The Use of Blended Teaching in Higher Medical Education during the Pandemic Era.

Objective: This study aims to compare the effect of blended teaching and traditional teaching in higher medical education during the pandemic era. Methods: Taking the teaching of neurology as an example, 293 Yangzhou University Clinical Medicine 2016 undergraduate students were selected as the research subjects, and were randomly divided into 2 groups a blended teaching group (n = 148) and a traditional teaching group (n = 145), and received blended teaching and traditional teaching, respectively. The blended teaching was based on a Massive Open Online Course, problem-based learning, and case-based learning and supplemented by Tencent video conferences, QQ messaging groups, and other auxiliary teaching tools. At the end of the course, the teaching effect and satisfaction rate were evaluated through theory assessment, practical skills assessment, and an anonymous questionnaire survey. Results: There were significant differences in theoretical achievements (81.83 ± 6.23 vs 76.79 ± 6.87, P < 0.001) and practical skill achievements (84.74 ± 6.50 vs 78.48 ± 6.53, P < 0.001). In addition, significant differences in all aspects of satisfaction rate were observed between the two groups (all P < 0.001). Conclusion: Blended teaching is beneficial to students' learning and stimulates their enthusiasm, cultivates clinical thinking ability, and improves teaching quality. Thus, it has played a positive role in the reform of higher medical teaching during the pandemic era.

The Relationship Between Serum YKL-40 Levels on Admission and Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke.

BACKGROUND: Stroke-associated pneumonia (SAP) is a standout complication after acute ischemic stroke (AIS), with a prevalence of 7-38%. The aim of this prospective study was to investigate the relationship between serum YKL-40 levels at admission and SAP. METHODS: Between August 2020 and February 2021, consecutive AIS patients from two centers were enrolled prospectively. Serum YKL-40 concentrations were measured via enzyme-linked immunosorbent assay. We performed logistic regression analyses to explore the relationship between YKL-40 and SAP. Receiver operating characteristic curve was also used to assess the predictive ability of YKL-40 in predicting SAP. RESULTS: Ultimately, a total of 511 AIS patients were recruited. Multivariate logistic regression analysis showed that YKL-40 was independently related to SAP, whether as a continuous variable or as quartiles (P=0.001). The area under curve of YKL-40 to predict SAP was 0.765. The optimal cutoff value of YKL-40 as a predictor of SAP was determined to be 206.4 ng/mL, where the sensitivity was 63.1% and the specificity was 82.0%. CONCLUSION: Our study demonstrated that YKL-40 might be considered as a useful biomarker to predict SAP in AIS patients.

Microglial TREM2 Mitigates Inflammatory Responses and Neuronal Apoptosis in Angiotensin II-Induced Hypertension in Middle-Aged Mice.

Growing evidence suggests that hypertension and aging are prominent risk factors for the development of late-onset Alzheimer's disease (LOAD) by inducement of neuroinflammation. Recent study showed that neuroinflammation via activated microglia induces reactive astrocytes, termed A1 astrocytes, that highly upregulate numerous classical complement cascade genes that are destructive to neurons in neurodegeneration diseases. Moreover, triggering receptor expressed on myeloid cells 2 (TREM2) is considered as one of the strongest single-allele genetic risk factors and plays important roles in neuroinflammation for LOAD. However, the mechanisms of microglia in the regulation of A1 astrocytic activation are still not clear. We introduced angiotensin II-induced hypertension in middle-aged mice and found that hypertension-upregulated TREM2 expression and A1 astrocytic activation were involved in neuroinflammation in the animal models used in this study. The in vitro results revealed that overexpression of microglial TREM2 not only mitigated microglial inflammatory response but also had salutary effects on reverse A1 astrocytic activation and neuronal toxicity.

Long noncoding RNA Nespas inhibits apoptosis of epileptiform hippocampal neurons by inhibiting the PI3K/Akt/mTOR pathway.

Epilepsy is one of the most common neurological diseases with spontaneous recurrent seizures. Long noncoding RNAs (lncRNAs) are crucial modulators in numerous diseases, including epilepsy. However, the functional role and potential mechanism of lncRNA Nespas in epilepsy remain unknown. Our study clarified that Nespas was underexpressed in epileptiform hippocampal tissues and neurons. Furthermore, Nespas promoted hippocampal neuron viability and proliferation, and inhibited hippocampal neuron apoptosis. Mechanistically, Nespas interacted with microRNA 615-3p (miR-615-3p) in epileptiform hippocampal neurons. 26S proteasome non-ATPase regulatory subunit 11 (Psmd11) was a downstream target of miR-615-3p, and Nespas elevated Psmd11 expression via competitively binding to miR-615-3p in epileptiform hippocampal neurons. In addition, rescue assays suggested that Nespas promoted hippocampal neuron viability and proliferation, and suppressed hippocampal neuron apoptosis by upregulation of Psmd11. Furthermore, Nespas suppressed the PI3K/Akt/mTOR pathway via upregulating Psmd11 in epileptiform hippocampal neurons. This report explored the function and regulatory mechanism of Nespas in epileptiform hippocampal neurons for the first time. Our findings revealed that Nespas suppressed the apoptosis of epileptiform hippocampal neurons by inhibiting the PI3K/Akt/mTOR pathway via upregulation of Psmd11 at a miR-615-3p dependent way, indicating that Nespas may offer a new direction for the treatment of epilepsy.

