Abivertinib inhibits megakaryocyte differentiation and platelet biogenesis / 医学前沿

Abivertinib, a third-generation tyrosine kinase inhibitor, is originally designed to target epidermal growth factor receptor (EGFR)-activating mutations. Previous studies have shown that abivertinib has promising antitumor activity and a well-tolerated safety profile in patients with non-small-cell lung cancer. However, abivertinib also exhibited high inhibitory activity against Bruton's tyrosine kinase and Janus kinase 3. Given that these kinases play some roles in the progression of megakaryopoiesis, we speculate that abivertinib can affect megakaryocyte (MK) differentiation and platelet biogenesis. We treated cord blood CD34+ hematopoietic stem cells, Meg-01 cells, and C57BL/6 mice with abivertinib and observed megakaryopoiesis to determine the biological effect of abivertinib on MK differentiation and platelet biogenesis. Our in vitro results showed that abivertinib impaired the CFU-MK formation, proliferation of CD34+ HSC-derived MK progenitor cells, and differentiation and functions of MKs and inhibited Meg-01-derived MK differentiation. These results suggested that megakaryopoiesis was inhibited by abivertinib. We also demonstrated in vivo that abivertinib decreased the number of MKs in bone marrow and platelet counts in mice, which suggested that thrombopoiesis was also inhibited. Thus, these preclinical data collectively suggested that abivertinib could inhibit MK differentiation and platelet biogenesis and might be an agent for thrombocythemia.

An interlaboratory comparison study on the detection of RUNX1-RUNX1T1 fusion transcript levels and WT1 transcript levels / 中华血液学杂志

Objective@#To investigate the current status and real performance of the detection of RUNX1-RUNX1T1 fusion transcript levels and WT1 transcript levels in China through interlaboratory comparison.@*Methods@#Peking University People’s Hospital (PKUPH) prepared the samples for comparison. That is, the fresh RUNX1-RUNX1T1 positive (+) bone morrow nucleated cells were serially diluted with RUNX1-RUNX1T1 negative (-) nucleated cells from different patients. Totally 23 sets with 14 different samples per set were prepared. TRIzol reagent was added in each tube and thoroughly mixed with cells for homogenization. Each laboratory simultaneously tested RUNX1-RUNX1T1 and WT1 transcript levels of one set of samples by real-time quantitative PCR method. All transcript levels were reported as the percentage of RUNX1-RUNX1T1 or WT1 transcript copies/ABL copies. Spearman correlation coefficient between the reported transcript levels of each participated laboratory and those of PKUPH was calculated.@*Results@#①RUNX1-RUNX1T1 comparison: 9 samples were (+) and 5 were (-) , the false negative and positive rates of the 20 participated laboratories were 0 (0/180) and 5% (5/100) , respectively. The reported transcript levels of all 9 positive samples were different among laboratories. The median reported transcript levels of 9 positive samples were from 0.060% to 176.7%, which covered 3.5-log. The ratios of each sample’s highest to the lowest reported transcript levels were from 5.5 to 12.3 (one result which obviously deviated from other laboratories’ results was not included) , 85% (17/20) of the laboratories had correlation coefficient ≥0.98. ②WT1 comparison: The median reported transcript levels of all 14 samples were from 0.17% to 67.6%, which covered 2.6-log. The ratios of each sample’s highest to the lowest reported transcript levels were from 5.3-13.7, 62% (13/21) of the laboratories had correlation coefficient ≥0.98. ③ The relative relationship of the reported RUNX1-RUNX1T1 transcript levels between the participants and PKUPH was not always consistent with that of WT1 transcript levels. Both RUNX1-RUNX1T1 and WT1 transcript levels from 2 and 7 laboratories were individually lower than and higher than those of PKUPH, whereas for the rest 11 laboratories, one transcript level was higher than and the other was lower than that of PKUPH.@*Conclusion@#The reported RUNX1-RUNX1T1 and WT1 transcript levels were different among laboratories for the same sample. Most of the participated laboratories reported highly consistent result with that of PKUPH. The relationship between laboratories of the different transcript levels may not be the same.

