ObjectiveTo determine whether there is an imbalance of KLF2/RelA in peripheral blood neutrophils in patients with bronchial asthma, and explore the relationship between KLF2/RelA imbalance and neutrophil apoptosis.MethodsFrom April 2011 to April 2012, a total of 39 patients with acute attack of asthma in Hunan People's Hospital and Third People's Hospital of Changsha were enrolled, with 13 cases in mild asthma group, 17 cases in moderate asthma group, and 9 cases in severe asthma group. Fifteen healthy subjects were recruited as control group. Peripheral blood were collected from all subjects followed by separation of neutrophils. The apoptosis of neutrophils were measured by flow cytometry. The expression of KLF2 and RelA were detected by Western blot. The relationship between the ratio of KLF2/RelA and neutrophil apoptosis rate was analyzed by Pearson correlation test.ResultsNeutrophil apoptosis rates in the mild, moderate and severe asthma groups [(4.45±0.76)%, (2.10±0.25)%, (1.81±0.67)%, repectively] were lower than that in the healthy control group [(5.36±0.57)%, all P<0.01]. The apoptosis rates of neutrophils in the moderate and severe asthma groups were lower than that in the mild asthma group (bothP<0.01), but there was no significant difference between the moderate asthma group and the severe asthma group (P>0.05). The ratios of neutrophil KLF2/RelA in the mild, moderate and severe asthma groups were lower than that in the normal control group (0.667±0.351, 0.384±0.203, 0.536±0.293vs. 4.038±2.011, all P<0.01). There was no significant difference between the groups of mild, moderate and severe asthma (P>0.05). The neutrophil apoptosis rate was positively correlated with the percentage of neutrophil KLF2/RelA (r=0.592 0, P<0.000 1).ConclusionThere is an imbalance of KLF2/RelA in peripheral blood neutrophils in patients with bronchial asthma, and the imbalance of KLF2/RelA may be the mechanism of apoptosis of peripheral blood neutrophils.
ObjectiveTo present the application of mini-health technology assessment (Mini-HTA) method in configuration management of anti-magnetic anesthesia machine.MethodsFrom February to March 2019, the specialist operation assistant used Mini-HTA method to analyze and evaluate the anti-magnetic anesthesia machine applied by the department from basic situation and four dimensions, including technical dimension, patient dimension, hospital dimension, and economic dimension.ResultsA hospital health technology assessment report was prepared based on the evaluation of the specialist operation assistant, the suggestion of which was adopted by the hospital. As a result, an anti-magnetic anesthesia machine was arranged in the MRI room.ConclusionMini-HTA method can provide decision support for hospital equipment configuration and is conducive to the scientific and rational allocation of resources in hospitals.
As the reform of medical insurance payment methods is implemented, it is necessary for the medical institutions to further improve cost control and standardize the rational use of medical supplies. Over the years, West China Hospital of Sichuan University has made the assessment of the access of supplies by using the existing external evidence and the internal evidence created through real world data analysis methods. In this thesis, the difficulties faced by the access of medical supplies are deeply analyzed. The supplies access management system of West China Hospital of Sichuan University and its achievements in average waiting time of new supplies, rationality of purchase application, scientificity of demonstration results, support for the implementation of fourth-level surgery, and cost control are taken as examples. From this, a set of new paths can be provided for other hospitals to learn from at the time of carrying out medical supplies access management.
In response to the education and teaching reform, West China School of Medicine/West China Hospital, Sichuan University, initiated a general course on clinical engineering technology assessment and evaluation for the undergraduates in 2018. Through the course practice in the past two years, the number of students increased significantly, and we also achieved certain teaching achievements. At the same time, the teaching evaluation among undergraduates was excellent. Nevertheless, there are still certain deficiencies in the content of teaching, teaching methods and faculty. Therefore, this article summarizes the experience and lessons since the start of the course, and proposes corresponding teaching reform measures, providing reference for the establishment or reform of related interdisciplinary courses such as clinical engineering technology assessment and evaluation in the future.
