Research on the demand of simulation operations specialists in simulated courses in standardized residency training / 中华医学教育探索杂志

Objective:To investigate the demand and practical utility of simulation operations specialists (SOS) in simulation teaching modules during the standardized residency training.Methods:Based on the feedback for stimulated courses of standardized residency training, subjective evaluation of all residents, teachers and SOS who participated in simulation courses in 2017-2018 academic year were investigated and studied via the mobile phone online investigation. At the same time, the design data of teaching concept map of relevant curriculum were also included. The SPSS 13.0 was used to conduct the t test and chi-square test. Results:At present, only 26.3% of the preset functions were used in the medical simulation courses based on high-tech medical simulator. Tutors commanded less than 30% functions, while SOS participated in the whole process of the course preparation and commanded 63.6% of the course operations, which was higher than the requirement of teaching concept map (45.5%). Among them, ECG monitoring regulation, venous management and special effects makeup were in greatest needs and were items with the biggest gap between ideality and reality. Resident physicians required SOS to replace the tutors to operate teaching facilities, so as to reduce interruption (37.0%), implications (31.3%) during courses, and improvement of experience sense during the course (32.3%). Furthermore, specialists with clinical background needed more assistance from SOS than those without clinical background ( tQ3=3.204, tQ4=2.573, tQ5=2.660; P<0.05). Differences were found between the actual work content of SOS and their job requirement ( χ2=12.632, P<0.01). Conclusion:SOS plays a significant role in the simulation course of standardized residency training, especially in the course of clinical professional physicians. Auxiliary functions of simulated courses, such as teaching aids management, special effects makeup, course designing, qualified SP and others are the main necessities for SOS at present. Participation of tutors and SOS together is essential to ensure a good development and performance of medical simulation courses for standardized residency training.

The application of feedback debriefing in simulation-based clinical training / 中华医学教育探索杂志

Objective To evaluate the educational effectiveness of feedback debriefing in clinical training.Methods Forty medical students and fifteen teachers were enrolled in the 2015 after-internship clinical training,which was newly designed to obtain the debriefing part.The test scores and single technical practices were collected and analyzed,before and after the training.DASH scoring system was used to evaluate the effect of debriefing in the team simulation.Results were statistically analyzed by SAS 9.2(SAS institute Inc).Quantitative data were described by x ± s,while qualitative data were described by number and/or constituent ratio.Student's t test and Wilcoxon rank sum test were applied as needed.A P-value ＜ 0.05 was considered to be significant.Results The scores of the students before and after the assessment were (41.88 ± 8.54) vs.(65.06 ± 13.83),and the difference was statistically significant(P=0.000).Individual skills before and after the course had a different degree of improvement.The average DASH-scores evaluated by the students,teachers and supervisors were (39.3 ± 2.12) (very good),(35.1 ± 4.18) (good) and (37.2 ± 3.03)(very good),separately.Conclusions Potent debriefing helps to improve the effectiveness of simulationbased clinical training.

Effects and mechanism of fibroblast growth factor 21 on rat vascular smooth muscle cells calcification / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the effect and mechanism of fibroblast growth factor 21 (FGF21) on rat vascular smooth muscle cells (VSMCs) calcification in vitro.</p><p><b>METHODS</b>VSMCs was treated with calcification medium containing calcium chloride and β-glycerophosphate to induce rat VSMCs calcification in vitro. VSMCs were divided into 5 groups: the control group (cultured in normal medium), the calcification group (incubated in calcified medium), the FGF21 group (cultured in calcified medium and FGF21), the PD166866 group (cultured in calcified medium and FGF21 and PD166866, inhibitor of fibroblast growth factor receptor-1 (FGFR1)), the GW9662 group (cultured in calcified medium and FGF21 and GW9662, inhibitor of peroxisome proliferators activated receptor-γ (PPAR-γ)). The calcification of VSMCs was detected by calcium content, alkaline phosphatase activity and alizarin red staining. The protein and mRNA expression of FGFR1, β-Klotho, osteocalcin and smooth muscle 22α (SM22α) were determined by western blot analysis and realtime-PCR, respectively.</p><p><b>RESULTS</b>(1) The mRNA (P < 0.01) and protein expressions of β-Klotho and FGFR1 were significantly downregulated in calcification group compared with control group (P < 0.05 or 0.01). (2) The protein levels and mRNA expression of calcium content, alkaline phosphatase activity and osteocalcin were significantly downregulated, while the protein levels and mRNA of SM22α were significantly increased in FGF21 group compared with calcification group (all P < 0.05). Moreover, alizarin red staining verified positive red nodules on calcified VSMCs was significantly reduced in FGF21 group than in calcification group. (3) Calcium content, alkaline phosphatase activity and alizarin red staining were similar between PD166866 group and calcification group (all P > 0.05). (4) Calcium content, alkaline phosphatase activity and alizarin red staining were similar between GW9662 group and calcification group (all P > 0.05).</p><p><b>CONCLUSION</b>The inhibition of VSMCs calcification by FGF21 is mediated by further downregulating FGFR1 and β-Klotho while activating PPAR-γ pathways.</p>

