OBJECTIVE To explore the changes of brain white matter of the patients with obstructive sleep apnea-hypopnea syndrome(OSAHS)with magnetic resonance diffusional kurtosis imaing(DKI).METHODS There were 38 patients with OSAHS examined by polysomnogram(PSG)from November 2017 to June 2021,and 32 non-OSAHS controls matched in gender and age who were included in this study.All the subjects were scanned by DKI.The different encephalic regions through comparing kurtosis fractional anisotropy(KFA)values of all encephalic regions between the two groups were found,and the relationship between the KFA values of the different encephalic regions in OSAHS patients and the apnea-hypopnea index(AHI),lowest saturation oxygen(LSaO2)and the percent of the total record time spent below 90%oxygen saturation(TS90%)in PSG were analyzed.RESULTS The KFA values of white matter fiber tracts in corpus callosum,bilateral corona radiata,cingulate gyrus,right superior cerebellar peduncle and inferior cerebellar peduncle of OSAHS group were obviously lower than control group(P<0.05).After controlling for age and body mass index(BMI),the partial correlation between AHI and the KFA values of corpus callosum,left posterior corona radiata,right anterior corona radiata,cingulate gyrus in OSAHS group were also negative(r=-0.344,-0.380,-0.406,-0.53,P<0.05).The partial correlation between LSaO2 and the KFA values of corpus callosum,left posterior corona radiata,right anterior corona radiata,cingulate gyrus,right superior cerebellar peduncle in OSAHS group were also positive(r=0.366,0.406,0.446,0.404,0.342,P<0.05).The partial correlation between TS90%and the KFA values of corpus callosum,left posterior corona radiata,right anterior corona radiata,cingulate gyrus,right superior cerebellar peduncle and inferior cerebellar peduncle in OSAHS group were also negative(r=-0.414,-0.352,-0.355,-0.336,-0.456,-0.360,P<0.05).CONCLUSION Recurrent apnea and hypoxemia at night of OSAHS patients can cause damage to white matter fibers in parts of encephalic regions.

Objective:To explore the influence and its mechanism of allogeneic dermal papilla cells (DPCs) on the wound healing of full-thickness skin defects in mice.Methods:This study was an experimental study. DPCs were isolated from the whisker follicles of five 6-week-old male C57BL/6J mice by combining microdissection with collagenase digestion and were successfully identified. Eighteen 8-week-old male C57BL/6J mice were divided into phosphate buffer solution (PBS) group and DPC group according to the random number table, with 9 mice in each group, and the full-thickness skin defect wound model was created on the back of all mice. On day 2, 4, and 6 after injury, the mice in DPC group were administered 100 μL of cell suspension containing 1×10 6 DPCs of the 4 th passage by subcutaneous injection around the wound, and the mice in PBS group was administered an equal volume of PBS. On day 3, 7, 10, and 14 after injury, the wound healing and hair growth of mice in two groups were observed, and the residual wound area was measured, and the hair coverage area on the wound of mice in two groups was measured on day 14 after injury. On day 14 after injury, the wound tissue samples of mice in two groups were collected. Hematoxylin-eosin staining was performed to observe the condition of newborn hair follicles and the number was counted, Masson staining was performed to observe the collagen deposition in the dermis and the collagen deposition area was measured, the immunofluorescence method was used to detect the protein expressions of Wnt/β-catenin signaling pathway related molecules β-catenin and lymphoid enhancer binding factor 1 (Lef1), and Western blotting and real-time fluorescence quantitative reverse transcription polymerase chain reaction were used to detect the protein and mRNA expressions of β-catenin and Lef1, respectively. The number of samples in each experiment was 3. Results:Compared with those in PBS group, the mice in DPC group had accelerated wound re-epithelialization at each time point after injury, and more hair growth on day 10 and 14 after injury. On day 7, 10, and 14 after injury, the residual wound areas of mice in DPC group were (13.92±2.90), (3.69±1.78), and (1.09±0.14) mm 2, respectively, which were significantly smaller than (26.19±2.06), (10.84±3.59), and (6.75±2.11) mm 2 in PBS group, respectively (with t values of 5.85, 3.09, and 4.63, respectively, P values all <0.05). On day 14 after injury, the hair coverage area on the wound of mice in DPC group was (62±7) mm 2, which was significantly larger than (35±6) mm 2 in PBS group ( t=2.89, P<0.05). On day 14 after injury, compared with those in PBS group, the number of newborn hair follicles in the wound tissue of mice in DPC group was significantly increased ( t=5.43, P<0.05), and the dermal collagen deposition area was significantly reduced ( t=3.56, P<0.05). On day 14 after injury, both the immunofluorescence method and the Western blotting detection showed that the protein expressions of β-catenin (with t values of 5.49 and 4.25, respectively, P values all <0.05) and Lef1 (with t values of 7.50 and 11.54, respectively, P values all <0.05) in the wound tissue of mice in DPC group were significantly higher than those in PBS group; the mRNA expressions of β-catenin and Lef1 in the wound tissue of mice in DPC group were significantly higher than those in PBS group (with t values of 7.68 and 9.67, respectively, P<0.05). Conclusions:DPCs can accelerate the re-epithelialization of full-thickness skin defect wounds in mice by activating Wnt/β-catenin signaling pathway and promote hair follicle regeneration during the process of wound healing.