Objective To study the current situation of doctor-patient communication education for medical undergraduates, and meanwhile to analyze the students’ satisfactory degree to communication education and its influencing factors, so as to provide sound suggestions to promote the students’ clinical communication abilities. Methods Using simple sampling, 50% of the students who majored in clinical medicine in grade 2006-2009 in West China Medical School of Sichuan University were selected as respondents. The investigation was conducted by face to face talk with a self-designed questionnaire. The data were input using EpiData 3.0 software and the results were analyzed by SPSS 13.0 software. Results A total of 450 questionnaires were distributed, and 404 were validly retrieved (89.78%). Among the respondents, 74.3% of them were satisfied with the current situation of doctor-patient communication education; 75.7% of them begun to know doctor-patient communication education since the stage of learning basic knowledge; 49.8% of them were trained by means of problem-based-learning (PBL); and 65.5% of them were trained with auxiliary standardized patient (SP). “Grade”, “Gender”, “SP used” and “PBL used” were the main factors affecting the satisfactory degree to current doctor-patient communication education (P=0.029, 0.023, 0.012, and 0.029, respectively). Conclusion The medical undergraduates’ satisfactory degree to current doctor-patient communication education is generally high, but it is also affected by various factors. Although doctor-patient communication education has started early, the training system is still problematic and the teaching resources coverage is limited. So in order to make a further systematic, standardized, overall designed education for students’ cognition and communication skills, the medical colleges should open integrated doctor-patient communication curriculum that combines with both PBL and SP auxiliary teaching methods, and covers all the undergraduate learning stage.
目的 通过检测人睾丸生殖细胞肿瘤中的Skp2蛋白质异常表达,探讨相关意义。 方法 应用S-P免疫组织化学法检测睾丸生殖细胞肿瘤，正常睾丸组织和慢性睾丸炎组织中Skp2的表达。 结果 睾丸生殖细胞肿瘤中Skp2阳性表达率为74.5%，正常睾丸组织中Skp2阳性表达率为20.0%，在慢性睾丸炎组织中Skp2阳性表达率为40.0%，在3种不同睾丸组织中表达差异有统计学意义（P＜0.05）；Skp2表达与不同组织学类型的睾丸生殖细胞肿瘤无相关性（P＞0.05）；随着临床分期的增高，睾丸生殖细胞肿瘤中的Skp2表达增多，差异无统计学意义（P＞0.05）。 结论 在人睾丸生殖细胞肿瘤中的Skp2高表达，提示细胞周期的异常调控在睾丸生殖细胞肿瘤的发生、分化中起着重要的作用。
Objective To investigate the effects of Neuritin on the regeneration of the neural axons after acute spinal cord injury (SCI) in rats. Methods The model of acute SCI at T10 was establ ished in 54 adult healthy Wistar rats (half males and half females) weighing 250-300 g by using the improved Allen’s weight-drop method. The rats were randomly dividedinto 3 groups. 100 μL (6 μg) Neuritin and His protein was injected into group A (n=24) and group B (n=24), respectively,through subarachnoid catheter. Six rats from each group were killed 3, 7, 14, and 28 days after injury to receive Basso, Beattie and Bresnahan (BBB) locomotor rating scal ing, HE staining observation, and immunohistochemistry staining observation for neurofilament 200 (NF-200) and growth associated protein 43 (GAP-43). Group C (n=6) served as sham-operated group receiving laminectomy without spinal injury and with an empty catheter in the subarachnoid space and received the above observations 7 days after injury. Results BBB scale: after operation, the scale of groups A and B was increased over time; group A was significantly higher than group B from 14 days (P lt; 0.05); group C was higher than groups A and B at different time points after operation (P lt; 0.05). HE staining: in group C, the injured spinal tissue was normal after operation; from 7 days after operation, group A presented deeper-stained nissl body, less physal iferous cells, and more nerve synapses when compared with group B. NF-200 and GAP-43 immunohistochemistry observation: in group C, there was just l ittle positive expression; while in groups A and B, positive expression of NF-200 and GAP-43 was evident in the spinal cord from 7 days after operation. Mean density integral absorbency (IA) value of NF-200 and GAP-43: group A was higher than group B at each time point (P lt; 0.05) and group C was lower than groups A and B at each time point (P lt; 0.05). Conclusion Local application of exogenous Neuritin can promote the axonal regeneration after acute SCI in rats and the recovery of the locomotion function of hind-limbs in rats.
