Clinical application and evaluation of health economics for non-invasive prenatal testing of fetuses in Tianjin / 中华医学遗传学杂志

OBJECTIVE@#To assess the clinical efficacy and health economic value of non-invasive prenatal testing (NIPT) for the prenatal screening of common fetal chromosomal aneuploidies.@*METHODS@#10 612 pregnant women from October 2017 to December 2019 presented at the antenatal screening clinic of the General Hospital of Tianjin Medical University were selected as the study subjects. Results of NIPT and invasive prenatal diagnosis and follow-up outcome for the 10 612 pregnant women were retrospectively analyzed and compared. Meanwhile, NIPT data for two periods were analyzed for assessing the health economic value of NIPT as the second- or first-tier screening strategy for the prenatal diagnosis of fetal trisomies 21, 18 and 13.@*RESULTS@#The NIPT was successful in 10 528 (99.72%) subjects, with the sensitivity for fetal trisomies 21, 18 and 13 being 100%, 92.86% and 100%, and the positive predictive value (PPV) being 89.74%, 61.90% and 44.44%, respectively. The PPV of NIPT for sex chromosome aneuploidies was 34.21%. Except for one false negative case of trisomy 18, the negative predictive value for trisomy 21, trisomy 13 and other chromosomal abnormalities were 100%. For pregnant women with high risk by serological screening, advanced maternal age or abnormal ultrasound soft markers, NIPT has yielded a significantly increased high risk ratio. There was no statistical difference in the PPV of NIPT among pregnant women from each subgroup. NIPT would have higher health economic value as a second-tier screening until 2019, while compared to 2015 ~ 2017, its incremental cost-effectiveness ratio as a first-tier screening had declined clearly.@*CONCLUSION@#The screening efficacy of NIPT for trisomies 21, 18 and 13 for a mixed population is significantly better than conventional serological screening, but it is relatively low for sex chromosomal abnormalities. NIPT can also be recommended for populations with relatively high risks along with detailed pre- and post-test genetic counselling. From the perspective of health economics, except for open neural tube defects, it is possible for NIPT to replace the conventional serological screening in the future as its cost continues to decrease.

Application study of panoramic teaching mode in the teaching of clinical interns in the department of respiratory medicine / 中华医学教育探索杂志

Objective:To explore the value of panoramic teaching in clinical practice teaching of department of respiratory medicine.Methods:A total of 35 clinical interns who had a 3-week rotation in the department of respiratory medicine from October 2019 to June 2020 were selected, and they were divided into a control group ( n=17) and a study group ( n=18) according to the order of admission. The control group used traditional teaching, and the research group used panoramic teaching. After the teaching, the teaching effect was evaluated through theoretical knowledge assessment, practical assessment and questionnaire survey. SPSS 19.0 was used for t test. Results:There was no statistically significant difference between the two groups of interns in theoretical assessment [(89.62±4.05) points vs. (90.84±4.12) points, t=-0.891, P=0.379]. The results of practice assessment (case analysis, physical examination of the department, medical history inquiry and skills manipulation) of the study group were significantly higher than those of the control group ( P<0.05). The interns in study group were better than those in control group in such aspects as learning interest, self-learning ability, self-study ability, doctor-patient communication language expression ability, literature review ability, clinical thinking ability, comprehensive analysis ability, knowledge development ability, system diagnosis ability, teamwork ability and teaching satisfaction ( P<0.05). Conclusion:Panoramic teaching can effectively improve the ability of interns to master the clinical diagnosis and treatment of respiratory medicine, improve the teaching effect, and improve the learning ability and clinical competence of interns in the future.

Construction of EZH2 Knockout Animal Model by CRISPR/Cas9 Technology / 中国肺癌杂志

BACKGROUND@#It has been proven that CRISPR/Cas9 (Clustered Regularly Interspaced Short Palindromic Repeats/CRISPR-associated 9) system was the modern gene-editing technology through the constitutive expression of nucleases Cas9 in the mammalian, which binds to the specific site in the genome mediated by single-guide RNA (sgRNA) at desired genomic loci. The aim of this study is that the animal model of EZH2 gene knockout was constructed using CRISPR/Cas9 technology.@*METHODS@#In this study, we designed two single-guide RNAs targeting the Exon3 and Exon4 of EZH2 gene. Then, their gene-targeting efficiency were detected by SURVEYOR assay. The lentivirus was perfused into the lungs of mice by using a bronchial tube and detected by immunohistochemistry and qRT-PCR.@*RESULTS@#The experimental results of NIH-3T3 cells verify that the designed sgEZH2 can efficiently effect the cleavage of target DNA by Cas9 in vitro. The immunohistochemistry and qRT-PCR results showed that the EZH2 expression in experimental group was significantly decreased in the mouse lung tissue.@*CONCLUSIONS@#The study successfully designed two sgRNA which can play a knock-out EZH2 function. An EZH2 knockout animal model was successfully constructed by CRISPR/Cas9 system, and it will be an effective animal model for studying the functions and mechanisms of EZH2.

