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Objective:To study the teaching effect of the teaching method of case-based learning (CBL) combined with team-based learning (TBL) based on the standard patient (SP) in the clinical teaching of department of intensive care medicine.Methods:A total of 60 medical students clinically studying in the department of intensive care medicine were randomly divided into 2 groups, with 30 students in each group. The two groups received the clinical teaching through the lecture-based learning (LBL) teaching method and the CBL combined with TBL based on SP teaching method respectively. By evaluating the clinical synthesis ability of the students of two groups and the satisfaction survey of the two teaching methods, the teaching effect was evaluated. SPSS 19.0 statistical software was used to perform Chi-square test and t-test. Results:Compared with LBL teaching method, the students who accepted the CBL combined with TBL based on SP teaching method had significantly better clinical comprehensive ability ( P < 0.05), mainly in their clinical thinking ability [(4.18±0.55) vs. (3.66±0.47)], clinical skills [(4.03±0.61) vs. (3.59±0.52)] and communication ability with patients [(4.11±0.58) vs. (3.74±0.50)]. In addition, student satisfaction with teaching methods was also higher ( P <0.05), especially in the satisfaction of learning interest [(4.38 ± 0.72) vs. (3.65±0.56)], self-learning ability [(4.24±0.71) vs. (3.91±0.52)], clinical thinking ability [(4.09±0.66) vs. (3.22±0.54)], communication ability [(4.42±0.60) vs. (3.67±0.48)], and team cooperation spirit [(4.15±0.58) vs. (3.78±0.51)]. Conclusion:The teaching method of CBL combined with TBL based on SP is feasible and has good teaching effect in the clinical teaching of department of intensive care medicine.
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Artesunate, which is a widely used anti-malaria medicine, can be made into liposome to overcome its poor bioactivity. Its tissue distribution in rats may change with different dosage forms, which therefore shall be studied after ARS-TPGS-Lipo was injected. Based on this experiment, ARS-TPGS-Lipo and ARS-Lipo were prepared by thin-film hydration method. LC-MS/MS method was used to simultaneously determine ARS and DHA in rat tissues at different time points. The results showed that this method was suitable for the content analysis of ARS and DHA in biological samples. The distribution of ARS and DHA in ARS-TPGS-Lipo, ARS-Lipo and ARS groups were quite different. The content of ARS-TPGS-Lipo in liver was the highest, with significant differences.ARS and DHA contents in ARS group eliminated rapidly. ARS and DHA contents in ARS-Lipo group were higher in liver and spleen, while those in ARS-TPGS-Lipo group significantly increased only in liver (<0.05).
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Animals , Rats , Artesunate , Pharmacokinetics , Chromatography, Liquid , Liposomes , Tandem Mass Spectrometry , Tissue Distribution , Vitamin EABSTRACT
Various forms of noninvasive respiratory support have been applied to the treatment of infant respiratory distress and hypoxemia.The most common noninvasive respiratory support in neonatal intensive care unit is nasal continuous positive airway pressure (NCPAP).But the NCPAP systems are not always well accepted by the neonatal population,with the risk of mucosal injury and nosocomial infection.In recent years,humidified high-flow nasal cannula (HHFNC) has been introduced and developed as a possible alternative to NCPAP for noninvasive respiratory support mode,because it increases patients' comfort and the effectiveness of the ventilation.This article summarized the current research progress of HHFNC therapy in pediatric patients.
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Elevated low density lipoprotein cholesterol (LDL-C) is a major risk factor for cardiovascular disease.Studies show that proprotein convertase subtilisin/kexin type 9 (PCSK9) is a circulation enzyme and serves a pivotal function in the degradation of low density lipoprotein receptor,which contributes to the decrease in hepatic cholesterol uptake and increase in circulating LDL-C.PCSK9 inhibitor can significantly elevate the surface of low density lipoprotein receptor of liver cells and bond more LDL-C to decrease the level of LDL-C.Thus PCSK9 has emerged as a popular target for the development of new cholesterol lowering drugs and therapeutic intervention of cardiovascular disease.In this article,the history,mechanism of action,metabolic effects of PCSK9 and the clinical outcomes of PCSK9 inhibitors will be briefly reviewed.
