Objective:To construct talent training objectives and courses for undergraduate education of tropical medicine.Methods:Two rounds of questionnaire consultation were conducted among 15 experts by Delphi method. SPSS 26.0 software was used for statistical analysis, and the recovery rate, expert authority coefficient, mean of importance score, full score ratio, coefficient of variation and Kendall coordination coefficient were calculated respectively. Kendall's rank correlation test was used to analyze the degree of expert coordination, and the "boundary value method" was used to screen the indicators.Results:The effective recovery rates of the two rounds of consultation were all 100.00% and the expert authority coefficient was 0.815. The coordination coefficient was 0.25, 0.32, and 0.27, 0.36 respectively, and the significance test showed P<0.001. Finally, 11 talent training objectives and 7 courses for undergraduate education of tropical medicine were formed. Conclusions:The talent training objectives and courses for undergraduate education of tropical medicine are reasonable and reliable, which can provide theoretical support for tropical medicine talent training and have certain guiding value.

It is estimated that approximately seven million people worldwide are affected by inflammatory bowel disease(IBD),causing a huge burden on healthcare systems and society.In the occurrence,progression,and treatment of IBD,the intestinal microbiota and its key metabolic product,bile acids,play a crucial role.The intestinal microbiota not only participates in the biotransformation of bile acids,enriching the diversity of bile acids,but also regulates their synthesis and transport through the farnesoid X receptor(FXR).Meanwhile,bile acids contribute to regulating the structure and function of the intestinal microbiota by supporting microbial diversity,exerting direct toxicity,participating in indirect antimicrobial pathways,and influencing microbial metabolic capabilities.Furthermore,under normal physiological conditions,intestinal microbiota-derived bile acids facilitate the repair process of the intestinal epithelial barrier.They also promote the balance of the immune system by modulating the functions of various immune cells including helper T(Th)cells 17,regulatory T(Treg)cells,CD8+T cells and natural killer T(NKT)cells,thereby slowing down the development of IBD.This article focuses on exploring the role of intestinal microbiota and bile acids in the onset and progression of IBD,and investigating new effective treatment strategies by targeting intestinal microbiota and bile acids,such as bile acid receptor modulators,probiotics,prebiotics,fecal microbiota transplantation(FMT),and phage therapy.

Objective:To investigate the application value of intraoperative motor nerve monitoring in cervical neurogenic tumor surgery.Methods:The efficacy of intraoperative neuromonitoring (IONM) was analyzed retrospectively in 18 patients, including 6 males and 12 females, aged from 15 to 74 years, treated in Affiliated Drum Tower Hospital, Medical School of Nanjing University from June 2019 to September 2022 who underwent total cystectomy of cervical neurogenic tumors under intraoperative nerve monitoring.Results:All 18 patients had complete tumor removal, including 8 patients with tumors from the vagus nerve and 10 patients with tumors from the brachial plexus nerve. Postoperative nerve functions were normal in patients with tumors from brachial plexus nerve, and incomplete vocal cord paralysis occurred in 2 patients with tumors from vagus vagus nerve. The total incidence of motor nerve injury was 11.1% (2/18). All patients were followed up for 6 to 45 months, with no tumor recurrence.Conclusion:Intraoperative neuromonitoring has significant values in surgery of cervical neurogenic tumors, which is helpful to remove completely the tumors on the basis of protecting the nerve functions to the maximum extent.

The structure and common faults of Philips iU22 and iE33 ultrasound diagnostic equipment were introduced,the fault phenomena,causes and maintenance ideas in the daily work of this series of ultrasonic equipment were analyzed.The equipment was repaired after the failure occurred by analyzing the fault causes,replacing the corresponding components or reinstalling the system software etc.,so as to etc.,so as to provide a reference for the daily maintenance work of medical engineers.

