ABSTRACT
Objective:To explore the application effect of medical science competition in nursing interns whocontribute to "healthy China" , and to improve their health education awareness, ability, method and self-confidence.Methods:A total of 205 nursing interns who worked in Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from 2019 to 2020 were selected as the research objects. They were divided into the control group (105 cases) and the experimental group (100 cases) according to whether they participated in the medical science competition. The control group learned the form and method of health education in clinical rotation according to the traditional practice teaching plan. The experimental group volunteered to participate in the medical science competition, which required the dissemination of health knowledge through various forms. Before and after the competition, the health education ability assessment scale was used for comparison.Results:Before the medical science competition, there was no significant difference in the total score of assessment, planning, implementation, evaluation and health education between the control group and the experimental group ( t values were 0.765 - 1.749, all P>0.05). After the medical science competition, the total scores of assessment, planning, implementation, evaluation and health education ability of nursing interns in the experimental group were (24.38 ± 4.72), (17.98 ± 3.98), (25.16 ± 5.36), (12.57 ± 2.96) and (80.09 ± 15.65) respectively, while those in the control group were (22.45 ± 6.29), (16.61 ± 4.77), (23.04 ± 6.55), (11.31 ± 3.46) and (73.41 ± 19.69).The differences between the two groups were statistically significant ( t values were 2.226 - 2.795, all P<0.05). Conclusions:The medical science competition can improve the health education ability of assessment, planning, implementation, evaluation of nursing interns and contribute to "healthy China" .
ABSTRACT
Objective:to construct and test the structural equation model of influencing factors of clinical nursing teaching quality, and analyze the influencing factors and strength of clinical nursing teaching quality.Methods:Based on the literature, 20 indexes influencing the quality of clinical nursing teaching were selected. In July 2019, clinical nursing teachers of a third class a medical institution were selected for convenient sampling survey. Through factor analysis, 20 indexes were classified into 6 dimensions, namely, teaching environment, teaching attitude, teacher quality, teacher behavior, teaching management and teaching quality.Results:The structural equation model of influencing factors of clinical nursing teaching quality was constructed. The fitting index of the model reached the standard value, and the model had a good fit.Conclusion:With the help of this model, the nursing administrators can find out the factors and intensity that affect the quality of clinical nursing teaching, which is helpful to put forward the improvement strategies of improving the quality of clinical nursing teaching, to improve the effect of clinical nursing teaching, to improve the quality of clinical nursing teaching, and to provide reference for the research of similar clinical nursing teaching quality.
ABSTRACT
Objective To explore the plasma level change of soluble tumor necrosis factor related apoptosis inducing ligand (sTRAIL) in patients with systemic lupus erythematosus (SLE) and its clinical significance.Methods Quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the mRNA expressions of TRAIL and TRAIL receptors-1 (TRAIL-R1) and TRAIL-R2 in the peripheral blood mononuclear cells (PBMCs) derived from active SLE patients (n =26) and healthy controls.Enzyme linked immuno sorbent assay (ELISA) was used to detect the plasma level of sTRAIL in the active SLE patients (n=42),healthy controls (n=21).Pearson correlation analysis was used to analyze the correlation of sTRAIL with clinical and laboratory parameters.Results The plasma levels of sTRAIL [(82±5) pg/ml] in SLE were significantly higher than that in healthy controls [(49 ±3) pg/ml],the difference was statistically significant (t=4.10,P＜0.01).The plasma levels of sTRAIL in SLE with inactive disease [(92±14) pg/ml],mild active disease [(80±9) pg/ml],moderate active disease [(74±12) pg/ml] and severe active disease [(83±8) pg/ml] were higher than healthy controls,the difference was statistically significant (H=18.07,P＜0.01).The mRNA levels of TRAIL and TRAIL-R2 in PBMCs derived from SLE patients were significantly higher than those in healthy controls [(1.04±0.08) vs (1.80±0.25),t=2.10,P＜0.05 and (1.07±0.12) vs (2.08±0.21),t=3.27,P＜0.01].In SLE with moderate and severe active disease,plasma sTRAIL levels were associated with the 24 hours urine protein.Conclusion Plasma sTRAIL may be predictors of SLE disease activity and TRAIL pathway may be a new potential target of SLE treatment.