Objective To investigate the rebuilding status of community health service (CHS) system after Wenchuan earthquake in Mianzhu, improve service ability and provide data for better reconstruction of CHS system after natural disaster. Methods The interview was conducted with local health system officials, and self-designed questionnaire for face-to-face interview was distributed to 508 community residents in Mianzhu who were selected by convenience sampling. Data entry and statistical analysis were completed using Microsoft Office Excel 2007 and SPSS 16.0 respectively. Results A total of 508 questionnaires were distributed, and then 486 questionnaires were retrieved effectively (response rate 95.7%). The analysis on 486 respondents in CHS after rebuilding showed the rate of respondents with health files rose from 20.1% to 43.8%, the rate of having regular health check-up rose from 7.4% to 46.7%, the rate of health education rose from 20.1% to 39.7%, the rate of chronic disease monitoring rose from 0.9% to 35.4%, the rate of knowing referral pattern rose from 15.7% to 51.2%, the rate of propaganda for disaster relief rose from 33.6% to 58.6%, and the rate of doing disaster emergency response exercise was 21.8% currently. 62.3% of residents chose CHS on the first visit. The satisfactory degree to CHS rose from 45.4% to 76.1% after earthquake. Both popularization of regular health check-up and propaganda for disaster relief were major factors with influence on residents’ satisfaction to CHS (Plt;0.001, P=0.010, respectively). Conclusion The residents’ satisfactory degree to the rebuilding status of CHS system is encouraging. It is necessary to strengthen the popularization of regular health check-up and propaganda for disaster relief in order to improve the quality of community health service.
ObjectiveTo explore the development and application of a novel ventilator alarm management model in critically ill patients receiving invasive mechanical ventilation (MV) in the intensive care unit (ICU) using machine learning (ML) and Internet of Medical Things (IoMT). The study aims to identify alarms’ intervention requirements. MethodsA retrospective cohort study and ML analysis were conducted, including adult patients receiving invasive MV in the ICU at West China Hospital from February 10, 2024, to July 22, 2024. A total of 76 ventilator alarm-related parameters were collected through the IoMT system. Feature selection was performed using a stratified approach, and six ML algorithms were applied: Gaussian Naive Bayes, K-Nearest Neighbors, Linear Discriminant Analysis, Support Vector Machine, Categorical Boosting (CatBoost), and Logistic Regression. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC-ROC). ResultsA total of 107 patients and their associated ventilator alarm records were included. Thirteen highly relevant features were selected from the 76 parameters for model training through stratified feature selection. The CatBoost model demonstrated the best predictive performance, with an AUC-ROC of 0.984 7 and an accuracy of 0.912 3 in the training set. External validation of the CatBoost model yielded an AUC-ROC of 0.805 4. ConclusionThe CatBoost-based ML model successfully constructed in this study has high accuracy and reliability in predicting the ventilator alarms in ICU patients, providing an effective tool for ventilator alarm management. The CatBoost-based ML method exhibited remarkable efficacy in predicting the necessity of ventilator intervention in critically ill ICU patients. Further large-scale multicenter studies are recommended to validate its clinical application value and promote model optimization and implementation.
Objective To investigate the students’ satisfaction on teaching content, teaching staff, organizations etc. of the evidence-based medical postgraduate summer school, so as to provide references for further effective training. Methods A self-made questionnaire with cluster sampling was used to investigate the regular students who had participated in the whole course of the evidence-based medical postgraduate summer school, and the feedbacks were analyzed. Results The total number of the questionnaires was 112 and the number of the effective questionnaires was 101; the effective recovery rate was 90.2%. The students were from 32 universities and medical institutions involving 36 disciplines in 26 provinces. A total of 93.1% of the students were satisfied with the general training organization and management, but the satisfaction rates of the class environment and the time arrangement were only 51.5% and 58.4%, respectively. The satisfaction rates of the whole course setting and the teaching materials were 84.2% and 90.1%, respectively. The satisfaction rate of the teaching content of “the progress of the evidence-based medicine” was up to 93.0%. Over 93.1% of the students believed that the teachers were great in teaching skills, but only 73.3% of the students thought that the interaction between teachers and students was plenty. Conclusion This summer school has active students, a great effect and a high overall satisfaction rate. The summer school is beneficial to the cultivation of innovative postgraduates, construction of excellent teaching teams, development of evidence-based medicine discipline and building of The Network Center for Evidence-Based Medicine Education. The satisfaction rate of the summer school training can get promoted by increasing schooling investments, appropriately prolonging training time, setting different subjects in different semesters and enhancing the teaching interaction.