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Objective:To develop an inquiry learning community centered on learning experience in the course of Nursing Clinical Comprehensive Experiment to verify the influence of this teaching mode on the learning gains and practical ability of nursing students. Methods:A total of 132 undergraduate nursing students form grade 3 in Chongqing Medical University were enrolled. The participants were randomly assigned to a learning community group ( n = 69) and a control group ( n = 63) using Minitab 14.0 software. The students in the learning community group adopted the inquiry learning community mode in accordance with the curriculum map for online self-learning, group discussion and skills practice, while the control group received the teacher-led teaching mode for offline theory teaching, operation teaching and skills practice. After the teaching intervention, both groups of students received the assessment questionnaire of learning gains and the comprehensive experimental ability evaluation. Chi-square test or paired t-test was performed using SPSS 23.0. Results:Compared with the control group, students in the learning community group reported that their sense of learning gain was enhanced ( P<0.001, Cohen d=0.97); sub-items showed that the effect size for the understanding of learning content ( P<0.001, Cohen d=1.22), the overall course situation ( P<0.001, Cohen d=0.90), the course activities ( P=0.000, Cohen d=0.83), and the information obtained ( P<0.001, Cohen d=1.16) was significantly different. The total score of practical ability of comprehensive experiment was significantly improved ( P = 0.005, Cohen d=0.51), in which the experimental situation displays ( P=0.002, Cohen d=0.55) and experimental effect ( P=0.006, Cohen d=0.49) were better than the control group. There was no significant difference in the performance of experimental preparation and case analysis between the two groups. Conclusion:Developing an inquiry learning community in nursing clinical comprehensive experiment can effectively enhance student' sense of learning gains and promote the improvement of clinical practical ability.
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OBJECTIVE@#To investigate the effect of Akt2 inhibitor on macrophage polarization in the periapical tissue in a rat model of periapical inflammation.@*METHODS@#Rat models of periapical inflammation were established in 28 normal SD rats by opening the pulp cavity of the mandibular first molars, followed by injection of normal saline and Akt2 inhibitor into the left and right medullary cavities, respectively. Four rats without any treatment served as the healthy control group. At 7, 14, 21 and 28 days after modeling, 7 rat models and 1 control rat were randomly selected for observation of inflammatory infiltration in the periapical tissues by X-ray and HE staining. Immunohistochemistry was used to detect the expression and localization of Akt2, macrophages and the inflammatory mediators. RT-PCR was performed to detect the mRNA expressions of Akt2, CD86, CD163, inflammatory mediators, miR-155-5p and C/EBPβ to analyze the changes in macrophage polarization.@*RESULTS@#X-ray and HE staining showed that periapical inflammation was the most obvious at 21 days after modeling in the rats. Immunohistochemistry and RT-PCR showed that compared with those in the control rats, the expressions of Akt2, CD86, CD163, miR-155-5p, C/EBPβ, and IL-10 increased significantly in the rat models at 21 days (P < 0.05). Compared with saline treatment, treatment with the Akt2 inhibitor significantly decreased the expression levels of Akt2, CD86, miR-155-5p and IL-6 and the ratio of CD86+M1/CD163+M2 macrophages (P < 0.05) and increased the expression levels of CD163, C/EBPβ and IL-10 in the rat models (P < 0.05).@*CONCLUSION@#Inhibition of Akt2 can delay the progression of periapical inflammation in rats and promote M2 macrophage polarization in the periapical inflammatory microenvironment possibly by reducing miR-155-5p expression and activating the expression of C/EBPβ in the Akt signaling pathway.
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Rats , Animals , Proto-Oncogene Proteins c-akt/metabolism , MicroRNAs/genetics , Interleukin-10 , Rats, Sprague-Dawley , Macrophages/metabolism , Inflammation/metabolismABSTRACT
The widespread of tigecycline resistance gene tet(X4) has a serious impact on the clinical efficacy of tigecycline. The development of effective antibiotic adjuvants to combat the looming tigecycline resistance is needed. The synergistic activity between the natural compound β-thujaplicin and tigecycline in vitro was determined by the checkerboard broth microdilution assay and time-dependent killing curve. The mechanism underlining the synergistic effect between β-thujaplicin and tigecycline against tet(X4)-positive Escherichia coli was investigated by determining cell membrane permeability, bacterial intracellular reactive oxygen species (ROS) content, iron content, and tigecycline content. β-thujaplicin exhibited potentiation effect on tigecycline against tet(X4)-positive E. coli in vitro, and presented no significant hemolysis and cytotoxicity within the range of antibacterial concentrations. Mechanistic studies demonstrated that β-thujaplicin significantly increased the permeability of bacterial cell membranes, chelated bacterial intracellular iron, disrupted the iron homeostasis and significantly increased intracellular ROS level. The synergistic effect of β-thujaplicin and tigecycline was identified to be related to interfere with bacterial iron metabolism and facilitate bacterial cell membrane permeability. Our studies provided theoretical and practical data for the application of combined β-thujaplicin with tigecycline in the treatment of tet(X4)-positive E. coli infection.
