Health communication aims to improve public health attitudes and behaviors by propagating health information. It plays an important role in promoting public health literacy and "Healthy China Initiative". The basic theories of health communication include "7 W" and Theory of Planned Behavior. Clinicians with profound medical expertise and a wealth of clinical practice play key roles in the communication, and they hold an unparalleled advantage in health communication by delivering authoritative and trustworthy information to the public. The capacity of health communication among clinicians in the nation is determined by various factors including professional characteristics, policy support, dissemination platforms and pathways, time and effort. Meanwhile, some problems in the research on the health communication capacity of clinicians remain, such as lack of well-established motivation systems, limited dissemination pathways, and imperfect evaluation frameworks. In some regions of China, health communication performance has been considered as part of the professional title evaluation for clinical physicians. Medical institutions and universities have also initiated relevant training and practice programs. It is crucial to improve evaluation frameworks, strengthen training pathways and effectiveness assessment, promote interdisciplinary integration, and enhance the role of clinicians in health communication in the future.

Objective To investigate the effect of dexmedetomidine on renal function in patients with septic-associated acute kidney injury(SAKI).Methods A prospective cohort study was conducted in 180 patients with sepsis admitted to ICU in the Second Affiliated Hospital of Guangdong Medical University from October 2021 to April 2023.According to the principle of randomized controlled trials,60 non-acute kidney injury(AKI)patients were divided into S-D group(n = 30,dexmedetomidine + conventional treatment)and S group(n = 30,conventional treatment),and the occurrence and disease score of AKI after treatment were compared between the two groups.A total of 120 AKI patients were divided into SA-D-RT group(n = 30,dexmedetomidine + blood purification + conven-tional treatment),SA-D group(n = 30,dexmedetomidine + conventional treatment),SA-RT group(n = 30,blood purification + conventional treatment)and SA group(n = 30,conventional treatment).Renal function,inflammatory factor level and disease change of the four groups were compared after treatment.Results After treatment,the inci-dence of AKI in S-D group was lower than that in S group,and the APACHEII score and SOFA score in S-D group were lower than those in S group on the 7th day after treatment(P<0.05).After 7 days of treatment,the level of Scr,BUN and CysC in the 4 groups was significantly lower than that on the 1st and 3rd day,and those in the SA-D-RT group were lower than those in the SA-D group,SA-RT group and SA group(P<0.05).After 7 days of treatment,the level of CRP,PCT,TNF-α,IL-6 and IL-1β in four groups was significantly decreased compared with on the 1st and 3rd day,and the level of CRP,PCT,TNF-α,IL-6 and IL-1β in SA-D-RT group was lower than that in SA-D group,SA-RT group and SA group(P<0.05).After 7 days of treatment,the APACHEII score and SOFA score of the four groups were significantly lower than on the 1st and 3rd day,and the scores of the SA-D group were lower than those of the SA-D group,the SA-RT group and the SA group(P<0.05).Conclusion Dexmedetomidine can effectively reduce the incidence of AKI,affect the expression level of renal function markers and inflammatory factors in serum of SAKI patients,and improve the condition of patients.

Objective:To investigate the implementation procedures and dosimetric verification of the first patient treated with total body irradiation (TBI) based on volumetric modulated arc therapy (VMAT).Methods:Two sets of CT images were acquired under the head-in first and foot-in first to contour the planning target volume (PTV) of the cranial and caudal segments to accomplish the treatment of the whole body length, on which two interrelated plans of 5 subsequent isocenters with a total of 15 VMAT fields were performed to cover all PTVs. The plans were prescribed to ensure 90% PTV dose coverage with a total dose of 12 Gy in 6 fractions. Firstly, a dose optimization was performed on the caudal CT images, then the cranial CT images were optimized based on the dose distribution of the caudal CT images. The evaluation of the final treatment plan was carried out based on a plan sum of both two sets of images. The parameters of PTV and organs at risk (OARs) were measured by dose volume histograms from the accumulated plan. The quality assurance comprised the verification of the VMAT plans for each individual isocenter via Delta4 phantom. The dose distribution in the overlapped region between two adjacent central fields was verified with EBT3 film. The absolute dose at the overlapped region between two images was measured via Pinpoint chamber. In vivo dosimetry on the patient′s skin was monitored by MOSFET dosimeters. The results of planning parameters and treatment duration were analyzed. Results:The mean doses of two segments of PTVs were 12.45 Gy and 12.37 Gy. The mean dose for the lung was 10.8 Gy. The machine unit (MU) and mean treatment delivery time were 2 883 MU and 24.3 min, and the mean total time per fraction was 121 min. The mean 3%/3 mmγ-analysis pass rate for each isocenter VMAT plan was (99.74±0.42)%, and the mean 5%/5 mmγ-analysis pass rate for the overlapped region was (90.11±2.72)%. The average deviation of absolute dose in the overlap region of the caudal and cranial images was (3.6±0.4)%. In vivo measurement of 8 points on the patient showed that the dose of each region was ranged from 1.57 Gy to 2.04 Gy. Conclusion:According to the results of dosimetric verification, TBI based on multi-isocenter VMAT can be applied in clinical practice, which remains to be improved in terms of dose distribution, measurement results and clinical efficiency.

