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Objective:To investigate the expression of cancer-associated fibroblasts(CAFs) marker proteins in papillary thyroid carcinoma(PTC) using immunohistochemistry and explore their correlation with clinicopathological characteristics.Methods:The clinicopathological data of 90 PTC patients at Tianjin Medical University General Hospital from December 2019 to January 2021 were retrospectively analyzed. Surgical pathological cancer tissue samples were selected for immunohistochemical staining, and control group tissues were obtained from normal thyroid tissue adjacent to the tumor lesion. Four CAFs marker proteins, including fibroblast-activated protein(FAP), α-smooth muscle actin(α-SMA), Vimentin, and platelet-derived growth factor receptor-α(PDGFR-α), were stained and scored, followed by statistical analysis.Results:The immunoreactivity score of the CAFs marker proteins were correlated with extrathyroid invasion, lymph node metastasis, and multi-focality of PTC. FAP and α-SMA demonstrated better performance in this regard. Multivariate logistic regression analysis and receiver operating characteristic(ROC) curve analysis showed that high immunoreactivity scores of FAP and α-SMA were risk factors for poor clinical pathological features, with good predictive sensitivity and accuracy.Conclusion:Strong expression of CAFs was the risk factor for extrathyroid invasion, lymph node metastasis, and mutli-focality of PTC. FAP has the highest clinical value compared with other CAFs marker proteins.
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Objective The expression and prognosis significance of CD59 in pancreatic cancer were analyzed by bioinformatics.Methods Gene expression profiling interactive analysis 2(GEPIA2)and human protein atlas(HPA)databases were used to compare the expression of CD59 between pancreatic cancer tissues and adjacent tissues;Kaplan-Meier plotter database was used to evaluate the effect of CD59 on prognosis;String and Cytoscape3.9.1 were used to analyze the CD59 protein interaction network;DAVID6.8 performed gene enrichment and pathway enrichment analysis of CD59 with key interacting genes.Results Compared with normal tissues,the expression of CD59 in pancreatic cancer tissues was significantly up-regulated(P<0.05),and the overall survival time(HR=2.3,95%CI:1.52-3.50)and recurrence free survival(HR=4.31,95%CI:1.57-11.83)of pancreatic cancer patients with CD59 high expression was shorter than CD59 low expression patients.Protein interaction network analysis revealed that CD59 is closely related to several molecules such as CD55,GOLGA2,LMAN1,TMED2 and SERPINA1.Gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis indicated that CD59 was mainly involved in pathways such as complement activation,innate immune response and coronavirus-COVID-19.Conclusion CD59 is highly expressed in pancreatic cancer tissue and is affected by several immune-related genes.It is associated with poor prognosis of patients and can be used as one of biomarkers for early diagnosis and prognosis prediction of pancreatic cancer.
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Cerebral amyloid angiopathy(CAA)is a small vascular disease caused by the deposition of amyloid protein in the vascular wall, mainly involving the cortical and leptomeningeal arterioles and capillaries.The main pathological and clinical manifestations are lobar hemorrhage, cerebral microbleeds, cortical superficial siderosis, subarachnoid hemorrhage, cortical infarction, white matter abnormalities, CAA-related autoimmune meningoencephalitis and dementia.Patients with CAA are prone to spontaneous cerebral hemorrhage.For CAA patients, the anticoagulant therapy for prevention of cardioembolism of artrial fibrillation or intravenous thrombolytic therapy for acute ischemic stroke may increase the chance of cerebral hemorrhage and lead to aggravation of the disease.Therefore, the risk of hemorrhage associated with CAA needs to be evaluated before antithrombotic therapy.CAA-related inflammation is a critical condition.Corticosteroids and immunosuppressive agents are effective treatments.Early diagnosis and treatment can significantly improve the prognosis.
