ABSTRACT
In order to optimize the undergraduate teaching methods and improve students' comprehensive competitiveness, this study explored the scientific research training methods of medical laboratory undergraduates during medical internship. On the premise of ensuring that students carry out clinical practice according to the internship plan, the research group leads students to carry out scientific research training in their spare time. The scientific research training was divided into two stages. In the first stage, on the basis of informed consent and independent choice, the students in the control group were trained by self-regulated learning and teachers' question answering, while the students in the experimental group were trained by the way of centralized scientific research lectures and scientific research practice. In the second stage, all the students were in independent research and exploration under the guidance of teachers within 5 months. The results showed that in the process of independent research, the time of topic selection in the experimental group [(3.5±1.1) days] was significantly shorter than that in the control group [( 5.4 ± 1.9) days], and the time of topic design in the experimental group [(12.2±2.5) days] was significantly shorter than that in the control group [(14.6±3.1) days]. It shows that carrying out scientific research training in the medical internship stage of undergraduates is helpful to increase the efficiency of students' later independent research and accelerate the process of independent research.
ABSTRACT
In order to improve the core competitiveness and the comprehensive ability of laboratory medicine students, we implemented the clinical teaching mode of evidence-based laboratory medicine in the department of Clinical Laboratory Center of Beijing Children's Hospital, Capital Medical University. This study relied on the platform of National Center for Children's Health, which had abundant case resources and excellent expert team. This study started with the clinical problem, summarized the scientific problem, and carried out teaching activities around the scientific problem. By guidance of the teachers, students used evidence-based medicine methods (clinical case information collection, literature reading, interviews with clinical experts and experimental data collection) to solve the clinical problem. Through research cases,evidence-based medicine methods, clinical thinking and scientific thinking were imparted to students, which can help them integrate theoretical knowledge with clinical practice, and improve learning efficiency, training in clinical thinking and scientific research innovation ability, so as to enhance core competitiveness.
ABSTRACT
In order to improve the core competitiveness and the comprehensive ability of laboratory medicine students,we implemented the clinical teaching mode of evidence-based laboratory medicine in the department of Clinical Laboratory Center of Beijing Children's Hospital,Capital Medical University.This study relied on the platform of National Center for Children's Health,which had abundant case resources and excellent expert team.This study started with the clinical problem,summarized the scientific problem,and carried out teaching activities around the scientific problem.By guidance of the teachers,students used evidence-based medicine methods(clinical case information collection,literature reading,interviews with clinical experts and experimental data collection)to solve the clinical problem.Through research cases,evidence-based medicine methods,clinical thinking and scientific thinking were imparted to students,which can help them integrate theoretical knowledge with clinical practice,and improve learning efficiency,training in clinical thinking and scientific research innovation ability,so as to enhance core competitiveness.
ABSTRACT
In order to enhance the comprehensive ability,scientific research consciousness and scientific research skills of laboratory medicine students,the clinical laboratory center of Beijing Children's Hospital carried out the exploration for strengthening the scientific research ability of laboratory medicine students in the implementation of scientific research projects.Depending on the platform of National Center for Children's Health,the clinical laboratory center of Beijing Children's Hospital used patient resources and top research facilities to provide comprehensive trainings for students who volunteered to take part in this project with the goal of offering more opportunities for further study and employment to them.Teachers can impart the ideas,thoughts and skills of scientific research to the students through the training,which can help them to improve their core competitiveness by combining the theoretical knowledge and practical work,developing the innovative thinking and improving the ability in scientific research innovation and practice.
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Objective:This study investigates the clinical effect of bodyγ-knife combined with radiosensitizer and/or hyperthermia. for the recurrence of soft tissue sarcoma. Methods:Sixty-three patients with recurrent soft tissue sarcoma from January 2012 to March 2014 were treated by bodyγ-knife combined with radiosensitizer and/or hyperthermia. The patients were exposed to radiation dose levels of 4-5.5 Gy/fraction (10-13 fractions) with total doses of 44-55 Gy and 55%-70%isodose, including 95%PTV. The radiosensitizer, sodium glycodidazolum (CMNa), was administered to all patients at 1.00-1.50 g V.D qod at 5-6 fractions 0-3 h before bodyγ-knife treat-ment. Hyperthermia for 30 patients was delivered during the bodyγ-knife treatment with two fractions/week for a total of six frac-tions. Results:The total response rate was 77.7%three months after the treatment. The one and two year local control rates were 78.8%and 63.6%, respectively, while the survival rates of patients treated with bodyγ-knife with radiosensitizer at one and two years were 75.7%and 63.6%, respectively. The local control rates at one and two years were 83.6%and 70.0%, respectively, while the surviv-al rates at one and two years for bodyγ-knife combined with radiosensitizer and hyperthermia treatments were 80.0%and 63.3%, re-spectively. Serious complications of radiotherapy were not observed. Conclusion:Bodyγ-knife combined with radiosensitizer and/or hyperthermia is effective for recurrent soft tissue sarcoma.
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The pediatric reference intervals in clinical laboratory play an important role in diagnosis of illness,therapeutic monitoring,prediction of prognosis and health evaluation.Compared with establishing reference interval for adults,there are more challenges to establish pediatric reference intervals.Therefore,the procedure and key technologies of direct method and indirect method are stated based on the characteristics of children population and pediatric,by which to define,transfer and validate pediatric reference intervals.This study will provide systematically methodological ideas for clinical laboratories to establish pediatric reference intervals.
