On the application effect of mobile augmented reality technology in the teaching of neuroanatomy / 中华医学教育探索杂志

Objective:To explore the application of mobile augmented reality (mAR) technology in the teaching of neuroanatomy, and to observe its effect on students' academic performance and cognitive load.Methods:By collecting and designing various neuroanatomy multimedia teaching resources (graphics, animations and videos), using augmented reality (AR) marker-based image recognition technology, the multimedia resources were placed at the tags in the traditional book pages to make the books interactive. And various multimedia resources were combined with traditional printed books through mobile devices. Forty students were randomized into the experimental group or the control group. The experimental group was taught with mAR multimedia materials, and the control group adopted traditional teaching methods. After a 6-hour course was completed, all students had a unified test, and the academic performance test and the PAAS(platform-as-a-service) cognitive load scale were used for data collection and analysis. The variance analyses (MANOVA and ANOVA) were used for significance testing.Results:One-way MANOVA test was used to determine the learning effect of mAR on academic performance and cognitive load. The results showed that there was a significant difference between the experimental group and the control group ( P<0.05). The univariate ANOVA test found that the experimental group students who learned neuroanatomy through mAR had better test scores than the control group students. In addition, compared with the control group students, the cognitive load of students in experimental group was significantly reduced, with statistical significance (all P<0.05). Conclusion:Through the teaching practice, we found that using mAR to learn neuroanatomy helps students improve their academic performance while reducing their cognitive load.

Value of endoscopic ultrasound-guided fine needle aspiration in pretest prediction and diagnosis of pancreatic ductal adenocarcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To identify the predictive factors for differentiating pancreatic ductal adenocarcinoma (PDAC) from other neoplastic solid pancreatic lesions and assess the accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for diagnosis of PDAC.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of patients referred for EUS-FNA evaluation of pancreatic lesions in the Digestive Endoscopic Center of Nanfang Hospital between January, 2009 and May, 2016. The cases with unknown diagnosis, missing data, repeated punctures, cystic lesions and benign lesions were excluded from the analysis. The positivity rates of EUS-FNA were compared between patients with PDAC and those with non-PDAC lesions, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of EUS-FNA were assessed in the diagnosis of PDAC. Univariate and multivariate logistic regression analyses were used to identify the factors for differentiating PDAC from non-PDAC lesions based on the demographic characteristics, clinical presentations, laboratory data, and endoscopic ultrasonography imaging features of the patients.</p><p><b>RESULTS</b>Among the 75 patients with solid neoplastic pancreatic lesions, 54 (72.0%) were found to have PDAC and 21 (28.0%) had non-PDAC lesions. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EUS-FNA for the diagnosis of PDAC were 77.8%, 100.0%, 100.0%, 63.6% and 84.0%, respectively. No significant difference was found in the positivity rate of EUS-FNA between patients with PDAC and those with non-PDAC lesions (77.8% 76.2%, > 0.05). Multivariate regression analysis identified abdominal pain (=5.163, 95%: 1.093-24.389, =0.038), lesion size (=0.926, 95%: 0.877-0.978, =0.006), characteristics of the solid lesions (=7.105, 95%: 1.440-35.043, =0.016), and evidence of metastases (=6.165, 95%: 1.332-28.533, =0.020) as the independent factors for predicting PDAC.</p><p><b>CONCLUSIONS</b>The pretest characteristics including abdominal pain, evidence of metastases, and lesion size and lesion characteristics defined by endoscopic ultrasonography findings can reliably predict a diagnosis of PDAC. EUS-FNA has a high sensitivity and a high specificity for the diagnosis of PDAC.</p>

Diagnostic value and influencing factors of endoscopic ultrasound-guided fine needle aspiration for space-occupying lesions of gastrointestinal adjacent tissue / 中华消化内镜杂志

