Objective:To investigate the current situation of satisfaction with graduate education among recent medical graduates in China, and analyze the differences between different populations, and to propose countermeasures and suggestions.Methods:From June to July 2023, a self-made questionnaire was used to survey 16 903 medical graduates who had recently earned a post-graduate degree from 78 institutions about their satisfaction with curriculum sessions, practical sessions, research training, tutoring, and institutional management. The degrees of satisfaction with education among different populations were compared through the t test and analysis of variance with the use of SPSS 26.0. Results:The scores of satisfaction of the graduates with tutoring, curriculum sessions, practical sessions, institutional management, and research training were 4.44, 4.03, 4.02, 3.90, and 3.82, respectively. Satisfaction scores for individual dimensions were significantly higher for males, doctors, non-transfers, comprehensive universities, non-agricultural household registration, moderate-to-high annual household income per capita, parents with high educational levels, and parents with mid- or senior-level occupations ( P<0.05). Conclusions:There is room for improvement in students' satisfaction with medical graduate education. To improve the quality of medical graduate education, attention should be paid to key populations, education policies, school management, and tutoring to provide appropriate education for different students.

The steps for installation and withdrawal of WYD2000 field surgical lamp were introduced.The failures and causes of broken cross-arm connector of WYD2000 field surgical lamp were analyzed.The problems of WYD2000 field surgical lamp in vulnerability to breaking and difficulty in maintenance were solved by designing and manufacturing a special maintenance tool and optimizing the materials and fixing mode of cross-arm connection.References were provided for main-tenance and improvement of WYD2000 field surgical lamp.[Chinese Medical Equipment Journal,2024,45(4):116-118]

Objective To explore the clinical characteristics and treatment strategies of infective endocarditis caused by Bartonella vinsonii subsp.berkhoffii(Bvb).Methods Clinical diagnosis and treatment of a 25-year-old male patient with infective endocarditis caused by Bvb in China was reported,combined with literatures about three similar cases reported abroad were summarized and analyzed.Results All 4 patients were young and middle-aged males with a history of close contact with canines in the past one year.The main symptoms were chest pain,fa-tigue,and dyspnea,accompanied by cerebrovascular accidents and severe anemia,as well as the formation of heart valve vegetations and valve function impairment.Multiple blood cultures were negative,2 and 3 cases were con-firmed to be infected with Bvb through metagenomic next-generation sequencing(mNGS)of pathogenic microorga-nisms and polymerase chain reaction respectively.All patients underwent surgical treatment due to heart failure,and all survived after surgery and targeted anti-infective treatment.Conclusion This case report is the first case of Bvb infective endocarditis in China.Patient's diagnosis is confirmed by serum indirect immunofluorescence assay and mNGS,combination of surgery and anti-infective treatment has achieved ideal effect.

Objective:To evaluate the gene mutation profile and prognostic significance of adult cytogenetically normal acute myeloid leukemia (CN-AML) with CEBPA-bZIP mutation. Methods:Targeted sequencing was implemented on the diagnostic bone marrow DNA samples of 141 adult CN-AML subjects with CEBPA-bZIP mutation. The nomogram model for leukemia-free survival (LFS) rate was generated by combining genetic abnormalities and clinical data. Risk stratification was conducted based on prognostic variables and the effect of risk-adjusted consolidation therapy was investigated by Kaplan-Meier method. Results:Four variables were finally included in our nomogram model after multivariate Cox analysis,and an equation for risk score calculation was obtained,risk score=1.3002×white blood cell (WBC) (≥18.77×109/L)+1.4065×CSF3R mutation positive+2.6489×KMT2A mutation positive+1.0128×DNA methylation-related genes mutation positive. According to the nomogram model,patients were further divided into low-risk group (score=0,n=46) and high-risk group (score>0,n=95). Prognostic analysis showed that the 5-year LFS rate,5-year overall survival (OS) rate,and 5-year cumulative incidence of relapse (CIR) of patients who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the high-risk group were 93.5％,97.1％,and 3.5％,while those in patients who received maintenance chemotherapy were 32.9％,70.5％,and 63.4％,respectively. The differences were statistically significant (all P<0.05). Allo-HSCT could significantly improve the prognosis of patients in high-risk group. However,no corresponding benefit was observed in the low-risk group. Conclusion:Adult CN-AML with CEBPA-bZIP mutation has a complex co-mutation pattern. The nomogram model based on mutations of CFS3R,KMT2A and DNA methylation-related genes together with WBC count can further divide this subset of patients into a relatively low-risk group and a relatively high-risk group. For individuals in the high-risk group,allo-HSCT is proposed as post-remission therapy. The above data will benefit the prognosis estimation and treatment decision for adult CN-AML with CEBPA-bZIP mutation.

