While the development of simulation-based medical education in China is facing such opportunities as increasing demand, information technology and internet development, there are also dilemmas that a systematic training system has not yet been formed, the professionalism of the faculty needs to be strengthened, clinical practice cannot be fully simulated, the relevant policies and systems are not perfect, and there is a gap between the construction of the center and developed countries. It is necessary to grasp the opportunity, improve the development level, adapt to social needs, strengthen teacher training, improve the rules and regulations, develop training standards, enrich simulation cases, etc., and further promote the connotative development of simulation-based medical education.

Objective: To identify the avian influenza virus subtype from the avian and environmental samples using the Ion Torrent new-generation semiconductor sequencing technology and to establish a high-throughput sequencing method to identify unclassified influenza A virus. Methods: Virus RNA was extracted from the nine avian swab and environmental samples and real-time RT-PCR was carried out to detect universal fluA, H5N1, H7N9 and H9N2. The whole genome of influenza A virus was amplified by PathAmpFluA kit. Sequencing library was prepared using Next Fast DNA Fragmentation & Library Prep Set for Ion Torrent kit and high-throughput sequencing was done by Ion Torrent Personal Genome Machine(PGM). Data from the PGM was processed and quality evaluated using Ion TorrentSuite v3.0 software. Sequence assembly and influenza database blast were carried out by FluAtyping v4.0 and PathogenAnalyzer bioinformatics software to identify the influenza A virus subtype of these nine samples. Results: The results of real-time RT-PCR for universal fluA of these nine samples were positive but the results for H5N1, H7N9 and H9N2 were negative. Seven subtypes of influenza A virus were identified by high-throughput sequencing and bioinformatics analysis: six samples were H2N3, H5N6, H5N8, H7N1, H7N7, H11N3 subtype respectively and three samples were H6N6 subtype. Conclusions Avian influenza virus has many subtypes in the environment of Zhejiang province. Ion Torrent semiconductor sequencing technology is suitable for fast identification of unclassified influenza virus for avian influenza environment monitoring.

Objective:To investigate the importance, satisfaction and influencing factors of college students in a medical university, and to provide reference for the teaching reform of public elective courses.Methods:A questionnaire survey was conducted in this study among Batch 2018 students of Southern Medical University. A total of 691 questionnaires were distributed and 674 valid ones were recovered. The data were analyzed descriptively, and one-way ANOVA analysis and multiple linear regression analysis were carried out by using SPSS 20.0.Results:There were statistical differences between students' objective of elective course, evaluation of teachers, evaluation of courses and harvest of courses and students' satisfaction and attention to public elective courses ( P<0.05). Students who chose courses for improving their comprehensive quality paid more attention to public courses [(4.3±0.73) points] and had higher satisfaction [(4.34±0.69) points] than other options. Students with good evaluation on teachers' teaching paid more attention to public elective courses [(4.32±0.71) points] and their satisfaction [(4.45±0.62) points] was higher than other options. Students with good evaluation on the courses had the highest degree of attention [(4.35±0.71) points] and satisfaction [(4.47±0.63) points]. Students paid the highest attention [(4.75±0.53)points] to and had the highest satisfaction [(4.85±0.36) points] with the public elective courses with more course harvest. The multiple linear regression analysis found that the 5 variables, gender, teaching forms, teaching evaluation, course quality and course harvest had significant differences in the scores of public elective course satisfaction ( P<0.05). Conclusion:The male students, in inquiry teaching form, the higher evaluation on the teacher, the higher the course quality, and the more the course harvest, the higher the students' satisfaction with the public elective courses.

