Mongolia Medical University Research Articles

Factors Associated with Male Health Professions Students' Smoking in Inner Mongolia.

Objectives: In this study, we describe the smoking patterns of male health professions students in Inner Mongolia, China, and identify factors associated with smoking status. Methods: First- to fourth-year male health professions students (N = 1074) in Inner Mongolia Medical University were interviewed in 2017 regarding their smoking pattern and exposures potentially influencing their smoking status (current-, ex- or never-smoker). We used logistic regression to identify exposures potentially influencing their smoking status. Results: Overall, one-third were current-smokers, among whom three-fifths had moderate or high nicotine dependence. The relative probability of being a current smoker was higher with exposure to a smoking mother, being unsure of the parents' acceptance of their smoking, and witnessing teachers smoking; it was lower with better knowledge of smoking-related harm and better smoking-related risk perception. Knowledge of smoking-related harm and risk perception may have a greater impact on smoking behavior than exposure to others' smoking. Conclusion: Promoting knowledge and risk perception related to smoking, and stricter enforcement of the smoke-free policy on campus may be feasible ways to reduce smoking among male health professions students who are future practitioners.

A study on the end criteria of forced vital capacity curve in adults

Objective: To explore the end criteria of forced vital capacity(FVC) curve in adults. Methods: A multicenter cross-sectional study was performed in Zhongshan Hospital Affiliated to Fudan University, the First Affiliated Hospital of Fujian Medical University, and the Third Affiliated Hospital of Inner Mongolia Medical University from January 2017 to August 2017. A consecutive sample of subjects who completed the spirometry test and FVC curves met end criteria of no volume change (<0.025 L) for ≥ 1 s were qualified in this study. Subjects were divided into a normal group (n=610), an obstructive group (n=536), and a restrictive group(n=306) according to pulmonary function test results. The FET values in different groups were compared. The side effects in the 3 groups and the diagnostic accuracy, specificity and security of different FET in the obstructive group were assessed. Results: The FET values of the normal group, the obstructive group, and the restricted group were (4.00±1.07) s, (8.08±1.56) s and (2.97±0.76) s respectively, and the 95% CI of FET in the 3 groups were between 3.88-4.12s, 7.02-10.14 and 2.21- 3.73s (F=2 263.80, P<0.01). When the exhalation platform was used as the standard of FVC curve, the adverse reaction rate in the normal group and the restricted group were 1.1% and 1.3% respectively, lower than the rate of 17.2% in the obstructive group (χ(2)=92.73, χ(2)=48.49 respectively; all P<0.05). In the obstructive group, 7 s as the ending criterion had similar incidence of adverse reactions to 6 s (χ(2)=0.01, P=0.93). With further extension of expiration time, the incidence of adverse reactions increased significantly. In the obstructive group, the sensitivity of FEV(1)/FEV(7) was 99.25%, higher than that at FEV(1)/FEV(6) (χ(2)=4.06, P=0.04), and the specificity of diagnosis was very similar and 100%. Conclusions: FET was variable in subjects with different lung function status. It is not appropriate to use a fixed FET≥ 6 s as the end criterion of spirometry for adults. For patients with normal lung function or restrictive lung function defect, exhalation platform should be used as the end of exhalation standard. For patients with obstructive lung function defect, an FET of up to 7 s is appropriate.

Correlation between Clinical Factors and Prognosis in Newly Diagnosed Multiple Myeloma.

To explore the correlation between clinical factors and the prognosis of multiple myeloma (MM). A cohort study. At the Third Affiliated Hospital of Inner Mongolia Medical University, Mongolia from January 2014 to December 2018. The clinical data of 81 patients with newly diagnosed MM were collected retrospectively. The correlation of prognosis with immunophenotype and (FISH) Fluorescence in situ hybridization was subjected to univariate and multivariate analyses. Overall and progression-free survival was determined. The overall survival (OS) and progression-free survival (PFS) of patients with CD200+, CD81+, and CD27- were significantly shortened. CD200+ and CD27- were independent prognostic factors for OS and PFS in MM patients. The prognosis-related abnormal genes were analyzed, and univariate analysis revealed that OS and PFS were significantly shortened in patients with RB-1 deletion, CDKN2C deletion, and IGH rearrangement. CDKN2C deletion was an independent prognostic factor for OS and PFS in MM patients. CDKN2C deletion is an independent prognostic factor of MM. CD200+ is an independent risk factor for poor prognosis of MM. Key Words: Multiple myeloma, Prognostic analysis, Fluorescence in situ hybridization, Immunity, Immunophenotype.

