ObjectiveTo investigate the willingness and influencing factors of clinical medicine graduate students to study abroad.MethodsFrom September 2019 to January 2020, a survey was conducted among the clinical medicine graduate students in West China School of Medicine, Sichuan University. An anonymous self-report questionnaire was used to investigate their willingness to study abroad, and the related influencing factors were analyzed.ResultsA total of 600 questionnaires were distributed, in which 518 valid questionnaires were collected. Among the 518 graduate students, 96.14% anticipated to study abroad, and 93.05% expected to subsidize the study abroad through the state-sponsored study abroad fund. The major obstacle for studying abroad for joint training was concerning the negative effects on domestic clinical work or scientific research work, resulting in failure to graduate; meanwhile, difficulty in applying was the primary obstacle for studying abroad for a doctorate.ConclusionsThere is a strong willingness for clinical medicine graduate students to study abroad. However, it is affected by graduation time and application.
With the publication of a vast amount of clinical research on hepatocellular carcinoma (HCC), the American Association for the Study of Liver Diseases (AASLD), the National Comprehensive Cancer Network (NCCN), the American Society of Clinical Oncology (ASCO), and the National Health Commission of China have all updated their diagnostic and treatment guidelines for HCC. There are no differences in the definition of HCC risk populations among the AASLD 2023, NCCN 2024, and China Liver Cancer Staging and Treatment Guideline (CNLC) 2024. Notably, CNLC 2024 has updated its guidance on high-risk factors and prospective surveillance for HCC based on the characteristics of HCC patients in China. The four guidelines have seen significant updates in the areas of neoadjuvant and adjuvant therapies, local treatments, and systemic treatments for HCC. CNLC 2024 refines the indications for local treatment, improves systemic treatment, and introduces new first-line therapy, including camrelizumab combined with rivoceranib or tislelizumab. The second-line therapy nivolumab plus ipilimumab for advanced HCC are recommended by AASLD 2023, NCCN 2024, and ASCO 2024, which may become a new first-line therapeutic option for patients with advanced HCC. We compare and interpret these four guidelines in this paper.
ObjectiveTo investigate the current situation of domestic registry studies, and to provide basis for future research.MethodsWorld Health Organization (WHO) registration platform, ClinicalTrials.gov registration platform and other registration platforms were searched to collect the registered registration studies in Mainland China from inception to July 31st, 2018. Two researchers collected and collated data, analyzed by descriptive statistical methods, and then python-igraph package in Python 3.5 was used to draw the network diagram.ResultsA total of 247 studies were retrieved, mainly for disease registry and pharmaceutical product registry. Cohort and case-series were the principally study design. The research focused on chronic diseases such as cardiovascular and cerebrovascular diseases, and research sites were based on the economically developed area, for example, Beijing, Shanghai and Guangdong. The network diagram of study design and disease system shows that cohort research design is widely used in the nervous system and circulatory system; the network diagram of the research sites and disease system found that Beijing mainly studied circulatory and nervous system diseases, Shanghai mainly studied circulatory system diseases, and Guangdong relatively studied more on nervous system and urinary system diseases.ConclusionThe increasing number of registry studies in China reflects the importance of long-term outcome assessment of diseases.
Scientific and rigorous study design could improve the reliability of results of the comparative diagnostic test accuracy studies. The design procedures of a comparative diagnostic test accuracy study included: constructing the clinical questions, identifying the appropriate gold standard, selecting the representative patient sample, calculating the sample size, blindly interpreting and comparing the results of diagnostic tests, and setting up the cut-off value. This paper introduced 5 categories of the designs of comparative diagnostic test accuracy studies: fully paired, partially paired with a random subset, partially paired with a nonrandom subset, unpaired randomized, and unpaired nonrandomized design.