Bufalin reverses hepatocyte growth factor-induced resistance to afatinib in H1975 lung cancer cells / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the effects of bufalin in reversing hepatocyte growth factor (HGF)-induced resistance to afatinib in H1975 lung cancer cells, and explore its possible mechanism.</p><p><b>METHODS</b>The afatinib-resistant H1975 lung cancer cells (H1975AR) were induced by exogenous HGF and transfected with recombinant adenoviral vector Ad-HGF-GFP. The cytostatic effects of bufalin, afatinib and bufalin plus afatinib on H1975AR cells were evaluated by MTT assay. The impact of combined therapy with bufalin and afatinib on invasion of H1975AR cells was determined by transwell migration assay. The concentrations of HGF in the culture supernatants of H1975/Vec and H1975/HGF cells were determined by ELISA. The expression of EGFR, cMET and EMT signal pathway-related proteins in H1975AR cells treated with bufalin, afatinib and bufalin plus afatinib were detected by Western blot.</p><p><b>RESULTS</b>The results of MTT assay showed that afatinib did not inhibit the growth of H1975 cells, but after 72 h of the combined treatment with bufalin and afatinib and in the presence of HGF, the growth rate of H1975 cells was (38.67 ± 8.76)%, significantly lower than the growth rate of (63.45 ± 12.65)% in the H1975 cells treated with HGF alone (P < 0.05). The results of transwell migration assay showed that in the presence of HGF, afatinib plus bufalin combination therapy markedly decreased the number of invaded H1975 cells through the Matrigel chamber (48.98 ± 11.43), significantly lower than the 118.92 ± 37.29 of afatinib-treated or the 88.84 ± 19.53 of bufalin-treated cells (P < 0.05 for all). The result of ELISA showed that H1975/HGF cells secreted high levels of HGF, and afatinib and bufalin had no effect on the HGF secretion in H1975/HGF cells. The results of Western blot analysis showed that the expression of p-EGFR, p-cMet, p-AKT, p-ERK, vimentin and snail in H1975AR cells treated with bufalin puls afatinb was down-regulated markedly, and the expression of E-cadherin was up-regulated markedly.</p><p><b>CONCLUSIONS</b>Combination of bufalin and afatinib strongly inhibits the growth of H1975AR lung cancer cells and decreases their invasion ability. The possible mechanism of combined treatment with bufalin and afatinib may be related to the blocking of cMet/PI3K/AKT and cMet/MAPK/ERK pathways and inhibiting of epithelial-mesenchymal transition.</p>

Effects of Chinese herbal medicine Feiyanning decoction on expressions of nucleosome conformation-regulating factors H3-K56, Rtt109, Asf1 and E2F1 in Lewis-bearing mice / 中西医结合学报

Malignant tumor cells were found with an abnormal cell cycle. Previous in vivo experiment had confirmed the Feiyanning's intervention effect on checkpoint signaling of G1/S in the cell cycle. This study was to further observe the expressions of nucleosome conformation-regulating factors intervened by Feiyanning decoction in S phase.

