微信课堂在绝经相关疾病诊治培训中的运用及效果评价

目的评价微信课堂在妇科医师绝经相关疾病诊治培训中的运用效果。方法选取2017年3月自愿参与北京世纪坛医院线下继续医学教育项目"绝经相关疾病诊治培训"的47位妇科医师作为对照组(传统教学),自愿参与线上微信课堂培训的52位妇科医师作为实验组(微信课堂教学)。通过比较培训前后妇科医师对绝经相关疾病知识的掌握情况及课程满意度,以评价教学效果。采用SPSS 20.0对组间数据行t检验或卡方检验。结果所有妇科医师均完成了研究,培训前后的测评问卷回收率均为100%。培训前实验组学员绝经相关疾病知识平均得分(63.65±21.42)、知识考核通过率为65.4%,与对照组[(60.85±24.83)分,63.8%]相比,差异无统计学意义(P>0.05)。两组学员培训后的绝经相关疾病知识得分和考核通过率均高于培训前,且差异有统计学意义(P<0.05)。培训后,实验组学员平均得分为(77.50±16.19)分、考核通过率为90.1%,优于对照组[(78.72±16.89)分,87.2%],但两组差异无统计学意义(P>0.05)。实验组学员对培训的满意度相较对照组更高,但两组差异无统计学意义(P>0.05)。结论微信课堂用于妇科医师绝经相关疾病诊治培训,具有与传统教学相同的效果且培训满意度更高,可进一步运用于妇科其他亚专业培训及向其他专科推广。     

西安地区人群肺功能问卷调查

目的探讨西安地区部分人群肺功能的特点,生活习惯和环境等因素与肺功能的关系。方法2012年7—8月对西安地区东郊和北郊共405人进行问卷调查和肺功能检测,并用多元逐步回归分析不同因素对肺功能指标的影响。结果西安地区东郊和北郊人群FVC,PEF和FEF25—75均低于正常预计值,东郊和北郊人群之间肺功能主要指标差异有统计学意义（P〈0．001）;肺功能主要指标与年龄增长、性别和肺部疾病呈负相关（P〈0．05）。结论西安地区部分人群肺功能主要指标偏低,为今后该地区呼吸系统疾病防治提供依据。     

Mycobacterium tuberculosis Region of Difference (RD) 2 Antigen Rv1985c and RD11 Antigen Rv3425 Have the Promising Potential To Distinguish Patients with Active Tuberculosis from M. bovis BCG-Vaccinated Individuals

Antigens encoded in the region of difference (RD) of Mycobacterium tuberculosis constitute a potential source of specific immunodiagnostic antigens for distinguishing tuberculosis (TB) infection from BCG vaccination. We evaluated the diagnostic potential of specific T-cell epitopes selected from two immunodominant antigens, Rv1985c and Rv3425, from RD2 and RD11, respectively, on the basis of epitope mapping, in TB patients and BCG-vaccinated healthy individuals. Using a whole-blood gamma interferon release assay, a wide array of epitopes was recognized on both Rv1985c and Rv3425 in TB patients. Those epitopes that could specifically discriminate TB infection from BCG vaccination were carefully selected, and the most promising peptide pools from Rv1985c showed a sensitivity of 53.9% and a specificity of 95.5%. When the novel specific peptides from Rv1985c joined the diagnostic antigens in the QuantiFERON-TB Gold In-Tube (QFT-IT) assay, the sensitivity was increased from 86.4% to 96.2%, with no drop in specificity. These results indicate that the peptide pools selected from Rv1985c and Rv3425 have the potential to diagnose TB infection by a method that may be routinely used in clinical laboratories.     

Protective effect of nitric oxide on hepatopulmonary syndrome from ischemia-reperfusion injury

