Objective This paper aims to use components as the key factors to explore the feasibility of evaluation method about the learning effect of Web-based PBL.Methods We distributed a questionnaire to 101 students of clinical class of 2007 and 2008 grade in Guangzhou Medical University,and electronically distributed after 2 weeks.Cranach's α coefficient WaS used to evaluate intrinsic consistency reliability of the questionnaire.We applied principal axis factoring to extract components and to explain components which were orthogonally rotated by varimax.Multi-factor regression model Was simulated with key factors and the model's performance of fitting WaS tested.Results Multi-factor regression mode(WPBLSUM)=0.545 Collective collaboration capabilities+0.202 Self-learning and quest skills+0.137 linical reasoning and problem-solving capabilities+0.116 memorizing and understanding of medical knowledge.The coefficient of determination R2Was 0.998 and the corrected coefficient of determination R2Was 0.998.indicating that the model's fit results are obvious.Conclusion This paper demonstrates that using components as the key factors to simulate and assessing the Web-based PBL learning effect is feasible,which assesses the Web-based PBL learning effect well from four different aspects.

Objective To discuss the clinical value of strain rate imaging in quantitatively evaluating segmental myocardial function of left ventricle in latent autoimmune diabetes in adult(LADA).Methods Thirty LADA without complication(LADA group),30 LADA patients with hypertension and normal geometric left ventricle(LADA+NLVH group)and 30 healthy people(control group)were enrolled.All patients had normal ejection fraction,normal fractional shortening and no cardiac symptoms.The strain rate in systolic,early and later diastolic periods were obtained from 3 consecutive heartbeats in 16 segments respectively.The parameters were quantitatively analyzed between the three groups.Results Compared with the control group,all of the measured parameter of LADA and LADA+NLVH were significantly lower(P＜0.05 or P＜0.01).Although the mean strain rate in early and later diastolic periods decreased significantly in LADA+NLVH group than in LADA group(P＜0.05),there was no significant difference in the mean systolic strain rate between the two groups (P＞0.05).Conclusions Strain rate imaging provides a sensitive and accurate tool to assess the left ventricular myocardial performance in patients with LADA.

Objective To investigate the possible role of high mobility group box 1 protein (HMGB1) and its advanced gly‐cation end products receptor (RAGE) in the pathogenesis of systemic lupus erythematosus (SLE) .Methods The enzyme‐linked immunosorbent assay (ELISA) was used to determine the level of plasma HMGB1 in 52 cases of SLE (SLE group) and 40 healthy females undergoing physical examination (HC group) ,at the same time real time quantitative polymerase chain reaction (RT‐qPCR) was employed to detect the expression of HMGB1 and RAGE mRNA in peripheral blood mononuclear cells (PBMCs) .The correlation between plasma HMGB1 ,PBMCs HMGB1 and RAGE mRNA levels with clinical indicators was analyzed .Results The levels of plasma HMGB1 ,PBMCs HMGB1 mRNA in the SLE group were significantly higher than those in the HC group ,the differences were statistically significant (P< 0 .05) ,while the level of PBMCs RAGE mRNA had no statistical difference (P>0 .05);the Spearman correlation analysis showed that the level of plasma HMGB1 was positively correlated with antinuclear anti‐bodies titers and SLEDAI score in the SLE patients (P<0 .01) ,while had no obvious correlation with the other clinical and labora‐tory indicators(P>0 .05);the HMGB1 mRNA expression level was positively correlated with the RAGE mRNA expression level and SLEDAI scores(P<0 .01 ,P<0 .05) ,and had no obvious correlation with other clinical and laboratory indicators (P>0 .05) . Conclusion The abnormal expression of plasma HMGB1 and PBMCs HMGB1 mRNA in SLE patients prompts that which might be involved in the occurrence and development of SLE ,might participate in the immune and inflammatory regulation of SLE .