Effects of chemotherapy combined with Chinese herbal medicine Kangliu Zengxiao Decoction on tumor markers of patients with advanced non-small-cell lung cancer: a randomized, controlled trial / 中西医结合学报

Background: Tumor markers are widely used in clinical practice and have become important indicators in assessing cancer progress. There is increasing concern that chemotherapy combined with traditional Chinese medicine has effects in decreasing the level of tumor markers. Objective: To investigate the effects of chemotherapy combined with Kangliu Zengxiao Decoction (KLZX), a compound Chinese herbal drug, on tumor markers carbohydrate antigen 50 (CA 50), cytokeratin 19 fragment (CYFRA21-1) and carcinoembryonic antigen (CEA) in patients with advanced non-small-cell lung cancer (NSCLC) and to explore the relationships between clinical efficacy and tumor markers. Design, setting, participants and interventions: Patients were included from Punan Hospital of Shanghai Pudong New District and Longhua Hospital between October 2008 and December 2009. Seventy-four subjects with advanced NSCLC were randomly assigned into treatment group (n=37) and control group (n=37). Patients in the control group were treated with chemotherapy alone while patients in the treatment group were treated with chemotherapy combined with KLZX. Chemotherapy of NP (vinorelbine + cisplatin) was given for two cycles and patients in the treatment group were administered with KLZX during chemotherapy. Main outcome measures: Levels of CA50, CYFRA21-1 and CEA before and after treatment were evaluated and the relationship between changes in levels of tumor makers and tumor size, clinical symptoms and living condition score (Karnofsky score) was analyzed. Results: No patients achieved a complete remission. The disease control rates (complete remission (CR)+partial remission (PR)+no change (NC)) were 89.20% (33/37) and 70.30% (26/37) in the treatment and control group respectively (P<0.05). The levels of CA50, CYFRA21-1 and CEA were clearly decreased in the treatment group after treatment (P<0.05) while also decreased in the patients without progression of disease. There were no obvious changes of CA50, CYFRA21-1 and CEA in the control group, and there was even a trend of increase. Furthermore, the improvement rates of clinical syndrome were 51% (19/37) vs 11% (4/37) (P<0.05) in the treatment group and control group respectively. The total response rates of quality of life were 91.89% (34/37) vs 56.76% (21/37) (P<0.01) in the treatment and control group respectively. Conclusion: Combined chemotherapy with KLZX in treating advanced NSCLC can acquire better stabilizing tumor foci, decrease levels of tumor markers and improve the clinical symptoms and Karnofsky score.

Gene polymorphism and physical constitution theory: starting point of exploring syndromes of lung cancer / 中西医结合学报

Physical constitution theory is an important part of traditional Chinese medicine theory. Physical constitution is associated with the incidence, development and prognosis of diseases. Gene polymorphism is a result of the interaction between internal and external environments during the human evolution, and it is the reason for differences in biological characteristics and disease susceptibility of individuals. Current status of the research on physical constitution theory, lung cancer syndromes and gene polymorphism are summarized in this paper. Exploring lung cancer syndromes from the point of view of gene polymorphism may reveal the scientific connotation of lung cancer syndromes, and provide new evidence and method for diagnosis of lung cancer.

Inhibitory effects of Feiyanning Decoction on proliferation, migration and tube formation of human umbilical vein endothelial cells in vitro / 中西医结合学报

To observe the inhibitory effects of Feiyanning Decoction, a compound traditional Chinese herbal medicine for replenishing qi, nourishing essence, and diminishing stagnation by detoxification, on proliferation, migration and tube formation of human umbilical vein endothelial cells (HUVECs).

Effects of Feiyanning Decoction on gene expression of nuclear factor-kappaB activated by tumor necrosis factor-alpha in lung adenocarcinoma cell line / 中西医结合学报

To study the effects of Feiyanning Decoction, a compound traditional Chinese herbal medicine, on gene expression of nuclear factor-kappaB (NF-kappaB) activated by tumor necrosis factor-alpha (TNF-alpha) in lung adenocarcinoma cell line (A549).

Effects of Feiyanning formula on expressions of mRNAs and proteins of CXCL12 and CXCR4 in mice with Lewis tumors / 中西医结合学报

To observe the effects of Feiyanning (FYN) formula, a compound traditional Chinese herbal medicine, on the expressions of CXCL12 and CXC chemokine receptor 4 (CXCR4) mRNAs and proteins in Lewis tumors in C57 mice.

