Study on the application value of scenario simulation teaching combined with flipped classroom in teaching nursing interns in department of gastroenterology / 中华医学教育探索杂志

Objective:To explore the effect of scenario simulation teaching combined with flipped classroom teaching for nursing interns in the department of gastroenterology.Methods:A total of 40 undergraduate nurses of 2019 from the Department of Gastroenterology of Renji Hospital, Shanghai Jiao Tong University School of Medicine were selected as the control group, and 40 undergraduate nurses of 2020 were selected as the research group. The control group adopted the traditional clinical teaching mode, and the research group adopted the scenario simulation combined with flipped classroom teaching mode. After 3 months of clinical teaching, theoretical and nursing operational assessment were performed on the nurses, and questionnaire survey was used to evaluate the teaching effect of clinical nursing teaching and the satisfaction of teaching quality. SPSS 20.0 was used for t test and chi-square test. Results:The theoretical and nursing operation skills assessment scores of the research group were higher than those of the control group, and the difference was statistically significant ( P<0.001). The research group was significantly better than the control group in improving nursing operation skills, improving autonomous learning ability, improving nurse-patient communication ability, improving response ability, improving overall analysis ability, enhancing humanistic care awareness, cultivating team spirit, and cultivating clinical thinking ability( P<0.001). The satisfaction rate of the practice nurses in the study group with the scenario simulation combined with the flipped classroom teaching was 100.00%, and that in the control group with the traditional clinical teaching mode was 70.00%, with statistical significance ( P<0.001). Conclusion:Scenario simulation teaching combined with flipped classroom can improve the theoretical foundation and operational skills of practical nurses in the department of gastroenterology, and improve the clinical nursing teaching effect and satisfaction of practical nurses, which is worthy of application and promotion.

N-glycosylation modification of heat shock protein gp96 affects its immunological function / 生物工程学报

N-glycosylation modification, one of the most common protein post-translational modifications, occurs in heat shock protein gp96. The purpose of this study is to investigate the effect of N-glycosylation modification on immunologic function of the recombinant gp96 using the mutant gp96 in N-glycosylation sites. Firstly, wild-type and mutant gp96 proteins were expressed by insect expression system and their glycosylation levels were detected. To determine the effect of N-glycosylation on gp96 antigen presentation function, the IFN-γ+ CD8+ T cells in gp96-immunized mice and secretion level of IFN-γ were examined by flow cytometry and ELISA. The ATPase activity of gp96 was further detected by the ATPase kit. Finally, the effect of N-glycosylation on adjuvant function of gp96 for influenza vaccine was investigated in immunized mice. It was found that total sugar content of mutant recombinant gp96 was reduced by 27.8%. Compared to the wild type recombinant gp96, mutations in N-glycosylation sites resulted in decreased antigen presentation ability and ATPase activity of gp96. Furthermore, influenza vaccine-specific T cell levels induced by mutant gp96 as adjuvant were dramatically reduced compared to those by wild type recombinant gp96. These results demonstrate that N-glycosylation modification is involved in regulation of ATPase activity and antigen presentation function of gp96, thereby affecting its adjuvant function. The results provide the technical bases for development of gp96- adjuvanted vaccines.

Performance test and evaluation of ADVIA Centaur XP automatic chemiluminescence immunoassay system / 国际检验医学杂志

Objective The ADVIA Centaur XP automatic chemiluminescence immunoassay system detec-tion performance of the thyroid hormones and antibodies for validation and evaluation.Methods With refer-ence to the American association of clinical laboratory standardization guide and other related documents,the ADVIA Centaur XP automatic chemiluminescence immunoassay system test 7 items thyroid hormones and an-tibodies(T3,T4,FT3,FT4,TSH,anti-TG,anti-TPO)of precision,accuracy,linear range and carry pollution rate for validation.Results Within the seven thyroid hormones and antibodies batch testing precision of CV and CV between batch precision between 1.51% -6.17% and 1.86% -6.17%.Is the average accuracy of bias of the largest testing project FT3(8.47%),but in the acceptable range,good correlation,correlation coefficient R of 0.994 or higher,Average bias <1/2 CLIA′88 TEa(12.5%).T3,T4,FT3,FT4,TSH,anti-TG and anti-T PO in 1.24-5.59 nmol/L respectively,and 60.07 -195.10 nmol/L,3.40 -22.87 pmol/L,14.59 -40.54 pmol/L,1.63-74.13 μIU/mL,60.10 -381.30 μIU/mL and 180.10 -531.50 μIU/mL range is linear,Carry pollution rate is between 0.04% -0.97%.Conclusion ADVIA Centaur XP automatic chemiluminescence im-munoassay system detecting thyroid hormones and antibodies results consistent with the data provided by the manufacturer,the test results are accurate and reliable,and can be used for the detection of clinical samples.

