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Objective:To apply self-directed learning-oriented multi-channel teaching to clinical digestive system integration course and explore its teaching effect.Methods:Seventy undergraduates of Batch 2015 majoring in clinical medicine in a medical college of Shandong Province were selected as subjects. In the clinical digestive system integration course, we designed and implemented multi-channel teaching methods including problem-based learning (PBL), integrated teaching of theory and practice, standardized patient teaching, group focus teaching and moral education. The scores of students' practice examination under the two teaching methods were compared, and the self-assessment of students' autonomous learning ability before and after the intervention was compared. SPSS 20.0 was used for t test. Results:The average total score of practical assessment in the intervention group was (86.10±6.01), which was higher than that (81.84±7.08) of the Batch 2014 students ( P<0.05). The total score of students' self-assessment of autonomous learning ability was (145.41±9.42) before the intervention. By comparison, the total score was (152.94±10.18) after the intervention. Except for the dimension of "self-innovation", the scores of self-directed learning ability in general and other dimensions were significantly different before and after the intervention ( P<0.05). Conclusion:Self-directed learning-oriented multi-channel teaching is a suitable teaching method for the integration curriculum of clinical digestive system.
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OBJECTIVE@#To investigate the distribution of Ret-He and RBC in thalassemia and the value of combining HbA2 in the detection of thalassemia among patients with microcytic or hypochromic.@*METHODS@#145 patients with microcytic or hypochromic outpatient or hospitalization in our hospital from May 2018 to December 2019 were selected and were divided into the thalassemia group(68 cases) and the non-thalassemia group (77 cases), and at the same time, the patients were divided into four groups of the non-anemia, mild anemia, moderate anemia and severe anemia group according to the degree of anemia. The Ret-He, RBC, RDW-CV and HbA2 in patients were detected, and the distribution of these parameters were compared, and the joint detection of Ret-He, RBC and HbA2 about its sensitivity, specific and other indicators of auxiliary diagnosis of thalassemia were analyzed.@*RESULTS@#Among patients with microcytic or hypochromic, according to the anemia grade Ret-He gradually decreased from the non-anemia group to the severe anemia group (P<0.05); while RDW-CV was increased gradually from the mild anemia group to the severe anemia group (P<0.05); both RBC and Ret-He were increased in the thalassemia group as compared with the non- thalassemia group (P<0.05); while RDW-CV was decreased in the thalassemia group as compared with the non-thalassemia group (P<0.05); meanwhile Ret-He in the α-thalassemia group was higher than that in the β-thalassemia group. ROC curve analysis showed that combined with HbA2, the specificity was 93.51%, the sensitivity was 66.18%, the positive predictive value was 90% and the negative predictive value was 75.189% when Ret-He was truncated with 19.25 pg and RBC was truncated with 4.95×10@*CONCLUSION@#Among patients with microcytic or hypochromic, the distribution of RBC, Ret-He and RDW-CV was different in the thalassemia group and the non-thalassemia group, and was also affected by the degree of anemia. Combined Ret-He and RBC could improve the diagnostic specificity for thalassemia, which were screened by HbA2 in patients with microcytic or hypochromic.