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@#Objective To analyze the clinical characteristics of the Guang’an Omicron epidemic and summarize the management experiences and practices in pandemic prevention and control of major infectious diseases. Methods Retrospective analysis was performed on patients infected with coronavirus disease (COVID-19), afterwards treated and observed in the isolation ward of Guang’an People’s Hospital and the shelter of Guang’an City from May 9 to June 26, 2022. The characteristics of patients at different age stages and the related factors affecting the severity, re-positive and negative conversion was analyzed. Results Finally 1 278 patients were collected, including 508 males and 770 females, with an average age of 41.3±22.6 years. Among them, 1 054 patients were asymptomatic carriers. The overall severe rate was 0.86%, the severe rate of the high-risk group was 3.06%. The median negative conversion time was 10.0 days and re-positive rate was 7.36%. Patients aged>60 years were 2.589 times more likely to have a longer negative conversion time than those aged≤60 years (95%CI 1.921-3.489, P<0.001). Conclusion The clinical characteristics of Guang’an COVID-19 epidemic are mainly that the elderly with high risk factors are more likely to develop severe cases, have longer clearance time, and re-positve is more likely to occur.
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Immune checkpoint inhibitors (ICIs) show unique advantages in the treatment of lung cancer, making the treatment of lung cancer enter the era of immunotherapy, but ICIs will also have adverse reactions, and the incidence of immune-induced hematological toxicity is not very high. Immunotherapy-induced thrombocytopenia is a rare adverse event.We report one case of thrombocytopenia induced by ICIs and review the literature on thrombocytopenia associated with ICIs and discuss the clinical features, possible mechanisms, and optimal treatment. .
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Humans , Purpura, Thrombocytopenic, Idiopathic/drug therapy , Lung Neoplasms/drug therapy , Thrombocytopenia/chemically induced , Antibodies, Monoclonal, Humanized/adverse effectsABSTRACT
In pursuit of effective agents for hepatocellular carcinoma derived from the Artemisia species, this study built upon initial findings that an ethanol (EtOH) extract and ethyl acetate (EtOAc) fraction of the aerial parts of Artemisia dubia Wall. ex Bess. exhibited cytotoxicity against HepG2 cells with inhibitory rates of 57.1% and 84.2% (100 μg·mL-1), respectively. Guided by bioactivity, fourteen previously unidentified sesquiterpenes, artemdubinoids A-N (1-14), were isolated from the EtOAc fraction. Their structural elucidation was achieved through comprehensive spectroscopic analyses and corroborated by the comparison between the experimental and calculated ECD spectra. Single crystal X-ray diffraction provided definitive structure confirmation for artemdubinoids A, D, F, and H. Artemdubinoids A and B (1-2) represented unique sesquiterpenes featuring a 6/5-fused bicyclic carbon scaffold, and their putative biosynthetic pathways were discussed; artemdubinoid C (3) was a novel guaianolide derivative that might be formed by the [4 + 2] Diels-Alder reaction; artemdubinoids D and E (4-5) were rare 1,10-seco-guaianolides; artemdubinoids F-K (6-11) were chlorine-containing guaianolides. Eleven compounds exhibited cytotoxicity against three human hepatoma cell lines (HepG2, Huh7, and SK-Hep-1) with half-maximal inhibitory concentration (IC50) values spanning 7.5-82.5 μmol·L-1. Artemdubinoid M (13) exhibited the most active cytotoxicity with IC50 values of 14.5, 7.5 and 8.9 μmol·L-1 against the HepG2, Huh7, and SK-Hep-1 cell lines, respectively, which were equivalent to the positive control, sorafenib.
