Construction and evaluation of clinical-thinking patterned curriculum for parallel graduate students with "running through clinical diagnosis and treatment process" / 中华医学教育探索杂志

Objective:To explore the construction and implementation effect of clinical-thinking patterned curriculum for parallel graduate students with "running through clinical diagnosis and treatment process."Methods:In this study, 94 Batch 2016-2017 graduate students with clinical medical professional degree in Shanxi Provincial People's Hospital were selected as the research subjects. Among them, 48 Batch 2017 parallel graduate students were selected as the experimental group. The curriculum of clinical-thinking patterned training of "running through the clinical diagnosis and treatment process" was used. In addition to participating in the degree courses and residency courses, a series of training to improve the clinical-thinking ability were introduced. And 46 Batch 2016 parallel graduate students were divided in the control group, using a traditional curriculum and only participating in degree courses and residency courses. The differences among mini-clinical evaluation exercise (Mini-CEX) scores, direct observation of procedural skills (DOPS) scores, objective structured clinical examination (OSCE) scores and students' satisfaction were compared by t test, chi-square test and repeated measures analysis of variance. Results:The Mini-CEX scores showed the average scores of other aspects except humanistic care were higher than those of the control group, and the score of communication skills was significantly higher than that of the control group [(6.55±0.98) vs. (5.77 ±1.12)], with significant differences ( t=3.62, P<0.001). In the DOPS scores, except for the skills of communication with patients, ability to consider patient's feelings and practice of occupational literacy, the average scores of other aspects of the experimental group were higher than those of the control group, and the real operation-ability score of clinical skills was significantly higher than that of the control group [(6.38 ± 1.38) vs. (5.53±1.23)], with a significant difference ( t=3.12, P=0.002). In terms of the outpatient receiving station, the emergency treatment station, the clinical thinking station①, the clinical thinking station②, the specialist skill station, the auxiliary examination station and the case writing station, their OSCE scores at different stages in the experimental group were higher than those in the control group, and in terms of clinical thinking station①, the score of the experimental group was significantly higher than that of the control group, with a significant difference ( F=6.51, P=0.012). The satisfaction rate of the experimental group in terms of curriculum was higher than that in the control group except for the future career development, and in improving logical-thinking ability, the score of the experimental group was significantly higher than that of the control group, with a significant difference ( χ2=19.18, P<0.001). Conclusion:The curriculum of clinical-thinking ability with "running through the clinical diagnosis and treatment process" can enhance the clinical practical ability of parallel graduate students, making them meet the residential academic standards as soon as possible and effectively promoting the training quality of the students.

Genetic analysis and reproductive intervention of 7 families with gonadal mosaicism for Duchenne muscular dystrophy / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for 7 families with gonadal mosaicism for Duchenne muscular dystrophy (DMD).@*METHODS@#For the 7 families presented at the CITIC Xiangya Reproductive and Genetic Hospital from September 2014 to March 2022, clinical data were collected. Preimplantation genetic testing for monogenic disorders (PGT-M) was carried out for the mother of the proband from family 6. Peripheral venous blood samples of the probands, their mothers and other patients from the families, amniotic fluid samples from families 1 ~ 4 and biopsied cells of embryos cultured in vitro from family 6 were collected for the extraction of genomic DNA. Multiplex ligation-dependent probe amplification (MLPA) was carried out for the DMD gene, and short tandem repeat (STR)/single nucleotide polymorphism (SNP)-based haplotypes were constructed for the probands, other patients, fetuses and embryos.@*RESULTS@#The results of MLPA showed that the probands and the fetuses/probands' brothers in families 1 ~ 4, 5, 7 had carried the same DMD gene variants, whilst the probands' mothers were all normal. The proband in family 6 carried the same DMD gene variant with only 1 embryo (9 in total) cultured in vitro, and the DMD gene of the proband's mother and the fetus obtained through the PGT-M were normal. STR-based haplotype analysis showed that the probands and the fetuses/probands' brothers in families 1 ~ 3 and 5 have inherited the same maternal X chromosome. SNP-based haplotype analysis showed that the proband from family 6 has inherited the same maternal X chromosome with only 1 embryo (9 in total) cultured in vitro. The fetuses in families 1 and 6 (via PGT-M) were both confirmed to be healthy by follow up, whilst the mothers from families 2 and 3 had chosen induced labor.@*CONCLUSION@#Haplotype analysis based on STR/SNP is an effective method for judging gonad mosaicism. Gonad mosaicisms should be suspected for women who have given births to children with DMD gene variants but with a normal peripheral blood genotype. Prenatal diagnosis and reproductive intervention may be adapted to reduce the births of further affected children in such families.

