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 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 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.

Amino Acid Metabolism, Inborn Errors ; blood ; diagnosis ; Humans ; Infant, Newborn ; Male

Objective To investigate the effects of metformin on blood glucose control and body weight management in over-weight patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods A retrospective study was performed in T2DM patients who were treated with metaformin (male 38,female 23,mean age (50.8 ± 7.9) years old).Based on body mass index (BMI),all the participants were assigned to obese,over-weight and normal weight group.Analysis of variance and multivariate analysis were used to confirm the effects of metformin on blood glucose and body weight.Results Fasting blood glucose (FBG),HbA1 c and BMI were significantly reduced over 2 years.In comparison with baseline,BMI of the obesity and overweight group was significantly decreased during follow up (P ＜ 0.05),while BMI of the normal weight group increased by 0.7 kg/m2.At baseline,FBS and HbAlc of the obese group were lower than those of the normal weight group (FBS (7.3 ± 0.8) vs.(11.8 ± 4.8) mmol/L,P ＜ 0.05 ; HbA1 c (6.8 ± 1.2) ％ vs.(8.5 ±3.1)％,P ＜0.05),whereas insulin level was higher than that of the normal weight group ((2.20 ± 0.36) vs.(1.87 ± 0.29) U,P ＜ 0.05).At 2 years,HbA1 c was reduced on average by 2.5％,1.4％ and 1.9％ in the obesity,over-weight and normal weight group,respectively.Conclusions The present study demonstrates the beneficial effect of metformin on newly diagnosed diabetics,especially obese patients.

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 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 dosimetrically compare three delivery techniques of VMAT,IMRT and 3D-CRT in the treatment of accelerated partial breast irradiation (APBI).Methods Twenty patients with T1/2N0M0breast cancer were treated with VMAT.These cases were subsequently re-planned using static gantry IMRT and 3D-CRT technology to evaluate dosimetric differences.Dosimetric parameters including dose conformity index (CI),dose volume histogram (DVH) analysis of normal tissue coverage,dose parameters of PTV and normal tissues were evaluated,the delivery parameters including MU and delivery time were also analyzed.Results The IMRT and VMAT plans provided lower maximum dose,better mean dose and more conformal target dose distributions than the 3D-CRT plans (F =14.86,8.57,18.23,P ＜0.05).The volume of ipsilateral breast receiving 5 Gy for VMAT technique was significantly less than that of3D-CRTor IMRT(F=5.83,P＜0.05).The ipsilateral lung volume receiving 20 Gy (V20),5 Gy(V5) and the 5％ volume dose (D5) of IMRT were superior to those of 3D-CRT and VMAT(F =16.39,3.62,4.81,P ＜ 0.05).The low volume dose distributions of D5 in contralateral lung for IMRT was better than that of VMAT and 3D-CRT(F =3.99,3.43,P ＜ 0.05).The total mean MUs for VMAT,3D-CRT and IMRT were 621.0 ± 111.9,707.3 ± 130.9 and 1161.4 ± 315.6,respectively (F =31.30,P ＜ 0.05).The average machine delivery time was(1.5 ± 0.2)min for the VMAT plans,(7.0 ± 1.6)min for the 3D-CRT plans and (11.5 ± 1.9)min for the IMRT plans.Conclusions VMAT and IMRT techniques offer improved dose conformity as compared with 3D-CRT techniques without increasing dose to the ipsilateral lung.In terms of MU and delivery time,VMAT is more efficient for APBI than conventional 3D-CRT and static beam IMRT.

Objective To evaluate the clinical application and safety of CT-guided transthoracic cutting needle lung biopsy in diagnosing diffuse lung diseases. Methods By using automatic biopsy gun (14 & 16 gauge), CT-guided transthoracic cutting needle lung biopsy was performed in 29 cases with diffuse lung diseases. The samples obtained were sent for pathological and immunohistochemical examination. The sampling successful rate, the diagnostic accuracy and the occurrence of complications were analyzed. Results Technical success rate was 100%, and large size of sample enough for pathological and immunohistochemical examination was obtained in all 29 cases. Definite pathological diagnosis could be made in 25 cases, with the positive diagnostic rate of 82.8%. The main complications included pneumothorax and pulmonary hemorrhage. The symptoms in most cases were not severe and disappeared within one week after the treatment. Conclusion For the diagnosis of diffuse lung diseases, CT-guided transthoracic cutting needle lung biopsy is a safe, easy, effective and reliable method with high successful rate, high diagnostic value and fewer complications, in these respects this technique is superior to transbronchial lung biopsy, open lung biopsy and video-assisted thoracoscopic lung biopsy. Therefore, this technique should be popularized in clinical practice.