Objective To evaluate the effect of applying palliative medicine teaching in the training of medical humanistic skills for resident physicians in the department of cardiovascular medicine. Methods A total of 36 resident physicians who received standardized training in the Department of Cardiology,China-Japan Friendship Hospital from June to December 2023 were allocated via the random number table method into two groups(n=18). According to the requirements of standardized training and palliative medicine teaching for resident physicians,the palliative medicine course was modulated and incorporated in the standardized training in the experimental group. The control group was taught in accordance with the requirements of standardized training for resident physicians and medical humanistic contents. After teaching,medical humanistic skills assessment and a self-evaluation questionnaire survey were employed to compare the teaching performance between the two groups. Results In terms of medical humanistic skills assessment:the experimental group scored higher than the control group in empathy,handling family feedback,reaching consensus,and overall score(all P<0. 05). The self-evaluation questionnaire survey showed that the experimental group had higher levels of interest in medical humanities and clinical communication skills than the control group(both P<0. 05). Conclusion Palliative medicine teaching can help stimulate the interest of resident physicians in humanistic medicine,improve clinical communication skills,and enhance medical humanistic skills.

Objective To evaluate the effect of pressure-controlled ventilation-volume guaranteed(PCV-VG)on the perioperative pulmonary oxygenation function of the patients undergoing off-pump coronary artery bypass grafting(OPCABG). Methods Forty patients aged 40-65 years,of both sexes,with the American Society of Anesthesiologists physical status Ⅲ or Ⅳ,preoperative cardiac function(NYHA)class Ⅱ or Ⅲ,scheduled for elective OPCABG were assigned via the random number table method into two groups(n=20):a volume-controlled ventilation(VCV)group(Group V)and a PCV-VG group(Group P). Other respiratory parameters of the anesthesia machine were set consistently in both groups. At the time of sawing the sternum(T₀),when left internal mammary artery harvesting with the operating table tilted 10° to the left(T₁),when left anterior descending coronary artery bypass grafting with the operating table tilted 10° to the right(T₂),when right coronary artery bypass grafting with the operating table in a 30° head-down and tilted 10° to the right(T₃),when circumflex coronary artery bypass grafting with the operating table in a 20° head-down and tilted 15° to the right(T₄),and at the end of the surgery(T₅),the peak airway pressure(Ppeak),mean airway pressure(Pmean),plateau airway pressure(Pplat),and pulmonary dynamic compliance(Cdyn)were recorded. The alveolar-arterial partial pressure difference of oxygen(PA-aDO₂),oxygenation index(OI),and respiratory index(RI)were recorded at the aforementioned time points as well as on postoperative day 1(T₆),day 3(T₇),and day 7(T₈). The dosages of intraoperative drugs(sufentanil,remifentanil,and rocuronium bromide),postoperative endotracheal tube indwelling time,the stay time in the cardiac surgery intensive care unit,and the occurrence of pulmonary complications within 7 days after the surgery were also recorded. Results Compared with Group V,Group P showed significant downward trends in Ppeak,Pmean,and Pplat during T₃-T₅,as well as in PA-aDO₂ and RI during T₃-T₈(all P<0. 05). Meanwhile,Group P exhibited significant upward trends in Cdyn during T₃-T₅ and in OI during T₃-T₈(all P <0. 05). Compared with those in Group V,the postoperative endotracheal tube indwelling time and the stay time in the cardiac surgery intensive care unit were shortened in Group P(all P<0. 05). There was no statistically significant difference in dosages of intraoperative drugs(sufentanil,remifentanil,and rocuronium bromide)or incidence of pulmonary complications within 7 days after the surgery between the two groups of patients(all P>0. 05). Conclusion Compared with VCV,PCV-VG can improve the perioperative pulmonary oxygenation function of the patients undergoing OPCABG.

Ischemic stroke(IS)remains a predominant contributor to mortality and disability,with current clinical interventions demonstrating suboptimal therapeutic efficacy. Recent studies have shown that circular RNA(circRNA)participates in pathological processes through the competing endogenous RNA(ceRNA)regulatory network,involving key processes such as apoptosis,inflammatory response,angiogenesis,autophagy,oxidative stress,and neuronal regeneration. This study reviews the molecular mechanism and application progress of circRNA regulating IS through the ceRNA network,aiming to provide theoretical support for the in-depth development of circRNA in the diagnosis and treatment strategies of IS and offer guidance for future related research and clinical practice

The conventional treatment for periapical periodontitis faces challenges,especially in the cases with immature roots.This article reports a case of periapical periodontitis in an adult permanent tooth with an immature root,where erbium-doped yttrium aluminum garnet(Er:YAG)laser-activated root canal disinfection was employed to induce apical bleeding and pulp revascularization.A 22-month postoperative follow-up showed healing of the periapical lesion,narrowing of the apical foramen,and positive pulp vitality test results.

Objective To explore the contemporary prevalence,cumulative incidence,distribution characteristics,and correlates of social isolation among middle-aged and older adults aged 45 years and older in China. Methods This study utilized data from the China Health and Retirement Longitudinal Study.Cross-sectional studies with stratified analysis were conducted to investigate the prevalence of social isolation and its age,gender,and regional differences in 2018 and 2020.A cohort study and binary logistic regression models were employed to analyze the cumulative incidence of social isolation and its correlates from 2018 to 2020.Multiple imputation based on chained equations and sensitivity analyses based on complete-case data were employed to ensure the reliability of the analysis. Results In 2018,the weighted prevalence of social isolation among middle-aged and older adults was 16.48%(95%CI=15.67%-17.32%).In 2020,the weighted prevalence of social isolation among middle-aged and older adults was 18.84%(95%CI=17.93%-19.74%).Weighted stratified analyses indicated that the prevalence of social isolation was significantly higher among older adults,individuals residing in rural areas,and females.The weighted cumulative incidence of social isolation during 2018-2020 was 9.24%(95%CI=8.47%-10.02%).The analysis revealed that 34.02%(95%CI=32.85%-35.19%)of middle-aged and older adults exhibited depressive symptoms.Depressive symptoms(OR=1.38,95%CI=1.07-1.78,P=0.013)were significantly associated with an elevated risk of social isolation. Conclusion The study reveals the epidemiology of social isolation among middle-aged and older adults in China,identifying advanced age,female gender,rural residence,and depressive symptoms as key correlates.These findings emphasize the need for early health management strategies to address social isolation in these high-risk populations.