Epidemiological characteristics of Brucella species isolated from different regions of the world using the MLVA genotyping / 中华流行病学杂志

Objective@#To study the molecular-epidemiological characteristics of Brucella species isolated from different countries, using the multiple locus tandem-repeat (MLVA) analysis.@*Methods@#Eleven variable-number tandem-repeat (VNTR) loci were selected. VNTR strains of Brucella isolated from 48 different countries in 1953-2013, were analyzed by using the BioNumerics software. Unweighted Paired Arithmetic Average method was used to cluster and draw phylogenetic tree as well as the minimum spannin.@*Results@#The evolutionary relationship of Brucella phylogenetic tree was consistent with the classical biological typing method. However, the Brucella suis biovar 5 strains were different from the other Brucella suis biovars 1, 2, 3 and 4. Brucella ceti strains were divided into two parts and different from each other. Worldwide epidemics of brucellosis were emerged from 2005 to 2008 under the MLVA11 Orsay analysis. China has been a brucellosis-prone regions, with Brucella melitensis as the main epidemic Brucella species, followed by Brucella abortus. Brucella suis was mainly identified in the southern provinces, but Brucella canis was mainly found in dogs. No human cases were found.@*Conclusion@#Molecular-epidemiological characteristics of the Brucella strains were related to factors as time, region and hosts of isolation, which are important to setting up prevention and control programs on brucellosis.

Recombinant human tumor necrosis factor receptor type Ⅱ-IgG Fc fusion protein for treatment of occupational medicamentosa-like dermatitis induced by trichloroethylene / 中华劳动卫生职业病杂志

Objective@#To investigate the efficacy and safety of the recombinant human tumor necrosis factor receptor Ⅱ-IgG Fc fusion protein (rhTNFR: Fc, etanercept) for the treatment of occupational medicamentosa-like dermatitis induced by trichloroethylene (OMLDT) .@*Methods@#In September 2011 to February 2016, 12 patients with OMLDT were treated with etanercept 25 mg, subcutaneous injection, twice per week, doubling of first dose. The course of treatment was 6 weeks. The drug eruption area and severity index (DASI) score, the proportion of patients achieving a 50%, 75% and 90% reduction in DASI (DASI50, DASI75, DASI90) and the serum level of TNF-α were used to assess the efficacy at different times. Adverse reactions were also recorded and evaluated. The results were statistically analyzed by nonparametric Friedman test and repetitive measurement ANOVA using the software SPSS19.0.@*Results@#After 4 weeks treatment, the DASI score decreased form 56.33±7.02 to 0.50±0.91 (P<0.01) . The DASI50, DASI75 and DASI90 were all increased to 12 (100%) . The serum level of TNF-α decreased form (43.74±41.62) pg/ml to (3.03±0.47) pg/ml (P<0.01) . Statistically significant difference was observed from the above indexes. There were no adverse reactions in clinical application.@*Conclusion@#Recombinant human tumor necrosis factor receptor Ⅱ-IgG Fc fusion protein may be a safe and effective drug in the treatment of OMLDT.

Analysis of FOXL2 gene mutations in 5 families affected with blepharophimosis, ptosis and epicanthus inversus syndrome / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To screen for FOXL2 gene mutations in 6 patients with blepharophimosis, ptosis, and epicanthus inversus syndrome (BPES), and explore their genotype-phenotype correlation.</p><p><b>METHODS</b>Peripheral venous blood samples were collected from the patients for the extraction of genomic DNA. PCR and Sanger sequencing were employed to analyze the coding region and flanking sequences of the FOXL2 gene. Pathogenicity of the identified mutations was verified through literature review and bioinformatic analysis.</p><p><b>RESULTS</b>A heterozygous c.672_701dup30 mutation was found in the probands from the two familial cases, while three heterozygous mutations (two were novel), namely c.462_468del (p.Pro156Argfs*113), c.251T to A (p.Ile84Asn) and c.988_989insG (p.Ala330Glyfs*204) were detected in the three sporadic cases. Literature review and bioinformatic analysis indicated that all these mutations are pathogenic.</p><p><b>CONCLUSION</b>Identification of causative mutations in the BPES patients has provided a basis for genetic counseling and reproductive guidance. The novel mutations have enriched the mutation spectrum of the FOXL2 gene.</p>

Taiji Quan for Senile Hypertension Patients (review) / 中国康复理论与实践

@#Taiji Quan, as a kind of mild to moderate aerobic exercise, may do benefit in senile hypertension patients. From the views of Traditional Chinese Medicine, Taiji Quan can make the Yin and Yang balance and the Channels and Meridians smooth. For the modern medicine, Taiji Quan can regulate the function of circulation, breath, nerve, incretion and metabolism, etc.