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Objective: (i) To determine whether clinical features and biochemical parameters help to predict survival of methylmalonic acidemia with homocystinuria; (ii) To find the cutoff values of biochemical parameters for predicting survival of methylmalonic acidemia with homocystinuria. Design: A prospective cohort study. Setting: A pediatric tertiary hospital in Beijing; all patients were followed until death or June 2013. Subjects: 45 pediatric patients diagnosed with methylmalonic acidemia with homocystinuria between 2006 and 2012. Outcome measures: The data of clinical characteristics and pretreatment biochemical parameters were collected. The Cox regression analysis was performed to identify independent risk factors for survival of patients with methylmalonic acidemia and homocystinuria. The best cutoff values for these independent factors were determined by the receiver characteristic curve. Results: Newborn onset (OR=6.856, 95%CI=2.241-20.976, P=0.001), high level of methylmalonic acid in urine (OR=1.022, 95%CI=1.011-1.033, P<0.001), and high level of urea in serum (OR=1.083, 95%CI=1.027-1.141, P=0.003) were independent negative risk factors for survival of patients with methylmalonic acidemia and homocystinuria. The cutoff values of maximum predictive accuracy of methylmalonic acid in urine and urea in serum were respectively 5.41 mmol/mmol creatinine and 7.80 mmol/L by receiver operating characteristic curve analysis. Conclusion: The patients of methylmalonic acidemia with homocystinuria tend to have an adverse outcome if they have newborn onsets. Elevated urea and urinary methylmalonic acid are predictors of adverse outcomes for the patients. They show similar effect for predicting severe adverse prognosis. The combination of methylmalonic acid in urine concentration and urea in serum concentration provided the most accurate predictive tool.
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Objective To evaluate the clinical toxicity and efficacy of S-1 combined with γ-ray body stereotactic radiation therapy in treatment of locally advanced pancreatic cancer.Methods Forty-five patients with locally advanced pancreatic cancer were randomly divided into two groups.The combination group received γ-ray stereotactic body radiation therapy which was given isodose curve of 50 ％-60 ％,tumor encircling dose of 3.0-4.5 Gy per fraction depended on dimension of tumors,9-12 fractions.Combined with S-1 40 mg/m2,2 times/d,for consecutive twenty-one days for four courses.The control group was given γ-ray stereotactic body radiation therapy only.Toxicities and effects were evaluated according to the criteria of WHO and RTOG.Results The CR rates in combination group and control group were 30.4 ％ (7/23) and 13.6 ％ (3/22),the response rates were 91.3 ％ (21/23) and 63.6 ％ (14/22) (x2 =4.980,P =0.026).The rates of gastrointestinal tract side reaction in combination group and control group were 82.6 ％ and 68.2 ％ (x2 =1.267,P =0.260),myelosuppression in combination group and control group were 78.3 ％ and 63.6 ％ (x2 =1.171,P =0.279).The rate of Ⅲ-Ⅳ grade myelosuppression in combination group were higher than that in control group (x2 =4.874,P =0.027).The median progression-free survival (PFS) rates of two groups were 8 months and 6 months respectively (x2 =1.357,P ＞ 0.05),the median survival period were 17 months and 14 months (x2 =1.017,P ＞ 0.05),1 year survival rates were 60.9 ％ and 54.5 ％ respectively (x2 =0.184,P ＞ 0.05).Conclusions S-1 combined with body gamma system treatment can improve local control rate and effective rate for inoperable patients with local advanced pancreatic carcinoma,and the adverse reactions are well tolerated.This method can be used as locally advanced pancreatic cancer chemoradiation safe and effective choice.
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Objective:To investigate the efficacy of stereotactic body radiation therapy with gamma-knife (γ-SBRT) combined with targeted drug sorafenib and hyperthermia for the treatment of recurrent and metastatic hepatocellular carcinoma. Methods:A total of 71 patients with recurrent and metastatic hepatocellular carcinoma were admitted from August 2007 to December 2009. Among these patients, 39 were treated with γ-SBRT and hyperthermia (group 1); 19 were treated with γ-SBRT combined with sorafenib and hyperthermia (group 2). Results: The total efficacy rate after a three-month treatment was 83.1% (59/71). In group 1, the following results were obtained:one-and three-year local control rates of 41.0%(16/39) and 18%(7/39), respectively;one-and three-year overall survival (OS) rates of 41.2% and 17.9%, respectively; and one- and three-year progression-free survival (PFS) rates of 38.4% and 15.4%, respectively. In group 2, the following results were obtained:one-and three-year local rates of 56.3%(18/32) and 28.1%(9/32), respectively;one-and three-year OS rates of 62.5%and 28.1%, respectively;and one-and three-year PFS rates of 59.4%and 25.0%, respectively. Significant differences in OS and PFS were observed between the two groups. Conclusion:The combination ofγ-SBRT with targeted drug sorafenib and hyperthermia can be used effectively to treat recurrent and metastatic hepatocellular carcinoma. Adverse reactions are mild, and patients can tolerate this treatment.
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Objective:To find a feasible method to stimulate tumor-draining lymph node(TDLN) cells in clinic.Methods:CTL activity of TDLN cells induced by different stimulus (IL-2 group, IL-2+autologous tumor antigen group, IL-2+GM-CSF+IL-4+autologous tumor antigen group) was measured by the method of maximal LDH enzyme release. The mechanisms were explored by observation in morphology and detection of the CD83 positive rate of TDLN cells.Results:The level of growth of TDLN cells induced by (IL-2+GM-CSF+IL-4+autologous tumor antigen) was significantly higher than TDLN cells induced by IL-2 and (IL-2+autologous tumor antigen)(P