Development of research hospital's humanistic system at Nanj ing Drum Tower Hospital / 中华医院管理杂志

In the practice of building its humanistic environment of a research hospital,Nanjing Drum Tower hospital adheres to such humanistic characteristics of the hospital as humanistic concept,planning, environment,management,service,and quality.Furthermore,the hospital upholds such keys as learning, innovation, cooperation, undertaking, competition and development. High focus, high starting point planning,persistence,and down-to-earth efforts,effectively promoting hospital development.

Analysis on proteome of culture filtrates of Mycobacterium tuberculosis, serum and pleural effusion from patients with tuberculous pleurisy / 实用医学杂志

Objective To find humoral protein markers to develop new experimental diagnostic methods for tuberculous pleurisy. Methods Proteomes of 7 d and 14 d culture filtrate of Mycobacterium tuberculosis growing in Middlebrook 7H9, serum and pleural effusion from five patients with tuberculous pleurisy were detected by surface-enhanced laser desorptionionization time-of-flight massspectrometry (SELDI-TOF-MS). And the data were analyzed with descriptive statistics method to observed the protein components all owned by three kinds of proteome. Results From protein species, proteins of all culture filtrate were far more than that of pleural effusion and serum while proteins of pleural effusion in four cases were more than that of serum. The kinds of common proteins between culture filtrate and pleural effusion, between culture filtrate and serum, between serum and pleural effusion, among culture filtrate and pleural effusion and serum were different. But the protein of relative molecular mass of 2 660 depending on the ratio of mass to charge existed in all samples of culture filtrate, pleural effusion and serum. Conclusion The protein of relative molecular mass of 2 660 possess the latent quality as a specific humoral protein marker for tuberculous pleurisy. But it is essential that must be further confirmed among large samples.

Expression and significance of four kinds of serum protein/polypeptide in tuberculosis patients and healthy controls / 实用医学杂志

Objective To assess the efficacy of using four kinds of proteins / peptides to distinguish the tuberculosis patients from healthy people. Methods A, B, C and D were used to represent four proteins /peptides with 1 060, 1 944, 2 081 and 3 954 of mass to charge ratio (m / z) in serum, respectively. Levels A, B, C and D in serum of 57 patients with tuberculosis and 30 healthy people were determined by using the surface-enhanced laser desorption-ionization time of flight mass spectrometry (SELDI-TOF-MS). Then the differences of levels of f A, B, C and D were anlyzed between tuberculosis patients and healthy people. The efficacy of distinguishing tuberculosis patient from healthy people were evaluated by using diagnostic test evaluation method. Results (1) The levels of A, B, C and D were 1 ± 11, 1 597 ± 3 102, 460 ± 765 and 1 208 ± 1 003 in tuberculosis patients, while they were 123 ± 201, 47 ± 98, 36 ± 93 and 397 ± 355 in healthy people. (2) The area under the receiver operator characteristic (ROC) curve was 0.644, 0.848, 0.735 and 0.810 respectively. The serum levels of A, B, C and D could be used to distinguish tuberculosis patient from healthy people and the cut-off values of A, B, C and D were ≤166, ≥318, ≥48 and ≥728, respectively. Conclusions B, C and D have better performances to distinguish tuberculosis patients from healthy people , which may be regarded as new promising candidate markers for diagnosis of tuberculosis.

Spatiotemporal expression patterns of three vernalization genes in wheat / 生物工程学报

To identify spatiotemporal expression patterns of vernalization genes in common wheat, we analyzed expression characteristics of several vernalization genes (VRN1, VRN2 and VRN3) in the wheat cultivars 'Chinese spring' and 'Luohan 2' by RT-PCR. The VRN1 gene was expressed at different levels in the leaves and roots at the 3-leaf stage, stems, flag leaves at the grain-filling stage, anthers, ovules, and developing seeds in 'Chinese spring'. Expression of VRN1 increased before flowering date, then decreased after flowering time. Expression of VRN1 was not detected in dry seeds or seeds germination. Expression patterns of VRN1 in 'Luohan 2' were similar to those in 'Chinese spring', except that it was not expressed in roots or in the leaves at the 3-leaf stage in 'Luohan 2'. Expression of VRN2 was only detected in the leaves at the 3-leaf stage and in the embryo buds during seeds germination. The Spatiotemporal expression of VRN3 was similar to that of VRN1, except that VRN3 was not expressed in roots. These results improved our understanding of the molecular regulation of vernalization genes in common wheat.