The sustainable development of the teaching staff is crucial to the overall advancement of medical education reform under the background of medical and educational collaboration. With the support of the Shanghai Key Teachers' Teaching Incentive Program, Shanghai Jiao Tong University School of Medicine has established the interdisciplinary and inter-school teaching teams for undergraduate students and broken though the "last mile" of fully implementing the medical teaching reform of organ-system integrated curriculum in the country. Meanwhile, we also has reformed hourly remuneration system, formulated rules and regulations corresponding to each link, and improved the supervision mechanism, which has consolidated the mechanism of medical and educational collaboration, promoted the development of community for teachers and comprehensively improved the quality of medical education.

The 2020 Nobel Prize in Chemistry recognized CRISPR-Cas9, a super-selective and precise gene editing tool. CRISPR-Cas9 has an obvious advantage in editing multiple genes in the same cell, and presents great potential in disease treatment and animal model construction. In recent years, CRISPR-Cas9 has been used to establish a series of rat models of drug metabolism and pharmacokinetics (DMPK), such as

The sustainable development of the teaching staff is crucial to the overall advancement of medical education reform under the background of medical and educational collaboration. With the support of the Shanghai Key Teachers' Teaching Incentive Program, Shanghai Jiao Tong University School of Medicine has established the interdisciplinary and inter-school teaching teams for undergraduate students and broken though the "last mile" of fully implementing the medical teaching reform of organ-system integrated curriculum in the country. Meanwhile, we also has reformed hourly remuneration system, formulated rules and regulations corresponding to each link, and improved the supervision mechanism, which has consolidated the mechanism of medical and educational collaboration, promoted the development of community for teachers and comprehensively improved the quality of medical education.

Objective:To evaluate the efficacy of proximal humerus internal locking system (PHILOS) via the minimally invasive plate osteosynthesis (MIPO) in the treatment of proximal humeral fractures.Methods:This retrospective study analyzed 30 elderly patients with proximal humeral fracture who had been treated by PHILOS via MIPO from September 2016 to March 2020 at Department of Orthopedic Surgery, People’s Hospital of Zhuxi County. They were 19 females and 11 males with an average age of 60.96 years (from 45 to 80 years). All patients were treated by closed reduction. After fracture reduction was confirmed by fluoroscopy, a minimally invasive incision was made below the acromion, with a couple of suture wires reserved at the rotator cuff attachments. A PHILOS plate was inserted at 4 mm lateral to the intertubercular sulcus, with the suture wires passing through the proximal suture holes on the PHILOS. After a lag screw was first screwed up into the compression hole on the PHILOS plate, the crossing suture wires were tightened up to resist the rotator cuff stress and maintain the internal inclination of the humeral head. Kirschner wires were used to temporarily stabilize the reduction. After satisfactory reduction and fine plate positions were confirmed by fluoroscopy, locking nails were screwed up. The internal inclination of the affected humeral head was compared between preoperation and the last follow-up. The therapeutic efficacy was evaluated by the shoulder Neer scoring system, and the visual analogue scale (VAS) pain scores and complications were recorded at the last follow-up.Results:All the 30 patients were followed for 6 to 18 months (average, 12 months). There was no incision infection, neurovascular injury, or internal fixation failure. Anatomical reduction was achieved in 25 patients and functional reduction in 5. The inclination of the humeral head was significantly improved. The VAS scores at the last follow-up averaged 1.9. Follow-up X-ray examination showed that bony union was achieved after 6 to 18 months (average, 9 months) for all patients. At the last follow-up, the inclination angle of the affected humeral head was 130°±5°, significantly improved compared with the preoperative 90°±11.2° ( P<0.05). All patients had good functional recovery of the shoulder. The efficacy was, according to the Neer shoulder scores at the last follow-up, excellent in 22, good in 6 and fair in 2 cases. Conclusions:Treatment of proximal humeral fractures using PHILOS via MIPO technique is suitable for patients with osteoporotic fracture, and may lead to fine therapeutic efficacy.