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Humans , Artemisia/chemistry , Sesquiterpenes/chemistry , Cell Line , Hep G2 Cells , Crystallography, X-Ray , Molecular StructureABSTRACT
OBJECTIVE@#To explore the clinical features, lysosomal enzymatic [acid α-glucosidase (GAA)] activities and genetic variants in a child with late-onset Pompe disease (LOPD).@*METHODS@#Clinical data of a child who had presented at the Genetic Counseling Clinic of West China Second University Hospital in August 2020 was retrospectively analyzed. Blood samples were collected from the patient and her parents for the isolation of leukocytes and lymphocytes as well as DNA extraction. The activity of lysosomal enzyme GAA in leukocytes and lymphocytes was analyzed with or without addition of inhibitor of GAA isozyme. Potential variants in genes associated with neuromuscular disorders were analyzed, in addition with conservation of the variant sites and protein structure. The remaining samples from 20 individuals undergoing peripheral blood lymphocyte chromosomal karyotyping were mixed and used as the normal reference for the enzymatic activities.@*RESULTS@#The child, a 9-year-old female, had featured delayed language and motor development from 2 years and 11 months. Physical examination revealed unstable walking, difficulty in going upstairs and obvious scoliosis. Her serum creatine kinase was significantly increased, along with abnormal electromyography, whilst no abnormality was found by cardiac ultrasound. Genetic testing revealed that she has harbored compound heterozygous variants of the GAA gene, namely c.1996dupG (p.A666Gfs*71) (maternal) and c.701C>T (p.T234M) (paternal). Based on the guidelines from the American College of Medical Genetics and Genomics, the c.1996dupG (p.A666Gfs*71) was rated as pathogenic (PVS1+PM2_Supporting+PM3), whilst the c.701C>T (p.T234M) was rated as likely pathogenic (PM1+PM2_Supporting+PM3+PM5+PP3). The GAA in the leukocytes from the patient, her father and mother were respectively 76.1%, 91.3% and 95.6% of the normal value without the inhibitor, and 70.8%, 112.9% and 128.2% of the normal value with the inhibitor, whilst the activity of GAA in their leukocytes had decreased by 6 ~ 9 times after adding the inhibitor. GAA in lymphocytes of the patient, her father and mother were 68.3%, 59.0% and 59.5% of the normal value without the inhibitor, and 41.0%, 89.5% and 57.7% of the normal value with the inhibitor, the activity of GAA in lymphocytes has decreased by 2 ~ 5 times after adding the inhibitor.@*CONCLUSION@#The child was diagnosed with LOPD due to the c.1996dupG and c.701C>T compound heterozygous variants of the GAA gene. The residual activity of GAA among LOPD patients can range widely and the changes may be atypical. The diagnosis of LOPD should not be based solely on the results of enzymatic activity but combined clinical manifestation, genetic testing and measurement of enzymatic activity.
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Humans , Child , Male , Female , Glycogen Storage Disease Type II/pathology , Retrospective Studies , alpha-Glucosidases/genetics , Mothers , Lysosomes/pathology , MutationABSTRACT
Objective:To investigate the effect of different chemotherapy drugs combined with DNA methylase inhibitor 5-Aza-2'-deoxycytidine (5-Aza-dC) on the apoptosis of lung adenocarcinoma cells.Methods:In the prospective randomized controlled study, lung adenocarcinoma A549 cells were treated with cisplatin plus paclitaxel (TP) or gemcitabine (GP) with or without 5-Aza-dC. According to different drug intervention methods, they were divided into control group, cisplatin combined with paclitaxel (TP) group, cisplatin combined with gemcitabine (GP) group, and 5-Aza-dC combined with TP group, 5-Aza-dC combined with GP group. CCK-8 assay was used to detect the proliferation of A549 cells. Transwell migration and invasion assay were used to detect the effect that each group of drugs on the migration and invasion ability of A549 cells. Quantitative Real-time Polymerase Chain Reaction was used to evaluate the effect of each treatment on the expression of apoptotic genes. One-way analysis of variance was used to compare the degree of cell proliferation in different drug treatment groups, and LSD- t method was used for pairwise comparison within groups. Results:The