Objective To summarize the medication law and prescription thinking of Professor Bai Changchuan in the treatment of chronic gastritis.Methods Effective medical records of chronic gastritis treated by Professor Bai Changchuan from January 2017 to December 2022 were selected.Frequency statistics,hidden structure model,association rules were used for data mining.Interview of Professor Bai Changchuan for the treatment of chronic gastritis was analyzed from the aspects of basic principles,core prescriptions and prescription thinking.Results Totally 328 medical cases were included,involving 1 128 prescriptions,among which 904 prescription were HP positive,209 prescription were bile reflux,268 prescriptions were located in the cardia,9 prescriptions in the gastric body,and 896 prescriptions in the gastric antrum.The pathological changes were erosion in 524 prescriptions,atrophy in 354 prescriptions,and intestinal metaplasia in 208 prescriptions.108 kinds of Chinese materia medica were involved.The properties were mainly warm,cold,and mild,the tastes were mainly bitter,sweet and pungent,and the main meridians were spleen meridian,lung meridian,and stomach meridian,involving 20 kinds of efficacy.20 hidden variables were obtained from the hidden structure model of high-frequency Chinese materia medica.There were 210 association rules high-frequence between Chinese materia medica.The core combination was ginger Pinelliae Rhizoma-Codonopsis Radix-Citri Reticulatae Pericarpium-Poria-Glycyrrhizae Radix et Rhizoma Praeparata cum Melle-fried Atractylodis Macrocephalae Rhizoma.Different etiology,disease location and pathological changes were associated with Liujunzi Decoction.The association of HP-Pogostemonis Herba,Amomi Fructus,fried Coicis Semen;bile reflux-Magnoliae Officinalis Corte,Aurantii Fructus Immaturu,Aucklandiae Radix,Galli Gigerii Endothelium Corneumm,Bupleuri Radix,fried Crataegi Fructus;gastric antrum-Pogostemonis Herba,Cyperi Rhizoma,Linderae Radix,Typhae Pollen;cardia-Fritillariae Thunbergii Bulbus,Nelumbinis Folium,Curcumae Radix,Aurantii Fructus Immaturu,Magnoliae Officinalis Corte;erosion-Fritillariae Thunbergii Bulbus,Sepiae Endoconcha,Magnoliae Officinalis Corte,Aurantii Fructus Immaturu,Aucklandiae Radix,fried Paeoniae Radix Alba,Catechu;atrophy-Aucklandiae Radix,Magnoliae Officinalis Corte,Fritillariae Thunbergii Bulbus,Cinnamomi Ramulus,Ophiopogonis Radix;intestinal transformation-Aucklandiae Radix,Magnoliae Officinalis Corte,Aurantii Fructus Immaturu,Galli Gigerii Endothelium Corneumm,Fritillariae Thunbergii Bulbus,Linderae Radix,Faeces Trogopterori,Typhae Pollen also had clinical significance.Conclusion Professor Bai Changchuan treats chronic gastritis with a combination of cold and warm,treating both symptoms and root causes,and applying both attack and tonics.The basic principle is to"promote spleen and stomach circulation,eliminate accumulation and stagnation",and the core prescription is Liujunzi Decoction.Combined with microscopic syndrome differentiation,he selects appropriate drugs for treatment.