Objective: To investigate the current bedtime routine among Chinese children less than 3 years of age and explore its dose-dependent association with sleep duration and sleep quality. Method: Healthy full-term born children aged 0-35 months were selected by stratified cluster random sampling method from 8 provinces in China following the "Hospital of Province-City-County" sampling technical route during 2012-2013.Brief Infant Sleep Questionnaire(BISQ) was used to assess sleep conditions of these children.Children′s personal and family information was obtained by Shanghai Children′s Medical Center Socio-demographic Questionnaire.Both of these questionnaires were filled in by parents. The effects of bedtime routine on children′s sleep duration and quality were analyzed by multivariate analysis of variance. Result: The children′s average age was(12±10) months(n=1 304), of whom 689 were males (52.8%, 689/1 304). There were 48.5%(632/1 304)of the parents reported that their children had not established regular sleep routines. There was a consistent dose-dependent association between bedtime routine and sleep duration, as well as other indicators for sleep quality (all P<0.05). The more regular the sleep routines, the longer the sleep duration, the earlier the children went to sleep, the shorter the sleep onset latency, the fewer the nighttime wakeup and the shorter the nighttime waking.The nighttime sleep duration was significantly longer for those with a bedtime routine 'every night’ than those who 'never’ had a bedtime routine (9.5(95%CI: 9.4-9.6)vs. 8.9(95%CI: 8.6-9.3)h, t=3.345, P=0.001). Compared with children who never had bedtime routines, children with regular bedtime routines had fewer night wakeup (1.3(95%CI: 1.2-1.4) vs. 2.4( 95%CI: 2.0-2.9), t=3.182, P=0.001) and shorter night waking duration(16.6(95%CI: 14.6-18.8) vs. 59.2 (95%CI: 47.0-72.7)min, t=6.383, P<0.01). Conclusion The percentage of children who have established regular bedtime routine is low in China. There is significant dose-dependent association between regular bedtime routine and sleep outcomes, especially sleep quality. The more regular the sleep routines, the better the sleep quality.

Objective To explore the role of night waking in the cognitive development of infants and young toddlers. Method A total of 116 infants aged 2 to 30 months were randomly selected in Yiwu, Zhejiang from December 2011 to February 2013. Social-demographic factors were investigated through questionnaire;sleep information were collected via the Brief Infant Sleep Questionnaire (BISQ);Cognitive development was assessed in all infants using Baley development scale. Results The mean age was 12.99 month-old. 50.86%(59/116) were males. Ocassional night waking was reported in 5.26%, one night waking in 29.82%, multiple night waking accounted in 64.91%of children under one year old. Ocassional night waking was reported in 32.20%, one night waking in 45.76%, multiple night waking in 22.03%of children over one year old. The frequency of night waking was signiifcantly different between children under one year old and children over one year old (P<0.01). The average duration of waking was 0.49±0.31 h in children under one year old, and 0.31±0.48 h in children older than one year old, and the difference was signiifcantly different (Z=4.35, P<0.001). In children over one year old, the more frequent night waking, the lowered MDI scores (F=3.98, P=0.024). The waking duration was negatively correlated with MDI scores in children over one year old (r=-0.26, P=0.035). Neither night waking duration nor night waking frequency had signiifcant correlation with MDI scores in children under one year old. Multivariable linear regression conifrmed that night waking was an independent inlfuential factor of MDI and PDI scores in children over one year old. Conclusions Persistent night waking should warrant attention.

