To establish a medical imaging teacher competency model and evaluate its application value in group teaching for undergraduates.

Based on literature review, a competency model for teachers in medical colleges and universities was established. This study collected the self-evaluation scores and student evaluation scores of the competency model for teachers from Radiology Department of Peking Union Medical College Hospital who participated in the undergraduate medical imaging group teaching from September 2020 to November 2021, and compared the differences of various competencies before and after training, between different professional titles and between different length of teaching.

A total of 18 teachers were included in the teaching of undergraduate medical imaging group, with 11 having short teaching experience (≤5 years) and 7 having long teaching experience (> 5 years). Altogether 200 undergraduate students participated in the course (95 in the class of 2016 and 105 in the class of 2017). There were 8 teachers with a junior professional title, 5 with an intermediate professional title, and 5 with a senior professional title. The teacher competency model covered a total of 5 first-level indicators, including medical education knowledge, teaching competency, scientific research competency, organizational competency, and others, which corresponded to 13 second-level indicators. The teachers' self-evaluation scores of two first-level indicators, scientific research competency and organizational competency, as well as three second-level indicators, teaching skills, academic research on teaching and research, and communication abilities, showed significant improvements after the training, compared to those before training(all P < 0.05). Compared to the teachers with intermediate to senior professional titles/long teaching years, the teachers with junior professional titles/short teaching years had lower self-evaluation scores for multiple first-level and second-level indicators before the teacher training. After the training, these teachers showed more significant improvements in multiple indicators of self-evaluation scores(all P < 0.05). Additionally, students' evaluation changes for the teachers with junior professional titles before and after the training were consistent with this trend.

The competency model of undergraduate medical imaging teachers based on teacher competency can be preliminarily applied for the training of medical imaging teachers, as it reflects the change of competency of the teachers with different professional titles and teaching years in the process of group teaching.

Objective:To compare the efficacy of ultrasound combined with endoscopy and ultrasound combined with X-ray guided percutaneous nephrolithotomy(PCNL) in the treatment of complex renal calculi.Methods:The clinical data of 119 patients with complex kidney stones treated by ultrasound combined with endoscopy or ultrasound combined with X-ray guided PCNL in the Second Affiliated Hospital of Anhui Medical University from March 2019 to February 2022 were analyzed retrospectively. According to different guidance methods, they were divided into ultrasound combined with endoscopic guidance group and ultrasound combined with X-ray guidance group.There was no significant difference in age [(53.9±14.2) years vs. (55.6±13.5) years], gender (male/female: 38/21 vs. 30/30), body mass index [(25.0±3.7) kg/m 2 vs. (24.8±3.8)kg/m 2], stone location (left/right: 34/25 vs. 31/29), maximum diameter of renal stones [(31.9±8.3)mm vs. (33.9±13.5)mm], kidney stones maximum cross-sectional area [(601.5±242.5)mm 2 vs. (632.6±278.9)mm 2], number of renal calices involved (3.5±0.9 vs. 3.6±1.3), S. T.O.N.E. scores (9.4±1.0 vs. 9.7±1.4), Guy's grade(Ⅲ/Ⅳ: 45/14 vs. 41/19), preoperative hemoglobin [(125.2±21.5)g/L vs. (125.6±18.4)g/L], serum creatinine[(89.1±33.8) μmol/L vs. (81.9±27.1) μmol/L], urinary tract infection (43/59 vs. 47/60)and positive urinary bacterial culture (12/59 vs.11/60) between the two groups(all P>0.05). The patients in the ultrasound combined with endoscopic guidance group were placed in the modified prone split-leg position. Flexible ureteroscope retrograde into the renal pelvis, combined with ultrasound to determine the best puncture calices. The channels were established and stones were removed under the guidance of ultrasound and endoscopy. In the ultrasound combined with X-ray guidance group, the F5 ureteral catheter was placed retrogradely into the operative side ureter under the lithotomy position. Then the patient changed to prone position and the target calices were punctured under the guidance of ultrasound and X-ray. Through anterograde or retrograde injection of contrast medium, the puncture position was determined to enter in the center of the calicean dome, and the channel establishment process and stone removal are monitored. The operative results and postoperative data were recorded. Results:The average operation time in the ultrasound combined with endoscopic guidance group was significantly shorter than that in the ultrasound combined with X-ray guidance group [(90.2 ± 34.5) min vs. (129.4 ± 43.0) min, P < 0.001]. There was no significant difference in the success rates of initial channel establishment [94.0% (63/67) vs. 87.7% (107/122), P = 0.167], the time of single channel establishment [(7.7 ± 1.9) min vs. (7.7 ± 1.4) min, P =0.765], serum creatinine on the first day after operation[ (89.3±33.6) μmol/L vs. (82.9±27.0) μmol/L, P=0.257] and postoperative hospital stay[(5.3±1.6) d vs.(5.4±1.7) d, P=0.883]. In contrast, patients in ultrasound combined with X-ray guidance group had higher stone free rate [93.3% (56/60) vs. 81.4% (48/59), P=0.049] and lower reoperation rate [3.3% (2/60) vs. 15.3% (9/59), P=0.025]. The mean hemoglobin decrease value of ultrasound combined with endoscopic guidance group was significantly lower than ultrasound combined with X-ray guidance group on the first day after operation [(8.7±6.3) g/L vs. (16.8±6.9) g/L, P<0.001]. The complication rate of ultrasound combined with endoscopic guidance group was significantly lower than that of ultrasound combined with X-ray guidance group [5.1% (3/59) vs. 16.7% (10/60), P = 0.043]. Conclusions:Ultrasound combined with endoscopic guidance PCNL does not need to change body position during operation and has fewer puncture channels, thus saving operation time and reducing complications. It is more suitable for patients with isolated kidney or easy bleeding. Ultrasound combined with X-ray guidance is conducive to the establishment of multi-channel, the stone clearance rate is high and the reoperation rate is low, which is suitable for patients with good health and more renal calices involved with stones.

