Empathy is a cornerstone in cultivating medical ethics.This article delves into the profound significance of empathy and underscores the importance of promoting it among medical students and practitioners.It also details methods for strengthening empathy and capacity building concerned in students through oral medicine instruction,with the goal of nurturing oral healthcare professionals who provide compassionate care.

In light of the professional characteristics of oral medicine,oral medical students may be challenged with higher medical risks during the clinical internship stage.This article analyzes the potential risk factors in the process of oral medicine internships and proposes corresponding preventive strategies,aiming to ensure medical safety and promote the healthy development of medical students.

Background and Aims:Rupture is the most serious complication of abdominal aortic aneurysm,requiring rapid diagnosis,emergency surgery,and posing significant surgical challenges,with high mortality rates. Currently,there is very limited reporting on ruptured abdominal aortic aneurysm (rAAA) in our country,which presents numerous difficulties for the prevention and treatment of rAAA. This study collected the data of epidemiological characteristics,treatment outcomes,and prognosis of rAAA patients from multiple centers with a large sample size,analyzing the current status and trends of rAAA surgery in China over the past decade,aiming to provide reference for clinical practice.Methods:The clinical and follow-up data of 161 rAAA patients treated at five major vascular surgery centers (50 from Drum Tower Hospital Affiliated to the Medical School,Nanjing University;19 from the First Affiliated Hospital of Anhui Medical University;33 from the Second Affiliated Hospital of Nanchang University;31 from Qilu Hospital,Shandong University;and 28 from the First Affiliated Hospital of the University of Science and Technology of China) were retrospectively analyzed.Results:Among the 161 patients,124 (77.02％) were male and 37 (22.98％) were female,with an average age of 68.27 years. The median age at diagnosis was 70 years for males and 71 years for females. The overall mean aneurysm diameter was 7.11 cm,with males at 7.72 cm and females at 6.82 cm,showing a statistically significant difference (P<0.05). The main comorbidities were hypertension and coronary artery disease. Over 80％ of patients presented with abdominal pain as the initial symptom,while 15％ presented with low back pain,and 8 patients sought medical attention for dizziness or visual disturbances. Among the 161 patients,86 underwent open surgical repair (OSR),and 75 received endovascular aneurysm repair (EVAR). The proportion of EVAR has increased annually,reaching nearly 70％ in the past five years,and up to 90％ in patients aged over 70 years. All OSR procedures were performed under general anesthesia,while 20 EVAR cases used local anesthesia and 55 used general anesthesia. Compared to the OSR group,the EVAR group showed significant differences in operative time (231.77 min vs. 162.49 min),intraoperative blood transfusion volume (1578.56 mL vs. 843.87 mL),length of hospital stay (21.21 d vs. 15.34 d),ICU stay duration (8.28 d vs. 5.49 d),and hospitalization costs (108500 CNY vs. 132800 CNY) (all P<0.05). No significant differences were found between the EVAR and OSR groups in total complications or perioperative mortality rates (both P>0.05). The main causes of perioperative death included respiratory and circulatory failure,acute myocardial infarction,and severe infections. Postoperative follow-up was effectively conducted for 92 patients,with follow-up durations ranging from 10 to 142 months. Survival analysis revealed no significant difference in survival rate between the OSR and EVAR groups (P=0.3182).Conclusion:rAAA is a rare and high-risk disease,with certain clinical differences between male and female patients. The number of EVAR procedures has increased rapidly;however,EVAR has not shown a significant advantage over OSR in improving long-term survival rates.

Objective To identify the N6-methyladenosine (m6A)-related characteristic genes analyzed by gene clustering and immune cell infiltration in myocardial ischemia-reperfusion injury (MI/RI) after cardiopulmonary bypass through machine learning. Methods The differential genes associated with m6A methylation were screened by the dataset GSE132176 in GEO, the samples of the dataset were clustered based on the differential gene expression profile, and the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of the differential genes of the m6A cluster after clustering were performed to determine the gene function of the m6A cluster. R software was used to determine the better models in machine learning of support vector machine (SVM) model and random forest (RF) model, which were used to screen m6A-related characteristic genes in MI/RI, and construct characteristic gene nomogram to predict the incidence of disease. R software was used to analyze the correlation between characteristic genes and immune cells, and the online website was used to build a characteristic gene regulatory network. Results In this dataset, a total of 5 m6A-related differential genes were screened, and the gene expression profiles were divided into two clusters for cluster analysis. The enrichment analysis of m6A clusters showed that these genes were mainly involved in regulating monocytes differentiation, response to lipopolysaccharides, response to bacteria-derived molecules, cellular response to decreased oxygen levels, DNA transcription factor binding, DNA-binding transcription activator activity, RNA polymerase Ⅱ specificity, NOD-like receptor signaling pathway, fluid shear stress and atherosclerosis, tumor necrosis factor signaling pathway, interleukin-17 signaling pathway. The RF model was determined by R software as the better model, which determined that METTL3, YTHDF1, RBM15B and METTL14 were characteristic genes of MI/RI, and mast cells, type 1 helper lymphocytes (Th1), type 17 helper lymphocytes (Th17), and macrophages were found to be associated with MI/RI after cardiopulmonary bypass in immune cell infiltration. Conclusion The four characteristic genes METTL3, YTHDF1, RBM15B and METTL14 are obtained by machine learning, while cluster analysis and immune cell infiltration analysis can better reveal the pathophysiological process of MI/RI.