Subject(s)
Humans , Anemia, Iron-Deficiency , Erythrocyte Indices , Proto-Oncogene Proteins c-ret , ROC Curve , alpha-Thalassemia , beta-Thalassemia/diagnosisABSTRACT
OBJECTIVE@#To explore the effects of Eriodictyol to the growth, apoptosis and oxidative stress of Burkitt lymphoma (BL) cells and phosphorylation of protein kinase B (AKT) in children.@*METHODS@#The effects of Eriodictyol (0, 1.25, 2.5, 5, 10, 20, 40, 80, 160, 320 μmol/L) to viability of BL cell line DG-75 cells were detected by CCK-8. The effects of Eriodictyol (0, 10, 20, 40 μmol/L) to the proliferation activity of DG-75, apoptosis rate, levels of apoptosis-related proteins, oxidative stress indexes ［superoxide dismutase (SOD), malondialdehyde (MDA)］, mitochondrial membrane potential (MMP) and phosphorylation level of phosphatidylinositol-3-kinase (PI3K)/AKT/mammalian target of rapamycinm (mTOR) were detected by clony formation assay and Wester blot.@*RESULTS@#When the treatment concentration of Eriodictyol was 20 μmol/L, the proliferation activity of the cells was decreased (P<0.05). The concentrations at 10, 20, 40 μmol/L were selected for subsequent experiments. Compared with 0 μmol/L Eriodictyol, the proliferation activity of DG-75, SOD activity, MMP, phosphorylation levels of PI3K, AKT and mTOR in 20 and 40 μmol/L Eriodictyol treatment groups were significantly decreased (P<0.05), while cells apoptosis rate, Cleaved-Caspase-3/Caspase-3, Bax/Bcl-2 and MDA level were significantly increased (P<0.05).@*CONCLUSION@#Eriodictyol may promote the mitochondrial apoptosis pathway by inhibiting the abnormal activation of PI3K/AKT/mTOR to reduce the proliferation activity of DG-75, and inhibit oxidative stress response to increase the apoptosis rate and play anti-tumor roles.
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Apoptosis , Flavanones , Phosphatidylinositol 3-Kinases/metabolism , Signal TransductionABSTRACT
Objective:To explore the effect of early drinking and eating for gastric cancer patients with multimode health propaganda and education during postoperative Enhanced Recovery After Surgery (ERAS).Methods:Sixty patients who would received radical operation of gastric cancer were randomly divided into two groups:observation group (30 cases) and control group (30 cases).Patients in the observation group were employed the multi-mode health propaganda and education which were guided more detailed and quantitative regimens for early drinking and eating.Patients in the control group were carried out with routine methods.The compliance of postoperative drinking and eating,the rate of complications and patients satisfaction were compared between the two groups.Results:The compliance of postoperative drinking and eating of the observation group was significantly higher than that of the control group.Hospital patient satisfaction in health-education projects (19.50 ± 0.50) of the observation group was significantly higher than that (16.12 ± 3.21) of the control group (P ＜ 0.05).The rate of gastrointestinal complications in the observation patients was significantly lower,compared with that in the control patients (P ＜ 0.05).Conclusion:During the postoperative ERAS for gastric cancer patients,early drinking and eating guided by multi-mode health propaganda and education is safe and effective,for which could increase the postoperative compliance,decrease the rate of complication.It is worth promoting early quantitative drinking and eating after operation.
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Objective To investigate the characteristics of microbial isolates and the positive rate from bile cultures taken from obstructive jaundice patients, then compare the antimicrobial sensitivities to guide the rational choice and use of antibiotics. Methods Bile cultures from 322 patients from January 2012 to April 2016 were reviewed. Specimens were obtained from patients that were diagnosed obstructive jaundice. The bile specimens were examined for pathogenic respectively. At the same time, the empirical antibiotics of the 322 cases prior to operation were also analyzed. Results Bile culture was positive in 246 among322 cases, the positive culture rate was 76.40%. A total of 267 pathogens were isolated in bile culture: 208 Gram-negative bacteria, 48 Gram-positive bacteria and 11 fungus. The most common pathogens in all were Escherichia coli (208 strains, 53.18%), Enterococcus faecium (28 strains, 10.49%), Klebsiella pneumoniae (27 strains, 10.11%). The most sensitive antibiotics against Gram-negative bacteria were imipenem and meropenem (with susceptibility rate for 98.08%, respectively). The more sensitive antibiotics against Gram-negative bacteria were efoperazone/sulbactam, amikacin, piperacillin/tazobactam (susceptibility 92.31%, 88.46% and 85.58%). The lowest susceptibility rate of Gram-negative to twelve kings of antimicrobial agents were levofloxacin, andaztreonam (susceptibility 29.81%, 28.37%). The most sensitive antibiotics against Gram-positive bacteria were linezolid, teicoplanin and vancomycin(with susceptibility rate for 100.00%, respectively). The more sensitive antibiotics against Gram-positive bacteria was chloromycrtin (susceptibility 88.89%). The lower susceptibility rate of Gram-positive were levofloxacin (susceptibility 25.00%). 281 cases of patients before surgery empirical use of antimicrobial drugs. Monotherapy was used in 219 cases. The main drug was levofloxacin (86/219), the second was cefoperazone/sulbactam (70/219). The dual therapy was used in 62 cases, the mainly was cefoperazone/sulbactam plus ornidazole or metrornidazole(27/62), the second was levofloxacin plus ornidazole or metrornidazole (12/62). Conclusions Gram negative bacteria were the predominant bile pathogens found in patients with obstructive jaundice. And the most prominent Gram-negative pathogens were Escherichia coli. The sensitive rates of cefoperazone/sulbactam, amikacin and piperacillin/tazobactam were higher, which could be used as the preferred antimicrobial agents. Imipenem and meropenem should remain the last alternative when all other therapies fail or serious infection; The empirical antibiotics's pertinence was not very suitable, levofloxacin's resistance rates in obstructive jaundice was higher. It should be avoided to choose during empirical antimicrobial therapy.