Objective:To discuss the feasibility and clinical efficacy of laparoscopic ureteroplasty with buccal mucosa graft for ureteral stricture.Methods:The clinical data of 10 patients with ureteral stricture admitted to the Second Affiliated Hospital of Anhui Medical University from July 2018 to November 2019 were retrospectively analyzed, including 7 males, 3 females, 5 cases on each side, with an average age of (47.9±7.8)years. All patients had a history of operation related to ureteral calculi. The median value of preoperative serum creatinine was 71(68~610)μmol/L. The status of hydronephrosis and ureteral stricture was evaluated by ultrasonography, CTU and ureteral retrograde angiography.The separation of the renal pelvis on the affected side was (3.1±0.7)cm.There were 7 cases of upper segment stenosis, 2 cases of middle segment stenosis, and 1 case of multiple stenosis. The length of ureteral stenosis was (3.2±0.7)cm. Laparoscopic buccal mucosa ureteroplasty was performed in all 10 cases under general anesthesia. After the stricture ureter segment was separated during the operation, the ureteral stenosis segment was longitudinally cut. According to the stenosis, the buccal mucosa with a length of 3.0-4.5 cm and a width of 1.0-1.5 cm was cut. Buccal mucosa grafts were harvested and placed in the ureter as an anterior onlay with omental wrapping.Results:Ureteral repair was performed laparoscopically in all cases, with no conversion to open and no serious complications. The operative time was (199.2±27.4)min, the blood loss was (101.5±54.7)ml, the median postoperative indwelling time of the drainage tube was 4.5(3.0-7.0)d, and the postoperative hospital stay was (7.9±1.9)days. The patients had clear pronunciation and barrier-free eating one week after the operation.The double J tube was removed one to two months after surgery. The patients were followed up for (11.3±4.2)months after the operation. Follow-up patients underwent imaging and other examinations, which showed significant improvement in hydronephrosis on the affected side, and the median value of renal pelvis separation on the affected side was 1.8(0-2.2)cm. The median value of serum creatinine was 82(66~235)μmol/L. The serum creatinine in 2 patients with renal insufficiency decreased significantly after operation.Conclusions:Laparoscopic buccal mucosa graft ureteroplasty could be a safe and feasible option for the treatment of ureteral stricture with less trauma and rapid recovery. The results of the initial experience are encouraging.

