Objective: To investigate the model, quality as well as effect of teaching-in-English in five-year clinical medicine program of Hainan Medical University.Methods: The questionnaire was carried out among clinical medic...Objective: To investigate the model, quality as well as effect of teaching-in-English in five-year clinical medicine program of Hainan Medical University.Methods: The questionnaire was carried out among clinical medicine undergraduates of2012–2015 grades in Hainan Medical University, to investigate studying time, studying habits and the impact of teaching in English. Additionally results of CET-4, CET-6 and overseas internship from undergraduates of 2012–2015 grade, as well as the result of phased medical licensing examination and post-graduate entrance examination from undergraduates of 2012 were accordingly collected from the Teaching Management Department.Results: For the Chinese students in international classes, the average time of self-study was 161.49 min, 58.3% had preview before classes, and 90.7% had habit of review after classes. Thus the first time pass rate, total pass rate, first time excellent rate and total excellent rate of CET-4 and CET-6 of international classes were significantly higher than those of regular classes. The result of post-graduate entrance examination in 2016 showed that the score, pass rate and acceptance rate of international classes of 2012 grade were significantly higher those of regular classes(P < 0.01).Conclusions: Teaching-in-English reform in Hainan Medical University has achieved initial success. Chinese students from international classes are superior to those from regular classes in many aspects. However, there are still many problems, and effective measures should be implemented to promote teaching quality continuously.展开更多
Objective:To explore how to choose the center locations to build the medical and health supplies reserve among many island towns.Methods:The center locations were selected from 18 towns Hainan Province,it's maximu...Objective:To explore how to choose the center locations to build the medical and health supplies reserve among many island towns.Methods:The center locations were selected from 18 towns Hainan Province,it's maximum service range(distance)was required to reach the minimum,or to minimize.Results:Three scenarios were considered,the center locations included only one town,two towns,three towns.By the use of graph theory and MATLAB programming,a mathematical model was established to obtain the shortest distance and the shortest path between arbitrary two towns.Conclusions:We find out the center sites under certain conditions,and determine the specific service ranges of the center sites.展开更多
BACKGROUND Wild rats have the potential to hold zoonotic infectious agents that can spread to humans and cause disease.AIM To better understand the composition of gut bacterial communities in rats is essential for pre...BACKGROUND Wild rats have the potential to hold zoonotic infectious agents that can spread to humans and cause disease.AIM To better understand the composition of gut bacterial communities in rats is essential for preventing and treating such diseases.As a tropical island located in the south of China,Hainan province has abundant rat species.Here,we examined the gut bacterial composition in wild adult rats from Hainan province.METHODS Fresh fecal samples were collected from 162 wild adult rats,including three species(Rattus norvegicus,Leopoldamys edwardsi,and Rattus losea),from nine regions of Hainan province between 2017-2018.RESULTS We analyzed the composition of gut microbiota using the 16S rRNA gene amplicon sequencing.We identified 4903 bacterial operational taxonomic units(30 phyla,175 families,and 498 genera),which vary between samples of different rat species in various habitats at various times of the year.In general,Firmicutes were the most abundant phyla,followed by Bacteroidetes(15.55%),Proteobacteria(6.13%),and Actinobacteria(4.02%).The genus Lactobacillus(20.08%),unidentified_Clostridiales(5.16%),Romboutsia(4.33%),unidentified_Ruminococcaceae(3.83%),Bacteroides(3.66%),Helicobacter(2.40%)and Streptococcus(2.37%)were dominant.CONCLUSION The composition and abundance of the gut microbial communities varied between rat species and locations.This work provides fundamental information to identify microbial communities useful for disease control in Hainan province.展开更多
The devastating COVID-19 pandemic over the past three years has made One Health a trending philosophy not only as a regional and national initiative but also as transboundary efforts calling for multilateral cooperati...The devastating COVID-19 pandemic over the past three years has made One Health a trending philosophy not only as a regional and national initiative but also as transboundary efforts calling for multilateral cooperations.Mwatondo et al.presented One Health Networks in a recent article published in The Lancet,calling for further promotion of the One Health approach[1].Likewise,recent studies in developing countries described the rapid adoption of One Health concepts globally and the major advances in practice of One Health in the past two decades[2-4].In this perspective,we highlight a pilot One Health program China spearheaded by the World Bank and the provincial government of Hainan.This pilot program aims to boost our awareness of preventing and combating emerging infectious diseases using the One Health approach[5].展开更多
Objective This study aimed to determine the HIV-1 subtype distribution and HIV drug resistance(HIVDR)in patients with ART failure from 2014 to 2020 in Hainan,China.Methods A 7-year cross-sectional study was conducted ...Objective This study aimed to determine the HIV-1 subtype distribution and HIV drug resistance(HIVDR)in patients with ART failure from 2014 to 2020 in Hainan,China.Methods A 7-year cross-sectional study was conducted among HIV/AIDS patients with ART failure in Hainan.We used online subtyping tools and the maximum likelihood phylogenetic tree to confirm the HIV subtypes with pol sequences.Drug resistance mutations(DRMs)were analyzed using the Stanford University HIV Drug Resistance Database.Results A total of 307 HIV-infected patients with ART failure were included,and 241 available pol sequences were obtained.Among 241 patients,CRF01_AE accounted for 68.88%,followed by CRF07_BC(17.00%)and eight other subtypes(14.12%).The overall prevalence of HIVDR was 61.41%,and the HIVDR against non-nucleoside reverse transcriptase inhibitors(NNRTIs),nucleotide reverse transcriptase inhibitors(NRTIs),and protease inhibitors(PIs)were 59.75%,45.64%,and 2.49%,respectively.Unemployed patients,hypoimmunity or opportunistic infections in individuals,and samples from 2017 to 2020 increased the odd ratios of HIVDR.Also,HIVDR was less likely to affect female patients.The common DRMs to NNRTIs were K103N(21.99%)and Y181C(20.33%),and M184V(28.21%)and K65R(19.09%)were the main DRMs against NRTIs.Conclusion The present study highlights the HIV-1 subtype diversity in Hainan and the importance of HIVDR surveillance over a long period.展开更多
The application of single-cell RNA sequencing(scRNA-seq)in biomedical research has advanced our understanding of the pathogenesis of disease and provided valuable insights into new diagnostic and therapeutic strategie...The application of single-cell RNA sequencing(scRNA-seq)in biomedical research has advanced our understanding of the pathogenesis of disease and provided valuable insights into new diagnostic and therapeutic strategies.With the expansion of capacity for high-throughput scRNA-seq,including clinical samples,the analysis of these huge volumes of data has become a daunting prospect for researchers entering this field.Here,we review the workflow for typical scRNA-seq data analysis,covering raw data processing and quality control,basic data analysis applicable for almost all scRNA-seq data sets,and advanced data analysis that should be tailored to specific scientific questions.While summarizing the current methods for each analysis step,we also provide an online repository of software and wrapped-up scripts to support the implementation.Recommendations and caveats are pointed out for some specific analysis tasks and approaches.We hope this resource will be helpful to researchers engaging with scRNA-seq,in particular for emerging clinical applications.展开更多