Evaluation of small dense low-density lipoprotein cholesterol detection by the direct clearance method and its preliminary clinical application / 中华检验医学杂志

Objective To verify and valuate the performance of small dense low-density lipoprotein cholesterol (sdLDL-C) detection by the direct clearance method and evaluate its preliminary clinical application in acute coronary syndrome (ACS).Methods Case control study:The performance (accuracy,precision,linearity) of sdLDL-C was assessed by direct clearance method.In 143 cases of ACS patients selected from Cardiology Department and Emergency Department of Shangdong Provincial Hospital from April to October in 2016,with 100 cases male,female 43 cases,including acute myocardial infarction (AMI)group of 59 cases,unstable angina pectoris (UAP) group of 84 cases;83 cases of healthy volunteers as a control group selected from health physical examination center of Shandong Provincial Hospital,with 59cases male,female 24 cases.Levels of sdLDL-C,total cholesterol (TCH),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),apolipoprotein A (ApoA I),apolipoprotein B (ApoB),lipoprotein (a) (Lpa) and high sensitive C-reactive protein (Hs-CRP) were detected separately by automatic biochemical analyzer.Non high density lipoprotein cholesterol (non-HDL-C) equals TCH minus HDL-C.x2 test,t test,one-way ANOVA,Pearson correlation and multiple linear regression analysis were used as statistical methods.Results The within-lot or between-lot variation was 2.85％ and 3.36％.Methodological comparison:regression equation Y =0.984X + 0.018,r2 =0.966,t =-0.191,P =0.850.There was a good linear correlation (Y =1.026X + 0.007,r2 =0.999) between theoretical values and actual detection results in range of 0.15-2.65 mmol/L.SdLDL-C concentrations were positive correlated with TCH,non-HDL,LDL-C,TG,ApoB (r =0.758,0.848,0.839,0.514,0.885,respectively,P ＜0.01),and negative correlated with HDL-C (r =-0.224,P =0.001),but no correlation with APOA I,Lpa and Hs-CRP(r =-0.021,0.050,0.003,respectively,P ＞ 0.05).Multiple linear regression analysis showed that the factors influencing sdLDL-C level were HDL-C,ApoB,LDL-C and TG.The levels of sdLDL-C,TG in the ACS group were significantly higher than those in the control group (t =3.415,4.660,respectively,P ＜ 0.01),but no difference between the two groups in the levels of TCH,non-HDL-C and LDL-C (t=-1.831,-0.452,-1.398,respectively,P ＞0.05).Comparing AMI group with control group,sdLDL-C,TG and Hs-CRP were significantly higher than the control group (P =0.000,0.000,0.000,respectively),but TCH,LDL-C and non-HDL were similar between the two groups (P =0.800,0.320,0.120,respectively);Comparing UAP group with control group,TG and Hs-CRP were higher than control group (P =0.001,0.047,respectively),TCH and LDL-C were significantly lower than the control group (P =0.003,0.008,respectively),but sdLDL-C had no difference (P =0.305);Comparing AMI group with UAP group,sdLDL-C,TCH,LDL-C and Hs-CRP were significantly higher than UAP group (P =0.000,0.003,0.001,0.000,respectively),and TG were no statistical significance (P =0.473).Conclusions Direct clearance method can meet the requirement of sdLDL-C detection.sdLDL-C level can assess the metabolism of blood lipids and be used as an independent risk factor and predictive index of ACS,superior to LDL-C.

Progress in revascularization strategy of ST-segment elevation myocardial infarction with multiple vessel disease / 天津医药

ST-segment elevation myocardial infarction (STEMI) is the most serious type of coronary heart disease, accounting for 25%to 40%of acute myocardial infarction (AMI). The key to treat STEMI is to restore myocardial perfusion in the infarct area, to rescue the ischemic myocardium, and to reduce the size of infarction. About 41%to 67%of patients with STEMI have multiple vascular disease (MVD). Compared with single vessel disease, the clinical outcome of MVD is worse. In these patients, it still remains a controversial topic in emergency interventions for STEMI patients, the infarct-related artery only revascularization or multi-vessel revascularization, and the timing of revascularization. The clinical studies of revascularization strategy for MVD in STEMI patients have been ongoing, and the results have also led to the continuous updating of guidelines and treatment strategies.

CD133 epitope vaccine with gp96 as adjuvant elicits an antitumor T cell response against leukemia / 生物工程学报

Cancer stem cells are currently under intensive investigation due to their capabilities for tumor initiation, self-renewal, and resistance to chemotherapy. CD133 is implicated in stemness and the malignancy of tumor cells. Here, we explored heat shock protein gp96 adjuvanted CD133 epitope vaccine against leukemia. We screened and identified three H2-Kd-restricted cytotoxic T lymphocyte (CTL) epitopes derived from CD133, CD133₄₁₉₋₄₂₈, CD133₇₀₂₋₇₁₀ and CD133₇₆₀₋₇₆₉. The immunogenicity and antitumor activity of the epitope vaccine using heat shock protein gp96 as adjuvant were further determined in CD133⁺ leukemia xenograft mice. Finally, we demonstrate that adoptive transfer of epitope-specific CTLs led to suppression of leukemia growth. Our data therefore provide the basis for designing a CD133 epitope vaccine to activate specific CTLs against CD133⁺ leukemia and other cancers.