inhibition rates of lung adenocarcinoma cells in the TP regimen at different time points at 24, 48, and 72 h were as follows (20.00±4.23) %, (35.00±2.80) %, and (56.00±3.11) %. The inhibition rate of 5-Aza-dC combined with TP regimen on lung adenocarcinoma cells was significantly increased, at different time points of 24, 48 and 72 h, respectively (38.00±3.80) %, (50.00±3.25) %, (93.00±4.33) %. The inhibition rates of cells at different time points at 24, 48, and 72 h in the GP regimen were (33.00±5.10) %, (54.00±3.80) %, and (74.00±2.82) %, respectively; while 5-Aza-dC combined with GP regimen could significantly reduce the rate of cell growth, the inhibition rates of cells at 24, 48, and 72 h different time points were as follows (54.00±3.00) %, (67.00±5.30) %, and (95.00±1.13) %. The inhibitory effect of the same drug on lung adenocarcinoma cells increased with time (TP group: F=35.93, P<0.001; 5-Aza-dC combined with TP group: F=97.33, P<0.001; GP group: F =41.73, P<0.001; 5-Aza-dC combined with GP group: F=79.00, P<0.001), and at different time points, the differences were statistically different (all P<0.05). 5-Aza-dC combined with TP and GP chemotherapy regimens can inhibit the migration and invasion of lung adenocarcinoma cell A549, and the inhibitory effect is stronger than that of TP or GP regimens alone. The expression of Caspase 8 was significantly elevated ( t=5.87, P=0.004) in cells treated with 5-Aza-dC combined with GP when compared with GP regimen alone. The expression of Caspase 8 ( t=3.94, P=0.017), Caspase 6 ( t=5.81, P=0.004) and BBC3 (BCL-2 binding component 3) ( t=6.53, P=0.003) were increased when drugged with 5-Aza-dC combined TP regimen compared with TP regimen alone. Conclusion:5-Aza-dC might serve as a chemotherapeutic sensitizer to increase the sensitivity of lung adenocarcinoma cells.
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Objective:To construct a risk prediction and assessment system for incisional infection after spinal surgery.Methods:Based on the failure mode and effect analysis (FMEA), risk factors and assessment indicators of postoperative incisional infection in spinal surgery were sorted out through literature search followed by expert consultation using the Delphi expert consultation method. After three-level assessment indicators were selected according to their importance and expert opinions and assigned by different scores, a risk prediction and evaluation system was constructed for postoperative incisional infection after spinal surgery.Results:The 2 rounds of expert consultation questionnaire resulted in an effective response rate of 100%. The degree of expert consultation authority was 0.85, showing high reliability; the Kendall coordination coefficients of expert consultation ranged from 0.525 to 0.686, showing good coordination ( P<0.05). The three-level assessment indicators consisted of 3 primary, 18 secondary and 54 tertiary ones. After statistical analyses of the important risk indicators selected which consisted of 6 preoperative evaluation ones and 18 postoperative evaluation ones, 6 preoperative and 12 postoperative predictive indicators were obtained. The values of risk priority number (RPN) were calculated for high, medium and low risks for postoperative incisional infection using a semi-quantitative method. Conclusion:A self-designed system has been constructed for risk prediction and assessment of incisional infection after spinal surgery based on expert consultation and FMEA method.
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In order to meet the needs of contemporary society for medicine and cultivate high-quality compound medical talents, Chongqing Medical University has carried out the "organ system-centered" urogenital system integration curriculum reform. In the practice of integrated curriculum teaching, students have deepened their systematic understanding of medical knowledge, enhanced their enthusiasm and initiative in classroom learning, cultivated students' logical thinking ability, and improved students' innovative scientific research ability, by reorganizing the curriculum system, rewriting textbooks, improving the teaching environment, forming a teaching team, and reforming teaching methods, which laids the foundation for the further improvement of the medical curriculum.