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Humans , Tigecycline/pharmacology , Escherichia coli/metabolism , Reactive Oxygen Species/therapeutic use , Plasmids , Anti-Bacterial Agents/metabolism , Escherichia coli Infections/microbiology , Bacteria/genetics , Microbial Sensitivity TestsABSTRACT
B7-H6 has been discovered as a new member of the B7 family in recent years, it can specifically bind to the NKp30, an activated receptor of natural killer (NK) cells to mediate NK cells' tumor immunity killing effect. B7-H6 expression is upregulated in a wide variety of malignant tumor cells, but expression deficiency in normal tissue is detected. The intrinsic mechanism of B7-H6 regulation has been explored, and the treatment targeting B7-H6 has achieved a good effect in animal experiments, which shows a wide prospect of clinical application. This paper summarizes the latest progress of B7-H6 molecule in malignant tumors.
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Objective@#To understand the prophylaxis of population exposed to rabies, and provide a basis for prevention and control of rabies.@*Methods@#The registration data of 1 019 cases with rabies exposure in Beijing Ditan Hospital Affiliated to Capital Medical University from Mar, 2017 to Feb, 2018 were analyzed using the descriptive epidemiologic method.@*Results@#Among the 1 019 cases of rabies exposure, the sex ratio of men to women was 0.90∶1, with the highest proportion of them were between 26 and 46 years of age old, accounting for 46.5%. Rabies exposure reached its peak (46.9%) between June and September. In addition, 63.3% of the injuries were caused by dogs and 36.7% by cats. Most of the wounds (55.1%) occurred in hands; and the second was lower limbs (26.6%). Most of the cases (60.7%) had grade II wounds; followed by grade III wounds (39.1%); 69.3% of the cases completed immunization with rabies vaccine. In grade III exposure, 73.7% of the patients were immunized with rabies immunoglobulin. Most of the persons of grade III exposure (73.7%) received inoculation with human rabies immunoglobulin (HRIG).@*Conclusions@#Measures to control rabies should be focused on the management of dogs and cats and the standardization of rabies post-exposure prophylaxis.
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Objective@#To analyze the clinical response in cases of multi-victims bitten by a dog in Beijing (one of whom was HIV positive), and to explore the route and prognosis of dual exposure to rabies virus and HIV.@*Methods@#Descriptive epidemiological methods were used to analyze the exposed cases, the post-exposure prophylaxis(PEP) of rabies and HIV and the follow-up outcomes.@*Results@#After six months-follow up, there was no rabies case was found among those nine victims bitten by the suspected dog. In addition, six HIV-negative victims who had been exposed to HIV via dog saliva were consistently tested to be HIV negative in the follow up period.@*Conclusions@#In cases with multi-victims bitten by one dog, except exposure to rabies virus, it is necessary to be alert to the presence of HIV, HBV or HCV infection in sequential victims. Therefore, the risk of the potential spreading of other blood-borne infectious pathogens should be assessed. It is important to initiate PEP as early as possible.
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Objective To analyze the diagnostic sensitivity and related impact factors of T cell spot test of tuberculosis (T‐SPOT .TB ) test in acquired immunodeficiency syndrome (AIDS )/tuberculosis (TB) patients .Methods Ninety‐two confirmed cases with AIDS/TB coinfection were tested by T‐SPOT . TB ,and the impact of CD4+ T cells counts on the diagnostic sensitivity was analyzed .Multivariate Logistic analysis was used for the analysis of impact factors of T‐SPOT .TB sensitivity .Blood samples of 19 cases with advanced stage AIDS/TB from January 2015 to January 2016 were collected ,and peripheral blood mononuclear cell (PBMC ) were isolated by Ficoll method , and lymphocytes were isolated by Percoll method .McNemar test was used for the comparison of these two methods .Results Among the 92 patients with AIDS/TB ,T‐SPOT .TB tests were positive in 51 cases ,with positive rate of 55 .4% .The sensitivity was 26 .3% (10/38) when CD4+ T cell count less than 20/μL ,and that was 92 .9% (13/14) when CD4+ T cell more than 200/μL .In Logistic analysis ,the sensitivity of T‐SPOT .TB test in patients with extra‐pulmonary tuberculosis was better than that in pulmonary tuberculosis patients (OR=3 .042 , P=0 .038) .The sensitivity of T‐SPOT .TB was positively correlated with CD4+ T cell count ,and the sensitivity increased by 2 .889 times when CD4+ T cells increasing 100/μL (OR=3 .889 ,P=0 .016) .The percentage of lymphocytes in PBMC was also positively correlated with T‐SPOT .TB positivity ,and the sensitivity increased by 1 .393 times when the percentage increasing 30% (OR=2 .393 ,P=0 .045) .When Percoll was used for lymphocytes isolation ,the T‐SPOT .TB sensitivity was 52 .6% (10/19) ,and when Ficoll was used for PBMC isolation ,the sensitivity was 36 .8% (7/19) .The difference was not statistically significant (P=0 .375) .Conclusion The sensitivity of T‐SPOT .TB test based on lymphocytes is higher than that based on PBMC .