Objective:To explore the correlation between coronary heart disease related genes and coronary heart disease in hospitalized patients in Hainan,and to provide theoretical basis for enriching the screening methods of h...Objective:To explore the correlation between coronary heart disease related genes and coronary heart disease in hospitalized patients in Hainan,and to provide theoretical basis for enriching the screening methods of high-risk groups of coronary heart disease in Hainan,and optimizing the prevention and treatment strategies.Methods:We select hospitalized patients born in Hainan and aged>30 years old from the Second Affiliated Hospital of Hainan Medical Unversity between January 1,2020 and June 30,2022,and divided the patients into the coronary heart disease group and the non-coronary heart disease group.PCR real-time fluorescence was used to measure gene expression,and Spearman correlation analysis was used to explore the correlation between gene expression and coronary heart disease.Results:A total of 55 whole blood samples were collected from non-coronary heart disease patients(including 26 women and 29 men),with a median age of 57 years,and 170 whole blood samples from coronary heart disease patients(including 44 women and 126 men),with a median age of 63.17.Apolipoprotein B gene(ApoB)was highly expressed in patients with coronary heart disease(P<0.001);AGT gene(P=0.0158),ApoE gene(P=0.0126),FGB gene(P=0.005),GNB gene(P=0.0151),MTFHR gene(P=0.0119),SEL gene(P=0.005),TNF gene(P=0.0298)were significantly overexpressed in the non-coronary heart disease group.The expression of NOS3 gene(P=0.3047),IL6 gene(P=0.7239),ACE gene(P=0.7852)was not different between the two groups.Coronary heart disease was negatively correlated with AGT gene(r=-0.163,P=0.011,P<0.05),positively correlated with APOB gene(r=0.75,P=0,P<0.01),negatively correlated with FGB gene(r=-0.163,P=0.011,P<0.05),negatively correlated with GNB gene(r=-0.165,P=0.011,P<0.05),negatively correlated withSEL gene(r=-0.171,P=0.007,P<0.01),negatively correlated with MHTHR gene(r=-0.210,P=0.001,P<0.01)and negatively correlated with TNF gene(r=-0.131,P=0.04,P<0.05),but coronary heart disease was not correlated with APOE,NOS3,ACE,IL6 and other genes(P>0.05).The ApoB gene of coronary heart disease was negatively correlated with triglyceride(r=-0.461,P=0),positively correlated with age(r=0.173,P=0.009),positively correlated with total cholesterol(r=0.499,P=0),negatively correlated with high-density lipoprotein(r=-0.181,P=0.007),and negatively correlated with low-density lipoprotein(r=-0.143,P=0.031).Conclusion:(1)The detection of apolipoprotein B gene expression may be used as an indicator for screening coronary heart disease in the coronary population in Hainan.It may increase the risk of coronary heart disease by affecting the level of total cholesterol.A larger sample of research is still needed.(2)AGT,ApoE,FGB,GNB,MTFHR,SELE,TNF and other genes may be the protective genes of non-coronary heart disease population in Hainan,and the high expression of these genes may reduce the occurrence of coronary heart disease,which still needs further study.展开更多
[Objectives]Peptides was extracted from Haemadipsa hainana and its activity was studied.[Methods]Electric stimulation,water extraction and ultrasonic extraction were used to extract the peptides from H.hainana.Then th...[Objectives]Peptides was extracted from Haemadipsa hainana and its activity was studied.[Methods]Electric stimulation,water extraction and ultrasonic extraction were used to extract the peptides from H.hainana.Then the protein content and molecular weight distribution of H.hainana peptides were detected by the BCA method and SDS-PAGE method,respectively.The antithrombin activity and analgesic activity of the three peptide extracts of H.hainana were detected by Markwardt thrombin titration method and mouse hot plate experiment,respectively.[Results]There extraction methods of electric stimulation,water extraction and ultrasonic extraction were used to extract the peptide extract of H.hainana,and the yields were as follows:water extraction>electrical stimulation>ultrasonic extraction.The three peptide extracts from H.hainana had antithrombin activity,and the antithrombin activity was as follows:water extraction>ultrasonic extraction>electrical stimulation.Through the hot plate experiment in mice,it was verified that the three peptide extracts of H.hainana had analgesic activity,and the analgesic activity was water extraction>electric stimulation>ultrasonic extraction.The analgesic activity of high-dose(100 mg/kg)group of H.hainana obtained by water extraction was slightly weaker than that of tramadol.[Conclusions]This study confirmed that the peptide extract of H.hainana had certain antithrombin and analgesic activity,laying a foundation for the subsequent development and application of H.hainana.展开更多
Objective:The integration of training in theory and practice across the medical education spectrum is being encouraged to increase student understanding and skills in the sciences.This study aimed to determine the dec...Objective:The integration of training in theory and practice across the medical education spectrum is being encouraged to increase student understanding and skills in the sciences.This study aimed to determine the deciding factors that drive students'perceived advantages in class to improve precision education and the teaching model.Methods:A mixed strategy of an existing flipped classroom(FC)and a case-based learning(CBL)model was conducted in a medical morphology curriculum for 575 postgraduate students.The subjective learning evaluation of the individuals(learning time,engagement,study interest and concentration,and professional integration)was collected and analyzed after FC-CBL model learning.Results:The results from the general evaluation showed promising results of the medical morphology in the FC-CBL model.Students felt more engaged by instructors in person and benefited in terms of time-saving,flexible arrangements,and professional improvement.Our study contributed to the FC-CBL model in Research Design in postgraduate training in 4 categories:1)advancing a guideline of precision teaching according to individual characteristics;2)revealing whether a learning background is needed for a Research Design course to guide setting up a preliminary course;3)understanding the perceived advantages and their interfaces;and 4)barriers and/or improvement to implement the FC-CBL model in the Research Design class,such as a richer description of e-learning and hands-on practice.Conclusion:Undertaking a FC-CBL combined model could be a useful addition to pedagogy for medical morphology learning in postgraduate training.展开更多
Based on constructivism theory and task-driven teaching methods,medical Chinese teaching gradually transitions from the current teaching mode to a“student-centered”teaching mode.The ideological elements are integrat...Based on constructivism theory and task-driven teaching methods,medical Chinese teaching gradually transitions from the current teaching mode to a“student-centered”teaching mode.The ideological elements are integrated into the medical Chinese teaching curriculum,guiding students in acquiring medical Chinese language skills while instilling a spirit of humanistic care and professional ethics inherent in the medical profession.展开更多
Objective:To explore the balance of peripheral blood T helper 17 cells/regulatory T cell(Th17/Treg)ratio and the polarization ratio of M1 and M2 macrophages in lower extremity arteriosclerosis obliterans(ASO).Methods:...Objective:To explore the balance of peripheral blood T helper 17 cells/regulatory T cell(Th17/Treg)ratio and the polarization ratio of M1 and M2 macrophages in lower extremity arteriosclerosis obliterans(ASO).Methods:A rat model of lower extremity ASO was established,and blood samples from patients with lower extremity ASO before and after surgery were obtained.ELISA was used to detect interleukin 6(IL-6),IL-10,and IL-17.Real-time RCR and Western blot analyses were used to detect Foxp3,IL-6,IL-10,and IL-17 expression.Moreover,flow cytometry was applied to detect the Th17/Treg ratio and M1/M2 ratio.Results:Compared with the control group,the iliac artery wall of ASO rats showed significant hyperplasia,and the concentrations of cholesterol and triglyceride were significantly increased(P<0.01),indicating the successful establishment of ASO.Moreover,the levels of IL-6 and IL-17 in ASO rats were pronouncedly increased(P<0.05),while the IL-10 level was significantly decreased(P<0.05).In addition to increased IL-6 and IL-17 levels,the mRNA and protein levels of Foxp3 and IL-10 in ASO rats were significantly decreased compared with the control group.The Th17/Treg and M1/M2 ratios in the ASO group were markedly increased(P<0.05).These alternations were also observed in ASO patients.After endovascular surgery(such as percutaneous transluminal angioplasty and arterial stenting),all these changes were significantly improved(P<0.05).Conclusions:The Th17/Treg and M1/M2 ratios were significantly increased in ASO,and surgery can effectively improve the balance of Th17/Treg,and reduce the ratio of M1/M2,and the expression of inflammatory factors.展开更多