Objective To investigate the role of high mobility group box 1 protein(HMGB1) and the receptor for advanced glycation end products (RAGE) in the pathogenesis of primary gouty arthritis (GA).Methods Enzyme-linked immunosorbent assay(ELISA) was used to determine the level of plasma HMGB1 in 68 acute gout (AG),48 quiescent gout (QG) and 45 healthy control(HC).Real-time quantitative polymerase chain reaction (RT-qPCR) was employed to measure the expression of HMGB1 and RAGE mRNA in the peripheral blood mononuclear cells (PBMCs) in 68 AG,48 QG and 94 HC.One way ANOVA or Wilcoxon test and Spearman's correlations were used for statistical analysis.Results The level of plasma HMGB1,PBMCs HMGB1 and RAGE mRNA were significantly higher in GA than that in HC [(24±34) ng/ml,0.019±0.029,0.000 5±0.000 3] (P＜0.05),while the level of plasma HMGB1 and PBMCs HMGB1 mRNA were significantly higher in AG [(222±178) ng/ml,0.235±0.954,0.001 5±0.003 5] than that in QG [(107±176) ng/ml,0.044±0.117,0.001 3±0.000 9] (P＜0.05),and the level of PBMCs RAGE mRNA was higher in AG than that in QG (P＞0.05).In the GA patients,the level of plasma HMGB1 was positively correlated with white blood cell count,neutrophile granulocytes count,mononuclear cells and erythrocyte sedimentation rate (r=0.34,0.44,0.39,0.33; P＜0.05),while negatively correlated with apolipoprotein A1 (r=-0.28,P＜0.05); the level of PBMCs HMGB1 mRNA was positively correlated with RAGE mRNA,white blood cell counts,neutrophil counts,lymphocyte counts,serum total cholesterol level,low density lipoprotein level and apolipoprotein B100 level (r=0.29,0.36,0.26,0.28,0.29; P＜0.05),while negatively correlated with high density lipoprotein (r=-0.30,P＜0.01); the level of PBMCs RAGE mRNA was positively correlated with lymphocyte counts,total cholesterol and apolipoprotein B100 (r=0.35,0.35,0.44; P＜0.05).Conclusion HMGB1 and its signaling pathway may play important role in the pathogenesis of gouty arthritis,which may also be involved in the regulation of the lipid metabolism of gout.

The aim of the research is to study the prevalence and antimicrobial resistance of Campylabocter jejuni isolated from poultry in Jiangsu Province.A total of 753 samples from poultry meat and cloacal swabs were investigated,after the pure culture and the polymerase chain reaction of the mapA gene,207 isolates were examined for antimicrobial resistance by using K-B method according to World Health Organization.Results showed that all isolates performed different degree of antimicrobial resistance except meropenem,gentamycin,kanamycin,florfenicol and fosfomycin,the resistance rates of 194 strains to trimethoprim,norfloxacin,ceftriaxone and tetracycline were 100％,84.02％,80.9％ and 79.4％ respectively,1 strain isolated from Xuzhou was resistant to 92.6 ％ antibiotics.The multi-drug resistance appeared and the advantage of drug-resistant spectrum was LIN/CTX/CRO/NOR/CIP/T/TE,the resistant type focused on 40％-60％.The research provided evidence for surveillance of the antimicrobial resistance of C.jejuni and highlighted the need to employ more prudent use of critically important antimicrobial.

Objective To investigate the role of long noncoding RNA-AK001903 in the pathogenesis of primary gout arthritis (GA).Methods The subjects were divided into four groups:30 acute gout patients (AGA),24 non-acute gout patients (NAGA),24 healthy controls and 24 hyperuricemia (HUA).Real-time quantitative polymerase chain reaction (RT-qPCR) was employed to examine the expression of AK001903 in peripheral blood mononuclear cells (PBMCs) from four groups.100 μg/ml monosodium (MSU) was used to stimulate the peripheral blood of NAGA and healthy control patients.Then the expression of AK001903 was detected by RT-qPCR.Kruskal-Wallis test,Mann-Whitney test,Spearman correlations were used for statistical analysis.Results The expression level of AK001903 in the AGA group (0.079±0.022) and the NAGA group (0.071±0.021) were higher than the healthy control group (0.014±0.004).There was no significant difference between the NAGA group and the NAGA group (Z=-0.655,P＞0.05).Those of the GA group (0.078±0.018) and the HUA group(0.047±0.016) was higher than the healthy control group (0.014±0.004) (Z=-2.887,Z=-4.157;P＜0.05).Compared with the control group,the expression of AK001903 in NAGA and the healthy control group which were stimulated by MSU was significantly increased.The Spearman correlation analysis found that the AK001903 expression levels in the GA groups were correlated with TG (r=0.938,P＜0.05),VLDL (r=0.873,P＜0.05),GLU9 (r=0.671,P＜0.05) and were negatively correlated with apoA1 (r=-0.661,P＜0.05).Conclusion Altered expression of AK001903 may be involved in the process of imbalance between lipid metabolism and hyperuricemia,and takes part in the pathogenesis of GA.

