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.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; Castleman Disease ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective To analyze, treatment of ipsilateral Pilon and calcaneal fractures (IPCF). Methods Injury causes included fallings in seven patients, traffic injury in two and impact injury in one, with ISS score of 5-22 points. There were seven patients with open injuries and 3 with close ones. Nine pa-tients had Ⅱ-Ⅲ degree of Pilon fractures according to the AO/OTA classification and six comminuted com-pression calcaneal fractures according to the Essex-Loprest classification. The Pilon fractures were fixed by cannulated nail, screw or Kirschner wire through open reduction in six patients including four fixed with ex-ternal fixators (the calcaneal fractures were fixed with percutaneous eannulated nail or Kirschner wire by poking reduction). The calcaneal fractures were fixed with only Kirschner wire through poking reduction in two patients and double fractures treated conservatively in two. Results The reduction of Pilon and cal-caneal fractures treated by operation were markedly improved in six patients, while there occurred angular deformity and joint surface introeession in the patients treated conservatively. The wound healing of soft tis-sue was sound in seven patients but unsatisfactory in the other three. The ankle-hind foot score was 82-94 points in four patients who were followed up. Conclusions IPCF is caused by the high energy force and characterized by severe injures of the soft tissues and the bone tissues at the distal tibia and calcaneua, for which limited internal fixation plus external fixation are suitable treatment choice.

Objective To study the clinical and the epidemiological features of hospitalized children with influenza virus infection. Methods Two hundred and fifty-three inpatients with laboratory-confirmed influenza virus infection from 1999 to 2008 were reviewed for analyzing the clinical and epidemiological characteristics. Type A and B influenza viruses in the nasopharyngeal aspirates were detected by immunofluorescence assay. Mann-Whitney U test were performed for comparing the median age and the length of hospitalization. Chi-square test was performed for comparing the proportion of patients with fever and cough. Results Among 253 hospitalized children aged between 5 days and 127 months, 182 (71.9%) were boys and 71 (28. 1%) were girls. The median age was 18 months. Fifty-three cases were infants younger than 6 months. 95 cases were children aged between 6 months and 2 years, 85 cases were aged between 2 years and 5 years and 20 cases were older than 5 years. The diagnosis of influenza-related admission included pneumonia (190 cases), bronchitis (49 cases) and upper respiratory tract infection (14 cases). Eleven cases developed febrile convulsion, 6 cases had acute exacerbation of asthma and 3 cases had concomitant viralencephalitis. Twenty-nine cases had basic diseases. Cough and fever were the most common symptoms. Two hundred and thirty-eight cases presenting cough and 209 case presenting fever. Sixty-seven percent (140/209) had high fever with body temperature higher than 39 ℃. The average duration of fever was (5. 0 ±2. 9) days. Fever and cough were both more common in children older than6 months (X2 = 22. 895,P<0. 01; X2 = 16. 992,P<0. 01, respectively). Febrile convulsion occurred in children older than 2 years. Fifteen point five (39/251) developed leukocytopenia. Conclusions Children younger than 5 years old are at high risk of influenza-related hospitalization. We should emphasize influenza vaccination in previously healthy children aged between 6 months and 5 years and children with underlying diseases.

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.

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.

This paper was aimed to study the genetic diversity and genetic relationship of germplasm resource of Lonicerae Japonicae Flos in order to provide references for its breeding. A total of 36 samples from 18 farm varieties and wild species, as well as related species of Lonicera japonica Thunb. from the main production areas were studied by ISSR-PCR markers. The Jaccard coefficient was worked out by NTSYS-pc software. And a cluster dendrogram of different samples was established based on unweighted pair-group method with arithmetic mean (UPGMA). The re-sults showed that 12 ISSR primers generated 129 loci of which 114 loci were polymorphic. The average percentage of polymorphic bands (PPB) is 88.37%. In the cluster dendrogram, different samples of Lonicera japonica are in the same group, which showed that it is a natural species; the wild sample is separated from the cultivated samples; the traditional type-Maohua is relative stable, but the type of Jizhuahua includes complicated varieties, and it has obvi-ous genetic variation; the new variety Jiufeng 1 has already distinct into one stable type. It was concluded that the ISSR method was suitable for germplasm identification, genetic diversity analysis of Lonicerae Japonicae Flos, thus providing a theoretical foundation for its cultivation and breeding.