To promote convergence education among national and international students, Nanjing Medical University designed an optional curriculum Two Sides of the Same Coin in Parasitic Diseases among international students for the Bachelor of Medicine and Bachelor of Surgery (MBBS) program, and a research-based teaching method was employed to teach 31 international students. This curriculum contained three parts, including parasitology-related knowledge, basic knowledge and skills of scientific research, and frontier topics in scientific research advances, and the assessment contents included course sign-in, classroom activity participation and scientific research presentation. Curriculum evaluation showed 100.0% (8/8) of students in batch 2018—2021, 81.8% (9/11) in batch 2022, and 83.3% (10/12) in batch 2023 with a total score of 80 points and higher, with median scores (interquartile range) of 91.1 (7.0), 90.8 (5.7) points and 90.8 (5.7) points, respectively (H = 0.04, P > 0.05). In addition, a questionnaire survey was performed with a Likert scale to assess the interests in curriculum learning, and the curriculum practicality and importance among 31 international students, and a total of 27 valid questionnaires were recovered, with a recovery rate of 87.1%. Questionnaire survey showed that the median total scores (interquartile range) were 7.0 (0.8) points among batch 2018—2021 students, 6.4 (1.4) points among batch 2022 students and 6.0 (1.1) points among batch 2023 students (H = 2.64, P > 0.05). Collectively, these data demonstrate that this optional curriculum improves the interests in parasitology learning of the international students for MBBS program, as well as their capability of self-directed learning, teamwork and innovative.

With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.

Information technology has become an important driver to facilitate higher education developments in the context of new medical sciences. A new “virtual-real combination” experimental teaching model was designed and created through integrating information technology with experimental teaching by Experimental Teaching Center of Basic Medical Sciences and Department of Pathogen Biology, Nanjing Medical University and was applied in Human Parasitology teaching, which achieved satisfactory teaching effectiveness. This new model showed effective to deepen the understanding of the basic human parasitology knowledge, improve the operative skills, and cultivate the moral literacy and comprehensive capability among medical students. This report presents the teaching protocols and implementation, teaching effectiveness and evaluation, and experiences of comprehensive schistosome experiments.

Microglial surveillance plays an essential role in clearing misfolded proteins such as amyloid-beta, tau, and α-synuclein aggregates in neurodegenerative diseases. However, due to the complex structure and ambiguous pathogenic species of the misfolded proteins, a universal approach to remove the misfolded proteins remains unavailable. Here, we found that a polyphenol, α-mangostin, reprogrammed metabolism in the disease-associated microglia through shifting glycolysis to oxidative phosphorylation, which holistically rejuvenated microglial surveillance capacity to enhance microglial phagocytosis and autophagy-mediated degradation of multiple misfolded proteins. Nanoformulation of α-mangostin efficiently delivered α-mangostin to microglia, relieved the reactive status and rejuvenated the misfolded-proteins clearance capacity of microglia, which thus impressively relieved the neuropathological changes in both Alzheimer's disease and Parkinson's disease model mice. These findings provide direct evidences for the concept of rejuvenating microglial surveillance of multiple misfolded proteins through metabolic reprogramming, and demonstrate nanoformulated α-mangostin as a potential and universal therapy against neurodegenerative diseases.

Insulin is produced and secreted by pancreatic β cells in the pancreas, which plays a key role in maintaining euglycemia. Insufficient secretion or deficient usage of insulin is the main cause of diabetes mellitus (DM). Drug therapy and islets transplantation are classical treatments for DM. Pancreatic β cell replacement therapy could help patients to get rid of drugs and alleviate the problem of lacking in transplantable donors. Pancreatic β-like cells can be acquired by cell reprogramming techniques or directed induction of stem cell differentiation. These cells are proved to be functional both in vitro and in vivo. Some hospitals have already performed clinical trials for pancreatic β cell replacement therapy. Functional pancreatic β-like cells, which obtained from in vitro pathway, could be a reliable source of cell therapy for treating DM. In this review, the approaches of obtaining pancreatic β cells are summarized and the remaining problems are discussed. Some thoughts are provided for further acquisition and application of pancreatic β cells.
Cell Differentiation ; Diabetes Mellitus/therapy* ; Humans ; Insulin/metabolism* ; Insulin-Secreting Cells/metabolism* ; Islets of Langerhans Transplantation ; Pancreas/metabolism*

