Objective:To construct a dynamic competency assessment system suitable for standardized training of resident physicians in the department of pediatric infectious diseases, verify its teaching practice effectiveness, and enhance the core competence of specialist physicians.Methods:Based on the Delphi method, an evaluation system was constructed. Through two rounds of expert consultation ( n=20, authority coefficient Cr=0.889-0.895), 5 primary indicators, 13 secondary indicators, and 38 tertiary indicators were established, covering dimensions such as clinical thinking, operational skills, and professional ethics. The hierarchical and progressive design and dynamic feedback mechanism were adopted. Sixty residents were randomly divide into an observation group (dynamic evaluation system) and a control group (traditional evaluation). Differences between the two groups were compared in terms of short-term teaching effectiveness (e.g., OSCE assessment and Mini CEX score) and long-term clinical competencies (e.g., exit assessment pass rate and incidence of adverse events). SPSS 24.0 was used for t-test, Mann Whitney U test, and internal consistency test (Cronbach's alpha=0.89). Results:The observation group outperformed the control group in core specialty competencies and clinical practice outcomes. In terms of core specialty competencies, the observation group had a higher response speed score for pathogen results [(4.10±0.84) vs. (3.60±0.95), P=0.042]. This indicates that the dynamic evaluation system effectively enhanced the ability of trained physicians to quickly adjust treatment plans based on pathogenic evidence. The implementation rate of infection prevention and control standards and diagnostic accuracy were also higher in the observation group compared to the control group, reflecting the advantages of this system in standardizing clinical operations and improving diagnostic levels. In terms of long-term clinical competencies, the observation group showed significantly increased exit assessment pass rate and significantly decreased incidence of medical adverse events, further verifying the continuous promotion effect of the dynamic evaluation system on the clinical competence of trained physicians. Conclusions:The dynamic evaluation system constructed in this study can effectively enhance the core specialty competencies (e.g., pathogen response and infection prevention and control) and long-term clinical competence of residents in the department of pediatric infectious diseases, providing scientific basis for optimizing the training models of specialist physicians.

Objective:To construct a dynamic competency assessment system suitable for standardized training of resident physicians in the department of pediatric infectious diseases, verify its teaching practice effectiveness, and enhance the core competence of specialist physicians.Methods:Based on the Delphi method, an evaluation system was constructed. Through two rounds of expert consultation ( n=20, authority coefficient Cr=0.889-0.895), 5 primary indicators, 13 secondary indicators, and 38 tertiary indicators were established, covering dimensions such as clinical thinking, operational skills, and professional ethics. The hierarchical and progressive design and dynamic feedback mechanism were adopted. Sixty residents were randomly divide into an observation group (dynamic evaluation system) and a control group (traditional evaluation). Differences between the two groups were compared in terms of short-term teaching effectiveness (e.g., OSCE assessment and Mini CEX score) and long-term clinical competencies (e.g., exit assessment pass rate and incidence of adverse events). SPSS 24.0 was used for t-test, Mann Whitney U test, and internal consistency test (Cronbach's alpha=0.89). Results:The observation group outperformed the control group in core specialty competencies and clinical practice outcomes. In terms of core specialty competencies, the observation group had a higher response speed score for pathogen results [(4.10±0.84) vs. (3.60±0.95), P=0.042]. This indicates that the dynamic evaluation system effectively enhanced the ability of trained physicians to quickly adjust treatment plans based on pathogenic evidence. The implementation rate of infection prevention and control standards and diagnostic accuracy were also higher in the observation group compared to the control group, reflecting the advantages of this system in standardizing clinical operations and improving diagnostic levels. In terms of long-term clinical competencies, the observation group showed significantly increased exit assessment pass rate and significantly decreased incidence of medical adverse events, further verifying the continuous promotion effect of the dynamic evaluation system on the clinical competence of trained physicians. Conclusions:The dynamic evaluation system constructed in this study can effectively enhance the core specialty competencies (e.g., pathogen response and infection prevention and control) and long-term clinical competence of residents in the department of pediatric infectious diseases, providing scientific basis for optimizing the training models of specialist physicians.

Objective To study the correlation between pterygium area and the clinical manifestation and signs of primary pterygium obtained from OCULUS Keratograph.Methods A prospective case observation study was performed.Thirty-nine (55 eyes) primary pterygium patients were selected from June to September 2016 in Zhongshan People's Hospital.The area of the pterygium invaded cornea and duration of pterygium were recorded.The ocular surface condition was detected by corneal fluorescein staining.The break up time of tear film (BUT) and the gland function score were measured with OCULUS Keratograph.This study was approved by the Ethics Committee of Zhongshan People's Hospital (2015 [13]).All operations followed the Helsinki Declaration and all patients signed informed consent forms.Results The areas of pterygium invaded cornea was 2-20 mm2,the mean size was 5 (3,10) mm2;the duration of pterygium was 3-8 years,the mean duration was 5 (4,6)years;the BUT was 2.1-15.0 seconds,the mean BUT was (6.3±3.0) seconds.The mean gland function score was 2 (1,3).The area of pterygium was not significantly correlated with the duration of pteryguim (r =0.197,P =0.148),while it was negatively correlated with BUT (r=-0.711,P＜0.001) and positively correlated with the tarsal gland score (r =0.554,P＜0.001).What's more,82％ (45/55 eyes) of the patients' tear film rupture appeared firstly near pterygium's head.Conclusion OCULUS Keratograph can directly evaluate the ocular surface condition of pterygium patients in a non-contact and non-invasive method.Assessing the ocular surface damage by observing the area of pterygium invaded cornea may provide a prospective treatment for pterygium patients.