Objective: To investigate the feasibility and safety of endoscopic combined simultaneous surgery in the modified prone split-leg position for complex renal calculi with ipsilateral ureteral calculi. Methods: The clinical data of 56 cases patients with simultaneous renal and ureteral stones admitted to the Second Affiliated Hospital of Anhui Medical University from January 2016 to March 2019 were retrospectively analyzed. A retrospective analysis was performed on 56 cases of patients with simultaneous renal and ureteral stones who received surgical treatment between January 2016 and March 2019. According to different surgical methods, 56 cases were divided into the modified prone split-leg position group (observation group) and the traditional pre-lithotomy position followed by prone position group (control group). In observation group, the average age of 11 males and 17 females was (54.1±10.2)years. The mean body mass index was (23.8±2.9) kg/m². The location of stones were left in 14 cases and right in 14 cases. The average kidney involvement calyces number was 2.4±0.7.The mean kidney stones maximum cross-sectional area was (870.9±157.7)m². According to the Guy′s classification system, there were 3 cases of grade Ⅰ, 11 case of grade Ⅱ and 14 case of grade Ⅲ in the observation group. The kidney stones S. T.O.N.E scores was 8.7±1.3 and ureteral calculi S. T.O.N.E scores were 13.1± 1.6.In the control group, the average age was (57.0±8.3)years old. The mean body mass index was (24.4±2.9)kg/m². The average kidney involvement calyces number was 2.1±0.7 and the mean kidney stones maximum cross-sectional area was (808.8±189.6)mm². To the kidney stones Guy′s classification, there were 5 cases of grade Ⅰ, 15 case of grade Ⅱ, 7 case of grade Ⅲ and 1case of grade Ⅳ in the control group. The kidney stones S. T.O.N.E scores were 8.5±0.6 and the ureteral calculi S. T.O.N.E scores were 12.4±1.7. The operation time, calculus clearance rate, postoperative hospitalization days, reoperation rate and severity of complications of Clavien-Dindo were statistically compared between the two groups. Results: The study found that the average operation time in the observation group was significantly shorter than that in the control group [(77.8±27.3)min vs.(94.4±22.8)min](P<0.05). In the observation group, 23 patients had complete removal of renal and ureteral calculi, and 3 patients need reoperation. While in the control group, 16 patients had complete removal and 10 patients had reoperation. There were significant differences between the two groups (P<0.05). According to the complication severity of Clavien-Dindo, there were 4 cases of grade Ⅰ and 1 case of grade Ⅱ in the observation group, 4 cases of grade Ⅰ, 2 case of grade Ⅱ and 2 case of grade Ⅲ in the control group. There were no serious complications of grade Ⅳ and Ⅴ in both groups (P>0.05). In observation group, one case accepted the DSA embolization therapy due to the severe bleeding. One case accepted the puncture drainage due to the perinephric effusion. There was no difference in average postoperative hospital stay between the two groups [(6.5±1.2)d vs.(7.0±2.1)d, P>0.05]. Conclusions It is safe and feasible to treat complex renal calculi with ipsilateral ureteral calculi by endoscopic combined simultaneous surgery in the modified prone split-leg position. One position can solve many problems simultaneously, which can significantly reduce the operation time, increase the stone free rates, reduce the reoperation rate and improve the effectiveness of the operation.

Objective To establish a method for the determination of protocatechuic acid, salidroside, and chlorogenic acid in Sargentodoxa cuneata. Methods The separation was performed on a Waters XSELECT CSH C18 (150 mm × 4.6 mm, 5 μm) with methanol-acetonitrile-0.2 % phosphoric acid as the mobile phase in a gradient elution at a flow rate of 0.8 ml/min. The detection wavelength was 260 nm and the column temperature was 35 ℃. Results The linear ranges of protocatechuic acid, salidroside, and chlorogenic acid were 0.0020-0.0120, 0.0600-0.3602, 0.0750-4.5006 mg/ml, respectively. The average recoveries were 98.01% (RSD=0.07%), 98.53 % (RSD=0.12%), and 101.10 % (RSD=1.92%), respectively. Conclusions The method is simple, accurate, and highly reproducible, which could provide the scientific evidence for the quality control of Sargentodoxa cuneata.

[Abstract ] Objective The pathogenesis underlying cognitive dysfunction has yet to be fully elucidated.The article was to investigate the effects of memantine on lipopolysaccharide (LPS)-induced spatial learning and memory impairment in C57BL/6J mice. Methods 36 male C57BL/6J mice were randomly divided into 3 groups:control group (C group), lipopolysaccharide group (L group) and memantine group (M group) (n=12).Mice in C, L and M groups were intraperitoneally injected with the same volume of saline, LPS and LPS plus memantine re-spectively for 7 consecutive days.On the 8th day, mice were tested in the Morris water maze, in which the latency to the platform and the propor-tion of time spent in the target quadrant were recorded .Then the mice were sacrificed and the hippocampi were harvested for the determination of expression levels of Amyloid-β(Aβ), glycogen synthase kinase-3β(GSK-3β) and mammalian target of rapamycin (mTOR). Results Com-pared with C group, L group significantly prolongated the latency to the platform (71.01 ±13.21 vs 50.56 ±9.89, P<0.05), decreased the propor-tion of time spent in the target quadrant (42.58 ±7.85 vs 63.74 ±12.43, P<0.05) and increased the levels of hippocampal Aβand GSK-3β(1.75 ±0.43 vs 1.27 ±0.23, 184.0 ±18.6 vs 100.0 ±12.1, P<0.05), (75.0 ±13.5 vs 100.0 ±10.3, P<0.05), while mTOR levels decreased significantly (97.0 ±14.3 vs 75.0 ±13.5, P<0.05).Compared with L group, M group significantly prolongated the latency to the platform (61.45 ±7.65 vs 71.01 ±13.21, P<0.05), decreased the proportion of time spent in the target quadrant shortened (58.25 ±9.02 vs 42.58 ±7.85, P<0.05) and increased the expression of hippocampal Aβ(1.35 ±0.28 vs 1.75 ±0.43,92.4 ±10.8 vs 184.0 ±18.6, P <0.05). Conclusion Memantine contributes to the improvement of LPS-induced spatial learning and memory impairment, which is probably related to the changes of the expression of GSK-3βand mTOR in hippocampus.

