CBI (Content-based instruction) , integrating the content and language, can be used to guide teaching EAP (English for academic purposes). Main Teaching Models based on CBI (Content-based instruction) include immersion model, theme-based instruction and content for language practice. EGAP (English for general academic purposes) curriculum can be set up in medical universities in the second and third academic years, such as medical integrated course, medical listening & speaking course, medical writing course. ESAP (English for specific academic purposes) curriculum can be set up in the fourth and fifth academic years, such as clinical English,nursing English and stomato-logical English. Theme-based instruction can be applied in medical integrated course and listening&speaking course, including creating situation to lead in the theme, assigning tasks to experience the theme, setting topics to deepen the theme and giving assignment to explore the theme. Content for language practice model can be applied into medical writing course, such as teacher's demonstrating and explaining, students' absorbing and imitating and mutual evaluating. Immersion model can be used in ESAP (English for specific academic purposes), such as choosing typical cases to teach in English, teaching ward round in English, doctor-patient communication in English. Preliminary practice was carried out for one year, experimental class with theme-based instruction and content for language practice model, and control class with traditional teacher-centered teaching model. At the end of the practice, they were given the same test and questionnaire, it was found that CBI teaching models facil-itated to improve the students' English level and also enhanced their study motive and independent study ability.

Objective To investigate the feasibility of pulse Doppler combined with electrocardiographic thinking for diagnosis of fetal arrhythmia. Methods Sixty-five fetuses with arrhythmia were examined with prenatal ultrasound. Pulse Doppler spectrum of pulmonary arteries and pulmonary veins were ontained and anlyzed with electrocardiographic thinking, and different kinds of fetal arrhythmia were diagnosed and classified. Results Among the 65 fetuses, 12 were found with sinus bradycardia, 8 with sinus tachycardia, 5 with supraventricular tachycardia, 28 with atrial premature beat, 7 with premature ventricular and 5 with atrioventricular block. Conclusion Pulse Doppler combined with electrocardiographic thinking plays an important role in the diagnosis and classification of fetal arrhythmia.

Objective To describe the distributions of FCGR polymorphisms in human immunodeficiency virus (HIV)-uninfected patients with cryptococcosis,and to investigate the association of FCGR polymorphisms with the susceptibility to cryptococcosis.Methods The distributions of the four functional polymorphisms,including FCGR2A 131H/R,FCGR3A 158F/V,FCGR3B NA1/NA2,and FCGR2B 232I/T were compared between 198 cryptococcosis patients and 190 healthy controls.The polymorphisms distribution patterns were also compared between patients with central nervous system (CNS) infection and those without CNS infection.Genotyping of eight single nucleotide polymorphism (SNP) in FCGR were performed by multiplex SNaPshot technology using DNA extracted from blood samples.The comparison between patients and controls was performed by chi square test or Fisher exact test.Results Compared to healthy controls,the frequency of FCGR2B 232I/I increased (65％ vs 53％,x2 =4.27,P=0.039,OR=1.652,95％CI:1.02-2.67) and that of FCGR2B 232I/T decreased (27％ vs 40％,x2 =5.77,P=0.016.OR=0.542,95％CI:0.33-0.90) in patients with cryptococcal meningitis.Among immunocompetent patients,the frequency of FCGR2B 232I/I was also over-presented (69％ vs 53％,x2=4.53,P =0.033,OR=1.958,95％CI:1.05-3.66) and the FCGR2B 232I/T genotype was also less frequently observed (24％ vs 40％,x2=5.14,P=0.023,OR=0.467,95％CI:0.24-0.91) compared to healthy controls.There were 117 cases with CNS infection and 81 non-CNS infection cases.The genotype of FCGR2A 131R/Rwas over-presented (19％ vs 6％,x2 =6.48,P=0.011,OR=3.52,95％CI:1.27-9.73) and the FCGR2B 232I/T genotype was under-presented (27 ％ vs 46 ％,x2 =7.56,P =0.006,OR=0.431,95％CI:0.24-0.79) in patients with CNS infection compared with those without CNS infection.Furthermore,the frequency of FCGR2B 232I/I genotypes increased (69％ vs47％,x2 =5.47,P=0.019,OR=2.479,95％CI:1.15-5.34) and the frequency of FCGR2B 232I/T decreased (24％ vs 51％,x2 =8.66,P=0.003,OR=0.307,95％CI:0.14-0.68) in immunocompetent patients with CNS infection compared with those without CNS infection.Conclusions FCGR2A 131H/R and FCGR2B 232I/T are associated with the susceptibility to cryptococcal CNS infection,which suggests that FcγRⅡA and FcγRⅡB may contribute to the pathogenesis of cryptococcosis.