Objective To study the correlation between pterygium area and the clinical manifestation and signs of primary pterygium obtained from OCULUS Keratograph. Methods A prospective case observation study was performed. Thirty.nine ( 55 eyes ) primary pterygium patients were selected from June to September 2016 in Zhongshan People's Hospital. The area of the pterygium invaded cornea and duration of pterygium were recorded. The ocular surface condition was detected by corneal fluorescein staining. The break up time of tear film ( BUT) and the gland function score were measured with OCULUS Keratograph. This study was approved by the Ethics Committee of Zhongshan People's Hospital ( 2015 [ 13 ] ) . All operations followed the Helsinki Declaration and all patients signed informed consent forms. Results The areas of pterygium invaded cornea was 2-20 mm2,the mean size was 5(3, 10)mm2;the duration of pterygium was 3-8 years,the mean duration was 5(4,6)years;the BUT was 2. 1-15. 0 seconds,the mean BUT was (6. 3±3. 0) seconds. The mean gland function score was 2(1,3). The area of pterygium was not significantly correlated with the duration of pteryguim (r=0.197,P=0.148),while it was negatively correlated with BUT (r=-0. 711, P<0. 001 ) and positively correlated with the tarsal gland score (r=0. 554,P<0. 001). What's more,82％ (45/55 eyes) of the patients' tear film rupture appeared firstly near pterygium's head. Conclusion OCULUS Keratograph can directly evaluate the ocular surface condition of pterygium patients in a non. contact and non.invasive method. Assessing the ocular surface damage by observing the area of pterygium invaded cornea may provide a prospective treatment for pterygium patients.

Objective To test the efficacy of behavioral intervention and rosuvastatin alone and in combination for antipsychotic-induced metabolic syndrome. Methods One hundred and twenty eight schizophrenic patients who met the diagnostic criteria for metabolic syndrome were randomly divided into four groups:behavioral intervention plus rosuvastatin (5 mg/d), rosuvastatin (5 mg/d), behavioral intervention, placebo. And four groups all finished 12-week individual treatments. The total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, fasting blood-glucose, blood pressure, height and body weight were measured at baseline and at weeks 4, 8, and 12. In addition, the body mass index (BMI) were calculated. All patients were assessed with the Schizophrenia Quality of Life Scale (SQLS), Montreal Cognitive Assessment Scale (MoCA), Positive and Negative Syndrome Scale (PANSS) and Treatment Emergent Syndrome Scale (TESS) at baseline and at week 12 to evaluate the schizophrenia quality of life, cognitive function, efficacy and side effects. Results (1) After treatment, the triglyceride, glucose, body fat index, systolic pressure levels decreased significantly in the behavioral intervention plus rosuvastatin (t=6.37, 3.56, 5.26, 3.71, P<0.05), the high density lipoprotein cholesterol levels increased significantly (t=- 3.89). The triglyceride, glucose, body fat index, systolic pressure levels decreased significantly in the rosuvastatin (t=3.19, 8.44, 2.76, 3.86, P<0.05), the high density lipoprotein cholesterol levels increased significantly (t=-1.80, P<0.05). The triglyceride, glucose, body fat index, systolic pressure levels decreased significantly (t=2.94, 3.10, 3.50, 3.38, P<0.05), the high density lipoprotein cholesterol levels increased significantly (t=- 3.06, P<0.05) in the behavioral intervention group. (2) After treatment, the triglycerides (95%CI:-0.249--0.091, -0.308--0.152, all P<0.05) and blood glucose (95%CI:-0.081--0.059,-0.051--0.029, P<0.05) decreased was the highest in the behavior intervention plus rosuvastatin, followed by the rosuvastatin intervention. The cholesterol (95%CI:-1.538--0.696,-1.391--0.535, P<0.05) and body mass index (95%CI:-0.677--0.024,-0.844--0.562, P<0.05) decreased had no difference in the behavior intervention plus rosuvastatin and rosuvastatin,significantly greater than the behavior intervention. (3) At week 12, the score of SQLS decreased significantly in the behavior intervention plus rosuvastatin (t=7.99), rosuvastatin (t=6.25), behavior intervention (t=10.98), and increased significantly in the placebo(t=-3.10). The score of MoCA increased significantly in the behavior intervention plus rosuvastatin(t=-8.75),all P<0.05. Conclusions Behavioral intervention and rosuvastatin alone and in combination have efficacy for antipsychotic-induced metabolic syndrome, in which the combination therapy shows the best effect on improving MS and cognitive function.