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Objective:To explore the role of blended learning in the undergraduate teaching of Clinical Biochemistry. Methods:The Batch 2017 medical laboratory technology undergraduates ( n=134) were selected as research objects, and the effect and opinions of blended learning were statistically analyzed by questionnaire survey and online-offline platform data. SPSS 23.0 was used to conduct rank sum test. Results:The application of blended learning in the Clinical Biochemistry teaching affected the learning effect in an all-round way. The average score increased from 70 (64, 76) to 79 (71, 85), with statistical difference ( Z=6.69, P<0.001). Conclusion:The combined application of blended learning, problem-based learning, flipped classroom and formative assessment is conducive to teaching students in accordance with their aptitude and cultivating students' clinical thinking ability.
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Background Some studies have shown that PM2.5 exposure is closely related to central nervous system diseases that lead to cognitive dysfunction and change the composition of intestinal flora. However, there are few studies on the role of intestinal flora in PM2.5-induced depression- and anxiety-like behaviors in mice. Objective To observe the effects of PM2.5 exposure on depression- and anxiety-like behaviors and the composition of intestinal flora in mice, and to explore the role of intestinal flora in regulating 5-hydroxytryptamine (5-HT) in depression- and anxiety-like behaviors in mice exposed to PM2.5. Methods Eight-week-old male SPF C57BL/6J mice were randomly divided into control group (NS group), probiotic group (LGG group), PM2.5 group (PM group), and combined exposure group (PML group), 6 mice in each group. Mice in the PM group and the PML group were exposed to PM2.5 in a dynamic exposure cabinet for 6 h per day, 6 d a week for 7 consecutive weeks, and the PM2.5 concentrations were approximately 8 times higher than the outdoor concentration. The LGG group and the PML group were orally administered with Lactobacillus rhamnosus while the NS group and the PM group were orally administered with the same amount of saline. Elevated plus maze test and open field test were used to detect depression and anxiety in mice. Fecal samples of mice were collected to evaluate intestinal flora abundance, diversity, and structure between groups using high-throughput sequencing of 16S rRNA. ELISA was employed to detect the levels of 5-HT in serum and hippocampus. Spearman correlation was used to analyze the correlations of differential intestinal flora with 5-HT level in hippocampus and depression- and anxiety-like behavior indicators in mice. Results The percentage of open-arm entry [M(P25, P75)] in the PM group was 0.0% (0.0%, 33.3%), lower than those in the NS group [47.7% (25.0%, 50.8%) ] and the PML group [46.9% (40.0%, 50.0%)], and the differences were statistically significant (P<0.05). The total travelled distance and the time spent in central area (\begin{document}$\bar x \pm s $\end{document}) in the PM group were (2.01±0.90) m and (10.31±1.99) s respectively, shorter than those of the NS group [(3.80±0.89) m, (14.47±3.07) s], the total travelled distance in the PML group [(2.73±1.12) m] was shorter than those of the NS group and the LGG group [(4.21±1.08) m], and the differences were statistically significant (P<0.05). Compared to the NS group, the Simpson index of the PM group significantly increased (P<0.05). Compared to the LGG group, the Simpson index of the PML group significantly decreased (P<0.05). The results of Beta diversity analysis showed that there were differences in the composition of intestinal flora among the four groups of mice. Compared with the NS group and the LGG group, the abundances of Erysipelotrichaceae and Dubosiella in the PM group and the PML group increased, while the abundances of Prevotellaceae_UCG-001 decreased, and the differences were statistically significant (P<0.05). In hippocampus, the level of 5-HT in the PM group [(135.02±10.31) μg·g−1] was lower than those in the NS group [(178.77±43.15) μg·g−1] and the LGG group [(224.85±22.98) μg·g−1], and the level of 5-HT in the PML group [(161.27±15.81) μg·g−1] was lower than that in the LGG group (P<0.05). 5-HT level in hippocampus was significantly positively correlated with the relative abundance of Prevotellaceae_UCG-001 (r=0.6090, P=0.012). The percentage of open-arm entry was significantly negatively correlated with the relative abundance of Dubosiella (r=−0.4630, P=0.023). Conclusion Atmospheric PM2.5 exposure may cause depression- and anxiety-like behaviors in mice. The observed behavior dysfunction may be associated with the changes in diversity and relative abundance of intestinal flora as well as the decrease of 5-HT level. Such depression- and anxiety-like behaviors are alleviated after adding probiotics.
