Objective:To explore the establishment, implementation, and application effect of the annual progressive assessment mode for standardized training of resident physicians in a medical laboratory base.Methods:Since 2020, the base has improved the annual progressive assessment system through assessment system establishment, question bank construction, routine assessment, rotation examination, and annual examination. This new assessment mode was adopted for the residency trainees enrolled in the base after 2020. The control group consisted of seven residency trainees enrolled before 2020, while the experimental group comprised 13 trainees enrolled in 2020 and later. The two groups were compared based on the rotation and annual examination scores of second- and third-year trainees, as well as their academic achievements. Additionally, teaching outcomes of the base before and after 2020 were analyzed. The t test, rank-sum test, and Fisher's exact test were performed using SPSS 27.00. Results:There were no significant differences in age, sex, and education level between the two groups. The experimental group showed significantly higher scores than the control group in theory assessment ( P<0.001 for second-year trainees and P=0.008 for third-year trainees) and skill assessment ( P<0.001 for second-year trainees and P=0.038 for third-year trainees) in rotation examination, as well as in theory assessment (both P<0.001) and skill assessment (both P<0.001) in annual examination. The improvement was particularly pronounced among second-year trainees. The trainees of the experimental group submitted 17 case reports in three years, and won awards at national conferences, provincial conferences, and institutional case speech competitions. In a national academic conference, the trainees won the second prize of "Excellent Case". Since 2020, we have been granted with our first teaching reform project and published our first teaching article. To date, we have obtained five teaching reform projects, published six teaching articles, and won multiple awards in provincial and institutional teaching competitions. Conclusions:The establishment of the annual progressive assessment mode is critical for training high-quality laboratory physicians, and puts forward higher requirements for residency training teachers.

Objective:To explore the establishment, implementation, and application effect of the annual progressive assessment mode for standardized training of resident physicians in a medical laboratory base.Methods:Since 2020, the base has improved the annual progressive assessment system through assessment system establishment, question bank construction, routine assessment, rotation examination, and annual examination. This new assessment mode was adopted for the residency trainees enrolled in the base after 2020. The control group consisted of seven residency trainees enrolled before 2020, while the experimental group comprised 13 trainees enrolled in 2020 and later. The two groups were compared based on the rotation and annual examination scores of second- and third-year trainees, as well as their academic achievements. Additionally, teaching outcomes of the base before and after 2020 were analyzed. The t test, rank-sum test, and Fisher's exact test were performed using SPSS 27.00. Results:There were no significant differences in age, sex, and education level between the two groups. The experimental group showed significantly higher scores than the control group in theory assessment ( P<0.001 for second-year trainees and P=0.008 for third-year trainees) and skill assessment ( P<0.001 for second-year trainees and P=0.038 for third-year trainees) in rotation examination, as well as in theory assessment (both P<0.001) and skill assessment (both P<0.001) in annual examination. The improvement was particularly pronounced among second-year trainees. The trainees of the experimental group submitted 17 case reports in three years, and won awards at national conferences, provincial conferences, and institutional case speech competitions. In a national academic conference, the trainees won the second prize of "Excellent Case". Since 2020, we have been granted with our first teaching reform project and published our first teaching article. To date, we have obtained five teaching reform projects, published six teaching articles, and won multiple awards in provincial and institutional teaching competitions. Conclusions:The establishment of the annual progressive assessment mode is critical for training high-quality laboratory physicians, and puts forward higher requirements for residency training teachers.