Nanog influences the proliferative ability of HepG2 cells through the modulation of the cell cycle related proteins / 实用肿瘤学杂志

Objective To study the effect of pluripotency factor Nanog on the expression of the cell cy-cle related proteins,and then to explore its effect on the proliferative ability of HepG 2 cells.Methods TALENs gene editing tool was employed to induce mutation and downregulation expression of Nanog .T7 endonuclease 1 and genomic sequencing was used to analyze the mutation efficiency of Nanog .RT-PCR and western blot were used to determine the expression of mRNA and protein of Nanog ,respectively .Real-time cell based assay system was used to measure the proliferative ability of wild -type HepG2 cells and monoclonal HepG 2 cells with Nanog mutation.Results TALENs successfully induced mutation of Nanog gene .The targeting efficiency of mixed cells was analyzed by T7 endonuclease 1 approached 40%after two transfection with plasmid of Nanog -TALENs.Ad-ditionally,the Nanog mRNA expression level of monoclonal HepG 2 with Nanog mutation was downregulated by 3.4 times compared to the wild type HepG 2 cells,and the Nanog protein expression level was downregulated by 3.6 times.The cell cycle related proteins CyclinD1/D3,CyclinE1 and CDK2 expression were downregulated in monoclonal HepG2 with Nanog mutation in comparison to the wild type HepG 2 cells.Conclusion Nanog plays a role in influencing the proliferative ability of HepG 2 cells through modulating the expression of the cell cycle re-lated proteins CyclinD1/D3,CyclinE1 and CDK2.The downregulation expression of Nanog can inhibit the prolif-erative capacity of HepG 2 cells via the regulation of the cell cycle related proteins .

Effect of clopidogrel on development of chemically induced colitis-associated cancer in mice / 中国药理学与毒理学杂志

OBJECTIVE To investigate the effect of clopidogrel(Clog),a platelet aggregation inhibitor,on the development of colitis-associated colon cancer(CAC)and its possible mechanism. METHODS To establish a CAC model,male BALB/c mice were treated with single azoxymethane(AOM) 10 mg · kg-1 by ip. One week later,the mice drank 2.5% dextran sulfate sodium(DSS)for one week and water for two weeks,which lasted three cycles. From the first day mice received 2.5%DSS water, Clog 12.5,25.0 and 50.0 mg · kg-1 was ig administered once a day. Body mass,clinical symptoms,the number of colon tumor and tumor size in colon tissue were recorded. Hyperplasia of tumors was analyzed by HE staining. In the early inflammatory phase of the CAC model,the length of colons was measured, histological structure and epithelium cell proliferation of colon tissues were evaluated by HE staining and Ki67 staining,respectively. In the tumorigenesis and progression phase of the CAC model,epithe?lium cell proliferation of colon tissues was evaluated by Ki67 staining. The mRNA expression of tumor necrosis factor-α(TNF-α)was detected by real-time quantitative PCR. The expression of chemokine(C-X-C motif)ligand 2(CXCL2)and its receptor 2(CXCR2)in colon tissues was detected by PCR and immu?nohistochemistry. RESULTS Compared with model group,clinical symptoms of mice in Clog 12.5 mg · kg-1 group were alleviated,the size of colon tumors was decreased(P<0.05),and hyperplasia of tumors was reduced(P<0.05). During the inflammatory phase,the clinical symptoms of mice in Clog 12.5 mg·kg-1 group were significantly alleviated(P<0.05),the decrease of body mass was reduced(P<0.01),the colon shrinkage was ameliorated(P<0.01),the inflammatory injury and epithelium cell proliferation in colon tissues were reduced(P<0.05). During the tumorigenesis and progression phase,epithelium cell prolif?eration in colon tissues in Clog 12.5 mg·kg-1 group was reduced(P<0.01),and the mRNA and protein expression of TNF-α,CXCL2 and CXCR2 of colon tissues was decreased(P<0.05). CONCLUSION Clog can alleviate inflammation during the CAC early inflammatory phase and inhibit the formation of CAC. The antitumor effect of Clog may be related to the decrease in expression of CXCL2 and CXCR2.