Erratum to: A Heterologous Fibrin Glue Enhances the Closure Effect of Surgical Suture on the Repair of Annulus Fibrous Defect in a Sheep Model.

The original version of this article unfortunately contained one mistake. The institutions of the authors are wrong. The corrected institutions are given below.Zhi-cai DU1, 2, Li-xin ZHU11Department of Spinal Surgery, Orthopaedic Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China 2Department of Minimally Invasive Spinal Surgery, The Second Affiliated Hospital of Inner Mon-golia Medical University, Hohhot 010030, China.

Drug resistance and molecular epidemiology of Acinetobacter baumannii isolated from pediatric patients

Objective To analyze the drug resistance and molecular epidemiological characteristics of Acinetobacter baumannii isolated from pediatric patients. Methods Acinetobacter baumannii isolated from patients hospitalized in Inner Mongolia Medical University Affiliated Hospital from January 2016 to June 2018 was collected.Vitek-2 Compact automatic microbiological identification and drug sensitivity analysis system was used to identify and test the drug sensitivity of Acinetobacter baumannii isolates, and pulse field gel electrophoresis (PFGE) and multilocus sequence analysis (MLST) were applied to the homology analysis of the strains. Results A total of 94 clinical isolates of Acinetobacter baumannii were collected, of which 42 strains were isolated from pediatric patients and 52 strains from adult patients.The drug resistance rates of pediatric isolates to Imipenem, and Meropenem and Tigecycline were 7.1%, 7.1% and 0, respectively, and the drug resistance rates of adult isolates to these 3 antibiotics were 67.3%, 54.8%, and 5.5%, respectively.The results of PFGE typing showed that 94 strains were divided into 49 genotypes (X1-X49 type), 52 adult strains were distributed in 22 genotypes, and 42 pediatric strains were distributed in 33 genotypes.The dominant genotype was X23 (21 strains, 22.3%), of which 18 strains(85.7%) were adult isolates and 3 strains (14.3%) were children isolates.The drug resistance rate of X23 genotypes to carbapenems was 100%, which was significantly higher than that of other genotypes.The results of MLST genotyping showed that X23 genotype was ST195, which belonged to clonal complex(CC92) clone. Conclusions The overall drug resistance rate of Acinetobacter baumannii isolates in Inner Mongolia Medical University Affiliated Hospital was significantly lower than that of adult isolates, and the diversity of genotypes was obvious.The dominant genotypes of the strains belongs to the CC92 clone population, and is the dominant clone strain in many places of our country. Key words: Pediatrics; Acinetobacter baumannii; Drug resistance; Homology analysis

Effect of continuous nursing care based on the IKAP theory on the quality of life of patients with chronic obstructive pulmonary disease: A randomized controlled study.

To explore the effect of continuous nursing care based on the Information, Knowledge, Attitude, and Practice (IKAP) theory on the quality of life of patients with chronic obstructive pulmonary disease (COPD). This study is a randomized control trial. COPD patients attending the Affiliated Hospital of Inner Mongolia Medical University, China between July 1 and October 31, 2017 were eligible. Following random assignment of participants to either the intervention group or control group, 70 patients (35 in each group) were included in the final sample. The intervention group received nursing care based on the Information, Knowledge, Attitude, and Practice theory, while the control group received standard nursing care. Data were collected before the intervention, 1 month after the intervention, and three months after the intervention. The St. George's Respiratory Questionnaire (SGRQ) was used to measure quality of life. Three months after the intervention, there were significant differences in the total SGRQ score (20.29 ± 10.03 vs 30.14 ± 12.52) and in the three SGRQ dimensions between the intervention group and the control group (P < .05). A repeated-measures analysis of variance showed that the total SGRQ score and the scores for impact and symptoms had a significant time effect (P < .001), that the total SGRQ score and the score for symptoms had a significant interaction effect (P < .05), and that the impact dimension had a significant group effect (P = .042). Pairwise comparisons of the data for the intervention group showed that there were significant differences between the pre-intervention and 1 month after intervention scores as well as between pre-intervention and three months after intervention, for the total SGRQ scores and the scores for impact and symptoms(P < .001). In terms of the impact dimension, there was a significant difference in the intervention group between 1 month after intervention and 3 months after intervention (P = .016). Continuous nursing care based on Information, Knowledge, Attitude, and Practice theory improved quality of scores at 3 months after intervention among COPD patients. Given limitations of the study, future large-scale studies are needed to validate our results.

