基于中国输血大讲堂的网络在线继续教育模式探索与实践

目的探索输血医学在线继续教育新模式,发挥继续教育对于学科可持续发展的促进作用。方法利用在线网络平台创建中国输血大讲堂,以在线直播专题讲座的方式将输血医学相关的基础与临床研究新进展传递给全国的一线工作人员。通过问卷星软件系统进行匿名网络问卷调查,了解大讲堂观众人群构成以及对课程设置和讲课效果的评价情况。结果过去四年多已完成166期、249个学时的网络授课,超过6.3万人次收看了直播讲座。问卷调查共回收有效问卷1266份,讲座内容安排满意度评分(S1)≥90、80≤S1<90和70≤S1<80分别占61.45%、30.88%和5.85%;整体师资能力水平满意度(S2)≥90、80≤S2<90和70≤S2<80分别占68.01%、25.91%和5.06%;讲课效果包括提高临床实际处理问题的能力(89.02%)、增强基础理论水平(84.36%)、完善对输血医学学科整体认识(83.89%)、开拓学科视野(81.04%)、有助于改善与临床之间的协作关系(64.14%)和锻炼临床思维(63.35%)。结论中国输血大讲堂这种网络在线继续教育模式,可以有效地克服时间、空间的限制,为广大输血从业人员提供便捷、系统的知识更新渠道,受众人群在基础知识、基本理论、基本技能等方面得到不同程度的提高。     

Bench to bedside: recent advances in lung cancer pathological research with implications for diagnostic clinical practice

After decades of relative stagnation lung cancer is emerging as a disease type where rapid progress is being made in diagnosis and therapy, as well as in our understanding of disease biology. Much of this progress is of immediate impact to diagnosticians, and more is likely to affect diagnostic practice in the near future. In this review we seek to briefly summarize several key areas of active research of immediate or probable imminent value to trainee and consultant pulmonary pathologists alike. We cover some major changes in tumour classification, grading, and patient stratification, as well as considering the state of the art in machine-assisted interpretation of lung cancer histology, and the use of genetically modified lung cancer models.     

Prolyl and lysyl hydroxylases in collagen synthesis

Collagens are the most abundant proteins in the extracellular matrix. They provide a framework to build organs and tissues and give structural support to make them resistant to mechanical load and forces. Several intra‐ and extracellular modifications are needed to make functional collagen molecules, intracellular post‐translational modifications of proline and lysine residues having key roles in this. In this article, we provide a review on the enzymes responsible for the proline and lysine modifications, that is collagen prolyl 4‐hydroxylases, 3‐hydroxylases and lysyl hydroxylases, and discuss their biological functions and involvement in diseases.     

前房注射卡波姆建立大鼠高眼压模型的观察

目的　前房注射卡波姆建立大鼠高眼压模型，观察卡波姆升眼压效果及对大鼠眼前节和视网膜的影响。方法　随机选取30只SD大鼠，注射前3 d早晚测量基线眼压。右眼定为实验眼，左眼定为对照眼，右眼放出房水后将30 μL的5 g·L^-1卡波姆混悬液注入前房，每日早10时、晚22时在大鼠清醒状态下测量眼压。每周进行双眼眼前节照相并对比。4周末处死26只大鼠（另4只持续观察眼压变化至注射后9周）并取双眼眼球行HE染色，观察实验眼与对照眼视网膜形态，对比视网膜厚度及房角形态。结果　注射前，实验眼白天和夜间眼压分别为（11.10±0.90）mmHg（1 kPa=7.5 mmHg）和（11.92±1.07）mmHg，对照眼分别为（11.22±1.07）mmHg和（11.76±1.08）mmHg；实验眼与对照眼相比，白天、夜间眼压差异均无统计学意义（均为 P＞0.05）；白天与夜间眼压相比，实验眼、对照眼差异均有统计学意义（均为P<0.05）。卡波姆在前房中呈现出弥散型和沉积型两种存在方式，弥散型和沉积型大鼠1周内眼压分别为（17.83±3.54）mmHg和（13.00±1.55）mmHg，两者相比差异具有统计学意义（P＜0.05）。注射后第1天至第19天，实验眼与对照眼白天眼压相比差异均具有统计学意义（均为P＜0.05）；注射后第1天至第27天，实验眼与对照眼夜间眼压相比差异均具有统计学意义（均为P＜0.05）。实验眼视网膜形态发生改变，注射后4周视网膜厚度为（254.70±21.80）μm，与对照眼的（346.73±24.63）μm相比，差异有统计学意义（P=0.00）。实验眼前房充满卡波姆及虹膜的混合成分，紧贴角膜内皮并延伸至房角，堵塞小梁网结构，正常虹膜形态消失；对照眼房角形态正常。结论　前房注射卡波姆建立大鼠高眼压模型，可维持高眼压4周以上，昼夜眼压差异较为明显，夜间眼压较白天更高，4周后视网膜出现高眼压损伤后的表现。     

Modelling human pathology of traumatic brain injury in animal models

Traumatic brain injury (TBI) is caused by a head impact with a force exceeding regular exposure from normal body movement which the brain normally can accommodate. People affected include, but are not restricted to, sport athletes in American football, ice hockey, boxing as well as military personnel. Both single and repetitive exposures may affect the brain acutely and can lead to chronic neurodegenerative changes including chronic traumatic encephalopathy associated with the development of dementia. The changes in the brain following TBI include neuroinflammation, white matter lesions, and axonal damage as well as hyperphosphorylation and aggregation of tau protein. Even though the human brain gross anatomy is different from rodents implicating different energy transfer upon impact, especially rotational forces, animal models of TBI are important tools to investigate the changes that occur upon TBI at molecular and cellular levels. Importantly, such models may help to increase the knowledge of how the pathologies develop, including the spreading of tau pathologies, and how to diagnose the severity of the TBI in the clinic. In addition, animal models are helpful in the development of novel biomarkers and can also be used to test potential disease‐modifying compounds in a preclinical setting.     

我国中药材产地市场整合研究——以金银花、枸杞子、板蓝根和太子参为例

中药材专业市场交易量逐渐下降,产地市场交易成为趋势。研究产地市场整合程度有利于了解中药材市场的运行情况,对于合理规划中药材生产和提高市场效率具有重要意义。选取大宗中药材金银花、枸杞子、板蓝根和太子参研究中药材市场整合程度,利用2013—2019年价格指数,运用协整检验、误差修正模型和格兰杰因果检验进行实证分析。结果表明,我国中药材产地市场长期整合程度较高;中药材产地市场的短期整合程度远不及长期整合程度。为此提出4点政策建议:完善中药材价格信息平台、打造非道地产区中药材优质品牌、加快建成中药材质量追溯体系和建设中药材现代物流体系。     

腰椎间盘突出症动物模型的研究进展

近年来,腰椎间盘突出症发病率逐渐增高,由于动物模型对于阐明疾病发病机制及评估新的治疗方法具有重要作用,越来越多的学者开始研究如何建立合适的、能够更好地模拟人类腰椎间盘突出的动物模型。近期的研究多选用包括大鼠、兔、羊、猪等动物作为实验对象,通过物理或化学方式直接损伤其椎间盘或神经根,或通过限制实验动物的行为动作、改变其饲养环境以及性别年龄导致的生理因素等方式诱导其出现椎间盘退变。各种造模方法均有其特点及局限性,适用于不同情况,有必要继续完善。