1.Practice and reflection of Research-oriented studies in clinical skills education
Jianming HE ; Jingxiang XU ; Kejin HU ; Xiaoqiang ZHOU
Chinese Journal of Medical Education Research 2014;13(11):1144-1147
Research-oriented study is a comprehensive learning method focusing on the experimental process deriving from a main issue.Given our clinical teaching experience in years,we incorporated the research-oriented studies into the undergraduate Clinical Medicine course for grade 2009,integrating the trait of the clinical skills education and our local professional training objectives.In the studies,students selected their own topic,designed and did their experiments,searched for the information,processed and analyzed the experiment result and finally completed the thesis.Practice showed that after the strict implementation of research learning plan,students' learning interest,innovative thinking,practical skills,research ability and cooperation spirit all significantly enhanced.
2.The application and effect evaluation of standard operation procedure (SOP) teaching in surgical practice teaching of local medical college
Jianming HE ; Kejin HU ; Jingxiang XU ; Qi WANG
Chinese Journal of Medical Education Research 2016;15(12):1233-1238
Objective To discuss the application and effect evaluation of the standard operation procedure ( SOP ) teaching method during applying surgical practice teaching in local medical college . Method 123 undergraduate students from Grade 2011 clinical medical major in Medical College of Shaoguan University were selected as objects of study. The students were divided into test (odd) group and control (even) group by draw. The two groups were taught by the same teachers, while the SOP method was applied to the test group (n=62) and the traditional surgical clinical teaching method was applied to the control group (n=61). Meanwhile, we used a combined method of the formative assessment and final assess-ment to compare and analyze the teaching feedback. After their graduate internship, we compared their autonomous study capability, clinical evaluation thought, normativity of the operation and capability in their intern positions as well as the degree of satisfaction of the test of two groups by doing a survey among them. All these were analyzed by SPSS 18.0 software, and t test was used to compare two groups' measurement in-formation and count data with chi-square. Results The comprehensive evaluation scores of the test group were significantly higher than the control group, in which the margin was of statistical value [(79.394 ± 8.049) vs. (71.703±10.462), t=39.632, P=0.000]. The percentage of excellence of the test group was signif-icantly higher than the control group, in which the margin was of statistical value (59.68% vs. 39.35%, χ2=5.082, P=0.024). The percentage of failure of the test group was lower than the group taught by the tradi-tional method, in which the margin was of statistical value (3.22%vs. 16.39%, χ2=4.652, P=0.031). Its for-mative assessment result on the evaluation of the experimental teaching process and summative assessment scores were higher than the control group, and the difference was statistically significant [formative scores points: (46.018 ±5.749) vs. (42.771 ±6.459), t=19.445, P=0.000; summative scores: (33.659 ±3.437) vs. (29.063±4.366), t=36.249, P=0.000]. As far as their clinical graduate internship adaptation capabilities were concerned, students from the test group had more satisfaction on the teaching feedback over 4 perspectives than the other group, in which the margin was of statistical value. Experimental groups' satisfaction showed that: 93.55% of students thought the standard operation procedure (SOP) teaching method was beneficial to improving their clinical practice skills, 91.94%thought that it improved their surgical clinical work ability to adapt, 85.48% thought it helped to cultivate their surgical clinical thinking and innovation ability. Conclusions The SOP teaching method in surgical practice teaching helps to enhance students' clinical operation and adaptation capability and promote the teaching quality.
3.Mechanism of action of Wuzi Yanzong pill in the treatment of oligoasthenozoospermia in rats determined via serum metabolomics
Zhenru Shen ; Zhaohua Zhang ; Kejin Tong ; Chunrui Wang ; Shuaiqiang Wang ; Ping Zhao ; Meng Gu ; Jingjing Hu ; Yibo Tang ; Zhenquan Liu
Journal of Traditional Chinese Medical Sciences 2024;11(2):180-190
Objective:
To investigate the mechanism of action of Wuzi Yanzong pill (WYP) in rats with oligoasthenozoospermia (OAZ) via metabolomics and to provide a possible basis for improving this WYP-based treatment.
Methods:
A rat model of OAZ was established by treating male Sprague–Dawley rats with glucosides from Tripterygium wilfordii Hook. F. Seventy-two rats were randomly divided into six groups: control, L-carnitine (positive control), model, and low-, medium-, and high-dose WYP groups. Rats in the experimental groups were treated with WYP for 4 weeks. At the end of the treatment period, sperm cell quality (density, motility, and viability) was assessed using a semen analysis system, mitochondrial membrane potential (MMP) was assessed using flow cytometry, and testicular injury was assessed using hematoxylin and eosin staining to validate the therapeutic effect of WYP in OAZ. Further, serum metabolomics-based analysis was performed using high-performance liquid chromatography-mass spectrometry to identify differential metabolic pathways and possible mechanisms of action of WYP in OAZ treatment.
