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Objective:To apply self-directed learning-oriented multi-channel teaching to clinical digestive system integration course and explore its teaching effect.Methods:Seventy undergraduates of Batch 2015 majoring in clinical medicine in a medical college of Shandong Province were selected as subjects. In the clinical digestive system integration course, we designed and implemented multi-channel teaching methods including problem-based learning (PBL), integrated teaching of theory and practice, standardized patient teaching, group focus teaching and moral education. The scores of students' practice examination under the two teaching methods were compared, and the self-assessment of students' autonomous learning ability before and after the intervention was compared. SPSS 20.0 was used for t test. Results:The average total score of practical assessment in the intervention group was (86.10±6.01), which was higher than that (81.84±7.08) of the Batch 2014 students ( P<0.05). The total score of students' self-assessment of autonomous learning ability was (145.41±9.42) before the intervention. By comparison, the total score was (152.94±10.18) after the intervention. Except for the dimension of "self-innovation", the scores of self-directed learning ability in general and other dimensions were significantly different before and after the intervention ( P<0.05). Conclusion:Self-directed learning-oriented multi-channel teaching is a suitable teaching method for the integration curriculum of clinical digestive system.
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Objective@#To develop a model incorporating radiomic features and clinical factors to accurately predict acute ischemic stroke (AIS) outcomes. @*Materials and Methods@#Data from 522 AIS patients (382 male [73.2%]; mean age ± standard deviation, 58.9 ± 11.5 years) were randomly divided into the training (n = 311) and validation cohorts (n = 211). According to the modified Rankin Scale (mRS) at 6 months after hospital discharge, prognosis was dichotomized into good (mRS ≤ 2) and poor (mRS > 2); 1310 radiomics features were extracted from diffusion-weighted imaging and apparent diffusion coefficient maps. The minimum redundancy maximum relevance algorithm and the least absolute shrinkage and selection operator logistic regression method were implemented to select the features and establish a radiomics model. Univariable and multivariable logistic regression analyses were performed to identify the clinical factors and construct a clinical model. Ultimately, a multivariable logistic regression analysis incorporating independent clinical factors and radiomics score was implemented to establish the final combined prediction model using a backward step-down selection procedure, and a clinical-radiomics nomogram was developed. The models were evaluated using calibration, receiver operating characteristic (ROC), and decision curve analyses. @*Results@#Age, sex, stroke history, diabetes, baseline mRS, baseline National Institutes of Health Stroke Scale score, and radiomics score were independent predictors of AIS outcomes. The area under the ROC curve of the clinical-radiomics model was 0.868 (95% confidence interval, 0.825–0.910) in the training cohort and 0.890 (0.844–0.936) in the validation cohort, which was significantly larger than that of the clinical or radiomics models. The clinical radiomics nomogram was well calibrated (p > 0.05). The decision curve analysis indicated its clinical usefulness. @*Conclusion@#The clinical-radiomics model outperformed individual clinical or radiomics models and achieved satisfactory performance in predicting AIS outcomes.
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OBJECTIVE@#To study the effect of nanohydroxyapatite (nHA) for promoting surface mineralization of demineralized dentin discs and adsorption of lead ions in simulated sewage water.@*METHODS@#Sixty dentin disks were prepared from freshly extracted teeth with intact crown (including 30 premolars and 30 molars) and treated with 10% citric acid for 2 min to simulate dentinal tubules with dentin hypersensitivity. The etched dentin discs were brushed with distilled water, 0.2 g HA or 0.2 g nHA for 2 min twice a day for 7 consecutive days, after which scanning electron microscopy (SEM) was performed and calcium and phosphorus contents in the dentin discs were detected using EDS. Lead ion adsorption capacities of HA and nHA were tested by mixing 1 mL serial concentrations of HA and nHA suspensions with 50 mL lead ion solutions (1.0 mg/L). After 24 h, the residual lead ion concentration in the supernatant was measured using ICP to calculate lead ion adsorption rate and adsorption capacity of the materials.@*RESULTS@#SEM showed a smooth surface and empty dentin tubules in the acid- etched dentin dics. The dentin dics treated with HA were covered with masses of particles that loosely attached to the surface, and the diameter of the dentin tubules was reduced. In nHA group, the dentin discs showed a fine and homogeneous surface clogging with a tight attachment, and the dentin tubule diameter was obviously reduced. Daily brushing with HA and nHA, especially the latter, significantly increased calcium and phosphorus contents on the surface of the dentin dics ( < 0.000). In lead ion adsorption experiment, the lead ion adsorption rate of HA decreased as its concentration increased with the highest adsorption rate of 83.01%; the adsorption rate of nHA increased with its concentration until the adsorption equilibrium was reached, and its highest adsorption rate was 98.79%. A good liner relationship was found between the adsorption ability and concentration of HA.@*CONCLUSIONS@#Compared with HA, nHA has a better capacity for surface mineralization of acid-etched dentin discs and also a better ability of lead ion adsorption.
