The seco-prezizaane-type sesquiterpenes (SPS), as a special class of sesquiterpenes with a highly oxidative five-ring cage structure and seven consecutive chiral centers, are isolated from the genus Illicium, which have a variety of biological activities, including neurotoxicity and neurotrophic effects, etc. This review summarizes the chemical constituents and pharmacological effects of SPS, and discusses the potential trend and scope of future research.

Objective:To develop employer's satisfaction evaluation index system towards post competency of residents.Methods:Using Delphi method, the employer's satisfaction evaluation index system towards post competency of residents was formulated through a two-round expert consultation among 19 experts. SPSS 20.0 was used for statistical analysis to calculate the positive coefficient, authority coefficient and coordination degree of experts.Results:For the two rounds of the expert consultation, the questionnaire recovery rate was 95.0% and 100% respectively. The experts' authority coefficient was 0.92, and the system was ultimately determined, including 5 first-level indicators, and 32 secondary indicators. The coefficient of variation (CV) of first-level indicators was 0.00, and the Kendall's W of secondary indicators was 0.663. Conclusions:Employer's satisfaction evaluation index system towards post competency of residents is scientific and reliable, which could provide employer with systematic and objective tool to evaluate residents' post competency.

Objective:To analyze the correlation between drug-induced sleep endoscopy (DISE), results, polysomnography (PSG) indicators, and clinical parameters in patients with obstructive sleep apnea (OSA), and to establish and validate a predictive model for tongue base plane obstruction.Methods:This retrospective study analyzed 117 OSA patients diagnosed via PSG and treated at the Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, between October 2014 and March 2022. The cohort comprised of 114 males and 3 females, with an age range of 20 to 54 years (mean age 38.1±8.4 years). Data on DISE results, PSG results, and clinical indicators were collected for all 117 patients. Logistic regression analysis was performed to identify relevant indicators, and a predictive model for tongue base plane obstruction was constructed and internally validated using the R programming language.Results:Univariate logistic regression analysis identified four independent risk factors for predicting tongue root plane obstruction: tonsil grading, N2, N3, and rapid eye movement sleep(REM) stage [ OR:0.412(0.260~0.652),1.045(1.012~1.079),0.943(0.903~0.984),0.961(0.925~0.998), P <0.05]. Multivariate logistic regression analysis confirmed tonsil grading and N3 sleep stage (12.48±12.22%) as significant predictors. A nomogram model incorporating these factors demonstrated good predictive performance, with an area under curve(AUC) of 0.82 (95% CI: 0.548-1.000), an optimal cutoff of 0.519, a specificity of 80.0%, and a sensitivity of 86.7%. Internal validation of the model in the validation cohort yielded an AUC of 0.751 (95% CI: 0.625-0.876). Conclusions:Tongue base plane obstruction observed during DISE in OSA patients is associated with tonsil grading and N3 sleep stage duration. The predictive model developed for tongue base plane obstruction based on DISE demonstrates good efficacy, as evidenced by its internal validation.

Pathological cardiac hypertrophy serves as a significant foundation for cardiac dysfunction and heart failure. Recently, growing evidence has revealed that microRNAs (miRNAs) play multiple roles in biological processes and participate in cardiovascular diseases. In the present research, we investigate the impact of miRNA-34c-5p on cardiac hypertrophy and the mechanism involved. The expression of miR-34c-5p was proved to be elevated in heart tissues from isoprenaline (ISO)-infused mice. ISO also promoted miR-34c-5p level in primary cultures of neonatal rat cardiomyocytes (NRCMs). Transfection with miR-34c-5p mimic enhanced cell surface area and expression levels of foetal-type genes atrial natriuretic factor (Anf) and β-myosin heavy chain (β-Mhc) in NRCMs. In contrast, treatment with miR-34c-5p inhibitor attenuated ISO-induced hypertrophic responses. Enforced expression of miR-34c-5p by tail intravenous injection of its agomir led to cardiac dysfunction and hypertrophy in mice, whereas inhibiting miR-34c-5p by specific antagomir could protect the animals against ISO-triggered hypertrophic abnormalities. Mechanistically, miR-34c-5p suppressed autophagic flux in cardiomyocytes, which contributed to the development of hypertrophy. Furthermore, the autophagy-related gene 4B (ATG4B) was identified as a direct target of miR-34c-5p, and miR-34c-5p was certified to interact with 3' untranslated region of Atg4b mRNA by dual-luciferase reporter assay. miR-34c-5p reduced the expression of ATG4B, thereby resulting in decreased autophagy activity and induction of hypertrophy. Inhibition of miR-34c-5p abolished the detrimental effects of ISO by restoring ATG4B and increasing autophagy. In conclusion, our findings illuminate that miR-34c-5p participates in ISO-induced cardiac hypertrophy, at least partly through suppressing ATG4B and autophagy. It suggests that regulation of miR-34c-5p may offer a new way for handling hypertrophy-related cardiac dysfunction.

