Résumé
Objective To explore the application of the model centering on organ system teaching in experimental diagnostics and evaluated its teaching effect.Methods A total of 185 clinical medical undergraduates of grade 2012 and 2013from School of Basic Medical Science in Tianjin Medical University joined the integrated curriculum of laboratory diagnostics for liver disease (abbreviated as integrated group).All of the teachers from varied professional fields were reconstituted into integrated teaching group.Training lecture was unified according to the new integrated teaching material.In order to make a contrast,180 clinical medical undergraduates of the grade 2010 and 2011 were involved in traditional laboratory diagnostics curriculum (abbreviated as traditional group).The results of terminal test of the integrated group and traditional group were analyzed with SPSS 21.0 software and Excel 2007.Glossary items,multiple choice,were indicated by scoring rate,and the objective items and subjective items total scores were indicted by real scores.Results Significant difference was found in the scoring rate of the glossary items,objective items,subjective items and the total scores between the two groups (P<0.01).The records of students were [75.00% (50.00%,100.00%)],(72.28 ± 22.63),(90.70 ± 22.36),(79.96 ± 18.59) in the integrated group and [66.67% (33.33%,83.33%)],(61.43 ± 28.85),(72.92 ± 22.14),(69.10 ± 17.95) in the traditional group.The scoring rate in the integrated group was higher than that in the traditional group (P<0.01).But the records of multiple choice were [100.00% (0.00%,100.00%)] in the traditional group and [66.67% (66.67%,100.00%)] in the integrated group.Conclusions The model centering on organ system teaching model is much more reliable and it may improve the teaching quality.
Résumé
Objective:To detect genomic aberrations and investigate the expression and clinical significance of TBX2,CHK2, and p53 in malignant peripheral nerve sheath tumor (MPNST) tissues. Methods:We collected 63 cases of MPNST tissue samples, which were re-moved by resection and were confirmed by pathology, from January 1991 to December 2011 in Department of Bone and Sofer Tissue Tumor, Tianjin Medical University Cancer Institute and Hospital. Twelve fresh tumor samples with qualified DNA quality were selected from the above 63 cases of tissue samples. Genome abnormalities of 12 MPNST tissues were detected by next-generation sequencing. The protein expression levels of TBX2, CHK2, and p53 in 63 MPNST tissue samples were assessed by immunohistochemistry staining. Results:One case of TBX2 gene mutation was observed out of the 12 MPNST tissue samples. In 63 MPNST tissue samples, the protein expression rates of TBX2, CHK2, and p53 were 60.3%(38/63), 47.6%(30/63), and 30.2%(19/63), respectively. TBX2 expression was sig-nificantly correlated with AJCC (American Joint Committee on Cancer, AJCC) stage, recurrence, and metastasis (P<0.05). TBX2 expres-sion was directly correlated with that of CHK2 (r=0.254, P=0.045), and CHK2 expression was directly correlated with that of p53 (r=0.343, P=0.006). In terms of the disease-free survival and overall survival time, patients with high expression levels of TBX2, CHK2, and p53 had significantly worse prognosis than patients with low expression levels of TBX2, CHK2, and p53(all P<0.05). TBX2, CHK2, and p53 were independent prognostic factors of MPNST. Conclusion:TBX2 and its associated proteins may play important roles in MPNST development and progression. Detecting TBX2 expression may provide the theoretical basis for estimating the prognosis of patients with MPNST.
Résumé
Objective To performed microarray-based comparative genomic hybridization (aCGH) detection and carried out pathway analysis to gain a systemic view on the pathway alterations of the genetically altered genes in human osteosarcoma.Methods aCGH experiments were carried on 10 fresh osteosarcoma samples to obtain recurrent copy number change pattern,then the samples were further subjected to the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis to identify the altered pathways in the osteosarcoma.To validate the aberrations of these key pathways,the alterations of VEGF pathway were selected to confirm by the methods of fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) in formalin-fixed and paraffin-embedded (FFPE) osteosarcoma archival tissues.Results The KEEG analysis of aCGH data identified 33 genetically altered pathways in osteosarcomas.Among them 20 pathways were identified genetic amplifications,such as VEGF and mTOR signaling pathways.Thirteen pathways were genetic deletions,such as Wnt and Hedgehog signaling pathways.The genetic aberrations of cell-cell-matrix pathway such as CAMs,Adherens junction and Tight junction pathways implied the genetically alterations of these pathways which are associated with the tumor invasion and metastasis.Validation the aberrations of VEGF pathway showed that VEGFA gene was significantly amplified.The positive protein expression of VEGFA had a significant association with microvessel density (MVD).Conclusion There are genetic aberrations which involved the component genes of VEGF,mTOR,CAMs,Adherens junction,Wnt,Hedgehog and other 26 signaling pathways.The alterations of these pathways which are significantly associated with tumor invasion,metastasis and progression suggest that the genetic aberrations of these key pathways might contribute to the tumorigenesis and progression in human osteosarcoma,and provide molecular genetic evidence for targeted therapy.