Relationship Between Aqueous Humor Levels of Cytokines and Axial Length in Patients With Diabetic Retinopathy.

A negative relationship between intraocular vascular endothelial growth factor-A (VEGFA) and axial length was found, which may help explain why myopia with long axial length was a protective factor for development of diabetic retinopathy (DR). The aim of this study is to further assess the relationship between the aqueous humor levels of interlukin (IL)-8, IL-10, VEGFA, vascular adhesion molecule-1 (VCAM-1), basic fibroblast growth factor, VEGFB, and placental growth factor (PLGF) and axial length in eyes with DR. Retrospective, single-center, unmasked study. Patients with age-related cataract and with/without DR who visited the Department of Ophthalmology at the Affiliated Hospital of Inner Mongolia Medical University were enrolled. The level of IL-8, IL-10, VEGFA, VCAM-1, and basic fibroblast growth factor were measured by cytometric bead array, and VEGFB and PLGF were measured by enzyme-linked immunosorbent assay. Axial length was measured by biometry. Totally 65 eyes of 65 patients were enrolled, including 14 patients with nonproliferative diabetic retinopathy, 16 patients with proliferative diabetic retinopathy (PDR), and 35 patients with age-related cataract as control. In the nonproliferative diabetic retinopathy group, the aqueous level of PLGF was negatively correlated with axial length (r = -0.576, P = 0.031), whereas the aqueous levels of IL-10 (r = 0.533, P = 0.049) and VCAM-1 (r = 0.566, P = 0.035) were positively correlated with axial length. In the proliferative diabetic retinopathy group, all cytokines did not significantly correlate with axial length. Among patients with diabetic retinopathy, we further found that aqueous levels of PLGF were negatively correlated with axial length, whereas VCAM-1 and IL-10 were positively correlated with axial length. These findings may suggest that these cytokines play a role in the development of DR, and further explain the relationship between the axial length and DR.

The change of blood gas and C reactive protein of obstructive sleep apnea-hypopnea syndrome patient with pretherapy and post-treatment of continuous positive airway pressure

Objective: To observe the efficacy of continuous positive airway pressure (CPAP) in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) and its affection on patients' blood gas analysis, C reactive protein(CRP) levels. Methods: This prospective study was performed from October 2016 to July 2017. Fifty hospitalized adult patients with medium or severe OSAHS, who were diagnosed by polysomnography (PSG) in Department of Otorhinolaryngology, Affiliated Hospital of Inner Mongolia Medical University, were collected as a case group. Those patients met the standards of medium or severe OSAHS, among whom 40 were male, 10 were female, the age was between 30 and 65, with a mean age of (47.24±10.28) years, and BMI was (27.94±3.43) kg/m(2). Meanwhile, 50 healthy individuals were chose in the same term as a control group, among whom 37 were male, 13 were female, the age was between 29 and 69, with a mean age of (51.28±10.58) years, body mass index(BMI) was (26.98±2.70) kg/m(2), and apnea-hypopnea index (AHI) was<5/h. The differences of blood gas analysis pH, arterial oxygen saturation (SaO(2)), arterial partial pressure of carbon dioxide (PaCO(2)), arterial partial pressure of oxygen (PaO(2)), CRP before and after the treatment of CPAP in case group and in the control group were compared. The choosing data were disposed and analyzed with statistics software of SPSS 20.0. Among which t test was adopted for measurement data, χ(2) test was adopted for enumeration data, and nonparametric rank sum test was adopted for other measurement data. Results: Before the CPAP treatment, pH, PaO(2) and SaO(2) levels in case group were lower than that in control group, respectively [7.34±0.03 vs. 7.37±0.04, (75.93±9.08) mmHg vs. (80.07±10.94) mmHg (1 mmHg=0.133 kPa), (89.71±6.09) mmHg vs.(93.29±5.36) mmHg, all P<0.05]. Both PaCO(2) level and CRP were higher than that in control group [(43.02±8.43) mmHg vs.(39.26±8.20) mmHg, 1.28[0.27,5.83] mg/L(Median[P(25),P(75)]) vs. 0.51[0.21,2.13] mg/L, both P<0.05]. After the CPAP treatment, pH(7.36±0.04), PaO(2) [(80.28±9.96) mmHg] and SaO(2) [(92.94±4.01) mmHg] level in case group were increased than pretreatment, respectively. Moreover, PaCO(2) level [(39.46±8.36) mmHg] and CRP(0.44[0.21,3.40] mg/L) are decreased than pretreatment (P<0.05), respectively. Conclusion: The CRP and blood gas analyses are significant index to evaluate the state of an illness and to estimate the prognosis of disease of OSAHS, which is deserved to generalize.

