Objective:To investigate the correlation between impulse oscillometry system examination indicators and conventional pulmonary ventilation function.Methods:The pulmonary ventilation function data of 10 883 patients from January 1, 2020 to December 31, 2022 at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology were included. The one-second rate [ratio of forced expiratory volume in the first second (FEV 1) to forced vital capacity (FVC)] measured as a percentage of the predicted value was ≥92% for the control group ( n=3 478) and <92% for the pulmonary obstruction group ( n=7 405). The obstruction group was subdivided into five groups according to the degree of pulmonary dysfunction: mild group ( n=3 938),moderate group ( n=1 142),oderate-severe group ( n=917),severe group ( n=737),and extremely severe group ( n=671). Conventional pulmonary ventilatory function FVC, FEV 1, one-second rate, and forced expired flow at 50% of FVC (MEF50%), forced expired flow at 75% FVC (MEF25%), maximal mid-expiratory flow (MMEF), peak expiratory flow (PEF), and pulsed oscillation pulmonary function test were detected in both groups of patients. Impedance at 5 Hz (Z5) means total respiratory resistance, resistance at 5 Hz (R5) means total airway resistance, reactance at 5 Hz (X5) indicates the elastic recoil of the peripheral airways, and resistance at 20 Hz (R20) represents resistance of the central airways. R5-R20 reflects resistance in the small airways. Additionally, peripheral resistance (Rp), respiratory resonance frequency (Frex), and area under the reactance curve (Ax) were also measured. Correlation between the indicators of the two groups and the sensitivity and specificity of the impulse oscillometry system parameters for the diagnosis of obstructive pulmonary ventilation dysfunction were analyzed. Results:Pulmonary function force expiratory volume in the first second as a percentage of predicted value (FEV 1%Pre) [80.10 (54.95,97.10)%],one-second rate [62.43(48.67, 67.02)%],MEF50% [1.33 (0.62,1.97)L/s],MEF25% [0.28 (0.17,0.41)L/s], MMEF [0.85 (0.43,1.29)L/s],and PEF [5.64 (3.73,7.50)]L/s in the obstruction group were significantly lower than those in the control group ( P<0.05). The differences within the subgroups of the obstruction group were also significant ( P<0.05). Pulsed oscillation Z5 [0.42 (0.33,0.55)kPa·L -1·s -1],Rp [0.25 (0.20,0.45)kPa·L -1·s -1], R5 [0.39 (0.31,0.49)kPa·L -1·s -1], R20 [0.28 (0.24,0.34)kPa·L -1·s -1], R5-R20 [0.09 (0.05,0.17)kPa·L -1·s -1],Frex [16.32 (13.07,20.84)Hz], and Ax [0.67 (0.28,1.64)] indices in the obstruction group were significantly higher than those in the control group. X5 [-0.14 (-0.23, -0.10)kPa·L -1·s -1] was significantly lower than that in the control group ( P<0.05). Z5, Rp, X5, R5, R5-R20, Frex, and Ax were statistically significant between different degrees of obstruction in the obstruction group ( P<0.05). The impulse oscillometry system parameters Z5, Rp, R5, R20, R5-20, Frex, and Ax were negatively correlated with the indices of conventional pulmonary ventilation ( r=-0.21-0.68, P<0.05), and the parameter X5 was positively correlated with the indices of conventional pulmonary ventilation ( r=0.41-0.68, P<0.05). The pulsed oscillation pulmonary function test parameters X5 (58.60%-95.68%) and Ax (57.08%-98.06%) presented the best sensitivity; X5 (86.29%-98.82%), Frex (86.69%-94.71%), and Ax (88.10%-98.53%) displayed the best specificity; and R20 presented the worst sensitivity and specificity. The sensitivity and specificity were slightly better in female patients than in male patients. Conclusion:The technical parameters of the impulse oscillometry system showed significant correlation with relevant indices of conventional pulmonary ventilation function detection. These well reflect the changes of different degrees of pulmonary ventilation function and have greater significance for reference in evaluating the degree of pulmonary function impairment.