Objective: To analyze the prevalence and the risk factors of fungal sepsis in 25 neonatal intensive care units (NICU) among preterm infants in China, and to provide a basis for preventive strategies of fungal sepsis. Methods: This was a second-analysis of the data from the "reduction of infection in neonatal intensive care units using the evidence-based practice for improving quality" study. The current status of fungal sepsis of the 24 731 preterm infants with the gestational age of <34⁺⁰ weeks, who were admitted to 25 participating NICU within 7 days of birth between May 2015 and April 2018 were retrospectively analyzed. These preterm infants were divided into the fungal sepsis group and the without fungal sepsis group according to whether they developed fungal sepsis to analyze the incidences and the microbiology of fungal sepsis. Chi-square test was used to compare the incidences of fungal sepsis in preterm infants with different gestational ages and birth weights and in different NICU. Multivariate Logistic regression analysis was used to study the outcomes of preterm infants with fungal sepsis, which were further compared with those of preterm infants without fungal sepsis. The 144 preterm infants in the fungal sepsis group were matched with 288 preterm infants in the non-fungal sepsis group by propensity score-matched method. Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of fungal sepsis. Results: In all, 166 (0.7%) of the 24 731 preterm infants developed fungal sepsis, with the gestational age of (29.7±2.0) weeks and the birth weight of (1 300±293) g. The incidence of fungal sepsis increased with decreasing gestational age and birth weight (both P<0.001). The preterm infants with gestational age of <32 weeks accounted for 87.3% (145/166). The incidence of fungal sepsis was 1.0% (117/11 438) in very preterm infants and 2.0% (28/1 401) in extremely preterm infants, and was 1.3% (103/8 060) in very low birth weight infants and 1.7% (21/1 211) in extremely low birth weight infants, respectively. There was no fungal sepsis in 3 NICU, and the incidences in the other 22 NICU ranged from 0.7% (10/1 397) to 2.9% (21/724), with significant statistical difference (P<0.001). The pathogens were mainly Candida (150/166, 90.4%), including 59 cases of Candida albicans and 91 cases of non-Candida albicans, of which Candida parapsilosis was the most common (41 cases). Fungal sepsis was independently associated with increased risk of moderate to severe bronchopulmonary dysplasia (BPD) (adjusted OR 1.52, 95%CI 1.04-2.22, P=0.030) and severe retinopathy of prematurity (ROP) (adjusted OR 2.55, 95%CI 1.12-5.80, P=0.025). Previous broad spectrum antibiotics exposure (adjusted OR=2.50, 95%CI 1.50-4.17, P<0.001), prolonged use of central line (adjusted OR=1.05, 95%CI 1.03-1.08, P<0.001) and previous total parenteral nutrition (TPN) duration (adjusted OR=1.04, 95%CI 1.02-1.06, P<0.001) were all independently associated with increasing risk of fungal sepsis. Conclusions: Candida albicans and Candida parapsilosis are the main pathogens of fungal sepsis among preterm infants in Chinese NICU. Preterm infants with fungal sepsis are at increased risk of moderate to severe BPD and severe ROP. Previous broad spectrum antibiotics exposure, prolonged use of central line and prolonged duration of TPN will increase the risk of fungal sepsis. Ongoing initiatives are needed to reduce fungal sepsis based on these risk factors.
Infant ; Infant, Newborn ; Humans ; Birth Weight ; Intensive Care Units, Neonatal ; Retrospective Studies ; Tertiary Care Centers ; Infant, Extremely Low Birth Weight ; Gestational Age ; Infant, Extremely Premature ; Sepsis/epidemiology* ; Retinopathy of Prematurity/epidemiology* ; Bronchopulmonary Dysplasia/epidemiology*

We provided the palliative care of a multiple disciplinary team care mode to a patient diagnosed with advanced head and neck cancer and her caregivers.People-centered integrated health services were provided according to the specific needs and preferences of individuals.The team-based palliative care relieved the suffering and improved the quality of life of the patient and that of her family who were facing challenges associated with life-threatening illness.
Humans ; Female ; Palliative Care ; Quality of Life ; Head and Neck Neoplasms/therapy*