【Abstract】 Objective To investigate the role of myosin l ight chain (Myl) in myogenesis in vitro. Methods The extraocular muscle, diaphragm and gastrocnemius muscle myoblasts (eMb, dMb and gMb) were isolated and purified from 12 3-week-old C57BL/6 mice by using the enzyme digestion and Preplate technique, and then were subcultivated. The Myl expression in Mb was detected by RT-PCR and Western blot analysis; the Mb prol iferation activity was tested by methylene blue assay, and the myotube formation was observed. After anti-Myl antibody (1, 2, 3, 8, 16 ng/mL) was induced in the Mb culture (experimental group), the abil ity of prol iferation of myoblasts and the myotube formation were identified. Meanwhile, the Mb which was cultured without anti-Myl antibody was indentified as the control group. Results The results of RT-PCR and Western blot analysis showed that Myl1 and Myl4 mRNA and Myl protein were expressed in eMb, dMb and gMb at 24 hours after seeding, and their expression level were lower in eMb than in dMb and gMb (P lt; 0.01), and the latter two did not show any significant difference (P gt; 0.05). Myl2 and Myl3 mRNA was not detected in these three myoblasts. The prol iferation assay showed that the eMb prol iferated faster as compared with dMb and gMb (P lt; 0.01). eMb began to yield myotubes at 40 hours after seeding and dMb and gMb at 16 hours after seeding. At 6 days, the number of myotubes derived from eMb was (137.2 ± 24.5)/ field, which was significantly larger than that of myotubes from dMb [(47.6 ± 15.5) / field ] and gMb [(39.8 ± 5.1) field ] (P lt; 0.01). There was not statistically significant difference between the latter two groups (P gt; 0.05). After the antibody treatment, the absorbency values of the eMb, dMb and gMb in the experimental groups at each antibody concentration point were significantly higher than those in the corresponding control groups (P lt; 0.05), and the dose-dependent way was performed.The numbers of myotubes from dMb at 16 hours were (48.2 ± 7.1)/ well in the experimental group and (23.4 ± 4.9)/ well in the control group, and at 6 days were (40.6 ± 10.2)/ field in the experimental group and (63.1 ± 6.1)/ field in the control group.There was statistically significant difference between the experimental and control groups (P lt; 0.01). Conclusion Myl may play a role in myogenesis through the negative effect on the myoblast prol iferation.
ObjectivesTo evaluate the level and variation of Chinese scholars' scientific research capability in the world by analysing the status of literature published on top-five global biomedicine journals by Chinese scholars in the past 10 years.MethodsLiterature published on NEJM, JAMA, BMJ, Lancet and PLoS Medicine from 2007 to 2016 were searched in PubMed database. Types of diseases were classified by using International Classification of Diseases (version 10) (ICD-10). Quantitatively analysis were used to classify the different authors, institutes, studies designs, quality of publication and variation.ResultsLiterature (56.4%) published on Lancet had the largest quantity among the top-five journals. Infectious and parasitic diseases, circulation system diseases, cancers, endocrine, nutrition and metabolic diseases and neuropsychiatric diseases were the top-five in disease categories list, accounting for 38.4%. In different study design, reviews (non-experimental research) and randomized controlled trials were the first and the second study types, separately.ConclusionsFor productivity of Chinese scholars’ diseases publications on top-five medical journals, the top-five specific diseases are from the top-five disease categories-infectious and parasitic diseases, circulation system diseases, cancer, endocrine, nutrition and metabolic diseases and neuropsychiatric diseases. The main study types are reviews, randomized controlled trials and cross-sectional studies.
ObjectiveThrough dynamic monitoring of bacterial contamination of the bedside curtain in different time periods, the bacterial contamination of the bedside curtain in different time periods was analyzed.MethodsThe bedside curtain in the pediatric ward and obstetric ward were selected, between April and September 2019. All bedside curtains were sampled for bacterial contamination on the day after the replacement of it. During the continuous use of the bedside curtain for 6 months, the bacterial contamination was monitored at 1-, 2-, 3- and 6- months respectively.ResultsA total of 2 058 samples were monitored, including 1 041 in the pediatric ward and 1 017 in the obstetric ward. After continuous use for 2 months, there was clear pollution in the bedside curtain of pediatric ward, and the unqualified rate was 65.24%. Obstetrical ward were contaminated significantly after 1 month of use, and the unqualified rate was 51.96%.ConclusionsAs part of the sickbed unit, the bedside curtain is frequently touched by the hands of patients, family members and medical personnel during use. It is suggested that the septum should be replaced once a month in common wards and in time in case of pollution. For departments received patients with low immunity, the frequency of replacement should be increased to reduce environmental risk factors.