Effects of sirolimus and starved culture on autophagy of human A431 cells / 中华皮肤科杂志

Objective To evaluate effects of sirolimus(a classic autophagy inducer)and starved culture on autophagy of a human cutaneous squamous cell carcinoma cell line A431. Methods Cultured A431 cells and HeLa (a human cervical carcinoma cell line)cells were both classified into 5 groups to be treated with DMEM alone(control group), 0.1%dimethyl sulfoxide alone(DMSO group), 20 nmol/L sirolimus(20?nmol/L sirolimus group), 80 nmol/L sirolimus(80?nmol/L sirolimus group), and Earle′s balanced salt solution(EBSS group)respectively. After 4?hour treatment, Western blot analysis was performed to measure the expressions of autophagy?related markers microtubule?associated protein 1 light chain 3A/3B (LC3A/B) and recombinant gamma?aminobutyric acid receptor associated protein(GABARAP), and acridine orange staining to determine autophagy levels in these cells. Results As Western blot analysis showed, the ratio of LC3A/B?Ⅱto LC3A/B?Ⅰin A431 cells was similar between the control group and DMSO group(P > 0.05), but significantly higher in the 20?nmol/L sirolimus group, 80?nmol/L sirolimus group and EBSS group than in the control group(all P < 0.05). Western blot results from HeLa cells were similar to those from A431 cells. Bivariate correlation analysis revealed that the protein expression of GABARAP was positively correlated with that of LC3A/B ?Ⅰ in both HeLa cells(r = 0.869, 95% CI: 0.807 - 0.999, P = 0.051)and A431 cells(r = 0.837, 95% CI: -0.173 - 0.989, P = 0.037), but negatively correlated with that of LC3A/B?Ⅱ in both HeLa cells(r = -0.742, 95% CI: -0.982 - 0.406, P = 0.042)and A431 cells(r = - 0.684, 95% CI: -0.977 - 0.500, P = 0.047). Acridine orange staining showed that the percentages of autophagosome?positive A431 cells and HeLa cells were significantly increased in both the 80?nmol/L sirolimus group(23.750% ± 0.260% and 33.307% ± 0.715% respectively)and EBSS group(32.450% ± 0.488% and 66.097% ± 1.141% respectively) compared with the control group(15.987% ± 0.242% and 14.117% ± 0.295%, respectively, all P < 0.05). Conclusion The classic autophagy inducer sirolimus and starved culture can upregulate the autophagy level of A431 cells, and GABARAP may be highly correlated with LC3A/B.

Treatment effect of a tumor necrosis factor-alpha antagonist on 17 patients with Stevens-Johnson syndrome / 中华皮肤科杂志

Objective To estimate the treatment effect of a tumor necrosis factor ? alpha antagonist (etanercept) on Stevens?Johnson syndrome induced by drugs. Methods After exclusion of tuberculosis, hepatitis, severe infections and tumors, 17 patients with drug?induced Stevens?Johnson syndrome were treated with subcutaneous injections of 25 mg(initial dose, 50 mg)etanercept once every 3 days for 6 times. Meanwhile, supportive therapies and compound glycyrrhizin injections were given to counteract inflammation and protect the liver. Results All of the patients were cured. Body temperature in 15 febrile patients gradually decreased within 24- 48 hours after the first injection of etanercept, and returned to normal in 72 hours. The number of vesicles stopped increasing, and lesion color turned from bright red to dull red within 24 hours. Skin condition was evidently controlled within 72 hours, and skin appearance almost returned to normal after 2 weeks of treatment, and was completely restored after 4- 5 weeks. The recovery of mucous membrane was slower than that of skin. Serum aminotransferase levels gradually declined after the first dose of etanercept and almost returned to normal in 2-4 weeks in 14 patients. Serum levels of urea nitrogen and creatinine began to decrease after 1- 2 weeks of treatment. The serum level of tumor necrosis factor?alpha nearly dropped into or was maintained in the normal range within 3 weeks after the start of treatment. Conclusion Early usage of tumor necrosis factor?alpha antagonists at an adequate dose is beneficial to the rapid control of Stevens?Johnson syndrome.

Effects of madder on bone biomechanical property in rats / 生物医学工程学杂志

Bones are stained into red color with feeding madder, but we do not know whether the fed madder can change the bone biomechanical properties and bone mineral contents in animals. In this research, we established a rat model with feeding madder. The bone biomechanical properties were detected by universal material mechanics, bone mineral contents were detected by inductively coupled plasma mass spectrometry and spectrometer, and red color material in bone was analyzed by high performance liquid chromatography. The results showed that bone biomechanical parameters in femur diaphysis in the 10% and 15% group rats were significantly higher than those in the control group after feeding madder for 6 months. The level of calcium, magnesium and zinc in femur diaphysis in 10% and 15% group rats were higher than those in the control group after feeding madder for 6 months. However, it was shown that the kidney congestion and hyperemia and the level of blood urea nitrogen and creatinine in the 15% group rats were significantly different compared to those in the control group rats after feeding madder for 6 months. The red colored material in bone is related to alizarin analyzed with high-performance liquid chromatography. The conclusion could be drawn that feeding 10% madder in diet was not toxic to the rats fed for 6 months, and it could improve bone biomechanical properties and increase bone mineral elements.