Objective To observe the effects of different epidural anesthesia regimens on pain degree and postpartum pelvic floor function of primiparas.Methods A total of 80 primiparas who underwent painless epidural anesthesia delivery in Xiangyang Hospital Affiliated to Hubei University of Traditional Chinese Medicine from September 2021 to September 2022 were selected as the research subjects.The primiparas were divided into control group(n=40)and observation group(n=40)according to the anesthesia plan.The primiparas in the control group received epidural anesthesia with ropivacaine combined with physiological saline,while the primiparas in the observation group received epidural anesthesia with ropivacaine combined with sufentanil.The rate of natural delivery,rate of cesarean section,rate of vaginal delivery and the duration of each labor of primiparas were compared between the two groups;the analgesic effect of primiparas in the two groups was evaluated by pain visual analogue scale(VAS)at 5,60 min after analgesia,full opening of the cervix and postpartum 24 hours;the asphyxia sta-tus of newborns in the two groups was evaluated by neonatal Apgar score at 1,5 min after birth;the complications of nausea and vomiting,cervical or perineal injuries,urinary retention of puerperas and neonatal asphyxia were recorded and the total inci-dence of complications was compared between the two groups.At 6-8 weeks after delivery,pelvic floor functional indicators such as fiber muscle strength,pelvic floor muscle closure contraction force,and static tension of pelvic floor muscles of postpar-tum women in the two groups were measured by biological stimulus feedback instrument.Results The natural delivery rate,vaginal delivery rate and cesarean section rate of primiparas in the control group was 72.5％(29/40),7.5％(3/40),20.0％(8/40),respectively;the natural delivery rate,vaginal delivery rate and cesarean section rate of primiparas in the observation group was 90.0％(36/40),5.0％(2/40)and 5.0％(2/40),respectively.The natural delivery rate of primiparas in the ob-servation group was significantly higher than that in the control group,and the cesarean section rate was significantly lower than that in the control group(P＜0.05);there was no significant difference in the vaginal delivery rate of primiparas between the two groups(P＞0.05).The first and second stages of labor of primiparas in the observation group were significantly shorter than those in the control group(P＜0.05),and there was no significant difference in the third stage of labor of primiparas be-tween the two groups(P＞0.05).The VAS score of primiparas in the observation group was significantly lower than that in the control group at 5,60 min after analgesia,full opening of the cervix and postpartum 24 hours(P＜0.05).There was no signifi-cant difference in the Apgar score of newborns between the two groups at 1,5 min after birth(P＞0.05).The total incidence of complications in the control group and the observation group was 42.50％(17/40)and 20.00％(8/40),respectively;the total incidence of complications in the observation group was significantly lower than that in the control group(x2=4.713,P＜0.05).The fiber muscle strength and pelvic floor muscle closure contraction force of postpartum women in the observation group were significantly higher than those in the control group,the static tension of pelvic floor muscles was significantly lower than that in the control group(P＜0.05).Conclusion Sufentanil combined with ropivacaine epidural anesthesia can improve the analgesic effect of primiparas during childbirth,reduce the cesarean section rate,shorten the labor process,and facilitate the recovery of pelvic floor function in primiparas,reduce maternal and infant complications.

Objective: To investigate the longitudinal association of plasma Irisin concentrations with changes in blood pressure (BP) levels among children,and to assess the moderating effect of physical activity (PA) or sedentary behavior (SB) on the relationship between Irisin levels and BP. Methods: Based on a cohort study, a cluster sampling method was used to select 3 651 school aged children from five schools in Guangzhou in 2017 at the baseline survey and follow up in 2019. Both at baseline and during follow up, PA and SB were assessed by validated questionnaires, and BP levels were measured by an electronic sphygmomanometer. A final sample of 521 children were enrolled based on the PA and SB at baseline. Plasma Irisin concentrations were measured by ELISA at baseline. Logistic regression analysis was recruited for exploring the associations of plasma Irisin concentrations with changes in BP. Moderating effects of PA and SB on the relationship between Irisin concentrations and BP were estimated using stratified analysis. Results: Logistic regression analysis indicated that there was no significant association between Irisin concentrations and changes in BP levels among children ( OR =0.98, P >0.05). After stratification for SB, Irisin levels in the low SB subgroup were inversely associated with changes in diastolic blood pressure ( OR=0.87, 95%CI=0.77-0.98, P =0.02). In addition, SB level had a moderating effect on the relationship between Irisin levels and the DBP changes ( P =0.01). Conclusion Increased Irisin concentration is associated with the decrease of DBP level among low SB children. Furthermore, SB level shows moderating role in the relationship between Irisin concentrations and changes in DBP levels.

