Objective:To provide a reference for integrated medical education reform in medical colleges by analyzing the scores of National Staged Examination of Clinical Physician Qualification (NSECPQ).Methods:The NSECPQ scores of our students in 2019 were analyzed by hypothesis testing. Chi-test was used to compare the pass rate of the examination, and the t-test was used to compare the total scores, the average mastery of disciplines and the average mastery of the system. Results:The total scores and pass rate of the examination of the students in the framework of integrated medicine education were significantly higher than those in traditional medical education. There was no significant difference in the scores of some subjects between the two educational frameworks, the scores of some subjects of the students in the framework of integrated medicine education were even lower than those in traditional medical education. For example, under the integrated medical education mode, the students' average mastery of obstetrics is 4.04 points, slightly lower than the students under the traditional medical education mode (4.11 points). It shows that the reform of integrated medical education still has some shortcomings in the teaching of some disciplines and systems.Conclusion:When implementing the teaching reform of integrated medical education in medical colleges, special attention should be paid to comparing the examination syllabus of clinical physician qualification, reasonably arranging the teaching contents of integrated medical courses, and strengthening the training of teaching staff and the construction of teaching teams, so as to ensure the teaching quality of integrated medical education reform.

To understand the learning satisfaction on the organ-system-based teaching model among medical students,the questionnaire on the model was designed referring to the actual situation,and the learning satisfaction was evaluated by questionnaire among all the students of excellent clinical medicine class in Chongqing Medical University.Questionnaire survey of learning satisfaction showed that most of the medical students thought highly of the teaching model and they had more harvest.The satisfaction scores of curriculum arrangement,classroom teaching,teachers and teaching material were relatively high.They agreed with the school to carry out the reform.Medical schools should not only fully sum up the achievements of organ-system-based teaching model,but also pay more attention to draw on the advanced experiences both at home and abroad.It should put emphasis on compiling teaching materials of integrated curriculum,strengthening the teaching staff construction,constructing the teaching organization of integrated curriculums,training students' clinical practice ability,as well as cultivating students' autonomous learning ability,to improve learning satisfaction and teaching quality.

Objective To explore the relation of gamma knife radiation doses and changes of trigeminal nerves after gamma knife irradiation by studying the changes of trigeminal somatosensory evoked potentials (TSEP) characteristics oftrigeminal nerve roots irradiated by gamma knife in normal animals.Methods Fifteen New Zealand rabbits were divided into 60 Gy irradiation group,80 Gy irradiation group,100 Gy irradiation group,120 Gy irradiation group and control group in accordance with random number table (n=3).The first 4 groups used Gamma Plan 5.34 planning system to design the radiation targets and radiation doses.The target was placed at trigeminal nerve root entry zone,bilateral irradiation was performed,and the central dose was divided into 60 Gy,80 Gy,100 Gy and 120 Gy.The bilateral TSEP was monitored before and 6 months after irradiation.The monitoring data were recorded and statistical analysis was performed.Results P1,N1,P2 wave latencies,P1-N1,N1-P2 interpeak latencies and amplitudes in the 60 Gy irradiation group after irradiation showed no significant differences as compared with those in the control group (P＞0.05);P1,N1,P2 wave latencies,P1-N1,N1-P2 interpeak latencies and amplitudes in the 80 Gy irradiation group,100 Gy irradiation group,and 120 Gy irradiation group after irradiation showed significant differences as compared with those in the control group (P＜0.05),and these changes increase with increase of doses.Conclusion The changes of TSEP,which increase with increase of doses,are closely related to the doses of gamma knife irradiation,of which 80 Gy is the lowest dose to produce changes.

