A case study: a continuous improvement project of lecturing skills for clinical teachers in Chinese residency standardized training.

BACKGROUND: Aiming at the poor quality of small lectures due to the lack of lecturing skills of the clinical teachers in residency standardized training, the Teaching and Training Department of Shanghai East Hospital set up a continuous improvement project of lecturing skills for the clinical teachers to search for effective ways to improve lecture quality, then the effect was evaluated. METHODS: Based on the ADDIE model of training design, the department conducted the project in accordance with a process of analysis, design, development, implementation and evaluation. A special course "Clinical Teacher Presentation Training" (CTPT) was developed to convey and train the 5 key behaviors in presentation to improving lecture quality of the clinical teachers. Ninety-nine clinical teachers who give lectures to the residents were recruited as subjects for the project. Adopted the model of "intensive training + practice transference" to strengthen lecturing skills, and applied the Kirkpatrick Four Levels to evaluate the effect of the project from multi-role and multi-stage. RESULTS: The training satisfaction of the CTPT course from the subjects reaches 100%. The subjects have a high degree of knowledge acquisition through CTPT and the knowledge of the 5 key behaviors has been actually used in their lectures at the stage of practice transference. Comparing the data before training and after transference, it is found that the average increasing of the subjects' 5 key behavior scores made by teaching secretaries is 14.12 points (14.12%) and that of the subjects' self-efficacy scores is 9.31 points (9.31%); the performance values were modeling based on the scores from different types of evaluators and increased by an average of 12.61 points (12.61%); and the star ratings of the overall performance increased by an average of 1.17 points (23.4%). The results showed statistically difference (P < 0.001). CONCLUSIONS: The project effectively promoted the improvement of the clinical teachers' lecturing skills and the quality of small lectures.

Systematic analysis of a xenograft mice model for KSHV+ primary effusion lymphoma (PEL).

Kaposi's sarcoma-associated herpesvirus is the causative agent of primary effusion lymphoma (PEL), which arises preferentially in the setting of infection with human immunodeficiency virus (HIV). Even with standard cytotoxic chemotherapy, PEL continues to cause high mortality rates, requiring the development of novel therapeutic strategies. PEL xenograft models employing immunodeficient mice have been used to study the in vivo effects of a variety of therapeutic approaches. However, it remains unclear whether these xenograft models entirely reflect clinical presentations of KSHV(+) PEL, especially given the recent description of extracavitary solid tumor variants arising in patients. In addition, effusion and solid tumor cells propagated in vivo exhibit unique biology, differing from one another or from their parental cell lines propagated through in vitro culture. Therefore, we used a KSHV(+) PEL/BCBL-1 xenograft model involving non-obese diabetic/severe-combined immunodeficient (NOD/SCID) mice, and compared characteristics of effusion and solid tumors with their parent cell culture-derived counterparts. Our results indicate that although this xenograft model can be used for study of effusion and solid lymphoma observed in patients, tumor cells in vivo display unique features to those passed in vitro, including viral lytic gene expression profile, rate of solid tumor development, the host proteins and the complex of tumor microenvironment. These items should be carefully considered when the xenograft model is used for testing novel therapeutic strategies against KSHV-related lymphoma.

The stimulatory activity of plasma in patients with advanced non-small cell lung cancer requires TLR-stimulating nucleic acid immunoglobulin complexes and discriminates responsiveness to chemotherapy.

BACKGROUND: Therapeutic options for patients with non-small cell lung cancer (NSCLC) are often restricted to systemic chemotherapy. However, the molecular and cellular processes during chemotherapy of advanced NSCLC patients still remain unclear. Here we investigated the stimulatory activity of plasma in advanced NSCLC patients and its correlation with chemotherapy. METHODS: Whole blood samples from advanced NSCLC patients were collected before the first, second, and third cycle of chemotherapy. Plasma was isolated following centrifugation of whole blood. PBMCs were isolated from whole-blood specimens by Ficoll-Hypaque density gradient centrifugation. Immune complexes (ICs) were isolated from NSCLC plasma using the IgG Purification Kit. qRT-PCR was used to detect a broad array of cytokines and chemokines. RESULTS: The plasma in advanced NSCLC patients was endowed with stimulatory activity and capable of inducing proinflammatory cytokines. Both nucleic acids and immunoglobulin components were required for the stimulatory activity of NSCLC plasma. In consistent, TLR8 and TLR9 conferred the stimulatory activity of plasma in NSCLC patients. Of note, we revealed the decreased stimulatory activity of plasma in patients who responded to chemotherapy. CONCLUSIONS: Our findings demonstrated that the plasma of advanced NSCLC patients required TLR-stimulating nucleic acid immunoglobulin complexes and could discriminate the responsiveness to chemotherapy, which might provide a novel mechanism by which the proinflammatory immune response was induced and a potential new biomarker for evaluating responsiveness to chemotherapy in NSCLC patients.