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Based on the recommendation of the Ministry of Education in China to differentiate between \"academic\" and \"professional\" degrees, medical schools offer both professional and academic degrees for postgraduates. In China, clinical postgraduates who are pursuing a professional master's degree also participate in standardised residency training (SRT). However, little attention has been given to feedback from students and supervisors regarding postgraduate curricula. An online questionnaire was designed for clinical postgraduates with professional master's degrees and their supervisors at Chongqing Medical University (CQMU), China. A total of 544 questionnaires from postgraduates and 220 questionnaires from supervisors were included for analysis. Regarding the positive effect of public courses on professional research, 20.04% of clinical professional master's degree students reported \"a significant positive effect.\" Compared with public courses, more postgraduates (33.46%) reported that professional courses had a \"significant positive effect\" on clinical work (  = 25.00, ). A total of 49.64% of respondents with clinical professional master's degrees reported at least some repetition between postgraduate public courses and undergraduate courses. Of the postgraduates, 47.43% preferred online learning for public courses, whereas supervisors tended to prefer mixed online and offline learning. A total of 66.73% of postgraduates and 64.55% of supervisors suggested that public alternative courses should be offered to meet the needs of postgraduates. \"Mental and health emotion management\" and \"employment and entrepreneurship guidance\" were the public alternative courses that were most strongly preferred by both postgraduates and supervisors. With respect to improvements in self-knowledge and ability through different forms of professional learning, the responses of postgraduates and supervisors differed. According to postgraduates, the most effective type of learning was \"participation in research projects,\" whereas supervisors believed that \"professional courses\" were the most effective. There are differences between clinical postgraduates pursuing professional master's degrees and their supervisors in terms of attitudes towards public and professional curricula. The results of this study may provide guidance to improve public and professional curricula for clinical professional master's degree students.

Plasminogen activator inhibitor-1 (PAI-1) and soluble urokinase-type plasminogen activator receptor (suPAR) participate in inflammation and tissue remolding in various diseases, but their roles in chronic obstructive pulmonary disease (COPD) are not yet clear. This study aimed to investigate if PAI-1 and suPAR were involved in systemic inflammation and small airway obstruction (SAO) in COPD. Demographic and clinical characteristics, spirometry examination, and blood samples were obtained from 84 COPD patients and 51 healthy volunteers. Serum concentrations of PAI-1, suPAR, tissue inhibitor of metalloproteinase-1 (TIMP-1), Matrix metalloproteinase-9 (MMP-9), and C-reactive protein (CRP) were detected with Magnetic Luminex Screening Assay. Differences between groups were statistically analyzed using one-way analysis of variance or chi-square test. Pearson's partial correlation test (adjusted for age, sex, body mass index, cigarette status, and passive smoke exposure) and multivariable linear analysis were used to explore the relationships between circulating PAI-1 and indicators of COPD. First, we found that serum PAI-1 levels but not suPAR levels were significantly increased in COPD patients compared with healthy volunteers (125.56±51.74 ng/mL versus 102.98±36.62 ng/mL, =0.007). Then, the correlation analysis showed that circulating PAI-1 was inversely correlated with pulmonary function parameters including the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV /FVC), FEV /Pre (justified =-0.308, <0.001; justified =-0.295, =0.001, respectively) and SAO indicators such as FEV /FVC, MMEF25-75/Pre (justified =-0.289, =0.001; justified =-0.273, =0.002, respectively), but positively related to the inflammatory marker CRP (justified =0.351, <0.001), the small airway remolding biomarker TIMP-1, and MMP-9 (justified =0.498, <0.001; justified =0.267, =0.002, respectively). Besides, multivariable linear analysis showed that FEV /FVC, CRP, and TIMP-1 were independent parameters associated with PAI-1. Our findings first illustrate that elevated serum PAI-1 levels are related to the lung function decline, systemic inflammation, and SAO in COPD, suggesting that PAI-1 may play critical roles in the pathogenesis of COPD.

The gene polymorphism of ( ) has been shown to be implicated in tuberculosis susceptibility in many studies, but with conflicting results. This study aimed to provide more accurate estimation of the relationship between gene polymorphism and tuberculosis risk through a meta-analysis. A literature search was performed in PubMed, EMBASE, and other databases. Data were retrieved, and pooled odds ratio (OR) with 95% CI were calculated. Statistical analyses were performed by using STATA 12.0. Twelve publications with 2635 cases and 3049 controls were included. The pooled analysis demonstrated significant evidence of association between (-174G/C) and low risk of tuberculosis in dominant model (CC+GC vs GG: OR =0.693, 95% CI 0.581-0.826, <0.001). Subgroup analysis got similar results for (-174G/C) in Asians and Latinos, but the significance did not exist in Caucasians. (-572C/G) polymorphism was also associated with low risk of tuberculosis in dominant model (CC+GC vs GG: OR =0.719, 95% CI 0.577-0.896, =0.003). No publication bias was detected in either of the polymorphisms. In summary, -572 C/G polymorphism may be associated with a decreased risk of tuberculosis, and C allele is the protective factor against tuberculosis for -174G/C among Asians and Latinos, but not in Caucasian population.