Expression of gene and its prognostic value in patients with acute myeloid leukemia / 浙江大学学报·医学版

OBJECTIVE@#To investigate the expression of Wilms'tumor 1 () gene in patients with acute myeloid leukemia (AML), and to explore its application in predicting prognosis of AML in patients with wild or mutated nucleophosmin 1() and Fms-like tyrosine kinase 3-internal tandem duplication ().@*METHODS@#One hundred and sixty-seven newly diagnosed AML patients(exclued M3 type) were enrolled in this study. The survival of patients were analyzed with Kaplan-Meier method. The clinical data, laboratory findings and the survival of patients were analyzed and compared between patients with high expression (high- group) and those with low expression (low- group), as well as among the patients with or wild type and mutants.@*RESULTS@#The overall response rates (ORR) in high- and low- groups were 65.9% (83/126) and 95.1% (39/41), respectively (0.05). In patients with wild type, the high- group had inferior ORR and 2-y OS rate (all 0.05).@*CONCLUSIONS@# gene overexpression indicated poor prognosis of AML patients; the patients with decreased gene expression ≥ 1 log after the first induction therapy show better prognosis than those with<1 log. The gene expression level at diagnosis can be used as an unfavorable prognostic factor for AML patients with or wild types.

Application research of the team-based autonomous learning in the medical ethics teaching / 中华医学教育探索杂志

Objective To demonstrate the practicality of a team-based autonomous learning in the medical ethics teaching. Methods 186 five-year program clinical medical juniors were randomly divided into Group A (96 people) and Group B (90 people) which were given a team-based autonomous learning and traditional learning style learning respectively, and the teaching effect was compared from the aspects of critical thinking ability and class final evaluation.All data were analyzed by SPSS 15.0 and checked by t test. Results In the critical thinking ability, CCTDI scores of two groups before the start of the subject were (271.10±19.77) (experimental group) and (272.54±23.44) (control group), while at the end of the course,the test scores were:(285.93±21.37) (experimental group), and(280.87±19.24) (control group). In the course of final evaluation, the experimental group was higher than that of control group, with the final scores[(79.86±12.37) vs. (77.24±9.17)], clinical case analysis scores[(81.07±7.43) vs. (75.23±10.74)], the scores of independent practice (7.598±1.231) vs. (7.019±0.997)]. Conclusion The team-based autonomous learning improve the learning effect positively. The practicability of this new way of learning is worth affirmation.

The research of teaching supervision mechanism in modern military academy / 中华医学教育探索杂志

In this study,with the mechanism for teaching supervision in military colleges and universities construction as the starting point,the author makes an in-depth analysis of the problems existing in the current teaching supervision system of military academies,such as the imperfect mechanism,the limitation of the function,the lack of full-time staff,the lag of information technology and so on,and investigates and surveys the status quo of teaching supervision at home and abroad.It also puts forward some countermeasures,such as constructing the comprehensive supervision system,realizing the function transformation,promoting the innovation of the mode,expanding the connotation of the supervision,optimizing the structure of the team,developing the professional training,and strengthening the information construction and so on.

A preliminary study on the curriculum model for master degree graduate students of medical psy-chology / 中华医学教育探索杂志

Medical psychology master's degree graduate student course mainly includes basic cour-ses, professional courses and psychological skills training, professional practice skills learning and scientific research quality training. Due to the constraints of discipline development starting late, teachers being rela-tively weak and other objective factors, in curriculum setting, there exist problems of unclear objectives, confusing the primary with secondary, unclear standard, lacking principles, and in particular, there are obvious deficiencies in the training and cultivation of students' ! professional skills . Based on the above objective problems, we made preliminary discussion on the training objectives, the main problems, curricu-lum setting, assessment standards and principles to follow, in order to achieve the purpose of cultivating high-level application-oriented talents through curriculum design and teaching practice.

Academy graduate students' psychological stress condition investigation and analysis / 中华医学教育探索杂志

Objective To understand the status of the academy graduate students' psychological pressure.Method The team used cluster random sampling method 5 times in 2015,Life Scale (LES) of the classic life event scale (event) was used to make investigation into graduate students of the different professional background in 8 universities,and recovered 1041effective questionnaires.SPSS 18.0 statistical method was applied to study the life events category,occurrence frequency and so on to make the analysis of variance (95％ confidence interval).Results According to the classification of events,the total score of work study class was the highest,the lowest was social and other categories,family class was centered,and the difference was statistically significant (F=21.987,P=0.000).According to the frequency of events,there were four life events whose mean intensity achieved the severe (2.5),that was,work and study pressure,love/engagement,family economic difficulties,the beginning of employment.There were 23 events whose intensity means reached moderate (1.5-2.5),such as husband and wife separation due to work,children's discipline difficulties,family members being seriously ill or seriously injured,etc.The rest were mild events (＜ 1.5).Conclusion At present,China's military academy graduates have obvious psychological pressure,mainly coming from work,school,family,marriage,economic,human relations,employment,etc.It is suggested that psychological intervention from multi channels should be made to improve the pressure of the current situation.