Purpose: We aimed to evaluate whether the addition of pemetrexed is effective in improving progression-free survival (PFS) in epidermal growth factor receptor (EGFR)–mutated patients with or without concomitant alterations. Materials and Methods: This multicenter clinical trial was conducted in China from June 15, 2018, to May 31, 2019. A total of 92 non–small cell lung cancer (NSCLC) patients harboring EGFR-sensitive mutations were included and divided into concomitant and non-concomitant groups. Patients in each group were randomly treated with EGFR–tyrosine kinase inhibitor (TKI) monotherapy or EGFR-TKI combined with pemetrexed in a ratio of 1:1. PFS was recorded as the primary endpoint. Results: The overall median PFS of this cohort was 10.1 months. There were no significant differences in PFS between patients with and without concomitant and between patients received TKI monotherapy and TKI combined with pemetrexed (p=0.210 and p=0.085, respectively). Stratification analysis indicated that patients received TKI monotherapy had a significantly longer PFS in non-concomitant group than that in concomitant group (p=0.002). In concomitant group, patients received TKI combined with pemetrexed had a significantly longer PFS than patients received TKI monotherapy (p=0.013). Molecular dynamic analysis showed rapidly emerging EGFR T790M in patients received TKI monotherapy. EGFR mutation abundance decreased in patients received TKI combined chemotherapy, which supports better efficacy for a TKI combined chemotherapy as compared to TKI monotherapy. A good correlation between therapeutic efficacy and a change in circulating tumor DNA (ctDNA) status was found in 66% of patients, supporting the guiding role of ctDNA minimal residual disease (MRD) in NSCLC treatment. Conclusion EGFR-TKI monotherapy is applicable to EGFR-sensitive patients without concomitant alterations, while a TKI combined chemotherapy is applicable to EGFR-sensitive patients with concomitant alterations. CtDNA MRD may be a potential biomarker for predicting therapeutic efficacy.

As a strategic emerging industry of China, the biotechnology industry develops rapidly in recent years, which significantly increased the demand for creative and capable talents. As a core curriculum of bioengineering specialty, biotechnology equipment plays an important role in fostering such talents. To address the problems in biotechnology equipment course teaching such as limited equipment availability, limited engineering practice, and lack of learning motivations, curriculum reform and optimization were performed based on curriculum resource development, virtual reality-physical combined engineering training, and boosting learning motivations. The optimized teaching contents focus on fostering morality, intelligence, and creative practice abilities by connecting new requirements of social development, introducing new progress in biotechnology research, as well as new practices in research and development (R & D). Measures such as teaching methods innovation, assessment and evaluation methods optimization, cutting-edge R & D progress, diverse resources integration, and online-offline combined teaching, were developed to boost the learning motivation and foster the innovation competence of students. By above exploration and practice, the practice and innovation competence of students were significantly enhanced.
Humans ; Students ; Learning ; Curriculum ; Bioengineering ; Biomedical Engineering

Objective To investigate the application of evidence-based medicine combined problem-based learning in clinical teaching of respiratory medicine. Methods 47 students were divided into two groups. EBM-PBL was applied in the experimental group including 27 students and PBL was applied in the control group including 20 students. Teaching effect was evaluated by objective and subjective indicators. Data were analyzed using SPSS 13.0 software and Fisher's exact probability test was also applied. Results The proportion of high level evidences (grade A) that provided by the students in experimental group (51.3％) was significantly higher than that in the control group (30.2％) (P<0.05). About 90％ students in the experi-mental group believed that EBM-PBL could improve their abilities of information acquisition and utiliza-tion, problem analysis and solving as well as multiple discipline literature synthesizing, which was signifi-cantly higher than that in the control group (P<0.05). Conclusion EBM-PBL could cultivate the students' awareness of evidence and the level of clinical decision-making so as to enhance their comprehensive abil-ities, which was superior to mere problem-based learning.