Objective To evaluate the practical value of procaleitonin(PCT)in diagnosis of pneumonia in patients after kidney transplantation.Method A total of 102 patients with pneumonia after kidney transplantation were reviewed.According to the diagnostic criteria of pathogens of pneumonia,32 patients were enrolled in bacterial group and 70 patients in non-bacterial group.The data of the PCT level and the C-reactive protein (CRP) level of the two groups were determined and compared with each other.Results There was significant difference in PCT level between bacterial pneumonia patients after kidney transplantation and non-bacterial pneumonia patients group (P<0.01).The difference in CRP level between bacterial pneumonia patients after kidney transplantation and non-bacterial pneumonia patients group was not significant (P>0.05).The changes of PCT level and the CRP level in 32 patients with bacterial pneumonia after kidney transplantation were not significant (P>0.05),and they were not associated with each other.Conclusions Monitoring the PCT level in patients with bacterial pneumonia after kidney transplantation would have an obviously clinical significance in diagnostic value.

Objective To investigate the clinical efficacy and safety of the high-intensity focused ultrasound therapy in patients with colorectal liver metastases. Methods 28colorectal lesions in 16 patients with liver metastases after HIFU treatment lines observed patient vital signs,the main organ,imaging studies (CT or MRI,etc. ) ,complications and prognosis of cancer cases. Results All patients with stable vital signs after treatment, liver, kidney function was normal,6-month follow up, six more than 80% reduced lesion size,lesion size decreased in 18 of 30% to 50% ,4tumor volume did not change significantly; 16 patients, 1 patient was lost. 15 cases were followed uPfor 6 to 24 months,5 patients were transferred because of lesions disseminated in death within 6 months after surgery, calculated with the Kaplan-Meier median survival time was 13 months; 1 patient skin burning streak marks, healed after 1 week after treatment. 1 patient treatment areas of the chest skin, mild subcutaneous edema. Conclusion The treatment of patients with liver metastasis of colon cancer lesions was a non-invasive, safe and effective treatment.

OBJECTIVETo observe trinucleotide repeat number, (CTG)n in the 3'-untranslated region of the myotonic protein kinase (MTPK) gene in a clinically suspected woman with myotonic dystrophy (DM) family history and her abortus, in order to confirm the necessity of exerting antenatal examination in patients or suspected individuals with DM family history.

METHODSLong Expand Template polymerase chain reaction (PCR) system was used to analyze CTG trinucleotide repeat numbers located in the 3' untranslated region of MTPK on chromosome 19q13.2-3 in both peripheral white cells and muscles of the suspected mother and the other two DM patients in the family. The tissues of her abortus and blood of a health woman were detected, too.

RESULTSCTG repeats in both peripheral white cells and muscles of the suspected mother and the tissue of abortus were higher than normal range of CTG repeat number. There is no significant difference between blood and muscle samples. High CTG repeats were detected in blood and muscles of the typical DM members in the family, but in the blood sample of control, CTG repeats is normal.

CONCLUSIONCTG trinucleotide analyses and antenatal examination should be done in pregnant with a DM family history, in order to reduce the birth rate of DM offspring.

Adult ; DNA ; analysis ; Female ; Fetus ; metabolism ; Humans ; Myotonic Dystrophy ; diagnosis ; genetics ; Prenatal Diagnosis ; Trinucleotide Repeats

Objective:To analysis the appearances and to evaluate the diagnostic value of X-ray CT and MR imaging in osteoid osteoma.Methods:22 cases 19 females and 3 males of osteoid osteoma proved by surgical pathology and their X-ray,CT and MRI were reviewed.The ability of X-ray,CT and MRI to demonstrate the nidus and surrounding reaction were analyzed.Results:The nidus were appeared as round or oval shape and the diameter was less than 2 cm.It was fomd in 17 cases of X-ray film，22 CT and 20 of MRI .There were different degree of bone sclerosis,periosteal reaction and soft tissues or bone marrow edema around the nidus.The diagnostic accuracy was 77.3% for X-ray，100% for CT and 90.9% for MRI.Conclusion:Most of osteoid osteoma have the typical appearances and is no difficult to make diagnosis.CT scan is the most accuracy method to demonstrate the nidus.It is possible to make misdiagnosis only with X-ray or MRI for the case that the hidus not be demonstodted.