Objective To evaluate the effect of comprehensive nursing on adverse reaction and psychological status of fundus fluorescein angiography. Methods A total of 96 patients were all underwent fundus fluorescein angiography in our hospital from October 2016 to October 2017 were selected. The patients were divided into two groups according to the single and double number grouping method. Among them, 48 patients in the single group underwent routine fundus fluorescein angiography (RCC) routine nursing as the conventional group. 48 patients with double number underwent routine nursing combined with comprehensive nursing intervention as the intervention group. The scores of psychological status (SAS, SDS), incidence of adverse reactions and satisfaction with nursing were compared between the two groups before and after nursing care. Results After nursing, the scores of SAS and SDS in the intervention group were significantly lower than those in the nursing group and the routine group. There was significant difference between the two groups(P＜0. 05). In the aspect of adverse reactions, the incidence of adverse reactions such as intestinal reaction, anaphylactic reaction and nervous system reaction was 8. 33％, which was significantly lower than that of the conventional group (P＜0. 05). In the aspect of nursing satisfaction, satisfaction in the intervention group was 95. 83％, which was sig nificantly higher than the conventional group (P＜0. 05). Conclusion On the basis of routine nursing, using integrated nursing intervention can reduce the incidence of adverse reactions of fundus fluorescein angiography, relieve the psychological state of patients and promote the successful completion of the examination, which is worth recommending in the future clinical application.

OBJECTIVETo explore the prevalence of isolated diastolic hypertension and associated cardiovascular risk and blood pressure changes during follow up.

METHODSThis cohort study screened 101 510 participants who were employees of the Kailuan Group, a state-run coal mining company in 2006 and 2007. Among them, 6 778 subjects were diagnosed with isolated diastolic hypertension (IDH). IDH subjects without history of cardiovascular disease and not treated with antihypertensive drugs were included in this analysis. Participants without health examination between 2008 to 2009 or 2010 to 2011 were excluded. A total of 4 600 participants were included in the final analysis. At the end of the third health examination, the conversion rate of different blood pressure turnover was calculated after standardizing age and gender according to demographic data of China in 2006. Multivariate logistic regression analysis was applied to analyze the risk factors of blood pressure turnover in IDH population.

RESULTS(1) Participants were followed up for (4.03 ± 0.26) years and the rates of turnover from IDH to normotension, isolated systolic hypertension (ISH) and systolic diastolic hypertension (SDH) were 51.4%, 3.5%, 18.3%, respectively (45.6%, 3.6%, 22.0% in male, 57.4%, 3.3%, 14.7% in female). (2) Multivariate logistic regression analysis showed that low baseline age, low diastolic pressure, low body mass index, low uric acid, physical exercise and low alcohol intake were associated with turnover from IDH to normotension; the risk factors of turnover from IDH to ISH were older age at baseline, higher systolic pressure and higher sensitivity C-reactive protein; the risk factors of turnover from IDH to SDH were older baseline age, high systolic pressure and excessive salt intake.

CONCLUSIONSUntreated subjects with IDH can transform from IDH to normotension,ISH, SDH, and the rate of turnover from IDH to normotension is higher than others during follow up. Aging, higher systolic pressure, higher sensitivity C-reactive protein and excessive salt intake are risk factors for IDH subjects to suffer from ISH and SDH.

Adult ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Hypertension ; epidemiology ; Logistic Models ; Male ; Middle Aged ; Prevalence ; Prognosis ; Risk Factors

Objective To investigate the impact of different levels of systolic blood pressure on brachial-ankle pulse wave velocity(baPWV). Methods A total of 5 852 participants was selected with stratified random sampling from the 101 510 workers of Tangshan Kaiuan Company who had undergone a physical check-up program. 5 222 of them with integral data were recruited into this survey. According to SBP collected during the 2010-2011 health examination program,the population under observation was divided into four groups:optimal SBP(SBP<120 mmHg),high-normal blood pressure Ⅰ period(120 mmHg≤SBP<130 mmHg),high-normal blood pressure Ⅱ period (130 mmHg≤SBP<140 mmHg)and hypertension(SBP≥140 mmHg or SBP<140 mmHg but antihypertensive drug user). Multivariate logistic regression analysis was used to analyze the influence of different levels of systolic blood pressure on baPWV. Results 1)There were 3 132 males and 2 090 females in all the 5 222 participants with an average age of 55.1 years old. Their mean of baPWV was(1 587.57±400.71)cm/s,with the detection rates as 62%(baPWV≥1 400 cm/s). 2)The means of baPWV for the above groups of SBP were 1 322.19,1 456.27,1 544.78 and 1 827.77 cm/s, respectively,with detection rates of baPWV≥1 400 cm/s as 26.4%,49.3%,64.2% and 88.3%, respectively. 3)Results from the Multiple linear regression analysis revealed that β of SBP was 0.40,only ranking second,on age(0.48). 4)Data from the Multiple logistic regression analysis showed that after adjusting for age,gender and other risk factors,when compared to optimal SBP,factors as high-normal blood pressure Ⅰ period、high-normal blood pressure Ⅱ period and hypertension were risk factors for increasing baPWV,with OR values as 2.70(95%CI:2.20-3.32),4.56(95%CI:3.67-5.67)and 13.51(95%CI:10.87-16.78),respectively. Conclusion Higher SBP seemed an independent risk factor for the increase of baPWV.