Research and practice in cultivation of medical undergraduates' innovation ability / 中华医学教育探索杂志

Through analyzing the connotation and current situation of the innovation ability training,the paper lists the main problems existing in the cultivation of medical students' innovation ability.With medical undergraduate education as the starting point,it summarizes the experience and practice of strengthening the cultivation of medical undergraduates' innovation ability from the following aspects as set-ting up the innovation education idea,promoting the innovation of teaching contents with minus three,three bases,three stresses,promoting the reform of teaching methods with innovation as the core,constructing new type teachers staff with science and education as one,improving training system innovation,accelerating the construction of integrated test system,and establishing and improving the innovation of educational system and mechanism and so on.

effect of problem-based learning on improvement of the medical educational environment: a systematic review and meta-analysis

Objectives: The aim of this study was to evaluate the effect of problem-based learning on improving the medical educational environment

Materials and Methods: All relevant studies on problem-based learning and the medical educational environment were searched for in PubMed, the Education Resources Information Center [ERIC] catalogue, Google Scholar, China National Knowledge Infrastructure [CNKI] and WanFang Data [WF] databases for material dating from 1969 to May 2015 without any language limitation. Six randomized controlled trials of problem-based learning compared to traditional lecture-based learning were included. The Cochrane risk of bias tool was used to assess the quality of the included studies. Review Manager [Revman] version 5.3 software was used for data analysis. The effect size of the improvement on the medical educational environment was calculated as the mean difference and 95% confidence interval. Heterogeneity was evaluated with Cochrane's chi[2] test and I[2]. Publication bias was assessed by funnel plot, Begg's rank correlation test, and Egg's linear regression test

Results: The six included studies were at low risk of bias in all domains except for three that were at high risk of bias in the domain of allocation concealment. The pooled effect size showed that problem-based learning was better than lecture-based learning in improving the medical educational environment, as measured by the Dundee Ready Education Environment Measure [DREEM], with statistically significant differences. No significant publication bias was observed. The sensitivity analysis showed that the result was reliable

Conclusions: This study showed that problem-based learning was able to improve the medical educational environment as measured by DREEM. However, further studies with larger sample sizes and high-quality data are needed

"Analysis of ""one-card""mode for division-level cadres hospitalized at military hospitals" / 军事医学

Objective To analyze the feasibility of theone-cardmode for division-level cadres hospitalized at military hospitals, and to provide reference for application of this mode to cadres under the regimental level who are hospitalized at military hospitals.Methods A 4-month pilot project was carried out among division-level cadres in Lanzhou, Jinan, Nanjing and Chengdu.Data collection and statistical analysis were conducted through the monitoring platform established in the administrative section.Results Division-level cadres outside the system mostly chose division-level hospitals.Patients thended to be hospitalized at nearby or high-quality hospitals mainly due to cardiovascular and cerebrovascular diseases and malignant tumor.Accommodation was not difficult.Conclusion The one-cardmode is feasible at military hospitals for division-level cadres, but the current system of initial diagnosis at basic medical institutions should be maintained.An information sharing platform of electronic medical records should be built to implement inter-hospital linking and sharing of diagnosis and treatment information.A budget subsidy mechanism should be established to normalize hospitalization.

Study on the construction of public health master curricula system based on the professional competencies / 中华医学教育探索杂志

This article analyzed the current problems existing in the public health master cur-ricula system, such as educational ideas being backward, tralning objectives not explicit, curricula teaching unsatisfactory and effects of practical curriculum needing to be improved. Based on the pro-fessional competencies, we discussed the ideas and principles of the new curricula system of master of public health, and proposed making sure of a refined professional competencies, making strict traln-ing standards, confirming tralning objectives, embodying advantages, setting up reasonable curricula, fostering practical abilities, strengthening cooperation and carrying on professional identification.

