1.Problem Oriented System to Diagnosing Learning Teaching Hitting the Target
Chinese Journal of Medical Education Research 2003;0(04):-
Problem oriented system teaching method has been put into practice,and contrast has been made with traditional teaching method in the teaching of diagnostics in the technical secondary school of Chinese and western medicine special field.Result indicates that the improved teaching effect has been obtained and the students'initiatives and their ability to learn independently have been cultivated.
2.Accuracy of ultrasonography in determining laryngeal mask airway position: evaluation using 3D-CTR
Shuang LYU ; Enqiang CHANG ; Yucai FAN ; Xiaoguo RUAN ; Jiaqiang ZHANG
Chinese Journal of Anesthesiology 2021;41(1):76-79
Objective:To evaluate the accuracy of ultrasonography in determining the laryngeal mask airway position using three-dimensional CT reconstruction (3D-CTR) images as the standard.Methods:One hundred and thirty-four patients, aged 18-64 yr, weighing 30-100 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective cerebral vascular interventional stent surgery in our hospital, were selected.Cervical ultrasonography was performed before and after laryngeal mask airway placement, and digital subtraction angiography was performed during operation to obtain 3D-CTR images.Neck ultrasound and 3D-CTR images were analyzed and graded.Results:A total of 125 patients completed the study.At the vertical position of the laryngeal mask airway, ultrasonic grading was positively correlated to 3D-CTR grading ( r=0.742, P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ultrasound in determining the rotation of the laryngeal mask airway was 73.0% (95% CI: 62.0%-84.4%), 92.8% (95% CI: 86.9%-98.7%), 89.1% (95% CI: 80.5%-97.7%), 81.0% (95% CI: 72.6%-89.4%), and 74.2% (95% CI 65.2%-81.1%), respectively.In terms of laryngeal mask airway depth grading, the correlation between ultrasonic grading was positively correlated to 3D-CT grading ( r=0.332, P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ultrasound in determining the depth of the laryngeal mask airway was 58.5% (95% CI: 46.9%-70.1%), 93.3% (95% CI: 87.2%-99.4%), and 90.5% (95% CI: 82.0%-99.0%), 67.5% (95% CI: 57.7%-77.3%), and 33.2% (95% CI: 16.8%-47.8%), respectively.The positive predictive value of ultrasound in determining the optimal placement of the laryngeal mask airway was 61.1% (95% CI: 48.6%-73.6%). Conclusion:Although ultrasound cannot measure the depth of the tip of the laryngeal mask airway into the esophagus, it has higher accuracy in determining the rotation and can be used as a reliable tool for clinical detection of the position of the laryngeal mask airway, especially the rotation.
3.The mechanism of damaged intestinal mucosal repair in a mouse model of sepsis
Ruiming CHANG ; Jianxing CHANG ; Liqiang WEN ; Yuru FU ; Zhipeng JIANG ; Shuang CHEN
Chinese Journal of Emergency Medicine 2011;20(8):792-796
ObjectiveTo investigate the unfavorable factors of intestinal mucosa repair after the intestinal epithelial injury in vivo in a mouse model of sepsis. MethodsThe method of cecal ligature and puncture (CLP) was used to induce sepsis and then the intestinal mucosa damage, epithelial cell apoptosis and the number of transformed goblet cells were observed, and the concentrations of serum TNF-αt, IL-1 and TGF-β1 and TFF3 ( trefoil factor 3) in small intestinal mucosa were determined. All above various laboratory examinations were made by different assays including H-E staining, western blot, ELISA and immunohistochemistry respectively. The experimental mice were divided into sepsis group and sham operation control group. The mice with sepsis were separately sacrificed 6 hours ( n = 7 ), 24 hours ( n = 7) and 48 hours ( n = 7) after CLP. Results In septic mice group, the injured intestinal mucosa was found 6 hours after CLP. The damage scores in mice 24 h and 48 h after CLP were higher than those 6 h after CLP, but there was no significant difference between those 24 h and 48 h after CLP. Moreover, a few goblet cells or other epithelial cells adjacent to the injured surface migrated onto the wound to cover the denuded area. The number of goblet cells was substantially decreased in mice of sepsis group 6 hours after CLP compared with sham operation control group. Compared with sham operation control group, levels of IL-1 and TNF-α significantly increased 3-4 times in mice of sepsis group at all intervals, and the phosphorylated caspase-3 increased 4 times. Although TFF3 assayed by using Western blot showed modest increase 6 h after CLP and it declined 24 h and 48 h later. A similar change was found in TGF-β1, it modestly increased 6h after CLP, but it didn't elevate 24 h and 48 h later. ConclusionsSevere sepsis keeps on the inflammatory reaction and epithelial cell apoptosis, preventing the repair of intestinal mucosa from injury.