Effects of Feiyanning Decoction on proliferation of lung adenocarcinoma cell line and their production of interleukin-6 and interleukin-8 induced by tumor necrosis factor-alpha / 中西医结合学报

To study the effects of Feiyanning Decoction, a compound traditional Chinese herbal medicine, on proliferation of lung adenocarcinoma cell line A549 cells and their production of interleukin-6 (IL-6) and IL-8 induced by tumor necrosis factor-alpha (TNF-alpha).

Dual regulation of cell cycles by Shuanghuang Shengbai Granule in Lewis-bearing mice with chemotherapy-induced myelosuppression and its mechanism / 中西医结合学报

To explore the dual regulatory effects of Shuanghuang Shengbai Granule, a compound traditional Chinese herbal medicine, on cell cycle in Lewis-bearing mice with chemotherapy-induced myelosuppression.

Feiyanning Decoction down-regulates the expressions of phosphorylated Akt and hypoxia inducible factor-1alpha proteins in transplanted lung adenocarcinoma in nude mice / 中西医结合学报

To observe the effects of Feiyanning Decoction, a compound traditional Chinese herbal medicine, in inhibiting the growth of transplanted A549 tumors in nude mice and the expressions of p-Akt and HIF-1alpha in A549 tumors.

An optimized 3-step strategy for preventing and treating post-operation relapse and metastasis of malignant tumors with traditional Chinese medicine / 中西医结合学报

Abstract: Relapse and metastasis are the main causes responsible for failure of surgical operation in treating malignant tumors. This article introduces the present development in post-operation treatment of lung cancer, liver cancer and stomach cancer, showing that the synthetic treatment by stages combined with traditional Chinese medicine is the important way to prevent and treat the post-operation relapse and metastasis of tumors, and suggesting the optimized method for treatment.

Effects of NK-104 on apoptosis and caspase-3 activity in hepatocellular carcinoma cells / 中西医结合学报

To study the apoptosis of human hepatocellular carcinoma cell line HepG 2 induced by pitavastatin (NK-104) and to investigate the change of caspase-3 activity.

Effects of Xuanyinning Recipe on invasion of SPC-A-1 cells and pathomorphological changes of peritoneum in mice inoculated with sarcoma 180 / 中西医结合学报

OBJECTIVE: To observe the effects of Xuanyinning Recipe (XYNR) in inhibiting SPC-A-1 cellular infiltration and on the pathomorphological changes of peritoneum in mice inoculated with sarcoma 180 (S(180)). METHODS: On the bases of isolated culture of mouse peritoneal mesothelial cells, we adjusted and added the human lung adenocarcinoma cell line SPC-A-1 into the double-layer culture medium to observe the number of clones formed. We also took out the peritoneum from the mice administered with three different dosages of XYNR and observed its pathomorphological changes with transmission electron microscope. RESULTS: In the in vitro experiment, the number of clones of SPC-A-1 in culture medium with XYNR (50 microg/ml) decreased distinctly. In the in vivo experiment, it was observed that, in the peritoneum from the XYNR-treated mice inoculated with S(180), the mesothelial cells arranged more and more regularly with the increasing of the dosage of XYNR, while the mesothelial cells in the peritoneum of the mice in the control group necrosed and arranged loosely. CONCLUSION: XYNR can inhibit the invasion of SPC-A-1 cells. It also can improve the loose arrangement of the peritoneal mesothelial cells in mice inoculated with S(180), so as to inhibit the malignant effusion.