Résumé
Mesenchymal to epithelial transition (MET), whereby mesenchymal cells become more epithelial like in phenotype, was observed to occur during normal development and in cancers. Numerous investigations have been conducted on MET in carcino-mas. In addition, accumulating evidence also suggests the critical function of MET in sarcomas. Integrated analyses reveal that MET may be an important biological and clinical process in sarcomas, and transcription factors such as Slug may also perform central func-tions in epithelial differentiation in several sarcomas such as leiomyo-sarcoma and synovial sarcoma. Given the scarcity of investiga-tions and evidence, several important issues about MET, such as its molecular markers, signaling mechanisms, micro RNA regulations, and clinical significance, need to be clarified. In this article, we review several important questions about MET in sarcomas, including molecular markers, signaling mechanisms, regulation by miRNAs, and therapeutic implications.
Résumé
Objective To investigate the change of antimicrobial resistance among gram-positive cocci from 1999 to 2006 in Beijing Chaoyang Hospital. Methods Antimicrobial susceptibility test was car-ried out by MIC method, data were analyzed by WHONET 5.3 software. Results A total of 6192 clinical isolates were collected. The top four pathogens were Staphylococcus coagulase-negative, Staphylococcus au-reus, Enterococcus faecalis and Enterococcus faecium. The prevalence of methicillin-resistant S. aureas and coagulase-negative were identified in 88.4% and 86.9%, respectively. The resistance rates of S. aureus to penicillin G and ampicillin were more than 90.0% during 1999-2006. Neither strains of S. aureus nor strains of coagulase-negative Staphylococcus were found resistant to vancomycin. Vancomyein-resistant Enterococci (VRE) strains were firstly isolated in 2003, thirteen vancomycin-resistant E.faecalis isolates were identified as VanB genotype by PCR and sequencing. The VanA gene was confirmed by PCR and sequencing in seven-teen vancomycin-resistant E.faecium, vancomycin-resistance E.faecium rate increased sharply. The most ac-tive antibiotics against E. faecalis were vancomycin, ampicillin, penicillin with the susceptible rates of 98.7%, 95.7% and 85.6%, however, the susceptibility rate of E. faecalis to penicillin decreased from 94.3%-84.6%. The resistance rates of E.faecalis to clindamycin was 99.0%. The resistance rates of E. faecium to erythromycin and clindamycin were more than 95.0%. The resistance rates of E.faecium to ampi-cillin, penicillin, ciprofloxacin were more than 90.0%. The most active antibiotics against E. faecium was vancomycin. The susceptibility rate of E.faecium to tetracycline increased from 27.8% to 82.6%. Conclu-sion Vancomycin remains highly active against gram-positive cocci. A total of 30 Enterococci isolates were found resistant to vancomycin.
Résumé
Objective To investigate the molecular mechanism of resistance to carbapenems in Pseudomonas aeruginasa from 5 teaching hospitals in Beijing. Methods A total of 213 non-duplicate imipenem-resistant Pseudomonas aernginosa (IRPA) isolates were collected from 5 hospitals in Beijing from June 2004 to December 2005. The minimal inhibitory concentrations (MICs) of meropenem, imipenem and others antibiotics were determined by agar dilution method. Disk diffusion test was used for screening metalloenzymes. The bla IMP,bla VIM and OprD2 genes were amplified by PCR and only sequenced. Results Out of 213 isolates, OprD2 loss was detected in 84 isolates and IMP-1 enzyme was detected in 6 isolates simultaneously. Thirteen IRPAs only produced IMP-1 and 2 isolates only produced VIM-2. Conclusion OprD2 loss and metallo-β-lactamuse production are the parts of the mechanisms of resistance to carbapenems in Pseudomonas aeruginosa in Beijing.
Résumé
OBJECTIVE To find out the clinical character and pathogen of intravascular catheter-related bloodstream infection(CRBSI),and analyze the related risk factors and provide prevention measures.METHODS Totally 44 patients who had the definite diagnosis of CRBSI were investigated retrospectively.RESULTS The distribution of CRBSI was higher in ICU.Gram-positive cocci were the main pathogens.The risk factors included: severe underlying diseases,weak immunity,unsuitable use of anitibiotic and so on.CONCLUSIONS Be strickly abide by the principle of sterilization technology,take good care of the catheleter and reduce the time of indwelling time are the effective measures for preventing CRBSI.
Résumé
OBJECTIVE To investigate the risk factors for vancomycin-resistant Enterococcus(VRE) infections and their effective isolation measures.METHODS The data of 21 cases of VRE nosocomial infections were analyzed from Jul 2003 to Dec 2005 in Beijing Chaoyang Hospital;28 cases of antibiotic-sensitive Enterococcus infection were randomized as control.T test,chi-square test and Logistic regression analysis were used for statistics.Strict measures were taken to all of the VRE infected patients.RESULTS According to univariate analysis,the factors associated with the development of VRE nosocomial infection were age,in ICU,accepted invasive operation,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ),live in hospital more than 30 days,co-infection with other pathogens,and fluoroquinolone and vancomycin/norvancomycin use 15 days before isolation of VRE.Multivariate Logistic regression analysis identified two independent factors: accepted invasive operation and previous vancomycin/norvancomycin use.Spreading of VRE had not occurred.CONCLUSIONS Accepted invasive operation and previous vancomycin/norvancomycin use are independent risk factors for VRE infection.Effective measures can prevent the spread of VRE.