Objective To investigate the influence of misoprostol and carboprost methylate for preoperative vaginal placement on the clinical index, the cervical dilatation degree and adverse reactions of patients with submucous myoma of uterus by hysteroscopic surgery.Methods150 patients with submucous myoma of uterus by hysteroscopic surgery were chosen in the period from August 2013 to August 2016 in Yiwu Maternal and Child Health Care Family Planning Service Center and divided into two groups including group A (75 patients) with misoprostol and group B (75 patients) with carboprost methylate for preoperative vaginal placement;and the operation time, the intraoperative blood loss, the recovery time of gastrointestinal function, the effects of cervical dilatation, the width of cervical dilatation and the adverse reactions incidence of both groups were compared.ResultsThe operation time and the intraoperative blood loss of B group were significantly better than A group(P<0.05).There was no significant difference in the recovery time of gastrointestinal function between the two groups.The effects of cervical dilatation in group B were significantly better than that in group A(P<0.05).The width of cervical dilatation in group B were significantly larger than that in group A(P<0.05).There was no significant difference in the adverse effects incidence between the two groups.ConclusionCompared with misoprostol, carboprost methylate for preoperative vaginal placement in the treatment of patients with submucous myoma of uterus by hysteroscopic surgery can efficiently shorten the operation time, reduce the operation bleeding, improve the effect of cervical dilatation and not increase the adverse reactions risk.

Objective To study the effect of small dose mifepristone in the treatment of uterine fibroids.Methodsfrom January 2013~2015 year in January 100 cases of uterine fibroids were treated in Yiwu Maternal and Child Health Care Family Planning Center as the research object in the course of the study, patients began taking mifepristone in menstruation third days to 5 days, taking a total of 6.5 months, after the observation of its long-term use of low-dose mifepristone after treatment, changes in sex hormone the level of the effect of low-dose mifepristone in the treatment of patients with uterine fibroids and patients in the body, including the effects on the endometrium.The clinical symptoms and signs, the changes of hormone levels and the results of B-ultrasound were followed up.ResultsAll of the 100 patients were treated with low dose mifepristone for a period of time, all of them had amenorrhea.Before treatment, the level of estradiol in patients was (298.5±156) pmol/L, and the level of progesterone (2.8±1.3) was pmol/L.After 6.5 months of treatment, the level of estradiolof the patients was(228.4±114)pmol/L, and the level of progesterone(1.3±0.5)pmol/L was pmol/L.The results showed that the levels of progesterone and estradiol in patients after treatment were significantly lower than those before treatment, with statistical difference (P<0.05).There was no significant change in endometrial thickness after long-term low-dose mifepristone treatment (P>0.05).After treatment, the total effective number of cases was 92 cases, the effective rate was 92%.ConclusionSmall dose of mifepristone for uterine fibroids clinical treatment effect is good, to a large extent, improve the effective rate of treatment and high safety, with the clinical significance of further promotion and application.

Objective To evaluate the efficacy and safety of levonorgestrel combined with danazol capsules in the treatment of endometriosis patients.Methods Ninety patients with endometriosis were randomLy divided into experimental group and control group(45 cases).The control group was treated with danazol capsules.The experimental group was treated with levonorgestrel on the basis of the control group.The clinical efficacy and serum CA125,CA199,ovarian function,and ovarian function were observed before and one month and three months after treatment.Adverse reaction rate.Results After three months of treatment,the clinical symptoms of the experimental group were lower than the control group(P<0.05); serum CA125,CA199 levels decreased,compared with the control group,the test group decreased significantly(P<0.05); ovarian function recovery Compared with the control group,the difference was statistically significant(P<0.05).two group compared with the incidence of adverse reactions,the difference was not statistically significant.Conclusion Levonorgestrel danazol capsules treatment of endometriosis Bitter patients than the use of danazol capsules better treatment,higher safety,worthy of clinical application to promote.

