The study was conducted among 120 general practitioners (GPs) in Shanghai Fengxian District from August 2022 to March 2024, the participants were randomly divided into two age-matched groups with 60 GPs in each group. The intervention group completed a 3-month SPOC (Small Private Online Course)program, including two weeks of narrative medicine theory (concepts, questioning skills, parallel medical record writing, and professionalism) followed by monthly writing practices (three parallel records per month) and group discussions. Both groups performed routine clinical tasks, while the control group received no narrative medicine training. Baseline data were collected, Jefferson Empathy Scale scores, and Doctor-Patient Communication Skills Evaluation Scale scores were evaluated pre- and post-intervention. There were no significant differences in empathy ( P>0.05) or communication skills ( P>0.05) between two groups before the intervention. Post-intervention, both groups showed improved empathy (both P<0.05) and communication skills (both P<0.05) after intervention, while the intervention group were outperforming the control group in both measures ( P<0.05). These findings suggest that SPOC-based narrative competence training effectively enhances the empathy and doctor-patient communication abilities of general practitioners.

The study was conducted among 120 general practitioners (GPs) in Shanghai Fengxian District from August 2022 to March 2024, the participants were randomly divided into two age-matched groups with 60 GPs in each group. The intervention group completed a 3-month SPOC (Small Private Online Course)program, including two weeks of narrative medicine theory (concepts, questioning skills, parallel medical record writing, and professionalism) followed by monthly writing practices (three parallel records per month) and group discussions. Both groups performed routine clinical tasks, while the control group received no narrative medicine training. Baseline data were collected, Jefferson Empathy Scale scores, and Doctor-Patient Communication Skills Evaluation Scale scores were evaluated pre- and post-intervention. There were no significant differences in empathy ( P>0.05) or communication skills ( P>0.05) between two groups before the intervention. Post-intervention, both groups showed improved empathy (both P<0.05) and communication skills (both P<0.05) after intervention, while the intervention group were outperforming the control group in both measures ( P<0.05). These findings suggest that SPOC-based narrative competence training effectively enhances the empathy and doctor-patient communication abilities of general practitioners.

Objective To investigate the clinical effect of metal supported multi-sided versus ordinary ultra-fine drainage tube in the uniportal video-assisted thoracic surgery (VATS) lower pulmonary lobectomy. Methods From January 2021 to June 2022, the clinical data of patients who underwent uniportal VATS lower lobectomy in our hospital were retrospectively analyzed. According to the different types of ultra-fine drainage tubes used in the surgery, the patients were divided into an experimental group (using multi-sided hole 10F ultra-fine drainage tubes with metal support) and a control group (using ordinary 12F ultra-fine drainage tubes). The clinical data of the two groups were compared. Results A total of 190 patients were enrolled, including 108 males and 82 females. There were 90 patients in the experimental group aged 56.60±10.14 years; and 100 patients in the control group aged 57.07±11.04 years. The incidences of postoperative lung infection and pleural effusion in the experimental group were lower than those in the control group, with statistically significant differences (P<0.05). The postoperative visual analogue scale score, the need to adjust the chest drainage tube after the surgery, the need for chest puncture after the surgery, the time of postoperative chest tube removal, and the hospitalization cost were statistically different (P<0.05). There was no statistical difference in the length of postoperative hospital stay or the incidences of postoperative lung leakage, arrhythmia, and atelectasis complications (P>0.05). Conclusion Compared with the ordinary ultra-fine drainage tubes, multi-sided hole ultra-fine drainage tubes with metal support can reduce the incidences of lung infection and pleural effusion complications after the uniportal VATS lower lobectomy, reduce the pain and economic burden, which can be applied in the uniportal VATS lower lobectomy.

Objective:The nasal swell body（NSB） consists of the nasal septal cartilage, nasal bone, and swollen soft tissue, all of which are visible during endoscopic and imaging examinations. Although the function of the NSB remains uncertain, there is evidence to suggest that it plays a vital role in regulating nasal airflow and filtering inhaled air. Based on anatomical and histological evidence, it is hypothesized that the NSB is indispensable in these processes. This study aims to investigate the impact of NSB on nasal aerodynamics and the deposition of allergen particles under physiological conditions. Methods:The three-dimensional （3D） nasal models were reconstructed from computed tomography （CT） scans of the paranasal sinus and nasal cavity in 30 healthy adult volunteers from Northwest China, providing basis for the construction of models without NSB following virtual NSB-removal surgery. To analyze the distribution of airflow in the nasal cavity, nasal resistance, heating and humidification efficiency, and pollen particle deposition rate at various anatomical sites, we employed the computed fluid dynamics（CFD） method for numerical simulation and quantitative analysis. In addition, we created fully transparent segmented nasal cavity models through 3D printing, which were used to conduct bionic experiments to measure nasal resistance and allergen particle deposition. Results:①The average width and length of the NSB in healthy adults in Northwest China were （12.85±1.74） mm and （28.30±1.92） mm, respectively. ②After NSB removal, there was no significant change in total nasal resistance, and cross-sectional airflow velocity remained essentially unaltered except for a decrease in topical airflow velocity in the NSB plane. ③There was no discernible difference in the nasal heating and humidification function following the removal of the NSB; ④After NSB removal, the deposition fraction（DF） of Artemisia pollen in the nasal septum decreased, and the DFs post-and pre-NSB removal were（22.79±6.61）% vs （30.70±12.27）%, respectively; the DF in the lower airway increased, and the DFs post-and pre-NSB removal were（24.12±6.59）% vs （17.00±5.57）%, respectively. Conclusion:This study is the first to explore the effects of NSB on nasal airflow, heating and humidification, and allergen particle deposition in a healthy population. After NSB removal from the healthy nasal cavities: ①nasal airflow distribution was mildly altered while nasal resistance showed no significantly changed; ②nasal heating and humidification were not significantly changed; ③the nasal septum's ability to filter out Artemisia pollen was diminished, which could lead to increased deposition of Artemisia pollen in the lower airway.
Adult ; Humans ; Cross-Sectional Studies ; Nasal Cavity/surgery* ; Allergens ; Pollen ; Artemisia ; Hydrodynamics