Results:
A rat model of OAZ was considered successfully-established after comparing the quality of spermatozoa in the model group to that in the control group. WYP-M and WYP-H treatments significantly improved sperm cell density, motility, and viability compared with those in the model group (all P < .05). Compared with the model group, both WYP-M and WYP-H treatments increased MMP values (P = .006 and P = .021 respectively), while there was no significant difference in the L-carnitine group. L-carnitine and WYP administration reversed damage to the testes to varying degrees compared with that in the model group. Further, 44 differential metabolites and four metabolic pathways, especially autophagy pathway, related to OAZ were identified via metabolomics.
Conclusions
WYP improves sperm cell quality and MMP in OAZ primarily via autophagy regulation. These findings can be employed to improve the efficacy of WYP in humans.
4.Feasibility of preparing human plasminogen by full chromatography from precipitation of Fraction Ⅲ in low temperature ethanol method
Jin ZHANG ; Shenglan YUE ; Chen ZHU ; Yan PENG ; Yanxiang ZHOU ; Lianzhen LIN ; Kejin CHEN ; Lu FENG ; Yong HU ; Zhijun ZHOU
Chinese Journal of Blood Transfusion 2024;37(11):1293-1300
[Objective] To determine the feasibility of preparing plasminogen (Pg) with Fraction Ⅲ precipitation (hereinafter referred to as FⅢ-P) from low-temperature ethanol process by full chromatography (hereinafter referred to as FⅢ-P process). [Methods] The FⅢ-P was diluted with dissolution buffer at different dilution times and stirring time. The potency and antigen concentration of Pg in dissolution sample were detected and the dissolution and clarification conditions were determined. Pre-treatment of loading sample and pre-experiment of affinity chromatography were carried out on the FⅢ-P dissolution sample to judge whether the loading sample had an impact on the chromatography by observing the performance of the affinity chromatography column and to evaluate whether the affinity chromatography could achieve the purpose of purifying Pg by detecting the plasma protein antigen concentration and Pg potency of the samples in the process. Two batches of FⅢ-P process were studied step by step, and the specific activity, steps and total recovery, and the output of Pg per ton of plasma were calculated. The feasibility of preparing Pg by FⅢ-P process was evaluated by comparing with the data of full chromatography process using plasma as raw material (hereinafter referred to as plasma process). [Results] The FⅢ-P was dissolved with 10 times of dissolution buffer, stirred for 1 hour, centrifuged at room temperature of 10 000×g for 15 minutes. The supernatant was first filtered with a screen, then clarified with an 8/0.8 μm filter, and finally filtered with a 0.45/0.2 μm filter and loaded. Pre-test showed that from clarification and filtration to Pg affinity chromatography, the step recovery of activity and antigen was 39.51% and 108.64%, respectively, the antigen concentration of Pg increased by 31.16 times and the activity increased by 11.39 times after affinity chromatography, which reaching the effect of affinity chromatography purification of Pg. The results of 2 batches of step-by-step scale-up FⅢ-P process showed that the total recoveries of antigen and activity from plasma to SP chromatography of FⅢ-P process were (45.76±1.10)% and (24.15±0.59)%, respectively, which had a total loss of about 1/3 of antigen and about 2/3 of activity compared to the plasma process. The Pg specific activity of SP chromatography eluent was (4.68±0.25) U/mg, which was about half of that of plasma process, but meeted the internal standard of > 4 U/mg. The output of Pg antigen per ton of plasma in the FⅢ-P process was 68.73% of that in the plasma process, and the output of Pg activity per ton of plasma in the plasma process was 29.82% of that in the plasma process, which basically achieved the purpose of waste utilization of FⅢ-P. [Conclusion] The technical route of preparing Pg from FⅢ-P by full chromatography is feasible.
