Objective To review the latest development in the research on the application of the electrostatic spinning technology in preparation of the nanometer high polymer scaffold. Methods The related articles published at home and abroad during the recent years were extensively reviewed and comprehensively analyzed. Results Micro/nano-structure and space topology on the surfaces of the scaffold materials, especially the weaving structure, were considered to have an important effect on the cell adhesion, proliferation, directional growth, and biological activation. The electrospun scaffold was reported to have a resemblance to the structure of the extracellular matrix and could be used as a promising scaffold for the tissue engineeringapplication. The electrospun scaffolds were applied to the cartilage, bone, blood vessel, heart, and nerve tissue engineering fields. Conclusion The nanostructured polymer scaffold can support the cell adhesion, proliferation, location, and differentiation，and this kind of scaffold has a considerable value in the tissue engineering field.
ObjectiveTo conduct meta-analysis with the reliability of objective structured clinical examination (OSCE), so as to the reliability of OSCE used in the tests for evaluating clinical capacities of medical students. MethodsArticles about evaluating clinical capacities of medical students using OSCE and using comprehensive coefficient of Cronbach's α to measure the reliability of OSCE were electronically searched in PubMed, ScienceDirect, CNKI, WanFang data and VIP from Jan. 1998 to May. 2013. Two reviewers screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then meta-analysis was performed using SSPS 17.0 software. ResultsThirty-four studies involving 53 coefficients of Cronbach's α were included, of which, there were 18 articles written in English involving 28 coefficients of Cronbach's α and 16 articles written in Chinese involving 25 coefficients of Cronbach's α. The results of meta-analysis showed that:the total coefficient of Cronbach's α of OSCE was 0.700 (95%CI 0.660 to 0.737). The coefficient of Cronbach's α of internationally-published literature was 0.745 (95%CI 0.696 to 0.790) and that of nationally-published literature was 0.648 (95%CI 0.584 to 0.705), with a significant difference between two groups. ConclusionCurrently, the reliability of internationally/nationally-used OSCE is 0.7, which has relatively better reliability when used in the tests for evaluating clinical capacities of medical students at home and aboard. However, the reliability of OSCE at abroad is fairly better than that at home.
This paper explores the relationship between the cardiac volume and time, which is applied to control dynamic heart phantom. We selected 50 patients to collect their cardiac computed tomography angiography (CTA) images, which have 20 points in time series CTA images using retrospective electrocardiograph gating, and measure the volume of four chamber in 20-time points with cardiac function analysis software. Then we grouped patients by gender, age, weight, height, heartbeat, and utilize repeated measurement design to conduct statistical analyses. We proposed structured sparse learning to estimate the mathematic expression of cardiac volume variation. The research indicates that all patients’ groups are statistically significant in time factor (P = 0.000); there are interactive effects between time and gender groups in left ventricle (F = 8.597, P = 0.006) while no interactive effects in other chambers with the remaining groups; and the different weight groups’ volume is statistically significant in right ventricle (F = 9.004, P = 0.005) while no statistical significance in other chambers with remaining groups. The accuracy of cardiac volume and time relationship utilizing structured sparse learning is close to the least square method, but the former’s expression is more concise and more robust. The number of nonzero basic function of the structured sparse model is just 2.2 percent of that of least square model. Hence, the work provides more the accurate and concise expression of the cardiac for cardiac motion simulation.
It has been absent from an accepted criteria for normalization and quality control of the thoracic surgery until now. The ideal assessing instrument which will be used to evaluate the technical skills and surgical procedures should present a few vital characterizations below: objectivity, speciality in the content, detailed structure, and quantifiability. Objective structured assessment of technical skills (OSATS) has developed as a reliable method of surgical skills measurement. This article focuses on the history of OSATS and its prospect in the thoracic surgery area by reviewing relevant literatures.
ObjectiveTo prepare hierarchically structured fibrous scaffolds with different morphologies, and to explore the additional dimensionality for tuning the physicochemical properties of the scaffolds and the effect of their hemocompatibility and cytocompatibility.MethodsElectrospinning poly (e-caprolactone) (PCL)/polyvinylpyrrolidone (PVP) bicomponent fibers (PCL∶PVP mass ratios were 8∶2 and 5∶5 respectively), and the surface porous fibrous scaffolds were prepared by extracting PVP components. The scaffolds were labeled PCL-P8 and PCL-P5 respectively according to the mass ratio of polymer. In addition, shish-kebab (SK) structured scaffolds with different kebab sizes were created by solution incubation method, which use electrospun PCL fibers as shish while PCL chains in solution crystallizes on the fiber surface. The PCL fibrous scaffolds with smooth surface was established as control group. The hierarchically structured fibrous scaffolds were characterized by field emission scanning electron microspore, water contact angle tests, and differential scanning calorimeter (DSC) experiments. The venous blood of New Zealand white rabbits was taken and hemolysis and coagulation tests were used to characterize the blood compatibility of the scaffolds. The proliferation of the pig iliac artery endothelial cell (PIEC) on the scaffolds was detected by cell counting kit 8 (CCK-8) method, and the biocompatibility of the scaffolds was evaluated.ResultsField emission scanning electron microscopy showed that porous morphology appeared on the surface of PCL/PVP bicomponent fibers after extracting PVP. In addition, SK structure with periodic arrangement was successfully prepared by solution induction, and the longer the crystallization time, the larger the lamellar size and periodic distance. The contact angle and DSC measurements showed that when compared with smooth PCL fiber scaffolds, the crystallinity of PCL surface porous fibrous scaffolds and PCL-SK fibrous scaffolds increased, while the hydrophobicity of PCL-SK fibrous scaffolds increased, but the hydrophobicity of PCL porous scaffolds did not change significantly. The hemolysis test showed that the hemolysis rate of PCL surface porous fibrous scaffolds and PCL-SK fibrous scaffolds was higher than that of PCL fibrous scaffolds. According to American Society of Materials and Tests (ASTM) F756-08 standard, all scaffolds were non-hemolytic materials and were suitable for blood contact materials. Coagulation test showed that the coagulation index of PCL surface porous fibrous scaffolds and PCL-SK fibrous scaffolds was higher than that of PCL fibrous scaffolds at 5 and 10 minutes of culture. CCK-8 assay showed that both hierarchically structured fibrous scaffolds were more conducive to PIEC proliferation than PCL fibrous scaffold.ConclusionBased on electrospinning technology, solution-induced and blend phase separation methods can be used to construct multi-scale fiber scaffolds with different morphologies, which can not only regulate the surface physicochemical properties of the scaffolds, but also have good blood compatibility and biocompatibility. The hierarchically structured fibrous scaffolds have high application potential in the field of tissue engineering.