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Objective To study the effect of macrophage migration inhibitory factor(MIF) antibody on the rat colonic aberrant crypt foci(ACF) induced by 1,2-dimethylhydrazine(DMH),carcinoma number and expression of MIF in rat colonic carcinogenesis.Methods Rat colonic carcinogenesis model was induced by DMH.In this model,the inhibitory effect of MIF antibody on the number of ACF and carcinoma was observed.ELISA and immunohistochemical staining were adopted to investigate the effect of MIF antibody in early cancerative intestinal mucosa and MIF expression after cancer formation.Results The number of ACF and carcinoma was significantly inhibited by MIF antibody intervention(P＜ 0.01).The expression of MIF in the colonic carcinoma model was significantly higher than that in the pre-carcinoma ACF model(P＜0.01).Applying MIF antibody could significantly inhibit the expression of MIF in both rat colonic ACF and colonic carcinoma model.Conclusion MIF antibody can significantly inhibit the rat colonic mucosal carcinogenesis,which may be related with inhibiting number of ACF and expression of MIF.MIF antibody may be expected to become a new target spot of precaution and treatment of colonic carcinoma.
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Objective To explore the application of amide proton transfer (APT) imaging in differentiating glioma from treatment effect and to evaluate the diagnostic efficiency of the quantitative APT-related parameters.Methods A total of 23 patients (15 males, 8 females, age: 13-80 years) with 27 lesions who had underwent APT imaging in Tongji Hospital(Wuhan, China) from October 2014 to June 2015 were enrolled in this prospective study.The scan protocols were MRI normal plain scanning, diffusion WI, contrast-enhancement T1WI and APT imaging.Both the magnetization transfer ratio (MTR) and the relative MTR (rMTR) of lesions were manually measured by drawing ROI in the functional post-processing workstation.The results were compared with those of pathologic examinations and radiographic follow-up (≥3 months).Mann-Whitney u test was used to analyze the data.Results Compared with contralateral white matter, the primary gliomas (n=12) and recurrent gliomas (n=8) manifested hyper-intensity, while the treatment induced injuries (n=7) showed iso-or hypo-intensity.The difference of MTR between tumors and treatment effects was significant (102.78(101.93,103.84) vs 100.17(99.94, 100.63);z=-3.76, P<0.01), so was the difference of rMTR between tumors and treatment effects (3.92%(2.69%,4.67%) vs 0.47%(-0.79%,1.11%);z=-3.43, P<0.01).Both those two quantitative parameters exhibited excellent diagnostic performance with the AUC of 0.986 and 0.943.The sensitivity, specificity and accuracy of MTR were 100%(20/20), 6/7 and 96.3%(26/27) in the threshold of 100.68, while those of rMTR were 95.0%(19/20), 6/7 and 92.6%(25/27) in the threshold of 1.66%.Conclusions Combined with the routine MRI images, APT imaging can provide excellent qualitative and quantitative information in differentiating glioma from treatment effect.Both MTR and rMTR are helpful for the differentiation with high sensitivity and specificity and can be used as non-invasive imaging biomarkers in evaluating treatment effect of glioma.