Objective To test the efficacy of behavioral intervention and rosuvastatin alone and in combination for antipsychotic-induced metabolic syndrome. Methods One hundred and twenty eight schizophrenic patients who met the diagnostic criteria for metabolic syndrome were randomly divided into four groups:behavioral intervention plus rosuvastatin (5 mg/d), rosuvastatin (5 mg/d), behavioral intervention, placebo. And four groups all finished 12-week individual treatments. The total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, fasting blood-glucose, blood pressure, height and body weight were measured at baseline and at weeks 4, 8, and 12. In addition, the body mass index (BMI) were calculated. All patients were assessed with the Schizophrenia Quality of Life Scale (SQLS), Montreal Cognitive Assessment Scale (MoCA), Positive and Negative Syndrome Scale (PANSS) and Treatment Emergent Syndrome Scale (TESS) at baseline and at week 12 to evaluate the schizophrenia quality of life, cognitive function, efficacy and side effects. Results (1) After treatment, the triglyceride, glucose, body fat index, systolic pressure levels decreased significantly in the behavioral intervention plus rosuvastatin (t=6.37, 3.56, 5.26, 3.71, P<0.05), the high density lipoprotein cholesterol levels increased significantly (t=- 3.89). The triglyceride, glucose, body fat index, systolic pressure levels decreased significantly in the rosuvastatin (t=3.19, 8.44, 2.76, 3.86, P<0.05), the high density lipoprotein cholesterol levels increased significantly (t=-1.80, P<0.05). The triglyceride, glucose, body fat index, systolic pressure levels decreased significantly (t=2.94, 3.10, 3.50, 3.38, P<0.05), the high density lipoprotein cholesterol levels increased significantly (t=- 3.06, P<0.05) in the behavioral intervention group. (2) After treatment, the triglycerides (95%CI:-0.249--0.091, -0.308--0.152, all P<0.05) and blood glucose (95%CI:-0.081--0.059,-0.051--0.029, P<0.05) decreased was the highest in the behavior intervention plus rosuvastatin, followed by the rosuvastatin intervention. The cholesterol (95%CI:-1.538--0.696,-1.391--0.535, P<0.05) and body mass index (95%CI:-0.677--0.024,-0.844--0.562, P<0.05) decreased had no difference in the behavior intervention plus rosuvastatin and rosuvastatin,significantly greater than the behavior intervention. (3) At week 12, the score of SQLS decreased significantly in the behavior intervention plus rosuvastatin (t=7.99), rosuvastatin (t=6.25), behavior intervention (t=10.98), and increased significantly in the placebo(t=-3.10). The score of MoCA increased significantly in the behavior intervention plus rosuvastatin(t=-8.75),all P<0.05. Conclusions Behavioral intervention and rosuvastatin alone and in combination have efficacy for antipsychotic-induced metabolic syndrome, in which the combination therapy shows the best effect on improving MS and cognitive function.

How follicular T-helper (Tfh) cells develop is incompletely understood. We find that, upon antigen exposure in vivo, both naïve and antigen-experienced T cells sequentially upregulate CXCR5 and Bcl6 within the first 24 h, relocate to the T-B border, and give rise to phenotypic Bcl6(+)CXCR5(+) Tfh cells before the first cell division. CXCR5 upregulation is more dependent on ICOS costimulation than that of Bcl6, and early Bcl6 induction requires T-cell expression of CXCR5 and, presumably, relocation toward the follicle. This early and rapid upregulation of CXCR5 and Bcl6 depends on IL-6 produced by radiation-resistant cells. These results suggest that a Bcl6(hi)CXCR5(hi) phenotype does not automatically define a Tfh lineage but might reflect a state of antigen exposure and non-commitment to terminal effector fates and that niches in the T-B border and/or the follicle are important for optimal Bcl6 induction and maintenance.
Animals ; CD40 Ligand ; metabolism ; Cell Differentiation ; physiology ; DNA-Binding Proteins ; metabolism ; Inducible T-Cell Co-Stimulator Protein ; metabolism ; Interleukin-6 ; metabolism ; Mice ; Proto-Oncogene Proteins c-bcl-6 ; Receptors, CXCR5 ; metabolism ; T-Lymphocytes, Helper-Inducer ; metabolism

Liver blood flow was measured in normal & CCl4-intoxicated mice & rats, using the electrolysis-generated hydrogen gas method. The results showed that the intramuscular injection of 6-15/kg of ISM increased significantly the liver blood flow in normal mice & rats. In acute or chronic CCl4-intoxicated mice & rats, the liver blood was decreased but the blood flow was restored the normal level by the ISM. In addition, the protective effect against liver injury was also observed by the histological examination & electron micrographs.The above results suggest that the protective effect of ISM against CCl4-induced liver injury seems to be through increasing the liver blood flow, improving liver's microcirculation & preventing or mitgating the denaturing or necrosis of liver cells.