Background Myopathy is the most widely reported statin-associated adverse event. Several studies have linked vitamin D deficiency with statin-related myopathy. Objective This meta-analysis aimed to investigate whether adult patients with statin-related myopathy have a lower 25-hydroxyvitamin D (25OHD) level than patients without myopathy and whether statin-related myopathy in vitamin D-deficient patients can be improved by vitamin D supplementation. Methods PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until 28 September 2020. Original studies comparing the 25OHD levels of patients with and without myopathy or detecting the impact of vitamin D supplementation on statin-related muscular intolerance were included. Subgroup analyses based on the sample size and baseline 25OHD level were conducted. Results This meta-analysis, based on nine cohort studies with a total of 2906 patients, revealed that the 25OHD level of patients with statin-related myopathy was significantly lower than that of patients without myopathy [weighted mean difference − 4.17 ng/mL; 95% confidence interval (CI) − 7.70 to − 0.63; p  = 0.021]. The overall analysis from another four studies with 446 patients who were previously vitamin D deficient and reported statin-related muscular intolerance showed that the pooled tolerance rate of statins improved to 89% (95% CI 8692; p  < 0.001) after vitamin D supplementation. Conclusions The present meta-analysis provides evidence that low 25OHD level is associated with statin-related myopathy and that exogenous vitamin D supplementation can improve statin-related muscular intolerance associated with low 25OHD level in most cases. Our findings may provide useful insight for the prevention and treatment of statin-related myopathy.

PurposeThe benefits of statins for ischemic cardio-cerebrovascular diseases are well known. However, concerns around muscle adverse events still exist. We therefore aimed to compare the muscle safety of individual statins in adults.MethodsPubMed, Embase, Cochrane Central Register of Controlled Trials and Web of Science were searched to include double-blind randomized controlled trials (RCTs) comparing one statin with another or with control treatment. Pairwise meta-analyses and network meta-analyses were undertaken with Stata 14.0 software. Relative risk (RR) with 95% confidence intervals (CIs) was adopted for each outcome.ResultsA total of 83 RCTs were included. In the pairwise meta-analysis, statins were significantly associated with only a slight increase in muscle symptoms compared with control (RR=1.05; 95% CI=1.01–1.09). In the drug-level network meta-analyses, no statistically significant difference was found between individual statins in the incidence of muscle symptoms, myalgia, myopathy, rhabdomyolysis, creatine kinase (CK) >10 times the upper limit of normal (ULN) or discontinuation due to muscle adverse events. In the dose-level network meta-analyses, there were no statistically significant dose-dependent effects on any outcomes except that moderate-intensity statins had a higher incidence of muscle symptoms than control (RR=1.13; 95% CI=1.01–1.27). Moderate simvastatin (RR=6.57; 95% CI=1.26–34.41) and moderate pravastatin (RR=5.96; 95% CI=1.00–35.44) had a statistically significantly higher incidence of CK >10×ULN compared with moderate atorvastatin. Lipophilic statins and statins metabolized by liver cytochrome P450 3A4 were not associated with an increased risk of muscle adverse events.ConclusionStatins may be generally safe on muscle. Moderate atorvastatin may be superior to equivalent simvastatin and pravastatin in muscle tolerability.

The role of thyroid transcription factor 1 (TTF-1) in the diagnosis of metastatic pulmonary adenocarcinomas in pleural, pericardial and peritoneal effusions has not been defined. This study aimed to assess the overall diagnostic accuracy of TTF-1 for metastatic pulmonary adenocarcinomas in pleural or other effusions. Literature search was conducted in PubMed, EMBASE and other databases to find eligible publications. Quality was assessed according to standardized QUADAS-2 criteria. Sensitivity, specificity, positive/negative likelihood ratio (PLR/NLR) and diagnostic odds ratio (DOR) were pooled. Summary receiver operating characteristic (SROC) curves were used to assess overall performance of the TTF-1 assay. A systematic search revealed 20 studies comprising a total of 1,213 subjects in this meta-analysis. The summary estimates were listed as follows: sensitivity, 0.74 (95% CI: 0.69–0.79); specificity, 0.99 (95% CI: 0.97–1.00); PLR, 78.16 (95% CI: 27.15–225.05); NLR, 0.26 (95% CI: 0.22–0.32); and diagnostic odds ratio, 297.75 (95% CI: 104.16–851.19). Estimated positive and negative post-probability values for metastatic pulmonary adenocarcinomas prevalence of 20% were 95% and 6%, respectively. The area under the SROC curve was 0.96. TTF-1 shows significant potential as a diagnostic marker to differentiate metastatic pulmonary from non-pulmonary adenocarcinomas in pleural or other effusions. These results justify larger, more rigorous studies to confirm such a diagnostic role.