Objective:To explore the practical effect of applied talent training model based on the"Four Combinations"among students majoring in Traditional Chinese Medicine in a Medical College.Methods:The undergraduate students majoring in Traditional Chinese Medicine at a medical college from grade 2021 and 2022 were selected as the research subjects and divided into two groups.Experimental group were students who had participated in various extracurricular competitions and innovation and entrepreneurship projects,while control group were students who had not participated in any competitions or projects.The final intellectual education scores of the two groups of students were compared(excluding the scores of Marxist basic principles).A questionnaire survey was conducted on the satisfaction of talent cultivation models among the above undergraduate students,and the validity and satisfaction analysis of the survey results were conducted.Results:The experimental group had significantly higher intellectual education scores than the control group(P＜0.05).The results of factor analysis indicated that the sample suitability and the questionnaire validity seem plausible(KMO=0.874).The overall satisfaction score of students towards the"Four Combinations"talent cultivation model was 4.16±0.2(out of 5),reflecting their high recognition of the model.Conclusion:The construction of a"Four Combinations"characteristic Traditional Chinese Medicine applied talent cultivation model is beneficial for improving the quality of cultivating high-quality and composite applied talents in Traditional Chinese Medicine,so as to provide high-quality applied talents with solid theoretical foundation and practical innovation capabilities for the Liaoshen region.

Background Prolonged awkward postures during occupational activities can lead to excessive musculoskeletal load on the wrist of workers and symptoms such as wrist pain or discomfort. Objective To survey the prevalence of wrist pain among workers in 10 key industries and analyze its correlation with wrist working postures. Methods By using stratified cluster sampling method, workers from 10 key industries, such as footwear manufacturing industry, shipbuilding manufacturing industry, and automobile manufacturing industry, were selected from seven regions in North China, East China, Central China, South China, Southwest China, Northwest China, and Northeast China. The demographic information, wrist working postures, pain in wrist of the workers were collected through a cross-sectional survey. Pearson χ² test was used to compare prevalence by selected factors, trend χ² test for between group comparison, and unconditional logistic regression models for the association of wrist working postures with wrist pain. Results There were 64052 workers enrolled in this survey, and 56286 provided valid questionnaires (the effective rate was 87.8%). According to the survey, the prevalence of wrist pain was 23.3% (13112/56286), and the industries with higher prevalences were footwear manufacturing (27.1%, 1927/7106), automobile manufacturing (24.9%, 5378/21560), and shipbuilding and related equipment manufacturing (24.4%, 850/3488) industries. Finger pinching (OR=2.09, 95%CI: 1.95-2.24), frequent wrist bending (OR=2.03, 95%CI: 1.92-2.15), fixed wrist bending (OR=1.77, 95%CI: 1.69-1.85), wrist on hard edge (OR=1.34, 95%CI: 1.28-1.40), and arms over shoulders (OR=1.11, 95%CI: 1.05-1.17) increased the risk of reporting wrist pain. Conclusion Awkward postures are related to wrist pain among workers in selected 10 key industries. The related factors are wrist on hard edge, frequent wrist bending, finger pinching, fixed wrist bending, and arms over shoulders.

Objective:To study the risk factors and microbial spectrum for infectious complications for patients with biliary tract cancer after major hepatectomy with cholangiojejunostomy.Methods:Enrolled into this study were 78 consecutive patients (57 patients with perihilar cholangiocarcinoma, 17 with intrahepatic cholangiocarcinoma and 4 with gallbladder cancer), who underwent major hepatectomy with cholangiojejunostomy at Nanjing Drum Tower Hospital between September 2010 and March 2019. The clinical data were reviewed using multivariate analysis to find independent risk factors for postoperative infectious complications. Microorganisms isolated from bile and infected sites were determined to study the microbial spectrum.Results:A total of 45(57.7%) patients suffered from postoperative infectious complications. Male sex ( OR=7.765, 95% CI=1.895-31.815, P<0.05) was the independent risk factor, whereas increased preope-rative red blood cell (RBC) ( OR=0.151, 95% CI=0.038-0.592, optimal cut-off value=3.7×10 12/L) and increased total cholesterol (TC) on postoperative day (POD) 1 ( OR=0.227, 95% CI=0.083-0.626, optimal cut-off value=3.5 mmol/L) were protective factors (both P<0.05). The area under the receiver operating characteristic (ROC) curve was 0.805 (95% CI=0.707-0.902, P<0.05). 205 and 230 microorganisms were cultured respectively from 286 and 681 specimens which were collected from pre-/intraoperative bile and potentially infected sites. Staphylococcus, enterococcus, acinetobacter, klebsiella and pseudomonas were the most common pathogens on bile culture. The first 5 most frequently isolated microorganisms from the infected sites were enterococcus, staphylococcus, klebsiella, candida and xanthomonas. Sixteen (61.5%) of 26 patients had at least one pathogen being isolated from the infected sites with the pathogen being previously isolated in bile culture. Conclusions:Male sex were independent risk factors of infectious complications. Increased preoperative RBC and inreased TC on POD were proteetive factors. For patients without a positive bile culture, a third-generation cephalosporin can be considered as a prophylactic antibiotic. It is important to identify high-risk patients and monitor perioperative pathogens actively to prevent and to cure postoperative infectious complications.

