Objective:To explore the correlation between the self-directed learning ability of medical students and the effect of flipped classroom teaching.Methods:The questionnaire survey was used. From November to December 2020, 123 students of 5-year program enrolled in 2019 in Peking University Health Science Center were chosen as the study objects and Neurobiology is a required course for them. The Medical Students' Autonomous Learning Ability Assessment Scale (MSALAAS) was used to assess the students' self-directed learning ability. The final examination score and a questionnaire survey were used to assess the teaching effect of the course. Descriptive analysis and Mann-Whitney analysis were used to analyze the change of self-directed learning ability of students after the course. One-dimensional linear regression was used to analyze the influence of self-directed learning ability on the final examination score, course experience and course assessment. Results:The total score of MSALAAS was increased from [(109.84 ± 14.12) points] to [(113.65±15.88) points] ( P<0.05) after the course. If the total score of the MSALAAS was referred to as an independent variant, and the final examination score, the course experience and course assessment was referred to as a dependent variable, respectively. The one-dimensional linear regression analysis showed that the total score of the MSALAAS was correlated with the final examination score ( B=0.248, t=3.59, P<0.001), the course experience ( B=0.049, t=3.15, P=0.002) and course assessment ( B=0.048, t=3.18, P=0.002). Conclusion:Flipped classroom teaching can promote the improvement of the self-directed learning ability of medical students. In converse, the students with higher self-directed learning ability might achieve higher examination score and get the better course experience and assessment.

OBJECTIVES: To investigate the distribution characteristics and correlation of intestinal and pharyngeal microbiota in early neonates. METHODS: Full-term healthy neonates who were born in Shanghai Pudong New Area Maternal and Child Health Hospital from September 2021 to January 2022 and were given mixed feeding were enrolled. The 16S rRNA sequencing technique was used to analyze the stool and pharyngeal swab samples collected on the day of birth and days 5-7 after birth, and the composition and function of intestinal and pharyngeal microbiota were analyzed and compared. RESULTS: The diversity analysis showed that the diversity of pharyngeal microbiota was higher than that of intestinal microbiota in early neonates, but the difference was not statistically significant (P>0.05). On the day of birth, the relative abundance of Proteobacteria in the intestine was significantly higher than that in the pharynx (P<0.05). On days 5-7 after birth, the relative abundance of Actinobacteria and Proteobacteria in the intestine was significantly higher than that in the pharynx (P<0.05), and the relative abundance of Firmicutes in the intestine was significantly lower than that in the pharynx (P<0.05). At the genus level, there was no significant difference in the composition of dominant bacteria between the intestine and the pharynx on the day of birth (P>0.05), while on days 5-7 after birth, there were significant differences in the symbiotic bacteria of Streptococcus, Staphylococcus, Rothia, Bifidobacterium, and Escherichia-Shigella between the intestine and the pharynx (P<0.05). The analysis based on the database of Clusters of Orthologous Groups of proteins showed that pharyngeal microbiota was more concentrated on chromatin structure and dynamics and cytoskeleton, while intestinal microbiota was more abundant in RNA processing and modification, energy production and conversion, amino acid transport and metabolism, carbohydrate transport and metabolism, coenzyme transport and metabolism, and others (P<0.05). The Kyoto Encyclopedia of Genes and Genomes analysis showed that compared with pharyngeal microbiota, intestinal microbiota was more predictive of cell motility, cellular processes and signal transduction, endocrine system, excretory system, immune system, metabolic diseases, nervous system, and transcription parameters (P<0.05). CONCLUSIONS The composition and diversity of intestinal and pharyngeal microbiota of neonates are not significantly different at birth. The microbiota of these two ecological niches begin to differentiate and gradually exhibit distinct functions over time.
Humans ; Infant, Newborn ; Bacteria ; China ; High-Throughput Nucleotide Sequencing ; Intestines ; Microbiota ; Pharynx/microbiology* ; RNA, Ribosomal, 16S/genetics*

OBJECTIVE: To investigate the prognostic value of interim ¹⁸F-FDG PET/CT in patients with diffuse large B-cell lymphoma (DLBCL). METHODS: A total of 97 patients with pathologically diagnosed DLBCL at Sichuan Cancer Hospital and Institute from March 2015 to June 2020 were enrolled in this retrospective study. Receiver operating characteristic analysis (ROC) was used to calculate the optimum maximum standard uptake value reduction ratio (△SUVmax%) cut-off value. The prognostic value of △SUVmax% and Deauville five-point scale (5-PS) in patients with DLBCL was compared, and the determined prognostic factors were analyzed. RESULTS: ROC curve indicated that the optimum △SUV max% cut-off value was 74.9%. Patients with △SUVmax%≥74.9% had a lower rate of progression or recurrence than those with △SUVmax% < 74.9% (both P<0.001). Meanwhile, patients with 5-PS score < 4 also had a lower rate of progression or recurrence than those with 5-PS score≥4 (both P<0.001). △SUVmax% and 5-PS had high specificity (83.7% vs 83.7%) and negative predictive value (87.3% vs 84.9%), while low sensitivity (56.0% vs 52.2%) and positive predictive value (53.8% vs 50.0%). △SUVmax% was more sensitive than 5-PS for the corresponding parameters (78.3% vs 76.2%). Univariate analysis showed that Ann Arbor stage, international prognostic index of National Comprehensive Cancer Network (NCCN-IPI), △SUVmax% and 5-PS were associated with TTP and PFS (all P<0.001). Multivariate analysis showed that △SUVmax% was an independent predictor of TTP and PFS (P=0.031, P=0.023). CONCLUSION Both 5-PS and △SUVmax% can be used to evaluate the prognosis of DLBCL patients, but the predictive value of △SUVmax% is superior to that of 5-PS.
Fluorodeoxyglucose F18/therapeutic use* ; Humans ; Lymphoma, Large B-Cell, Diffuse/drug therapy* ; Positron Emission Tomography Computed Tomography ; Positron-Emission Tomography ; Prognosis ; Retrospective Studies ; Thiamine

