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Objective:To study the methods of hormone-related teaching in standardized residency training of endocrinology.Methods:From February 2022 to June 2022, 25 residents in the Department of Endocrinology, Peking University Third Hospital were given a standardized residency training. The teaching mode combined with a hundred years of insulin development was adopted to practice insulin teaching, and questionnaires were evaluated before and after the teaching. Chi-square test was performed by SPSS 20.0.Results:A total of 31 physicians participated in the training, and 25 residents who were included in the first-stage standardized training were analyzed. Before the training, only 3 people (12%) knew the development history of insulin, and 10 people (40%) answered all the questions about clinical use of insulin correctly. After the training, 23 residents (92%) said they knew or were familiar with the history of insulin development, and 20 residents (80%) answered the questions about the clinical use of insulin correctly, all of which were higher than those before the training, and the difference was statistically significant.Conclusion:The integration of medical history in standardized residency training in endocrinology department can effectively improve the teaching effect, and enhance the humanity quality of young doctors, which can become an effective vehicle in standardized residency training.
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To evaluate effects of PDCA cycle in improving residency diagnosis and treatment ability of endocrine and metabolic diseases, this paper selected the problems of insufficient diagnosis and treatment ability in the results of the endocrinology examination paper as the research breakthrough point, and investigated 62 residents receiving standardized residency training to analyze main reasons of the problems such as "busy clinical work", "special clinical thinking" and "difficult to remember knowledge of endocrinology". The study implemented information-based teaching and daily self-education, followed the law of memory, strengthened the construction of teaching staff, improved teaching methods, etc., and effects of these methods were assessed after the teaching. It's found that the application of PDCA cycle can improve the residents' ability of clinical diagnosis and treatment in endocrine and metabolic diseases.
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To evaluate effects of PDCA cycle in improving residency diagnosis and treatment ability of endocrine and metabolic diseases, this paper selected the problems of insufficient diagnosis and treatment ability in the results of the 2016 endocrinology examination paper as the research breakthrough point, and investigated 62 residents receiving standardized residency training to analyze main reasons of the problems such as "busy clinical work", "special clinical thinking" and "difficult to remember knowledge of endocrinology". The online teaching, daily self-education, following the law of memory to remember and re-recognize knowledge, strengthening the construction of teachers, improving teaching methods were used and evaluated. It’s found that the application of PDCA cycle can improve the residents' ability of clinical diagnosis and treatment in endocrine and metabolic diseases.
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Osteoporosis(OS)is a systemic skeletal disorder characterized by low bone mass and increased risk of fracture.Bone mineral density(BMD)is a gold standard in the diagnosis of OS,but is not sensitive enough for detecting the earlier bone loss.Bone metabolic markers have high sensitivity and specificity.Therefore,they are able to reflect the early changes of bone mass and can be used to monitor the efficacy of anti-OS agents.This article summarizes the research advance in both traditional and newly identified bone metabolic markers.
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A 39-year-old female with central diabetes insipidus complained of polydipsia and polyuria and was found to be accompanied by lung lesions. The diagnosis of IgG4-related disease was confirmed by laboratory and pathological results. It should be alert to consider the possibility of IgG4-related disease in a patient with central diabetes insipidus coexisting with the signs of multisystem lesions such as lung disease.
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Objective To investigate the efficacy and safety of domestic exenatide injection versus imported exenatide injection in type 2 diabetic patients with inadequate glycemic control on monotherapy or combination therapy of metformin and insulin secretagogues. Methods A multicenter, randomized, parallel-controlled, and non-inferiority trial was carried out. A total of 240 subjects were randomized at a 1:1 ratio to add domestic exenatide injection (trial group) or imported exenatide injection (control group) on the background therapies. The primary endpoint of efficacy was HbA1C change from baseline to week 16. The secondary endpoints of efficacy were the proportion of HbA1C0.05). The changes in FPG, 2hPG, 7P-SMBG and body weight from baseline to week 16 were comparable between the two groups (all P>0.05). Moreover, the incidences of hypoglycemia and adverse events were similar between the two groups (both P>0.05). Conclusion In type 2 diabetic patients inadequately controlled by monotherapy or combination therapy of metformin and insulin secretagogues, the efficacy of cotreatment with domestic exenatide injection is not inferior to that of imported product ones, with a similar safety profile.
