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Objective:To explore the effect of integrated application of multi-mode teaching in presentation-assimilation-discussion (PAD) class of medical microbiology.Methods:A total of 102 2017-batch clinical medical students of Hubei University of Medicine were collected, and the quasi-experimental study was adopted. The experimental class (50 students) was established by setting a PAD class, integrating the use of WeChat public account, Rain Classroom and WJX software during the teaching implement. And traditional mode of teaching was carried out in the control class (52 students). Moreover, the questionnaire survey and the test assessment were applied to compare the teaching effects of the two classes.Results:Questionnaire results showed that scores of indicators related to the teaching effectiveness in the experimental group were significantly higher than those in the control group ( P<0.01), and scores of tests in the experimental group were significantly better than those in the control group ( P<0.01). The t test was performed by SPSS 20 in the study. Conclusion:The integrated application of multi-mode teaching enriches the teaching mode of PAD class, which fully describes the student-centered concept, and increases students' initiative, participation, as well as students' knowledge mastery and innovation.
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Objective To evaluate the effect of sildenafil on the expression of hexokinase-2 (HK-2) in lung tissues in a rat model of pulmonary arterial hypertension. Methods Thirty-two male Sprague-Dawley rats, aged 2 months, weighing 200-220 g, were allocated into 4 groups with 8 rats in each group using a random number table: control group ( group C), pulmonary arterial hypertension group ( group PAH), low-dose sildenafil group (group S1 ) and high-dose sildenafil group (group S2 ). The model of pul-monary arterial hypertension was established through combining left pneumonectomy with subcutaneous in-jection of 60 mg∕kg monocrotaline. Two percent sildenafil 30 and 50 mg∕kg were administered by intragastric gavage once a day for 3 consecutive weeks starting from 5 weeks after pneumonectomy in S1 and S2 groups, respectively. The chest was opened after the end of administration for measurement of mean pulmonary arte-rial pressure (mPAP) and right ventricular systolic pressure (RVSP). The hearts and lungs were excised for determination of the percentage of the thickness of tunica media of pulmonary arterioles, size of right ventricular cardiomyocytes, α-smooth muscle actin (α-SMA) expression (by immunohistochemistry) and expression of hypoxia-inducible factor-1α (HIF-1α) and HK-2 ( by Western blot). Results Compared with group C, the mPAP, RVSP and percentage of MT were significantly increased, the size of right ven-tricular cardiomyocytes was enlarged, and the expression of HIF-1α, HK-2 and α-SMA was up-regulated in PAH and S1 groups, and the RVSP and percentage of MT were significantly increased, the size of right ventricular cardiomyocytes was enlarged, and the expression of HIF-1α, HK-2 and α-SMA was up-regula-ted (P<0. 05), and no significant change was found in mPAP in group S2 (P>0. 05). Compared with group PAH, the percentage of MT was significantly decreased, the size of right ventricular cardiomyocytes was decreased, and the expression of HIF-1α, HK-2 and α-SMA was down-regulated in group S1 , and the mPAP, RVSP and percentage of MT were significantly decreased, the size of right ventricular cardiomyo-cytes was decreased, and the expression of HIF-1α, HK-2 and α-SMA was down-regulated in group S2 (P<0. 05). Conclusion The mechanism by which sildenafil inhibits proliferation of pulmonary vascular smooth muscle cells is related to inhibiting the expression of HK-2 in lung tissues in a rat model of pulmona-ry arterial hypertension.