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Objective To evaluate the efifcacy of endoscopic Over-The-Scope-Clip system (OTSC) system for the acute iatrogenic digestive tract perforation. Methods To collect 11 cases with digestive tract perforation closed with the OTSC system, including 7cases of gastric perforation, 1 case of duodenal perforation,3 cases of colorectal perforation. Results 11 cases were successfully closed with OTSC system in time, the average time needed for the endoscopic closure is 6~15 min. And the perforation diameter is 0.6~3.7 cm, average diameter is (1.89 ± 0.27) cm. No intraoperative bleeding and delayed hemorrhages, no deaths occurred. Conclusion Endoscopic OTSC system is a successful method for the digestive tract perforation and is worth to popularize.
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Objective To evaluate the clinical efficacy of the over-the-scope-clip (OTSC) for endoscopic closure of acute refractory non-variceal upper gastrointestinal bleeding. Methods This retrospective study selected 16 refractory patients, including 2 cases with Mallory-Weiss syndrome, 7 cases with gastric ulcer, 1 case with gastric carcinoma and 6 cases with duodenal ulcer, underwent OTSC treatment of acute non-variceal upper gastrointestinal bleeding from January 2015 to June 2016 as study subjects. Results All of the 16 patients with bleeding lesions were successfully controlled. The successful rate is 100.0%. The mean procedure of OTSC for endoscopic bleeding closure was between 5.0 and 6.0 min. Conclusion The Over-the-Scope-Clip system is safe and effective for closure of acute non-variceal upper gastrointestinal bleeding in refractory patients, and deserves further clinical applications.
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Objective To compare three dimensional arterial spin labeling(3D-ASL) and dynamic susceptibility contrast-perfusion weighted imaging(DSC-PWI) in evaluating the cerebral hemodynamic of Moyamoya disease. Methods Approved by the institutional review board, 26 cases of Moyamoya patients who were diagnosed by DSA were enrolled. Diffusion weighted image, 3D-TOF-MRA, 3D-ASL, DSC-WPI, and T1WI were performed in 3.0 T MR scanner. ROI were positioned in the abnormal perfusion areas and the control area according to the arterial dominant territory to obtain quantitative parameters of perfusion. Perfusion parameters including cerebral blood flow(CBF) of ASL, cerebral blood flow(CBF), cerebral blood volume(CBV), mean transit time(MTT), and time to peak(TTP)of DSC-PWI , and relative parameters (ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, DSC-rTTP) that the ratio of abnormal perfusion area and the control area were calculated. Meanwhile, the areas of the lower perfusion region of ASL and TTP images in the same slice were measured. Difference of the above-mentioned parameters and areas was processed by paired Student′ t test. Furthermore, correlation of relative values of perfusion parameters(ASL-rCBF, DSC-rCBF, DSC-rCBV, DSC-rMTT, and DSC-rTTP) was processed by Pearson correlation test. Results There were significant statistics differences between values of ASL-CBF, DSC-MTT, and DSC-TTP in abnormal perfusion [(28.18 ± 10.19)ml · 100 g-1 · min-1,(7.98 ± 2.22)s,(29.93 ± 3.95)s] and the control areas [(49.50 ± 11.37)ml · 100 g-1 · min-1,(6.07 ± 1.11)s,(27.34 ± 2.58)s] (t=-12.818, 4.193, 6.163, all P0.05). Furthermore, the Pearson correlation test showed significant linear dependence between ASL-rCBF(0.56±0.14)and DSC-rMTT(1.34± 0.42), and DSC-rTTP(1.09 ± 0.69)(r=-0.630,-0.748, P<0.01). Conclusions There is a correlation between 3D-ASL and DSC-PWI in assessing the magnitude and areas of the reduction of blood perfusion of Moyamoya patients. Moreover, the ASL technique possesses advantages of non-invasion use of the gadolinium contrast.
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To construct “developmental assessment” in the course of emergency nursing and inten-sive care nursing by applying the combination of formative assessment and summative evaluation, the com-bination of qualitative assessment and quantitative assessment and the incorporation of self-assessment and other evaluation. Specifically, this project contains investigation activity (accounting for 10%), operating activity (10%), checking on work attendance and homework evaluation (15%), reflection activity (15%), comprehensive design experiment evaluation (20%) and theoretical evaluation (30%). Process evaluation and self-evaluation are highlighted, especially feedback and improvement after evaluation. Through multi stage and multi form evaluation, the goal of emergency and critical care professional education has been achieved, which has promoted the development of student nurses' quality and overall development.