We reviewed and developed an indicator system framework for assessing teaching effect of laparoscopic simulation training through literature research, expert consultation, analytic hierarchy process and factor analysis. We also made an empirical study on the constructed index system. The system included 3 domains (A1: evaluation of laparoscopic simulator; A2: operation evaluation of experimental animals; A3: evaluation of clinical practice), 10 second-level indicators and 23 third-level indicators for assessing teaching effect of laparoscopic simulation training. The indicator system framework has good internal consistency (Cronbach α= 0.968) and external consistency (>0.72). The empirical study found that: in the results of A1-A3 in the first level indicator, the score of the experienced group was significantly higher than that of the inexperienced group ( P<0.05). In the evaluation results of the 10 secondary indicators in the secondary indicators B1-B10, the score of the experienced group was significantly higher than that of the inexperienced group ( P<0.01). For the first time, we have established and evaluated a comprehensive evaluation indicator system which is reliable and effective and can be used for further evaluation of teaching effect of laparoscopic simulation training. The following empirical studies have verified the effectiveness and practicability of the evaluation system.

Uncovering the risk factors of pulmonary hypertension and its mechanisms is crucial for the prevention and treatment of the disease.In the current study,we showed that experimental periodontitis,which was established by ligation of molars followed by orally smearing subgingival plaques from patients with periodontitis,exacerbated hypoxia-induced pulmonary hypertension in mice.Mechanistically,periodontitis dysregulated the pulmonary microbiota by promoting ectopic colonization and enrichment of oral bacteria in the lungs,contributing to pulmonary infiltration of interferon gamma positive(IFNγ+)T cells and aggravating the progression of pulmonary hypertension.In addition,we identified Prevotella zoogleoformans as the critical periodontitis-associated bacterium driving the exacerbation of pulmonary hypertension by periodontitis,and the exacerbation was potently ameliorated by both cervical lymph node excision and IFNγ neutralizing antibodies.Our study suggests a proof of concept that the combined prevention and treatment of periodontitis and pulmonary hypertension are necessary.

OBJECTIVETo investigate the effect of betulinic acid (BA) on the proliferation, migration, apoptosis and cell cycle of pancreatic cancer cells (BxPC-3) in vitro and elucidate the underlying.

METHODThe effect of BA on the proliferation of BxPC-3 was measured by using sulforhodamine B (SRB) assay. Migratory ability of BxPC3 cells were detected by wound healing assay, and the morphological change was observed with light microscope. The influence of BA on cell cycle of BxPC-3 cells was tested by flow cytometry (FCM). Apoptosis was analyzed by using Hochest33342-PI double staining. Western blot technologies were applied to detect the expression of Bcl-2 and Bax.

RESULTBA exhibited significant cell proliferation and migration inhibition, as well as its potency of inducing apoptosis in BxPC-3 cells in vitro in a dose-dependent manner. The IC50 value for 72 h was 16.54 mg x L(-1). Cell migration was significantly inhibited at 5 mg x L(-1) of BA. Cells treated with BA showed increased cell population in G0 phase, with decreased G2/M phase population. The expression of Bax and Bcl-2 was up and down-regulated respectively in BA-treated BxPC-3 cells in a dose-dependent manner.

CONCLUSIONBA exerted potent effect on growth inhibition, G0 cell cycle arrest and induction of apoptosis in BxPC-3 cells in vitro, possibly associated with the down-regulation of Bcl-2 and up-regulation of Bax expression. The potent antitumor capacity of BA suggested that it could be a promising new anticancer agent in human pancreatic cancer treatment.

Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Pancreatic Neoplasms ; drug therapy ; genetics ; metabolism ; physiopathology ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Triterpenes ; pharmacology ; bcl-2-Associated X Protein ; genetics ; metabolism

Objective:To conduct meta analysis to compare the effect of complete resection with or without postoperative radiotherapy (PORT) on survival in stage Ⅲ(N 2) non-small cell lung cancer (NSCLC). Methods:Relevant studies of the efficacy of PORT for stage Ⅲ(N 2) NSCLC were searched from Wanfang Data, PubMed, and Cochrane Library from January 2006 to January 2022. Literature screening, extraction of information and assessment of the risk of bias of the included literature was carried out by two independent researchers. Meta analysis was performed using R4.0.3 software. Results:A total of 12 publications consisting of 2992 patients were included, 1479 cases in the PORT group and 1513 cases in the control group. PORT improved the overall survival (OS) and disease free survival (DFS) compared to the control group. Fixed-effects model meta analysis of 6 randomized controlled trials showed that PORT did not significantly reduce the risk of death ( HR=0.98, 95% CI: 0.80-1.20). Fixed-effects model meta analysis of 6 retrospective studies showed that PORT improved prognosis ( HR=0.68, 95% CI: 0.59-0.79). PORT could improve OS of patients with multiple (station) metastasis of ipsilateral mediastinum and / or submandibular lymph nodes ( HR=0.89, 95% CI: 0.80-0.99). Conclusions:PORT could improve OS and DFS in stage Ⅲ(N 2) NSCLC. A trend towards benefit can be observed in the subgroup with multiple/multi-station N2 metastasis.