ABSTRACT
BACKGROUND@#Colorectal carcinogenesis and progression are related to the gut microbiota and the tumor immune microenvironment. Our previous clinical trial demonstrated that berberine (BBR) hydrochloride might reduce the recurrence and canceration of colorectal adenoma (CRA). The present study aimed to further explore the mechanism of BBR in preventing colorectal cancer (CRC).@*METHODS@#We performed metagenomics sequencing on fecal specimens obtained from the BBR intervention trial, and the differential bacteria before and after medication were validated using quantitative polymerase chain reaction. We further performed ApcMin/+ animal intervention tests, RNA sequencing, flow cytometry, immunohistochemistry, and enzyme-linked immunosorbent assays.@*RESULTS@#The abundance of fecal Veillonella parvula ( V . parvula ) decreased significantly after BBR administration ( P = 0.0016) and increased through the development from CRA to CRC. Patients with CRC with a higher V. parvula abundance had worse tumor staging and a higher lymph node metastasis rate. The intestinal immune pathway of Immunoglobulin A production was activated, and the expression of TNFSF13B (Tumor necrosis factor superfamily 13b, encoding B lymphocyte stimulator [BLyS]), the representative gene of this pathway, and the genes encoding its receptors (interleukin-10 and transforming growth factor beta) were significantly upregulated. Animal experiments revealed that V. parvula promoted colorectal carcinogenesis and increased BLyS levels, while BBR reversed this effect.@*CONCLUSION@#BBR might inhibit V. parvula and further weaken the immunomodulatory effect of B cells induced by V. parvula , thereby blocking the development of colorectal tumors.@*TRIAL REGISTRAION@#ClinicalTrials.gov, No. NCT02226185.
Subject(s)
Animals , Humans , Berberine/therapeutic use , Carcinogenesis , Veillonella , Colorectal Neoplasms/genetics , Tumor MicroenvironmentABSTRACT
As a neotype learning mode, team-based learning has been applied in some medical schools and has become one of the most common self-regulated learning modes around the world. According to the process of team-based learning in medical classes at University of British Columbia in Canada. In terms of its effects, we discuss its advantages and shortcomings, and analyze its application status and im-plementation difficulties in China, and then propose several suggestions on domestic medical education.
ABSTRACT
Nowadays, ceremony education, as a specific education method, is becoming increasingly popular in medical humanistic education.It is a truth generally acknowledged that the importance of ceremony education is located at its extensive scope and plasticity.The cultivation of medical students' human-oriented spirit, strengthening their career identity and enhancing their ideological moralitycan be processed by ceremony education, in which much attention is attached to its four features, identity recognition, emotion polymerization, spirit conduction and cultural inheritance.However, there still exist some problems to be solved in the practice of ceremony education such as overformalization, insufficient individuation and systematization.That is what we mean to discuss in this paper.