Objective To investigate the relationship between estimated glucose disposal rate (eGDR) and the incidence of cardiovascular disease (CVD) in individuals without diabetes and those with diabetes. Methods Participants were drawn from the China Health and Retirement Longitudinal Study from 2011 to 2018. Participants were divided into four subgroups based on quartiles of baseline eGDR. In this study, data were analyzed using Kaplan-Meier survival curves, Cox proportional hazards models, restricted cubic spline curves, subgroup analyses, and receiver operator characteristic curves. Results A total of 6 283 participants were included. Among them, 47.2% are male, with an average age of (59.6±9.5) years; 285 cases (4.5%) had diabetes; there were 1 571 cases in Q1 group, 1 572 cases in Q2 group, 1 583 cases in Q3 group, and 1 557 cases in Q4 group. A total of 761 CVD events occurred. According to the multivariate-adjusted model, baseline eGDR levels were significantly associated with the risk of CVD events (P<0.05). Baseline eGDR was associated with the risk of CVD events in individuals without diabetes (P<0.05), but the results were not entirely consistent for those with diabetes [CVD: hazard ratio (HR)=0.85, 95% confidence interval (CI) (0.75, 0.96), P=0.012; heart disease: HR=0.91, 95%CI (0.78, 1.06), P=0.211; stroke: HR=0.74, 95%CI (0.58, 0.93), P=0.012]. Restricted cubic spline curves revealed significant negative linear relationships between baseline eGDR and CVD, heart disease, and stroke. Subgroup analyses with interaction testing revealed that the association between baseline eGDR and CVD was not modified by age, sex, smoking status, alcohol consumption, or dyslipidemia. Receiver operator characteristic curves further demonstrated that baseline eGDR exhibited significantly better predictive performance than the triglyceride-glucose (TyG) index, obesity indices, and the TyG index-obesity composite. Conclusions Low level baseline eGDR is associated with an increased risk of CVD in individuals without diabetes. This finding may help improve risk stratification to guide preventive measures and enhance the prognosis of CVD.
Objective To understand the effect of estradiol in different concentrations on proliferation of diverse mammary primary cells in vitro. Methods The primary cells of cancer tissue, the adjacent tissue to tumors and normal mammary tissue from patiens with breast cancer were obtained using collagenase digesting method. All the tissue samples were cultivated in vitro, and were given estradiol in different concentrations. The effect of estradiol on the proliferation of those primary cells was measured by MTT. Results Estradiol remarkedly promoted the proliferation of primary cells of cancer tissue and peritumor tissue in vitro, whose ER expression were positive. Whereas, the promotion effect of estradiol on the proliferation of normal mammary primary cells was relatively weak, and there was no correlation between the promotion effect with the expression of ER in cancer tissue. Conclusion The risks of occurrence and relapse of breast cancer would increase significantly when the concentration of estradiol is no less than 103 pmol/L in vivo.
ObjectiveTo evaluate the developing methodologies of Essential Medicines Lists for Children (EMLcs) in global, in order to provide reference in developing EMLc of China.
MethodsWe searched ProQuest, ScienceDirect, SpringerLink and MEDLINE databases, World Health Organization (WHO) official website, and 67 websites of National Ministry of Health and Drug Administration Section, to collect literature about selection methodology of children and/or adult essential medicines list (EML). A descriptive analysis was conducted.
ResultsA total of fourteen literatures were included. Of which, 6 were about the essential medicines selection methodology in children, and the other 8 were about the essential medicines selection methodology in adult. The WHO had established independent EMLc selection committee. Paediatricians were involved in the selection of EMLc in the WHO and India. There was no selection criteria and process for EMLc globally. The WHO, India, and South Africa selected their EMLcs referring to the WHO EML selection criteria. The WHO and South Africa had their own updating time, period and process for EMLc. The WHO EMLc was updated per 2 years, which in high frequency and conducts in rigorous process. However, the EMLc of India had not been updated yet.
ConclusionIt is suggested that China could build a national EMLc selection committee involving paediatricians and evidence-based medicine experts etc. in referring to the framework of the WHO Child Health Working Group. The EMLc selection criteria and process of China could be established referring to the one of the WHO, based on the disease burden, drug accessibility and medical insurance of children of China. The EMLc of China should be simultaneously updated with the adult EML of China.