Objective To explore the relation of gamma knife radiation of different doses with trigeminal nerve radiation damage by investigating the pathologic changes of trigeminal nerve roots after different doses of gamma knife radiation.Methods Fifteen New Zealand rabbits were randomly divided into 60 Gy radiation group,80 Gy radiation group,100 Gy radiation group,120 Gy radiation group and control group (n=3).Bilateral trigeminal nerves of all New Zealand rabbits,excepted for the control group,were irradiated;and a 4-mm isocenter was placed at trigeminal nerver root entry zone.All New Zealand rabbits for pathological observation were sacrificed after six months.The roots were examined by light microscopy,immunohistochemistry,and electron microscopy.Integrated optical density of the myelin staining and immunohistochemistry staining results of the four groups were examined by Image-pro plus 6.0 image processing system,and analyzed using method of statistics.Results Pathological observation showed the result of 60 Gy group after irradiation did not differ significantly as compared with the result of control group;in 80 Gy group,there was part nerve fiber fragmentation and degeneration,and demyelination;in 100 Gy group,there was nerve fiber fragmentation,degeneration and demyelination,and part of nervous necrosis;in 120 Gy group,there was almost all nerve fiberdissolution,disappearance and demyelination,and most of nervous necrosis.The integrated optical density of the myelin staining and immunohistochemistry staining results of 60 Gy group did not differ significantly as compared with that of the control group (P＞0.05);the results of 80 Gy,100 Gy and 120 Gy group differed significantly as compared with that of control group (P＜0.05) and decreased following the increase of irradiation doses.Conclusions The histopathological changes of the trigeminal nerve irradiated by gamma knife have significant correlation with irradiation doses.The result of 60 Gy group after irradiation does not change significantly;the radiation injury of 80 Gy-120 Gy group aggravates with the increase of irradiation doses;irradiation of high dose (100 Gy and 120 Gy) can cause nervous necrosis.

BACKGROUNDBare stent implantation in the treatment for native and recurrent coarctation of the aorta (CoA) has become established as an alternative to surgery and balloon angioplasty. However, this modality still encounters significant complications during the procedure and/or follow-up. The covered Cheatham-Platinum (CP) stent commonly used to be chosen as a rescue treatment in these patients. The purpose of this study was to evaluate the use of covered CP stent as the primary modality in the treatment for native CoA.

METHODSTwenty-five covered CP stents and 2 bare CP stents were implanted in 25 patients with native CoA. All patients after the intervention were invited for follow-up examinations.

RESULTSThe peak systolic gradient across the lesion decreased significantly from a median value of 67.5 mmHg (quartile range, 19.3 mmHg) to 2 mmHg (quartile range, 4.0 mmHg) (P < 0.0001). Stenotic segment diameter increased from a median value of 5.0 mm (quartile range, 1.5 mm) to 17.9 mm (quartile range, 2.5 mm) (P < 0.0001). The median ratio of diameter of the coarctation postprocedure to preprocedure was 4.2 (quartile range, 1.6). All of the CP stents were placed in the suitable position without any acute complications. During a follow-up period of up to 72 months, no complications were encountered. Most of the patients (21/25) were normotensive, apart from four patients requiring antihypertensive medication during the follow-up.

CONCLUSIONThe implantation of covered CP stent as the primary modality is safe and effective in the treatment for native CoA in adolescents and adults.

Adolescent ; Adult ; Angioplasty, Balloon ; Aortic Coarctation ; pathology ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Platinum ; Stents ; adverse effects ; Systole

OBJECTIVESTo investigate the expression of P120 catenin in pancreatic carcinoma and to explore the association between P120 catenin gene polymorphism at T755G position and pancreatic carcinoma.

METHODSThe expression of P120 catenin in 52 cases of pancreatic carcinoma and normal pancreatic tissues on the mRNA and protein levels were evaluated by RT-PCR and Western Blot methods respectively. P120 catenin gene polymorphism at T755G position of in 52 patients and 60 healthy controls were examined by PCR-restriction fragment length polymorphism (PCR-RFLP) technique.

RESULTSThe mRNA and protein expressions of P120 catenin in pancreatic carcinoma tissues were significantly lower than normal pancreatic tissues (P=0.000, P=0.002). Reduced expression of P120 catenin mRNA was significantly correlated with differentiated (P=0.033), lymph node metastasis (P=0.004), vascular invasion (P=0.022), and pTNM stage (P=0.003). Additionally, there were significant difference of P120 catenin gene polymorphism genotypes and alleles at T755G position between patients and healthy controls (P=0.008, P=0.016). The GG genotype of P120 catenin gene was associated with higher risk of incidence for pancreatic carcinoma compared with the TT genotype (OR=2.765, 95%CI=1.312-3.958).