4.Establishment of a novel high throughput screening assay for identifying small molecular antagonists of human interleukin-6 receptor
Yu YAN ; Yangyang HE ; Chang ZHANG ; Xiaobin PANG ; Peng DU ; Zhiwei SUN ; Shuang WANG ; Guanhua DU
Military Medical Sciences 2014;(12):921-926
Objective To establish a high throughput screening assay for identifying human small molecular antagonists targeted IL-6R.Methods The full length gene of the human IL-6R extracellular region was amplified by PCR and cloned into a eukaryotic expression vector to construct recombination expression plasmid pABHis -IL6R that was then transfected transiently into HEK293T cells to prepare recombination protein IL-6R.Western blotting assay and receptor-ligand binding experiment were used to analyze the bioactivity of IL-6R.A new screening method based on ELISA was established using the function of IL-6R binding to its ligand and the characteristics of Fc fragment binding to IgG-HRP.Then Z′-factor was calculated and a known antagonist ab 47215 was used to assess the stability and reliability of the new assay .Results Recombination plasmid pABHis-IL6R was constructed and soluble IL-6R was prepared.IL-6R reported herein could be recognized by an anti-IL-6R antibody and specifically bind to its ligand in a dose response manner .A Z′-factor of 0.53 was obtained that could serve high throughput screening assay .Ab47215 , as a known specific antagonist , was able to block rhIL-6 from binding to the receptor in a dose-dependent manner in the new screening assay , the IC50 of which was (0.55 ± 0.11)μg/ml.Conclusion An innovative and easy screening assay for identifying human IL-6R antagonists is established , which might help discover potent and specific antagonists .
5.Multisystem Langerhans cell histiocytosis with diabetes insipidus as the first symptom: a case report and literature review
Luxi SONG ; Cha GUO ; Yao ZHANG ; Shuang HAN ; Qingxia ZHANG ; Jin HUANG ; Chunkang CHANG
Journal of Leukemia & Lymphoma 2014;23(12):743-745
Objective To study the clinical features and differential diagnosis of Langerhans cell histiocytosis (LCH).Methods A case of LCH was reported and the literatures were reviewed.Results The of multisystem LCH patient,presented with a diabetes insipidus (DI) and panhypopituitarism,was 44 years old,and developed costal,tibial and femoral multiple lesions.The final diagnosis as LCH was made based on biopsy of tibia and lymph nodes.The biopsy specimen showed that the cells were infiltrated exhibiting the characteristic morphologic features of Langerhans cell (LC) with a convoluted shape,elongated nuclei exhibiting longitudinal grooves,and immunohistochemistry results revealed positive LC for the S-100,CD1a and Langerin immunostaining.Conclusions LCH may range from a solitary lytic bone lesion (for example eosinophilic granuloma) with a favorable course to a fatal disseminated leukaemia-like form.LCH typically involves the bone,lesions almost can be found in all organs.DI and CNS involvement often present as a puzzling syndrome,which renders the diagnosis problematicly,and often delays the diagnosis of LCH.The damage to the pituitary/hypothalamus axis results in life-long hormonal replacement therapy.