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Atherosclerosis is an immune-mediated inflammatory disease of the arterial wall,with both the innate and adaptive immune systems responding to many endogenous and exogenous antigens.Both proatherogenic as well as atheroprotective roles have been identified for the immune system in atherosclerosis.Hence,it is conceivable that an immuno-modulatory strategy via active immunization against many of these antigens could potentially alter the natural history of atherosclerosis.Cholesterol ester transfer protein (CETP) plays an important role in lipid metabolism,suggesting it might prevent atherosclerosis.This review discusses the recent advances of vaccine targeting the development of atherosclerosis,mainly about the CETP targeting vaccines.
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AIM To establish a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the simultaneous content determination of matrine,oxymatrine,salvia acid B,tanshinol,protocatechualdehyde,liquiritin,astragaloside,cinnamaldehyde,tanshinone Ⅱ A,ophiopogonin D and ruscogenin in Huxin Oral Liquid (Glycyrrhizae Radix et Rhizoma,Astragali Radix,Ophiopogonis Radix,etc.).METHODS The analysis of methanol extract of this drug was performed on a 25 ℃ thermostatic Ultimate XB-C18 column (4.6 mm × 100 mm,3 μm),with the mobile phase comprising of water-methanol (containing 0.05％ formic acid) flowing at 0.4 mL/min in a gradient elution manner.RESULTS Eleven constituents showed good linear relationships with-in their own ranges (r ＞0.999 0),whose average recoveries were 96.66％-103.2％ with the RSDs of 1.4％-3.4％.CONCLUSION This sensitive,reliable and accurate method can be used for the quality control of Huxin Oral Liquid.
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Objective· To prepare nanocarriers capable of improving the immunogenicity of cholesteryl ester transfer protein (CETP) hapten. Methods · Prepare CETP polypeptide modified by thiol in Fmoc, then Sulfo-SMCC were used to prepare CETP peptide-ovalbumin (OVA) nanoparticle and CETP peptide - OVA molecule conjugates in a two-step reaction scheme. The particle size and zeta potential of nanovaccine were determined and the morphology was observed. New Zealand White rabbits were vaccinated by subcutaneous injection of vaccine and serum collected from rabbits was detected by ELISA assay for the analysis of antibodies, high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol (LDL-C). The rabbits were randomly allocated to the PBS group (n=3), traditional vaccine group (n=3), and nanovaccine group (n=3). Results · Nanovaccine targeting CETP were successfully synthesized, with about 70 nm in size and about -8.81 mV in zeta potential, and possessed homogeneous spherical shape under transmission electron microscopy. Compared with traditional vaccine group, rabbits in nanovaccine group got higher antibodies. Conclusion · Nanovaccine improve immunogenicity of CETP haptens, and stimulate experiment rabbits to produce higher antibodies.
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Objective·To investigate the potential value of serum miRNAs for early diagnosis of acute coronary syndrome (ACS). Methods·Blood samples were collected from 28 emergency patients with suspected ACS in 3 h after enrollment. Eighteen patients were finally diagnosed as ACS and ten as non-ACS according to the ACS guideline. The expression levels of cardiac miR-499 and myocardial injury related miR-652 were measured with qRT-PCR. At the same time levels of troponin I (cTnI) were monitored. Then the correlations between miRNAs and cTnI were analyzed. In addition, 95% reference range was established. Results·The expression levels of serum miRNAs increased in ACS patients within 3 h and serum miR-499 in the ACS patients was 9.2 times the amount in the non-ACS patients (P=0.009). Serum miR-499 (r=0.595, P=0.001) and miR-652 (r=0.579, P=0.001) levels both had positive correlations with cTnI. The area under the ROC curve (AUC) of serum miR-499 and miR-652 was 0.786 and 0.583, respectively. The sensitivity and specificity of miR-499 were 72.22% and 80.00%, respectively, while 72.22% and 60.00% for miR-652. The reference ranges of serum miR-499 and miR-652 were 0.001-2.723 and 0.122-9.660, respectively. Conclusion·Cardiac miR-499 in serum has potential to be a biomarker for early diagnosis of ACS.
