An important issue facing university education is the adaptation and transformation of freshmen.In order to guide students to adapt to the needs of research-based learning,Jilin University has opened a freshman seminar for all first-year undergraduate students,emphasizing the cultivation of students'thinking patterns and learning abilities.For medical students,it is necessary to ap-ply the learned medical knowledge to clinical problem analysis.Therefore,it is particularly important to cultivate students'integrated thinking from basic to clinical at the beginning of enrollment.In recent years,organ system integration has gradually been carried out in medical schools both domestically and internationally.In the course of integrating the immune system and diseases,the morphology of the immune system is relatively abstract and difficult to observe.In the early stages of enrollment,students still lack the thinking of organ system integration,and the initial stage of immune system integration courses is difficult to carry out.Therefore,we aimed to guide students towards adaptability and academic transformation through freshman seminars,explored the integration of the immune system's organ system as a pathway,and used the BOPPPS teaching model as a means for preliminary exploration.In the freshman seminar,the main focus is on the"morphology and structure-mechanism and function-disease-diagnosis-treatment"of the immune sys-tem,helping students establish a learning mindset that integrates disease diagnosis and treatment based on basic medical courses such as immunology and anatomy.Using BOPPPS to reform the"teaching"of teachers,establishing a student-centered teaching model from six aspects:bridge,objective,pre-assessment,participatory learning,post-assessment and summary,can better guide students to actively think and participate in the entire learning process,focus on the construction of students'fragmented knowledge thinking mode,internalize medical humanities literacy,and improve the quality of medical talent cultivation in colleges and universities.

AIM: To investigate the expression of glucose metabolism genes associated with tacrolimus-induced post-transplant diabetes in the mouse kidney and the mechanisms involved in the regulation of glucose metabolism by farnesylate X (FXR) receptor activator. METHODS: The gene expression levels of FXR, small heterodimeric partner-1 (SHP-1), phosphoenolpyruvate carboxykinase (PEPCK), and glucose transporter protein-2 (GLUT2) were measured after 72 h in HK-2 cell lines treated with tacrolimus and tacrolimus+FXR agonist (GW4064) and control groups, respectively. C57BL/6J male mice were gavaged with tacrolimus and tacrolimus+FXR agonist for 12 weeks, respectively, and the control group was given saline to observe the changes in body weight and blood glucose; after the animals were treated, the gene expression levels of FXR, SHP-1, PEPCK, and GLUT2 were detected, respectively. RESULTS: In cellular experiments, the expression of FXR, SHP-1 and GLUT2 genes was decreased in the tacrolimus-treated group (P< 0.05) and the expression of the PEPCK gene was significantly upregulated compared with the control group (P< 0.05). In animal experiments, compared with the control group, the blood glucose values were significantly increased in the tacrolimus-treated group and significantly decreased in the tacrolimus+FXR agonist combination intervention group (P< 0.05), and the expression of FXR, SHP-1 and GLUT2 genes were upregulated (P< 0.05) and the expression of PEPCK genes was significantly decreased in the mice kidney (P< 0.05).CONCLUSION: FXR agonists can improve tacrolimus-induced abnormal glucose metabolism after transplantation. Therefore, FXR may be a potential new target for the prevention and treatment of post-transplant diabetes.

Objective:To explore the effect of the hospital discharge readiness plan based on deep integration of medical nursing and rehabilitation in children with cerebral palsy.Methods:From January 2020 to September 2021, 60 children with cerebral palsy and their 60 parents admitted to the Children's Rehabilitation Department of Anhui Children's Hospital were selected as the research object. The children and parents were divided into the observation group and the control group by random number table, with 30 children and 30 parents in each group. The control group was given routine nursing, and the observation group was given the hospital discharge readiness plan based on the deep integration of medical nursing and rehabilitation. On the first day of admission and the day before discharge, the effects were evaluated using the Chinese version of the Chinese version of the Readiness for Hospital Discharge Scale (RHDS) -Parent Form, the Chinese version of the Quality of Discharge Teaching Scale (QDTS) -Parent Form, the Activities of Daily Living (ADL) Rehabilitation Nursing Rating Scale for Children with Cerebral Palsy.Results:After the intervention, the scores of the observation group were higher than those of the control group in terms of readiness for hospital discharge, quality of discharge teaching, and the differences were statistically significant ( P<0.05) . Conclusions:The hospital discharge readiness plan based on deep integration of medical nursing and rehabilitation in children with cerebral palsy can effectively improve their discharge readiness, the quality of discharge teaching and the ADL of children with cerebral palsy.