AIM:To investigate the influence and mechanisms of human pancreatic cancer tumor microenvironments on T-cell immunoglobulin mucin-3 (TIM-3) expression and function of dendritic cells (DCs).METHODS:Tumor-infiltrating dendritic cells (TIDC) and para-carcinoma tissue DCs were isolated by Ficoll-Hypaque density centrifugation from trypsinized pancreatic carcinoma tissues, and the peripheral blood mononuclear cells were isolated from pancre-atic cancer patients or healthy people.The expression of TIM-3 on DCs was detected by flow cytometry.DCs isolated from healthy people peripheral blood mononuclear cells were induced by rhGM-CSF and IL-4.The expression of TIM-3 in the DCs treated with the culture supernatants of Capan-2, SW1990 and Panc-1 pancreatic cancer cells or human skin fibroblast (Hs27) cells for 48 h, and in the DCs treated with supernatants of Capan-2 cells, anti-VEGF-R2, anti-IL-10 and EP2 re-ceptor blocking peptide were evaluated by flow cytometry.The releases of IFN-βand IL-12 in the culture supernatants of DCs pretreated with monoclonal antibody ( mAb) to TIM-3 or DNase+RNase, followed by stimulation with apoptotic Ca-pan-2 cells, were detected by ELISA.RESULTS:DCs in tumor microenvironments had higher expression of TIM-3 than the DCs from para-carcinoma tissues and pancreatic cancer patient or healthy people peripheral blood ( P<0.01 ) .TIM-3 expression in the DCs treated with the culture supernatants of Capan-2, SW1990 and Panc-1 pancreatic cancer cells for 48 h was much higher than that in Hs27 cells (P<0.05).Treatment with a combination of anti-VEGF-R2, anti-IL-10 and EP2 receptor blocking peptide largely diminished the upregulation of TIM-3 on the DCs mediated by Capan-2 cell superna-tants (P<0.05).The concentrations of IFN-βand IL-12 in the DCs with high expression level of TIM-3 were lower than those in the DCs with low TIM-3 expression level.Treatment with mAb to TIM-3 resulted in much more IFN-βand IL-12 releases (P<0.01), but DNase+RNase made this effect disappear.CONCLUSION:TIM-3 serves as a negative regula-tor of DCs innate immune responses in the pancreatic cancer microenvironments.The secretion of soluble factors to tumor microenvironment by pancreatic cancer cells, including IL-10, VEGF and PGE2 , may contribute to the regulation of TIM-3 expression.

To characterize the CD45RA+and CD45RO+T lymphocyte subsets in the peripheral blood of patients with cGVHD induced by allogeneic haematopoietic stem cell transplantation ( allo-HSCT ) and to explore their relations with the disease.Methods:The peripheral blood was collected from 64 patients after allo-HSCT,including 21 non-cGVHD patients,15 light grade cGVHD patients,18 mild grade cGVHD patients and 10 severe grade cGVHD patients,then CD4+CD45RA+,CD4+CD45RO+, CD8+CD45RA+and CD8+CD45RO+T lymphocyte subsets were detected by flow cytometry ( FCM).Results: Compared with the control,the percent of CD4+CD45RA+T lymphocyte in patients with light,mild and severe grade cGVHD decreased markedly (P<0.05),the percent of CD4+CD45RO+T lymphocyte increased markedly (P<0.05).But there were not obviously change in the patient with different grade cGVHD.The percent of CD8+CD45RA+,CD8+CD45RO+T lymphocyte did not change obviously.Conclusion:CD4+CD45RA+and CD4+CD45RO+may play an important role in the pathogenesis of cGVHD.

Objective To evaluate the protective effectiveness of intranasal immunizations with recombinated-pneumococcal autolysin(Re-LytA), which protects mice against local and systemic Streptococ- cus pneumoniae(Sp) infection. Methods Testing group (group A): CpG as an adjuvant, the mice were intranasally immunized with purified Re-LytA, obtained by affinity chromatograph. The negative control group(group B) were intranasally immunized with sterile saline. And the positive control group (group C) were received 23-valent polysaccharide commercial vaccine through intramuscular injection. All the samples were collected 2 weeks post the last immunization. The levels of antibody was determined by ELISA. Then the mice were challenged intraperitoneally and intranasally with Sp, respectively. The infection and coloniza- tion was followed by monitoring colony-forming units of Sp in the blood, homogenized lung, and nasopharyn- geal lavage fluid 4 days post intranasal immunization. The mice were observed daily to note the livability of each group. Results The level of the LytA antibody (IgG, IgA, slgA) in group A were higher than that in group B and C (P < 0.05). Neither the LytA nor polysaccharide antibody could be detected in group B. Polysaccharide antibody could be detected in group C. After challenged intraperitoneally there was no signifi- cant difference in survival rates between group A and group C (P > 0.05), which was significant higher than that in group B (P <0.05). After challenged intranasally, compared with the group A, the geometric mean colony-forming units washed from the nasopharyngeal lavage fluid of the group B and group C were signifi- cantly higher (P <0.05). Conclusion lntranasal immunizations with Re-LytA can protect mice against lo- cal and systemic pneumococcal infection, and the protective immunity may be related to sIgA.