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Background and purpose:This study was to investigate the effect of miRNA-486 on the growth of human colorectal cancer cell line SW620 xenograft in nude mice and to explore the possible mechanism of action. Methods:Eighteen mice were randomly divided into three groups, including the experimental group, the negative control group and the blank control group. Each group contained 6 mice. The SW620 cell line was inoculated subcutaneously into nude mice to establish the model of human colorectal cancer xenografts. Peritumoral injection of miRNA-486 overexpres-sion plasmid, or blank vector and PBS were performed every 3 days. The volumes of subcutaneous tumors in each group of inoculated mice were compared. Then mice were sacrificed 3 weeks after infection. Immunohistochemistry and Western blot were used to measure the expression of neuropilin-2 (NRP2).Results:The growth rate of tumors in the experimental group was significantly lower than that in the negative control group and the blank control group. After 21 days, the size of transplanted tumors in the experimental group nude mice was (0.32±0.12) cm3, that in the negative control group was (0.77±0.31) cm3, and that in blank control group was (0.82±0.18) cm3. Tumor mass in the experimental group was sig-nificantly smaller than that in the other two groups (P=0.006<0.05). Tumor mass in the experimental group was (0.40±0.08) g, significantly smaller than that in the negative control group (0.75±0.18) g and in the blank control group (0.79±0.18) g (P=0.008<0.05). Compared with the expression of NRP2 in other groups, the growth of tumor in the experimental group de-clined (P=0.000<0.05).Conclusion:Colorectal cancer cell line SW620 xenografted tumor in nude mice can be suppressed after injection of miR-486, which may decrease the expression of NRP2.
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Objective To investigate the protective effect of glutamine(Gln) pretreatment on intestinal ischemia-reperfusion (I/R) injury and endothelial nitric oxide synthase (eNOS)/nitric oxide (NO) signaling pathway in rat model. Methods Thirty male Wistar rats were randomly divided into three groups(n=10 for each group):sham group, I/R group and Gln group. Animals were pretreated with 1 g/(kg·d)Gln by orogastric route for 7 days in Gln group, and normal saline was given to the other two groups in the same dose. Intestinal I/R was induced by 30 min occlusion of the superior mesenteric artery followed by 24 h of reperfusion. After the operation, the intestinal histopathological changes, the plasma endotoxin level, serum D-lactic acid, eNOS, inducible NOS(iNOS)activity and NO levels were detected by ultraviolet spectrophotometer. The mRNA expressions of myocardial eNOS and iNOS were detected by real-time fluorescence quantitative PCR (RT-PCR). Results After reperfusion, in IR group, extensive epithelial sloughing and mucosal ulceration of villous tips were observed, whereas these findings did not occur in Gln group and sham group. Compared with IR group, the serum NO, eNOS levels and eNOS mRNA expression of intestinal tissue were elevated in Gln group (P<0.01), but the plasma endotoxin level, serum D-lactic acid, serum iNOS and intestinal iNOS mRNA expression decreased in IR group(P<0.05). Conclusion Glutamine pretreatment has protective effects on intestinal ischemia-reperfusion injury in vivo. The mechanism may be related to the inhibition of iNOS expression and the increased expression of eNOS, thereby increasing NO activity.
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AIM:To determine the effects of glutamine ( Gln) pretreatment on occludin protein in the rats with intestinal ischemia-reperfusion ( I/R ) injury.METHODS: Male Wistar rats ( n =30 ) were randomly divided into 3 groups (n=10):sham group, I/R group and Gln pretreatment group.The rats in Gln pretreatment group were pretreated with Gln at dose of 1 g? kg-1? d-1 by orogastric route for 7 d, and those in the other 2 groups were pretreated with the same volume of normal saline .Intestinal I/R was induced by 30-min occlusion of the superior mesenteric artery followed by 24 h of reperfusion.After the operation, the levels of IL-10, IL-2, TNF-α, SOD and MDA were measured.The occludin protein was determined by the methods of immunohistochemistry and Western blotting .RESULTS: The occludin protein level in I/R group was significantly lower than that in sham group and Gln group (P<0.05).The levels of MDA and TNF-αin I/R group were significantly higher than those in sham group and Gln group ( P<0.05 ) .The levels of SOD , IL-10 and IL-2 in I/R group were significantly lower than those in sham group and Gln group ( P<0.05 ) .CONCLUSION:Glutamine has a protective effect on occludin protein in intestinal ischemia-reperfusion injury .The mechanism may be rela-ted to oxidative stress response and inflammatory inhibition .