bThis study explored whether the transplantation of modified marrow stromal cells (MSCs) has angiogenic effects in a left middle cerebral artery occlusion infarction/reperfusion (MCAO I/R) rat model and preliminarily examined the mechanism of angiogenesis following cerebral infarction. MSCs were isolated by using a direct adherent method and cultured. Vascular endothelial growth factor (VEGF) was transfected into MSCs by employing the liposome transfection. The transfection efficiency was measured by the optical density method. The protein expression of VEGF gene before and after transfection was measured by Western blotting. SD rat model of transient occlusion of the left middle cerebral artery was established by using an approach of intra-luminal occlusion. Tetrazolium (TTC) and HE staining were performed to observe the cerebral infarction. ELISAs were used to measure the levels of VEGF in the rat cerebral tissues. The expression patterns of angiopoietin-2 (Ang-2) and CD34 in cells surrounding the area of infarction were immunohistochemistrically observed. Ang-2 protein expression in the tissue surrounding the area of infarction was measured by Western blotting. VEGF expression in the MSCs increased after transfection at a rate of approximately 28%±3.4%. ELISA showed that the expression of VEGF in the cerebral tissue was significantly increased after induction of infarction, peaking on the 4th day and decreasing to the levels of the sham surgery group (normal) within 7 to 10 days. The VEGF level was significantly higher at each time point in the VEGF-MSC and MSC groups compared to the model group. Moreover, the VEGF level was higher in the VEGF-MSC group than in the MSC group and stayed relatively high until the 10th day. The immunohistochemical results showed that 10 days after the infarction, the number of Ang-2 and CD34-expressing cells in the area surrounding the infarction was significantly higher in the VEGF-MSC group and the MSC group compared to the model group. Moreover, the VEGF level was higher in the VEGF-MSC group than the MSC group. A similar trend in Ang-2 protein expression was revealed by Western blotting. In the MCAO rat model transfected with modified MSCs over-expressing VEGF, compared to the MSC transplantation group, the concentration of VEGF was significantly increased in the brain tissue after cerebral infarction. In addition, the level of Ang-2 was up-regulated, with angiogenesis promoted, the blood supply to the areas surrounding the cerebral infarction increased, and neurological function improved. We are led to speculate that the synergistic effects of VEGF and Ang-2 may be responsible for the angiogenesis following cerebral infarction.
Angiopoietin-2 ; genetics ; metabolism ; Animals ; Bone Marrow ; metabolism ; pathology ; Cerebral Infarction ; genetics ; metabolism ; pathology ; Male ; Neovascularization, Pathologic ; genetics ; pathology ; Rats ; Rats, Sprague-Dawley ; Stromal Cells ; metabolism ; pathology ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

bThis study explored whether the transplantation of modified marrow stromal cells (MSCs) has angiogenic effects in a left middle cerebral artery occlusion infarction/reperfusion (MCAO I/R) rat model and preliminarily examined the mechanism of angiogenesis following cerebral infarction. MSCs were isolated by using a direct adherent method and cultured. Vascular endothelial growth factor (VEGF) was transfected into MSCs by employing the liposome transfection. The transfection efficiency was measured by the optical density method. The protein expression of VEGF gene before and after transfection was measured by Western blotting. SD rat model of transient occlusion of the left middle cerebral artery was established by using an approach of intra-luminal occlusion. Tetrazolium (TTC) and HE staining were performed to observe the cerebral infarction. ELISAs were used to measure the levels of VEGF in the rat cerebral tissues. The expression patterns of angiopoietin-2 (Ang-2) and CD34 in cells surrounding the area of infarction were immunohistochemistrically observed. Ang-2 protein expression in the tissue surrounding the area of infarction was measured by Western blotting. VEGF expression in the MSCs increased after transfection at a rate of approximately 28%±3.4%. ELISA showed that the expression of VEGF in the cerebral tissue was significantly increased after induction of infarction, peaking on the 4th day and decreasing to the levels of the sham surgery group (normal) within 7 to 10 days. The VEGF level was significantly higher at each time point in the VEGF-MSC and MSC groups compared to the model group. Moreover, the VEGF level was higher in the VEGF-MSC group than in the MSC group and stayed relatively high until the 10th day. The immunohistochemical results showed that 10 days after the infarction, the number of Ang-2 and CD34-expressing cells in the area surrounding the infarction was significantly higher in the VEGF-MSC group and the MSC group compared to the model group. Moreover, the VEGF level was higher in the VEGF-MSC group than the MSC group. A similar trend in Ang-2 protein expression was revealed by Western blotting. In the MCAO rat model transfected with modified MSCs over-expressing VEGF, compared to the MSC transplantation group, the concentration of VEGF was significantly increased in the brain tissue after cerebral infarction. In addition, the level of Ang-2 was up-regulated, with angiogenesis promoted, the blood supply to the areas surrounding the cerebral infarction increased, and neurological function improved. We are led to speculate that the synergistic effects of VEGF and Ang-2 may be responsible for the angiogenesis following cerebral infarction.

The curriculum construction of medical students' occupational career planning has its own character. Principles of curriculum construction siuh as practical object, professional content and target-oriented organization should be sticked to and four aspects of curriculum construction such as target,content, organization and evaluation. are discussed in detail.

The second-stage-supervisor activity carried out by Medical school,Shanghai Jiao Tong University had good effect on promotion of students'learning attitude and behavior and had some implications on current medical education reform. Take the teaching practice of College of Stomatology,Shanghai Jiao Tong University for example,we discussed the student-centered teaching focusing on extracurricular activities in medical education reform.