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Cancer pain is an inherently subjective feeling. As such, a patient's report of pain is the basis of assessment. Self-re-ported questionnaires are extensively used in clinical practice and research. Single-item unidimensional rating scales are often used to assess pain intensity. Numerical rating scale is recommended by the European Palliative Care Research Collaborative. Multidimension-al measurements, such as brief pain inventory and short-form McGill pain questionnaire (revised version), can also be used for more comprehensive pain assessments than other questionnaires. Furthermore, specific tools can be applied when cancer-related break-through pain or neuropathic pain is assessed. For patients with cognitive function impairments, face rating scale is a useful tool to screen pain. Multidimensional measurements should also be used for further evaluation. In cancer pain evaluation, the development of simple and practical computer-administered questionnaires is a new trend. Repeated cancer pain assessment is strongly recommended regardless of the applied scale.
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[Summary] A 19-year-old male patient with central diabetes insipidus complained of polydipsia and polyuria and was found to be accompanied by cervical vertebra lesions.The diagnosis of Langerhans cell histiocytosis was confirmed by laboratory and pathological results.Therefore,it should be alert to consider the possibility of Langerhans cell histiocytosis in a patient with central diabetes insipidus coexisting with the signs of multisystem lesions such as bone disease.
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<p><b>OBJECTIVE</b>To assess the efficacy of prophylactic treatment with recombinant human thrombopoietin (rhTPO) on chemotherapy-induced thrombocytopenia in tumor patients.</p><p><b>METHODS</b>In this randomized cross-over self-controlled clinical trial, 24 patients with malignant neoplasms were randomized group A (12 cases) and group B (12 cases). All the patients underwent two identical cycles of chemotherapy. In group A, RhTPO (1.0 µg/kg) was administered subcutaneously on a daily basis 3 days before the second chemotherapy cycle for 7 consecutive days, and in group B, RhTPO was administered daily 6-24 h after the second chemotherapy cycle for 7 days. In both groups, RhTPO was not administered in the first chemotherapy cycle, which served as the control cycle.</p><p><b>RESULTS</b>In both the groups, platelet count was significantly higher in the second cycle than in the control cycle, and the duration of thrombocytopenia was significantly shortened in the second cycle. Compared with group B, the patients in group A showed a significantly higher platelet count in the second cycle and a significantly shorter duration of thrombocytopenia in the second cycle.</p><p><b>CONCLUSION</b>Prophylactic administration of rhTPO can significantly reduce the severity and duration of thrombocytopenia and promote platelet recovery in patients undergoing chemotherapy for malignant tumors.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Cross-Over Studies , Neoplasms , Drug Therapy , Platelet Count , Recombinant Proteins , Therapeutic Uses , Thrombocytopenia , Thrombopoietin , Therapeutic UsesABSTRACT
Objective:To investigate the inhibitory effect of RNA interference (RNAi) on the expression of multidrug resistance (MDR1) gene and analyze the altered sensitivities of human renal carcinoma cell line to cisplatin.Methods:Three small interfering RNA (siRNA) sequences targeted MDR1 gene were synthesized and transfected into renal carcinoma A498 cells. The expression level of MDRl mRNA was measured by RT-PCR to identify the most effective siRNA sequence. The recombinant plasmid was packed by lentivirus and transfected into A498 cells. RT-PCR was used to screen the A498 cells with the optimal silencing efficacy. The MDR1 protein expression level in the cloned cells was verified by Western blotting. The inhibitory effect of cisplatin on the proliferation of A498 cells was assessed by MTT assay and the IC_(50) value was calculated. Results:The 3 siRNA sequences suppressed MDR1 gene expression at different degrees. The siRNA 1 sequence silenced MDR1 gene more effectively with a significant reduction of 67%. The MDR1 protein expression greatly decreased in screened A498 cells compared with non-transfected cells (P<0.01), and the IC_(50) value of cisplatin on screened A498 cells was significantly decreased by 83.37% (P<0.01). Conclusion: The RNAi could effectively inhibit the expression of MDR1 gene and increase the sensibility to cisplatin in human renal carcinoma A498 cell line, which make it possible to reverse the resistance of renal carcinoma to chemotherapy.
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Objective To investigate the relationship of apoptosis, proliferation and its related factors (p53, Fas ) with clinical pathological characteristics in hepatocellular carcinoma (HCC). Methods Apoptosis, nuclear antigen of proliferating cells (PCNA), p53, and Fas proteins were detected by labelling technique of in situ terminal deoxynucleotide transferase and immunohistochemical method on 35 HCC samples. Statistical analysis was employed to evaluate the correlations between the experimental data and clinical pathological characteristics. Results There was no significant difference between the apoptotic index (AI), PCNA index (LI), expressions of p53 and Fas and the age, sexual distinction of patient, and tumor size. Expressions of p53, Fas, and AI were not associated with the histological types of tumor at all. However, the index of PCNA was much higher in poorly differenciatiated type than that in trabecular type and pseudo glandular type of HCC. Importantly, following the advanced Edmondson stages and the TNM stages, p53 expression and LI increased in HCC, but AI showed a lower level at same time. Conclusion The malignancy of HCC is negatively correlated with AI but positively with PCNA. The apoptosis in HCC occurs in a p53-dependent manner. The higher mutant of p53 and the lower regulation of Fas expression may contribute to the genesis and progression of HCC.