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Objective:To explore the value of series situational simulation teaching combined with symptoms-centered integrated teaching mode in clinical clerkship of obstetrics and gynecology.Methods:A total of 181 students from Batch 2016 of Clinical Medicine (experimental group) were enrolled to receive the series situational simulation teaching combined with symptoms-centered integrated teaching mode. The teaching results were evaluated by formative evaluation scores and questionnaire, compared with 195 students from Batch 2015 (control group). The statistical analysis was performed with SPSS 21.0.Results:Scores of formative evaluation in experimental group [(88.66±5.92) points] was higher than those in control group [(81.11±7.36) points], with statistically significant differences ( P<0.05). Satisfaction of students for teaching flexibility, teaching innovation, learning interest and clinical thinking in experimental group was greater than that of students in control group ( P<0.05). Meanwhile, compared with the control group, teachers from experimental group were more satisfied with teaching flexibility, teaching integration, students' participation and activity in classroom and cultivation of the clinical thinking ability and post competences ( P<0.05). Conclusion:The series situational simulation teaching combined with symptoms-centered integrated teaching mode can help students to form a systemic knowledge system, cultivate their clinical thinking ability and establish a holistic view of disease.
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Objective:To verify the effects of microlecture based on robot carrier on standardized residency training of orthopedics.Methods:Sixty orthopedic residents from our hospital were divided into two groups according to different training methods. One was control group ( n = 30), receiving regular training methods, and the other one was experimental group ( n = 30), receiving additional microlecture based on robot carrier besides regular training methods. The teaching effects of the two groups were compared after the training in orthopedics department. SPSS 20.0 was used for t test. Results:There was no significant difference between the experimental group and the control group in theoretical tests results [(88.63±10.24) vs. (87.85±9.62), P > 0.05]. The operation test scores in experimental group (92.12±7.52) were significantly better than that in control group (85.35±8.12), with statistical significance ( P < 0.05). The satisfaction scores for teaching in experimental group (90.00%) was significantly higher than that in control group (70.00%) ( P < 0.05). Conclusion:Microlecture based on robot carrier could enhance abilities of skills operation for orthopedic residents during the standardized residency training and improve their satisfaction for the teaching effect.
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Leading by cytotoxicity against HepG2 cells, bioactivity-guided fractionation of the EtOAc fraction from
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Clinical practice of Medical Genetics involves application of various genetic techniques for the diagnosis of genetic disorders and subsequent genetic counseling and treatment. The principles of Medical Ethics must be fully taken into account when applying genetic knowledge for medical practice. Medical Ethics education is therefore essential for the standardized training of resident doctors in medical genetics department. With a basic system of Medical Genetics Physician Training established, our hospital has made a preliminary exploration for the development of Medical Ethics teaching in resident training through various teaching practices including seminar, network teaching, case study, scene teaching and outpatient teaching, with an aim to strengthen Medical Ethnics knowledge, professionalism and communication skills, and implement Medical Ethics principles throughout clinical practice.