Objective:To explore and optimize the teaching content of clinical case discussion course based on clinical pathophysiology and therapy (CPPT), and to improve the teaching quality of this course.Methods:Self-compiled evaluation form was sent to all the students who participated in this course in 2016-2017 school year, and the teaching satisfaction and teaching characteristics were evaluated. The differences of evaluation results from students with different educational programs or teachers with different seniority were compared, and the correlation between evaluation results and teachers' seniority was analyzed.Results:The students had a high evaluation on the course, but students from different programs had significant different comments on thinking inspiring, speech encouraging, questions guiding, process holding and effective feedback, as well as the self-evaluation of mastery degree. For teachers with different seniority, there were significant differences in scores in all aspects except speech encouraging, but no differences in mastery degree. Spearman analysis showed that there was a certain correlation between scores and teachers' seniority.Conclusion:The overall situation of the CPPT case discussion course in our school is worthy of recognition, but it needs to be improved in many aspects.

Problem-based learning (PBL), which originated in foreign countries, advocates the core idea of multidisciplinary integrated learning, which coincides with the trend of curriculum integration in current medical education. First, this article systematically introduces the process of PBL in the organ system integrated course which is conducted in Nanshan College of Guangzhou Medical University. Second, this article discusses the teaching results and reflection so as to provide reference for the continuous localization reformation of PBL and further medical curriculum integration in college and university.

Objective:To evaluate the effect of epidural labor analgesia on hyperalgesia in the early postpartum period.Methods:Ninety nulliparas of primigravid, of American Society of Anesthesiologists physical statusⅠor Ⅱ, aged 20-35 yr, who were at full term with a singleton fetus, at 38-41 weeks of gestation, were assigned to labor analgesia group (group LA, n=38) and labor group (group L, n=52) according to whether the patient requested epidural labor analgesia or not.Epidural labor analgesia was performed when the cervical dilatation was 3-4 cm in LA group.The mechanical pain threshold was measured on admission to the delivery room and at days 1, 2 and 3 after delivery.Visual analog scale scores were assessed and recorded when cervical dilatation was 3 cm (T 1), at complete cervical dilatation (T 2), and at 12, 24 and 48 h after delivery (T 3-5). The duration of the first and second stage of labor and amount of intrauterine bleeding 2 h after delivery were recorded.Apger scores at 1, 5 and 10 min after birth were recorded. Results:Fifty-one cases completed surgery in group L and 37 cases in group LA.Compared with group L, the mechanical pain threshold was significantly increased, and visual analog scale score at T 2-4 was decreased, the first and second stages of labor were prolonged( P<0.05), and no statistically significant change was found in intrauterine bleeding volume or Apgar score at 2 h after delivery in group LA( P >0.05). Conclusion:Epidural labor analgesia can reduce hyperalgesia in the early postpartum period.