BACKGROUND Fecal microbiota transplantation(FMT)is a promising therapeutic approach for treating Crohn’s disease(CD).The new method of FMT,based on the automatic washing process,was named as washed microbiota transpl...BACKGROUND Fecal microbiota transplantation(FMT)is a promising therapeutic approach for treating Crohn’s disease(CD).The new method of FMT,based on the automatic washing process,was named as washed microbiota transplantation(WMT).Most existing studies have focused on observing the clinical phenomena.However,the mechanism of action of FMT for the effective management of CD-particularly in-depth multi-omics analysis involving the metagenome,metatranscriptome,and metabolome-has not yet been reported.AIM To assess the efficacy of WMT for CD and explore alterations in the microbiome and metabolome in response to WMT.METHODS We conducted a prospective,open-label,single-center clinical study.Eleven CD patients underwent WMT.Their clinical responses(defined as a decrease in their CD Activity Index score of>100 points)and their microbiome(metagenome,metatranscriptome)and metabolome profiles were evaluated three months after the procedure.RESULTS Seven of the 11 patients(63.6%)showed an optimal clinical response three months post-WMT.Gut microbiome diversity significantly increased after WMT,consistent with improved clinical symptoms.Comparison of the metagenome and metatranscriptome analyses revealed consistent alterations in certain strains,such as Faecalibac-terium prausnitzii,Roseburia intestinalis,and Escherichia coli.In addition,metabolomics analyses demonstrated that CD patients had elevated levels of various amino acids before treatment compared to the donors.However,levels of vital amino acids that may be associated with disease progression(e.g.,L-glutamic acid,gamma-glutamyl-leucine,and prolyl-glutamine)were reduced after WMT.CONCLUSION WMT demonstrated therapeutic efficacy in CD treatment,likely due to the effective reconstruction of the patient’s microbiome.Multi-omics techniques can effectively help decipher the potential mechanisms of WMT in treating CD.展开更多
Background:In this study,we used network pharmacology and molecular docking combined with vitro experiments to explore the potential mechanism of action of Gualou Qumai pill(GLQMP)against DKD.Methods:We screened effec...Background:In this study,we used network pharmacology and molecular docking combined with vitro experiments to explore the potential mechanism of action of Gualou Qumai pill(GLQMP)against DKD.Methods:We screened effective compounds and drug targets using Chinese medicine systemic pharmacology database and analysis platform and Chinese medicine molecular mechanism bioinformatics analysis tools;and searched for DKD targets using human online Mendelian genetics and gene cards.The potential targets of GLQMP for DKD were obtained through the intersection of drug targets and disease targets.Cytoscape software was applied to build herbal medicine-active compound-target-disease networks and analyze them;protein-protein interaction networks were analyzed using the STRING database platform;gene ontology and Kyoto Encyclopedia of Genes and Genomes were used for gene ontology and gene and genome encyclopedia to enrich potential targets using the DAVID database;and the AutoDock Vina 1.1.2 software for molecular docking of key targets with corresponding key components.In vitro experiments were validated by CCK8,oil red O staining,TC,TG,RT-qPCR,and Western blot.Results:Through network pharmacology analysis,a total of 99 potential therapeutic targets of GLQMP for DKD and the corresponding 38 active compounds were obtained,and 5 core compounds were identified.By constructing the protein-protein interaction network and performing network topology analysis,we found that PPARA and PPARG were the key targets,and then we molecularly docked these two key targets with the 38 active compounds,especially the 5 core compounds,and found that PPARA and PPARG had good binding ability with a variety of compounds.In vitro experiments showed that GLQMP was able to ameliorate HK-2 cell injury under high glucose stress,improve cell viability,reduce TC and TG levels as well as decrease the accumulation of lipid droplets,and RT-qPCR and Western blot confirmed that GLQMP was able to promote the expression levels of PPARA and PPARG.Conclusion:Overall,this study revealed the active compounds,important targets and possible mechanisms of GLQMP treatment for DKD,and conducted preliminary verification experiments on its correctness,provided novel insights into the treatment of DKD by GLQMP.展开更多
BACKGROUND Guidewire slippage into the peritoneal cavity during clinical operations is extremely rare.Therefore,this paper aims to report a successful case of guidewire removal using transgastric natural orifice trans...BACKGROUND Guidewire slippage into the peritoneal cavity during clinical operations is extremely rare.Therefore,this paper aims to report a successful case of guidewire removal using transgastric natural orifice transluminal endoscopic surgery(NOTES).The goal is to enhance physicians'understanding of the management plan for this unique scenario and provide a valuable reference for clinical practice.CASE SUMMARY A 64-year-old man presented with abdominal distension and was diagnosed with cirrhosis combined with massive ascites.To proceed with treatment,the patient underwent ultrasound-guided peritoneal puncture and underwent catheterization and drainage.Unfortunately,a 0.035-inch guidewire slipped into the abdominal cavity during the procedure.Following a comprehensive evaluation and consultation by a multidisciplinary team,the guidewire was successfully removed using NOTES.CONCLUSION This case highlights the potential consideration of transgastric NOTES removal when encountering a foreign body,such as a guidewire,within the abdominal cavity.展开更多
Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A c...Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023.Participants completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final analysis.Data were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent variables.Results:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural intention.Males,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk.Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.展开更多
Inflammatory bowel disease(IBD)is a complex and multifactorial disease characterized by chronic inflammation of the gastrointestinal tract,mainly manifested by the accumulation of immune cells and pro-inflammatory cyt...Inflammatory bowel disease(IBD)is a complex and multifactorial disease characterized by chronic inflammation of the gastrointestinal tract,mainly manifested by the accumulation of immune cells and pro-inflammatory cytokines in the intestinal mucosa.It is a kind of immune digestive system disease with high incidence in humans and can be divided into ulcerative colitis(UC)and Crohn's disease(CD).The pathogenesis of IBD is complex,and numerous studies have shown that genetic,environmental,microbial,immune,autophagy and other factors may be involved in the pathogenesis of IBD.MicroRNAs(miRNAs)play an important role in the pathophysiology of IBD.Studies have confirmed that miRNA play an important role in the targeted regulation of intestinal barrier homeostasis,immune response,and intestinal epithelial autophagy.MiRNA have not only been confirmed as important diagnostic biomarkers for IBD.It also shows new prospects for treatment strategies for IBD.This article mainly describes the differences in miRNA expression between UC and CD,summarizes the relationship between miRNA and intestinal barrier,immune homeostasis and autophagy mechanism in the pathogenesis of IBD,and the research progress of miRNA involved in the diagnosis and treatment of IBD,so as to provide new insights for the development of IBD.展开更多