Breakfast prevalence of medical students is higher than students from nonmedical faculties in Inner Mongolia Medical University.

Skipping breakfast is becoming common worldwide. Our previous studies showed that the breakfast prevalence was relatively low. In three cross-sectional studies, breakfast prevalence in various populations in Inner Mongolia Medical University campus in 2011, 2013 and 2017 was investigated. Risk of skipping breakfast in 2017 was analyzed. In follow-up study, the incidence, RR, AR% and PAR% of eating and skipping breakfast from 2011 to 2013 were calculated. Data of 18,231 individuals were collected. Breakfast prevalence growth was 16.1% during the seven years. The annulus growth of breakfast prevalence was 9.3% (2013 vs 2011, P < 0.001) and 6.3% (2017 vs 2013, P < 0.001). The breakfast prevalence of three cross-sectional studies (73.0 vs 64.9%, P < 0.001; 79.5 vs 69.6%, P < 0.001; and 82.8 vs 77.4%, P < 0.001) and the breakfast incidence of a two-year follow-up study (70.6 vs 48.5% 95% CI: 1.12-1.90) both showed that breakfast consumption in medical students is higher than that in students from nonmedical faculties. The seven-year average breakfast prevalence of male and female medical students (70.0 and 82.5%) was 1.31 (95% CI: 1.23-1.39) and 1.09 (95% CI: 1.06-1.11) that of male and female students from nonmedical faculties (53.6 and 75.8%), respectively. Medical students have a higher breakfast consumption than nonmedical students. Male students from nonmedical faculties have the lowest breakfast prevalence and the highest breakfast skip risk in our university.

The Use of Floss in Medical Faculties of Inner Mongolia Medical University in 2017

Purpose: The aim of the present study was to determine the degree of using floss and the demographic characteristics of medical faculties of Inner Mongolia Medical University. Materials and Methods: Participants completed the questionnaire in the classroom. These participants came from the medical faculties of Chinese Medicine and Western Medicine. These participants were interviewed to determine the demographic characteristics. Non-flossors responded according to their reasons for not flossing. Results: A total of 3481 effective data were available for analysis. The floss prevalence was 17.21%, which was lower by 5.72% for students living in rural areas, when compared to students living in urban areas. The largest proportion of non-flossing participants in rural areas answered, “I do not know what a floss is”, while participants in urban answered, “I do not want to use it”. The largest proportion of answered flossing frequency was less than once a month. Conclusion: The present study indicates that the prevalence of using floss in medical faculties in Inner Mongolia Medical University was higher, when compared to that in Sichuan province, China, but lower than that in other countries. Although the students use floss, more than one-third of students use floss less than once a month, which is close to “never”. The prevalence in rural areas is lower than those in urban areas. Male not only comprises the total number of prevalence, but also has a frequency greater than that in females. The emphasis on using floss should be improved in medical students.

The clinical research of serum glial fibrillary acidic protein combined with craniocerebral MRI in neonatal hypoxic-ischemic encephalopathy