Objective To explore perioperative risk factors for postoperative pancreatic fistu?la. Methods Six hundred and forty?three cases patients who underwent radical gastrectomy for gastric cancer from January 2010 to June 2015 in the NO. 309 Hospital of Chinese People’ s Liberation Army were selected and divided into Postoperative Pancreatic Fistula( POPF) group with 53 cases and Non?Postoperative Pancreatic Fis?tula( NPOPF) group with 590 cases. Preoperative,intraoperative and postoperative data were analyzed by statisti?cal analysis of two groups. Results POPF rate was 8. 24%(53/643). There were no significanct differences in terms of gender,age,preoperation with disease,preoperative serum albumin,TNM stage,abdominal surgery,sur?gical procedure,lymph node dissection,digestive tract reconstruction,surgical approach,blood loss and length of time between the POPF group and NPOP group(P>0. 05). The level of BMI of POPF group was higher than that of NPOPF group,the difference was statistically significant((25. 63±2. 54) kg/m2 vs. (21. 11±2. 44) kg/m2,t=2. 245,P=0. 025). The number of lymph node dissection in POPF group was (32. 25±5. 82),in NPOPF group was (27. 06±6. 79),there was significant difference between the two groups(t=2. 093,P=0. 037). The operation time in POPF group was (242. 50±52. 30) min,in NPOPF group was (229. 51±59. 21) min,the difference was statistically significant between the two groups( t=2. 398,P=0. 017) . The serum CRP of 1 d in POPF group was (85. 72±12. 05) mg/L,in NPOPF group was (76. 41±12. 52) mg/L,and there was significant difference between the two groups( t=1. 979,P=0. 048) . The serum albumin of 2?4 d after operation in POPF group was (26. 0±5. 9) g/L,in NPOPF group was (32. 6±6. 8) g/L,the difference between the two groups was statistically significant(t=-10. 185,P=0. 000). The drainage fluid amylase of 1 and 2 d after operation in POPF group was (2094+1444) U/L,in NPOPF group was (746+486) U/L,and there was significant difference be?tween the two groups( t=10. 400,P=0. 000) . Logistic regression analysis results showed that body mass index ( BMI) ,lymph node dissection number,time of operation,postoperative 1,2 d drainage fluid amylase and serum albumin of 2?4 d after operation were postoperative occurred pancreatic fistula risk factors( OR=1. 972,183. 6, 2. 004,0. 150,9. 809,P>0. 05). Conclusion BMI,number of dissected lymph node,duration of surgery,serum albumin of 2?4 d after operation and postoperative 1,2 d drainage fluid amylase have important clinical values for predicted POPF.

In this study,the common critical medical cases were organically combined with SimMan simulation system,which enabled students to deeply understand the diagnosis,treatment of disease and clinical operation as consulting real patients.Also,it could improve their clinical thinking ability,clinical skills and operational level.

This study compared the efficacy and safety of tiotropium bromide inhalation powder (spiriva) and doxofylline oral tablet (doxofylline) in the treatment of chronic obstructive pulmonary disease (COPD).A multi-center,randomized,double-blind,double-dummy,parallel-controlled study involved 127 eligible stable moderate to severe COPD patients treated with inhaled tiotropium dry powder (18 μg/day) or oral doxofylline tablets (0.2 g/time,2 times a day) for 12 and 24 weeks.Before and after treatment for 12 weeks and 24 weeks,respectively,pulmonary function,6-min walking distance and dyspnea index were recorded.The results showed that in both tiotropium group and doxofylline groups,after 12-week treatment,FEV1,FEV1/FVC％ and 6-min walk distance were significantly higher than those before the medication,while dyspnea index decreased as compared with that before treatment.After 24-week treatment,a slight improvement in the measures was observed as compared with that of 12-weeks treatment,but the difference was not statistically significant.With both 12-week and 24-week treatment,the effect of tiotropium was slightly better than that of doxofylline tablets,with the difference being statistically insignificant.The major adverse events in the tiotropium group and doxofylline group were observed in 9 cases (9.9％) and 12 cases (12.9％),respectively,and no statistically significant difference was found between them.We are led to conclude that both tiotropium at 18 μg a day and doxofylline tablets at 0.2 g/day (two times a day) are effective and safe for the treatment of COPD.