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Objective To investigate the effects of isoliquiritigenin on the invasive ability of human gastric carcinoma SGC7901 cells, and its molecular mechanisms thereof. Methods The logarithmic phase human gastric carcinoma SGC7901 cells were divided into control group (normal cell culture fluid) and isoliquiritigenin group (isoliquiritigenin solu?ble in cell culture fluid, the concentrations were 10, 25, 50 and 100 μmol/L respectively). Each group had four repeated holes. The proliferation of SGC7901 cells were detected with MTT assay after 24 h, 48 h and 72 h of culture. The experimen?tal drug concentration and action time were researched for the subsequent experiments. The in vitro invasion abilities of SGC7901 cells were assessed with Transwell test. The expression levels of MMP9, Akt and P-Akt were detected by Western blot assay. Results The proliferation of SGC7901 cells were inhibited by 10μmol/L isoliquiritigenin, which can be signifi?cantly inhibited by 25, 50 and 100μmol/L isoliquiritigenin in a concentration-dependent and time-dependent manner. The half inhibitory concentrations (IC50) of 24, 48 and 72 h were 52.48, 44.49 and 32.50μmol/L, respectively. Therefore, the 25, 50 and 100μmol/L isoliquiritigenin were selected as the subsequent experimental drug concentration, and 24 h was used as the action time. Compared with the control group (209.75±9.29), the membrane cell number of 25μmol/L (138.50±10.15), 50μmol/L (89.50 ± 16.56) and 100μmol/L (45.00 ± 8.08) decreased gradually (F=267.948,P<0.05). There was no signifi?cant difference in the expression level of Akt protein between four groups (F=1.492). The expression levels of P-Akt and MMP9 were gradually decreased with the increase of the isoliquirigenin concentration (F=359.219 and 431.324,P<0.05). Conclusion Isoliquiritigenin can obviously inhibit invasion ability of SGC7901 cells, which may be related to the down reg?ulation of the signal transduction pathway protein PI3K/Akt and the down steam protein MMP9.
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Objective To apply teaching integration of theory and practice in curriculum integration of medical and surgical nursing,in order to improve staff-students' satisfaction and promote teaching quality of curriculum integration.Methods The teaching method was designed as the combination of autonomous learning,entering the clinical scene and centralized instructions,and was applied into teaching integration of theory and practice in curriculum integration of medical and surgical nursing in grade 2009 undergraduates.Teachers and students were investigated by the satisfaction questionnaire.Results The students got high average score which was (90.20±2.72) points in the examination of teaching integration of theory and practice.The total satisfaction degree showed significant difference between the normal teaching mode and the new one.Conclusions As an explored innovative teaching mode,teaching integration of theory and practice can well arouse staff-students' learning enthusiasm,promote teaching quality.It is the requirement of curriculum integration and be worthy of being developed.
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Background and purpose:MicroRNA-486-5p (miR-486-5p) has been demonstrated to play an important role in many kinds of tumor, however, there are few reports about the relationship between miRNA-486-5p in gastric carcinoma. This study was aimed to explore the effect of miR-486-5p on the proliferation, apoptosis and migration abilities of the human gastric cancer cell line SGC7901.Methods:Quantitative real-time PCR (qRT-PCR) analysis was performed to detect the expression of miR-486-5p in the SGC7901 and GES-1 cells, miR-486-5p over-expressing plasmid was constructed and transfected into the human gastric carcinoma cell line SGC7901 using LipofectamineTM2000. The expression of miR-486-5p of the transfected cells was measured by qRT-PCR, the proliferation level of SGC7901 cells was detected by MTT method, the apoptosis rate of the cells was measured by lfow cytometry and the in vitro migration abilities of SGC7901 cells by transwell test. Results:The miR-486-5p expression in SGC7901 cells was down-regulated compared with GES-1 cells. The expression of miR-486-5p in SGC7901 cells that was transfected miR-486-5p over-expressing plasmid was obviously up-regulated. The proliferation and migration abilities of SGC7901 cells were inhibited signiifcantly, and the apoptosis rate of the cells increased. Conclusion:miR-486-5p can effectively suppress the proliferation and in vitro migration abilities of SGC7901 cells, indicating that miR-486-5p might be used as a target for molecular therapy of gastric cancer.
