It is one of the common problems faced by many medical schools how to carry out the hidden curriculum in humanities education of medical education.This article approaches the composition and connotation of the curriculum in order to improve the relevance and effectiveness of the humanities education of medical education

Adolescent ; Atherosclerosis ; drug therapy ; etiology ; prevention & control ; therapy ; Child ; Humans ; Hyperlipidemias ; complications ; prevention & control ; therapy ; Hypolipidemic Agents ; therapeutic use ; Life Style ; Obesity ; complications ; prevention & control ; Primary Prevention ; Risk Factors

Objective Response surface methodology ( RSM ) was applied to optimize the ultrasonic extraction conditions for flavonoids from Coreopsis tinctoria Nutt. Methods The influence factors of ultrasonic extraction were evaluated using the Box-Behnken central component experiments and analyzed by RSM. Results The optimum extraction conditions were confirmed as follows:extraction time 30. 0 min, ratio of liquid to solid 21∶1, concentration of ethanol 60%. The yield of flavonoids under this condition was (4.65±0.036)% (n=3). Conclusion The flavonoids could be extracted with stability and higher yield from Coreopsis tinctoria Nutt under optimized conditions.

Objective To establish a novel Monte Carlo simulation method for reconstruction of medical accelerator model and X?ray energy spectrum based on IAEA Varian 6 MV X?ray phase?space file and photon energy spectrum of the target accelerator. Methods The verified 6 MV X?ray phase?space files were preprocessed to elevate the energy of each particle. Particles were saved in different Phase?Space?Let ( PSL) files according to their position and energy, yielding an initial photon energy spectrum for Monte Carlo simulation of accelerator under an initial target energy. The initial photon energy spectrum was fit to a photon energy spectrum of an accelerator ( Elekta Precise 10 MV X?ray accelerator) under an unknown target energy to yield a fitting coefficient, which was the weight of each PSL. Finally, an accelerator model under an unknown target energy was reconstructed using the initial PSL files and the weight information. The percentage depth dose ( PDD) distribution was calculated in different square open fields. The effectiveness of this method was verified using one dimensional gamma passing rate. Results The peak position and overall distribution of the reconstructed 10 MV photon energy spectrum were in accordance with those of the verified 10 MV photon energy spectrum. The PDD calculated from the reconstructed 10 MV accelerator model agreed well with the measured PDD. The one?dimensional gamma passing rate was above 96%( 1%/1 mm, threshold=0%) . Conclusion The Monte Carlo reconstruction method proposed in this study is reliable, accurate, and effective.

Objective To analyze the relationship between pulse wave velocity (PWV)in young and middle-aged normal body mass patients with mild -moderate hypertensive and risk factors of cardiovascular diseases,and to explore the main factors influencing large arterial elasticity.Methods PWV were measured by Complior (Colson, France).Systolic blood pressure (SBP)and diastolic blood pressure were measured and fasting blood glucose,blood lipid were tested at the same time.The results was analyzed by correlation and multiple regression method.Results (1)Patients with hypertension had statistically significant higher cfPWV than nonhypertensive cases(P <0.01).(2) Correlation analysis showed that the cfPWV were positively related to age,systolic pressure,diastolic pressure,pres-sure difference(r =0.401,0.467,0.289,0.278,P =0.001,0.000,0.020);Deleting the factors of age,abdomen circumference and BMI,the cfPWV was still positively related to systolic pressure,diastolic pressure and pressure differences(r =0.417,0.297,0.315,P =0.001,0.018,0.012).Multiple regression analysis showed that age,systol-ic pressure were mostly related to cfPWV(t =3.945,3.481,P =0.000,0.001).Conclusion Artery elastic function in young and middle aged people is obviously lower in patients with hypertension.cfPWV has strong positive relation with age and systolic pressure.

Objective To study the role of CT in the evaluation after patellar dislocation triple surgeries.Methods Retrospectively analysed the CT measurements of 60 recurrent patellar dislocation patients (61 knees),who had undergone patellar dislocation triple surgeries,within one month before and after procedures.The measurements included patellar tilt angle,lateral patellar displacement,trochlear con-gruence angle,Tibial Tuberosity-Trochlear Groove distance,Insall-Salvati Ratio and Caton-Deschamps Index.Moreover,the troch-lear dysplasia classifications of all patients were evaluated.In addtion,an analysis has also been completed for 40 (41 knees)of 60 patients who had second postoperative CT examinations as follow-up assessment 3 to 6 months after surgeries.Results All one-month postoperative measurements decreased obviously with statistical significance(P <0.05 ).Furthermore,one case of subluxa-tion,1 1 cases of abnormal Tibial Tuberosity-Trochlear Groove distance,13 cases of abnormal Insall-Salvati Ratio and 14 cases of Ca-ton-Deschamps Index abnormities were also observed.Besides that,it was also found that all patients had trochlear dysplasia and 5 cases were diagnosed with patellar subluxation or dislocation at the second postoperative follow-up assessment.Conclusion The patients with redislocation or risks for patellar instability can be detectecd by CT which provides objective evidence for postoperative evaluation and further treatments.