Construction of Hospital Service System Based on WeChat Public Platform / 医学信息学杂志

〔Abstract〕 Based on elaborating the application of WeChat public platform in various industries, the paper overviews the function and characteristics of WeChat public platform, taking Shanxi Provincial Peoplel's Hospital as an example, it introduces the application of We-Chat public platform in outpatient and inpatient departments, points out that WeChat service could be carried out in hospital in the futrue.

Suppression of epipolythiodioxopiperazine compound C87 on growth of tumor cells and its effect on production of reactive oxygen species / 中国药理学与毒理学杂志

OBJECTIVE To study the effect of epipolythiodioxopiperazine compound C87 on tumor cell proliferation and explore the potential mechanisms. METHODS Tumor cells were exposed to C87 0.05-1 μmol.L-1 for 24, 48 and 72 h, cell viability was determined by sulforhodamine B (SRB) assay and the half growth inhibition (Gl50 ) was calculated. After treatment with C87 0.1-2.5 μmol.L-1 for 6 h, or C87 2.5 μmol.L-1 for 0-6 h, the generation of reactive oxygen species (ROS) was measured using the compound 2′,7′-dichlorofluoresceindiacetate and flow cytometry analysis. After treatment with C87 2.5 μmol.L-1 , either alone or with antioxidant N-acetylcysteine (NAC), for 6 h, the generation of ROS was measured by flow cytometry analysis. Tumor cells were exposed to C87 0.05-1 μmol.L-1 , either alone or with NAC, for 24 and 48 h, while cell viability was determined by SRB assay. RESULTS The cell viability was significantly reduced following exposure to C87 0.05-1 μmol.L-1 for 24, 48 and 72 h in a concentration-dependent manner in A549, HCT116, HeLa and SMMC7721 cells(P<0.05). At 72 h, the value of r2 was 0.946, 0.989, 0.973 and 0.984(P<0.05), respectively. The cell viability was significantly reduced following exposure to C87 1 μmol.L-1 for 24 - 72 h in a time-dependent manner in A549, HCT116, HeLa and SMMC7721 cells(P<0.05). The value of r2 was 0.983, 0.956, 0.951 and 0.873(P<0.05), respectively. The generation of ROS was increased after exposure to C87 0.25-2.5 μmol.L-1 in a concentration-dependent manner in HCT116 and HeLa cells for 6 h (r2 = 0.760, P = 0.045: r2 = 0.987, P=0.001), and after exposure to C87 2.5 μmol.L-1 in a time-dependent manner in HCT116 and HeLa cells for 0.5-6 h (r2 = 0.886, P = 0.017: r2 = 0.994, P = 0.000).The C87-induced ROS generation could be blocked by NAC in HCT116 and HeLa cells(P<0.05). The C87 induced cell death could be blocked by NAC 5 and 10 mmol.L-1 , and the Gl50 value was 1.446 and 1.134 μmol.L-1 for 24 h (the Gl50 value of C87 group was 0.513 μmol.L-1 ), and 0.882 and 1.166 μmol.L-1 for 48 h (the Gl50 value of C87 group was 0.333 μmol.L-1 ). CONCLUSION The novel epipolythiodioxopiperazine derivative C87 exerts potent antitumor activity in vitro, possibly via triggering ROS production.

Association between the GGN tri-nucleotide repeat polymorphism in androgen receptor gene and prostate cancer risk:a systematic review and meta-analysis / 国际检验医学杂志

Objective To provide a powerful and conclusive result for the association between the GGN polymorphic repeats in androgen receptor (AR)gene and prostate cancer (PCa)risk.Methods CNKI,VIP,Wanfang,PubMed/Medline,Embase and The Cochrance Library electronic database were used to retrieve the eligible publications addressing the association between the AR gene GGN polymorphic repeats and prostate cancer risk.16 GGN polymorphism repeats were used as cut off value,meta-analysis was ap-plied to the study on the association between the length of polymorphism repeats and prostate cancer risk.Results 9 cases of con-trol studies were included in this meta-analysis and a total of 2 438 cases and 1 968 controls were included.People with ≤16 GGN polymorphism repeats displayed a higher risk of prostate cancer(OR =1.15,95%CI :1.00 -1.31,P =0.04).Conclusion ≤16 GGN polymorphism repeats polymorphism associated with increased risk of prostate cancer.