Objective:Explore the clinical diagnosis and treatment strategies of recurrent multiple chondritis in children with airway involvement as the main cause. Methods:From June 2021 to May 2023, five children with relapsing polychondritis were admitted to our department, all of whom met the Damiani criteria. Tracheotomy was performed in all five patients. Endoscopy indicated subglottic stenosis, with one case classified as grade Ⅲ and four cases as grade Ⅳ according to the Myer-Cotton classification. Enhanced CT scans of the head and neck showed fixed lumen narrowing and stenosis, including thickening of the soft tissue in the laryngeal cavity and partial absorption of the laryngotracheal cartilage anterior wall. In one patient, tracheal wall thickening and deformation with stenosis and calcification involved the posterior tracheal wall. One patient underwent "laryngeal tracheal reconstruction with hyoid graft, T-tube implantation, and bioabsorbable corticosteroid-eluting stent implantation", while three patients underwent "balloon dilatation, T-tube implantation, and bioabsorbable corticosteroid-eluting stent implantation" . Follow-up was performed every two months after the initial surgery, and three bioabsorbable corticosteroid-eluting stents were placed on the upper left, upper right, and lower T-tube, respectively, during this time. The entire follow-up period was six months. Results:All the 5 cases were in the outpatient department, of which 1 case had been extubation, 3 cases were still in the outpatient follow-up, and the remaining 1 case was still being treated in the rheumatology and immunology department due to poor control of the primary disease. Conclusion:In relapsing polychondritis children with airway involvement, tracheotomy could be used to quickly improve the symptoms of dyspnea in the disease progression. In the stable stage of the disease, the surgical method of 'Balloon dilatation + T-tube implantation + Bioabsorbable corticosteroid-eluting stents implantation' was adopted to reduce the secondary injury caused by surgical trauma as much as possible and improve the survival and quality of life of the children.
Humans ; Polychondritis, Relapsing/surgery* ; Child ; Male ; Female ; Tracheotomy ; Laryngostenosis ; Child, Preschool ; Trachea/surgery* ; Adolescent ; Stents

BACKGROUND:Compared with traditional two-dimensional culture,three-dimensional microtissue culture can show greater advantages.However,more favorable cultivation methods in three-dimensional culture still need to be further explored. OBJECTIVE:To evaluate the cell behavior of microtissue and its ability to promote cartilage formation under two three-dimensional culture methods. METHODS:Cartilage-derived microcarriers were prepared by chemical decellularization and tissue crushing.DNA quantification and nuclear staining were used to verify the success of decellularization,and histological staining was used to observe the matrix retention before and after decellularization.The microcarriers were characterized by scanning electron microscopy and CCK-8 assay.Cartilage-derived microtissues were constructed by combining cartilage-derived microcarriers with human adipose mesenchymal stem cells through three-dimensional static culture and three-dimensional dynamic culture methods.The cell viability and chondrogenic ability of the two groups of microtissues were detected by scanning electron microscopy,live and dead staining,and RT-qPCR. RESULTS AND CONCLUSION:(1)Cartilage-derived microcarriers were successfully prepared.Compared with before decellularization,the DNA content significantly decreased after decellularization(P<0.001).Scanning electron microscope observation showed that the surface of the microcarrier was surrounded by collagen,maintaining the characteristics of the natural extracellular matrix of cartilage cells.CCK-8 assay indicated that microcarriers had no cytotoxicity and could promote cell proliferation.(2)Scanning electron microscopy and live and dead staining results showed that compared with the three-dimensional static group,the three-dimensional dynamic group had a more extended morphology of microtissue cells,and extensive connections between cells and cells,between cells and matrix,and between matrix.(3)The results of RT-qPCR showed that the expressions of SOX9,proteoglycan,and type Ⅱ collagen in microtissues of both groups were increased at 7 or 14 days.The relative expression levels of each gene in the three-dimensional dynamic group were significantly higher than those in the three-dimensional static group at 14 days(P<0.05).At 21 days,the three-dimensional static group had significantly higher gene expression compared with the three-diomensional dynamic group(P<0.001).(4)The results showed that compared with three-dimensional static culture microtissue,three-dimensional dynamic culture microtissue could achieve higher expression of chondrogen-related genes in a shorter time,showing better cell viability and chondrogenic ability.

The senescence accelerate mouse prone strain was identified by Professor T.Takeda's laboratory in Japan from the offspring produced by the brother-sister inbred line of AKR/J mice donated by Jackson Laboratory in the United States SAMP),and SAMP8 mice showed a variety of aging characteristics,such as:Pathological changes such as memory and learning disorders,behavioral abnormalities,skin roughness,aging,hair loss,eye lesions(visual impairment,cataract,periocular lesions),hearing impairment,weight loss,muscle strength loss,reproductive system aging,liver and fat metabolism disorders,etc.,are widely used in experimental studies of related diseases or pathology,and have made considerable contributions to the research of diseases.However,there are also many problems in its application,such as the selection of month age,the use of intervention methods,the suitability of pathological changes and research content,and the understanding of models under different theoretical backgrounds,which are of great research value.Therefore,this paper systematically analyzes the above problems based on existing literature,in order to provide relevant basis for the application of SAMP8 mice in different fields and different mechanisms.