In the past 20 years,near infrared spectrum technology has been widely used in human body monitoring due to its non-invasive and real-time characteristics.Oxygen,as the main metabolic substance of the human body,is consumed the most in brain tissue.In order to prevent complications caused by a decrease in brain tissue oxygen during treatment,the patient's brain tissue blood oxygen saturation needs to be monitored in real time.Currently,most of the clinically used non-invasive cerebral blood oxygen detection equipments use dual wavelengths.Other substances on the detection path will cause errors in the measurement results.Therefore,this article proposes a three-wavelength method based on the basic principle of non-invasive monitoring of cerebral blood oxygen using near-infrared spectrum.The brain tissue oxygen saturation monitoring method of detecting light sources was initially verified through the built system,laying the foundation for subsequent system engineering.

Objective:To explore the brain white matter damage in patients with moderate to severe obstructive sleep apnea hypopnea syndrome(OSAHS) using diffusional kurtosis imaging(DKI), and to analyze its relationship with anxiety, depression and cognitive impairment in patients.Methods:This was a retrospective case-control study. Fifty confirmed cases (47 males and 3 females) of moderate to severe OSAHS diagnosed by polysomnography(PSG) from November 2017 to December 2022 were selected as OSAHS group(age range from 22 to 65 years old, with median age of 40 years old), and 32 healthy controls(27 males and 5 females) of non-OSAHS diagnosed by PSG were selected as control group(age range from 19 to 56 years old, with median age of 34 years old). DKI scanning, Beck Anxiety Inventory(BAI), Beck Depression Inventory-Ⅱ(BDI-Ⅱ), and Montreal cognitive assessment(MoCA) scores were performed in all subjects. Differences in kurtosis fractional anisotropy(KFA) of various brain regions were compared between the two groups to identify differential brain regions. Correlations were analyzed between KFA reduction and anxiety, depression, and cognitive impairment in OSAHS patients. To study the correlation between brain injury and anxiety, depressive mood, and cognitive dysfunction, statistical methods such as non-parametric tests for two independent samples, chi-square tests, and partial correlation analysis, were used to analyze the evaluation indicators of the two groups.Results:The KFA values in right external capsule, left anterior corona radiata, right anterior corona radiata, left posterior corona radiata, right posterior corona radiata, left superior corona radiata, right superior corona radiata, left superior longitudinal fasciculus, right superior longitudinal fasciculus, genu of corpus callosum, splenium of corpus callosum, body of corpus callosum, posterior cingulate gyrus of moderate to severe OSAHS group were all lower than those in the control group( t=-2.247, -3.028, -3.955, -4.871, -2.632, -2.594, -2.121, -2.167, -3.129, -2.015, -2.317, -2.313, -2.152, P<0.05). For the moderate to severe OSAHS group, the correlation between AHI and KFA values of right posterior corona radiata, right superior corona radiata, left anterior corona radiata, left posterior corona radiata, left superior corona radiata, left superior longitudinal fasciculus, genu of corpus callosum, body of corpus callosum, splenium of corpus callosum were all negative( r=-0.378, -0.307, -0.337, -0.343, -0.341, -0.613, -0.390, -0.384, -0.396, P<0.05). The correlation between LSO 2 and KFA values of right anterior corona radiata, right posterior corona radiata, right superior corona radiata, right superior longitudinal fasciculus, left anterior corona radiata, left posterior corona radiata, left superior corona radiata, left superior longitudinal fasciculus, genu of corpus callosum, body of corpus callosum, splenium of corpus callosum, posterior cingulate gyrus were all positive( r=0.330, 0.338, 0.425, 0.312, 0.433, 0.358, 0.410, 0.459, 0.473, 0.659, 0.489, 0.356, P<0.05). The correlation between BAI scores and KFA values of right external capsule, right anterior corona radiata, left posterior corona radiata, left superior corona radiata, body of corpus callosum, splenium of corpus callosum were all negative( r=-0.306, -0.372, -0.296, -0.346, -0.318, -0.386, P<0.05). The correlation between BDI-Ⅱ scores and KFA values of right superior corona radiata, right superior longitudinal fasciculus, left anterior corona radiata, genu of corpus callosum, body of