AIM: To evaluate immunological protection of nitric oxide (NO) in hepatopulmonary syndrome and probable mechanisms of ischemia-reperfusion (IR) injury in rat liver transplantation.METHODS: Sixty-six healthy male Wistar rats were randomly divided into three groups (11 donor/recipient pairs). In group II, organ preservation solution was lactated Ringer’s solution with heparin 10  000/μL at 4 °C. In groups I and III, the preservation solution added, respectively, L-arginine or N^G-L-arginine methyl ester (L-NAME) (1 mmol/L) based on group II, and recipients were injected with L-arginine or L-NAME (50 mg/kg) in the anhepatic phase. Grafted livers in each group were stored for 6 h and implanted into recipients. Five rats were used for observation of postoperative survival in each group. The other six rats in each group were used to obtain tissue samples, and executed at 3 h and 24 h after transplantation. The levels of alanine aminotransferase (ALT), tumor necrosis factor (TNF)-α and NO metabolites (NOx) were detected, and expression of NO synthase, TNF-α and intercellular adhesion molecule 1 (ICAM-1) was examined by triphosphopyridine nucleotide diaphorase histochemical and immunohistochemical staining.RESULTS: By supplementing L-arginine to strengthen the NO pathway, a high survival rate was achieved and hepatic function was improved. One-week survival rate of grafted liver recipients in group I was significantly increased (28.8 ± 36.6 d vs 4 ± 1.7 d, P < 0.01) as compared with groups II and III. Serum levels of ALT in group I were 2-7 times less than those in groups II and III (P < 0.01). The cyclic guanosine monophosphate (cGMP) levels in liver tissue and NOx in group I were 3-4 times higher than those of group II after 3 h and 24 h reperfusion, while in group III, they were significantly reduced as compared with those in group II (P < 0.01). The levels of TNF-α in group I were significantly lower than in group II after 3 h and 24 h reperfusion (P < 0.01), while being significantly higher in group III than group II (P < 0.01). Histopathology revealed more severe tissue damage in graft liver and lung tissues, and a more severe inflammatory response of the recipient after using NO synthase inhibitor, while the pathological damage to grafted liver and the recipient’s lung tissues was significantly reduced in group I after 3 h and 24 h reperfusion. A small amount of constitutive NO synthase (cNOS) was expressed in liver endothelial cells after 6 h cold storage, but there was no expression of inducible NO synthase (iNOS). Expression of cNOS was particularly significant in vascular endothelial cells and liver cells at 3 h and 24 h after reperfusion in group II, but expression of iNOS and ICAM-1 was low in group I. There was diffuse strong expression of ICAM-1 and TNF-α in group III at 3 h after reperfusion.CONCLUSION: The NO/cGMP pathway may be critical in successful organ transplantation, especially in treating hepatopulmonary syndrome during cold IR injury in rat orthotopic liver transplantation.     

Rebamipide suppresses diclofenac-induced intestinal permeability via mitochondrial protection in mice

AIM: To investigate the protective effect and mechanism of rebamipide on small intestinal permeability induced by diclofenac in mice.METHODS: Diclofenac (2.5 mg/kg) was administered once daily for 3 d orally. A control group received the vehicle by gavage. Rebamipide (100 mg/kg, 200 mg/kg, 400 mg/kg) was administered intragastrically once a day for 3 d 4 h after diclofenac administration. Intestinal permeability was evaluated by Evans blue and the FITC-dextran method. The ultrastructure of the mucosal barrier was evaluated by transmission electron microscopy (TEM). Mitochondrial function including mitochondrial swelling, mitochondrial membrane potential, mitochondrial nicotinamide adenine dinucleotide-reduced (NADH) levels, succinate dehydrogenase (SDH) and ATPase activities were measured. Small intestinal mucosa was collected for assessment of malondialdehyde (MDA) content and myeloperoxidase (MPO) activity.RESULTS: Compared with the control group, intestinal permeability was significantly increased in the diclofenac group, which was accompanied by broken tight junctions, and significant increases in MDA content and MPO activity. Rebamipide significantly reduced intestinal permeability, improved inter-cellular tight junctions, and was associated with decreases in intestinal MDA content and MPO activity. At the mitochondrial level, rebamipide increased SDH and ATPase activities, NADH level and decreased mitochondrial swelling.CONCLUSION: Increased intestinal permeability induced by diclofenac can be attenuated by rebamipide, which partially contributed to the protection of mitochondrial function.     

Trends in Hypertension Prevalence, Awareness, Treatment, and Control Rates in Shandong Province of China

J Clin Hypertens (Greenwich). 2012; 14:637–643. © 2012 Wiley Periodicals, Inc. The authors retrospectively examined data from 3 surveys on hypertension according to the 2010 Chinese Guidelines for the Management of Hypertension. These surveys were conducted in 1991, 1999, and 2007, and included 85,371 individuals 18 years and older who were living in Shandong Province, China. Age‐standardized prevalent hypertension increased from 15.6% in 1991 to 17.3% in 1999 and 32.7% in 2007 (both P<.0001). The ascending prevalence can be partially explained by increasing body weight. Among individuals with hypertension, awareness increased significantly from 27.8% in 1991 to 39.1% in 1999 and 49.2% in 2007. The proportion of pharmacologic treatment also considerably improved, with the estimate of 12.9%, 28.1%, and 43.3% in the 3 surveys, respectively. Hypertension control increased from 3.0% to 4.4% to 7.1% in the past 20 years. The upward trend in blood pressure control was mostly attributable to a rise among men and persons at middle age. This study suggests that the prevalence of hypertension increased in the Shandong population from 1991 to 2007. Although substantially improved, control rates were still unacceptably low. Comprehensive strategies are urgently required to put into practice for the management of hypertension in Shandong Province, China.