Objective    To evaluate short-term clinical outcomes of skeletonized bilateral internal mammary artery (sBIMA) in coronary artery bypass grafting (CABG). Methods    The clinical data of 62 patients (54 males and 8 females with an average age of 56.8±6.0 years) undergoing isolated CABG using sBIMA in our hospital from October 2016 to May 2017 were retrospectively analyzed. The coronary graft flow, perioperative clinical outcomes and CT results were reviewed. Results    All the operations were carried out under extracorporeal circulation. Anastomosis of 124 internal mammary arteries was performed and 116 great saphenous veins were used simultaneously with an average anastomosis site of 4.5±0.8 for each patient. The cardiopulmonary bypass time was 116.4±22.9 min, aortic clamping time was 83.0±18.3 min, mechanical ventilation time was 20.8±21.3 h and ICU stay was 2.7±1.7 d. The graft flow of left internal mammary artery (LIMA), right internal mammary artery (RIMA) and great saphenous vein were 28.8±12.4 mL/min, 32.8±13.8 mL/min and 41.5±21.5 mL/min, respectively. There was no significant difference in the graft flow between LIMA and RIMA (P=0.112). There was no perioperative mortality, myocardial infarction or cerebrovascular accident. Only one male patient suffered sternal complication and poor wound healing and then received debridement as well as suturing. Coronary CT angiography showed that distal anastomosis of 7 vein grafts and 5 artery grafts was demonstrated shallow and 1 vein graft was undemonstrated, suggesting occlusion. Conclusion    CABG with sBIMA is a safe and reliable technique with excellent early results.

OBJECTIVE:To observe therapeutic efficacy and safety of Rupi sanjie capsules in the treatment of mammary gland hyperplasia after minimally invasive rotation and surgical. METHODS:A total of 180 patients with mammary gland hyperplasia or mammary gland hyperplasia combined with mammary fibroma were selected retrospectively from general surgery department of the First Affiliated Hospital of Soochow University during May 2015 to May 2017. They were divided into control group(n＝90)and observation group (n＝90) according to medication methods. Both groups received minimally invasive rotation and surgical treatment. After operation,control group was given Tamoxifen citrate tablets 10 mg orally,twice a day. Observation group was given Rupi sanjie capsules 2.12 g orally,3 times a day. Two groups stopped taking medication during menstruation,and both groups were treated for 8 weeks. Clinical efficacies of 2 groups were observed,and the levels of VEGF,FGF and MVD,the occurrence of ADR were observed before and after treatment. RESULTS:The total response rate of observation group(95.56%) was significantly higher than that of control group(86.67%),with statistical significance(P＜0.05). Before treatment,there was no statistical significance in the levels of VEGF,FGF and MVD between 2 groups (P＞0.05). After treatment,the levels of VEGF,FGF and MVD in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance(P＜0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:After minimally invasive rotation and surgical,Rupi sanjie capsules shows significant therapeutic efficacy for mammary gland hyperplasia,can reduce the levels of VEGF,FGF and MVD with good safety.

Objective To investigate the predictive value of plasma gelsolin in the prognosis of patients with ST-sgement elevation myocardial infarction ( STEMI ) and undergone primary percutaneous coronary intervention ( PCI ) .Methods The study included 206 patients with STEMI and undergone primary PCI, 148 patients with stable angina pectoris and received elective PCI and 80 healthy volunteer as the health population (NP) control.Blood samples were taken at admission on day 1, 3, 5, 7 and 9 to determine the plasma gelsolin level .Patients′baseline clinical characteristics , blood biochemistry tests results , details of operation and their cardiovascular risk factors were recorded .Major adverse cardiovascular events (MACE) within one year were recorded.Results (1) Compared to the stable angina group and the NP group, the level of plasma gelsolin of STEMI patients were obviously decreased at various time points ( all P<0.05 ) .There were no statistical differences between the stable angina group and the NP group .( 2 ) Patients with STEMI were catagorized into MACE group (n=78) and non-MACE group (n=128) according their follow up record in 1 year.The level of plasma gelsolin in patients with MACE were lower than the non-MACE group ( P <0.05 ) with the minimum value detected on day 7.Among patients complicated with MACE (n=78), they were further devided into the deceased group (n=18) and the survival group (n=60).Plasma gelsolin levels were lower in the deceased group with satistical differences found on day 5, 7 and 9.(3) Single factor Logistic regression analysis showed that the level of plasma gelsolin on day 7 was independent risk factor of MACE within one year ( P =0.014 ) .( 4 ) Setting the cutoff value of plasma gelsolin on day 7 as 21.7 mg/L,the sensitivity and speciticity for the MACE in STEMI patients treated with primary PCI within one year were 82.1%and 81.4%respectively , with the area under the receiver operator characteristic curve ( ROC ) was 0.854 ( 95% confidence interval 0.732 -0.961 , P <0.01 ) . Conclusions Plasma gelsolin levels are correlated with the severity of STEMI lesions and plasma gelsolin can be used as predicting factor of prognosis .