Evidence-based medicine and treatment of lung cancer / 中西医结合学报

Traditional Chinese medicine (TCM) thinks highly of Zheng Hou in the treatment of lung cancer. Zheng is evidence. Hou is clinical manifestations. After obtaining information and evidence of patients by means of the four diagnostic methods, doctors treat patients by syndrome differentiation. In TCM, the collection and study of medical literature of tumor are emphasized. Medical classics and successful treatment of certain cases are used to guide clinical treatment. Such practice of TCM is similar to that of evidence-based medicine (EBM). Oncology of TCM and EBM are all of ancient origin. There are many clinical reports of satisfactory curative effects in treating lung cancer by TCM. But there are still many problems in methodology, such as careless random method, incomparability in base line, and deficiency of large exponent, multicenter, blind method or randomization. Sometimes the effects of control drugs are incredible. The determination of near effect is not strict. There are exponent errors in statistics of near effect(CR+PR). Certainly, treatment of lung cancer by TCM has its uniqueness. The main characteristic of treatment by TCM is that it can restrain or slow the growth of tumor. At the same time, physical signs, symptoms and quality of life can be improved, and survival period is prolonged. "Survival rate is the golden standard". If we can explore a new treatment strategy to control the growth and metastasis of advanced NSCLC and prevent relapse and metastasis of earlier period or metaphase NSCLC by the method of binding TCM and west medicine under the rules of EBM, such as multicenter (TCM hospital and western medicine hospital), blind method, strict randomization and control, the conclusion of the study will be more scientific.

The effect of traditional Chinese medicine therapy on serum CA-125 in lung cancer patients / 中国癌症杂志

Background and purpose:CA-125 is already recognized as one of the biomarkers for ovarian cancer.The serum CA-125 also had some significance in terms of the diagnosis and determination of the prognostic values for lung cancer.The purpose of this study was to investigate the effect of traditional Chinese medicine(TCM)therapy on serum CA-125 level in lung cancer patients.At the same time,we investigated the relationship between the serum CA-125 level and the clinical stages as well as the pathological types.Methods:Serum CA-125 levels from 30 normal donors were detected and compared to 60 patients with lung cancer by microparticle enzyme immunosorbant assay(MEIA).Results:Serum CA-125 levels in lung cancer group were(91?45)and significantly higher than those in healthy control group(18?5)(P

Effect of NK-104 on NF-?B activated by TNF-? in hepatocellular carcinoma cells / 中国癌症杂志

Background and purpose:A causal relationship between inflammation and cancer has been extensively investigated. Nuclear factor-kappa B (NK-?B) is a key regulator in inflammation-associated cancer, and is activated by a variety of stimuli. This paper studied the anti-inflammatory effect of NK-104 on NF-?B activated by TNF-? in hepatocellular carcinoma cell line (Huh 7). Methods:The cell proliferation was examined by the WST-8 assay. The NF-?B and I?B? expressions were evaluated by western blotting. IL-8 and its product were quantitated by ELISA.Results:TNF-?(1 ng/ml) strongly induced the expression of NF-?B by approximately 1.8-fold compared with the control in the nuclei of Huh 7 cells, the induced NF-?B expression was significantly suppressed by the addition of pitavastatin at 0.1 ?mol/L (P 0.05). Subsequently, the addition of TNF-? significantly increased IL-8 production, which could be reversed by the addition of NK-104.Conclusions:These results suggest that NK-104 at low dose (0.1 ?mol/L) inhibits NF-?B activation and decreases IL-8 production induced by TNF-?. It is therefore expected to play a role in the new strategy for the treatment of hepatocellular carcinoma.

Shuanghuang Shengbai Granule on the mechanism of leukogenic effect / 中成药

AIM: To observe the effect of Shuanghuang Shengbai Granule (Radix astragli, Rhizoma polygonati, Fructus ligustri lucidi, Radix trichosanthis, Rhizoma drynariae, etc) (SHSB) on the proliferation of bone marrow cells and the growth of granulocyte-macrophage colony stimulating factor(GM-CSF) in leukopenia model mice, and to investigate the related mechanism. METHODS: Mouse leukopenia models were made by radiation, the proliferation of bone marrow cells was determined by MTT chromatoptometry, the content of GM-CSF in serum was measured by double antibody sandwich ELISA, and the protein expression of GM-CSF in cultured spleen cells was measured by SP immunocytochemistry. RESULTS: SHSB could promote the proliferation of bone marrow cells; increase the content of GM-CSF in serum and enhance the protein expression of GM-CSF in spleen cells. CONCLUSION: SHSB Granule has the improvement in enhancing the proliferation of bone marrow cells in leucopenia model mice, increasing the content of GM-CSF in serum and the protein expression of GM-CSF in spleen cells.