Objective:To analyze the effects of angiotensin converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) on coronavirus disease 2019 (COVID-19) patients with hypertension, and to provide an evidence for selecting antihypertensive drugs in those patients.Methods:Clinical data were retrospectively analyzed in 58 COVID-19 patients with hypertension admitted to Shanghai Public Health Clinical Center from January 20 to February 22, 2020, including epidemiological history, clinical manifestations, laboratory findings, chest CT and outcome. Patients were divided into ACEI/ARB group and non-ACEI/ARB group.Results:Twenty-six patients were in ACEI/ARB group and the other 32 patients in non-ACEI/ARB group, with median age 64.0 (49.5, 72.0) years and 64.0 (57.0, 68.8) years respectively. The median time to onset was 5(3, 8) days in ACEI/ARB group and 4 (3, 7) days in non-ACEI/ARB group, the proportion of patients with severe or critical illness was 19.2% and 15.6% respectively. The main clinical symptoms in two groups were fever (80.8% vs. 84.4%) and cough (23.1% vs. 31.3%). The following parameters were comparable including lymphocyte counts, C-reactive protein, lactate dehydrogenase, D-dimer, bilateral involvement in chest CT (76.9% vs. 71.9%), worsening of COVID-19 (15.4% vs. 9.4%), favorable outcome (92.3% vs. 96.9%) between ACEI/ARB group and non-ACEI/ARB group respectively (all P>0.05). However, compared with non-ACEI/ARB group, serum creatinine [80.49 (68.72, 95.30) μmol/L vs. 71.29 (50.98, 76.98) μmol/L, P=0.007] was higher significantly in ACEI/ARB group. Conclusions:ACEI/ARB drugs have no significant effects on baseline clinical parameters (serum creatine and myoglobin excluded) , outcome, and prognosis of COVID-19 patients with hypertension. Antihypertensive drugs are not suggested to adjust in those patients, but the potential impairment of renal function as elevation of serum creatinine should be paid attention in patients administrating ACEI/ARB drugs.

OBJECTIVE: To evaluate the efficacy and safety of hydroxychloroquine (HCQ) in the treatment of patients with moderate coronavirus disease 2019 (COVID-19). METHODS: We prospectively enrolled 30 treatment-naïve patients with confirmed COVID-19 after informed consent at Shanghai Public Health Clinical Center. The patients were randomized 1：1 to HCQ group and the control group. Patients in HCQ group were given HCQ 400 mg per day for 5 days plus conventional treatments, while those in the control group were given conventional treatment only. The primary endpoint was negative conversion rate of SARS-CoV-2 nucleic acid in respiratory pharyngeal swab on days 7 after randomization. This study has been approved by the Ethics Committee of Shanghai Public Health Clinical Center and registered online (NCT04261517). RESULTS: One patient in HCQ group developed to severe during the treatment. On day 7, nucleic acid of throat swabs was negative in 13 (86.7%) cases in the HCQ group and 14 (93.3%) cases in the control group (>0.05). The median duration from hospitalization to virus nucleic acid negative conservation was 4 (1,9) days in HCQ group, which is comparable to that in the control group [2 (1,4) days, Z=1.27, >0.05]. The median time for body temperature normalization in HCQ group was 1 (0,2) day after hospitalization, which was also comparable to that in the control group [1 (0,3) day]. Radiological progression was shown on CT images in 5 cases (33.3%) of the HCQ group and 7 cases (46.7%) of the control group, and all patients showed improvement in follow-up examinations. Four cases (26.7%) of the HCQ group and 3 cases (20%) of the control group had transient diarrhea and abnormal liver function (>0.05). CONCLUSIONS The prognosis of COVID-19 moderate patients is good. Larger sample size study are needed to investigate the effects of HCQ in the treatment of COVID-19. Subsequent research should determine better endpoint and fully consider the feasibility of experiments such as sample size.
Betacoronavirus ; isolation & purification ; China ; Coronavirus Infections ; diagnostic imaging ; drug therapy ; Humans ; Hydroxychloroquine ; therapeutic use ; Pandemics ; Pilot Projects ; Pneumonia, Viral ; diagnostic imaging ; drug therapy ; RNA, Viral ; isolation & purification ; Treatment Outcome