Objective To observe the relationship between morphological and hemodynamic changes of female internal genital organs in the patients with hypomenorrhea with transvaginal color Doppler ultrasound (TVCDS). Methods Thirty female patients with hypomenorrhea of unknown origin were studied, and 30 healthy women of eumenorrhea aged 20 to 40 years were selected as control group. The size and shape of uterus, ovaries, and the thickness of endometria of uterus were observed with TVCDS in follicular phase, ovulation phase, luteal phase and luteal atrophy phase, respectively. Hemodynamic parameters of ovarian artery, uterus artery and their branches were measured. At the same time, hormones of female were examined in 30 patients in follicular phase, ovulation phase and luteal atrophy phase, respectively. Results ①No difference of the size of uterus and ovaries, the thickness of endometria and the amount of egg follicles was found between two groups (P＞0.05). ②Compared with that in the control group, type C of endometria increased in hypomenorrhea group (P＜0.05). ③RI, PI and S/D of spiral arteries in hypomenorrhea group were higher than those in control group, but no significance in these parameters of uterine arteries, arcuate arteries and radiate arteries was found. RI of uterine arteries, arcuate arteries and radiate arteries decreased successively. ④RI, PI and S/D of ovarian arteries in hypomenorrhea group was higher than those in control group in ovulation phase (P＜0.05). Conclusion Reduction in blood supply of ovary and endometria may be the causes of hypomenorrhea with unknown origin. TVCDS can be used as a conventional examination method for these patients.

Objective To investigate the association between genetic polymorphisms of Dectin-2 and pulmonary cryptococcosis.Methods A total of 134 non-human immunodeficiency virus (HIV)patients with pulmonary cryptococcosis and 464 healthy controls were included in this case control study.The peripheral leucocyte DNA was extracted and genotyping was performed by multiplex SNaPshot technology.The single nucleotide polymorphism (SNP)of rs11045418 located at 5′-flanking locus of Dectin-2 gene was genotyped.Patients without predisposing conditions were compared independently.The differences of gene polymorphism distributions compared between pulmonary patients and healthy control, and between patients without predisposing conditions and healthy control.All data were analyzed withχ2 tests.Results Among the total 134 patients,82 patients had no predisposing factors.Thirty two patients met the proven diagnosis criteria and 102 patients were probable pulmonary cryptococcosis.According to the site of infection, 72 patients had local infection in lungs and 62 patients had disseminated cryptococcosis.Three samples failed in genotyping,one of which was a patient without predisposing factor.Compared with the control group,there was a trend of increasing proportion of heterozygote rs11045418 CT in the 131 pulmonary cryptococcosis patients (59% vs 50%,P =0.069,OR=1.44,95%CI :0.97-2.13),and the heterozygote was significantly increased in 81 patients without predisposing conditions(64% vs 50%,P =0.017,OR= 1 .82,95 %CI :1 .11 -2.95 ).No significant difference of genotype distribution was found between the local and disseminated infection patients.Conclusion Our study shows that rs11045418 CT heterozygote in Dectin-2 is associated with the susceptibility of pulmonary cyrptococcosis among non-HIV-infected Chinese patients,which indicated that the change of Dectin-2 receptor may play a role in the pathogenesis of pulmonary cyrptococcosis.

Diagnostic Imaging ; Humans ; Liver Diseases ; pathology ; Portal Vein ; pathology

The English curriculum in medical university can include English for general purpose (EGP), English for medical academic purposes (EMAP) and English for medical occupational purposes (EMOP). Teachers can dig deeply the medical humanities elements in the teaching materials, enrich the medical humanities knowledge and expand the medical terms. Combining production-oriented approach (POA) and online course, the teachers set up study groups, design medical scenarios, assign production tasks and carry out flipped classroom teaching practice. The three stages of POA, motivating, enabling and assessing, can organically connect pre-class, in-class and after-class. This model can cultivate effectively the medical students language competency, critical thinking ability and cooperative ability and improve their humanistic quality, and at the same time, it also poses higher requirements and challenges for front-line English teachers and students.