Objective    To explore the safety, feasibility and superiority of tubeless video-assisted thoracoscopy in the treatment of primary palmar hyperhidrosis (PPH). Methods    The clinical data of 46 patients with palmar hyperhidrosis treated by thoracoscopy in the Department of Thoracic Surgery of the First Hospital of Lanzhou University from March 2017 to September 2020 were retrospectively analyzed. Among them, 22 received tubeless video-assisted thoracoscopic surgery, and were divided into a tubeless group, including 10 males and 12 females with an average age of 24.3±6.4 years; 24 received conventional thoracoscopic surgery, and were divided into a control group, including 13 males and 11 females with an average age of 23.5±4.8 years. The operation status, anesthesia effect and postoperative complications of the two groups were compared. Results    Forty-six patients successfully completed the operation with the assistance of thoracoscopy. There was no intraoperative transfer to thoracotomy, or intraoperative transfer to tracheal intubation in the tubeless group. Anesthetic recovery time (14.4±1.6 min vs. 20.1±1.8 min, P=0.000), time to get out of bed on the first postoperative day (3.1±0.6 h vs. 1.6±0.4 h, P=0.000), visual analogue score for postoperative pain (1.4±0.6 points vs. 3.4±1.1 points, P=0.000), postoperative hospital stay (1.7±0.5 d vs. 2.8±0.6 d, P=0.000), postoperative satisfaction rate of patients (95.5% vs. 66.7%, P=0.037) in the tubeless group were shorter or better than those in the control group. There was no statistical difference in age, gender, smoking history, palmar hyperhidrosis classification, palms or other  associated parts, the total time of bilateral surgery, intraoperative blood loss, postoperative complications, or compensatory hyperhidrosis (mild) between the two groups (P>0.05). Conclusion    Compared with traditional thoracoscopic surgery for PPH, tubeless video-assisted thoracoscopic surgery for PPH has the advantages of safety, reliability, light pain and quick recovery, in line with the concept of accelerated rehabilitation surgery.

Objective:To investigate the intention of medical students to be vaccinated against COVID-19 and to analyze the influencing factors.Methods:A self-filled electronic questionnaire survey was conducted among medical students from a medical school in Shanghai randomly selected from June 21 to 29, 2021. The questionnaire contained items of basic information, intention for COVID-19 vaccination, awareness of COVID-19 prevention measures and awareness of COVID-19 vaccine. Logistic regression was used to analyze the influencing factors.Results:The average age of the 966 respondents was (20.4±2.9) years, and 63.6% (614/966) of them were female;23.7% (229/966) of them had family members or relatives who had participated in anti-pandemic work or volunteer service;90.6% (875/966) of the respondents expressed they were very willing or willing to be vaccinated against COVID-19. The majority of the respondents thought that “COVID-19 infection is very serious” (94.3%, 911/966), “good protection can effectively prevent COVID-19 infection” (92.4%, 893/966), and “they can fully implement all kinds of protection measures” (73.5%, 710/966). About half of the respondents (51.8%, 501/966) knew about the adverse reactions and contraindications of COVID-19 vaccine. The low protected capability (47.4%, 458/966), short duration of protection (50.6%, 489/966), and many side effects (48.7%, 470/966) were the major concerns about COVID-19 vaccine. Logistic regression analysis showed that people thought that “COVID-19 infection is very serious” ( OR=5.30, 95 %CI:2.60-10.81, P<0.001), thought that “good protection can effectively prevent COVID-19 infection” ( OR=2.46, 95 %CI:1.26-4.81, P=0.009), thought that “they can fully implement all kinds of protection measures” ( OR=2.55, 95 %CI:1.53-4.25, P<0.001) were more willing to receive COVID-19 vaccination. While those concerned about vaccine quality did the opposite ( OR=0.29, 95 %CI:0.13-0.65, P=0.003). Conclusions:Medical students have a high intention of vaccination against COVID-19. The vaccine-related knowledge quality should be emphasized in future publicity to further enhance the intention of COVID-19 vaccination.