Objective To establish a genetic monitoring method for laboratory quails.Methods Quail microsatellite loci were searched in the literature,and microsatellite DNA loci suitable for quails were screened by an interspecific transfer method in closely related species,namely chickens and ducks.Quail liver DNA was extracted as a template,and the corresponding loci were screened by PCR amplification and agarose gel electrophoresis.On the basis of amplification of the selected microsatellite loci,the number of alleles,polymorphisms,and microsatellite loci combinations for quail genetic quality detection were selected and detection method were developed.Results We preliminary determined 23 microsatellite loci for genetic monitoring of closed-colony laboratory quails.Conclusions A genetic monitoring method for laboratory quails was preliminary developed.

Objective:To compare the clinical outcomes between percutaneous Kirschner wire leverage plus plaster fixation and elastic intramedullary nailing in the treatment of radial neck fractures in children.Methods:A retrospective study was conducted to analyze the 60 children with radial neck fracture who had been treated by percutaneous Kirschner wire leverage plus plaster fixation at Department of Pediatric Orthopedics, Children's Hospital of Soochow University from January 2016 to July 2023 (set as an internal fixation-free group). They were 30 males and 30 females (34 left and 26 right sides) with an age of (7.7±3.0) years. At the same time, another cohort of 60 patients were chosen as an intramedullary nailing group who had been treated by percutaneous Kirschner wire leverage plus elastic intramedullary nailing and matched in age and gender with those in the internal fixation-free group. The preoperative fracture angulation, operative time, hospitalization time, fracture angulation on the first postoperative day, fracture angulation at 1 month postoperatively, rate of angulation loss after reduction, Mayo elbow performance score (MEPS) at the last follow-up and complications were compared between the 2 groups.Results:There was no significant difference between the 2 groups in their preoperative general data, showing comparability ( P<0.05). The 120 pediatric patients were followed up for (7.5±3.2) months. The operative time [(27.4±15.0) min] and hospitalization time [(3.4±1.9) d] in the internal fixation-free group were significantly shorter than those in the intramedullary nailing group [(45.4±13.5) min and (4.4±1.3) d] ( P<0.05). The preoperative fracture angulation (50.8°±1.9°), fracture angulation on the first postoperative day (11.3°±1.2°), fracture angulation at 1 month postoperatively (12.1°±1.3°), rate of angulation loss after reduction (2.9%±0.5%), and MEPS at the last follow-up [(90.4±2.0) points] in the internal fixation-free group showed no significant differences from those in the intramedullary nailing group [49.5°±1.7°, 11.1°±1.2°, 13.3°±1.5°, 3.9%±1.4%, and (90.2±2.3) points] ( P>0.05). None of the patients in the internal fixation-free group developed pin-tail irritation sign or premature epiphyseal closure after surgery, whereas 3 patients in the intramedullary nailing group developed pin-tail irritation sign and 2 ones premature epiphyseal closure after surgery, showing a significant difference in the complication rate between the 2 groups [0 (0/60) versus 8.3% (5/60)] ( P<0.05). Conclusions:Percutaneous Kirschner wire leverage plus plaster fixation and close elastic intramedullary nailing can both achieve satisfactory outcomes in the treatment of radial neck fractures in children. However, percutaneous Kirschner wire leverage plus plaster fixation needs shorter operative time and hospitalization time, leads to fewer complications, and requires no reoperation to remove internal fixation.

Post traumatic depression (PTD) is a serious complication after traumatic brain injury, with high incidence rate; PTD seriously affects the rehabilitation, outcome and quality of life of patients. Due to unclear pathogenesis of PTD, effective treatments have not yet been found in clinical practice. Repetitive transcranial magnetic stimulation (rTMS), as a new non-invasive neuroregulatory technique, has been used in major depression disorder (MDD). Few clinical evidence on PTD treated by rTMS is noted and optimal rTMS treatment regimen has not yet been defined.This article reviews the clinical studies of rTMS in PTD in recent years, with a view to provide references for clinical application.

