To investigate the effect of pancreatic elastase on diabetic nephropathy,104 cases of type Ⅱ diabetic patients were selected as control group and group treated with elastase separately for a course of 6 months.The results showed that pancreatic elastase reduced microproteinuria significantly,especially mi- croalbuminuria and microtransfer rrinuria which reflect the glomerular filtration rate.It was concluded that elastase could improve early diabetic nephropathy and might have some protective effect as well.At the same time,elastase had some good effect on lipid and lipoprotein metabolism.

Objective To investigate the relationship between serum nitric oxide (NO) and bone metabolism in streptozotocin induced early diabetic (STZ DM) rats. Methods Twenty SD rats were divided into 2 groups, 12 STZ DM rats and 8 controls. Fasting blood glucose, HbA 1c , serum insulin, bone mineral density (BMD) (whole body, lumbar and femoral bone), bone metabolic parameters 〔such as serum calcium, vitamin D 3, parathyroid hormone (PTH), calcitonin, osteocalcin, and urinary pyridinoline/creatinine〕, as well as serum NO were measured. Results Compared with the controls, serum NO in STZ DM group significantly elevated 〔(51.3?11.9 vs 38.1?12.0)?mol/L, P

Objective To investigate the effect of human epidermal growth factor receptor-2 (HER2) silenced by lentivirus-mediated RNA interference (RNAi) on the growth of SKOV-3 ovarian cancer,and to explore the value of radioimmunoimaging in monitoring the biotherapy of RNAi.Methods The ovarian cancer cell line SKOV-3 was infected with lentivirus-mediated HER2-short hairpin (sh) RNA expression vector and scrambled control lentivirus vector,respectively.Both infected cells were inoculated into nude mice to establish two ovarian cancer xenograft models:knock down 1 (KD1) group and normal control (NC) group.The uninfected SKOV-3 xenograft model served as blank control (CON) group.The tumor formation rate,tumor generation time and tumor size at different time points were measured.The expression of HER2 protein was measured by immunohistochemistry.1n Ⅰ-Herceptin was injected before radioimmunoimaging,and the T/B ratios were acquired.One-way analysis of variance and the least significant difference (LSD)-t test were performed with SPSS 17.0.Results All mice models were constructed successfully (100％,15/15).The average time of tumor generation was (4.583±0.520) d,(4.567±0.284) d and (6.023±0.316) d in CON,NC and KD1 groups,respectively(F=13.946,P＜0.01).The tumor formation time of KD1 group was significantly longer than the other two groups (t=4.557,4.608,both P＜0.01),respectively.On the 28th day after the tumor cell implantation,the tumor size was significantly different among the three groups (F=26.343,P＜0.01).The tumor mass was (0.614±0.135) g,(0.558±0.190) g and (0.120±0.489) g in CON,NC and KD1 groups,respectively (F=225.026,P＜0.01).Both the tumor size (t=7.125,4.759) and tumor mass (t=19.158,16.977) of KD1 group were significantly less than those of CON and NC groups (all P＜0.01),respectively.Immunohistochemical results showed that the HER2 protein expression was inhibited in the KD1 group.The tumor could be visualized clearly on radioimmunoimaging at different time points.The T/B ratio of the KD1 group (0.208-4.427) was significantly lower than those of the other two groups at any intervals (0.576-5.508,0.640-5.695; F=9.197-39.375,all P＜0.05).Conclusions The growth of SKOV-3 could be inhibited remarkably by lentivirus-mediated HER2-siRNA.Radioimmunoimaging with 1nI-Herceptin might positively correlate with the expression of HER2 protein,which might have potential for monitoring the biotherapy of RNAi targeting HER2.

Clinical research design is the beginning and the cornerstone for clinical research,and it functions as the preliminary step of translational research.In order to improve clinical research ability,foster quality research talents team,and to promote the development of translational research,Peking Union Medical College Hospital (PUMCH) started to provide the online course Designing Clinical Research (DCR),which has greatly contributed to enhancing clinical research capacity.The management of DCR online course serves as a great exploration on training junior medical professionals and international research collaboration.This study aims at sharing the management experiences of clinical research design and junior talents training.