Objective To explore the relationship between serum glial fibrillary acidic protein (GFAP) level and neonatal hypoxic-ischemic encephalopathy (HIE), and to verify whether GFAP combined with craniocerebral magnetic resonance imaging (MRI) can more accurately evaluate the prognosis of HIE. Methods We selected HIE children who hospitalized in the department of neonatology, the affiliated hospital of Inner Mongolia Medical University from January 2017 to December 2017, and full-term newborns without brain injury who were hospitalized in the same period. Serum samples were taken for GFAP detection on the 1st, 3rd, 7th day after birth of HIE and the 3rd day after birth of full-term newborns without brain injury. All the subjects completed craniocerebral MRI examination and followed up. At the same time, the correlation between GFAP level and the severity of brain MRI was evaluated. Results ⑴ The level of serum GFAP in HIE group on the 3rd day after birth [(5.54±1.30)ng/ml] was significantly higher than that in control group [(3.38±0.31)ng/ml] (P 0.05); there was significant difference between sequelae group [(6.93±1.29)ng/ml] and non-sequelae group [(4.91±0.77)ng/ml] on the 7th day (P 0.05), and there were significant differences on day 7 (P<0.05). Conclusions It is speculated that the increase of serum GFAP level in HIE newborns is related to the severity and prognosis of the disease, and is positively related to the results of craniocerebral MRI examination.Detecting the changes of serum GFAP in HIE newborns is helpful to determine the severity of the disease and evaluate the prognosis of the children. Combining GFAP with craniocerebral MRI may improve the accuracy of the judgment. Key words: Glial fibrillary acidic protein; Magnetic resonance imaging; Hypoxia-ischemia, brain; Infant, newborn, diseases

Operative treatment of Sneppen V talus fracture through approach for malleolus medialis V osteotomy plus hollow compression screw fixation

Objective To report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation. Methods From January 2015 to January 2019, 16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery, The Second Affiliated Hospital to Inner Mongolia Medical University. They were 14 men and 2 women with a mean age of 38.4 years (range, from 20 to 55 years). All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy. The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes. Results All patients were followed up for a mean time of 12.6 months (range, from 6 to 30 months). The mean operation time was 68.4 minutes (range, from 52 to 96 minutes); the mean amount of hemorrhage during operation was 96.8 mL (range, from 48 to 122 mL); the mean period of bone union was 4.8 months (range, from 3 to 8 months). The postoperative mean AOFAS score was 75.3 points (range, from 43 to 91 points). Complications occurred in 4 cases, including one case of talus ischemic necrosis, one case of partial talus ischemic necrosis accompanied by tibial arthritis, one case of subtalar arthritis, and one case of combined tibial, talar and subtalar arthritis. All incisions obtained primary healing, with no complications like infection, screw breakage, delayed union or nonunion. Conclusion Operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced. Key words: Talus; Fractures, bone; Fracture fixation, internal; Bone nails; Malleolus medialis osteotomy

Treatment of complex acetabular fractures involving the posterior column by anterograde lag screws via the ilioinguinal approach

Objective To evaluate the treatment of complex acetabular fractures involving the posterior column by anterograde lag screws via the ilioinguinal approach. Methods A retrospective study was conducted of the 8 patients with complex acetabular fracture involving the posterior column who had been treated at Department of Orthopaedics, The Second Affiliated Hospital to Inner Mongolia Medical University from January 2017 to June 2018. They were 5 males and 3 females, aged from 35 to 62 years (average, 43.5 years). According to the Letournel-Judet classification, 3 cases were T-shaped fractures, 4 anterior column plus posterior hemitransverse fractures and one both column fracture. The interval from injury to operation averaged 8 days (from 7 to 17 days). The anterior acetabulum was fixated by a reconstruction plate and the posterior column by antegrade lag screws, all through the ilioinguinal approach. The quality of fracture reduction, fracture union time, function of the affected hip and complications were recorded. Results By the Matta imaging criteria, the quality of fracture reduction was rated as excellent in 7 cases and as fine in one. Intraoperative major hemorrhage or injury to sciatic nerve occurred in none of the patients. This cohort obtained an average follow-up of 8 months (from 6 to 18 months). All fractures united well after an average of 10 weeks (from 8 to 12 weeks). The function of affected hip evaluated by the improved Merle d’Aubigne & Postel criteria at the last follow-up was excellent in 7 cases and fine in one. Follow-ups revealed no incidence of deep vein thrombosis or heterotopic ossification. Conclusions For patients with complex acetabular fracture involving the posterior column, internal fixation of the anterior acetabulum with a reconstruction plate through the ilioinguinal approach and fixation of the posterior column with antegrade lag screws also through the ilioinguinal approach can result in fine therapeutic effects, because complications like ectopic ossification and sciatic nerve injury related to the Kocher-Langenbeck approach can be prevented. This treatment is particularly suitable for the patients whose condition of the soft tissues at the posterior pelvis is poor. Key words: Acetabulum; Fractures, bone; Fracture fixation, internal; Bone nails; Surgical approach

Preventive Effects of Dexmedetomidine on Renal Dysfunction and Hemodynamic Stability in Malignant Obstructive Jaundice Patients During Peri-Operative Period.