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Objective·To investigate the potential value of serum miRNAs for early diagnosis of acute coronary syndrome (ACS). Methods·Blood samples were collected from 28 emergency patients with suspected ACS in 3 h after enrollment. Eighteen patients were finally diagnosed as ACS and ten as non-ACS according to the ACS guideline. The expression levels of cardiac miR-499 and myocardial injury related miR-652 were measured with qRT-PCR. At the same time levels of troponin I (cTnI) were monitored. Then the correlations between miRNAs and cTnI were analyzed. In addition, 95% reference range was established. Results·The expression levels of serum miRNAs increased in ACS patients within 3 h and serum miR-499 in the ACS patients was 9.2 times the amount in the non-ACS patients (P=0.009). Serum miR-499 (r=0.595, P=0.001) and miR-652 (r=0.579, P=0.001) levels both had positive correlations with cTnI. The area under the ROC curve (AUC) of serum miR-499 and miR-652 was 0.786 and 0.583, respectively. The sensitivity and specificity of miR-499 were 72.22% and 80.00%, respectively, while 72.22% and 60.00% for miR-652. The reference ranges of serum miR-499 and miR-652 were 0.001-2.723 and 0.122-9.660, respectively. Conclusion·Cardiac miR-499 in serum has potential to be a biomarker for early diagnosis of ACS.
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To study the effect of Gegen Qinlian decoction and its major effective components on five hepatic microsomal CYP450 isozymes in rats. The in vitro hepatic microsomal incubation technique was used to co-culture Gegen Qinlian decoction and its major effective components together with each probe substrate. HPLC-MS/MS was used to establish the analytical method for metabolites of the five isoform probe substrates of CYP450 isozymes, detect the linearity among micoromal protein concentration, incubation time and metabolite formation amount. And HPLC-MS/MS was applied to determine the formation rate (V) of corresponding metabolites (acetaminophen, 4-OH-chlorzoxazone, dextrophan, 6-OH-chlorzoxazone and 6β-hydroxytestosterone) specific probe substrates of the five isoform probe substrates of CYP450 isozymes (phenacetin, polbutamide, dextromethorphan, chlorzoxazone, testosterone), in order to determine the activity of each isozyme. The result showed good linearity among acetaminophen, 4-OH-tolbutamide, dextrophan, 6-OH-chlorzoxazone and 6β-hydroxytestosterone, satisfactory precision, stability and average recovery, suggesting the method was feasible. The optimized in vitro microsomal incubation conditions conformed to the requirements in the guideline of drug-drug interaction. Gegen Qinlian decoction showed different degrees of inhibitor effect on 5 CYP450 isoforms (CYP1A2, CYP2C11, CYP2D2, CYP2E1, CYP3A1/2). Its major effective component berberine could inhibit each CYP450 isoform at high concentrations (except for CYP1A2, CYP3A1/2).