5.Changes and distribution of antibodies in plasma before and after infection of SARS-CoV-2 Omicron strain
Zhijun ZHOU ; Shenglan YUE ; Yan PENG ; Jun LIU ; Yunfen WU ; Kun DENG ; Yun ZHANG ; Juan LI ; Kejin CHEN ; Cesheng LI ; Shuangying ZENG ; Yong HU ; Jin ZHANG
Chinese Journal of Blood Transfusion 2023;36(7):578-583
【Objective】 To determine the best collection time period of plasma which can be used for human COVID-19 immunoglobulin for intravenous injection through SARS-CoV-2-IgG change and neutralizing antibody distribution against different virus strain in representative mixed plasma before and after Omicron strain infection by ELISA and pseudovirus neutralization test. 【Methods】 An ELISA method for quantitative detection of SARS-CoV-2-IgG was established and its linear range,accuracy and precision was verified. SARS-CoV-2-IgG potency was detected in 25 convalescent plasma which were collected 20-40 days after confirmed Omicron infection, two groups of mixed plasma samples WP1 and WP2 were prepared according to the SARS-CoV-2-IgG results, and pseudovirus neutralization experiments with different virus strain (prototype strain, BA. 1,BA.2, BA.4/5, BF.7, BQ.1.1) were carried out to determine the distribution of neutralizing antibodies against different virus strain. SARS-CoV-2-IgG potency of representative mixed plasma collected from 14 plasma stations subordinate to the company before and after Omicron strain infection was detected, including Omicron convalescent plasma (OP) collected from different plasma stations from December 2022 to May 2023 and normal pool plasma (VN) feed in March 2023 which collected from March 2022 to December 2022. According to the results, the difference and the change rule with time of SARS-CoV-2-IgG before and after Omicron strain infection were analyzed. 【Results】 The linearity of SARS-CoV-2-IgG ranged from 6.25 to 200 EIU/mL, the accuracy in-batch ranged from 81.793% to 106.985%, the precision in-batch ranged from 1. 100% to 13.000%, and the total error in-batch ranged from 2.988% to 22.679%. The accuracy between batches ranged from 90.788%to 96.893%, the precision between batches ranged from 4.870% to 6.272%, and the total error between batches ranged from 9.192% to 15.399%. The results of pseudovirus neutralizing antibody showed that the potency of different virus strain neutralizing antibodies were in the order of prototype strain>BA.2>BA.4/5>BF.7≈ BQ.1.1>BA.1 and the correlation between WP1 and WP2 was high (Pearson r=0. 931 1, P=0.002 3) which indicated that the potency distribution of neutralizing antibodies of different virus strain in Omicron convalescent plasma was basically stable. Compared with the mixed convalescent plasma sample G128 collected in June 2022, the potency of Omicron neutralizing antibodies of WP series were significantly higher, the ratio of BA.2 antibody to prototype antibody increased from 26.9% (before infection) to 82.6%-87.5% (after infection). The results of VN series before Omicron infection were < 100 EIU/mL, and the results of OP series after Omicron infection showed that the plasma collected from the beginning of December 2022 was the peak of antibody in the same month,and then dropped sharply, entering a short plateau in February-March 2023 (potency was about 40% of the peak value),and then dropped sharply again in April (potency was about 20% of the peak value). 【Conclusion】 The potency and proportion of neutralizing antibody against Omicron subtype in convalescent plasma after COVID-19 Omicron strain infection increased significantly. IgG antibody of plasma donors in different regions reached its peak in the month of infection, then continued to dropped sharply. The best collection period of plasma that can be used for human COVID-19 immunoglobulin for intravenous injection was 1 to 2 months after infection.
6.Determination of the ELISA kits for screening convalescence plasma with high potency of SARS-CoV-2 IgG
Zhijun ZHOU ; Lu FENG ; Shenglan YUE ; Yan PENG ; Bin GAO ; Deiming JI ; Juan LI ; Kejin CHEN ; Lianzhen LIN ; Cesheng LI ; Yong HU ; Taojing LI
Chinese Journal of Blood Transfusion 2023;36(3):199-203
【Objective】 To determine the ELISA kit for screening convalescence plasma with high potency of SARS-CoV-2 IgG by comparing and analyzing the plasma detection results of convalescent plasma collected in different periods via ELISA kits from two manufacturers and the results of mixed plasma with different potency via pseudovirus neutralization experiments. 【Methods】 Two ELISA kits from different manufacturers(named A, B) were used to detect the plasma of 269 convalescent patients collected from Feb.2020~Jan.2022. The correlation and concordance rate of the two results were analyzed to determine the kit preliminarily. According to the titers of diluted series of standard of the preliminary selected kit, 5 mixed plasma samples (G4-G128) with different potency were prepared. The correlation of ELISA IgG results of product A/B, as well as the pseudovirus neutralization test of the original strain, Omicron mutant BA.1 and BA.2 strains were analyzed. Combined with the outside-well dilution mode of the strongly positive samples, the kit for high potency of SARS-CoV-2 IgG screening was determined. 【Results】 When the internal control reference B