In recent years,with the development of medical technology,the detection rate of cancer is getting higher and higher,and the population of patients is getting younger.Many studies have begun to study the early diagnos...In recent years,with the development of medical technology,the detection rate of cancer is getting higher and higher,and the population of patients is getting younger.Many studies have begun to study the early diagnosis,prognostic monitoring markers and pathogenesis of cancer.In recent years,with the development of bioinformatics technology,lncRNA have gradually attracted the attention of researchers.More and more studies have shown that lncRNA are responsible for various biological functions in the process of cancer progression.lncRNA MAFG-AS1 has been shown to be associated with multiple cancers,function as an oncogene,and is significantly associated with poor clinical features and prognosis.This article reviews the research progress of lncRNA MAFG-AS1 in cancer,hoping to provide some help for the future clinical diagnosis and treatment of cancer.展开更多
Watermarks can provide reliable and secure copyright protection for optical coherence tomography(OCT)fundus images.The effective image segmentation is helpful for promoting OCT image watermarking.However,OCT images ha...Watermarks can provide reliable and secure copyright protection for optical coherence tomography(OCT)fundus images.The effective image segmentation is helpful for promoting OCT image watermarking.However,OCT images have a large amount of low-quality data,which seriously affects the performance of segmentationmethods.Therefore,this paper proposes an effective segmentation method for OCT fundus image watermarking using a rough convolutional neural network(RCNN).First,the rough-set-based feature discretization module is designed to preprocess the input data.Second,a dual attention mechanism for feature channels and spatial regions in the CNN is added to enable the model to adaptively select important information for fusion.Finally,the refinement module for enhancing the extraction power of multi-scale information is added to improve the edge accuracy in segmentation.RCNN is compared with CE-Net and MultiResUNet on 83 gold standard 3D retinal OCT data samples.The average dice similarly coefficient(DSC)obtained by RCNN is 6%higher than that of CE-Net.The average 95 percent Hausdorff distance(95HD)and average symmetric surface distance(ASD)obtained by RCNN are 32.4%and 33.3%lower than those of MultiResUNet,respectively.We also evaluate the effect of feature discretization,as well as analyze the initial learning rate of RCNN and conduct ablation experiments with the four different models.The experimental results indicate that our method can improve the segmentation accuracy of OCT fundus images,providing strong support for its application in medical image watermarking.展开更多
Objective:To assess the predictive value of systemic immune inflammation index(SII)for sepsis in low-and medium-risk community-acquired pneumonia.Methods:A total of 589 elderly patients with low-and medium-risk commun...Objective:To assess the predictive value of systemic immune inflammation index(SII)for sepsis in low-and medium-risk community-acquired pneumonia.Methods:A total of 589 elderly patients with low-and medium-risk community-acquired pneumonia admitted to the Emergency Department of the Second Affiliated Hospital of Hainan Medical University from January 2020 to January 2023 were included as the research subjects,and the general information and laboratory test results of the patients were collected,and the optimal cut-off value of continuous variables for predicting sepsis in elderly patients with low-and medium-risk community-acquired pneumonia was determined by plotting the receiver work characteristic(ROC)curve,which was converted into dichotomous variables and univariate and multivariate logistic Regression analysis of the influencing factors of sepsis in elderly patients with low-and medium-risk community-acquired pneumonia.Based on this,a nomogram model is constructed to predict the risk of sepsis.The differentiation,consistency and accuracy of the model were verified by calibration curve and subject operating characteristic(ROC)curve,and the clinical utility of the model was determined by decision curve analysis.Results:A total of 589 elderly patients with low-and intermediate-risk community-acquired pneumonia were included in this study,of which 96(16.30%)developed sepsis.There were significant differences in age,diabetes mellitus and chronic obstructive pulmonary disease,Lac,PCT,SII and other indexes between sepsis and non-sepsis groups(P<0.05).Logistics regression analysis showed that age,diabetes mellitus and chronic obstructive pulmonary disease,Lac,and SII were independent risk factors for sepsis in elderly patients with low-and medium-risk community-acquired pneumonia.The nomogram prediction model was used to verify the results,and the AUC was 0.826(95%CI:0.780-0.872),and the calibration curve tended to the ideal curve with good accuracy.The decision curve shows that when the threshold of the model is between 0.10~0.78,the model has the advantage of clinical benefit.Conclusion:The nomogram prediction model constructed based on SII to predict sepsis in elderly patients with low-and medium-risk community-acquired pneumonia has good accuracy,which can predict the occurrence of sepsis early,help early identification of high-risk groups and timely intervention,and thus improve the prognosis of patients.展开更多
Breast cancer is a critical threat to women around the globe. Current radio- and chemotherapy regimens can induce multiple drug-resistant effects, e.g., anti-apoptosis, anti-pyroptosis, and anti-necroptosis, causing a...Breast cancer is a critical threat to women around the globe. Current radio- and chemotherapy regimens can induce multiple drug-resistant effects, e.g., anti-apoptosis, anti-pyroptosis, and anti-necroptosis, causing a poor clinical response to therapy. Ferroptosis is a newly programmed cell death characterized by iron overload, the massive production of reactive oxygen species (ROS), and membrane lipid peroxidation. The occurrence of ferroptosis results from an imbalance between peroxidation mechanisms (execution systems) and anti- oxidation mechanisms (defense systems), including the iron metabolism pathway, amino acid metabolism pathway, and lipid metabolism pathway. Recently, the vital role of ferroptosis in various diseases, including cancer, hypertension, diabetes, and Alzheimer's, has been identified. Specifically, triggering ferroptosis in breast cancer cells can inhibit their proliferation and invasion, and improve the chemoradiotherapy sensitivity, which makes it a potential strategy for breast cancer therapy. This review summarizes the definition and features of ferroptosis, as well as its role in the treatment of breast cancer, aimed at providing a theoretical basis for future drug development.展开更多
基金supported by Key Research and Development Project of Hainan Province(Grant No ZDXM2017123)
文摘Objective: To investigate the model, quality as well as effect of teaching-in-English in five-year clinical medicine program of Hainan Medical University.Methods: The questionnaire was carried out among clinical medicine undergraduates of2012–2015 grades in Hainan Medical University, to investigate studying time, studying habits and the impact of teaching in English. Additionally results of CET-4, CET-6 and overseas internship from undergraduates of 2012–2015 grade, as well as the result of phased medical licensing examination and post-graduate entrance examination from undergraduates of 2012 were accordingly collected from the Teaching Management Department.Results: For the Chinese students in international classes, the average time of self-study was 161.49 min, 58.3% had preview before classes, and 90.7% had habit of review after classes. Thus the first time pass rate, total pass rate, first time excellent rate and total excellent rate of CET-4 and CET-6 of international classes were significantly higher than those of regular classes. The result of post-graduate entrance examination in 2016 showed that the score, pass rate and acceptance rate of international classes of 2012 grade were significantly higher those of regular classes(P < 0.01).Conclusions: Teaching-in-English reform in Hainan Medical University has achieved initial success. Chinese students from international classes are superior to those from regular classes in many aspects. However, there are still many problems, and effective measures should be implemented to promote teaching quality continuously.