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Objective To analyze the tendency and influential factors and relationship for behavior problem among 3 to 6 years old preschool children.Methods By a prospective study,the questionnaire survey was carried out in 551 parents of 3 to 6 years old children from kindergarten in Guangzhou,including General Situation Questionnaire,the Strengths and Difficulties Questionnaire(parent version) and 3-7 years old children Behavioral Style Questionnaire.The data were collected at baseline and 1 year follow-up,and were analyzed by the prospective study method.Results Baseline survey 733 valid questionnaires,551 questionnaires were followed up (follow-up rate was 75.2％),the effective questionnaires were 526 (effective rate was 95.5％).The detection rate of behavior problem reduced by age (t =1.975,P =0.049),especially in the kind problem of conduct (t =2.888,P =0.004),friendship (t =2.572,P =0.010) and prosocial behavior(t =-3.329,P =0.001).In the mean time,the degree of cutting down in girls was more obvious than in boys (t =2.359,P =0.019).The influential factors include mother'age,parental education level,structure of family and children' temperament.Children's gender and whether the only child has no significant effect on behavior problems,and the family income only affects the change of behavior problems.Conclusions The detection rate of behavior problem reduce by age and influenced by many factors.Intervention measures must be synthetically considered various related factors.
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<p><b>OBJECTIVE</b>To investigate the etiology of hand, foot and mouth disease (HFMD) in Beijing during 2013, and study the clinical characteristics of HFMD caused by the main serotypes of enterovirus in the study.</p><p><b>METHOD</b>Clinical data and 128 stool samples were collected from 128 hospitalized children with HFMD in Beijing Ditan Hospital during 2013. One step RT-PCR method was used for enterovirus genotyping to investigate the etiology of HFMD. Clinical characteristics of HFMD caused by the main serotypes of enterovirus were analyzed. And VP1 segments of the main virus were amplified to construct phylogenetic tree for the phylogenetic analysis.</p><p><b>RESULT</b>A total of 128 hospitalized children with HFMD were included. HFMD was more likely developed in children under 2 years of age (81.6%, 102/125); 11 different enteroviruses were genotyped, with a total enterovirus positive rate of 76.6% (98/128); the positive rate of coxsackievirus A6 (CA6), 43.0% ( 55/128), was the highest, followed by enterovirus 71 (EV71), accounting for 14.8% (19/128). HFMD caused by CA6 was atypical, the rashes of which involved the perioral, trunk, limbs, face and neck (47%, 26/55), besides the common parts. Of the 55 cases caused by CA6, 6 children had clinical manifestations of nervous system involvement, one of whom even displayed type 2 respiratory failure. Mental status change more likely to occur in EV71-infected children than in CA6-infected ones (42% (8/19) vs. 11% (6/55) (χ(2)=7.041, P=0.008)); 13 children displayed onychomadesis, including 12 CA6 cases (23%, 12/53) and 1 CA10 cases (17%, 1/6), in the convalescence of hand, foot and mouth disease, and the correlation between onychomadesis and CA6 infection was significant (χ(2)=9.297, P=0.002). Phylogenetic analysis of 33 CA6 VP1 showed that the CA6 isolates of this study were highly similar to that of Taiwan and the nucleotide similarity was 95.91%-98.89%.</p><p><b>CONCLUSION</b>CA6 was the major pathogen of hospitalized children with hand, foot and mouth disease in Beijing during 2013, followed by EV71. The rashes caused by CA6 involved a wide range of skin sites and patients with CA6 infection displayed manifestations of neurological involvement or pulmonary edema similar to EV71 infection. Mental status change more likely occurred in EV71-infected children when neurological system was involved..</p>
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Child, Preschool , Humans , Infant , Child, Hospitalized , Enterovirus , Classification , Enterovirus Infections , Diagnosis , Virology , Exanthema , Pathology , Genotype , Hand, Foot and Mouth Disease , Diagnosis , Virology , Hospitals , Phylogeny , Pulmonary Edema , Pathology , Skin , Pathology , TaiwanABSTRACT
This study examined the effects of flow shear stress on the bio-capacity of the endothelial cells' induced from mesenchymal stem cells (MSCs). After cultivating the SD rat mesenchymal stem cells in vitro, we exposed them under different intensity of flow shear stress and induced these cells to endothelial cells. The variations of total anti-oxidation competence (T-AOC) and quantity of nitrogen monoxide (NO) were tested. The results showed that shear stress has an enhanced effect on the T-AOC and NO of endothelial cells induced from MSCs in an intensity-dependent manner. Flow shear stress could provide a protective action on the in vitro induction of endothelial cells, thus formulating a theoretical foundation for the therapeutics of ischemic heart diseases and vascular tissue engineering.