Objective To investigate the levels of oxidative stress in liver tissues of hepatocelluar carcinoma(HCC)patients after transcatheter arterial chemotherapy(TAC).Methods Immunohistochemistry streptavidin biotinylated peroxidase(S-P)method was used to detect the cellular levels of 8-hydroxy-2'-deoxyguanosine(8-OHdG),p53 and p21~(waf1/cip1).Eighty-nine HCC patients were divided into TAC group(39 cases)and Non-TAC group(50 cases).15 Non-HCC liver tissues served as controls.Result 8-OHdG level was higher in Non-TAC group than that in TAC group in tumor tissues (F=9.516,P＜0.05),with that being the lowest in control group(F=9.516,P＜0.01);8-OHdG levels in cancer tissues were significantly higher than that in tumor surrounding tissues in both TAC group (t=7.101,P＜0.001)and Non-TAC group(t=8.020,P＜0.001),there was no significant difference of 8-OHdG levels between para-tumor tissues and controls.The levels of 8-OHdG between tumor and its surrounding tissues in TAC group(r=0.651,P＜0.001)and non-TAC group(r=0.493,P＜0.01)was in positive correlation.The difference of p53 levels in cancer tissues in TAC group and Non-TAC group were not statistically significant and p53 was not detected in para-tumor tissues.The difference of p21~(waf1/cip1) levels among TAC group,Non-TAC group and controls was statistically significant,the levels of p21~(waf1/cip1) in normal group was the highest(F=13.459,P＜0.001),followed by that in TAC and Non-TAC group in cancer tissues(TAC vs.Non-TAC group,P＜0.01);p21~(waf1/cip1) expression in normal controls was significantly higher than that in both TAC and Non-TAC group in para-tumor tissues(F=16.613,P＜0.001).The correlation of p21 ~(waf1/cip1) levels between tumor and its surrounding tissues was significant in non-TAC group(r=0.872,P＜0.001).Conclusions Oxidative stress levels in HCC tumor tissues were higher than in para-tumor tissues and non-HCC liver tissues.Cancer cells probably survive chemotherapy by fortifying oxidative stress repair mechanism.

Objective:To analyze the sequence of a novel HLA- DPB1 allele in an individual. Methods:A individual identified from the database of blood donors for matched platelet transfusion at the Blood Center of Zhejiang Province in May 2022 was selected as the study subject. HLA genotype of the individual was determined by next-generation sequencing (NGS) on an Ion Torrent S5 platform. The sequence of the HLA- DPB1 locus was also determined by NGS on an Illumina Miseq platform and third generation sequencing using Oxford Nanopore MinION. This study was approved by Medical Ethics Committee of the Blood Center of Zhejiang Province (Ethics No. 2021-001). Results:A novel HLA- DPB1*02 allele was identified in the specimen, for which the closest genotype was HLA- DPB1*02: new, 17: 01: 01G, with the variant located in exon 3. Meanwhile, the NGS also revealed a novel HLA- DPB1*17 allele, with the closest genotype being HLA- DPB1*02: 01: 02G, 17: new. Both the HLA- DPB1*17: 01: 01: 01 and novel HLA- DPB1*02 alleles were identified by third-generation sequencing. Compared with the HLA- DPB1*02: 01: 02: 01 allele, the novel allele had a G>A variation at position 369 in the exon 3, which did not result in amino acid change. Conclusion:A novel HLA- DPB1 allele has been identified and validated by both NGS and TGS, which has been named as HLA- DPB1*02: 01: 69 by the World Health Organization Committee on Nomenclature of Factors of the HLA System.

Mindful self-care (MSC) involves paying attention to what is happening in the mind, body, and external environment in the present moment with curiosity and kindness. In recent years, mindfulness has become a key topic in the medical field. MSC abilities have been shown to significantly improve empathy fatigue, job burnout and emotional stability in medical and nursing staff. By summarizing and sorting out the existing research, this article reviews the overview, current situation, impact on individuals, relevant assessment tools and intervention methods of MSC, so as to provide a reference for domestic research on MSC.