基金National Natural Science Foundation(81060160)National Natural Science Foundation(71263014)+1 种基金Natural Science Foundation of Hainan Province(811209)Natural Science Foundation of Hainan Province(110005)
文摘Objective:To explore how to choose the center locations to build the medical and health supplies reserve among many island towns.Methods:The center locations were selected from 18 towns Hainan Province,it's maximum service range(distance)was required to reach the minimum,or to minimize.Results:Three scenarios were considered,the center locations included only one town,two towns,three towns.By the use of graph theory and MATLAB programming,a mathematical model was established to obtain the shortest distance and the shortest path between arbitrary two towns.Conclusions:We find out the center sites under certain conditions,and determine the specific service ranges of the center sites.
基金Supported by Hainan Province Science and Technology Special Fund,No.ZDYF2022SHFZ114Hainan Provincial Natural Science Foundation of China,No.820RC650+1 种基金National Natural Science Foundation of China,No.82060377Innovative Research Project for Graduate Students of Hainan Medical University,No.HYYS2020-18,No.HYYS2021A09,and No.HYYS2021A22.
文摘BACKGROUND Wild rats have the potential to hold zoonotic infectious agents that can spread to humans and cause disease.AIM To better understand the composition of gut bacterial communities in rats is essential for preventing and treating such diseases.As a tropical island located in the south of China,Hainan province has abundant rat species.Here,we examined the gut bacterial composition in wild adult rats from Hainan province.METHODS Fresh fecal samples were collected from 162 wild adult rats,including three species(Rattus norvegicus,Leopoldamys edwardsi,and Rattus losea),from nine regions of Hainan province between 2017-2018.RESULTS We analyzed the composition of gut microbiota using the 16S rRNA gene amplicon sequencing.We identified 4903 bacterial operational taxonomic units(30 phyla,175 families,and 498 genera),which vary between samples of different rat species in various habitats at various times of the year.In general,Firmicutes were the most abundant phyla,followed by Bacteroidetes(15.55%),Proteobacteria(6.13%),and Actinobacteria(4.02%).The genus Lactobacillus(20.08%),unidentified_Clostridiales(5.16%),Romboutsia(4.33%),unidentified_Ruminococcaceae(3.83%),Bacteroides(3.66%),Helicobacter(2.40%)and Streptococcus(2.37%)were dominant.CONCLUSION The composition and abundance of the gut microbial communities varied between rat species and locations.This work provides fundamental information to identify microbial communities useful for disease control in Hainan province.
文摘The devastating COVID-19 pandemic over the past three years has made One Health a trending philosophy not only as a regional and national initiative but also as transboundary efforts calling for multilateral cooperations.Mwatondo et al.presented One Health Networks in a recent article published in The Lancet,calling for further promotion of the One Health approach[1].Likewise,recent studies in developing countries described the rapid adoption of One Health concepts globally and the major advances in practice of One Health in the past two decades[2-4].In this perspective,we highlight a pilot One Health program China spearheaded by the World Bank and the provincial government of Hainan.This pilot program aims to boost our awareness of preventing and combating emerging infectious diseases using the One Health approach[5].
基金supported by grants from the 2021 Graduate Education Innovation Program Project of Guangxi Zhuang Autonomous Region [YCBZ2021041]the National innovative training program for college students [202100001580]grants from the National Natural Science Foundation of China [NSFC,31860040]。
文摘Objective This study aimed to determine the HIV-1 subtype distribution and HIV drug resistance(HIVDR)in patients with ART failure from 2014 to 2020 in Hainan,China.Methods A 7-year cross-sectional study was conducted among HIV/AIDS patients with ART failure in Hainan.We used online subtyping tools and the maximum likelihood phylogenetic tree to confirm the HIV subtypes with pol sequences.Drug resistance mutations(DRMs)were analyzed using the Stanford University HIV Drug Resistance Database.Results A total of 307 HIV-infected patients with ART failure were included,and 241 available pol sequences were obtained.Among 241 patients,CRF01_AE accounted for 68.88%,followed by CRF07_BC(17.00%)and eight other subtypes(14.12%).The overall prevalence of HIVDR was 61.41%,and the HIVDR against non-nucleoside reverse transcriptase inhibitors(NNRTIs),nucleotide reverse transcriptase inhibitors(NRTIs),and protease inhibitors(PIs)were 59.75%,45.64%,and 2.49%,respectively.Unemployed patients,hypoimmunity or opportunistic infections in individuals,and samples from 2017 to 2020 increased the odd ratios of HIVDR.Also,HIVDR was less likely to affect female patients.The common DRMs to NNRTIs were K103N(21.99%)and Y181C(20.33%),and M184V(28.21%)and K65R(19.09%)were the main DRMs against NRTIs.Conclusion The present study highlights the HIV-1 subtype diversity in Hainan and the importance of HIVDR surveillance over a long period.
基金suppor ted by the National Key Research and Development Program of China (2022YFC2702502)the National Natural Science Foundation of China (32170742, 31970646, and 32060152)+7 种基金the Start Fund for Specially Appointed Professor of Jiangsu ProvinceHainan Province Science and Technology Special Fund (ZDYF2021SHFZ051)the Natural Science Foundation of Hainan Province (820MS053)the Start Fund for High-level Talents of Nanjing Medical University (NMUR2020009)the Marshal Initiative Funding of Hainan Medical University (JBGS202103)the Hainan Province Clinical Medical Center (QWYH202175)the Bioinformatics for Major Diseases Science Innovation Group of Hainan Medical Universitythe Shenzhen Science and Technology Program (JCYJ20210324140407021)
文摘The application of single-cell RNA sequencing(scRNA-seq)in biomedical research has advanced our understanding of the pathogenesis of disease and provided valuable insights into new diagnostic and therapeutic strategies.With the expansion of capacity for high-throughput scRNA-seq,including clinical samples,the analysis of these huge volumes of data has become a daunting prospect for researchers entering this field.Here,we review the workflow for typical scRNA-seq data analysis,covering raw data processing and quality control,basic data analysis applicable for almost all scRNA-seq data sets,and advanced data analysis that should be tailored to specific scientific questions.While summarizing the current methods for each analysis step,we also provide an online repository of software and wrapped-up scripts to support the implementation.Recommendations and caveats are pointed out for some specific analysis tasks and approaches.We hope this resource will be helpful to researchers engaging with scRNA-seq,in particular for emerging clinical applications.