Eight cases of hypothyroid myopthy admitted in Zhanshan Hospital Xiamen University from 1995 to 2011 were retrospectivrely analyzed.The main clinical features were proximal muscle weakness,susceptibility to fatigue,and elevation of muscle enzymes.Electromyography revealed no specific findings.All patients obtained clinical recovery after thyoid hormone replacement.Hypothyroid myopathy should be considered in cases of muscle weakness and elevation of muscle enzymes.

Objective To assess the correlation of promoter methylation of DAPK1,RAR-β and MGMT with cervical lesions from cytology to histology,and to reveal the clinical value of DNA methylation in diagnosis of cervical intraepithelial neoplasia (CIN).Methods A total of 103 random-selected cervical samples were collected from residual liquid-based cytology specimens after clinical use in cytopathological diagnosis in outpatient clinic of obstetrics and gynecology,Peking Union Medical Collage Hospital from March 2010 to October 2010.Informed consent was obtained from each woman before the initiation of the study.The methylation seusitive-high resolution melt (MS-HRM) assay was used to evaluate promoter methylation of three genes ( DAPKI,RAR-β and MGMT) in 103 biopsy-confirmed liquid-based cervical cytology samples.Methylation levels and high-risk HPV DNA loading ( HC Ⅱ values) were analyzed in relation to both cytological and histological diagnosis.Results The methylation level of all three genes showed significant difference among the different cytological groups ( P =0.000,0.011 and 0.002,respectively).The methylation level of DAPK1 and RAR-β showed significant difference among the different histological groups ( P =0.000 and 0.021 ),while there was no significant difference for MGMT.DAPK1 methylation levels was 1.47％ in the CIN Ⅱ/high-grade precancerous lesions group,and 20.98％ in the normal/CIN I groups ( P =0.000 ),but there was no significant difference between CIN I/high-grade precancerous lesions and normal/CIN Ⅰ groups for RAR-β and MGMT.The combination of DAPK1/HR-HPV loading showed a sensitivity of 0.825 and an area under the receiver operating characteristic curve (ROC) curve (AUC) of 0.695 as diagnostic methods for detecting CIN Ⅱ/high-grade precancerous lesions.Conclusions DNA methylation such as DAPK1 and RAR-β,in combination with HR-HPV detection,may serve as biomarkers to detect CIN Ⅱ/high-grade precancerous lesions.Detection of methylated DNA from liquid-based cervical cytology specimens is technically feasible with the MS-HRM assay.

OBJECTIVE To study the therapeutic effect of arytenoid within-shift combining with recurrentlaryngeal nerve (RLN) anastomosis to ansa cervicalis for patients with long-term unilateral vocal cord paralysis (UVCP) . METHODS Twelve patients with traumatic RLNs paralysis were studied. The courses of injury varied from 3 to 22 years. RLN was anastomosed to ansa cervicalis and arytenoid was within-shifted on ipsilateral side in all patients. Therapeutic efficacy was evaluated by laryngoscope, strobe-laryngoscope, voice evaluation, voice acoustics parameter analysis, and laryngeal electromyography (LEMG) . RESULTS The voice was improved in all cases after arytenoid within-shift immediately. The mean values of voice acoustics parameters (jitter, shimmer, NNE) were significantly smaller and maximum phonation time (MPT) were significantly longer after operation compared with those of before treatment. Laryngoscope showed that arytenoid was significantly within-shifted. The glottic posterior chink vanished in 9 cases and reduced in 3 cases. The voice resumed normal, obviously improved, improved and no improved were found in 9、 3、0、0 cases respectively 12 months after operation. The mass and tension of all treated vocal cords may become the same as the contralateral normal vocal cords, thus resuming symmetric vibration of the vocal cords. The reinnervation of the RLNs were approved by LEMG in these patients whose RLNs were restored. CONCLUSION Arytenoid within-shift combining with RLN anastomosis to ansa cervical can restored normal voice in patients with long-term UVCP.

Objective To explore the mechanism of inhibitory effect of dimethyl sulfoxide (DMSO) on the hyperplasia of the fibrous capsule around the tissue expander. Methods The experimental model was established in rats as follows: after implanting the expander on the back of rats, 30 % DMSO or normal saline was injected into the expander. The former was classified as experimental group, and the latter as control group. The cystic wall was resected after the skin and soft tissues were expanded. In situ hybridization and the immunohistochemical staining were used to determine the expression of typesⅠand Ⅲ of collagen and procollagen mRNA in the cystic walls. Results It was found that both the typeⅠand Ⅲ of collagen content and the expressing quantity of mRNA of procollagen in the cystic wall of the experimental group were less than those of control group. Conclusion The results imply that the mechanism that DMSO inhibits the expression of typesⅠand Ⅲ of collagen in the fibrous cystic wall may be achieved through down-regulating the genetic expression of procollagen in the fibroblasts.