corpus callosum, splenium of corpus callosum were all negative( r=-0.334, -0.289, -0.309, -0.310, -0.503, -0.469, P<0.05). The correlation between MoCA scores and KFA values of right posterior corona radiata, right superior longitudinal fasciculus, left anterior corona radiata, left superior corona radiata, left superior longitudinal fasciculus, genu of corpus callosum, body of corpus callosum, splenium of corpus callosum were all positive( r=0.368, 0.431, 0.324, 0.410, 0.469, 0.384, 0.369, 0.309, P<0.05). Conclusions:With the aggravation of OSAHS, the damage to some brain regions becomes more pronounced in moderate to severe OSAHS patients. These damage brain functional areas are closely related to the anxiety, depression, and cognitive impairment of patients.

Objective:To investigate the role of 20 MHz high-frequency ultrasound in evaluating scar thickness and morphology.Methods:The clinical data of patients with the initial stage of scar formation after burn trauma (<1 month), hypertrophic scar (1-6 months) and atrophic scar (>6 months) treated by the Department of Burn and Cutaneous Surgery, the First Affiliated Hospital of Air Force Medical University from April 2019 to December 2020, were retrospectively analyzed. All patients were evaluated by 20 MHz high-frequency ultrasound, histopathology and Vancouver scar scale (VSS). Three measurement points were randomly selected at the scar during ultrasonic examination, and the average value was recorded as the ultrasonic thickness measurement value. The scar tissue samples were collected from the site of ultrasonic examination, and HE staining and Masson staining were performed. At the same time, scar thickness was evaluated by two physicians using VSS. The difference of scar thickness assessment result among the 3 method in patients at the initial stage of scar formation, hypertrophic scar and atrophic scar was compared. Meanwhile, the relationship between the characteristics of 20 MHz high-frequency ultrasound and histopathology was compared. The measurement data of normal distribution were expressed as Mean±SD. One-way ANOVA was used for comparison among three groups, and SNK- q test was used for pairwise comparison between groups. Counting data were analyzed by Chi-square test. Results:A total of 224 patients were included, including 91 males and 133 females, aged from 1 to 34 years, with an average age of 25.7 years. There were 79 patients at the initial stage of scar formation, 102 at the hypertrophic stage, and 43 at the atrophic stage. (1) In the initial stage of scar formation, the thickness measured by 20 MHz ultrasound was about (2.01±0.68) mm, the thickness evaluated by VSS was (1.72±0.49) mm, and the thickness measured by pathological section was (2.11±0.45) mm. In the hyperplastic scar stage, the thickness measured by 20 MHz ultrasound was (4.11±0.73) mm, the thickness evaluated by VSS was (3.02±0.47) mm, and the thickness measured by pathological section was (4.27±0.44) mm. In the atrophic scar stage, the thickness measured by 20 MHz ultrasound was (1.74±0.64) mm, the thickness measured by VSS was (1.77±0.61) mm, and the thickness measured by pathological section was (1.71±0.67) mm. For scars in the above three periods, there was no statistical significance between scar thickness measured by 20 MHz high-frequency ultrasound and that measured by pathological sections(all P<0.05). In the initial stage of scar formation and hypertrophic stage, the thickness evaluated by VSS was significantly different from that measured by 20 MHz high-frequency ultrasound and pathology (all P<0.05), respectively. (2) Echo intensity was evaluated by ultrasound. In the initial stage of scar formation, the thickness of the epidermis shown by high-frequency ultrasound was close to that of the normal epidermis and presented a high-intensity echo, but there was a strip of echoless or no echo zone of <1 mm between the high-intensity echo epidermis and dermis, which looked like dermal edema. Pathology showed that there were acanthoid changes in the epidermis of the scar at this stage, rich capillaries and a small amount of collagen fibrous tissue in the dermis. In the hyperplastic scar stage, the scar epidermis still showed strong echo, while the dermis showed uneven echo, the superficial dermis showed obvious isoecho, and the deep dermis showed no echo or hypoecho. Pathology showed that the epidermis was thin and smooth, and keratosis was obvious. Collagen fibers parallel to the epidermis could be seen in the superficial layer of