Promotion of self-directed learning abilities among Chinese medical students through preparing for career calling and enhancing teaching competencies in medical education: a cross-sectional study.

BACKGROUND: Medical students face a heavy burden as they are tasked with acquiring a vast amount of medical knowledge within a limited time frame. Self-directed learning (SDL) has become crucial for efficient and ongoing learning among medical students. However, effective ways to foster SDL ability among Chinese medical students are lacking, and limited studies have identified factors that impact the SDL ability of medical students. This makes it challenging for educators to develop targeted strategies to improve students' SDL ability. This study aims to assess SDL ability among Chinese medical students and examine the effects of career calling and teaching competencies on SDL ability, as well as the possible mechanisms linking them. METHODS: Data were collected from 3614 respondents (effective response rate = 60.11%) using cross-sectional online questionnaires and analyzed using IBM SPSS Statistics 22.0. The questionnaire comprised a Demographic Characteristics Questionnaire, Self-directed Learning Ability Scale (Cronbach's alpha = 0.962), Teaching Competencies Scale, and Career Calling Scale. RESULTS: The average SDL ability score of Chinese medical students was 3.68 ± 0.56, indicating a moderate level of SDL ability. The six factors of the Self-directed Learning Ability Scale-self-reflection, ability to use learning methods, ability to set study plans, ability to set studying objectives, ability to adjust psychological state, and willpower in studying-accounted for 12.90%, 12.89%, 12.39%, 11.94%, 11.34%, and 8.67% of the variance, respectively. Furthermore, career calling was positively associated with SDL learning ability (ß = 0.295, p < 0.001), and SDL learning ability was positively associated with teaching competencies (ß = 0.191, p < 0.01). Simple slope analysis showed that when the level of teaching competencies was higher, the influence of career calling on SDL ability was stronger. CONCLUSIONS: Chinese medical students' SDL ability has room for improvement. Medical students could strengthen their willpower in studying by setting milestones goals with rewards, which could inspire their motivation for the next goals. Teachers should guide students to learn experience to improve students' reflective ability. Educators play a crucial role in bridging the gap between career calling education and SDL ability enhancement, highlighting the significance of optimal teaching competencies. Colleges should focus on strengthening teachers' sense of career calling and teaching competencies.

Combination of schisandrin and nootkatone exerts neuroprotective effect in Alzheimer's disease mice model.

Alzheimer's disease (AD) is one of the most common neurodegenerative diseases which seriously affect the quality of life of the elderly. Schisandrin (SCH) and nootkatone (NKT) are the two marked active components in ASHP. In this study, the effects of Alpinia oxyphylla-Schisandra chinensis herb pair (ASHP) as well as its bioactive components on cognitive deficiency and dementia were revealed via Aß1-42-induced AD in mouse. Morris water maze test showed that acute administration of ASHP and SCH + NKT treatments had higher discrimination index in the object recognition task, more quadrant dwell time and shorter escape latency compared with those in the Morris water maze. The levels of TNF-α, IL-1ß and IL-6 were decreased after ASHP and SCH + NKT treatment. The inflammatory response was attenuated by inhibiting TLR4/ NF-κB/ NLRP3 pathway. In addition, ASHP and SCH + NKT treatments significantly restored the activities of superoxide dismutase (SOD), glutathione S-transferase (GST), cyclooxygenase-2 (COX-2), total antioxidant capacity (T-AOC) and inducible nitric oxide syntheses (iNOS), and the levels of glutathione (GSH), malondialdehyde (MDA) and nitric oxide (NO). The histopathological changes of hippocampus were noticeably improved after ASHP and SCH + NKT treatments. These findings demonstrate that ASHP as well as its bioactive components exerted a protective effects on cognitive disorder, inflammatory reaction and oxidative stress.

Sleep quality and creativity in Chinese college student during the COVID-19 pandemic: The mediating role of executive function.

Background: COVID-19 has impacted adolescents' interpersonal relationships, life attitudes, and mental health during the past 3 years. However, previous studies predominantly focused on negative problems, while few studies assessed the situation of teenagers from the perspective of positive psychology. Therefore, this study explores the creativity level of Chinese college students during the COVID-19 pandemic, the relationship between sleep quality and creativity, and the mediating role of executive function. Method: A cross-sectional study was conducted across six colleges in Heilongjiang in China, with a sample of 4,258 college students recruited via stratified cluster sampling. Data were collected through an online survey. A mediation model was constructed, and SPSS PROCESS macro was used to analyze the data. Results: The creativity score of Chinese college students during the COVID-19 pandemic was 106.48 ± 13.61. Correlation analysis demonstrated that sleep quality correlated negatively with creativity (r = -0.08, P < 0.01) but positively with executive function (r=0.45, P < 0.01), whilst executive function correlated negatively with creativity (r = -0.10, P < 0.01). Moreover, the mediation model revealed that executive function partially mediated the relationship between sleep quality and creativity in college students (indirect effect = -0.017, SE = 0.004, 95% CI = [-0.025, -0.008]). Executive function accounted for 48.6% of the variance in college students' creativity. Conclusion: School administrators should implement measures such as sleep education to enhance students' sleep quality. Concurrently, curriculum and assessment implementation should enhance executive function. Such measures can contribute to improved student creativity, thus helping students overcome the negative emotional impact of the COVID-19 pandemic.

