ABSTRACT
To improve the phenomenon of low participation and lack of innovation in education mode in general medical education elective courses, we have applied "creating significant learning experiences" to the design and implementation of medical general education curriculum, starting from six dimensions of learning including basic knowledge, application, synthesis, humanistic dimension, humanistic care, and learning to learn, setting learning goals, developing assessment tools and finally choosing teaching methods, thus forming a closed-loop teaching. And through the curriculum reform, collection of feedback and collation of data, the teaching activities designed according to this method fully meet and serve the teaching purposes, and assessment methods become more diverse and the content is more comprehensive, which reflects the multi-dimensional evaluation of the needs of general education.
ABSTRACT
Objective To measure the levels of human interleukin (IL)-32 in the serum and induced sputum of patients with chronic obstructive pulmonary disease (COPD) and investigate the possible roles of IL-32 in COPD.Methods Sixty patients with acute exacerbation of COPD ( AECOPD),60 patients with stable COPD,and 30 healthy subjects were recruited.The concentrations of IL-8,tumor necrosis factor alpha (TNF-α),and IL-32 in serum and induced sputum were measured by enzyme-linked immunosorbent assay (ELISA).The correlations among IL-32,IL-8,TNF-α,and lung functions were investigated. The data were analyzed using a statistical software package (SPSS 13.0).Variables were compared with one-way ANOVA,and correlations among variables were analyzed using Pearson's correlation coefficient or Spearman's correlation coefficient.Results The serum IL-32 level was significantly higher in AECOPD patients [(175 ± 88) ng/L] than in healthy subjects [ (59 ± 21 ) ng/L] and in stable COPD patients [ (89 ± 34) ng/L] (P ＜ 0.05) ; the serum IL-32 level was also significantly higher in stable COPD patients than in healthy subjects (P ＜ 0.05).The sputum IL-32 level was significantly higher in AECOPD patients [ ( 163 ± 117) ng/L] than in healthy subjects [ ( 75 ± 38 ) ng/L] and stable COPD patients [ ( 108 ± 63 )ng/L] (P ＜0.05); the sputum IL-32 level was also significantly higher in stable COPD patients than in healthy subjects ( P ＜ 0.05 ).The sputum IL-32 level in AECOPD patients was positively correlated with the sputum IL-8 and TNF-α levels (r =0.49 and 0.53,respectively) (P ＜0.01 ).The sputum IL-32 level in AECOPD patients was negatively correlated with FEV1 predicted values,FEV1/FVC,and PaO2 (r =-0.44to -0.33) (P ＜ 0.01 ).The serum IL-32 level in AECOPD patients was positively correlated with the serum IL-8 and TNF-o levels (r =0.45 and 0.61,respectively) (P ＜ 0.01 ).The serum IL-32 level in AECOPD patients was negatively correlated with FEV1 predicted values,FEV1/FVC,and PaO2 (r =-0.46to - 0.29) ( P ＜ 0.01 ).Conclusions IL-32 may be involved in the pathogenesis of airway inflammation in COPD.IL-32 may be a useful marker of acute exacerbation of COPD.