BackgroundThis study aimed to investigate effects of intra-operative administration with dexmedetomidine (Dex) on hemodynamics and renal function in patients with malignant obstructive jaundice.Material/MethodsOur randomized, double-blinded, placebo-controlled study was conducted among 40 patients with malignant obstructive jaundice between August 2009 and March 2011 in The Affiliated Hospital of Inner Mongolia Medical University. The 40 patients were randomly divided into 2 groups: the Dex group (receiving Dex 0.5 μg/kg 10-minutes before induction and then a 0.5 μg/kg/hour maintenance infusion until end of operation 30 minutes) and the Control group (receiving normal saline of same amount and at same rate). The adverse events, including incidence of cardiovascular complications and nausea and vomiting, and length of hospital stay were determined. The level of cystatin C (CysC), retinol-binding protein (RBP), creatinine (Scr), and blood urea nitrogen (BUN) were also evaluated.ResultsDexmedetomidine administration significantly decreased heart rate (HR) and stroke volume variation (SVV) and significantly increased capital venous pressure (CVP) and mean arterial pressure (MAP) values compared to that in the Control group (P<0.05). Dexmedetomidine administration significantly upregulated urine volume and significantly downregulated atropine levels compared to the Control group (P<0.05). Dexmedetomidine administration significantly improved renal functions, by modulating CysC, RBP, Scr and BUN levels compared to the Control group (P<0.05). Dexmedetomidine administration demonstrated no additional side-effects. Dexmedetomidine administration significantly shortened length of hospitalization in the Dex group compared to the Control group (P<0.05).ConclusionsDexmedetomidine plays preventive effects on renal dysfunction and hemodynamic stability in malignant obstructive jaundice patients during peri-operative period.

Application of three-dimensional digital reconstruction and printing technology in the clinical teaching of complex orthopedics

Objective To explore the effect of 3d digital reconstruction and printing technology on the teaching of complex orthopedics. Methods A total of 90 interns in the Second Affiliated Hospital of Inner Mongolia Medical University from September 2016 to September 2017 were selected as research subjects. According to the different teaching methods, they were divided into control group (n=45) and experimental group (n=45). The former received traditional teaching; the latter used three-dimensional digital reconstruction and printing technology to print out complex fracture models of patients, digitally reproduced fracture classification, developed scientific surgical plans through fracture models, and simulated surgical fixation methods. Examination was divided into clinical skills and written exam according to exam outline requirements; Self-cognitive ability score included professional interest, fracture understanding, etc. The satisfaction of the medical students in the experimental group was determined using self-made questionnaires. t test was used to compare data between groups. Results Experimental groups' scores for surgical skills (84.36±0.28) and theoretical knowledge (87.55±0.44) were higher than the control group, and the differences were statistically significant (P<0.05). The professional interest of the experimantal group was higher than that of the control group, and the difference was statistically significant (P<0.05). The students' classroom atmosphere was significantly better compared with the control group, and the difference was statistically significant (P<0.05). Conclusion Using 3 d digital reconstruction and printing technology to establish modes in complex orthopedics teaching process can effectively improve interns' surgical skills and theoretical knowledge, and promote student satisfaction. Key words: Complex trauma; Orthopedic teaching; 3d digital; 3d printing technology

Clinical value of peroral endoscopic cardial constriction for gastroesophageal reflux disease