Synergistic neuroprotective effect of schisandrin and nootkatone on regulating inflammation, apoptosis and autophagy via the PI3K/AKT pathway.

Alzheimer's disease (AD) is a neurodegenerative disease that seriously threatens elderly health. Schisandrin (SCH) and nootkatone (NKT) are two core components derived from Alpinia oxyphylla-Schisandra chinensis herb pair (ASHP), a traditional Chinese medicine formulation. Previous studies demonstrated that the combination of NKT and SCH exerted a neuroprotective effect in AD mouse models. The present study was undertaken to investigate whether there was a synergistic effect between NKT and SCH and the possible mechanism in Aß1-42 induced PC12 cells. SCH (50 µM) and NKT (10 µM) had the most notable inhibitory effect on the level of Aß secreted by cells. Treatment with NKT + SCH activated the PI3K/AKT/Gsk-3ß/mTOR pathway. Inflammation related proteins such as NF-κB, IKK, IL-1ß, IL-6 and TNF-α were decreased. The levels of cleaved-Caspase3 and LC3-II were reduced, indicating that apoptosis and autophagy were inhibited. These results revealed that NKT + SCH exerted a neuroprotective effect via the PI3K/AKT pathway, inhibiting inflammation, apoptosis and autophagy.

Alpinia oxyphylla-Schisandra chinensis Herb Pair Alleviates Amyloid-ß Induced Cognitive Deficits via PI3K/Akt/Gsk-3ß/CREB Pathway.

Alzheimer's disease (AD), one of the most common neurodegenerative diseases, threatens people's health. Based on the theory of traditional Chinese medicine (TCM) efficacy and treatment theory, we first proposed the Alpinia oxyphylla-Schisandra chinensis herb pair (ASHP) for finding a candidate of AD treatment. This study aimed at exploring the effects of ASHP on improving the cognitive function and neurodegeneration, and revealing the possible mechanism. In this study, an amyloid-ß (Aß) induced AD model was established in mice via intracerebroventricular injection. The Y-maze test and Morris water maze test were carried out to observe the behavioral change of mice, which showed that ASHP significantly ameliorated cognitive impairment. In addition, ASHP reduced amyloid-ß deposition and downregulated the hyperphosphorylation of tau via immunofluorescence assay and western blot analysis, respectively. Subsequently we focused on the PI3K/Akt pathway that is a classical pathway related to nervous system diseases. It also noticeably ASHP improved the histopathological changes in the hippocampus and cortex. Moreover, it was found that ASHP could upregulate the PI3K/Akt/Gsk-3ß/CREB signaling pathway in N2a-SwedAPP cells. Taken together, it suggests that ASHP might reverse cognitive deficits and neurodegeneration via PI3K/Akt/Gsk-3ß/CREB pathway.

Comparative pharmacokinetic study of the components in Alpinia oxyphylla Miq.-Schisandra chinensis (Turcz.) Baill. herb pair and its single herb between normal and Alzheimer's disease rats by UPLC-MS/MS.

Alzheimer's disease (AD) is a neurodegenerative disease that seriously affects daily life. Schisandra chinensis (Turcz.) Baill. Fructus (SCF) and Alpinia oxyphylla Miq. Fructus (AOF) have been regarded as classical herbs for dementia since ancient times. Alpinia oxyphylla Miq.-Schisandra chinensis (Turcz.) Baill. herb pair (ASHP) is the compatible form of the two herbs. Ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was established for the simultaneous determination of protocatechuic acid, chrysin, schisandrin, gomisin A, gomisin B, nootkatone, deoxyschizandrin, schisandrin B and schisandrin C in rat plasma. The pharmacokinetic differences of the above nine active components in normal rats and AD model rats after oral administration of SCF, AOF, and ASHP ethanol extracts were investigated. Chloramphenicol and bifendate were used as the internal standards. Extraction of plasma sample was by liquid-liquid extraction with ethyl acetate. A SBC18 column (2.1 mm × 100 mm, 1.8 µm) was used in this experiment at a flow rate of 0.3 mL/min at 30 °C with linear gradient elution using acetonitrile and water containing 0.1% formic acid. This study showed ASHP can improve the absorption of protocatechuic acid, chrysin, schisandrin, gomisin B, nootkatone, deoxyschizandrin, schisandrin B and schisandrin C in vivo and slow down part of these components' elimination. In addition, compared with normal rats, the pharmacokinetic parameters changed significantly in AD model rats' plasma after oral administration of ASHP. Hence, these may be the pharmacokinetic mechanism of ASHP, in addition to serving as a potential agent in the treatment of AD.