6.Therapeutic effect of adipose-derived mesenchymal stem cells on radiation enteritis
Pengyu CHANG ; Shuang CUI ; Jinghua LUO ; Chao QU ; Xin JIANG ; Yaqin QU ; Lihua DONG
Chinese Journal of Radiological Medicine and Protection 2014;34(10):729-734
Objective To evaluate the therapeutic effect of adipose-derived mesenchymal stem cells on radiation enteritis.Methods A total of 52 male Sprague-Dawley rats were used in the present study.Herein,46 rats were randomly selected and irradiated with a dose of 15 Gy at their abdomens.Two hours post-irradiation,23 rats were randomly selected and infused intraperitoneally with adipose-derived mesenchymal stem cells in passage 6 from young-female donor.The other 23 rats were intraperitoneally infused with PBS.The rest 6 rats were set as normal control.During the first 10 days post-irradiation,peripheral blood-samples from irradiated rats were harvested for testing the levels of IL-10 in serum using ELISA assay.Additionally,after isolating the thymic cells and peripheral blood mononuclear cells,the percentages of CD4/CD25/Foxp(3)-positive regulatory T cells in thymus and peripheral blood were tested by flow-cytometry.Finally,infiltration of inflammatory cells and deposition of collagens within irradiated small intestine were analyzed by H&E staining and Masson Trichrome staining,respectively.Based on the MPO-immunohistochemistry staining,the type of infiltrated cells was identified.The Kaplan-Meier method was used for analyzing the survival rate of irradiated rats.Results During a period of 30 days post-irradiation,the irradiated rats receiving adipose-derived mesenchymal stem cells survived longer than those receiving PBS (t =4.53,P < 0.05).Compared to the irradiated rats with PBS-treatment,adipose-derived mesenchymal stem cells could elevate the level of IL-10 in serum (7 d:t =13.93,P < 0.05) and increase the percentages of CD4/CD25/Foxp(3)-positive regulatory T cells in both peripheral blood (3.5 d:t =7.72,7 d:t=11.11,10 d:t =6.99,P <0.05) and thymus (7 d:t =16.17,10 d:t =12.12,P< 0.05).Moreover,infiltration of inflammatory cells and deposition of collagens within irradiated small intestine were mitigated by adipose-derived mesenchymal stem cells.Conclusions Adipose-derived mesenchymal stem cells were capable of curing radiation enteritis.
7.Analysis of volatile sulfur compounds production of oral cavity in preschool children and influencing factors
Qun ZHANG ; Xuenan LIU ; Qing CHANG ; Shuang AO ; Shuguo ZHENG ; Tao XU
Journal of Peking University(Health Sciences) 2015;47(6):983-989
Objective:To investigate the prevalence of volatile sulfur compounds ( VSC ) in oral cavity of preschool children, and to analyze related factors, thus to provide scientific basis for the prediction and treatment of halitosis. Methods:The VSC content ( hydrogen sulfide, methyl mercaptan, dimethyl sul-fide) of 170 preschool children (4 to 6 years old) was detected by a portable gas chromatograph Oral-ChromaTM . The status of the oral health was evaluated. The living habits and other aspects were obtained through questionnaires from the children' s parents. A soft package for social statistics version 13. 0 ( SPSS 13 . 0 ) was used in which univariate analysis and multivariate analysis were utilized to analyze the related factors of halitosis in children. Results:In the study, 34. 4% of the total subjects had excessive VSC. Hydrogen sulfide (H2S) [(1. 59 ± 2. 41) ng/10 mL] and total VSC concentration [(2. 14 ± 4. 42) ng/10 mL] in the girls were significantly higher (P<0. 05) than those in the boys. The tongue coating score had a significant positive correlation with H2S [tongue coating area (1. 68 ± 2. 48) ng/10 mL,tongue coating thickness (2. 18 ± 2. 69) ng/10 mL] and total VSC concentration [ tongue coating area, (2. 26 ± 4. 31) ng/10 mL,tongue coating thickness (2. 41 ± 3. 02) ng/10 mL , P<0. 01]. The site number of DI-S≥2 had a significant positive correlation with methyl mercaptan ( CH3 SH) and dime-thyl sulfide [(CH3)2S] concentration (P<0. 01). The concentration of H2S [(1. 19 ± 1. 62) ng/10 mL] in children, whose mother had a higher degree of education, was statistically lower (P<0. 01).The children who took dessert or sweat drinks more frequently had lower H2S [(1. 04 ± 1. 55) ng/10 mL, P<0. 05] concentration, while CH3SH and (CH3)2S concentration [(0. 29 ± 1. 92) ng/10 mL, (0. 37 ± 2. 06) ng/10 mL, P<0. 05) were higher in the children with mouth -breath habit. Conclu-sion:A high prevalence of halitosis was noted in preschool children. Gender, tongue coating index, deb-ris index-simplified, status of the mother' s education, frequency of eating dessert or sweat drinks and dry mouth breath were related with halitosis of preschool children. The different related factors resulted in changes of each VSC concentration.