the dermis, with regular arrangement. Collagen fibers were increased and thickened in the deep layer of the dermis, in the shape of nodules and swirls. In the atrophic scar stage, the scar epidermis presented a strong echo, and there was no obvious demarcation between the dermis and subcutaneous tissue, presenting a uniform echo. Pathological findings showed that the epidermis became thinner with a "skin nails" -like structure, the junction between the superficial and deep dermis was not obvious, and the collagen fibers were arranged in parallel or oblique direction, and the surface boundary was unclear. Conclusion:20 MHz high-frequency ultrasound is more accurate than VSS in the assessment of thickness of hypertrophic scar, and can reflect the collagen content and moisture ratio in scar. Compared with pathological examination, it has the advantages of non-invasive and fast, and is an effective means to evaluate scar thickness and morphology.

Objective:To investigate the role of 20 MHz high-frequency ultrasound in evaluating scar thickness and morphology.Methods:The clinical data of patients with the initial stage of scar formation after burn trauma (<1 month), hypertrophic scar (1-6 months) and atrophic scar (>6 months) treated by the Department of Burn and Cutaneous Surgery, the First Affiliated Hospital of Air Force Medical University from April 2019 to December 2020, were retrospectively analyzed. All patients were evaluated by 20 MHz high-frequency ultrasound, histopathology and Vancouver scar scale (VSS). Three measurement points were randomly selected at the scar during ultrasonic examination, and the average value was recorded as the ultrasonic thickness measurement value. The scar tissue samples were collected from the site of ultrasonic examination, and HE staining and Masson staining were performed. At the same time, scar thickness was evaluated by two physicians using VSS. The difference of scar thickness assessment result among the 3 method in patients at the initial stage of scar formation, hypertrophic scar and atrophic scar was compared. Meanwhile, the relationship between the characteristics of 20 MHz high-frequency ultrasound and histopathology was compared. The measurement data of normal distribution were expressed as Mean±SD. One-way ANOVA was used for comparison among three groups, and SNK- q test was used for pairwise comparison between groups. Counting data were analyzed by Chi-square test. Results:A total of 224 patients were included, including 91 males and 133 females, aged from 1 to 34 years, with an average age of 25.7 years. There were 79 patients at the initial stage of scar formation, 102 at the hypertrophic stage, and 43 at the atrophic stage. (1) In the initial stage of scar formation, the thickness measured by 20 MHz ultrasound was about (2.01±0.68) mm, the thickness evaluated by VSS was (1.72±0.49) mm, and the thickness measured by pathological section was (2.11±0.45) mm. In the hyperplastic scar stage, the thickness measured by 20 MHz ultrasound was (4.11±0.73) mm, the thickness evaluated by VSS was (3.02±0.47) mm, and the thickness measured by pathological section was (4.27±0.44) mm. In the atrophic scar stage, the thickness measured by 20 MHz ultrasound was (1.74±0.64) mm, the thickness measured by VSS was (1.77±0.61) mm, and the thickness measured by pathological section was (1.71±0.67) mm. For scars in the above three periods, there was no statistical significance between scar thickness measured by 20 MHz high-frequency ultrasound and that measured by pathological sections(all P<0.05). In the initial stage of scar formation and hypertrophic stage, the thickness evaluated by VSS was significantly different from that measured by 20 MHz high-frequency ultrasound and pathology (all P<0.05), respectively. (2) Echo intensity was evaluated by ultrasound. In the initial stage of scar formation, the thickness of the epidermis shown by high-frequency ultrasound was close to that of the normal epidermis and presented a high-intensity echo, but there was a strip of echoless or no echo zone of <1 mm between the high-intensity echo epidermis and dermis, which looked like dermal edema. Pathology showed that there were acanthoid changes in the epidermis of the scar at this stage, rich capillaries and a small amount of collagen fibrous tissue in the dermis. In the hyperplastic scar stage, the scar epidermis still showed strong echo, while the dermis showed uneven echo, the superficial dermis showed obvious isoecho, and the deep dermis showed no