Objective To study the safety and efficacy of peroral endoscopic cardial constriction (PECC) for gastroesophageal reflux disease (GERD). Methods A total of 27 patients with GERD who visited the Affiliated Hospital of Inner Mongolia Medical University from August 2016 to December 2017 and met the inclusion criteria received PECC. The 24 h esophageal pH-resistance monitoring (DeMeester) scores, GERD health-related quality of life (GERD-HRQL) scores, GERD-questionnaires (GERD-Q) symptom scores and clinical efficacy before and after operation were compared. Results DeMeester score at 3 months (Z=-6.940, P=0.001) and 6 months (Z=-6.307, P=0.001) after treatment, GERD-HRQL score at 3 months (t=11.499, P=0.001) and 6 months (t=10.959, P=0.001) as well as GERD-Q symptom score at 3 months (t=30.647, P=0.001) and 6 months (t=27.217, P =0.001) after surgery significantly decreased, compared with those before. The curative rates were 81.5% (22/27) and 77.8% (21/27) at 3 months and 6 months after operation. Conclusion PECC, a new method for the treatment of GERD with good short-term effect, safety and feasibility, can be recommended for clinical application. Key words: Cardia; Gastroesophageal reflux; Efficiency; Safety; Peroral endoscopic cardial constriction

On the Effect of Peer-assisted learning in the teaching of pelvic fractures

Objective To explore the feasibility and effectiveness of peer-assisted learning (PAL) in the clinical probation teaching of orthopaedics in excellent doctors classes. Methods Forty students in the 2014 excellent doctors class in Inner Mongolia Medical University were selected and randomly divided into the experimental group and the control group. The experimental group adopted the PAL teaching mode, and the control group received the ordinary teaching mode. At the end of the internship, theoretical knowledge and practical skills tests were conducted, and self-evaluation and course evaluation were completed in the form of questionnaires. Results The scores of the experimental group in theoretical knowledge and practical skills were higher than those of the control group, and the differences are statistically significant [theoretical scores (97.2±0.7) vs. (90.2±1.3); practical operation scores (98.5±2.4) vs. (89.2±1.5); case analysis (98.1±0.8) vs. (92.3±2.8), P<0.05]. Students in the experimental group were generally satisfied with their mastering of the basic theoretical knowledges and clinical practice skills of orthopaedics. Conclusion The application of the PAL model in clinical probation teaching not only stimulates students' enthusiasm for learning, but also enhances their eagerness in self-learning; it helps students master the basic theoretical knowledge and clinical skills better in clinical probation. Key words: Peer-assisted learning; Internship; Excellent doctors; Teaching

A Study Investigating Markers in PLeural Effusion (SIMPLE): a prospective and double-blind diagnostic study

IntroductionSerum and fluid laboratory markers are valuable for exploring the aetiologies of pleural effusion (PE) because of their relative non-invasiveness, low cost, objective result and short turnaround time. The diagnostic...

Modulation of Gut Mucosal Microbiota As a Mechanism of Probiotics-Based Adjunctive Therapy for Ulcerative Colitis

Background: Ulcerative colitis (UC) is a chronic subtype of inflammatory bowel disease (IBD), and is associated with gut microbiota. The aim of the present study was to evaluate the effects of probiotics as adjunctive treatment for ulcerative colitis. Methods: Twenty-five active UC subjects were assigned two groups (probiotic group, n=12; placebo group, n=13). The probiotic group received oral probiotics twice daily plus the standard drug regimen (mesalazine at a dose 60 mg / kg / day) for 12 weeks, while the placebo group received only the standard drug regimen. Findings: The trial outcomes were assessed at week 0 and week 12 by clinical assessment and profiling the gut mucosa microbiota by samples at week 0 and week 12 were analyzed using PacBio single-molecule, real-time sequencing (SMRT) of full-length 16S rRNA. We observed a significantly greater reduction in ulcerative colitis disease activity index (UCDAI) in the probiotic group compared with the placebo group (P=0.043), accompanying by a higher remission rate (91.67% for probiotic-receivers versus 69.23% for placebo-receivers, P=0.034). The gut mucosal microbiota of the probiotic-receivers had significantly more beneficial bacteria, such as Eubacterium ramulus (P<0.05), Pediococcus pentosaceus (P<0.05), Bacteroides fragilis (P=0.02), and Weissella cibaria (P=0.04). Additionally, these beneficial bacteria correlated negatively and significantly with UCDAI, suggesting that the probiotics might have contributed to improve UC by modulating the gut mucosal microbiota. Interpretation: Our research has provided new insights into the mechanism of the symptom alleviation effects of probiotics as adjuctive treatment for UC. Funding: This research was supported by the National Natural Science Foundation of China (31720103911), Inner Mongolia Science & Technology Major Projects (ZDZX2018018). Declaration of Interest: The authors declare that they have no conflict of interest. Ethical Approval: All subjects provided written informed consent prior to the start of the study. The Ethical Committees of Inner Mongolia Agriculture University and the Affiliated Hospital of Inner Mongolia Medical University approved the study. The study was registered in Chinese Clinical Trial Registry (chiCTR-IPR-17010306).