The senescence accelerate mouse prone strain was identified by Professor T.Takeda's laboratory in Japan from the offspring produced by the brother-sister inbred line of AKR/J mice donated by Jackson Laboratory in the United States SAMP),and SAMP8 mice showed a variety of aging characteristics,such as:Pathological changes such as memory and learning disorders,behavioral abnormalities,skin roughness,aging,hair loss,eye lesions(visual impairment,cataract,periocular lesions),hearing impairment,weight loss,muscle strength loss,reproductive system aging,liver and fat metabolism disorders,etc.,are widely used in experimental studies of related diseases or pathology,and have made considerable contributions to the research of diseases.However,there are also many problems in its application,such as the selection of month age,the use of intervention methods,the suitability of pathological changes and research content,and the understanding of models under different theoretical backgrounds,which are of great research value.Therefore,this paper systematically analyzes the above problems based on existing literature,in order to provide relevant basis for the application of SAMP8 mice in different fields and different mechanisms.

OBJECTIVEOn the basic therapy, to assess the clinical effects of dynamic scalp acupuncture, scalp acupuncture combined with proprioceptive neuromuscular facilitation (PNF) therapy and simple PNF therapy for upper limb motor impairment in ischemic post-stroke spastic hemiplegia.

METHODSA total of 90 cases were randomly assigned into a PNF group, a dynamic scalp acupuncture group and a scalp acupuncture group, 30 cases in each group. Basic therapy and PNF therapy were applied in the three groups. PNF therapy was used during scalp acupuncture in the dynamic scalp acupuncture group. PNF therapy was applied after scalp acupuncture in the scalp acupuncture group. The points were the upper 1/5 and middle 2/5 of (MS 6) and (MS 7) at the lesion side, the hemiparalysis contralateral side. The treatment was given for 6 months, once a day and 1 month as a course. The modified Ashworth scale (MAS), the Fugl-Meyer motor assessment (FMA) and Barthel index (BI) were observed before treatment and 2 weeks, 1 month, 3 months, and 6 months after treatment.

RESULTSThe MAS 1 month, 3 months and 6 months after treatment were improved compared with those before treatment in the three groups ( all <0.05), and the MAS results in the dynamic scalp acupuncture group were better than those in the PNF and scalp acupuncture group (all <0.05). The FMA and BI scores 1 month, 3 months and 6 months after treatment were higher than those before treatment (all <0.05). The FMA Scores in the 3 time points and after treatment in the dynamic scalp acupuncture group were higher than those in the other two groups (all <0.05).

CONCLUSIONPNF therapy during scalp acupuncture can relieve the spasmodic condition of patients with upper limb motor impairment in ischemic post-stroke spasmodic hemiplegia, and improve the limb function and life activity, which is better than PNF therapy after scalp acupuncture and simple PNF therapy.

Acupuncture Therapy ; Brain Ischemia ; complications ; rehabilitation ; Combined Modality Therapy ; Hemiplegia ; rehabilitation ; therapy ; Humans ; Scalp ; Stroke ; complications ; Stroke Rehabilitation ; Treatment Outcome

Objective To construct the professional competency evaluation index system for clini-cal medical professional degree postgraduates. Methods With the literature review and expert consulting, we constructed preliminarily the evaluation index system framework; using the Delphi method, we selected indicators and determined the weights system. Data are recorded and processed using Excel 2003 and SPSS 19. Result The response rate of the Delphi survey were 97％and 96％. The mean of authorities was 0.827 and 0.812, and the harmonious coefficients had statistical significance (P<0.05). The professional compe-tency evaluation index system was established, which was composed of 2 first level indicators, 5 second level indicators and 31 third level indicators; The weight coefficients of the indicators at first level was 0.586 and 0.414. Conclusion The index system construction method is scientific, the process is reasonable, and has certain practical value.

Objective To evaluate the occupational competency of clinical post-graduate students by the 360-degree feedback system.Methods The occupational competencies of the 102 clinical post-graduate students were evaluated by department directors, teachers, the superior band taught physicians, peers, post-graduate themselves using a self-designed questionnaire.The evaluation content of professional competence included 12 core elements, such as medical knowledge, clinical skills, and professional ethics and so on.EpiData 3.02 was used to establish the database, SPSS 19.0 software was used to carry on the statistical analysis, and the statistical analysis method was mainly for the descriptive statistics analysis, the single factor analysis of variance.Results 5 kinds of evaluation subjects were statistically significant (P＜0.05) in medical knowledge, clinical skills, clinical thinking ability, lifelong learning ability, professional ethics, team cooperation ability, self cognition and management ability and total score.Students themselves and their peers scored high in various aspects, teaching superior doctors rated middle and the director and mentor gave low grade in all aspects and the scores rated by the department directors and teachers were lower than students themselves(P=0.003, P=0.047).Conclusion The 360-degree evaluation system can comprehensively and objectively evaluate the clinical post-graduate students' occupational competency and offer beneficial assistant to clinic and practice.

Identifying the goals of outstanding doctor tralning and orienting medical students' competency, we conducted rational integration and construction of curriculum system for graduate students of clinical medicine and implemented 5 modes of module teaching including professional course, foreign language course, practical skill course, scientific research course and comprehensive ability course . According to the different characters of courses and professional development , we adopted multi-dimensional teaching methods and input the quality education throughout the whole teaching process. These efforts promoted the reform of graduate course evaluation system and provided effective security for improving teaching contents, teaching methods, teaching means and evaluating methods.