echo or hypoecho. Pathology showed that the epidermis was thin and smooth, and keratosis was obvious. Collagen fibers parallel to the epidermis could be seen in the superficial layer of the dermis, with regular arrangement. Collagen fibers were increased and thickened in the deep layer of the dermis, in the shape of nodules and swirls. In the atrophic scar stage, the scar epidermis presented a strong echo, and there was no obvious demarcation between the dermis and subcutaneous tissue, presenting a uniform echo. Pathological findings showed that the epidermis became thinner with a "skin nails" -like structure, the junction between the superficial and deep dermis was not obvious, and the collagen fibers were arranged in parallel or oblique direction, and the surface boundary was unclear. Conclusion:20 MHz high-frequency ultrasound is more accurate than VSS in the assessment of thickness of hypertrophic scar, and can reflect the collagen content and moisture ratio in scar. Compared with pathological examination, it has the advantages of non-invasive and fast, and is an effective means to evaluate scar thickness and morphology.

Objective:To analyze the epidemiological characteristics of hospitalized children with burns who developed nosocomial infection, and screen their independent risk factors, based on which, a risk prediction model was established and evaluated.Methods:A retrospective cohort study was conducted. From May 2010 to April 2023, 417 children with burns who met the inclusion criteria were admitted to the First Affiliated Hospital of the Air Force Medical University, including 248 males and 169 females, aged ≤14 years. Statistics on the composition and source distribution of pathogenic bacteria in children were detected. According to the occurrence of nosocomial infection, the children were divided into infected group (216 cases) and uninfected group (201 cases), and the children gender, age, total area of burns, presence of full-thickness burns, cause of the injury, and season of the injury of the children in the 2 groups were collected, as well as presence of an abnormal serum albumin level, delayed resuscitation, combination of inhalation injury at admission, and early shock, tracheotomy, admission to the intensive care unit, and deep venous catheterization after post-hospitalization, and more or less times (>2 times being more and ≤2 times being less) of surgeries, indwelling catheter days, and length of hospitalization stay on post-hospitalization. The burned children were divided into modeling group (291 cases) and validation group (126 cases) according to the ratio of 7∶3, and the data of the 2 groups were recorded as before. Data were statistically analyzed with Mann-Whitney U test, chi-square test, and Fisher's exact probability test. The least absolute value selection and shrinkage operator (LASSO) regression analysis was used to reduce the risk factors of nosocomial infection in the children in modeling group. Multivariate logistic regression analysis was used to further screen the above screened risk factors, and the nomogram prediction model was drawn based on the further screened independent risk factors. The Bootstrap method was used for internal validation of the aforementioned predictive models, and the receiver operator characteristic (ROC) curves, calibration curves, and clinical decision curves of the predictive models were plotted in modeling group and validation group in order to assess its discriminative power, calibration, and clinical utility, respectively. Results:A total of 245 strains of pathogenic bacteria were detected, with Staphylococcus aureus (101 strains, accounting for 41%), Pseudomonas aeruginosa (54 strains, accounting for 22%), and Acinetobacter baumannii (33 strains, accounting for 13%) dominating, and the wound secretions were the most frequent source of pathogenic bacteria (211 strains, accounting for 86%), followed by blood (10 strains, accounting for 4%), and sputum (5 strains, accounting for 2%). There were statistically significant differences between infected group and non-infected group in the total burn area, indwelling catheter days, length of hospitalization stay, presence of full-thickness burns, combined with inhalation injury, and deep vein catheterization, and more or less times of surgeries (with Z values of -2.32, -3.29, and -3.85, respectively, with χ2 values of 26.36, 7.03, 10.13, and 10.53, respectively, P<0.05); there was statistically significant difference in cause of the injury between the