Subject(s)
Animals , Rats , Chromatography, High Pressure Liquid , Methods , Cytochrome P-450 Enzyme Inhibitors , Pharmacology , Drugs, Chinese Herbal , Pharmacology , Isoenzymes , Liver , Tandem Mass Spectrometry , MethodsABSTRACT
<p><b>OBJECTIVE</b>To investigate whether Epimedium brevicornu Maxim (EB) and icariin could exert their protective effects on hydrocortisone induced (HCI) rats by regulating the hypothalamus-pituitary-adrenal (HPA) axis and endocrine system and the possible mechanism.</p><p><b>METHODS</b>Male 10-week-old Sprague Dawley (SD) rats were allotted to 6 groups (A-F) with 12 each, group A was injected normal saline (NS) 3 mL/kg day intraperitoneally, group A and B were given NS 6 mL/kg day by gastrogavage, group B-F were injected hydrocortisone 15 mg/kg intraperitoneally, group C and D were given EB 8 or 5 g/(kg day) by gastrogavage, group E and F were given icariin 25 or 50 mg/(kg day) by gastrogavage. Gene expressions of hypothalamus corticotropin releasing hormone (CRH) and pituitary proopiomelanocortin (POMC) were detected by reverse transcription-polymerase chain reaction (RT-PCR), and protein of pituitary POMC by Western-blot.</p><p><b>RESULTS</b>The serum T4, testosterone, cortisol and POMC mRNA expression were increased after treatment with EB or icariin in HCI rats, the serum CRH and the hypothalamus CRH mRNA expression released from hypothalamus corticotropin decreased compared with group B (P<0.05).The treatment with only icariin increased serum adrenocorticotropic hormone (ACTH) compared with group B (P<0.05).</p><p><b>CONCLUSION</b>EB and icariin might be therapeutically beneficial in the treatment of HCI rats through attuning the HPA axis and endocrine system which was involved in the release of CRH in hypothalamic, and the production of POMC-derived peptide ACTH in anterior pituitary, the secretion of corticosteroids in adrenal cortex.</p>
Subject(s)
Animals , Male , Rats , Adrenocorticotropic Hormone , Blood , Blotting, Western , Corticotropin-Releasing Hormone , Blood , Genetics , Epimedium , Flavonoids , Pharmacology , Therapeutic Uses , Gene Expression , Hydrocortisone , Pharmacology , Hypothalamo-Hypophyseal System , Hypothalamus , Chemistry , Pituitary-Adrenal System , Plant Extracts , Pharmacology , Pro-Opiomelanocortin , Chemistry , Genetics , Proteins , RNA, Messenger , Rats, Sprague-Dawley , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of visfatin on the MMP-2 and MMP-9 expressions in human monocytes and related mechanisms.</p><p><b>METHODS</b>Human monocytes were isolated from blood, the expressions of MMP-2 and MMP-9 at mRNA and protein levels were detected in visfatin stimulated monocytes (0, 100, 200, 400 ng/ml) in the absence and presence of NF-kappaB inhibitor specific Bay11-7082 by Realtime PCR or Western blot, the MMP-2 and MMP-9 enzyme activity in the culture media was also detected by Gelatin Zymography. The NF-kappaB protein level and NF-kappaBp65 expression in visfatin stimulated cells were measured by Western blot and ELISA, respectively.</p><p><b>RESULTS</b>Visfatin upregulated MMP-2 and MMP-9 expressions in human monocytes in a dose dependent manner. After treatment with visfatin 400 ng/ml for 24 h, comparing with the free visfatin treatment, the protein expressions of MMP-2 and MMP-9 were up-regulated to 1.644 +/- 0.052 and 3.578 +/- 0.081 (all P < 0.001); the enzyme activities of MMP-2 and MMP-9 were enhanced by 1.661 +/- 0.036 (P < 0.001) and 1.662 +/- 0.100 (P < 0.001). NF-kappaB was also activated in these cells by visfatin and these effects could be significantly attenuated by Bay11-7082. Visfatin induced a dose-dependent (100 - 400 ng) increase of NF-kappaBp65 nuclear translocation from 0.763 +/- 0.056 to 1.290 +/- 0.065 at 100 and 400 ng/ml, comparing with free visfatin treatment 0.467 +/- 0.046 (all P < 0.05). Bay11-7082 decreased the protein expression of MMP-2 and MMP-9 to 1.183 +/- 0.030 and 2.024 +/- 0.056 (all P < 0.001 comparing with 400 ng/ml visfatin treatment).</p><p><b>CONCLUSION</b>Visfatin enhanced the expression and activity of MMP-2 and MMP-9 in human monocytes via activating NF-kappaB signaling pathway.</p>