Objective:To study the impact of preoperative serum HBV DNA levels on prognosis of hepatocellular carcinoma (HCC) patients undergoing hepatectomy with curative intent.Methods:The clinical data of patients with HCC treated by hepatectomy with curative intent at the Guangxi Medical University Cancer Hospital from January 2010 to December 2016 were retrospectively analyzed. According to the preoperative serum HBV DNA levels, patients were divided into three groups: the control group (HBV DNA negative), the low load group (<10 4 copy/ml) and the high load group (≥10 4 copy/ml). The clinical data of these patients were collected and long-term survival outcomes of these patients were followed-up. The Kaplan-Meier method was used to compare the overall survival (OS) and recurrence-free survival (RFS) rates among the three groups. Using the Barcelona clinic liver cancer classification (BCLC), patients with different serum HBV DNA levels were further divided into three subgroups: stage 0/A, stage B and stage C. The OS and RFS rates of patients in each of these subgroups were compared. Results:Of 1 180 patients who were enrolled in the study, there were 1 024 males and 156 females, aged (48.6±10.8) years. The 1-, 3- and 5-year OS rates for patients in the control group ( n=258) were 91.5%, 79.3% and 74.9%, respectively; while those in the low load group ( n=289) were 87.2%, 68.6% and 61.6%, respectively; and those in the high load group ( n=633) were 85.4%, 68.9% and 60.7%, respectively. The 1-, 3- and 5-year OS rates in the control group were significantly better than those in the low load group and the high load group ( P<0.05). The 1-, 2- and 3-year RFS rates in the control group were significantly higher than those in the high load group ( P<0.05). Subgroup analysis showed that in the BCLC 0/A subgroup ( n=786) the 1-, 3- and 5-year OS rates in the control group were significantly better than those in the high load group ( P<0.05). In the BCLC B subgroup ( n=181), the 1-, 2- and 3-year RFS rates in the control group were significantly higher than those in the high load group ( P<0.05). In the BCLC C subgroup ( n=214), there were no significant differences in the 1-, 3- and 5-year OS and 1-, 2- and 3-year RFS rates among the three groups ( P>0.05). Conclusion:For HCC patients undergoing hepatectomy with curative intent, the higher the preoperative serum HBV-DNA level, the worse the long-term survival outcomes.

Objective: To investigate the relationship between hope, mental suffering and quality of life in radiotherapy patients with cervical cancer, to provide the basis for the cancer patient′s psychological intervention. Methods: A cross-sectional study of 120 cases of radiotherapy cervical cancer patients was conducted, using the psychological distress thermometer, Herth Hope Scale, Life Quality Measurement Scale for patients with cervical cancer to evaluate patients′ hope, quality of life and psychological distress. Results: Radiotherapy cervical cancer patients′ psychological distress and hope were negatively correlated (r=-0.385, P <0.01), psychological distress and quality of life were negatively correlated (r=-0.602, P <0.01), hope and quality of life were positive correlation (r=0.711, P <0.01). Patients′ hope played partially mediated effect between psychological distress and quality of life, emotional status, functional status, played fully mediated effect between psychological distress and social family status. The Mediated effect sizes were 35.9%, 36.3%, 55.9% and 100.0%. Conclusions Psychological distress has not only a direct negative effect on the quality of life of cancer patients, but also an indirect negative effect through hope. During the Medical care, we should accurately assess of patient's psychological distress and hope, and take measures to help improve patients' hope and alleviate psychological distress, so as to improve patients′ quality of life.

Objective To investigate the epidemiological characteristics of nosocomial fungal infections in severe sepsis patients and analyze the influencing factors by logistic regression.Methods The clinical data of 578 patients with severe sepsis admitted to our hospital from January 2008 to January 2016 were retrospectively analyzed.The epidemiological characteristics were investigated.The possible influencing factors of nosocomial fungal infection were analyzed by univariate analysis and multivariate logistic regression analysis.Results Among 578 cases of severe sepsis,215 cases were accompanied by nosocomial fungal infection (infection rate 37.20％).The infection sites were mostly lungs and the fungal types were Candida albicans.The prognosis of the patients was poor.The survival time was less than 90 days,accounting for 42.33％ (91/215).There were significant differences in age,length of stay in intensive care unit (ICU),duration of more than two antibiotics,use of ventilators,hormones,invasive procedures,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score between the infected group and the uninfected group (P ＜ 0.05).The danger degree from high to low of the risk factors were ICU stay ≥ 100 h (OR =5.697),use respirator (OR =5.388),invasive operation (OR =4.987),age ≥65 years (OR =4.584),and continuous use of two antibiotics ＞ 7 d (OR =3.287),use steroid (OR =2.141).Conclusions Severe sepsis with hospital acquired fungal infection is more common in the lung,and most of them are Candida albicans infection,with poor prognosis and high mortality.ICU stay ≥ 100 h,use respirator and steroid,invasive operation,age ≥65 years,and continuous use of two antibiotics ＞ 7d are risk factors.Specific preventive measures should be taken to reduce fungal infections.

A molecularly imprinted two-dimensional photonic crystal hydrogel sensor was developed with erythromycin as imprinted molecule, polystyrene two-dimensional photonic crystal as templates, methanol as solvent, methacrylic acid as monomers and ethylene glycol dimethylacrylate as cross-linkers.The imprinted molecule was removed by methanol/acetic acid (9∶1, V/V).The results showed that the diameter of Debye ring increased 6 mm when the concentration of EM changed from 0 to 1×10-6 mol/L.Namely the lattice spacing decreased 30 nm.In addition, the diameter of Debye ring only increased 1.5 and 2.0 mm when the hydrogel immersed in 1×10-6 mol/L roxithromycin (RM) or erythromycin ethylsuccinate (EEs) solution.The result indicated that the sensor had high selectivity and could be used in determination of erythromycin with low cost and easy operation.

A biosensor was constructed to detect the endotoxin.The amine-terminated aptamer was immobilized on the gold electrode surface covered in advance with a self-assembled monolayer (SAM) of 3-mercaptopropionic acid (MPA).The modification of the gold electrode was confirmed by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS).It was found that MPA assembly time at 6 h in the gold electrode surface to form a stable self-assembled monolayer.The biosensor has a good linear relationship with concentration of endotoxin in the range of 0.001 ～0.1 EU/ml,it is possible to be applied for quality control in the actual biological sample.