two groups ( P<0.05). All clinical characteristics of children with burns in the modeling and validation groups were similar ( P>0.05). The six risk factors obtained from the LASSO regression analysis were full-thickness burns, deep vein catheterization, abnormal serum albumin level, multiple surgeries, indwelling catheter days, and length of hospitalization stay; the multivariate logistic regression analysis showed that full-thickness burns, abnormal serum albumin level, deep vein catheterization, and multiple surgeries were the independent risk factors for the occurrence of nosocomial infection in burned children (with odds ratios of 2.27, 2.66, 4.08, and 2.92, respectively, with 95% confidence intervals of 1.22-4.21, 1.03-6.87, 1.07-15.49, and 1.15-7.42, respectively, P<0.05). The ROC curves of the prediction models showed that, the areas under the ROC curves of the modeling and validation groups were 0.81 (with 95% confidence interval of 0.78-0.84) and 0.81 (with 95% confidence interval of 0.76-0.85), respectively; the calibration curves showed that, the calibration curves of the prediction models of modeling and validation groups were around the ideal curves; the clinical decision curves showed that, the threshold probability values of the prediction models in modeling and validation groups were in the ranges of 5% to 70% and 1% to 46%, respectively. Conclusions:The main pathogen of infection in children with burns is Staphylococcus aureus from wound secretions. A nomogram risk prediction model constructed based on independent risk factors such as full-thickness burns, abnormal serum albumin level, deep venous catheterization, and multiple surgeries has good accuracy and can be easily used to predict the occurrence of nosocomial infections in hospitalized children with burns.

Objective:To analyze the correlation between recessive obesity and lifestyle in physical examination population.Methods:A total of 1 026 people with body mass index (BMI) of 18.5<-24.9 kg/m 2 who completed physical examination in the Health Management Center of Affiliated Hospital of Qingdao University from March 1, 2019 to September 31, 2019 were included in this study. Inbody770 body composition analyzer was used to check the percent body fat, and the subjects were divided into recessive obesity group (405 cases) and control group (621 cases) with the results. The results of routine physical examination were compared between the two groups. The data of five dimensions including marital status, education level, income, occupation and dietary habits were obtained with lifestyle questionnaire. The correlation between recessive obesity and lifestyle was analyzed by binary logistic regression. Results:The proportion of women, BMI, total cholesterol, low density lipoprotein cholesterol and waist-hip ratio were significantly higher in the recessive obesity group than those in the control group [65.2% vs 27.1%, (21.83±1.63) vs (21.56±1.74) kg/m2, 4.68 (4.18, 4.22) vs 4.39 (4.13, 4.83) mmol/L, 2.54 (2.08, 3.00) vs 2.24 (2.13, 2.78) mmol/L, 0.87 (0.84, 0.90) vs 0.82 (0.80, 0.86)]; while the systolic blood pressure, albumin and aspartate aminotransferase were significantly lower [(114.99±11.49) vs (118.97±11.84) mmHg (1 mmHg=0.133 kPa), (45.13±2.83) vs (46.37±2.60) g/L, 15 (12, 18) vs 16 (14, 20) U/L] (all P<0.05). Unmarried ( OR=0.200, 95% CI: 0.123-0.325), eating less white meat [occasionally eating, OR=0.565, 95% CI: 0.304-1.053; rarely eating, OR=0.186, 95% CI: 0.094-0.368], eating less spicy food (occasionally eating, OR=0.298, 95% CI: 0.171-0.519; rarely eating, OR=0.828, 95% CI: 0.487-1.408), drinking more water (1 000-2 000 ml/d, OR=0.366, 95%CI: 0.218-0.615; ≥2 000 ml/d, OR=0.176, 95% CI: 0.087-0.356) were negatively correlated with the occurrence of recessive obesity (all P<0.05). Eating takeout food frequently ( OR=4.639, 95% CI: 2.412-8.923), eating too much edible oil ( OR=10.900, 95% CI: 4.376-27.148), drinking beer ( OR=3.702, 95% CI: 2.290-5.982) and infrequent physical exercise (occasional, OR=13.417, 95% CI: 6.907-26.066; rarely, OR=28.290, 95% CI: 13.532-59.142) were positively correlated with the occurrence of recessive obesity (all P<0.05). Conclusions:There is a correlation between recessive obesity and the lifestyle in physical examination population. Attention should be paid to control the intake of white meat, spicy food, edible oil and beer, ensure the amount of drinking water, reduce the frequency of takeout food, and increase physical exercise to prevent recessive obesity.