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Objective The aim of our study is to investigate the prevalence of Carbapenem-resistant Klebsiella pneumoniae (CRKP) and the genetic characteristics of the class 1 integron in CRKP on multi-drug resistance.Methods Clinical Klebsiella pneumoniae strains were collected from multiple departments of a hospital in central China. CRKP strains were identified among the isolates, and antibiotics susceptibility of CRKP strains was analyzed. The polymerase chain reaction (PCR) was adopted to amplify the class 1 integron variable area. The integron genetic structure was analyzed with enzyme digestion and DNA sequencing technology. The relation between class 1 integron and drug resistance was analyzed statistically.Results Totally 955 strains of Klebsiella pneumoniae were isolated from varied sites of the hospital, and 117(12.3%) of them were identified as CRKP, with a separation rate of 8.9% (26/292) in 2013, 11.3% (38/336) in 2014 and 16.2% (53/327) in 2015, which shows an increasing trend by year. 44.4% (52/117) of CRKP strains were separated from specimen of ICU, and 61.5% (72/117) were from sputum. Over 95% CRKP strains were resistant to ampicillin/sulbactam, aztreonam, imipenem, meropenem, ceftazidme, cefotaxime, cefepime,and piperacillin, while relatively low resistant rates were found in tigecycline (12.8%) and colistin (35.9%). The class 1 integron was detected in 77.8% (91/117) of CRKP strains. Class 1 integron of CRKP was significantly correlated with the antibiotic resistance to the tobramycin, gentamicin and amikacin (all P<0.01). The gene cassette analysis of variable area of class 1 integron showed that aadA2 accounts for 64.8% (59/91), aacA4-catB8-aadA1 23.1% (21/91), and aadA2-dfrA25 12.1% (11/91).Conclusions CRKP has an increasing trend in a clinical setting in China, and most of them were resistant to multiple antibiotics. Class 1 integron in CRKP has strong ability to capture the genes resistant to aminoglycosides antibiotics from environment, with the aadA2 gene as the most popular one.
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Anti-Bacterial Agents , Pharmacology , Carbapenems , Pharmacology , Drug Resistance, Bacterial , Integrons , Klebsiella pneumoniae , GeneticsABSTRACT
Objective To explore the impact of metabolic syndrome (MS)in bone mineral density (BMD) in elderly male type 2 diabetics (T2DM). Methods One hundred and fourty cases were divided into MS group and non-MS(NMS)group according to with or without MS. Height,weight were measured, body mass index(BMI) were calculated and the total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c)were tested. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DEXA). The differences among these groups were compared and the risk factors for MS were analyzed. Results The MD, BMI, TC,TG in MS group was higher than that in NMS group (P < 0.05 vs. P < 0.01),and HDL-C was lower than NMS group (P < 0.05). Correlation analysis showed that BMD was negatively correlated with age , TG , HDL-C , and was positively correlated with BMI.The results of multiple stepwise regression analysis showed that age ,HDL-C,BMI were independent risk factors for BMD. Conclusion The BMD significantly increases in T2DM with MS.Obesity and low HDL-C have positive effects in bone mass.
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The validity of HbA1C and fasting plasma glucose(FPG)for screening of diabetes in community population was investigated.A total of 1 794 subjects from two sub-districts of Yangpu District,Shanghai,underwent a 75 goral glucose tolerance test(OGTT)and HbA1C determination.Based on 1999 World Health Organization criteria,there were 1 411 subjects with normal glucose tolerance(NGT),111 impaired fasting glucose(IFG),73 impaired glucose tolerance(IGT),33 IFG+IGT,and 166 diabetes.According to the receiver operating characteristic curve,the optimal cut-point of FPG for diagnosing diabetes was 6.15 mmol/L with sensitivity of 89.0%,specificity of 92.8%,and area under the curve of 0.959.The cut-point of HbA1C for diagnosing diabetes was 6.5% with a sensitivity and specificity of 71.1% and 80.2%.The area under the curve was 0.822.The screening model using FPG ≥6.1mmol/L and HbA1C≥6.5% had sensitivity of 66.9% and specificity of 97.0%.When the model was FPG ≥6.1 mmol/L or HbA1C ≥6.5%,the sensitivity and specificity was 96.3% and 76.7% respectively.The results suggest that both FPG and HbA1C have good value for screening diabetes in community,and FPG combined with HbA1C may further promote diagnostic efficacy.