Clear cell renal cell carcinoma (ccRCC) has been proved to be a metabolic disease with high

Objective To evaluate the effects of water body environments on the microbial community of Oncomelania hupensis snails in marshlands of the eastern Dongting Lake where natural extinction of O. hupensis snails are found, so as to explore the correlation between the natural extinction of O. hupensis snails and the microbial community in snails. Methods Snails were caged water bodies in the Qianliang Lake marshland (Qianliang Lake regions) where natural extinction of snails was found and in the Junshan Park marshland (Junshan Park regions) in the eastern Dongting Lake for 30 days, and then all snails were collected and identified for survival or death. DNA sequencing of the fungi and bacteria was performed in snails before and after immersion in waters, and the biodiversity and abundance were analyzed. Results The survival rates of O. hupensis snails were 28.0% (70/250) and 64.8% (162/250) in Qianliang Lake regions and Junshan Park regions 30 days after immersion in waters, respectively (χ² = 81.365, P < 0.01). The number of the fungal community and the biodiversity of the bacterial community were both greater in snails caged in Qianliang Lake regions post-immersion than pre-immersion, and there was a significant difference in the structure of the fungal and bacterial communities. The microbial community with a significant difference included Flavobacteriaceae,which was harmful to O. hupensis snails. Conclusion The water body environment affects the composition of the microbial community in O. hupensis snails in marshlands with natural snail distinction around the eastern Dongting Lake; however, further studies are required to investigate whether the natural distinction of snails is caused by water body environments-induced changes of the microbial spectrum in O. hupensis snails.

Objective To investigate the reasons of natural extinction of Oncomelania hupensis snails by comparing the difference of the water chemical properties between the snail-breeding marshland and non-snail marshland in Eastern Dongting Lake areas. Methods Three adjoining marshlands in Eastern Dongting Lake areas were selected, one was a snail-breeding marshland, the second was a non-snail marshland, and the third was a boundary zone between them. During the periods of water-rising season, wet season and water-falling season, the water samples from the bottom of 0.5 m were collected by the systematic random sampling method (200 m × 200 m grid method). In addition, the water samples below the surface of 0.5 m were also collected in the wet season. The physicochemical indexes of the sampling water were detected. Results According to the Surface Water Environmental Quality Standard (GB 3838–2002), the water quality indicators which were less than the detection limit were Cr, Cd, Zn, Hg, Cu, S－ and CN－ during the three sampling seasons. The pollutants which were slightly higher than Grade III but lower than Grade IV (Hg ≤ 1 μg/L, TP ≤ 0.1 mg/L) were Hg and TP. The pollutants below the Grade III included As and F－. The temperature and pH values were within the Grade III. The oxygen consumption indicators covering DO, COD and BOD in the water-rising season and wet season were within the Grade III, while the value of BOD was beyond the scope of Grade III but was between Grade Ⅳ (≤ 6 mg/L) and Grade V (≤ 10 mg/L) in the water-falling season. The differences of the water pollution indexes between the snail-breeding marshland and non-snail marshland were statistically significant, and these indexes included F－, As and pH in the water-rising season (P < 0.05); pH, BOD and Fat the surface layer in the wet season (P < 0.05); F－ at the bottom in the wet season (P < 0.05); TP and F－ in the water-falling season. Moreover, the above-mentioned indexes in the non-snail marshland of Qianliang Lake were higher than those in the snail-breeding marshland of Junshan Park. Thus, F－ was the only index which had statistical differences in every sampling season, and the concentration of F－ at the non-snail marshland was also higher than that at the snail-breeding marshland. In the water-rising season, the pH value at the non-snail marshland exceeded the suitable range for the growth of snails (6.8 to 7.8). Conclusion In the Eastern Dongting Lake area, the high concentration of F－ and pH of water may be responsible for the natural extinction of O. hupensis snails.