Objective:To understand the current research status of master of professional degree students in clinical medicine in provincial teaching hospitals with moderate scientific research level under the " dual-track" training system.Methods:Sojump online survey was conducted to investigate the cognition, current situation and self-evaluation of all clinical master degree students in three grades in a provincial teaching hospital, and the research status of professional degree and scientific degree students was compared and analyzed respectively.Results:The proportion of scientific degree students participating in scientific research projects was significantly higher than that of professional degree students. The proportion of professional degree students participating in scientific research projects was still not high even in the third year of graduate students. However, there was no difference between scientific degree and professional degree students in the publication of scientific research papers. The scientific degree of scientific research knowledge is significantly higher than that of professional degree students. Although scientific degree students receive more scientific research guidance from their supervisors, professional degree students communicate more with their supervisors, and the results show that professional degree students are significantly more satisfied with their supervisors, graduate policies and scientific research policies than scientific degree students. In addition, the results of graduate students found that the degree of research stress of both scientific and professional degrees exceeded 50%.Conclusions:Scientific degree is better than professional degree in research status because of professional characteristics and more research guidance from their supervisors. However, through the reform of professional degree training mode based on scientific research project management in recent years, professional degree students have been able to communicate more with their supervisors, and their satisfaction with their supervisors and colleges has significantly increased. In addition, sufficient attention should be paid to high scientific research pressure of medical graduate students.

Objective:To investigate therapeutic effect of cisplatin sequential recombinant human vascular endostatin thoracic perfusion in treatment of malignant pleural effusion.Methods:A total of 80 patients with malignant pleural effusion in Maoming People's Hospital from January 2018 to February 2021 were enrolled, and all patients were divided into 2 groups according to the random number table methods, each group with 40 cases. The control group was treated with small-bore catheter minimally invasive drainage combined with cisplatin thoracic perfusion, and the study group was treated with small-bore catheter minimally invasive drainage combined with cisplatin sequential recombinant human vascular endostatin thoracic perfusion. And then the clinical efficacy, expressions of vascular endothelial growth factor (VEGF) expression, pain degree and adverse reactions were compared of both groups.Results:The treatment efficacy rate of the study group was higher than that of the control group [90% (36/40) vs. 75% (30/40)], and the difference was statistically significant ( χ2 = 5.04, P < 0.05). After treatment, the level of VEGF in pleural fluid and serum of the study group was lower than that of the control group [(304±106) pg/ml vs. (598±159) pg/ml,(103±43) pg/ml vs. (189±49) pg/ml], and the difference was statistically significant ( t = 6.62, P < 0.001; t = 6.23, P < 0.001). After treatment, the visual analogue scale (VAS) score of the study group was lower than that of the control group [(3.7±0.3) scores vs. (4.4±0.7) scores], and the difference was statistically significant ( t = 2.10, P < 0.05). The incidence of adverse reactions including stethalgia, fever, nausea and vomiting in both groups had no statistically significant differences (all P > 0.05). Conclusions:Cisplatin sequential recombinant human vascular endostatin thoracic perfusion combined with small-bore catheter minimally invasive drainage can effectively ameliorate clinical symptoms, inhibit the expression of VEGF, and alleviate pain degree with no serious adverse reactions in patients with malignant pleural effusion.