Effect of Alpinia oxyphylla-Schisandra chinensis herb pair on inflammation and apoptosis in Alzheimer's disease mice model.

ETHNOPHARMACOLOGICAL RELEVANCE: Alpinia oxyphylla-Schisandra chinensis herb pair (ASHP), composed of Alpinia oxyphylla Miq. Fructus (Yizhi, in Chinese) and Schisandra chinensis (Turcz.) Baill Fructus (Wuweizi, in Chinese) has been used in many traditional Chinese prescriptions such as Yizhi Wuwei pill and Jiannao pill. AIMS OF THE STUDY: This study was primarily dealt with studying the effects of Alpinia oxyphylla-Schisandra chinensis herb pair (ASHP) on learning and cognitive impairment in the Aß1-42 induced mouse model. MATERIALS AND METHODS: The chemical composition quantitative analysis was by UPLC. Then the Y maze and Morris water maze test were used to determine the capability of ASHP extracts on improving memory. Histological changes and apoptotic features were detected by HE staining and TUNEL staining, respectively. qPCR was used to detect the changes in the mRNA of caspase3, caspase8 and caspase9 and western-blot was used to detect the changes in the levels of cleaved-caspase3, cleaved-caspase8 and cleaved-caspase9. The levels of some inflammatory factors such as IKK, IκB and NF-κB; anti-apoptotic factors such as bcl-2, bcl-xl, pro-apoptotic factors including bad, bax, p53 were assessed via immunohistochemistry (IHC) and western-blot. RESULTS: Administration of ASHP extracts had higher spontaneous alternation ratio in the Y maze, more quadrant dwell time and shorter escape latency compared with model group in the Morris water maze. ASHP treated groups significantly inhibited NF-κB pathway and apoptosis-related pathway in the hippocampus. CONCLUSIONS: This study demonstrated that ASHP had the ability to ameliorate abnormal changes in cognitive behavior, biochemical and histopathology induced by Aß1-42 in the mouse model. The powerful role of ASHP is to inhibit the NF-κB inflammatory signaling pathway and cut down the damage of apoptosis. This study revealed ASHP might be a potential therapy for cognitive and behavioral deficits.

Regulating the Balance of Th17/Treg via Electroacupuncture and Moxibustion: An Ulcerative Colitis Mice Model Based Study.

AIM: To investigate the relationship between the effects of electroacupuncture/moxibustion and the balance of Th17/Treg in treating ulcerative colitis (UC) and to preliminary compare the effects of the above two methods. METHODS: DSS-induced UC mice were treated by electroacupuncture and moxibustion. Disease activity index (DAI) was scored; intestinal pathological structure and ultrastructure were observed. The levels of IL-2, IL-6, IL-10, IL-17A, IL-17F, and TGF-ß in plasma were measured by ELISA. The percentages of Treg and Th17 in spleen lymphocytes were analyzed by flow cytometry. Also, the expressions of TLR2, TLR4, RORγt, and FOXP3 in the distal colon were detected by immunohistochemistry or western blot. RESULTS: Both electroacupuncture and moxibustion can relieve UC. These effects are further supported by ELISA results. In addition, the ratio of Treg and Th17 in spleen lymphocytes and the expression of TLR2 and TLR4 are significantly improved. Also, the expression of RORγt and FOXP3 in distal colon were improved. Besides, the effect of moxibustion is better than that of electroacupuncture on TLR2, TLR4, and FOXP3 expression (P < 0.05). CONCLUSION: Both electroacupuncture and moxibustion may ameliorate UC by regulating the balance of Th17/Treg. Whether moxibustion has better efficacy than electroacupuncture needs further study.

[Surgical techniques for the ureterointestinal anastomosis in continent urinary diversion].

OBJECTIVE: To compare the complications of direct and antirefluxing techniques of ureterointestinal anastomosis in continent urinary diversion. METHODS: Sixty-three patients underwent continent urinary diversion. Twenty-four patients were treated by the direct ureteroenteric anastomosis and the others treated by the antirefluxing technique. The follow up studies included following-up the information of ureteric stricture, ureteric reflux, renal function and acute urinary infection. It was assessed for 3 months to 6 years with a mean follow up of 26 months after operation. RESULTS: Of 78 ureters reimplanted using antirefluxing technique. A total of 12 ureters had anastomotic stricture formation postoperatively. Only one of 48 ureters reimplanted using direct anastomoses had anastomotic stricture. The difference between the direct and antirefluxing technique groups was remarkable (chi2 = 4.375, P < 0.05). Furthermore, there was no significant difference between the direct and antirefluxing technique groups in regard to ureteric reflux, renal function and acute urinary infection. CONCLUSIONS: Antirefluxing anastomoses resulted in obviously higher rate of ureterointestinal anastomotic stricture in comparison with the direct anastomosis. The direct ureteroenteric anastomosis may be the suitable choice for patients undergoing continent urinary diversion.