Research progress on wear particles and periprosthetic osteolysis after artificial joint replacement / 中国骨伤

It is an important influencing factor that the generated wear particles lead to periprosthetic osteolysis after artificial joint replacement. Current research suggests that the primary cause of wear particles results in periprosthetic osteolysis is relate to the prosthetic materials and the stimulations because of these materials generated wear particles to relevant cells such as macrophage, osteoblast, osteoclast. Induced a variety of inflammatory cytokines, activating and openning the cell signal and channels, producing the long term chronic inflammation leads to periprosthetic osteolysis. Therefor, the paper mainly studies the different types of wear particles influence on periprosthetic osteolysis, and the wear particles around the periprosthetic osteolysis mechanism in the process of progress, moreover, to explore how to reduce the occurrence of wear particles and blocking its role in the periprosthetic osteolysis, in order to achieve the purpose of prevention and treatment of periprosthetic osteolysis.

Analysis of distribution and drug resistance of pathogenic bacteria in patients with lower respiratory tract in-fection in ICU / 中国基层医药

Objective To investigate the distribution and drug resistance of pathogenic bacteria in hospital ICU patients with lower respiratory tract infection , and provide scientific reference for clinical rational drug use . Methods The strains were identified by VITEK -32 automatic bacterial identification instrument , the bacterial sensitivity was determined by K -B disk diffusion method , and the statistical analysis was performed by WHONET 5.4 software.Results The total isolated pathogenic bacteria of lower respiratory tract infection in ICU patients was 453 strains.332 strains of gram negative bacteria accounted for 73.3%,and the former three ones were Pseudomonas aeruginosa (115 strains,accounted for 25.4%),Klebsiella pneumonia (90 strains,accounted for 19.8%),Acineto-bacter baumannii (38 strains,accounted for 8.4%).102 strains of gram positive bacteria accounted for 22.5%,and the top three were Staphylococcus aureus (31 strains,accounted for 6.8%),coagulase negative Staphylococcus (22 strains,accounted for 4.9%),Enterococcus (18 strains,accounted for 4%).Meropenem,imipenem (Stenotroph-omonas maltophilia was excepted ) ,Cefoperazone /sulbactam and Amikacin were most sensitive against gram negative bacteria;Teicoplanin and vancomycin were highly sensitive against gram positive bacteria .Conclusion The main pathogenic bacteria of respiratory tract infection in ICU patients was gram negative bacilli ,which were seriously resist-ant to commonly used antimicrobial drugs .So strengthening the infection management of ICU and the control for risk factors,and rationally using of antimicrobial drugs has great significance in reducing the drug resistance of pathogenic bacteria rate .

Preparative resolution of gatifloxacin enantiomers with pre-column esterification strategy and comparing their enantioselectivity to bacteria and antibody / 生物医学与环境科学（英文）

Gatifloxacin (GFX) is a kind of chiral fluoroquinolones compound due to the methyl group at the C-3 position of the piperazine ring[1]. Although the enantiomers of GFX show similar levels of antimicrobial activity and pharmacokinetics[2], the other biological activities (i.e., toxicity or enantioselective recognition to various receptors in vivo) of GFX enantiomers have not yet been studied. With this in mind, we developed a rapid and cost-effective high performance liquid chromatographic (HPLC) separation procedure for GFX enantiomers with a pre-column esterification strategy. With significant enhancement of drug solubility and optimization for chromatographic conditions, the proposed method was scaled up to preparative HPLC to obtain optical active S-(-)- and R-(+)-GFX. The antibacterial activities of GFX enantiomers after preparative separation were further verified by measuring the Minimum Inhibitory Concentration (MIC) values against Escherichia coli ATCC 25922. In addition, the binding selectivity of GFX enantiomers to protein receptor were evaluated by antibody using enzyme-linked immunosorbent assay (ELISA) for the first time.

Validation of Actiwatch for Assessment of Sleep-wake States in Preterm Infants

PURPOSE: The purpose of this study was to validate the Actiwatch with behaviorally determined sleepe-wake state in preterm infants and to explore the influence of postmenstrual age on the accuracy of Actiwatch. METHODS: A prospective and comparative research design was used. Twenty-four preterm infants with postmenstrual age ranging from 28-38 weeks were studied. The infants were studied for 2 hours between two feedings. Infant's sleep and wake state was measured every 30 seconds using Actiwatch and the Anderson Behavioral State Scale simultaneously. RESULTS: Actiwatch demonstrated high agreement, sensitivity, and predictivity of sleep state, when validated with the Anderson Behavioral State Scale at the setting of high and automatic activity thresholds, and was not influenced by the infant's postmenstrual age. However, lower specificity and predictivity were found in the wake state, and influenced by postmenstrual age. CONCLUSION: Results of this study suggest that high activity thresholds are the most accurate for determining sleep state in preterm infants, and health care professionals must take the limitations into consideration while using the Actiwatch to assess wake states.