Objective:To investigate the consistency of Velum, Oropharygneal, Tongue base, Epiglottis (VOTE) scores between two surgeons with similar clinical experience in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with different degree of disease, and to analyze the influencing factors leading to the difference in score.Methods:This was a cross-sectional study. 64 preoperative drug-induced sleep endoscopy (DISE) videos of OSAHS patients during December 2014 to July 2018, from Nanfang Hospital, Southern Medical University were analyzed. The VOTE score was assessed single-blind by two similar experienced surgeons, and the Kappa value between the two scorers was calculated by the third researcher. According to the characteristics of the case, Fisher's exact test or chi-square test method was used to further explore the factors that influenced the consistency.Results:Sixty-four patients were divided into four groups according to the severity of the disease, including mild (7 cases), moderate (30 cases), severe(18 cases), and extremely severe (9 cases). The scores evaluated between two researchers were analysed for consistency. For mild patients, the two scorers were completely consistent in the configuration and degree of obstruction in the velum and epiglottis (Kappa=1). There was no agreement on whether obstruction or not, obstructed configuration, obstructed degree of the oropharynx and tongue base, and presence of velum and epiglottis obstruction. For moderate patients, the two scorers had a good consistency in the configuration and degree of the velum (0.61≤Kappa≤0.80), and there was no consistency in the evaluation of the degree of tongue base and epiglottis ( P>0.05). The consistency of the remaining obstructed conditions in the four planes was generally or moderate (0.21≤Kappa≤0.60). For patients with severe OSAHS, the two raters were completely consistent in the evaluation of palatopharyngeal and epiglottic planes for the presence of obstruction, but there was no consistency in the degree of obstruction. Although the degree of obstruction in the oropharyngeal plane can be assessed with good consistency, the consistency of whether the plane was blocked or not was generally not high. In the assessment of other obstructive conditions in the four planes of severe patients, the agreement between the two scorers was moderate or generally. For extremely severe patients, the two scorers were completely consistent in the evaluation of the velum obstruction, but there was no consistency in the degree of obstruction of the oropharynx and tongue base, and the obstruction configuration and degree of the epiglottis. The evaluation of other obstructed conditions in the four planes is good or moderate. Among the patients with severe OSAHS, the difference in the assessment of obstruction of the oropharynx was associated with tonsil size ( P<0.05). Conclusion:When physicians with similar clinical experience scored VOTE, the consistency of whether the velum and oropharyngeal planes are obstructed is related to the severity of the disease. Better consistency is observed among more severe OSAHS patients. The reason for the poor consistency of the oropharyngeal plane in severe OSAHS patients OSAHS is due to the difference of the tonsils size. For severe OSAHS patients with small tonsils, the assessment of whether the oropharynx is obstructed should be more cautious.

Objective To evaluate the effect of intraoperative warming on delirium during emergence from general anesthesia in elderly patients.Methods Eighty elderly patients of both sexes,aged ≥ 65 yr,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective total hip replacement,were assigned to routine group (group R,n=40) and warming group (group W,n=40).The non-operated site was covered using the sterile cloth,and no other active warming measurements were given in group C.Fluid was infused and warmed to 37 ℃,the non-operated site was covered using the forced-air warming system,and the temperature of the forced-air warming system was maintained at 38-42 ℃ in group W.The tympanic membrane temperatures was recorded at 5 min after anesthesia induction,at 30,60 and 90 min after beginning of surgery,at the end of surgery and at 30 min after emergence from anesthesia,and the difference between monitored values and monitored values on admission to operating room (△ T) was recorded at each time point.The intraoperative volume of fluid infused,operation time,extubation time,duration of postanesthesia care unit stay and development of delirium during emergence and shivering were recorded.Results Compared with group R,△T was significantly decreased at 60 and 90 min after beginning of surgery,the incidence of delirium during emergence and shivering was decreased,the extubation time and duration of postanesthesia care unit stay were shortened in group W (P＜0.05).Conclusion Intraoperative warming can decrease the development of delirium during emergence from general anesthesia and is helpful in improving the quality of recovery from anesthesia in elderly patients.

Objective To understand the effect of teacher training to provide reference for teachers' teaching methods in the standardization of clinical resident training.Method The teachers carried out five days of teacher training.Teacher training adopted the method of theory teaching and group discussion.The main content of the training had a "daily rounds with teaching","the proper use of ORIME evaluation","feedback of sandwich type","a minute tutor teaching method","SOAP method to report cases".Before the training,100 residents were randomly selected to evaluate the teaching in teaching teachers through self-designed questionnaire.After the training,the questionnaire survey was conducted among 100 residents again.All data were statistically analyzed by SPSS 22.0.The measurement data were represented by (mean or + standard deviation),and the date were compared by t test.Results Residents believed that after the teacher training,teachers' teaching level improved (P＜0.05).The three aspects of "general and phased learning goals","training students' clinical thinking ability through questions","requiring students to report cases and give guidance and feedback" were the most obvious.The pre training score was (3.28 ± 0.92) (3.31 ± 1.12) (3.55 ± 0.85),and the corresponding score was after training (3.98 ±0.85) (4.19 ± 0.85) (4.11 ± 0.74).Conclusion From the comparison of the survey results before and after the residents,the teachers' teaching modes,skills and methods have been improved after receiving teachers' training.