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Objective To evaluate the efifcacy of endoscopic Over-The-Scope-Clip system (OTSC) system for the acute iatrogenic digestive tract perforation. Methods To collect 11 cases with digestive tract perforation closed with the OTSC system, including 7cases of gastric perforation, 1 case of duodenal perforation,3 cases of colorectal perforation. Results 11 cases were successfully closed with OTSC system in time, the average time needed for the endoscopic closure is 6~15 min. And the perforation diameter is 0.6~3.7 cm, average diameter is (1.89 ± 0.27) cm. No intraoperative bleeding and delayed hemorrhages, no deaths occurred. Conclusion Endoscopic OTSC system is a successful method for the digestive tract perforation and is worth to popularize.
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Objective To investigate the protective effect of glutamine(Gln) pretreatment on intestinal ischemia-reperfusion (I/R) injury and endothelial nitric oxide synthase (eNOS)/nitric oxide (NO) signaling pathway in rat model. Methods Thirty male Wistar rats were randomly divided into three groups(n=10 for each group):sham group, I/R group and Gln group. Animals were pretreated with 1 g/(kg·d)Gln by orogastric route for 7 days in Gln group, and normal saline was given to the other two groups in the same dose. Intestinal I/R was induced by 30 min occlusion of the superior mesenteric artery followed by 24 h of reperfusion. After the operation, the intestinal histopathological changes, the plasma endotoxin level, serum D-lactic acid, eNOS, inducible NOS(iNOS)activity and NO levels were detected by ultraviolet spectrophotometer. The mRNA expressions of myocardial eNOS and iNOS were detected by real-time fluorescence quantitative PCR (RT-PCR). Results After reperfusion, in IR group, extensive epithelial sloughing and mucosal ulceration of villous tips were observed, whereas these findings did not occur in Gln group and sham group. Compared with IR group, the serum NO, eNOS levels and eNOS mRNA expression of intestinal tissue were elevated in Gln group (P<0.01), but the plasma endotoxin level, serum D-lactic acid, serum iNOS and intestinal iNOS mRNA expression decreased in IR group(P<0.05). Conclusion Glutamine pretreatment has protective effects on intestinal ischemia-reperfusion injury in vivo. The mechanism may be related to the inhibition of iNOS expression and the increased expression of eNOS, thereby increasing NO activity.
