New Thoughts on the Construction of Hospital Ethics Review Committee / 中国医学伦理学

Advanced technology not only brings good news to patients, but also causes a series of ethical issues. Subject risk/benefit assessment is the core of ethical review in clinical research. By combing the development status of China ethics review committee, analyzing the problems existing in the current ethical review, this paper proposed to standardize the establishment and independence of ethics review committee, improve the relevant laws and regulations of the ethics review committee, establish the administrative access and evaluation mechanism of the ethics review committee, build a multi-center mutual recognition alliance, improve the standardized operating procedures of the ethics review committee, set up an ethical personnel training system, and strengthen the review capacity building of the ethics review committee, so as to provide new ideas for the review work of the committee, then better protect the rights and interests of subjects and promote the development of medical science.

Association between Retinal Vascular Geometric Changes and Cognitive Impairment: A Systematic Review and Meta-Analysis

BACKGROUND@#AND PURPOSE: Previous studies have explored the association between retinal vascular changes and cognitive impairment. The retinal vasculature shares some characteristics with the cerebral vasculature, and quantitative changes in it could indicate cognitive impairment. Hence, a comprehensive meta-analysis was performed to clarify the potential relationship between retinal vascular geometric changes and cognitive impairment.@*METHODS@#Relevant databases were scrupulously and systematically searched for retinal vascular geometric changes including caliber, tortuosity, and fractal dimension (FD), and for cognitive impairment. The Newcastle-Ottawa Scale was used to evaluate the methodological quality of included studies. RevMan was used to perform the meta-analysis and detect publication bias. Sensitivity analyses were also performed.@*RESULTS@#Five studies that involved 2,343 subjects were finally included in the meta-analysis. The results showed that there was no significant association between central retinal artery equivalents (Z=1.17) or central retinal venular equivalents (Z=1.74) and cognitive impairment (both p>0.05). Similarly, no significant difference was detected in retinal arteriolar tortuosity (Z=0.91) and venular tortuosity (Z=1.31) (both p>0.05). However, the retinal arteriolar FD (mean difference: −0.03, 95% CI: −0.05, −0.01) and venular FD (mean difference: −0.03, 95% CI: −0.05, −0.02) were associated with cognitive impairment.@*CONCLUSIONS@#A smaller retinal microvascular FD might be associated with cognitive impairment. Further large-sample and well-controlled original studies are required to confirm the present findings.

Research and practice on quality and homogeneity of standardized training for resident physicians in training bases / 中华医学教育探索杂志

In this paper, we lay down a homogenization training standard for resident standardized training through a joint discussion among experts from three national resident standardized training bases. The aim of the homogenization of resident standardized training quality shall be reached through the synchronous implementation of tutorial system and comprehensive formative evaluation, the strengthening of training quality process management and the promotion and advancement of training quality of resident standardized training.

Roles of Wnt/ß-catenin signaling in retinal neuron-like differentiation of bone marrow mesenchymal stem cells from nonobese diabetic mice.

Recent studies have shown that mesenchymal stem cells (MSCs) are expected to become promising therapeutic agents for the treatment of diabetic retinopathy (DR); moreover, we previously demonstrated that bone marrow (BM)-MSCs from nonobese diabetic (NOD) mice (an ideal DR model) had abnormal migration and adhesion. So, we hypothesized that NOD-MSCs also have abnormal retinal neuron-like differentiation potential. MSCs were cultured with brain-derived neurotrophic factor, nerve growth factor, and basic fibroblast growth factor. Western blot analysis and immunofluorescence both showed that the level of retinal neuron-like markers, such as glial fibrillary acidic protein, neuron-specific nuclear protein, tyrosine hydroxylase, Thy-1, glutamine synthetase, and rhodopsin was lower in NOD-MSCs than in imprinting control region MSCs. Furthermore, we explored the precise mechanisms controlling this change in NOD-MSCs. The expression levels of some important member proteins in Wnt/ß-catenin signaling were determined and suggested the downregulation of Wnt/ß-catenin signaling with retinal neuron-like differentiation of NOD-MSCs. Incubation of NOD-MSCs in medium supplemented with human recombinant Wnt1 resulted in a significant upregulation of retinal neuron-like markers, and the effects of Wnt1 were dose-dependent. Taken together, our study indicated that the inhibition of Wnt/ß-catenin signaling in NOD-MSCs after induction could contribute to the abnormal retinal neuron-like differentiation. These data provide important preclinical references supporting the basis for further development of autologous MSC-based therapies for DR.

Application of problem-based learning in clinical practice teaching / 中华医学教育探索杂志

Objective To explore the effects of problem-based learning (PBL) on improving intern doctors' clinical thinking and problem-solving capacities in clinical practice teaching.Methods PBL teaching courses were designed and used among 72 intern doctors come from 2010 grade clinical medical major (experiment group)and traditional teaching model was applied in 55 intern doctors come from 2009 grade clinical medical major ( control group).The PBL teaching effectiveness was evaluated through expert comment,exam and questionnaire survey.Test was conducted concerning the score of objective theoretical test on clinical thinking and the quality of case report writing.Results There were differences between experiment group and control group in theoretical test score and case report writing quality ( P ＜ 0.01 ).According to the results of questionnaire survey,teachers and students thought that the PBL teaching mode was better than traditional teaching mode in cultivating students' clinical thinking ability and problem solving ability.Conclusion The teaching effect of PBL in clinical practice is satisfactory.PBL teaching can effectively develop the students' clinical thinking and problem-solving capacities and play an active role in improving education quality and promoting education reform.