In recent years, many researchs have found that microRNA (miRNAs) has differential expression in pancreatic tissues, pancreatic cancer cells and drug-resistant pancreatic cancer cells, and miRNAs can change the sensitivity of pancreatic cancer cells to chemotherapy drugs by acting on downstream target genes.The molecular mechanism of drug resistance in tumors is complex. In the drug-resistance of pancreatic cancer, miRNAs can mediate drug resistance in pancreatic cancer cells by affecting epithelial-mesenchymal transformation, DNA damage and repair, downstream signaling pathways, non-coding RNA, related coding genes, pancreatic cancer stem cells and other mechanisms. Therefore, the investigation of drug resistance mechanism and related miRNAs in pancreatic cancer will help to find new anti-drug resistance treatment methods. The authors summarize exosome miRNAs invloved in regulating chemoresistance in pancreatic cancer, in order to provide theoretical support for clinical treatment and find new targeted therapy of pancreatic cancer.

Effective expression of pIFN-α in recombinant Pichia pastoris was conducted in a 5 L fermentor. Ethanol accumulation during the late glycerol feeding period inhibited heterologous protein expression. Comparative transcriptome analysis was thus performed to compare the gene transcription profiles of Pichia pastoris KM71H in high and low ethanol concentration environments. The results showed that during the glycerol cultivation stage, 545 genes (265 up-regulated and 280 down-regulated) were differentially expressed with ethanol stress. These genes were mainly involved in protein synthesis, energy metabolism, cell cycle and peroxisome metabolism. During the methanol induction stage, 294 genes (171 up-regulated and 123 down-regulated) were differentially expressed, which were mainly related to methanol metabolism, amino acid metabolism and protein synthesis. Ethanol stress increased protein misfolding and reduced structural integrity of ribosome and mitochondria during cultivation stage, and led to the failure of endoplasmic reticulum stress removal and damaged amino acid metabolism during induction stage in Pichia pastoris.
Amino Acids ; metabolism ; Bioreactors ; Endoplasmic Reticulum Stress ; Energy Metabolism ; Ethanol ; chemistry ; Gene Expression Profiling ; Gene Expression Regulation, Fungal ; Glycerol ; Methanol ; Pichia ; metabolism ; Protein Biosynthesis ; drug effects ; Protein Folding ; Recombinant Proteins ; biosynthesis ; Transcriptome

Objective To study the effect of low frequency stimulation (LFS) in the pedunculopontine tegmental nucleus (PPTg) on gait and movement ability in unilateral lesioned Parkinson's disease(PD) rats.Methods Thirty-two male SD rats were randomly assigned to control group (6-hydroxydopamine treatment,n=8) and experimental group (6-hydroxydopamine treatment combined with electrode implantation,n=24).All subjects were processed with injection of 6-hydroxydopamine in the fight medial forebrain bundle (MFB) and simultaneously the rats in the experimental group were received an electrode implantation into the ipsilateral PPTg.Catwalk gait and open field test data were acquired at 1 week before stereotactic surgery and 3 weeks after operation in the rats of control and experimental groups; the behavioral data of rats in the experimental group were recorded again 4 weeks after operation when they were under ongoing LFS-PPTg.Results Catwalk results showed that the postoperative couplings values (right front→left front,right front→left hind,right hind →left front,right hind →left hind) were significantly increased in all subjects as compared with the preoperative ones (P＜0.05); while couplings value in rats of the experimental group after LFS-PPTg significantly reduced as compared with that before LFS-PPTg (P＜0.05).The postoperative run speed variation statistically increased and postoperative cadence significantly decreased in all rats as compared with the preoperative ones (P＜0.05); the run speed variation significantly decreased and cadence obviously increased in experimental group after LFS-PPTg as compared with those before LFS-PPTg (P＜0.05).Open field test:the moving distance of all subjects decreased significantly after operation; the distance in rats of the experimental group after LFS-PPTg increased significantly as compared with that before LFS-PPTg.Conclusion LFS-PPTg can effectively improve gait function and motor activity of unilateral PD rat models.

Objective To explore the effect of clinical pathway in surgical treatment for patients with mandibular fracture.Methods 80 patients with mandibular fracture were randomly divided into the conventional therapy group(the control group) (n =40） and the clinical pathway therapy group (CP group) (n =40).The hospitalization time,medical expenses,satisfaction for the treatment,health awareness,and incidence of complications were compared between two groups.Results The results of hospitalization time,medical expenses,satisfaction for the treatment,and health awareness of the CP group were (11.86 ± 3.05) d,(9 115.43 ± 1 689.84) yuan,(91.19 ± 1.02) ％,(95.18 ±4.11)points,respectively,which were significantly better than those of the control group [(17.53 ± 2.98)d,(12 066.75 ±2 513.22)yuan,(89.39 ±1.35)％,(82.83 ± 6.56) points] (t =8.41,6.16,6.73,10.01,all P ＜0.05).The complication rate of the two groups was 2.5％,7.5％,respectively,which had no significant differences (χ2 =0.26,P ＞ 0.05).Concltsion The clinical pathway for mandibular fracture surgery is worthy of promotion.