CONCLUSIONSThe reduced expressions of both P120 catenin mRNA and protein in pancreatic carcinoma suggest its association with pancreatic carcinoma development. Polymorphism of P120 catenin gene at T755G situation might be a risk factor for pancreatic carcinoma, and it may be used to diagnosis and prevent pancreatic carcinoma early.

Case-Control Studies ; Catenins ; genetics ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms ; genetics ; metabolism ; Polymorphism, Genetic

BACKGROUNDThe clinical outcome of percutaneous coronary intervention (PCI) is poorer in women than that in men. This study aimed at comparing the impact of gender difference on the strategy of primary PCI in patients with acute ST-segment elevation myocardial infarction (STEMI).

METHODSTwo hundred and fifty-nine patients with STEMI who underwent primary PCI within 12 hours of symptom onset were enrolled. The male group consisted of 143 men aged > 55 years, and a female group included 116 women without age limitation. Procedural success was defined as residual stenosis < 20% with thrombolysis in myocardial infarction flow grade > 2 and without death, emergency bypass surgery or disabling cerebral events during the hospitalization. The rate of major adverse cardiac events (MACE), including death, nonfatal myocardial infarction and target vessel revascularization during follow-up, was recorded.

RESULTSFemale patients were more hypertensive and diabetic and with fewer cigarette smokers than male counterparts. The prevalence of angiographic 3-vessel disease was higher in the female group, but the procedural success rate was comparable between the two groups (94.4% vs 92.2%). The occurrence rate of MACE did not differ during the hospitalization (4.2% vs 6.0%, P = 0.50), but was significantly higher in the female group during follow-up (mean (16.0 +/- 11.2) months) than that in the male group (5.4% vs 0.7%, P = 0.02).

CONCLUSIONDespite a similar success rate of primary PCI and in-hospital outcomes in both genders, female patients with acute STEMI still have a worse prognosis during the long-term follow-up.

Aged ; Angioplasty, Balloon, Coronary ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Sex Factors ; Treatment Outcome

OBJECTIVETo study the effect of co-blockage of vascular endothelial growth factor (VEGF) and its receptor (KDR) on growth of bladder carcinoma T24 cells and nude mice xenograft.

METHODST24 cell line co-transfected with VEGF siRNA and sKDR expression plasmids was developed and its proliferation was assayed by MTT and apoptosis by FCM. The nude mice model bearing bladder carcinoma xenograft was established. The tumor cell VEGF expression, stroma microvessel density (MVD) and tumor cell topoisomerase II alpha (Topo II alpha) expression were detected by immunohistochemistry. Cell apoptosis was estimated by TUNEL assay.

RESULTSMTT assay showed that cell proliferation in VEGF siRNA, sKDR and combination groups was 56.3% +/- 8.3%, 42.6% +/- 13.8% and 32.5% +/- 4.3%, respectively, significantly lower than that in the scramble control (97.3% +/- 11.6%, P < 0.0001). FCM showed there were sub-diploid apoptotic peaks before G1 phase in VEGF siRNA, sKDR and combination groups, and apoptosis ratio was 5.1% +/- 0.9%, 4.2% +/- 0.5% and 8.8% +/- 0.7%, respectively, all of which were higher than that in the scramble control (0.9% +/- 0.4%, P < 0.05), and the combination group had even more higher apoptosis than the two singlely treated groups (P < 0.01). In vivo test showed that tumor growth was inhibited in VEGF siRNA, sKDR and combination groups, and from day 16 the tumor volume in combination group was significantly smaller than that in scramble control (P < 0.05), and from day 28 the tumor almost lost the ability to further growth. Immunohistochemistry revealed VEGF expression in combination group was 54.37 +/- 5.28, significantly lower than that in the scramble control (141.66 +/- 8.59, P < 0.0001). MVD number was only 8.22 +/- 3.79, much less compared with that in the scramble control (61.76 +/- 5.28, P < 0.0001) or sKDR group (19.46 +/- 4.16, P = 0.0089). Tumor cell proliferation index in the combination group (1.5% +/- 0.7%) was significantly decreased compared with that in the scramble control (11.8% +/- 5.2%, P < 0.0001), and apoptosis index (67.2% +/- 8.5%) was much higher than that in the scramble control (8.7% +/- 2.7%, P < 0.0001), VEGF siRNA group (54.3% +/- 4.8%, P = 0.0492) or sKDR group (52.3% +/- 6.4%, P = 0.0293).