OBJECTIVE: To explore the value of water swallow test(WST)and simple two-step swallowing provocation test(SSPT)in the diagnosis of aspiration in patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS:87 hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease were recruited from the First Affiliated Hospital of Guangzhou Medical University during the period between December 2014 to December 2015. RESULTS: The number of patients of grade1,2,3,4 and 5 of water swallow test successively were 44,39,4,0 and 0. Patients with positive aspiration by the first-step(water injection of 0.4 mL)and the second-step(water injection of 2.0 m L)were 16 and 0. Patients with positive aspiration by radionuclide imaging was 35. Comparison of radionuclide imaging, the rate of missed diagnosis applying water swallow test was high 37.3%(31/83). Both the water swallow test and simple two-step swallowing provocation test have poor consistency with radionuclide imaging in the diagnosis of aspiration in patients with acute exacerbation of chronic obstructive pulmonary disease(McNemar consistency test P=0.00).CONCLUSION: There is a high rate of missed diagnosis applying water swallow test and simple two-step swallowing provocation test to diagnosis aspiration in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and combined use of multiple assessment methods can reduce the missed diagnosis rate of aspiration.

Five sesquiterpenoids were isolated from 90% ethanol extract of Croton yunnanensis by silica gel,Sephadex LH-20 column chromatography,as well as prep-HPLC methods. Based on MS,1 D and 2 D NMR spectral analyses,the structures of the five compounds were identified as 11-methoxyl alismol(1),6β,7β-epoxy-4α-hydroxyguaian-10-ene(orientalol C,2),multisalactone D(3),arvestonol(4),and 4,5-dihydroblumenol A(5). Compound 1 was a new guaiane-type sesquiterpenoid. Compounds 2-4 were isolated from the Croton genus for the first time,and compound 5 was obtained from this plant for the first time.
Croton ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Sesquiterpenes ; Sesquiterpenes, Guaiane

OBJECTIVE: We performed a pooled analysis to examine cigarette smoking and household passive smoke exposure in relation to the risk of human papillomavirus (HPV) infection and cervical intraepithelial neoplasia grade 2+ (CIN2+). METHODS: Data were pooled from 12 cross-sectional studies for cervical cancer screenings from 10 provinces of China in 1999–2007. A total of 16,422 women were analyzed, along with 2,392 high-risk-HPV (hr-HPV) positive women and 381 CIN2+ cases. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models controlling for sexual and non-sexual confounding factors. RESULTS: There was an excess risk between active smoking and hr-HPV infection and CIN2+. Adjusted OR for ever smokers vs. never smokers was 1.45 (95% CI=1.10–1.91), for hr-HPV infection and 1.89 (95% CI=1.03–3.44), for CIN2+. Passive smoking had a slightly increased risk on the hr-HPV infection with adjusted OR 1.11 (1.00–1.24), but no statistical association was observed between passive smoke exposure and CIN2+. Compared with the neither active nor passive smokers, both active and passive smokers had a 1.57-fold (95% CI=1.14–2.15) increased risk of HPV infection and a 1.99-fold (95% CI=1.02–3.88) risk of CIN2+. CONCLUSION: Our large multi-center cross-sectional study found active smoking could increase the risk of overall hr-HPV infection and CIN2+ adjusted by passive smoking and other factors. Passive smoking mildly increased the risk of HPV infection but not the CIN2+. An interaction existed between passive tobacco exposure and active smoking for hr-HPV infection and the CIN2+.
Asian Continental Ancestry Group ; Cervical Intraepithelial Neoplasia* ; China ; Cross-Sectional Studies ; Family Characteristics ; Female ; Humans* ; Logistic Models ; Mass Screening ; Odds Ratio ; Papillomaviridae ; Papillomavirus Infections* ; Smoke ; Smoking ; Tobacco ; Tobacco Smoke Pollution* ; Uterine Cervical Neoplasms

Objective To investigate the status of Cryptosporidium infection in the population in Nanjing City so as to pro-vide the evidence for the prevention and control of cryptosporidiosis. Methods A total of 100 fecal samples were collected from each of three districts(Liuhe,Qixia and Gaochun)and one hospital(Nanjing Zhongda Hospital)in 2015 and 2016 respective-ly. The fecal samples were detected for Cryptosporidium with microscopy(by using the gold amine phenol-modified acid-fast staining)and the positive samples were detected again for the molecular biology confirming by using the fluorescence quantita-tive PCR. Results During the two years,581 cases of normal population who lived in the city were surveyed and no Cryptospo-ridium infection was found. Among 202 cases of outpatients with chronic diarrhea,there were 9 Cryptosporidium positive cases with the microscope scanning method (4.46％),and among the 9 cases,7 cases showed obvious logarithmic amplification curves showing positive Cryptosporidium nucleic acid,but 2 cases without the obvious logarithmic amplification curves,and the Cryptosporidium nucleic acid positive rate was 3.47％. Conclusions Cryptosporidium infection is not found in the normal popu-lation of Nanjing City,but the Cryptosporidium infection is found in the chronic diarrhea patients. The results imply that we should strengthen the detection of Cryptosporidium in the chronic diarrhea patients,so as to provide the evidence for improving the diagnosis and treatment of cryptosporidiosis.