Objective To investigate the diagnostic value of endoscopic ultrasound-guided fine needle aspiration ( EUS-FNA) on malignant lesions in gastrointestinal adjacent tissue, and further to analyze the risk factors influencing positive rate of EUS-FNA. Methods The clinical data of 171 patients undergoing EUS-FNA from January 2009 to May 2016 were collected. The lesion location, size and characteristics, the number of needle passes, puncture suction negative pressure, size of puncture needle, and years of operator experience in EUS were retrospectively analyzed. Results The overall sensitivity, specificity, and accuracy of EUS-FNA in the diagnosis of malignant lesions were 78. 3％ ( 83/106) , 100. 0％ ( 65/65) , and 86. 5％( 148/171) , respectively. The univariable logistic regression analysis demonstrated that the risk factors of EUS-FNA were lesion location, lesion characteristics, and lesion size. In multivariate analysis, larger lesion size ( OR=1. 029, 95％CI: 1. 011-1. 047, P=0. 001) and lesion characteristics of solid ( OR=5. 098, 95％CI:1. 324-19. 633, P=0. 018) were independent factors affecting the positive rate of EUS-FNA. Among 171 cases performed by EUS-FNA, the incidence of postoperative complications was 1. 75％ ( 3/171 ) included 2 cases of fever and 1 case of acute pancreatitis, which were improved after conservative treatment. Conclusion EUS-FNA is a safe and effective method of cytological and histological diagnosis with high accuracy and sensitivity, importantly in distinguish malignancy from benign lesion in gastrointestinal adjacenttissue. Positive rate of diagnosis on malignant lesions by EUS-FNA is positively correlated with lesion size, and EUS-FNA positive rate of solid malignant lesions is significantly higher than that of cystic lesions.

Glioma Stem Cell-Targeted Dendritic Cells as a Tumor Vaccine Against Malignant Glioma

PURPOSE: Cancer stem cells have recently been thought to be closely related to tumor development and reoccurrence. It may be a promising way to cure malignant glioma by using glioma stem cell-targeted dendritic cells as a tumor vaccine. In this study, we explored whether pulsing dendritic cells with antigens of glioma stem cells was a potent way to induce specific cytotoxic T lymphocytes and anti-tumor immunity. MATERIALS AND METHODS: Cancer stem cells were cultured from glioma cell line U251. Lysate of glioma stem cells was obtained by the repeated freezing and thawing method. Dendritic cells (DCs) were induced and cultured from the murine bone marrow cells, the biological characteristics were detected by electron microscope and flow cytometry. The DC vaccine was obtained by mixing DCs with lysate of glioma stem cells. The DC vaccine was charactirizated through the mixed lymphocyte responses and cell killing experiment in vitro. Level of interferon-gamma (IFN-gamma) in the supernatant was checked by ELISA. RESULTS: After stimulation of lysate of glioma stem cell, expression of surface molecules of DC was up-regulated, including CD80, CD86, CD11C and MHC-II. DCs pulsed with lysate of glioma stem cells were more effective than the control group in stimulating original glioma cells-specific cytotoxic T lymphocytes responses, killing glioma cells and boosting the secretion of IFN-gamma in vitro. CONCLUSION: The results demonstrated DCs loaded with antigens derived from glioma stem cells can effectively stimulate naive T cells to form specific cytotoxic T cells, kill glioma cells cultured in vitro.

Clinical analysis of 901 cases with Henoch-Sch(o)nlein purpura in children / 中华风湿病学杂志

Objective To investigate the variation of morbidity and clinical features of Henoch-Seh(o)nlein purpura (HSP) in childhood in recent years.Methods The clinical data of 901 cases with HSP admitted to our hospital from January 1,1995 to December 31,2005 were retrospectively analyzed.The constitute rate of admission,the initial clinical presentations,specific manifestations such as multi-system 23/2165(1.06%),29/2098(1.38%),24/1973(1.22%),39/2008(1.94%),54/2433(2.22%),86/2611(3.29%),94/2724(3.45%),99/3014(3;28%),138/2900(4.76%),143/3177(4.50%)and 172/3500(4.91%),resp-sixty-five of 901 HSP children (1 8.3%) had no palpable purpura at onset, 90 cases initially manifested as abdominal pain and (or) gastrointestinal bleeding,14 of them was diagnosed by gastroendoscopy which demonstrated mucous membrane vasculitis.Sixty-three cases manifested as arthritis/arthralgias,6 cases presented as renal involvement,1 case with neurological symptoms and 5 cases with other symptoms at their pancreatic involvement was present in 3 cases,cardiac involvement in 47 Cases and one case had lung hemorrhage.Conclusion The morbidity of HSP has increased in recent years.The diagnosis in patients who do not have palpable purpura at onset and patients who present with the cerebral,pulmonary,cardiac and pancreatic involvement as the initial manifestations is difficult.Special attention should be paid to this group of patients.Gastrointestinal endoscope is valuable in diagnosing HSP in patients whose initial symptoms are abdominal pain and (or) gastrointestinal bleeding.