OBJECTIVE: To explore the clinical characteristics and genetic basis of a child with autism spectrum disorder (ASD) in conjunct with congenital heart disease (CHD). METHODS: A child who was hospitalized at the Third People's Hospital of Chengdu on April 13, 2021 was selected as the study subject. Clinical data of the child were collected. Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing (WES). A GTX genetic analysis system was used to analyze the WES data and screen candidate variants for ASD. Candidate variant was verified by Sanger sequencing and bioinformatics analysis. Real-time fluorescent quantitative PCR (qPCR) was carried out to compare the expression of mRNA of the NSD1 gene between this child and 3 healthy controls and 5 other children with ASD. RESULTS: The patient, an 8-year-old male, has manifested with ASD, mental retardation and CHD. WES analysis revealed that he has harbored a heterozygous c.3385+2T>C variant in the NSD1 gene, which may affect the function of its protein product. Sanger sequencing showed that neither of his parent has carried the same variant. By bioinformatic analysis, the variant has not been recorded in the ESP, 1000 Genomes and ExAC databases. Analysis with Mutation Taster online software indicated it to be disease causing. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted to be pathogenic. By qPCR analysis, the expression level of mRNA of the NSD1 gene in this child and 5 other children with ASD was significantly lower than that of the healthy controls (P < 0.001). CONCLUSION The c.3385+2T>C variant of the NSD1 gene can significantly reduce its expression, which may predispose to ASD. Above finding has enriched the mutational spectrum the NSD1 gene.
Male ; Child ; Humans ; Autism Spectrum Disorder/genetics* ; Heart Defects, Congenital/genetics* ; Computational Biology ; Genomics ; Mutation ; RNA, Messenger/genetics* ; Histone-Lysine N-Methyltransferase/genetics*

Abstract Sedentary behaviors have gradually become the most popular “activity” in daily life. Too many non essential sedentary behaviors, such as the excessive consumption of video entertainment, pose a serious threat to health and generate a heavy burden of disease to society. There is an urgent need to raise awareness and take measures to curb sedentary behaviors. Childhood is a period of opportunity, during which caregivers can shape the behavioral habits of children and encourage them to adopt favorable behaviors, which can directly affect the physical health of the nation s future population. Recently, the government has successively promulgated relevant policies to encourage students sports and labor education to livelihood. It is particularly critical that such policies are implemented in practice.

Incentive system is an indispensable means in the process of standardized residency training, which plays an important role in improving the work efficiency and service quality of residents, teachers and other participants. Based on the analysis of the problems existing in the holistic incentive system, we have implemented a set of personalized incentive measures for the training of residents in department rotation and achieved preliminary results, which provides ideas for exploring personalized incentive system for standardized residency training.

Objective: To explore the features of close contacts of coronavirus disease 2019 ( COVID-19 ) cases in Jiulongpo District, Chongqing, so as to provide evidence for the management of close contacts and the control of the epidemic. Methods: Demographic characteristics, contact history and medical records of close contacts of COVID-19 cases in Jiulongpo District from January 22 to April 10, 2020 was collected according to the COVID-19 Prevention and Control Program ( sixth version ) . Descriptive statistical analysis was performed. Results: Totally 602 close contacts were found, and 30 of them were infected, with an attack rate of 4.98%. Twenty-seven cases were diagnosed before February 10. The close contacts mainly aged from 20 to 59 years ( 457, 75.91% ) ; most were relatives of COVID-19 cases ( 219, 36.38% ) , and 64 (10.63%) were medical staff. Most contacted occasionally ( 338, 56.15% ), at home ( 190, 31.56% ) , and through the same meal ( 181, 30.07% ) . The attack rate of close contacts aged 40 years and over was 7.49%, which was higher than 2.37% of those aged under 40 years ( P<0.05 ). The attack rate of close contacts increased with contact frequency ( P<0.05 ) . The attack rates of close contacts were significantly different in different relations with cases, contact places and contact modes ( P<0.05 ); the attack rates of colleagues and relatives were 20.41% and 8.68%; the attack rates of close contacts in the workplace settings and family were 17.54% and 10.00%; the attack rates of sharing the same bed, living in the same room and working in the same room were 44.44%, 18.60% and 17.24%. Conclusions The close contacts of COVID-19 cases in Jiulongpo District, Chongqing who aged 40 years or above, exposed in family settings and in the workplace were associated with higher risk of infection.