To explore the cultivation path of excellent physicians in regional medical universities, a horizontal integration of clinical courses was performed to construct a curriculum centered on systemic diseases. Clinical courses adopted bedside rotation teaching with small class (30-40 students, 3-4 students/group). A comprehensive approach was designed and implemented, covering overall framework, organizational guarantee, teaching arrangement, teaching method, and assessment system. The effectiveness of the reform was evaluated through the comprehensive exams during the basic stage and national clinical medicine proficiency test. Despite no significant differences in the basic stage, the national clinical medicine proficiency test scores of the C2E class with teaching reform increased continuously from 2017 to 2020. The theoretical examination score of the C2E class was higher than that of regular classes 1 in 2017, 2019, and 2020. With continuous optimization, the skill examination score of the C2E class was significantly higher than that of regular class 1 in 2020. These findings highlight the effectiveness of the teaching reform and provide a foundation for the teaching reform of large class in five-year clinical medicine programs.

To explore the cultivation path of excellent physicians in regional medical universities, a horizontal integration of clinical courses was performed to construct a curriculum centered on systemic diseases. Clinical courses adopted bedside rotation teaching with small class (30-40 students, 3-4 students/group). A comprehensive approach was designed and implemented, covering overall framework, organizational guarantee, teaching arrangement, teaching method, and assessment system. The effectiveness of the reform was evaluated through the comprehensive exams during the basic stage and national clinical medicine proficiency test. Despite no significant differences in the basic stage, the national clinical medicine proficiency test scores of the C2E class with teaching reform increased continuously from 2017 to 2020. The theoretical examination score of the C2E class was higher than that of regular classes 1 in 2017, 2019, and 2020. With continuous optimization, the skill examination score of the C2E class was significantly higher than that of regular class 1 in 2020. These findings highlight the effectiveness of the teaching reform and provide a foundation for the teaching reform of large class in five-year clinical medicine programs.

Peroxisome proliferator-activated receptordelta (PPARdelta), as a downstream target of adenomatous polyposis coli (APC) signaling pathway, has been presumed to play some roles in colorectal carcinogenesis. However, the exact role of PPARdelta in colorectal cancer remains unclear. An HIV-1-based lentivirus packaging system was used for the construction of a lentiviral vector (lentivector) mediating RNA interference against PPARB. The direct sequencing demonstrated that the resulting lentivector containing the short-hairpin RNA expression cassette specifically targeting PPARdelta (sh-PPARdelta) was successfully constructed, and designated as pLVshPPARdelta. The control vector was designated as pLVControl. After the transduction, we observed highly efficient transduction (> 90%) of lentivirus in KM12C cells by fluorescent microscopy and fluorescence-activated cell sorting. Quantitative RT-PCR showed that pLVshPPARdelta lentivirus reduced PPARdelta mRNA expression by about 70.0% in KM12C cells as compared with that of the untreated cells (P < 0.05), while pLVControl had no significant effect on the PPARdelta mRNA level (P > 0.05). Western blot revealed an obvious reduction of PPARdelta protein expression in pLVshPPARdelta treated cells and showed no obvious difference between the control group and the untreated group. The results demonstrated that the lentivector mediating RNAi against PPARdelta was successfully constructed, which could stably knock down the PPARdelta expression in KM12C cells. This study finally provided a new cell model for the study of PPARdelta's function in colorectal cancer.
Cell Line, Tumor ; Colonic Neoplasms ; genetics ; pathology ; Gene Knockdown Techniques ; Genetic Vectors ; genetics ; Humans ; Lentivirus ; genetics ; metabolism ; PPAR delta ; biosynthesis ; genetics ; RNA Interference ; RNA, Messenger ; biosynthesis ; genetics ; RNA, Small Interfering ; genetics

Objective To study the prognostic value of circumferential resection margin(CRM)status. Methods Specimens of 62 patients with rectal cancer,who underwent total mesorectal excision from December,2001 to June,2002,were examined using whole-mount sections.All patients were followed up for 4～60 months. Results Circumferential resection margin involvement(CRMI)was identified in 12 specimens.while only 4 of them were cancer positive in the resection margin.Analyzed by logistic regression test,the occurrence of CRMI was related to tumor differentiation [ P=0.015,Exp(B)=0.131]and lymph node metastases[P=0.013,Exp(B)=7.488 ],but not tumor distance to anal verge(P=0.246).The difference in local recurrence rate,overall recurrence rate,disease-free survival rate and overall survival rate between CRMI and that of CRM negative,were significant(P=0.002,0.000,0.000 and 0.003,respectively). Conclusions CRMI is an accurate prognostic factor of recurrence and postoperative survival,and its occurrence is mainly determined by biologic characteristics of the tumor.TME could decrease the incidence of CRMI.

Objective To discuss the diagnostic value of DSA for massive hemorrhage in lower gastrointestinal tract resulting from tumour. Methods 24 patients with massive lower gastrointestinal hemorrhage were performed DSA and then operated as tumour. Results Among 24 patients, 17 cases demonstrated direct signs of hemorrhage, 9 cases visible turnout vessels; 24 patients all showed clumping tumour-specifie dyeing. Conclusion DSA is of great value to determining the location and qualitation of the massive lower gastrointestinal hemorrhage resuhing from tumours.