8.Adipose-derived mesenchymal stem cell therapy for radiation-induced vascular injury in small intestine of rat
Pengyu CHANG ; Shuang CUI ; Xin JIANG ; Chao QU ; Xinping JIANG ; Jinghua LUO ; Yaqin QU ; Lihua DONG
Chinese Journal of Radiological Medicine and Protection 2014;(9):652-657
Objective To assess the therapeutic effect of human adipose-derived mesenchymal stem cells on radiation-induced vascular injury in the small intestine of rat. Methods A total of 34 male Sprague-Dawley rats were enrolled in this study. To establish a model of radiation-induced intestinal injury, each rat was irradiated with 15 Gy in whole abdomen. 17 rats were randomly selected and infused intraperitoneally with passage 6 ( P6 ) Ad-MSCs, and the other 17 rats that received PBS were set as control. 10 days post-irradiation, the number of CD31+ endothelial cells in the small intestine villus was measured by flow-cytometry, the expressions of CD31, CD105 and isolectin-B4 in the na?ve endothelial cells with detected by IHC-staining, and the vascular integrity was evaluated by measuring VE-Cadherin. The origination of na?ve endothelial cells within injured intestine was also analyzed. In addition, total mRNA were extracted from irradiated small intestine to assay the expressions of VEGF, bFGF, Flk-1 and SDF-1 using quantitative Real-time PCR. Results Compared to the control, the amount of CD31-postive endothelial cells within irradiated intestine was significantly increased after Ad-MSCs infusion ( t=12?15, P<0?05). The microvascular density in the injured sites was also significantly increased by the infusion of Ad-MSCs (20 d:t=10?33, P<0. 05;30 d:t=32?85, P<0?05). Moreover, the expressions of VEGF, bFGF, Flk-1 and SDF-1 were significantly up-regulated after delivery of Ad-MSCs ( VEGF:t =10?34, bFGF:t=11?25,Flk-1:t=6?73, SDF-1:t=6?73, all P<0?05), which was beneficial in maintaining the integrity of intra-villus blood-vessels as well as promoting neovascularization in the injured sites. Conclusion Ad-MSCs had potentials in healing radiation-induced vascular injury in rat small intestine.
9.Clinical significance of integrin?_5?_1,Fn and CD_(44v6) expression in ovarian epithelial neoplasms
Rui-Xia CHANG ; Jian-Ping WEI ; Shuang-Ling JIN ; Rui WANG ;
Cancer Research and Clinic 1997;0(03):-
Objective Through the investigating the molecular expressions of integrin?_5?_1,Fn and CD_(44v6) in ovarian epithelial neoplasms,this study is trying to explore the relationship between the lymphatic spread of the tumor with these molecules.Methods The expression of 80 cases of integrin?_5?_1,Fn and CD_(44v6) was examined through ElivisionTM immunohistochemistry method in ovarian epithelial neoplasm.The system of image analysis was used to measure the expression of various molecules quantitatively.Results Qualitative and semi-quantitative results:The expression levels of integrin?_5?_1 and Fn in the ovarian epithe- lial neoplasms had downward tendency in the order of benign,boundary and malignant neoplasms and there was a significant difference in the expression levels of integrin?_5?_1 and Fn(P
10.A study to investigate the prevalence of animal plague in Horqin Right Wing Front County, Inner Mongolia,2012
Shuang-quan, XIN ; Chang-shan, GUO ; Yan, HAI ; Wu-yun, BAI ; Zhen-qiang, WANG
Chinese Journal of Endemiology 2013;32(6):648-650
Objectives To investigate the prevalence of animal plague in Horqin Right Front County and provide scientific bases for prevention and treatment of the disease.Methods Plague surveillance was carried out according to the requirements of National Plague Monitoring Programme at 3 monitoring points in Horqin Right Front County in 2012.Squirrel density,the number of small rats,rat fleas,pathogenic and serological surveillance of Yersinia pestis were included in the study.Results A total of 356 dauricus were captured,the average density was 0.88 rats/hm2; female and male ratio was 1 ∶ 1.31 and the female embryo rate was 96.46%.The captured 13 small nocturnal mice belonged to 2 species,which included 10 cricetulus barabensis and 3 cricetulus longicaudatus,and the capture rate of small nocturnal mouse was 4.33% (13/300).A total of 98 rat fleas were collected from 25 rats; rat flea carrying rate was 100%(25/25) and flea index was 3.92.Eighty rat burrows were detected,and flea index was 0.188.Pathogen test results were negative.Indirect hemagglutination test was used to examine 356 rat sera and 1 serum was positive.Conclusions Detection of positive rat sera has proved the existence of plague epidemic in Horqin Right Front County.Therefore,the work on plague prevention and control has a long way to go.