Long non-coding RNA (lncRNA) is not "transcriptional noise". It can regulate gene expression at pre-transcriptional, post-transcriptional and epigenetic level and participate in the occurrence and development of diseases. A large number of studies have shown that the abnormal expression of lncRNA plays an important role in the occurrence and development of acute myeloid leukemia (AML) and drug resistance. LncRNA can participate in the occurrence, development and drug resistance of AML by acting on target genes and regulating related signal pathways. Detection of its expression has a certain prognostic value. Therefore, this article briefly discusses the research progress of lncRNA in AML, hoping to provide ideas for clinical diagnosis and targeted therapy.
Humans ; RNA, Long Noncoding/metabolism* ; Leukemia, Myeloid, Acute/drug therapy* ; Prognosis

BACKGROUND: Treatment duration of wrist-ankle acupuncture (WAA) is uncertain for post-thyroidectomy pain relief. OBJECTIVE: This study evaluated the effect of different WAA treatment duration on post-operative pain relief and other discomforts associated with thyroidectomy. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: This randomized controlled trial was conducted at a single research site in Guangzhou, China. A total of 132 patients receiving thyroidectomy were randomly divided into the control group (sham WAA, 30 min) and three intervention groups (group 1: WAA, 30 min; group 2: WAA, 45 min; group 3: WAA, 60 min), with group allocation ratio of 1:1:1:1. Acupuncture was administered within 1 hour of leaving the operating room. OUTCOMES AND MEASURES: Primary outcome was patients' pain at the surgical site assessed by visual analogue scale (VAS) at the moment after acupuncture treatment (post-intervention). Secondary outcomes included the patients' pain VAS scores at 6, 12, 24, 48 and 72 h after the thyroidectomy, the 40-item Quality of Recovery (QoR-40) score, the grade of post-operative nausea and vomiting (PONV), and the use of additional analgesic therapy. RESULTS: The adjusted mean difference (AMD) in VAS scores from baseline to post-intervention in group 1 was -0.89 (95% confidence interval [CI], -1.02 to -0.76). The decrease in VAS score at post-intervention was statistically significant in group 1 compared to the control group (AMD, -0.43; 95% CI, -0.58 to -0.28; P < 0.001), and in groups 2 and 3 compared to group 1 (group 2 vs group 1: AMD, -0.65; 95% CI, -0.81 to -0.48; P < 0.001; group 3 vs group 1: AMD, -0.66; 95% CI, -0.86 to -0.47; P < 0.001). The VAS scores in the four groups converged beyond 24 h after the operation. Fewer patients in group 2 and group 3 experienced PONV in the first 24 h after operation. No statistical differences were measured in QoR-40 score and the number of patients with additional analgesic therapy. CONCLUSION Compared with the 30 min intervention, WAA treatment with longer needle retention time (45 or 60 min) had an advantage in pain relief within 6 h after surgery. WAA's analgesic effect lasted for 6-12 h post-operatively. Please cite this article as: Han XR, Yue W, Chen HC, He W, Luo JH, Chen SX, Liu N, Yang M. Treatment duration of wrist-ankle acupuncture for relieving post-thyroidectomy pain: A randomized controlled trial. J Integr Med. 2023; 21(2): 168-175.
Male ; Humans ; Ankle ; Wrist ; Duration of Therapy ; Thyroidectomy ; Postoperative Nausea and Vomiting/drug therapy* ; Acupuncture Therapy ; Analgesics/therapeutic use* ; Pain/drug therapy*

Uric acid (UA) is the final product of purine metabolism in human body,and its metabolic disorder will induce hyperuricemia (HUA).The occurrence and development of HUA are associated with a variety of pathological mechanisms such as oxidative stress injury,activation of inflammatory cytokines,and activation of renin-angiotensin-aldosterone system.These mechanisms directly or indirectly affect the bioavailability of endogenous nitric oxide (NO).The decrease in NO bioavailability is common in the diseases with high concentration of UA as an independent risk factor.In this review,we summarize the mechanisms by which high concentrations of UA affect the endogenous NO bioavailability,with a focus on the mechanisms of high-concentration UA in decreasing the synthesis and/or increasing the consumption of NO.This review aims to provide references for alleviating the multisystem symptoms and improving the prognosis of HUA,and lay a theoretical foundation for in-depth study of the correlations between HUA and other metabolic diseases.
Humans ; Nitric Oxide ; Uric Acid ; Hyperuricemia ; Biological Availability ; Cytokines