OBJECTIVETo compare the prevalence of hypertension between low birth weight infant (LBWI) women and non-LBWI women.

METHODSA retrospective cohort study was applied and 3 172 pregnant women giving births during October 1976 to December 2008 in our hospital and underwent physical check-up between 2010 and 2011 at the Kailuan medical group were included and divided into LBWI group and non-LBWI group by the history of LBWI. Prevalence of hypertension was obtained during the follow-up program. Multiple logistic regression analysis was used to assess the relative risk of hypertension.

RESULTSA total number of 3 172 women, with an average age of 42.3 years old were divided into LBWI group (n = 147) and non-LBWI group (n = 3 025), with the average birth weights of their infants were 2.31 kg and 3.39 kg, respectively. The prevalence of hypertension from the follow-up program was significantly higher in LBWI group than that in the non-LBWI group (23.8% vs. 16.9%, P < 0.05). After adjustment for other traditional risk factors, the risk of hypertension in LBWI group was 1.60 (95%CI:1.02-2.53) folds higher than that in the non-LBWI group.

CONCLUSIONPrevalence of hypertension in women with LBWI was higher than that in those women without LBWI. History of LBWI seemed to have had an increased risk to develop hypertension.

Adult ; Female ; Humans ; Hypertension ; epidemiology ; Infant, Low Birth Weight ; Logistic Models ; Postpartum Period ; Pregnancy ; Prevalence ; Retrospective Studies ; Risk Factors ; Young Adult

OBJECTIVETo investigate the impact of different levels of systolic blood pressure on brachial-ankle pulse wave velocity (baPWV).

METHODSA total of 5 852 participants was selected with stratified random sampling from the 101 510 workers of Tangshan Kailuan Company who had undergone a physical check-up program. 5 222 of them with integral data were recruited into this survey. According to SBP collected during the 2010-2011 health examination program, the population under observation was divided into four groups:optimal SBP(SBP < 120 mmHg), high-normal blood pressure I period (120 mmHg ≤ SBP < 130 mmHg), high-normal blood pressure II period (130 mmHg ≤ SBP < 140 mmHg)and hypertension (SBP ≥ 140 mmHg or SBP < 140 mmHg but antihypertensive drug user). Multivariate logistic regression analysis was used to analyze the influence of different levels of systolic blood pressure on baPWV.

RESULTS1) There were 3 132 males and 2 090 females in all the 5 222 participants with an average age of 55.1 years old. Their mean of baPWV was (1 587.57 ± 400.71) cm/s, with the detection rates as 62% (baPWV ≥ 1 400 cm/s). 2)The means of baPWV for the above groups of SBP were 1 322.19, 1 456.27, 1 544.78 and 1 827.77 cm/s, respectively, with detection rates of baPWV ≥ 1 400 cm/s as 26.4% , 49.3% , 64.2% and 88.3% , respectively. 3) Results from the Multiple linear regression analysis revealed that β of SBP was 0.40, only ranking second, on age (0.48). 4) Data from the Multiple logistic regression analysis showed that after adjusting for age, gender and other risk factors, when compared to optimal SBP, factors as high-normal blood pressure I period, high-normal blood pressure II period and hypertension were risk factors for increasing baPWV, with OR values as 2.70 (95% CI:2.20-3.32), 4.56(95% CI: 3.67-5.67) and 13.51 (95% CI:10.87-16.78), respectively.