Objective:To explore effects of clinical learning environment on occupational values of nursing students in higher vocational colleges under the background of industry-education integration so as to provide the basis for improving the clinical learning environment and improving the quality of nursing personnel training.Methods:From May to June 2019, 3 colleges were selected from the higher vocational colleges in Jiangsu Province that carried out medical and educational cooperative nursing personnel training and 200 nursing students in the second grade (2017 grade) of nursing majors from each of 3 colleges were selected as research objects by the convenient sampling method.Results:The total score of the nursing occupational value scale for 85 nursing students was (90.70±10.88) , and the total score of the clinical learning environment assessment scale was (152.72±14.84) . The results of multiple linear regression analysis showed that interpersonal relationship, working atmosphere and team spirit, task positioning in the clinical learning environment assessment scale were the influencing factors of occupational values of nursing students ( P<0.05) . Conclusions:Under the medical and educational cooperation talent training model, occupational values of nursing students are at a medium level, and clinical learning environment has positive effects on occupational values. It is necessary for schools and teaching hospitals to further improve the clinical learning environment so as to improve occupational values of nursing students.

Objective To explore the effects of donor/recipients' gender on delayed graft function (DGF) .Methods A retrospective analysis was performed for clinical data of donors (n=174) and recipients (n=265) during renal transplantation between May 1 ,2012 and December 31 ,2017 . Types of China donation after citizen's death ,age ,last creatinine level ,height ,weight ,body mass index (BMI) and protopathy of donors were collected .And pre-dialysis method ,dialysis time ,HLA mismatch ,post-creatine at Day 7 ,whether dialysis after transplantation ,height ,weight and BMI of recipients were analyzed .The data were checked by t and chi square tests and P<0 .05 was deemed as statistically significant .Results Donor gender had no correlation with DGF occurrence rate ( P=0 .689) while DGF occurrence rate among female recipients was evidently lower than that among males (P=0 .036);Female recipients selected peritoneal dialysis therapy more than male recipients (P=0 .023);Cerebral hemorrhage female donors were more than male donors (P= 0 .034);BMI (P<0 .001) and postoperative creatinine (P= 0 .001) among female recipients were evidently lower than that among males .Conclusions DGF occurrence rate is significantly lower among female receptors than that among males after kidney transplantation .