Objective: To explore the relationship of family function with sleep and externalizing problem behaviors of preschool children, so as to provide a guidance for externalizing problem prevention and intervention among preschool children. Methods: From October 2023 to January 2024, a convenience sampling method was used to select 5 138 preschool children from kindergartens in 8 districts of Wuhan City, Hubei Province. Parents completed the survey for Family Adaptability and Cohesion Scale, children s sleep habits and Child Behavior Checklist (CBCL). Spearman correlation analysis was used to examine the correlation of family function with scores of sleep quality and externalizing problem behaviors among preschool children. A mediation model analysis and bootstrap test were conducted to further investigate the mediating role of sleep quality between family function and externalizing problem behaviors. Mplus 8.7 software was used for latent profile analysis of family function. Results: The reported rates of poor sleep quality and externalizing problem behaviors among preschool children were 11.8% ( n =607), 20.0% ( n =1 026). The relevant analysis results showed that family function was negatively correlated with sleep quality and externalizing problem behaviors ( r = -0.20, -0.23), and sleep quality was positively correlated with externalizing problem behaviors ( r =0.27) ( P <0.01). The mediation effect test showed that family function negatively predicted externalizing problem behaviors ( β =-0.079) and sleep quality ( β = -0.075), while sleep quality positively predicted externalizing problem behaviors ( β =0.215) ( P <0.01). The latent profile analysis results showed that family function could be classified into 4 categories: high family function group (23.01%), upper middle family function group (44.65%), moderate family function group (26.24%) and low family function group (6.11%). Compared to high family function, the other three categories significantly positively predicted externalizing problem behaviors, and the mediating effects of sleep quality on different categories of family function were statistically significant [upper middle family function: mediation effect value was 0.022 (95% CI =0.004-0.041) and direct effect value was 0.329 (95% CI =0.263-0.396); middle family function: mediation effect value was 0.087 (95% CI =0.063-0.115) and direct effect value was 0.491 (95% CI =0.416-0.565); low family function: mediation effect value was 0.144 (95% CI =0.107-0.185) and direct effect 0.621 (95% CI =0.503-0.740)] ( P < 0.05 ). Conclusion Family function negatively predicts the externalizing problem behaviors of preschool children, and sleep quality plays a partial mediating role.

The competency-based medical education has formed a global trend, and puts forward a greater challenge for educational design of resident training. The traditional curriculum cannot meet the goal of competency-based education as the curriculum design is lack of theoretical support. Curriculum design is the core of training content, and serves as a significant contributing factor of training outcome. Based on the six-step approach curriculum design, the theory and practice are integrated to form a curriculum design based on theoretical guidance. Through feedback evaluation, the current curriculum design is continuously improved in order to achieve a higher competency-based training quality. With the 5-year experiences and practice, preliminary reform demonstrates effectiveness. The current study hopes to share the teaching reform experiences of residency training base and provide references for colleagues of medical education.

OBJECTIVE: To detect loss of heterozygosity (LOH) at human leukocyte antigen (HLA) loci in a Chinese patient with leukemia after haploidentical hematopoietic stem cell transplantation. METHODS: HLA genotyping was carried out on peripheral blood, hair follicle and buccal swab samples derived from the patient after the transplantation as well as peripheral blood samples from his parents by using PCR-sequence specific oligonucleotide probe method and PCR-sequence based typing method. Short tandem repeat (STR) loci were detected by using a 23 site STR assay kit and a self-developed 6 STR loci assay for the HLA regions. RESULTS: After the transplantation, the HLA genotype of the peripheral blood sample of the patient was identical to his father. The patient was HLA-A*02:01,24:02, C*03:03,03:04, B*13:01,15:01, DRB1*08:03,12:02, DQB1*03:01,06:01 for his hair follicle specimen. However, homozygosity of the HLA loci was found in his buccal swab sample. Only the HLA-A*24:02-C*03:03-B*15:01-DRB1*08:03-DQB1*06:01 haplotype from his father's was present, while the HLA-A*02:01-C*03:04-B*13:01-DRB1*12:02-DQB1*03:01 haplotype from his mother was lost. After the transplantation, the alleles of the 23 STR sites in the patient's peripheral blood sample were consistent to his father, with no allelic loss detected in his buccal swab sample. However, at least 4 STR loci in the HLA region were lost in his buccal swab sample. CONCLUSION LOH at the HLA loci has been detected in the buccal swab sample of a patient with leukemia who received haploidentical hematopoietic stem cell transplantation.
HLA Antigens/genetics* ; HLA-A Antigens/genetics* ; Histocompatibility Antigens Class I/genetics* ; Humans ; Leukemia/genetics* ; Loss of Heterozygosity