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Objective To investigate the effects of isoliquiritigenin on the invasive ability of human gastric carcinoma SGC7901 cells, and its molecular mechanisms thereof. Methods The logarithmic phase human gastric carcinoma SGC7901 cells were divided into control group (normal cell culture fluid) and isoliquiritigenin group (isoliquiritigenin solu?ble in cell culture fluid, the concentrations were 10, 25, 50 and 100 μmol/L respectively). Each group had four repeated holes. The proliferation of SGC7901 cells were detected with MTT assay after 24 h, 48 h and 72 h of culture. The experimen?tal drug concentration and action time were researched for the subsequent experiments. The in vitro invasion abilities of SGC7901 cells were assessed with Transwell test. The expression levels of MMP9, Akt and P-Akt were detected by Western blot assay. Results The proliferation of SGC7901 cells were inhibited by 10μmol/L isoliquiritigenin, which can be signifi?cantly inhibited by 25, 50 and 100μmol/L isoliquiritigenin in a concentration-dependent and time-dependent manner. The half inhibitory concentrations (IC50) of 24, 48 and 72 h were 52.48, 44.49 and 32.50μmol/L, respectively. Therefore, the 25, 50 and 100μmol/L isoliquiritigenin were selected as the subsequent experimental drug concentration, and 24 h was used as the action time. Compared with the control group (209.75±9.29), the membrane cell number of 25μmol/L (138.50±10.15), 50μmol/L (89.50 ± 16.56) and 100μmol/L (45.00 ± 8.08) decreased gradually (F=267.948,P<0.05). There was no signifi?cant difference in the expression level of Akt protein between four groups (F=1.492). The expression levels of P-Akt and MMP9 were gradually decreased with the increase of the isoliquirigenin concentration (F=359.219 and 431.324,P<0.05). Conclusion Isoliquiritigenin can obviously inhibit invasion ability of SGC7901 cells, which may be related to the down reg?ulation of the signal transduction pathway protein PI3K/Akt and the down steam protein MMP9.
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AIM:To determine the effects of glutamine ( Gln) pretreatment on occludin protein in the rats with intestinal ischemia-reperfusion ( I/R ) injury.METHODS: Male Wistar rats ( n =30 ) were randomly divided into 3 groups (n=10):sham group, I/R group and Gln pretreatment group.The rats in Gln pretreatment group were pretreated with Gln at dose of 1 g? kg-1? d-1 by orogastric route for 7 d, and those in the other 2 groups were pretreated with the same volume of normal saline .Intestinal I/R was induced by 30-min occlusion of the superior mesenteric artery followed by 24 h of reperfusion.After the operation, the levels of IL-10, IL-2, TNF-α, SOD and MDA were measured.The occludin protein was determined by the methods of immunohistochemistry and Western blotting .RESULTS: The occludin protein level in I/R group was significantly lower than that in sham group and Gln group (P<0.05).The levels of MDA and TNF-αin I/R group were significantly higher than those in sham group and Gln group ( P<0.05 ) .The levels of SOD , IL-10 and IL-2 in I/R group were significantly lower than those in sham group and Gln group ( P<0.05 ) .CONCLUSION:Glutamine has a protective effect on occludin protein in intestinal ischemia-reperfusion injury .The mechanism may be rela-ted to oxidative stress response and inflammatory inhibition .
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AIM:To determine the effects of glutamine ( Gln) pretreatment on intestinal ischemia-reperfusion (I/R) injury in the rats.METHODS: Thirty male Wistar rats were randomly divided into 3 groups (n=10): sham group, I/R group and Gln pretreatment group .The rats in Gln pretreatment group were pretreated with 1 g· kg -1 · d-1 Gln by orogastric route for 7 d, the rats in the other 2 groups were pretreated with normal saline .Intestinal I/R was induced by 30-min occlusion of the superior mesenteric artery followed by 24 h of reperfusion .After the operation , the plasma endo-toxin, serum D-lactic acid, superoxide dismutase ( SOD) and malondialdehyde ( MDA) levels were measured .The intesti-nal mucosal injury was observed with HE staining and evaluated using Chiu 's scoring.RESULTS: Serum D-lactic acid, endotoxin level , MDA level and Chiu's score in I/R group were significantly higher than those in sham group and Gln group (all P<0.05).Serum SOD activity was significantly lower than that in sham group and Gln group (P<0.05).CON-CLUSION:Glutamine has a protective effect on the intestines during ischemia-reperfusion injury .The mechanism may be related to oxidative stress response .