基金This study was supported by the High-level Talents Project of Hainan Basic and Applied Basic Research Program(Natural Sciences)in 2019(2019RC382)。
文摘Objective:To explore the correlation between coronary heart disease related genes and coronary heart disease in hospitalized patients in Hainan,and to provide theoretical basis for enriching the screening methods of high-risk groups of coronary heart disease in Hainan,and optimizing the prevention and treatment strategies.Methods:We select hospitalized patients born in Hainan and aged>30 years old from the Second Affiliated Hospital of Hainan Medical Unversity between January 1,2020 and June 30,2022,and divided the patients into the coronary heart disease group and the non-coronary heart disease group.PCR real-time fluorescence was used to measure gene expression,and Spearman correlation analysis was used to explore the correlation between gene expression and coronary heart disease.Results:A total of 55 whole blood samples were collected from non-coronary heart disease patients(including 26 women and 29 men),with a median age of 57 years,and 170 whole blood samples from coronary heart disease patients(including 44 women and 126 men),with a median age of 63.17.Apolipoprotein B gene(ApoB)was highly expressed in patients with coronary heart disease(P<0.001);AGT gene(P=0.0158),ApoE gene(P=0.0126),FGB gene(P=0.005),GNB gene(P=0.0151),MTFHR gene(P=0.0119),SEL gene(P=0.005),TNF gene(P=0.0298)were significantly overexpressed in the non-coronary heart disease group.The expression of NOS3 gene(P=0.3047),IL6 gene(P=0.7239),ACE gene(P=0.7852)was not different between the two groups.Coronary heart disease was negatively correlated with AGT gene(r=-0.163,P=0.011,P<0.05),positively correlated with APOB gene(r=0.75,P=0,P<0.01),negatively correlated with FGB gene(r=-0.163,P=0.011,P<0.05),negatively correlated with GNB gene(r=-0.165,P=0.011,P<0.05),negatively correlated withSEL gene(r=-0.171,P=0.007,P<0.01),negatively correlated with MHTHR gene(r=-0.210,P=0.001,P<0.01)and negatively correlated with TNF gene(r=-0.131,P=0.04,P<0.05),but coronary heart disease was not correlated with APOE,NOS3,ACE,IL6 and other genes(P>0.05).The ApoB gene of coronary heart disease was negatively correlated with triglyceride(r=-0.461,P=0),positively correlated with age(r=0.173,P=0.009),positively correlated with total cholesterol(r=0.499,P=0),negatively correlated with high-density lipoprotein(r=-0.181,P=0.007),and negatively correlated with low-density lipoprotein(r=-0.143,P=0.031).Conclusion:(1)The detection of apolipoprotein B gene expression may be used as an indicator for screening coronary heart disease in the coronary population in Hainan.It may increase the risk of coronary heart disease by affecting the level of total cholesterol.A larger sample of research is still needed.(2)AGT,ApoE,FGB,GNB,MTFHR,SELE,TNF and other genes may be the protective genes of non-coronary heart disease population in Hainan,and the high expression of these genes may reduce the occurrence of coronary heart disease,which still needs further study.
基金Supported by"2020 Hainan Provincial Higher Education Teaching Reform Research and Scientific Research"Project of The Education Department of Hainan Province(Hnky2020-76)Research Fund of Hainan Health Management College(2020ZR01)。
文摘[Objectives]Peptides was extracted from Haemadipsa hainana and its activity was studied.[Methods]Electric stimulation,water extraction and ultrasonic extraction were used to extract the peptides from H.hainana.Then the protein content and molecular weight distribution of H.hainana peptides were detected by the BCA method and SDS-PAGE method,respectively.The antithrombin activity and analgesic activity of the three peptide extracts of H.hainana were detected by Markwardt thrombin titration method and mouse hot plate experiment,respectively.[Results]There extraction methods of electric stimulation,water extraction and ultrasonic extraction were used to extract the peptide extract of H.hainana,and the yields were as follows:water extraction>electrical stimulation>ultrasonic extraction.The three peptide extracts from H.hainana had antithrombin activity,and the antithrombin activity was as follows:water extraction>ultrasonic extraction>electrical stimulation.Through the hot plate experiment in mice,it was verified that the three peptide extracts of H.hainana had analgesic activity,and the analgesic activity was water extraction>electric stimulation>ultrasonic extraction.The analgesic activity of high-dose(100 mg/kg)group of H.hainana obtained by water extraction was slightly weaker than that of tramadol.[Conclusions]This study confirmed that the peptide extract of H.hainana had certain antithrombin and analgesic activity,laying a foundation for the subsequent development and application of H.hainana.
基金supported by grants from the Hunan Province Academic Degree and Graduate Education Reform Project(No.2020JGYB028)the National Natural Science Foundation of China(No.81971891,No.82172196,No.81772134)+1 种基金the Key Laboratory of Emergency and Trauma(Hainan Medical University)of the Ministry of Education(No.KLET-202108)the College Students'Innovation and Entrepreneurship Project(No.S20210026020013).
文摘Objective:The integration of training in theory and practice across the medical education spectrum is being encouraged to increase student understanding and skills in the sciences.This study aimed to determine the deciding factors that drive students'perceived advantages in class to improve precision education and the teaching model.Methods:A mixed strategy of an existing flipped classroom(FC)and a case-based learning(CBL)model was conducted in a medical morphology curriculum for 575 postgraduate students.The subjective learning evaluation of the individuals(learning time,engagement,study interest and concentration,and professional integration)was collected and analyzed after FC-CBL model learning.Results:The results from the general evaluation showed promising results of the medical morphology in the FC-CBL model.Students felt more engaged by instructors in person and benefited in terms of time-saving,flexible arrangements,and professional improvement.Our study contributed to the FC-CBL model in Research Design in postgraduate training in 4 categories:1)advancing a guideline of precision teaching according to individual characteristics;2)revealing whether a learning background is needed for a Research Design course to guide setting up a preliminary course;3)understanding the perceived advantages and their interfaces;and 4)barriers and/or improvement to implement the FC-CBL model in the Research Design class,such as a richer description of e-learning and hands-on practice.Conclusion:Undertaking a FC-CBL combined model could be a useful addition to pedagogy for medical morphology learning in postgraduate training.
基金2021 Educational Research Project of Hainan Medical University“Research and Practice of Chinese Curriculum Evaluation System for International Students Majoring in Clinical Medicine”(HYYB202147)。
文摘Based on constructivism theory and task-driven teaching methods,medical Chinese teaching gradually transitions from the current teaching mode to a“student-centered”teaching mode.The ideological elements are integrated into the medical Chinese teaching curriculum,guiding students in acquiring medical Chinese language skills while instilling a spirit of humanistic care and professional ethics inherent in the medical profession.
基金supported by Natural Science Foundation of Hainan Province(820MS135)Hainan Provincial Health Commission 2023 Provincial Key Clinical Discipline(Clinical Medical Center)Construction Unit Fund Project(Qiongwei Yihan[2022]No.341)Hainan Provincial Health Technology Innovation Joint Project(WSJK2024MS209).