CONCLUSIONHigher SBP seemed an independent risk factor for the increase of baPWV.

Adult ; Aged ; Ankle Brachial Index ; Blood Pressure ; physiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Pulse Wave Analysis ; Risk Factors ; Surveys and Questionnaires ; Systole

OBJECTIVETo explore the impact of isolated diastolic hypertension (IDH) on new-onset cardio-cerebral vascular diseases (CVD).

METHODSThis cohort study involved 101 510 participants who were employees of the Kailuan Group-a state-run coal mining company, in 2006 and 2007. Among them, 6 780 subjects were diagnosed with IDH, 35 448 subjects were diagnosed with high-normal blood pressure and 19 460 subjects were diagnosed with normal tension. However, none of them had the history of either cardio-cerebral vascular disease or malignant cancer. Cardio-cerebral vascular events including cerebral infarction, cerebral hemorrhage, acute myocardial infarction were recorded every 6 months during the follow-up (47.1 ± 4.8) period. Multivariable Cox proportional hazards regression models were used to analyze the risk factors of first-ever CVD events.

RESULTS1) There were 675 CVD events occurred during the follow-up period. The incidence rates of CVD events (1.7% vs. 0.9%), cerebral infarction (1.0% vs. 0.6%) and cerebral hemorrhage (0.4% vs. 0.1%) were significantly higher in IDH group than that in the normal tension group (all P < 0.05). 2) After adjustment for other established CVD risk factors, the hazards ratios became 1.67 (95% CI: 1.28-2.17) for total CVD events and 1.59 (95% CI: 1.12-2.27) for cerebral infarction and 2.67 (95% CI: 1.54-4.65) for cerebral hemorrhage in the IDH group. 3). In stratified analysis on age, after adjustment for other established CVD risk factors, the hazards ratio was 2.22 (95% CI: 1.41-3.50) for cerebral infarction in lower 60 years old group, while the it was 7.27 (95% CI: 2.58-20.42) for cerebral hemorrhage in groups older than 60 years of age.

CONCLUSIONIDH was the independent risk factor for the total cardio-cerebral vascular events, on both cerebral infarction and cerebral hemorrhage. The predicted values of IDH for different CVD events were diverse on different age groups.

Adult ; Cardiovascular Diseases ; epidemiology ; Female ; Follow-Up Studies ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Proportional Hazards Models ; Risk Factors

Glioblastoma (GBM) is the most common and aggressive malignant brain tumor in adults and is poorly controlled. Previous studies have shown that both macrophages and angiogenesis play significant roles in GBM progression, and co-targeting of CSF1R and VEGFR is likely to be an effective strategy for GBM treatment. Therefore, this study developed a novel and selective inhibitor of CSF1R and VEGFR, SYHA1813, possessing potent antitumor activity against GBM. SYHA1813 inhibited VEGFR and CSF1R kinase activities with high potency and selectivity and thus blocked the cell viability of HUVECs and macrophages and exhibited anti-angiogenetic effects both in vitro and in vivo. SYHA1813 also displayed potent in vivo antitumor activity against GBM in immune-competent and immune-deficient mouse models, including temozolomide (TMZ) insensitive tumors. Notably, SYHA1813 could penetrate the blood-brain barrier (BBB) and prolong the survival time of mice bearing intracranial GBM xenografts. Moreover, SYHA1813 treatment resulted in a synergistic antitumor efficacy in combination with the PD-1 antibody. As a clinical proof of concept, SYHA1813 achieved confirmed responses in patients with recurrent GBM in an ongoing first-in-human phase I trial. The data of this study support the rationale for an ongoing phase I clinical study (ChiCTR2100045380).