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Objective To investigate the"Precision Treatment for Oncology"course,which is offered by Peking Union Medical College.The course is aiming for collecting students'opinions and suggestions to optimize the course setting and improve the teaching quality.Methods This investigation collected data by questionnaire survey and in-terviewing from Dec.2021 to Feb.2022.The questionnaire data and interview data were analysed.Results Thirty-six quantitative questionnaires and five qualitative questionnaires were included.Improving professional knowledge and personal interests were two main reasons for students to choose courses,which existed statistical differences on different aspects of course evaluation.The overall score evaluated by medical students was 9.22 and 94.4%of the students thought the course achieved the desired goal.The scores of teachers'teaching attitude,frontier and practi-cality of course content were 9.81,9.08 and 8.86 points respectively.The students hoped to increase the case analysis practice and thematic discussion activities to enrich the teaching form.Conclusions This elective course for graduate is recognized and accepted by students.More efforts are needed in future to optimize curriculum set-tings,innovate teaching methods,improve teaching quality and explore new pathways for medical graduate educa-tion matching the needs of students.
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Ulcerative colitis (UC) is a common inflammatory bowel disease (IBD) in clinical practice, characterized by symptoms such as abdominal pain, diarrhea, and bloody mucus in the stool. It is difficult to cure and has a high recurrence rate. The pathogenesis of UC is related to abnormal immune response, oxidative stress in intestinal tissues, and inflammatory reactions. As reported, the abnormal activation of the NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome is involved in the pathological process of UC. This activation triggers pathological mechanisms such as oxidative stress, pyroptosis, and inflammation in intestinal epithelial cells. Therefore, blocking the abnormal activation of NLRP3 is beneficial for alleviating UC. Currently, western medicine treatment for UC mainly includes salicylic acid derivatives, corticosteroids, and biologics, but the overall efficacy is unsatisfactory. Traditional Chinese medicine (TCM) treatment of this disease has the advantages of significant efficacy and low recurrence rate. In recent years, great advances have been made in the basic research of using TCM methods to treat UC. Studies have found that TCM intervention targeting the NLRP3 inflammasome can significantly promote intestinal mucosal healing and treat UC, and the mechanism of action involves multiple targets, levels, and pathways. This article summarized the experimental research on the impact of TCM targeting the NLRP3 inflammasome on UC in recent years, and found that NLRP3 interacted with factors such as Caspase-1 and nuclear factor-κB (NF-κB), thereby promoting the release of pro-inflammatory factors and cell pyroptosis in intestinal epithelial cells. This activation triggered oxidative stress, inflammatory reactions, and other pathological mechanisms. TCM acted on the NLRP3 inflammasome and its upstream and downstream factors to block the pathological process of UC, inhibit the pathological damage to the intestinal mucosa, and thereby alleviate colonic ulcers. The findings of this study provide a theoretical basis for the prevention and treatment of UC and further drug development.
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Immune checkpoint inhibitors (ICIs) have shown significant efficacy in clinical trials and applications of various malignant tumors, and have been approved for clinical application in China. ICIs can cause immune-related adverse events (irAEs), which may affect any organs. Early identification and appropriate treatment can improve patient outcome. 18F-FDG PET/CT is capable of early detection of irAEs and provides effective clinical guidance. This article reviews the clinical application of 18F-FDG PET/CT in detecting irAEs, including typical imaging findings and research progress.
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Osimertinib-induced interstitial lung disease (ILD) is an uncommon, but fatal pulmonary toxicity in some patients. We report a case of a 64-year-old male with stage IV adeno-non-small cell lung cancer (NSCLC) harboring an exon 19 deletion in the epidermal growth factor receptor (EGFR) treated with osimertinib 80 mg/d for first-line targeted therapy. On day 60 after initiating treatment of osimertinib, the patient developed ILD. Osimertinib was discontinued immediately and oral prednisone 60 mg/d was initiated, ILD improved within 13 d. After balancing the risk and benefit, osimertinib was restarted concurrently with prednisone. The patient showed neither disease progression nor a recurrence of ILD for more than 16 months. Based on our case and literature review, retreatment with osimertinib under steroid coverage could be considered as an effective treatment option after careful risk-benefit assessment for patients with EGFR-mutant NSCLC. .