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<p><b>OBJECTIVE</b>To investigate the change in the expression of E-Cadherin of human hepatocarcinoma cell line SMMC-7721 after transfection by antisense human DNA MTase gene.</p><p><b>METHODS</b>DNA MTase gene eukaryotic expression vectors, including sense and antisense fragments, were constructed with recombinant technology and transfected into the hepatocarcinoma cell line SMMC-7721 with liposome DOTAP. The expression of DNA MTase gene mRNA and E-Cadherin gene mRNA was examined with RT-PCR and the expression of E-Cadherin with immunohistochemical and flow cytometry. The status of methylation in E-Cadherin gene promoter area was examined with methylation specific PCR (MSP).</p><p><b>RESULTS</b>The sense and antisense eukaryotic expression vectors were successfully constructed and then the constructed recombinant plasmids were successfully transfected into SMMC-7721 cell with liposome DOTAP. The expression of endogenous DNA MTase mRNA was obviously decreased with E-Cadherin gene mRNA and its activity increased in the SMMC-7721 cell, which was tranfected with antisense DNA MTase gene fragment. Moreover, demethylation in the promoter area of E-Cadherin gene was observed with MSP.</p><p><b>CONCLUSION</b>Demethylation in the promoter area and increasing mRNA level of E-Cadherin gene can be induced by expression inhibition of DNA MTase gene of SMMC-7721 cell line.</p>
Subject(s)
Humans , Cadherins , Genetics , Metabolism , Carcinoma, Hepatocellular , Pathology , CpG Islands , DNA , Metabolism , DNA Methylation , DNA Modification Methylases , DNA, Antisense , Genetics , Pharmacology , Gene Expression , Liver Neoplasms , Pathology , Promoter Regions, Genetic , RNA, Messenger , Metabolism , Transfection , Tumor Cells, CulturedABSTRACT
Objective To explore the effects and the underlying mechanisms of inhibiting three kinds of DNA methyltransferases(DNMT1,DNMT3a and DNMT3b) on the re-expression of cancer/testis antigen(CTA) in hepatic cells.Methods Transient transfection of HepG2 cells with siRNA was targeted against DNMT1,DNMT3a and DNMT3b(DNMT1+3a+3b),DNMT1 and DNMT3a(DNMT1+3a),DNMT1 and DNMT3b(DNMT1+3b),DNMT3a and DNMT3b(DNMT3a+3b),respectively.The other batch of cells was treated with 5'-aza-deoxycytidine(5-aza-dC) as positive control.Real-time PCR and Western blotting were used to detect the expressions of DNMTs and CTAsm,and the promoter methylation of partial CTA genes was detected with methylation specific PCR(MSP).Results Expressions of DNMT1,DNMT3a and DNMT3b declined significantly after siRNA interference in HepG2 cells.Two CTAs,CT10 and SSX1,re-expressed in the cells transfected by DNMT1+3a and DNMT1+3b.MAGE1 and MAGE3 were equally expressed in all cells despite been transfected or not.Demethylation occurred in the promoter region of CT10,while the promoter region of MAGE1 was in a state of unmethylation.Conclusions In HepG2 cells,CTA promoter can be demethylated via interference of DNMTs,which may lead to the re-expression of CTA that was originally unexpressed due to methylation.
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Objective To compare the short-term and long-term efficacy of chemotherapy with biotherapy and same chemotherapy followed by biotherapy on malignant melanoma in stage Ⅲ and Ⅳ.Methods 82 cases with malignant melanoma were treated with chemotherapy(dacarbazing,cis-platin and carmustine)or biotherapy(interleukin-2,interferon ? and dendritic cell vaccine)or biochemotherapy(chemotherapy plus biotherapy).Among them,32 cases were received biochemotherapy,26 for biotherapy and 24 for chemotherapy.Therapentic response was assessed every 3 cycles.The median time of follow up was 2 years(1-4 years).Results Response rate was 71.9% for biochemotherapy,46.2% for biotherapy and 54.2% for chemotherapy(P