OBJECTIVE: To analyze the clinical characters, surgical treatments and prognosis of differentiated thyroid carcinoma (DTC) with laryngeal or tracheal invasion. METHOD: Forty-six cases including 33 papillary and 13 follicular were retrospectively reviewed. Thirty-four cases with tracheal invasion received conservative resection (17), window resection (11) and sleeve resection (6). One case with subglottic invasion was performed subglottic partial laryngectomy. Eleven cases with trachea-laryngeal invasion received total laryngectomy(4), 3 shave technique and 4 preservative laryngectomy. RESULT Complications included infections and hypocalcaemia, 15 patients got permanent fistula. 5-year survival rate in cases of tracheal shave resection was 88.2%, while 63.6% in those of window resection and 83.3% in those of sleeve resection. Survival rate within 5 years of patients received preservative laryngectomy was 62. 5%. Conclusion: With meticulous preoperative examination and positive surgical treatment, both survival rate and quality of life could be improved in patients of DTC with laryngeal or tracheal invasion.
Adenocarcinoma ; Humans ; Laryngectomy ; Larynx ; pathology ; Larynx, Artificial ; Neoplasm Invasiveness ; Prognosis ; Quality of Life ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; pathology ; surgery ; Trachea ; pathology

Objective To compare the different expressions of transforming growth factor beta1 (TGFβ1) and its type one receptor(TGFβR1) between primary pancreatic cancer cell line AsPC-1 and metastatic pancreatic cancer cell line BxPC-3. Methods The mRNA expressions of TGFβ1 and TGFβR1 in AsPC-1 and BxPC-3 pancreatic carcer cell lines were quantatitived by real-time RT-PCR. The protein levels of TGFβ1 and TGFβR1 in these two cell lines were measured by Western blot assay. Results Compared with the primary pancreatic cancer cell AsPC-1, the mRNA and protein expressions of TGFβ1 and TGFβR1 were much higher in BxPC-3 pancreatic cancer cells(P<0.05). Conclusions Upregulations of TGFβ1 and TGFβR1 might be a pivotal incidence in the procedure of malignant progressing and metastasis in pancreatic cancer cells.

Objective To study the effect of Guipi Decoction on serum IL-1? and hippocampus IL-1RⅠ expression of depression model rats, and approach its mechanism of treating depression. Methods The depression model was established by received chronic unpredictable stress stimulus. Forty female Wistar rats were divided into four groups:control group, model group, saline group and Chinese medicine group. All rats were weighed and taken Open-field test on 0 and 22nd day, the serum IL-1? was detected with radio-immunity, and the expression of IL-1RⅠ was detected with immunohistochemical method. Result Compared with the control group, the weight, behavior points, serum IL-1?, expression of IL-1RⅠ of the model group and the saline group changed obviously while that in Chinese medicine group did not. Conclusion The anti-depressive mechanism of Guipi Decoction is related to maintaining the normal excretion of IL-1? and IL-1RⅠ expression from the chronic stress.