With advancements in robotic surgery technology and applications,its prospects in pancreatic surgery are becoming increasingly promising.Recent studies have shown that robotic pancreatic surgery has unique advantages over open and laparoscopic methods in certain aspects.While the international minimally invasive surgery field continues to evolve,the comprehensive clinical application of robotic pancreatic surgery still requires evidence-based medical guidance.Our team has taken the lead in updating and publishing the International Consensus Guidelines for Robotic Pancreatic Surgery(2023 Edition)in the journal Hepatobiliary Surgery and Nutrition,based on the International consensus statement on robotic pancreatic surgery This effort brought together numerous experts in minimally invasive surgery from the United States,Europe,and Oceania.The analysis of 176 studies included after systematic literature evaluation was conducted using the World Health Organization(WHO)Handbook for Guideline Development,GRADE Grid method,Delphi vote,and AGREE-Ⅱ instrument.Detailed discussions were provided on topics such as robotic pancreatoduodenectomy,robotic distal pancreatectomy,and robotic central pancreatectomy.Following expert assessments and a comprehensive evaluation of evidence quality and credibility,19 questions and 14 recommendations were proposed,aiming to provide a basis for the safe and effective promotion of robotic pancreatic surgery in comprehensive or specialty medical centers both in China and elsewhere.The new consensus also emphasizes the importance of randomized controlled trial evidence for several issues,highlighting a direction for further efforts to promote the safe and effective implementation of robotic pancreatic surgery.

OBJECTIVE To investigate the effects and mechanism of polysaccharides from Hedyotis diffusa （HDP） on isoniazid （INH）-induced liver injury. METHODS Healthy transgenic zebrafish with liver-specific fluorescence were divided into normal group， model group （4 mmol/L INH）， HDP low-concentration group （4 mmol/L INH+50 mg/mL HDP） and HDP high- concentration group （4 mmol/L INH+100 mg/mL HDP）. After grouping treating， the liver fluorescence area， fluorescence intensity and pathological changes of liver tissue were observed. Human liver L02 cells were divided into normal group， model group （4 mmol/L INH）， HDP low-concentration group （4 mmol/L INH+2 mg/mL HDP）， and HDP high-concentration group （4 mmol/L INH + 4 mg/mL HDP）. After grouping treating， the cell viability was detected， and the levels of alanine transaminase （ALT）， aspartate transaminase （AST）， and the content of glutathione （GSH） as well as the expression levels of silent information regulator 1 （Sirt1）， nuclear factor-erythroid 2-related factor 2 （Nrf2）， heme oxygenase-1 （HO-1） and quinone oxidoreductase 1 （NQO1） proteins were detected. RESULTS Compared with the model group， the HDP low- and high-concentration groups showed varying degrees of increase in the fluorescence area and fluorescence intensity （except for HDP low-concentration group） of zebrafish liver （P＜0.05 or P＜0.01）， and the characteristics of liver injury and necrosis had been improved to varying degrees. Compared with model group， the survival rate of L02 cells， the content of GSH （except for HDP low-concentration group）， the protein expression levels of Sirt1 （except for HDP low-concentration group）， Nrf2， NQO1， HO-1 （except for HDP low-concentration group） were significantly increased in HDP low- and high-concentration groups （P＜0.05 or P＜0.01）， and the levels of ALT and AST （except for HDP low-concentration group） were significantly decreased （P＜0.05）； the number of survival cells significantly increased， while the number of damaged or dead cells significantly decreased. CONCLUSIONS HDP has a potential protective effect against INH-induced liver injury， the mechanism of which may be associated with activating Sirt1/Nrf2 signaling pathway， improving mitochondrial function and enhancing antioxidant capacity.

External apical root resorption is among the most common risks of orthodontic treatment, and it cannot be completely avoided and predicted. Risk factors causing orthodontic root resorption can generally be divided into patient- and treatment-related factors. Root resorption that occurs during orthodontic treatment is usually detected by radiographical examination. Mild or moderate root absorption usually does no obvious harm, but close attention is required. When severe root resorption occurs, it is generally recommended to suspend the treatment for 3 months for the cementum to be restored. To unify the risk factors of orthodontic root resorption and its clinical suggestions, we summarized the theoretical knowledge and clinical experience of more than 20 authoritative experts in orthodontics and related fields in China. After discussion and summarization, this consensus was made to provide reference for orthodontic clinical practice.
Humans ; Tooth Movement Techniques/adverse effects* ; Root Resorption/etiology* ; Consensus ; Dental Cementum ; Risk Factors