CONCLUSIONVEGF siRNA or sKDR alone can inhibit tumor cell proliferation and induce cell apoptosis, but co-blockage of VEGF and KDR by their combination shows more significant therapeutic efficacy.

Animals ; Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Neovascularization, Pathologic ; prevention & control ; Plasmids ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection ; Tumor Burden ; Urinary Bladder Neoplasms ; metabolism ; pathology ; Vascular Endothelial Growth Factor A ; genetics ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; genetics ; metabolism ; Xenograft Model Antitumor Assays

AIMTo develop a method for assessing sperm function by measuring released acrosin activity during the acrosome reaction (AR).

METHODSHuman semen samples were obtained from 24 healthy donors with proven fertility after 3-7 days of sexual abstinence. After collection, samples were liquefied for 30 min at room temperature. Standard semen parameters were evaluated according to World Health Organization (WHO) criteria. Calcium ionophore A23187 and progesterone (P4) were used to stimulate the sperm to undergo AR. After treatment, sperm were incubated with the supravital dye Hoechst33258, fixed in a glutaraldehyde-phosphate-buffered saline solution, and the acrosomal status was determined by fluorescence microscopy with fluorescein isothiocyanate-labeled Pisum sativum agglutinin (FITC-PSA). The percentage of sperm undergoing AR (AR%) was compared to sperm acrosin activities as assessed by spectrocolorimetry. The correlation between AR% and acrosin activity was determined by statistical analysis.

RESULTSThe AR% and released acrosin activity were both markedly increased with A23187 and P4 stimulation. Sperm motility and viability were significantly higher after stimulation with P4 versus stimulation with A23187 (P < 0.001). There was a significant positive correlation between released acrosin activity and AR% determined by FITC-PSA staining (r=0.916, P < 0.001).

CONCLUSIONSpectrocolorimetric measurement of released acrosin activity might serve as a reasonable alternative method to evaluate AR.

Acrosin ; physiology ; Acrosome Reaction ; Adult ; China ; Humans ; Male ; Progesterone ; pharmacology ; Semen ; drug effects ; physiology ; Sperm Motility ; drug effects ; physiology

OBJECTIVETo evaluate the relationship between sperm motility parameters and sperm morphology.

METHODSSeven hundred and eighty-three semen samples were tested. Sperm motility parameters were analyzed by computer-aided sperm analysis (CASA) , and sperm morphology assessed by automated sperm morphology analyzer (ASMA). The cases were classified based on the World Health Organization criteria. Morphologically 241 of the samples were normal and the other 542 abnormal.

RESULTSVCL, WOB, VAP of the morphologically abnormal group were significantly higher than those of the normal group (P < 0.05, P < 0.001), while MAD, LIN, STR of the abnormal group were significantly lower (P < 0.05, P < 0.001). There were significant positive correlations between the morphologically normal sperm rates and MAD, LIN, WOB, STR, and a significant negative correlation between the morphologically normal sperm rate and ALH.

CONCLUSIONMorphological abnormality of sperm is often accompanied with weak motility, which is probably attributed more to some factors that coact on both sperm motility and morphology than to the influence of sperm morphological abnormality on sperm motility.

Adult ; Humans ; Infertility, Male ; pathology ; physiopathology ; Male ; Sperm Count ; Sperm Motility ; Spermatozoa ; pathology