensin-aldosterone system,cell factor,oxidative stress,inflamatory factor,endothelial function obstacles,Intracellular calcium ion. These factors influences the occurrence of myocardial fibrosis by the same or different pathway.

Purpose To use two-dimensional speckle tracking imaging(2D-STI)to evaluate left ventricular myocardial strain in term and preterm neonates.Materials and Methods A total of 81 neonates who accepted echocardiography in Soochow University Affiliated Children's Hospital from February to August 2018 were retrospectively enrolled,including 42 term neonates and 39 preterm neonates.Longitudinal and circumferential peak strain of each segment of left ventricle were measured by 2D-STI,and the average global longitudinal peak strain(GLPS-avg)and the average global circumferential peak strain(GCPS-avg)of left ventricular were measured too.Left ventricular ejection fraction(LVEF-M,LVEF-Simpson),short-axis shortening rate(LVFS-M),left ventricular end-diastolic diameter(LVEDD),and tissue Doppler imaging parameters(E',A' and E'/A')of the septal mitral annulus were also measured.The differences in each segment of left ventricle and echocardiography between term neonates and preterm neonate were further compared.Results There were statistically significant differences in GLPS-avg,the global longitudinal peak strain from the apical two-chamber view(GLPS-a2c),GCPS-avg and the global circumferential peak strain in the middle and apical segments(GCPS-M ang GCPS-A)(t=-3.60--2.18,all P<0.05)between term neonates and preterm neonates,while there were no significant differences between the global longitudinal peak strain from the apical four-chamber and three-chamber view(GLPS-a4c and GLPS-a3c),the global circumferential peak strain in the basal segments(GCPS-M)(all P>0.05).There were statistically significant differences in GLPS-a4c,GLPS-a2c,GLPS-a3c in preterm neonates group(F=3.20,P=0.044),and the strain value GLPS-a4c was the highest.There were statistically significant differences in GCPS-B,GCPS-M,GCPS-A in preterm neonates group(F=79.15,P<0.001).There were statistically significant differences in GCPS-B,GCPS-M,GCPS-A in term neonates group(F=97.95,P<0.001),and the strain value increased from the basal segment to the apical segments.There was statistically significant difference in LVEDD between term neonates and preterm neonates(all P<0.05).There were no statistically significant differences in LVEF-M,LVEF-Simpson,LVFS-M,E',A' and E'/A' between term neonates and preterm neonates(all P>0.05).Conclusion 2D-STI may be a useful method of measuring left ventricular myocardial systolic function and can provide early detection of differences in left ventricular myocardial contraction between term and preterm neonates.

Presynaptic dopaminergic PET imaging is a useful method for the diagnosis of parkinsonism. Based on the expert consensus on operation and clinical application of dopamine transporter brain PET imaging technology published in 2020, this paper further recommends the relevant elements of result interpretation of presynaptic dopaminergic PET imaging.

OBJECTIVE： To observe the effects of Shenfu yixin decoction on reactive oxygen species （ROS） and energy metabolism in primary hypoxic cardiomyocytes. METHODS： After isolation， culture and identification， primary cardiomyocytes of neonatal SD rats were randomly divided into normal group， model group， positive control group （coenzyme Q10， 0.1 mmol/L） and Shenfu yixin decoction low-dose and high-dose groups （0.25， 0.5 mg/mL）. Except for normal group， other groups were cultured with 5％O2， 5％CO2 and 90％N2 for 6 h to induce hypoxic injury model. After 6 hours of hypoxia， ROS contents in cardiomyocytes and mitochondria of each group were detected by ROS probe and flow cytometry. Luciferase luminescence and Western blotting were used to detect ATP content and CK protein expression of each group. Transmission electron microscope was used to observe ultrastructure of cardiomyocytes in each group. RESULTS： Compared with normal group， the expression of ROS in primary hypoxic cardiomyocytes and mitochondria as well as the content of ROS were increased significantly， while the content of ATP and expression levels of CK protein were decreased significantly （P＜0.05）； there were swelling of endoplasmic reticulum and mitochondria， dissolution or even disappearance of mitochondrial ridge， obvious cardiomyocytes injury. Compared with model group， the expression of ROS in primary hypoxic cardiomyocytes and mitochondria of administration groups， the contents of ROS in primary hypoxic cardiomyocytes of positive control group and Shenfu yixin decoction high-dose group as well as the content of ROS in primary hypoxic cardiomyocytes mitochondria of administration groups were all decreased significantly， while ATP contents in primary hypoxic cardiomyocytes of positive control group and Shenfu yixin decoction high-dose group as well as expression levels of CK protein in primary hypoxic cardiomyocytes of administration groups were all increased significantly （P＜0.05）. The primary hypoxic cardiomyocytes injury was relieved significantly in positive control group and Shenfu yixin decoction high-dose group. CONCLUSIONS： Shenfu yixin decoction can improve primary hypoxic cardiomyocytes， down-regulate the expression of ROS in cardiomyocytes and mitochondria and also improve its energy metabolism.