ABSTRACT
Objective To investigate the regulation of mesenchymal stem cells (MSCs) on the expression of tumor necrosis factor-α-induced protein 8-like 2 (TNFAIP8L2, TIPE2) in the peripheral blood-derived macrophages of systemic lupus erythematosus (SLE) patients. Methods The expression of TIPE2 mRNA in peripheral blood mononuclear cells (PBMCs) and macrophages from SLE patients were detected by Quantitative polymerase chain reaction (qPCR). The TIPE2 protein levels in SLE PBMCs and peripheral blood-derived macrophages were detected by western blot, flow cytometry and immunofluorescence staining, respec-tively. Data were analyzed by t test and Spearman correlation analysis. Results The TIPE2 mRNA expres-sion in PBMCs of SLE patients was significantly lower than that of healthy controls [(0.41 ±0.14) vs (1.06±0.39), t=5.376, P<0.01], as well as the TIPE2 protein level [(0.40 ±0.21) vs (1.09 ±0.26), t=2.963, P<0.05]. The expression of TIPE2 mRNA in peripheral blood-derived macrophages from SLE patients was significantly decreased [(0.56±0.24) vs (1.07±0.38), t=5.203, P<0.01). Moreover, TIPE2 mRNA level of peripheral blood-derived macrophages was negatively correlated with systemic lupus erythematosus disease activity index (SLEDAI) score (r=-0.60, P<0.01), 24-hour urinary protein (r=-0.46, P<0.05) and erythrocyte sedimentation rate (r=-0.46, P<0.05) in SLE patients. The percentage of TIPE2+cells in peripheral blood-derived macrophages (TIPE2+/CD14+)％ from SLE patients was significantly lower than that in healthy controls [(51.4 ±18.5)％ vs (82.4 ±7.5)％, t=2.679, P<0.05]. After 24 hours co-cultured with MSCs, the TIPE2 mRNA expression in SLE per-ipheral blood-derived macrophages was significantly increased [(2.2 ±0.7) vs (1.0 ±0.3), t=3.729, P<0.05). Immunofluorescence results showed the same increase of TIPE2 protein in SLE peripheral blood-derived macrophages [(0.112 ±0.020) vs (0.074 ±0.016), t=3.268, P<0.05]. Conclusion The TIPE2 level in peripheral blood-derived macrophages of SLE patients are decreased. MSCs upregulate the TIPE2 expression in vitro, suggesting that TIPE2 can be a new target for MSCs in the treatment of SLE.
ABSTRACT
Objective@#To explore the plasma level change of soluble tumor necrosis factor related apoptosis inducing ligand (sTRAIL) in patients with systemic lupus erythematosus (SLE) and its clinical significance.@*Methods@#Quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the mRNA expressions of TRAIL and TRAIL receptors-1 (TRAIL-R1) and TRAIL-R2 in the peripheral blood mononuclear cells (PBMCs) derived from active SLE patients (n=26) and healthy controls. Enzyme linked immuno sorbent assay (ELISA) was used to detect the plasma level of sTRAIL in the active SLE patients (n=42), healthy controls (n=21). Pearson correlation analysis was used to analyze the correlation of sTRAIL with clinical and laboratory parameters.@*Results@#The plasma levels of sTRAIL [(82±5) pg/ml] in SLE were significantly higher than that in healthy controls [(49±3) pg/ml], the difference was statistically significant (t=4.10, P<0.01). The plasma levels of sTRAIL in SLE with inactive disease [(92±14) pg/ml], mild active disease [(80±9) pg/ml], moderate active disease [(74±12) pg/ml] and severe active disease [(83±8) pg/ml] were higher than healthy controls, the difference was statistically significant (H=18.07, P<0.01). The mRNA levels of TRAIL and TRAIL-R2 in PBMCs derived from SLE patients were significantly higher than those in healthy controls [(1.04±0.08) vs (1.80±0.25), t=2.10, P<0.05 and (1.07±0.12) vs (2.08±0.21), t=3.27, P<0.01]. In SLE with moderate and severe active disease, plasma sTRAIL levels were associated with the 24 hours urine protein.@*Conclusion@#Plasma sTRAIL may be predictors of SLE disease activity and TRAIL pathway may be a new potential target of SLE treatment.