Clinical application value of modified invagination for pancreaticojejunostomy in pancreaticoduodenectomy

Objective To explore the clinical application value of modified invagination for pancreaticojejunostomy in pancreaticoduodenectomy (PD). Methods The retrospective cohort study was conducted. The clinicopathological data of 39 patients who underwent PD in the Affiliated Hospital of Inner Mongolia Medical University from January 2014 to December 2017 were collected. There were 26 males and 13 females, aged (60±7)years, with a range of 41-75 years. All the 39 patients underwent PD, using Child method to reconstruct digestive tract. Of 39 patients, 19 undergoing modified invagination for pancreaticojejunostomy and 20 undergoing mucosa-to-mucosa end-to-side pancreaticojejunostomy were allocated to innovative group and traditional group, respectively. Observation indicators: (1) surgical situations; (2) postoperative complications; (3) follow-up. Follow-up was performed by outpatient examination and telephone interview to detect postoperative tumor recurrence, main pancreatic duct dilatation, survival, and discomfort (abdominal pain, bloating, indigestion, etc.) of patients up to October 2018. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed by t test. Measurement data with skewed distribution were represented as M (P25, P75) or M (range), and comparison between groups was analyzed by Mann Whitney U test. Count data were expressed as absolute numbers, and comparison between groups was analyzed by chi-square test or Fisher exact probability. Results (1) Surgical situations: operation time, volume of intraoperative blood loss, cases with soft pancreas or hard pancreas (pancreatic texture), pancreatic duct diameter, time of pancreatic duct removal, cases using somatostatin, and duration of postoperative hospital stay of the innovative group were (342±47)minutes, 400 mL (300 mL, 400 mL), 10, 9, 3.1 cm (2.9 cm, 3.4 cm), 37 days (32 days, 63 days), 17, 18 days (15 days, 22 days), respectively, versus (392±95)minutes, 400 mL (300 mL, 525 mL), 6, 14, 3.6 cm (2.6 cm, 4.2 cm), 43 days (34 days, 49 days), 18, and 24 days (15 days, 27days) of the traditional group; there was no significant difference in the volume of intraoperative blood loss, cases with soft pancreas or hard pancreas (pancreatic texture), pancreatic duct diameter, time of pancreatic duct removal, cases using somatostatin, and duration of postoperative hospital stay between the two groups (Z=-0.775, χ2=2.063, Z=-1.155, Z=-0.295, χ2=0.003, Z=-1.286, P>0.05); but a significant difference in operation time between the two groups (t=-2.114, P 0.05), but there was a significant difference in postoperative grade B and C pancreatic leakage between the two groups (P<0.05). Patients with postoperative complications were improved after symptomatic support treatment, and no patient died during the perioperative period. (3) Follow-up: of the 39 patients, 33 (18 in the innovation group and 15 in the traditional group) were followed up for 3-57 months, with a median follow-up time of 17 months. Of the 18 patients receiving follow-up in the innovative group, 5 died of tumor recurrence and metastasis, with a survival time of 5-24 months, 1 had tumor recurrence at 34 months after operation, 1 had main pancreatic duct dilatation and intermittent abdominal pain and abdominal distension, 5 had indigestion, 1 had back pain, and 5 had good recovery. Of 15 patients receiving follow-up in the traditional group, 10 died of tumor recurrence and metastasis, with a survival time of 3-57 months, 2 had main pancreatic duct dilatation and intermittent abdominal pain and abdominal distension, 2 had indigestion, 1 had good recovery. Conclusion Compared with the traditional mucosa-to-mucosa end-to-side pancreaticojejunostomy, modified invagination for pancreaticojejunostomy in the PD is safe and feasible, which can simplify the operation, reduce the requirements for the operator′s operation skills, shorten the operation time, and reduce incidence of postoperative grade B and C pancreatic leakage. Key words: Pancreatic neoplasms; Duodenal neoplasms; Common bile duct tumors; Pancreaticoduodenectomy; Pancreaticojejunostomy; Pancreatic leakage; Surgical techniques