[Community Structure and Activity Analysis of the Nitrifiers in Raw Sewage of Wastewater Treatment Plants].

The communities and activity of nitrifiers collected from the raw sewage of the 2nd and 3rd wastewater treatment plants (WWTP) in Xi'an were investigated. FISH results indicated that the (AOB+NOB)/EUB percentages were (5.35±2.1)% and(6.0±2.8)% in the 2nd and 3rd WWTP, respectively. The dominant AOB was Nitrosomonas europaea/Nitrosococcus mobilis lineage and the dominant NOB was Nitrospira, the sub-dominant NOB was Nitrobacter, and coexisted with Nitrococcus, Nitrospina. Respirometric assays showed that the influent nitrifiers were active following a 2-16 hour period of metabolic induction. The ammonium utilized rate was (0.32±0.12) mg·(L·h)-1 and (0.43±0.17) mg·(L·h)-1, nitrite utilized rate was (0.71±0.18) mg·(L·h)-1 and (0.58±0.27) mg·(L·h)-1 for nitrifers in raw sewage fed to the 2nd and 3rd WWTP, respectively. Therefore, nitrifiers were present and active in the raw sewage, and played the role of natural continuous seeding in the activated sludge system. Based on the nitrification activity, the estimated continuous seeding intensity of AOB and NOB was 0.08-0.09 g·(g·d)-1 and 0.11-0.24 g·(g·d)-1, respectively.

Lesion patterns of single small subcortical infarct and its association with early neurological deterioration.

Early neurological deterioration (END), happening in the acute phase of infarct, is not rare in patients with single small subcortical infarction (SSSI). The aim of this study was to investigate the lesion patterns of SSSI and its association with END as well as functional outcome at 90 days after onset. 227 patients with acute SSSI in the perforator territory of MCA were prospectively recruited from Yangzhou No.1 People's Hospital between May 2010 and Jan 2014 and divided into proximal SSSI (pSSSI) and distal SSSI (dSSSI) according to the lesion patterns. END was defined as a change in National Institutes of Health Stroke Scale score ≥2 points in the first 72 h after admission. Functional outcome at 90 days after onset was assessed using the modified Rankin Score (mRS) and dichotomized as good (0-2) and poor (≥3). Of them, 93 (40.97%) patients had pSSSI and 134 (59.03%) patients had dSSSI. Univariate analysis found that the risk factors profiles differ significantly between patients with pSSSI and those with dSSSI (P < 0.05). During hospitalization, 60 (26.43%) patients experienced END during the first 72 h after admission, and 46 (22.01%) patients had poor outcome at 90 days after onset. After adjusting for potential confounders, pSSSI pattern (OR 2.242, 95% CI 1.165-4.313, P = 0.016) was an independent predictor of END and that the END (OR 2.637, 95% CI 1.208-5.759, P = 0.015) independently predicted the poor outcome at 90 days after onset. The pSSSI patterns might predict END for patients with SSSI in the MCA perforating territory.

[Determination of calceolarioside B in Caulis Akebiae by RP-HPLC].

OBJECTIVE: To establish a quantitative method for calceolarioside B in Caulis Akebiae. METHOD: The samples were separated at 35 degrees C on a Phenomenex Luna C18 column eluted with methanol-water-phosphoric acid (35: 65: 0.05) as mobile phase. Flow rate was at 1.0 mL x min(-1) and the detection wavelength was at 330 nm. RESULT: The calibration curve was linear over the range from 0. 04 to 0. 86 g (r = 0. 9998) and the average recovery was 97.2%. 39 Crude drug materials collected from different areas were determined and the contents of calceolarioside B in Caulis Akebiae were fluctuated from 0. 021% to 0. 745%. CONCLUSION: The method is simple and repeatable and could be used for the quality control of Caulis Akebiae.

[Multi-components quantitation by one marker new method for quality evaluation of Chinese herbal medicine].

OBJECTIVE: To establish a new quality evaluation method for Chinese herbal medicine, using one chemical reference substance to calculate multi-components simultaneously. METHOD: Relative correction factors (RCF) of mutongsaponin B and C to saponin PJ1, a characteristic component as marker, were calcalated in The chromatographic conditions for determination of the three saponins in Caulis Akebiae akebiae as a research model. The contents of saponin PJ1 were determined by external standard method, and those of mutongsaponin B and C were calculated by saponin PJ1 and their RCF. The accuracy of the new method was evaluated by comparing the calculated contents with the determined contents. RESULT: The analysis procedures were validated. There has been no significant difference between the calculated contents and the determined contents, according to the angle cosine value, and the calcalated RCF have confidence value. CONCLUSION: The method of multi-components quantitation by one marker has been verified in caulis akebiae and it is to be a new quality evaluation pattern for Chinese herbal medicines.