Objective:To evaluate the effects of perioperatively administrated enteral immunonutrition in gastrointestinal cancer patients on immune and inflammatory responses,nutrition states and postoperative morbidity.Methods:Sixty patients with gastrointestinal cancer were divided randomly into two groups.Two groups perioperatively(from preoperative day 5 to postoperative day 7) received an supplemented diet with arginine,RNA,and ?-3fatty acids(immunonutrition group;n=30) or an isoenergetic and isonitrogenous standard diet (standard-nutrition group;n=30).All variables of immune and inflammatory responses,nutrition states and postoperative morbidity were measured on preoperative day 5 and postoperative day 1,4 and 8.Results:On postoperative day 4 and 8,most immune variables and prealbumin in the immuno-group were significantly higher than those in the standard-group(P0.05),and inflammatory variables as CRP in the immunonutrition group were significantly lower than those in the standard group.In the immunonutrition group,there were significantly fewer patients who experienced postoperative complications and shorter days of hospital stay compared with standard group(P0.05).Conclusion:The perioperative administration of enteral immunonutrition in gastrointestinal cancer patients can significantly modulate the postoperative immunosuppressive and inflammatory responses at the early postoperative day,can significantly decrease the occurrence of infectious and overall postoperative complications as well as the length of hospital stay.

Objective To explore the application effect of de-escalation thinking shift mode in emergency condition of morning shift meeting. Methods Guided by the de-escalation thinking, critical ill patients transfer tables were established in the emergency department, patients admitted into the emergency resuscitation room were selected from January 2015 to December 2015, and divided into the observation group (329 cases) and the control group ( 310 cases) . Patients in the control group applied the traditional oral shift meeting mode by the bed to check the patient; patients in the observation group applied the de-escalation thinking shift mode of morning shift meeting, followed by the specification of morning shift process and content; additionally, the cooperation of nursing staff, the transfer of nursing adverse events, nurses awareness of the patient′s condition, the patient satisfaction survey were counted before and after the implementation, respectively. Results Chinese version of Nursing Assessment Shift Report (NASR) was used to evaluate the cooperation status between the two sides of nursing staffs, and the mean scores of nursing staffs were 60.50±1.80 and 78.20±2.50 in the control group and the observation group, respectively, showing statistical significance (t=14.23, P<0.01);before application, corresponding statistical results regarding the shift meeting related nursing adverse events showed that there were 5 cases of infusion prolapse/leakage, 2 cases of pressure ulcer, 3 cases of pipe extrusion, and 2 cases of delayed drug delivery;after application, there were 2 cases of infusion prolapse/leakage, 0 case of pressure ulcer, 1 case of pipe extrusion, and 1 case of delayed drug delivery;comparison results showed significantly statistical difference (χ2=1.76-6.74, P<0.05). Before application, assessment results regarding the mean scores of nurses awareness of the patient's condition showed that mean scores of patients′ state of illness, test results, current treatment, potential risk, and nursing focus were 3.83 ± 0.62, 3.16 ± 0.64, 4.17 ± 0.36, 3.47 ± 1.26, and 3.64 ± 1.10, respectively;and after application, mean scores of patients′state of illness, test results, current treatment, potential risk, and nursing focus were 4.71 ± 0.27, 4.53±0.66, 4.89 ± 0.10, 4.50 ± 0.61, and 4.72 ± 0.43, respectively;the differences were statistically significant (t=-8.86--3.35, P<0.05). Furthermore, patient satisfaction with nursing staff in emergency department was improved from 91.6%(284/310) to 96.0%(316/329)(χ2 =25.74,P<0.05). Conclusions The application of de-escalation thinking shift mode in emergency condition of morning shift meeting may contribute to the specification of the transfer process, improvement of nursing work efficiency, and finally result in the promotion of patients′safety and teamwork.

Objective:To establish the quality standard for Kechuanning granules. Methods: A TLC method was used for the qualitative study on the main ingredients, Radix stemonae,ephedra and bitter almond. An HPLC method was used to determine the con-tents of ephedrine hydrochloride,pseudoephedrine hydrochloride and amygdalin. The separation of targeted compounds was performed on a Tech Mate C18-ST column (250 mm × 4. 6 mm,5 μm) . The mobile phase consisted of methanol(A) and 0. 1% phosphoric acid (B) with gradient elution at a flow rate of 1. 0 ml·min-1. The detection wavelength was 207nm and the column temperature was 35℃. Results:The spots in TLC were quite clear without any interference from negative control. The linear relationship of ephedrine hydrochloride,pseudoephedrine hydrochloride and amygdalin was 1. 826-182. 600μg·ml-1( r=0. 9997),1. 848-184. 815μg·ml-1 (r=0. 9997) and 2. 981-298. 069 μg·ml-1(r=0. 9996),respectively. The average recovery was 97. 00%,97. 40% and 98. 30%(RSD=3.7%,2.5%,1.6%)(n=9),respectively. Conclusion: The method is sensitive,accurate,simple and reproducible,which can be used for the quality control of Kechuanning granules.

OBJECTIVE:To establish the method to control the quality of Qilian suppository.METHODS:TLC was per?formed to identify Rhizoma coptidis and Radix Notoginseng.A reverse phase HPLC-ELSD method was adopted to determine the content of ginsenoside Rg 1 and ginsenoside Rb 1 in Radix Notoginseng.RESULTS:The study on the quality control showed that the characteristic of identification by TLC was distinct and highly specific.In this quantification method,the linear ranges of ginsenoside Rg 1 and Rb 1 were1.56?g～3.74?g(r=0.9993,RSD=1.6%)and1.44?g～3.46?g(r=0.9981,RSD=1.2%)respectively.The average recovery rate of ginsenoside Rg 1 was99.10%,and RSD=1.6%(n=3);the average recovery rate of ginsenoside Rb 1 was102.13%,and RSD=1.2%(n=3).CONCLUSION:The method is simple,sensitive,accurate and re?peatable.It can be used for the quality control of Qilian suppository.