Objective To investigate the protein and mRNA expressions of Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) on colons of rats with trinitrobenzene sulfonic acid (TNBS)- induced colitis,and to evaluate the effects of probiotics.Methods Thirty male Wistar rats were randomly divided into normal control group (NC group),model control group(UC group) and probiotics-treated group(PC group).The experimental colitis was induced by TNBS/ethanol enema.Rats in PC group were fed with Bifico [live probiotics of combined hifidobacterium(Bif),lactobaeillus(Lac) and enteroeoccus] by 2.2?10~9 CFU/d for 4 weeks.Inflammatory scores were studied.Expressions of protein and mRNA of TLR2 and TLR4 were measured by Western blot and real-time quantitative polymerase chain reaction (PCR),respectively.Results Inflammatory scores in NC group,UC group and PC group were 4.35?0.88,10.25?1.36 and 7.94?0.85,respectively.The inflammatory scores in PC group were decreased compared with that in UC group (P

Objective To investigate the effect of H.pylori infection and eradication on gastric parietal cell and H + K +ATPase mRNA expression in a murine model. Methods Twenty 7 week old SPF BALB/C mice (10 males and 10 females) each were fed by H.pylori strain (Sydney Strain 1,SS1) at a dose of 0.4 ml (10 9CFU) per day for consecutive 5 days. Two months after infection of H. pylori, all mice were divided into two groups, the eradication group (10 mice) and the infection group (10 mice). Mice in the eradication group were administered clarithromycin ( 13.5 mg?kg -1 ?d -1 ) twice per day for one week (one mouse was died).Meanwhile, mice in the infection group were given the same amount placebo. All mice were killed at one month after the administration.The gastric mucosa was removed for rapid urease testing (RUT) and Giemsa stainning. The expression of H + K +ATPase mRNA was detected by RT PCR. Morphological changes in parietal cells were assessed by electron microscope. Results The animals in infection group were 100% infected by H.pylori, and RUT and Giemsa staining were all positive. Meanwhile , all but one mouse in the eradcation group were negative to RUT and Giemsa staining. In the infection group, the average ratio A C to A T (A C means the area of the canaliculi, A T means the area of the parietal cells ) was ( 2.20 ? 0.06 )/10 4, significant lower than that in the eradication group [(3.20 ? 0.06 )/10 4, P

Objectives Pancreatic ischemia is a pathogeny of acute pancreatitis(AP), and systemic blood rheologic changes have close relationship with AP. The aim of this study was to investigate the potential role of the systemic blood rheologic and pancreatic hemodynamic changes in rats with AP, and to reveal their relationship. Methods Acute edematous pancreatitis(AEP, n =20) and acute necrotizing pancreatits(ANP, n =20) models were induced by injection of sodium taurocholate into the pancreatic duct of rats, another 10 normal rats were used as control group. The pancreatic blood flow(PBF) was measured by Doppler ultrasound before and after the operation. At 12 h after the induction of AP, 10 rats in each group were sacrificed, the blood rheologic indexes were detected, and the pathological study of pancreas was performed. The survival rate in 3 days of the rest 10 rats in AEP and ANP group was also observed. Results Compared with the control group, only the hemagglatination index increased in AEP group and all the blood rheologic indexes increased in ANP group distinctly with the elevation of blood viscosity curve. The velocity of PBF was decreased in AEP and ANP groups, reducing to 79% and 30% of theirs levels before the induction of AP. Compared with the control group, the pathological scores of pancreatic edema, inflammation, hemorrhage and necrosis of AEP rats significantly increased, and compared with AEP group, these four indexes increased significantly in ANP rats. The survival rate in 3 days of AEP group was 90%, but that of ANP group was 0. Conclusions Systemic blood rheologic and pancreatic hemodynamic changes happen synchronously in rats with AP. The injury of pancreatic microcirculation due to ischemia is one of the initial pathogeneses of AP. The change of blood rheology is not a contributing factor causing AP, it could aggravate pancreatic ischemia and accelerate the pancreatic injury after onset.

Objective To investigate the feasibility of L-[1- 13 C]phenylalanine breath test to assess liver function and determine the effective parameters of the test for quantitative assessment of liver function in adult. Methods Twelve healthy volunteers served as control group, and 26 liver cirrhotic patients with hepatitis B were divided into three groups, 10 patients in Child-Pugh classification A, 8 in B and 8 in C, An oral dose of 100 mg of nonradiative tracer L-[1- 13 C]phenylalanine were administered to all the subjects. Breath samples were taken before and different intervals within 360 min after administration. 13 CO_2 enrichment was measured by isotope ratio mass spectrometer. Results After the oral administration of L-[1- 13 C] phenylalanine, 13 C excretion reached a peak within 10-30 min. The parameters of 13 CO_2 excretion rate at 30 min ( 13 CO_2ER_ 30 ) , 13 C cumulative excretion of 60 min ( 13 C_ cum60 ), 75 min( 13 C_ cum75 ), 90 min( 13 C_ cum90 ) and 13 CO_2 half excretion time ( t _ 1/2 ) were shown sensitive, which could differentiate significantly the groups( P