A multicenter study on the revalidation of validated conversion factor for the conversion of BCRABL（P210）transcript levels to the international scale in chronic myeloid leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To revalidate the conversion factor（CF）for the conversion of BCR-ABL （P210）transcript levels to the international scale（BCR- ABLIS）in chronic myeloid leukemia（CML） which validated before.</p><p><b>METHODS</b>Peking University People's Hospital（PKUPH）prepared the exchange samples for revalidation of CFs of 15 laboratories which validated nine or eighteen months ago. The fresh BCR-ABL（P210）（+）bone morrow or peripheral blood nucleated cells were diluted with BCR-ABL （P210）（-）cells to achieve different BCR- ABL levels, totally 16 sets and 24 samples per set were prepared. TRIzol reagent was added in each tube. Each laboratory tested BCR-ABL transcript levels of one set of samples. Agreement between BCR-ABLIS of each laboratory and PKUPH was assessed by the Bland- Altman method. For laboratories which did not meet the criteria of revalidation, linear regression equation was derived after the samples with maximum BCR-ABL deviation were removed until R²>0.98, then new CF was calculated.</p><p><b>RESULTS</b>10 laboratories met the revalidation criteria with both bias within ±1.4 fold and 95% limits of agreement within ±6 folds, and their CFs still could be used for accurately conversion of BCR-ABLIS. New CFs were recalculated as of 1.8-6.3 folds of their previous CFs in 5 laboratories not met the criteria.</p><p><b>CONCLUSION</b>Revalidation of CF by sample exchange among laboratories was necessary for accurate and continuous application of BCR-ABLIS, which not only tested the validity of CF acquired before but also calculated new available CFs for those with invalid CFs.</p>

Influence of RNA interference on MSI-2 gene in THP-1 cell and expression of NUMB / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of small interfering RNA（siRNA）for MSI-2 on the growth, apoptosis and NUMB expression of THP-1 cells.</p><p><b>METHODS</b>Three siRNA for MSI-2 gene was designed and transfected into THP- 1 cells. The cell inhibition, colony formation and apoptosis were determined. The protein expression of NUMB, caspase- 3 and PARP were detected by Western blotting.</p><p><b>RESULTS</b>After MSI- 2 expression of THP- 1 cells was down- regulated for 24 hours, cell inhibition of siRNA MSI-2 group was（47.89±7.64）%, obviously higher than that of negative control group（P=0.005）. After 9 days, cell colony count of siRNA MSI-2 group was 7.50±1.53, also lower than that of negative control group（35.75±7.46, P<0.001）. In addition, apoptotic rates of siRNA MSI- 2 group at 24 hours ［（15.22±1.52）%］and 48 hours［（33.83±3.96）%］were significantly higher than those of negative control group（P=0.008 and P=0.001, respectively）. Accordingly, activations of caspase-3 and PARP and increased NUMB were observed in siRNA MSI- 2 group.</p><p><b>CONCLUSION</b>siRNA for MSI- 2 gene could increase the expressions of NUMB to inhibit the proliferation and induce apoptosis of THP-1 cells.</p>

Sticking to the development of military and civilian integration, cultivating outstanding scientific and technological achievements:thoughts concerning the management of scientific and technological achievements in military medical university / 中华医学科研管理杂志

The role of Military Medical University featuring both battlefield and market service determines the necessity to seek balance between military and civilian planning for scientific and technological innovation.In the management of scientific and technological achievements,Third Military Medical University sticks to the development mode of military-civil integration.First,it establishes the management concept suit for its roles and characteristics,organizational strategy,policy and system.Secondly,it implements transitional development.Thirdly,it serves social development and military medical services.As a result,a series of outstanding scientific and technological achievements have been obtained,and remarkable progress and results have been achieved.

Puzzles and solutions of the cultivation of medical psychology undergraduates / 中华医学教育探索杂志

As an emerging discipline, medical psychology undergraduate education is restricted by many conditions, such as subject orientation, training objectives, curriculum setting, teaching con-tent, teaching material system, teaching mode, professional practice, assessment and graduation and so on. To improve the training quality and level, the paper explores the corresponding education strat-egy from the aspects of subject orientation, training objectives, curriculum and teaching contents. For example in the subject orientation and training objectives the principle of paying equal attention to medical and psychological disciplines is reflected, and at the same time the construction of the curricu-lum, teaching contents and curriculum system is strengthened to highlight the psychology and medical integration and mutual penetration. In the link of teaching, professional practice, graduation appraisal and award process, practical skills training and assessment are focused on, and the relevant national qualification examination is taken as award criteria.