The informatization construction in medical field not only brings convenience to clinical doctors, but also creates huge data for clinical research. Taking the application of information technology in thoracic surgery as an example, we decide to talk about the establishment and application of esophageal cancer database based on standardized and structured electronic medical records. The aim, through the construction of database, is to improve clinical doctors’ management ability of esophageal cancer, to provide reference of the information construction to medical colleagues, and to promote the application of information in medicine.
Objective To analyze the impact of body mass index (BMI) on tumor characteristics of colorectal patients served by West China Hospital as a regional center in the current version of Database from Colorectal Cancer (DACCA). MethodsThe data of DACCA was updated on October 16, 2021. All data items included BMI, precancerous lesions, cancer family, tumor site, tumor morphology, location, differentiation, pathological properties of tumor, obstruction, overlap, perforation, pain, edema, and bleeding. The patients were divided into lean (BMI<18.5 kg/m2), normal (BMI 18.5–23.9 kg/m2), overweight (BMI 24.0–27.9 kg/m2) and obesity (BMI≥28.0 kg/m2) by Chinese classification methods. ResultsAfter scanning, 5 761 data rows were analyzed. Chi-square test showed that there was significant difference in the type composition ratio of tumor location in colorectal cancer patients under different BMI groups (χ2=31.477, P<0.001). Rank sum test showed that there was significant difference in the degree of obstruction (H=42.490, P<0.001), intussusception (H=8.179, P=0.042), edema (H=14.795, P=0.002), and bleeding (H=9.884, P=0.020) among different BMI groups. ConclusionsThe BMI classification of colorectal cancer patients is related to the location of tumor and the occurrence of some tumor complications. Patients with tumor involving intestinal lumens for one week are more likely to have low BMI. The patients with low BMI are more likely to have severe bleeding, obstruction, intestinal intussusception, and severe intestinal wall edema.
A team with strong cohesion and high execution is an important guarantee for conducting high-quality and sustainable clinical researches. Combined with the previous literature and the author’s view, this paper summarizes the key points of team building, which include a clear research direction, a balanced composition of team members, an outstanding team leader, the competence enhancement of team members, and a member-oriented management philosophy. Clear research direction is the premise of the existence and development of a team. Multi-level, multi-disciplinary membership can avoid potential conflicts of interest caused by homogeneity, and enable research to be refined and strengthened in interdisciplinary collisions. Team leader is the key to team development. The enhancement of team members’ competence is the cornerstone of team development. Adherence to member-oriented principle can form a true team culture. This paper aims to summarize and analyze the key points of clinical research team construction for peer reference.
ObjectiveTo analyze the value of structured electronic medical records for pulmonary nodules in increasing the ability of outpatient service and hospital management by resident physicians.MethodsWe included 40 trainees [94 males and 26 females aged 22-31 (26.45±2.81) years] who were trained in the standardized training base for surgical residents in our hospital from January 2018 to January 2021. The trainees were randomly divided into two groups including a structured group using the structured electronic medical record for pulmonary nodule and an unstructured group using unstructured electronic medical record designed by our department. The time of completing hospitalization records and first-time course records, the quality of course records, the accuracy of issuing admission orders, the quality of teaching rounds, and patient’s satisfaction between the two groups were analyzed and compared.Results(1) The average time in the structured group to complete inpatient medical records was significantly shorter than that of the unstructured group (53.61±8.12 min vs. 84.25±16.09 min, P<0.010); the average time in the structured group to complete the first-time course record was shorter than that of the unstructured group (13.20±5.43 min vs. 27.51±8.62 min, P<0.010), and there was a significant statistical difference between the two groups. (2) The overall teaching round quality score of the students in the structured group was significantly higher than that in the unstructured group (84.21±15.61 vs. 70.91±12.28, P<0.010). (3) The score of the medical record writing quality of the structured group was significantly higher than that of the unstructured group (80.25±9.22 vs. 74.22±5.40, P<0.010).ConclusionThe structured electronic medical record specific for pulmonary nodules can effectively improve the training efficiency in the standardized training of surgical residents, improve the clinical ability to deal with pulmonary nodules, improve the integrity and accuracy of key clinical data collected by students, and improve doctor-patient relationship.