Objective To investigate the spatiotemporal distribution characteristics and potential influencing factors of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022, so as to provide insights into the formulation of the echinococcosis control strategy in Qinghai Province. Methods The number of individuals screened for echinococcosis, number of newly diagnosed echinococcosis cases, number of registered dogs and number of stray dogs were captured from the annual reports of echinococcosis control program in Qinghai Province from 2016 to 2022, and the detection of newly diagnosed echinococcosis cases was calculated. The number of populations, precipitation, temperature, wind speed, sunshine hours, average altitude, number of year-end cattle stock, number of year-end sheep stock, gross domestic product (GDP) per capita, and number of village health centers in each county (district) of Qinghai Province were captured from the Qinghai Provincial Statistical Yearbook, and county-level electronic maps in Qinghai Province were downloaded from the National Platform for Common Geospatial Information Services. The software ArcGIS 10.8 was used to map the distribution of newly diagnosed echinococcosis cases in Qinghai Province, and the spatial autocorrelation analysis of newly diagnosed echinococcosis cases was performed. In addition, the spacetime scan analyses of number of individuals screened for echinococcosis, number of newly diagnosed echinococcosis cases and geographical coordinates in Qinghai Province were performed with the software SaTScan 10.1.2, and the spatial stratified heterogeneity of the detection of newly diagnosed echinococcosis cases was investigated with the software GeoDetector. Results A total of 6 569 426 residents were screened for echinococcosis in Qinghai Province from 2016 to 2022, and 5 924 newly diagnosed echinococcosis cases were found. The detection of newly diagnosed echinococcosis cases appeared a tendency towards a decline over years from 2016 to 2022 (χ² = 11.107, P < 0.01), with the highest detection in Guoluo Tibetan Autonomous Prefecture in 2017 (82.12/10⁵). There were spatial clusters in the detection of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2018 (Moran’s I = 0.34 to 0.65, all Z values > 1.96, all P values < 0.05), and the distribution of newly diagnosed echinococcosis cases appeared random distribution from 2019 to 2022 (Moran’s I = −0.09 to 0.04, all Z values < 1.96, all P values > 0.05). Local spatial autocorrelation analysis showed high-high clusters and low-low clusters in the detection of new diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022, and space-time scan analysis showed that the first most likely cluster areas of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022 were mainly distributed in Yushu Tibetan Autonomous Prefecture and Guoluo Tibetan Autonomous Prefecture. GeoDetector-based analysis of the driving factors for the spatial stratified heterogeneity of detection of newly diagnosed echinococcosis cases in Qinghai Province showed that average altitude, number of village health centers, number of cattle and sheep stock, GDP per capita, annual average sunshine hours, and annual average temperature had a strong explanatory power for the spatial distribution of newly diagnosed echinococcosis cases, with q values of 0.630, 0.610, 0.600, 0.590, 0.588, 0.537 and 0.526, respectively. Conclusions The detection of newly diagnosed echinococcosis cases appeared a tendency towards a decline in Qinghai Province over years from 2016 to 2022, showing spatial clustering. Targeted control measures are required in cluster areas of newly diagnosed echinococcosis cases for further control of the disease.