文摘Objective:To explore the balance of peripheral blood T helper 17 cells/regulatory T cell(Th17/Treg)ratio and the polarization ratio of M1 and M2 macrophages in lower extremity arteriosclerosis obliterans(ASO).Methods:A rat model of lower extremity ASO was established,and blood samples from patients with lower extremity ASO before and after surgery were obtained.ELISA was used to detect interleukin 6(IL-6),IL-10,and IL-17.Real-time RCR and Western blot analyses were used to detect Foxp3,IL-6,IL-10,and IL-17 expression.Moreover,flow cytometry was applied to detect the Th17/Treg ratio and M1/M2 ratio.Results:Compared with the control group,the iliac artery wall of ASO rats showed significant hyperplasia,and the concentrations of cholesterol and triglyceride were significantly increased(P<0.01),indicating the successful establishment of ASO.Moreover,the levels of IL-6 and IL-17 in ASO rats were pronouncedly increased(P<0.05),while the IL-10 level was significantly decreased(P<0.05).In addition to increased IL-6 and IL-17 levels,the mRNA and protein levels of Foxp3 and IL-10 in ASO rats were significantly decreased compared with the control group.The Th17/Treg and M1/M2 ratios in the ASO group were markedly increased(P<0.05).These alternations were also observed in ASO patients.After endovascular surgery(such as percutaneous transluminal angioplasty and arterial stenting),all these changes were significantly improved(P<0.05).Conclusions:The Th17/Treg and M1/M2 ratios were significantly increased in ASO,and surgery can effectively improve the balance of Th17/Treg,and reduce the ratio of M1/M2,and the expression of inflammatory factors.
基金Supported by the Innovation Platform for Academicians of Hainan Province,No.YSPTZX202313Hainan Province Clinical Medical Center,No.2021818+3 种基金Hainan Provincial Health Industry Research Project,No.22A200078Hainan Provincial Postgraduate Innovation Research Project,No.Qhyb2022-133Hainan Medical University Graduate Student Innovative Research Project,No.HYYB2022A18Nanjing Medical University Fan Daiming Research Funds for Holistic Integrative Medicine,No.2020-3HIM.
文摘BACKGROUND Fecal microbiota transplantation(FMT)is a promising therapeutic approach for treating Crohn’s disease(CD).The new method of FMT,based on the automatic washing process,was named as washed microbiota transplantation(WMT).Most existing studies have focused on observing the clinical phenomena.However,the mechanism of action of FMT for the effective management of CD-particularly in-depth multi-omics analysis involving the metagenome,metatranscriptome,and metabolome-has not yet been reported.AIM To assess the efficacy of WMT for CD and explore alterations in the microbiome and metabolome in response to WMT.METHODS We conducted a prospective,open-label,single-center clinical study.Eleven CD patients underwent WMT.Their clinical responses(defined as a decrease in their CD Activity Index score of>100 points)and their microbiome(metagenome,metatranscriptome)and metabolome profiles were evaluated three months after the procedure.RESULTS Seven of the 11 patients(63.6%)showed an optimal clinical response three months post-WMT.Gut microbiome diversity significantly increased after WMT,consistent with improved clinical symptoms.Comparison of the metagenome and metatranscriptome analyses revealed consistent alterations in certain strains,such as Faecalibac-terium prausnitzii,Roseburia intestinalis,and Escherichia coli.In addition,metabolomics analyses demonstrated that CD patients had elevated levels of various amino acids before treatment compared to the donors.However,levels of vital amino acids that may be associated with disease progression(e.g.,L-glutamic acid,gamma-glutamyl-leucine,and prolyl-glutamine)were reduced after WMT.CONCLUSION WMT demonstrated therapeutic efficacy in CD treatment,likely due to the effective reconstruction of the patient’s microbiome.Multi-omics techniques can effectively help decipher the potential mechanisms of WMT in treating CD.
基金supported by the grants from National Natural Science Foundation of China(No.82174334)Hainan Provincial Key Laboratory of Tropical Brain Science Research and Transformation Research Project(JCKF2021001)Innovative Research Projects for Graduate Students(HYYS2021B01).
文摘Background:In this study,we used network pharmacology and molecular docking combined with vitro experiments to explore the potential mechanism of action of Gualou Qumai pill(GLQMP)against DKD.Methods:We screened effective compounds and drug targets using Chinese medicine systemic pharmacology database and analysis platform and Chinese medicine molecular mechanism bioinformatics analysis tools;and searched for DKD targets using human online Mendelian genetics and gene cards.The potential targets of GLQMP for DKD were obtained through the intersection of drug targets and disease targets.Cytoscape software was applied to build herbal medicine-active compound-target-disease networks and analyze them;protein-protein interaction networks were analyzed using the STRING database platform;gene ontology and Kyoto Encyclopedia of Genes and Genomes were used for gene ontology and gene and genome encyclopedia to enrich potential targets using the DAVID database;and the AutoDock Vina 1.1.2 software for molecular docking of key targets with corresponding key components.In vitro experiments were validated by CCK8,oil red O staining,TC,TG,RT-qPCR,and Western blot.Results:Through network pharmacology analysis,a total of 99 potential therapeutic targets of GLQMP for DKD and the corresponding 38 active compounds were obtained,and 5 core compounds were identified.By constructing the protein-protein interaction network and performing network topology analysis,we found that PPARA and PPARG were the key targets,and then we molecularly docked these two key targets with the 38 active compounds,especially the 5 core compounds,and found that PPARA and PPARG had good binding ability with a variety of compounds.In vitro experiments showed that GLQMP was able to ameliorate HK-2 cell injury under high glucose stress,improve cell viability,reduce TC and TG levels as well as decrease the accumulation of lipid droplets,and RT-qPCR and Western blot confirmed that GLQMP was able to promote the expression levels of PPARA and PPARG.Conclusion:Overall,this study revealed the active compounds,important targets and possible mechanisms of GLQMP treatment for DKD,and conducted preliminary verification experiments on its correctness,provided novel insights into the treatment of DKD by GLQMP.
基金Supported by the Specific Research Fund of The Innovation Platform for Academicians of Hainan Province,No.YSPTZX202313Hainan Province Clinical Medical Center,No.2021818+1 种基金Hainan Provincial Health Industry Research Project,No.22A200078and Hainan Provincial Postgraduate Innovation Research Project,No.Qhyb2022-133.
文摘BACKGROUND Guidewire slippage into the peritoneal cavity during clinical operations is extremely rare.Therefore,this paper aims to report a successful case of guidewire removal using transgastric natural orifice transluminal endoscopic surgery(NOTES).The goal is to enhance physicians'understanding of the management plan for this unique scenario and provide a valuable reference for clinical practice.CASE SUMMARY A 64-year-old man presented with abdominal distension and was diagnosed with cirrhosis combined with massive ascites.To proceed with treatment,the patient underwent ultrasound-guided peritoneal puncture and underwent catheterization and drainage.Unfortunately,a 0.035-inch guidewire slipped into the abdominal cavity during the procedure.Following a comprehensive evaluation and consultation by a multidisciplinary team,the guidewire was successfully removed using NOTES.CONCLUSION This case highlights the potential consideration of transgastric NOTES removal when encountering a foreign body,such as a guidewire,within the abdominal cavity.