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Humans , Curriculum , Educational Status , Ethics, Medical , Genetics, MedicalABSTRACT
Objective:To investigate the anti-rejection effect of the berberine combined with ciclosporin A (CsA) against mice with xenogenic skin transplantation and explore the mechanisms.Methods:The skin transplantation model was established by an operation, tergal skin flaps from BALB/c donor mice were transplanted to the back of C57BL/6 recipient mice. Then recipient mice were randomly divided into 5 groups ( n=20), namely sham (0.5% CMC-Na), model (0.5% CMC-Na), berberine (100 mg/kg), CsA (10 mg/kg), berberine combined with CsA (berberine 100 mg/kg and CsA 5 mg/kg). All recipient mice were intraperitoneally administered once a day for 10 days. The skin graft survival time of all mice were noted everyday. At the end of the experiment, the levels of Th1 cytokines (IL-2 and IFN-γ) and Th2 cytokines (IL-4 and IL-10) in plasma were detected by ELISA, and quantity of CD4 + CD25 + T cells were analysed by flow cytometry. Results:Compared with model group, the survival days of skin graft of those in groups treated with drugs were all significantly prolonged ( P<0.01). Berberine combined with CsA group showed a longer survival days than berberine or CsA group ( P<0.01). Compared to the model group, the content of IL-2 (11.55 ± 3.14 pg/ml vs. 19.85 ± 2.42 pg/ml), IFN-γ (26.41 ± 6.20 pg/ml vs. 57.23 ± 10.15 pg/ml) of berberine combined with ciclosporin A group significantly decreased ( P<0.05). The content of IL-4 (192.45 ± 70.12 pg/ml vs. 61.09 ± 21.61 pg/ml), IL-10 (106.79 ± 27.83 pg/ml vs. 40.08 ± 11.23 pg/ml) of berberine combined with ciclosporin A group significantly increased ( P<0.05). The amount of CD4 + CD25 + T cells (7.65% ± 2.42% vs. 3.69% ± 0.83%) in berberine combined with ciclosporin A group significantly increased ( P<0.01). Conclusions:The immunosuppressive effect of berberine combined with CsA maybe related with induction of immune tolerance, balance of Th1/Th2 cytokines and increasement of CD4 + CD25 + T cells expression.
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Objective:To summarize the nursing experience of an elderly patient with anorexia and weight loss.Methods:The patient was admitted to the acute care for the elderly unit(ACE) after the acute assessment, and multidisciplinary team care was performed on the patient. To recovery patient to a healthy level and to return quickly the family and society, the team applied the comprehensive assessment technology for the elderly to comprehensively assess the patient′s situation, including multidisciplinary team rounds, routine ACE meetings, implementation of patient-centered care.Results:The anorexia and nutritional status were improved, to be discharged after 8 days. There were no functional declines and hospital-related complications during hospitalization.Conclusion:ACE improves the quality of care and patient outcomes in elderly patients.
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Objective:To explore the teaching of medical record writing based on tutorial system.Methods:The tutors and residents in standardization training both scored the medical record. The observation indexes included the difference of scoring time between the two editions, the difference of scoring value between tutors and doctors, the distribution of deduction points in medical record writing, and the change trend of medical record score in one year.Results:The scoring value of tutors was significantly lower than that of residents undergoing standardization training ( t=8.919, P<0.05); the deduction of medical records was mainly in the aspects of history of present illness, physical examination, diagnosis and analysis, and treatment plan. After one year of implementation, the score of tutors increased, while that of residents decreased. Conclusion:This method can effectively improve the teaching quality of medical record writing and the ability of residents to discerning problems in medical record writing.
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Objective:To investigate whether coxsackievirus A 16 (CVA16) infection would affect the expression of N6-methyladenosine (m 6A) methylation-related proteins in human bronchial epithelial cells (16HBE), ICR suckling mice and SCRBA2 humanized mice and influence their subcellular localization. Methods:CVA16 was used to infect 16HBE cells at a multiplicity of infection (MOI) of 0.1 and mice at 10 7 CCID 50/ml. Changes in the expression of methyltransferases, demethylases and methylated reading proteins were analyzed by Western blot. Cellular localization of these proteins was observed using immunofluorescence. Results:The expression of m 6A methylation-related proteins was gradually reduced in CVA16-infected cells with time, but showed no obvious change in ICR suckling mice or SCRBA2 humanized mice. After infection, m 6A methylation-related proteins were redistributed in both the nucleus and cytoplasm and even degraded. Conclusions:CVA16 replication in host cells altered the expression and cellular localization of m 6A methylation-related proteins, which indicated that m 6A modification might be a new potential target for enterovirus therapy.