ABSTRACT
Objective To investigate the immune regulatory effects of umbilical cord mesenchymal stem cells (UC-MSCs) transplantation on CD4+LAP+Treg cells in the peripheral blood of patients with systemic lupus erythematosus (SLE).Methods CD4+LAP+ Treg cells were detected in the peripheral blood from 30 SLE patients and 30 normal controls by flow cytometry.Five SLE patients received UC-MSCs transplantation,and their peripheral blood was collected before and after 24 hours of cell infusion.The percentages of CD4+ LAP+ T cells were detected by flow cytometry.Data were analyzed with t test and Spearman correlation test.Results The percentage of CD4+LAP+ Treg cells in the peripheral blood of SLE patients [(2.49 ±0.23)％]decreased remarkably compared with healthy controls [(3.35±0.19)％] (r=3.079,P＜0.01),and it was negatively correlated with serum alanine aminotransferase (ALT) [(40±44) U/L,r=-0.51,P＜0.05],AST [(35±53) U/L,r=-0.52,P＜0.05) and ALP [(64±25) U/L,r=-0.53,P＜0.01) level res-pectively.24 hours after UC-MSCs transplantation,the percentages of CD4+LAP+ Treg cells increased signif-icantly in SLE patients[(3.6±0.9)％ vs (2.1±0.6)％,r=3.508,P＜0.05].Conclusion The significantly decreased percentage of CD4+LAP+ Treg cells in patients with SLE suggests thatthey may participate in the pathogenesis of SLE.UC-MSCs transplantation can upregulate the expression of CD4+LAP+Treg cells in SLE patients,and the modulatory effects of UC-MSCs on CD4+LAP+ Treg cells may be one of the mechanisms of UC-MSCs therapy in ameliorating the disease.
ABSTRACT
Objective The purpose of this study is to observe the changes of immune cell subsets in lupus mice after umbilical cord mesenchymal stem cells (UC-MSCs) transplantation. Methods B6.MRL-Faslpr lupus mice were randomly divided into the following three groups: the UC-MSCs treated group, the fibroblast like synoviocytes (FLS) treated group and the untreated group. MSC (1×106) or FLS (1×106) were injected into the tail vein of lupus mice respectively. Four weeks after treatment, the spleen index was calculated. The pathological changes of kidney were assessed by HE staining. The frequencies of immune cell subsets in spleen and macrophage in kidney as well as abdominal cavity were analyzed by flow cytometry. Data were analyzed with t test. Results The spleen index of UC-MSCs treated lupus mice [(79 ±9) mg/10 g] and IgG level [(7.5±1.5) mg/ml] were significantly decreased when compared with FLS treated group [(147±23) mg/10 g, t=2.78, P<0.01] [(17.0 ±2.8) mg/ml, t=3.00, P<0.01] and the untreated group [(156 ±16) mg/10 g, t=4.29, P<0.01] [(16.7 ±1.6) mg/ml,t=4.01, P<0.01]. HE staining also showed that the pathological changes of kidney were alleviated after MSCs transplantation. In addition, the frequency of plasma cells in the untreated group [(2.61 2± 0.318)% vs (0.306±0.017)%, t=7.22, P<0.01] and the FLS treated group [(2.412±0.297)% vs (0.306±0.017)%, t=7.07, P<0.01] were markedly higher than MSCs treatment [(0.306 ±0.017)%]. Moreover, the frequency of CD25+Foxp3+/CD4+Treg in the MSCs treated group [(15.08±0.81)%] was significantly increased compared with the untreated group [(8.02 ±0.47)%, t=7.45, P<0.01] and FLS treated group [(8.80 ±0.23)%, t=7.39, P<0.01]. MSCs treatment resulted in a decrease in CXCR5+PD1+/CD4+Tfh and IFNγ+/CD4+Th1 subset, compared with the untreated group [(14.3±1.5)%vs (31.5±3.3)%, t=5.25, P<0.01] [(1.78±0.27)% vs (5.93±1.56)%, t=2.60, P<0.05] and the FLS treated group [(14.3±1.5)%vs (28.8±2.2)%, t=5.49, P<0.01] [(1.78±0.27)%vs (4.88±0.81)%, t=3.61, P<0.01]. The frequency of macrophage in kidney of the MSCs treated group [(3.52 ±0.37)%] was markedly increased compared with the untreated group[(1.58±0.29)%, t=3.25, P<0.01], while neither the IL4+/CD4+Th2 subset nor the IL17+/CD4+Th17subset and the frequency of macrophage in abdominal cavity showed significant changes in the three groups. Conclusion These findings suggest that the therapeutic effects of MSCs on lupus mice may mediate through increasing the frequency of spleen Treg and renal macrophage and decreasing the frequency of Tfh, Th1 and plasma cells.