Objective To investigate the incidence and risk factors of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture. Methods Live born infants, including those diagnosed with neonatal asphyxia, were recruited from 16 different hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture from January to December of 2016. The 16 hospitals included four grade A tertiary hospitals (three general hospitals and one traditional Chinese medicine hospital) and 12 grade A secondary hospitals (eight general hospitals, one maternal and child health hospital and three traditional Chinese medicine hospitals). A retrospective investigation was conducted using questionnaire to analyze the basic information, perinatal risk factors and prognosis of those infants. Chi-square test was used for statistical analysis. Results Among 22 294 recruited live born infants, 733 (3.29%) were diagnosed with neonatal asphyxia on discharge, including 627 (85.54%) mild cases and 106 (14.46%) severe cases. And neonatal asphyxia resulted in deaths of 27 cases (3.68%). The risk factors for neonatal asphyxia included multiple pregnancy, pregnancy conceived with assisted reproductive technology, premature infant, low birth weight infant, fetal malposition, congenital malformation, male infant, born during transfer, mother of Tujia nationality, low educational level (primary school or lower), living in rural area, the number of antenatal visits ≤3, history of early threatened abortion, anemia in pregnancy, hypertensive disorders of pregnancy, chorioamnionitis, abnormal pregnancy history and abnormality of umbilical cord, amniotic fluid or placenta. Conclusions The incidence of neonatal asphyxia in Enshi area is obviously higher than the national average. The main risk factors for neonatal asphyxia in this area are related to maternal background and the living condition of the mother during pregnancy, delivery as well as the newborn at birth.

OBJECTIVE:To observe clinical efficacy and safety of Kangfuxin liquid in the treatment of radioactive dermatitis of nasopharyngeal carcinoma patients. METHODS:A total of 73 nasopharyngeal carcinoma patients with radioactive dermatitis in the Third Affiliated Hospital of Kunming Medical University during Feb. 2016 to Feb. 2017 were divided into control group (36 cases) and observation group (37 cases) according to random number table. Both groups received routine treatment as Methylrosanilinium chloride solution,Compound cod liver oil and zinc oxide ointment for external use. Observation group was additionally given gauze soaked with Kangfuxin liquid on affected area,3 times a day on the basis of routine treatment. Both groups were treated for 4 weeks. Clinical efficacies of 2 groups were compared,and RTOG classification and dermatitis area were compared before and after treatment. The occurrence of ADR was recorded. RESULTS:There was statistical significance in the total response rate between observation group (94.6％) and control group (97.2％)(P<0.05). Before and after treatment,there were no RTOG Ⅳ patients in 2 groups. Before treatment,there was no statistical significance in the proportion of RTOG 0-Ⅲpatients or dermatitis area between 2 groups (P>0.05). After treatment,RTOG classification of observation group was improved significantly, the proportion of grade 0 patients was significantly higher than control group, that of gradeⅠpatients was significantly lower than control group,with statistical significance(P<0.05). There was no statistical significance in the proportion of RTOG 0-Ⅲpatients of control group before and after treatment(P>0.05). Two,four weeks after treatment,dermatitis areas of 2 groups were decreased significantly;dermatitis area 4 weeks after treatment was significantly smaller than 2 weeks after treatment;observation group was significantly smaller than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Additional use of Kangfuxin liquid in the treatment of radioactive dermatitis of nasopharyngeal carcinoma patients can effectively relieve symptoms and reduce dermatitis area with good safety.

Objective To evaluate the clinical effect of dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization.Methods The retrospective comparative study was used to analyze 120 patients with chronic dacryocystitis in our hospital from June,2012 to May,2016,of whom 60 patients were treated with traditional dacryocystorhinostomy,and 60 patients were treated with dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization.Half year after the operation the patients were re-examined for the patency of their lacrimal passages and postoperative complication.The disappearance of tearing and the unobstructed patency of the lacrimal passages were set as the standard of a successful operation.The statistically analyzing was performed.Results Six months after operation,the success rate of dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization was 93.3％,the success rate of traditional dacryocystorhinostomy was 90.0％,without statistical difference between two types of operation (P ＞ 0.05).The skin scar formation rate in dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization was 0,while 100％ in traditional dacryocystorhinostomy,with statistical significant difference (P =0.00).The success rate of two-stage operation was 100％ after dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization for recurrence,while 16.7％ after traditional dacryocystorhinostomy,the difference is of statistical significance (P =0.048).Conclusions Dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization is not only reliable,effective method for treating chronic dacryocystitis,but also with less iatrogenic trauma,and no scar.