Background and Aims:Rupture is the most serious complication of abdominal aortic aneurysm,requiring rapid diagnosis,emergency surgery,and posing significant surgical challenges,with high mortality rates. Currently,there is very limited reporting on ruptured abdominal aortic aneurysm (rAAA) in our country,which presents numerous difficulties for the prevention and treatment of rAAA. This study collected the data of epidemiological characteristics,treatment outcomes,and prognosis of rAAA patients from multiple centers with a large sample size,analyzing the current status and trends of rAAA surgery in China over the past decade,aiming to provide reference for clinical practice.Methods:The clinical and follow-up data of 161 rAAA patients treated at five major vascular surgery centers (50 from Drum Tower Hospital Affiliated to the Medical School,Nanjing University;19 from the First Affiliated Hospital of Anhui Medical University;33 from the Second Affiliated Hospital of Nanchang University;31 from Qilu Hospital,Shandong University;and 28 from the First Affiliated Hospital of the University of Science and Technology of China) were retrospectively analyzed.Results:Among the 161 patients,124 (77.02％) were male and 37 (22.98％) were female,with an average age of 68.27 years. The median age at diagnosis was 70 years for males and 71 years for females. The overall mean aneurysm diameter was 7.11 cm,with males at 7.72 cm and females at 6.82 cm,showing a statistically significant difference (P<0.05). The main comorbidities were hypertension and coronary artery disease. Over 80％ of patients presented with abdominal pain as the initial symptom,while 15％ presented with low back pain,and 8 patients sought medical attention for dizziness or visual disturbances. Among the 161 patients,86 underwent open surgical repair (OSR),and 75 received endovascular aneurysm repair (EVAR). The proportion of EVAR has increased annually,reaching nearly 70％ in the past five years,and up to 90％ in patients aged over 70 years. All OSR procedures were performed under general anesthesia,while 20 EVAR cases used local anesthesia and 55 used general anesthesia. Compared to the OSR group,the EVAR group showed significant differences in operative time (231.77 min vs. 162.49 min),intraoperative blood transfusion volume (1578.56 mL vs. 843.87 mL),length of hospital stay (21.21 d vs. 15.34 d),ICU stay duration (8.28 d vs. 5.49 d),and hospitalization costs (108500 CNY vs. 132800 CNY) (all P<0.05). No significant differences were found between the EVAR and OSR groups in total complications or perioperative mortality rates (both P>0.05). The main causes of perioperative death included respiratory and circulatory failure,acute myocardial infarction,and severe infections. Postoperative follow-up was effectively conducted for 92 patients,with follow-up durations ranging from 10 to 142 months. Survival analysis revealed no significant difference in survival rate between the OSR and EVAR groups (P=0.3182).Conclusion:rAAA is a rare and high-risk disease,with certain clinical differences between male and female patients. The number of EVAR procedures has increased rapidly;however,EVAR has not shown a significant advantage over OSR in improving long-term survival rates.

Nasopharyngeal carcinoma (NPC) is the third most common malignancy with a high recurrence and metastasis rate in South China. Natural compounds extracted from traditional Chinese herbal medicines have been developed and utilized for the treatment of a variety of cancers with modest properties and slight side effects. Maackiain (MA) is a type of flavonoid that was first isolated from leguminous plants, and it has been reported to relieve various nervous system disorders and exert anti-allergic as well as anti-inflammatory effects. In this study, we demonstrated that MA inhibited proliferation, arrested cell cycle and induced apoptosis in nasopharyngeal carcinoma CNE1 and CNE2 cells in vitro and in vivo. The expression of the related proteins associated with these processes were consistent with the above effects. Moreover, transcriptome sequencing and subsequent Western blot experiments revealed that inhibition of the MAPK/Ras pathway may be responsible to the anti-tumor effect of MA on NPC cells. Therefore, the effects of MA and an activator of this pathway, tertiary butylhydroquinone (TBHQ), alone or combination, were investigated. The results showed TBHQ neutralized the inhibitory effects of MA. These data suggest that MA exerts its anti-tumor effect by inhibiting the MAPK/Ras signaling pathway and it has the potential to become a treatment for patients with NPC.
Humans ; Nasopharyngeal Carcinoma/pathology* ; Cell Line, Tumor ; Cell Proliferation ; Apoptosis ; Signal Transduction ; Nasopharyngeal Neoplasms/pathology*