ABSTRACT
Objective Whether the bone marrow cells (BMC) derived from systemic lupus erythematosus (SLE) could transmit autoimmune disease was studied for the purpose of clarifying the role of BMC in SLE pathogenesis.The effects of bone marrow mesenchymal stem cells (MSC) from SLE and control mice on the SLE BMC-induced symptoms were compared to elucidate the role of MSC in SLE.Methods Six-week-old B6.MRL-Fas mice were randomly divided into 3 groups.One group was transplanted with BMC from the 30-week-old B6.MRL-Faslg mice.One group was co-transplanted with BMC from the 30-week-old B6.MRL-Fasr mice and bone marrow MSC from the age-matched B6.MRL-Faslpr mice.One group was co-transplanted with BMC from the 30-week-old B6.MRL-Faslg mice and bone marrow MSC from the age-matched C57BL/6 mice.Before transplantation,the recipient mice received irradiation by an X-ray source.The levels of serum antinuclear antibody (ANA) and proteinuria were measured with enzyme linked immunosorbent assay (ELISA) and Bradford method every 4 weeks,respectively.The survival rate was recorded.All mice were sacrificed 18 weeks later.Splenic plasma cells,Th1,Th2 and Th17 cells were measured by flow cytometry.Statistical analyses were performed using the independent t test and ANOVA.Results Eight weeks after transplantation,ANA was positive in all the recipient mice.However,there was no significant difference between the three groups (P＞0.05).No proteinuria was observed in all the recipient mice.The mice received BMC from the 30-week-old B6.MRL-Fasr mice and bone marrow MSC from the age-matched B6.MRL-Fasr mice showed an elevated trend of the percentages of splenic plasma cells,Th1,Th2 and Th17 cells compared with the other two groups,plasma cells [(1.05±0.16)％,(0.58±0.11)％,t=2.53,P＞0.05;(1.05±0.16)％,(0.71±0.18)％,t=1.45,P＞0.05],Th1 cells [(6.6±2.2)％,(5.7±1.0)％,t=0.38,P＞0.05;(6.6±2.2)％,(4.0±1.7)％,t=0.96,P＞0.05],Th2 cells [(3.3±0.4)％,(2.1±0.6)％,t=1.76,P＞0.05;(3.3±0.4)％,(2.2±0.6)％,t=1.51,P＞0.05],Th17 cells [(2.30±0.71)％,(1.31±0.31)％,t=1.27,P＞0.05;(2.30±0.71)％,(1.12±0.27)％,t=1.67,P＞0.05].However,there was no significant difference between the groups.The survival rate of the three groups was 43％,43％ and 80％ respectively.And the survival rate of the mice received BMC from the 30-week-old B6.MRL-Fasr mice and bone marrow MSC from the age-matched C57BL/6 mice was significantly higher than those of the other groups.Conclusion Our results indicate that BMC from SLE can transmit autoimmune disease.The bone marrow MSC can not prevent lupus-like presentations induced by BMC from SLE.Transplantation of bone marrow MSC from C57BL/6 mice can significantly elevate the survival rate.
ABSTRACT
Objective To explore the preventive effect of early umbilical cord mesenchymal stem cells (UC-MSCs) transplantation on MRL/lpr mice and the underly mechanisms.Methods Fourteen 10-week-old MRL/lpr mice were labeled and numbered.They were randomly divided into 2 groups by using random number table and injected with 1 ×106 UC-MSCs or PBS via tail vein respectively.Proteinuria was measured with Bradford method every 4 weeks.All mice were sacrificed at the age of 28 weeks, with the level of serum antidsDNA antibody and IL-17 detected by enzyme linked immunosorbent assay (ELISA).Splenic Th17 cells, as well as regulatory T cells (Treg) were examined by flow cytometry.Data were analyzed with t test and Pearson's correlation test.Results The onset of proteinuria was delayed for 4 weeks in UC-MSC-treated group compared with that in the control group.At the age of 28 weeks, the 24 hour proteinuria [(1.78±0.17) mg vs (4.77±0.98)mg, t=2.99, P＜0.05] and the spleen weight [(0.149±0.009) g vs (0.273±0.052) g, t=2.33, P＜0.05] in UC-MSCtreated group were significantly lower than those in the control group.There was also a trend of the decline of serum anti-dsDNA antibody and IL-17 level after UC-MSCs transplantation.Compared with those in the control group, both the percentage and the absolute number of Th17 cells were significantly decreased in UC-MSC-treated group [(0.90±0.19)％ vs (2.81±0.50)％, t=3.54, P＜0.01 and (3.7±0.8)×105 vs (19.3±3.7)×105, t=4.12,P＜0.01].Meanwhile, the percentage of Treg elevated after UC-MSCs treatment.The ratio of Th17/Treg was significantly lower in UC-MSC-treated group than that in the control group (0.11±0.03 vs 0.50±0.09, t=4.23,P＜0.01).Both the ratio of Th17/Treg (r=0.73, P＜0.01;r=0.59, P＜0.05) and serum IL-17 level (r=0.78, P＜0.01;r=0.56, P＜0.05) was positively correlated with the level of 24 hour proteinuria and anti-dsDNA antibody respectively in MRL/lpr mice.Conclusion Early UC-MSCs transplantation helps to delay disease onset and ameliorate disease progression in MRL/lpr mice, which may act through the modulation of Th17/Treg balance.