A multicenter study on the validation of conversion factor for the conversion of BCR-ABL (P210) transcript levels to the international scale in chronic myeloid leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To validate the conversion factor (CF) for the conversion of BCR-ABL (P210) transcript levels to the international scale in chronic myeloid leukemia (CML).</p><p><b>METHODS</b>In 2012, the international reference laboratory in Adelaide, Australia (IMVS) sent two batches of RNA samples, 30 samples per batch, to Peking University People's Hospital (PKUPH). By comparing BCRABL (P210) transcript levels reported by the two laboratories, CF of PKUPH was calculated and validated by IMVS. In 2013, PKUPH prepared the exchange samples for validation of CF of 9 hospitals who have calculated CFs before. The fresh BCR-ABL (P210) (+) cells were serially diluted by BCR-ABL (P210) (-) cells to prepare 22 kinds of samples with different BCR-ABL transcript levels, each kind had 10 parallel samples. Trizol reagent was added in each tube. Ten hospitals tested BCR-ABL transcript levels of one set of 22 samples. Agreement between BCR-ABL transcript levels of each laboratory and PKUPH was assessed by the Bland-Altman method.</p><p><b>RESULTS</b>PKUPH successfully validated its CF with bias 1.1 fold and 95% limits of agreement between -4.7 and 4.9 fold. Of 9 hospitals whose validation performed by sample exchanges with PKUPH, 6 hospitals successfully validated their CF with bias ≤±1.4 fold and 95% limits of agreement within ±6 fold.</p><p><b>CONCLUSION</b>Validation of CF examined the stability of the detection of BCR-ABL (P210) transcript levels, which was necessary for the valid conversion of BCR-ABL (P210) transcript levels to the international scale in CML.</p>

Research and practice on scientific research ability cultivation for eight-year clinical medical students / 中华医学教育探索杂志

The Third Military Medical University promotes the scientific research ability of the eight-year clinical medicine students through accurately fixing cultivation objectives,reasonably arranging teaching,implementing supervisor group for many-to-one teaching,carrying out plentiful innovative re-search projects,establishing reading system of scientific research papers,setting up scientific research innovation courses and setting up the credit system for innovative education. Eight-year program is signifi-cantly better than the five-year program in cultivating abilities of problem-discovering,researching and thesis writing.

Discussions on training methodology of equipments use for the national medical rescue team / 中华医院管理杂志

Objective To study the training methods of equipments for the national medical rescue team,for the purpose of enhanced equipment operation ability of team members and enhanced overall capacity for emergency rescue.Methods Using such methods as investigation and discussion,procedures development,examination standards development,and training and examination.These methods are designed to improve the equipment training methods for the national medical rescue team.Results Following the training,get-ready time of the whole team is cut back from 200 minutes to 90 minutes,and the roll-up time from 170 minutes to 80 minutes.Number of equipments mastered by the whole team has risen from 147 pcs/sets(47.2 ％) to 290 pcs/sets(94.5 ％),while average number of equipments mastered per person has risen from 98 pcs/sets(31.9％) to 185 pcs/sets(60.3％).Conclusion The Equipment Operation Procedures List and Equipment Training and Examination Standards should be made in consideration of the development needs of a national medical rescue team and disaster rescue experiences.In addition,such trainings and examinations as those by means of whole team,groups,and group-section crossing can improve the emergency rescue capabilities of the national medical rescue team.

The construction of the indicator system for evaluating clinical teaching quality of medical universities guided by the regular teaching assessment / 中华医学教育探索杂志

In recent years,medical colleges have generally accepted the higher education assessment(evaluation).How to put the good practices and experience we obtained during the educational assessment into the daily teaching management and achieve normalization of teaching evaluation is of great significance to continuously improving the teaching quality.It is the primary condition to establish the evaluation index system for evaluating clinical teaching quality by regular teaching assessment. In this paper,the author constructed a clinical teaching quality evaluation index system through systematic research and exploration.

Innovation and management of curriculum system for medical postgraduates / 中华医学教育探索杂志

In order to suit the trend of integration and development of modem medical disciplines and the reform trend of integration of curriculum system, the Third Military Medical University attempts to build a new curriculum system for medical postgraduates. The new system reveals the accuracy towards the teaching objects, the integration of curriculum structure, the update of the teaching contents and the diversity of the teaching methods. Besides, it combines the reform of teaching management, which will push forward the cultivation quality of the medical postgraduates.