基金This work was supported by the Ministry of Higher Education(MOHE),Malaysia,through Fundamental Research Grant Scheme(FRGS/1/2022/SKK10/UTAR/02/1)Universiti Tunku Abdul Rahman,Malaysia,through UTAR-Research Grant(IPSR/RMC/UTARRF/2021-C2/L08)MBBS Community Health Project(2022/2023),UTAR.
文摘Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023.Participants completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final analysis.Data were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent variables.Results:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural intention.Males,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk.Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.
基金Natural Science Foundation Project of Hainan Province(No.821QN390)。
文摘Inflammatory bowel disease(IBD)is a complex and multifactorial disease characterized by chronic inflammation of the gastrointestinal tract,mainly manifested by the accumulation of immune cells and pro-inflammatory cytokines in the intestinal mucosa.It is a kind of immune digestive system disease with high incidence in humans and can be divided into ulcerative colitis(UC)and Crohn's disease(CD).The pathogenesis of IBD is complex,and numerous studies have shown that genetic,environmental,microbial,immune,autophagy and other factors may be involved in the pathogenesis of IBD.MicroRNAs(miRNAs)play an important role in the pathophysiology of IBD.Studies have confirmed that miRNA play an important role in the targeted regulation of intestinal barrier homeostasis,immune response,and intestinal epithelial autophagy.MiRNA have not only been confirmed as important diagnostic biomarkers for IBD.It also shows new prospects for treatment strategies for IBD.This article mainly describes the differences in miRNA expression between UC and CD,summarizes the relationship between miRNA and intestinal barrier,immune homeostasis and autophagy mechanism in the pathogenesis of IBD,and the research progress of miRNA involved in the diagnosis and treatment of IBD,so as to provide new insights for the development of IBD.
基金Hainan Province Higher Education Science Research Project(No.Hnky2020ZD-15)。
文摘In recent years,with the development of medical technology,the detection rate of cancer is getting higher and higher,and the population of patients is getting younger.Many studies have begun to study the early diagnosis,prognostic monitoring markers and pathogenesis of cancer.In recent years,with the development of bioinformatics technology,lncRNA have gradually attracted the attention of researchers.More and more studies have shown that lncRNA are responsible for various biological functions in the process of cancer progression.lncRNA MAFG-AS1 has been shown to be associated with multiple cancers,function as an oncogene,and is significantly associated with poor clinical features and prognosis.This article reviews the research progress of lncRNA MAFG-AS1 in cancer,hoping to provide some help for the future clinical diagnosis and treatment of cancer.
基金the China Postdoctoral Science Foundation under Grant 2021M701838the Natural Science Foundation of Hainan Province of China under Grants 621MS042 and 622MS067the Hainan Medical University Teaching Achievement Award Cultivation under Grant HYjcpx202209.
文摘Watermarks can provide reliable and secure copyright protection for optical coherence tomography(OCT)fundus images.The effective image segmentation is helpful for promoting OCT image watermarking.However,OCT images have a large amount of low-quality data,which seriously affects the performance of segmentationmethods.Therefore,this paper proposes an effective segmentation method for OCT fundus image watermarking using a rough convolutional neural network(RCNN).First,the rough-set-based feature discretization module is designed to preprocess the input data.Second,a dual attention mechanism for feature channels and spatial regions in the CNN is added to enable the model to adaptively select important information for fusion.Finally,the refinement module for enhancing the extraction power of multi-scale information is added to improve the edge accuracy in segmentation.RCNN is compared with CE-Net and MultiResUNet on 83 gold standard 3D retinal OCT data samples.The average dice similarly coefficient(DSC)obtained by RCNN is 6%higher than that of CE-Net.The average 95 percent Hausdorff distance(95HD)and average symmetric surface distance(ASD)obtained by RCNN are 32.4%and 33.3%lower than those of MultiResUNet,respectively.We also evaluate the effect of feature discretization,as well as analyze the initial learning rate of RCNN and conduct ablation experiments with the four different models.The experimental results indicate that our method can improve the segmentation accuracy of OCT fundus images,providing strong support for its application in medical image watermarking.
基金Natural Science Foundation of Hainan Province(No.819MS128)。
文摘Objective:To assess the predictive value of systemic immune inflammation index(SII)for sepsis in low-and medium-risk community-acquired pneumonia.Methods:A total of 589 elderly patients with low-and medium-risk community-acquired pneumonia admitted to the Emergency Department of the Second Affiliated Hospital of Hainan Medical University from January 2020 to January 2023 were included as the research subjects,and the general information and laboratory test results of the patients were collected,and the optimal cut-off value of continuous variables for predicting sepsis in elderly patients with low-and medium-risk community-acquired pneumonia was determined by plotting the receiver work characteristic(ROC)curve,which was converted into dichotomous variables and univariate and multivariate logistic Regression analysis of the influencing factors of sepsis in elderly patients with low-and medium-risk community-acquired pneumonia.Based on this,a nomogram model is constructed to predict the risk of sepsis.The differentiation,consistency and accuracy of the model were verified by calibration curve and subject operating characteristic(ROC)curve,and the clinical utility of the model was determined by decision curve analysis.Results:A total of 589 elderly patients with low-and intermediate-risk community-acquired pneumonia were included in this study,of which 96(16.30%)developed sepsis.There were significant differences in age,diabetes mellitus and chronic obstructive pulmonary disease,Lac,PCT,SII and other indexes between sepsis and non-sepsis groups(P<0.05).Logistics regression analysis showed that age,diabetes mellitus and chronic obstructive pulmonary disease,Lac,and SII were independent risk factors for sepsis in elderly patients with low-and medium-risk community-acquired pneumonia.The nomogram prediction model was used to verify the results,and the AUC was 0.826(95%CI:0.780-0.872),and the calibration curve tended to the ideal curve with good accuracy.The decision curve shows that when the threshold of the model is between 0.10~0.78,the model has the advantage of clinical benefit.Conclusion:The nomogram prediction model constructed based on SII to predict sepsis in elderly patients with low-and medium-risk community-acquired pneumonia has good accuracy,which can predict the occurrence of sepsis early,help early identification of high-risk groups and timely intervention,and thus improve the prognosis of patients.
基金National Natural Science Foundation of China(No.82203813)。
文摘Breast cancer is a critical threat to women around the globe. Current radio- and chemotherapy regimens can induce multiple drug-resistant effects, e.g., anti-apoptosis, anti-pyroptosis, and anti-necroptosis, causing a poor clinical response to therapy. Ferroptosis is a newly programmed cell death characterized by iron overload, the massive production of reactive oxygen species (ROS), and membrane lipid peroxidation. The occurrence of ferroptosis results from an imbalance between peroxidation mechanisms (execution systems) and anti- oxidation mechanisms (defense systems), including the iron metabolism pathway, amino acid metabolism pathway, and lipid metabolism pathway. Recently, the vital role of ferroptosis in various diseases, including cancer, hypertension, diabetes, and Alzheimer's, has been identified. Specifically, triggering ferroptosis in breast cancer cells can inhibit their proliferation and invasion, and improve the chemoradiotherapy sensitivity, which makes it a potential strategy for breast cancer therapy. This review summarizes the definition and features of ferroptosis, as well as its role in the treatment of breast cancer, aimed at providing a theoretical basis for future drug development.