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AIM:To determine the effects of glutamine ( Gln) pretreatment on intestinal ischemia-reperfusion (I/R) injury in the rats.METHODS: Thirty male Wistar rats were randomly divided into 3 groups (n=10): sham group, I/R group and Gln pretreatment group .The rats in Gln pretreatment group were pretreated with 1 g· kg -1 · d-1 Gln by orogastric route for 7 d, the rats in the other 2 groups were pretreated with normal saline .Intestinal I/R was induced by 30-min occlusion of the superior mesenteric artery followed by 24 h of reperfusion .After the operation , the plasma endo-toxin, serum D-lactic acid, superoxide dismutase ( SOD) and malondialdehyde ( MDA) levels were measured .The intesti-nal mucosal injury was observed with HE staining and evaluated using Chiu 's scoring.RESULTS: Serum D-lactic acid, endotoxin level , MDA level and Chiu's score in I/R group were significantly higher than those in sham group and Gln group (all P<0.05).Serum SOD activity was significantly lower than that in sham group and Gln group (P<0.05).CON-CLUSION:Glutamine has a protective effect on the intestines during ischemia-reperfusion injury .The mechanism may be related to oxidative stress response .
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Erythropoitin producing hepatocellular receptors(Ephs) and their ligands ephrins,the largest subset of tyrosine protein kinase receptor family,play a key role in the adhesion,orientation,migration and differentiation of cells.Eph and Ephrins are found closely correlated with tumorigenesis and development in human gastrointestinal tumors,especially colorectal cancer.The members of Ephs and ephrins show diverse expression in intestinal epithelial cells.Studying the mechanism and role of Ephs and ephrins on the malignant tumor occurrence and development will provide more accurate clinical basis for the treatment of colorectal cancer.
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Objective:To investigate the regulatory effects of sodium butyrate on p53 target genes(p21waf1,bax,and gadd45)in HT-29 colorectal cancer cells and the related mechanisms.Methods:HT-29 cells were cultured in the absence or presence of sodium butyrate.The cell proliferation and cell cycle were studied by MTT and FCM,respectively.Apoptosis was assessed by observing cell morphology,percentage of sub-G_ 1 cells and AnnexinV-FITC.The effects of sodium butyrate on transcription of p21waf1,bax and gadd45 were analyzed by RT-PCR and Western blot.Results:Sodium butyrate inhibited proliferation and induced apoptosis of HT-29 cells in a time-and dose-dependent manner,and it blocked HT-29 cell at G_ 1 phase.Sodium butyrate stimulated p21waf1 and bax expression both at mRNA and protein level in HT-29 cells,but had little effect on the transcription of gadd45.Conclusion:Sodium butyrate can inhibit proliferation and induce apoptosis of HT-29 cells,which might be through up-regulating p21waf1 and bax expression both at mRNA and protein levels.
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Objective To study the effect of imbalance of proliferation and apoptosis in the development of colorectal carcinoma(CRC),and the molecular mechanism of the dynamic change.Methods ORC was(induced) with dimethylhydrazine(DMH) in male mice of Kimming strain.The mice were killed in batches in the 12th,18th and 24th weeks of carcinoma induction.The distribution and extent of proliferation and(apoptosis) of the colorectal mucosa,at various intervals,were dynamically observed.Three genes,p21waf1,Bax and Gadd45 were analyzed by RT-PCR,immunohistochemistry and Western blot.Results During the course of carcinoma induction,the mucosas of the model mice showed sequential changes of atypital(hyperplasia),adenoma,and carcinoma.Compared with control group,the PCNA expression of the model group mice was significantly higher(P