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Humans , Male , Middle Aged , Acrylamides/therapeutic use , Aniline Compounds/therapeutic use , Carcinoma, Non-Small-Cell Lung/genetics , ErbB Receptors/genetics , Lung Diseases, Interstitial/genetics , Lung Neoplasms/genetics , Prednisone , Protein Kinase Inhibitors/adverse effectsABSTRACT
Objective To explore the relationship between the serum neuropeptide Y (NPY) levels and the pathogenesis,therapeutic intervention of schizophrenia. Methods One hundard twenty-five patients with schizophrenia (case group) with no medication for at least 4-week and 136 healthy controls (control group) were evaluated by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Positive and Negative Syndrome Scala (PANSS). Simultaneously blood tests were performed to detect serum NPY levels. In the case group, PANSS was evaluated and blood collected again after 4 weeks of treatment with olanzapine. Result At the baseline,the serum NPY concentration was significantly lower in the case group than in control group (t=-5.79, P<0.01). The scores of RBANS and its factors were significantly lower in the case group than in control group (all P<0.01). The concentration was positively correlated with the score of the attention factor for RBANS scale (r=0.20, P=0.04). After treatment with olanzapine for 4 weeks,the serum NPY level in the case group was significantly increased (t=-2.23,P=0.03).The scores of PANSS total scale and subscale were significantly decreased(all P<0.01).There was no significant correlation between alterations of the serum level of NPY and PANSS total or subscale scores from baseline to 4-week (all P>0.05). Conclusion The present study has revealed a significant decrease in serum NPY levels in patients with schizophrenia which can be attenuated by treatment of Olanzapine.The action of Olanzapine may be related to the mechanism of action of Olanzapine.However,there is no correlation between alterations of the serum level of NPY and the improvement in the patientˊs clinical symptoms.
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Objective To examine the correlation between the gene of phosphate and tension homology deleted on chromosometen (PTEN gene) polymorphism and schizophrenia (SCZ) associated with the type 2 diabetes mellitus (T2DM ) in Shanghai Han population. Methods The study recruited 591 long-stay schizophrenic inpatients including 304 with and 287 without type 2 diabetes mellitus, 206 patients with the type 2 diabetes mellitus and 205 normal subjects from Shanghai Han population. SNPs of PTEN gene (rs1234225, rs12569998, rs1234223) were genotyped by using Taqman genotyping. The frequency distributions of allele, genotype and haplotype between groups were analyzed. Results There were significant differences in the frequency of rs1234223 genotype (P=0.01) and allele distribution (P=0.02) between the SCZ with type 2 diabetes mellitus group and the SCZ without type 2 diabetes mellitus group. The difference of genotype frequencies remained statistically significant (P=0.03) but the allele distribution was not (P=0.06) after Bonferroni correction. Haplotype analysis showed that TTC haplotype was less common in the SCZ with type 2 diabetes mellitus group than in the SCZ without type 2 diabetes mellitus group (P=0.02). Conclusions PTEN gene may be a susceptibility gene for schizophrenia with type 2 diabetes mellitus in Chinese Han population. The TTC haplotype may be a protective factor for schizophrenia with type 2 diabetes mellitus.
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Objective To study the clinical application value of the low forceps in vaginal delivery. Methods To retrospectively analyze the clinical data of 280 cases of the low forceps in vaginal delivery,and randomly selected 140 cases pregnant women who cesarean section, as the control group. To compare the influence of maternal and neonatal morbidity in the two groups. Results There were no statistically significant differences between the two groups for the incidence of the postdelivery hemorrage,birth trauma infectious, asphyxia neonatorum associated with delivery from low forceps when compared with cesarean section. The incidenc of the postdelivery sick rate was significantly lower in the low forceps group( 3.2% ) than that in the control group ( 10.0% ) ( x2 = 8.30, P < 0.05 ). Conclusion Low forceps may be a valuable instrument and safety or efficacy in vaginal delivery and that it should be more widely used in appropriate clinical situations.
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Objective To investigate clinical characteristics,diagnosis,treatment and prognosis of mucormycosis in patients with renal failure. Methods We reported a 65-year old case of mucormycosis with chronic renal failure. The patient was successfully treated with amphotericin B. Mucormycosis complicated with renal failure were reviewed excluding mucormycosis peritonitis associated with peritoneal dialysis and desferrioxamine-related mucormycosis. Results Fifteen cases including our case were involved with mean age of 49.87?15.84 years old. Rhinocerebral,pulmonary,and disseminated forms accounted for 46.7%,33.3% and 20% respectively. Autopsy was made in 46.7% of patients. Mortality was 73.3% in all of them and 42.9% in seven patients who received antifungal therapy. All patients without treatments died. Conclusion Mucormycosis is a lethal invasive infection in patients with renal failure. The management to improve prognosis are early diagnosis,surgical debridement,drainage and aggressive antifungal chemo-therapy.