The PROFILE of assessment program for internal medicine internship of Sun Yat-Sen University

Objective: To reflectively look at the present methods by which the clinical competence of 5th-year medical students (i.e. interns) in Sun Yat-Sen University (SYSU) are assessed upon finishing internship rotation in internal medicine (IM).

Methods: Current procedures for the competence assessment of end-of-rotation IM interns in the First Affiliated Hospital of SYSU were reviewed, along with a point-by-point appraisal based on the PROFILE approach to structured assessment, and, whenever possible, suggestions for future improvement.

Results and discussions: On a scale of 1–10, with 10 being the best or the most ideal, our marks for current methods to assess end-of-rotation IM interns in terms of being Programmatic, Real-World, Outcome-based, Formative, Impactful, Learner-engaged, and Evaluation-guaranteed were 7, 9, 3, 4, 6, 8, and 1, respectively. The strengths, weaknesses as well as potential solutions in each of the seven aspects are also discussed separately.

Conclusions: Current assessment program for IM internship is strong in being programmatic, real-world, educationally impactful and learner engaged, and has room for further improvement in its time-based arrangements, relative shortage of feedback provision, as well as a systematic lack of quality control measures.     

A rare case of monozygotic triplets with Duchenne muscular dystrophy

Twins with Duchenne muscular dystrophy (DMD) have been widely studied. We report the first rare case of monozygotic triplets with DMD who shared consistent phenotypes, including delayed motor and language milestones, muscle wasting and weakness, joint contracture, and lumbar lordosis. Muscle magnetic resonance imaging and biopsy revealed the similar muscle injury characteristics and dystrophin absence. Short tandem repeat analysis confirmed monozygosity. A de novo mutation (exon 49–52 deletion) was found in the triplets but not in their mother. Treatment included prednisone, idebenone, and rehabilitation management. At the 2-year follow-up, motor function had deteriorated, and muscle fatty infiltration was more extensive and severe. Our case offers a unique opportunity for genetic and therapeutic research. Furthermore, it highlights the critical role of genetic factors in DMD phenotypes and provides a potential choice for treatment observations.     

Detection of Memory B Activity Against a Therapeutic Protein in Treatment-Naïve Subjects

Bridging immunoassays commonly used to detect and characterize immunogenicity during biologic development do not provide direct information on the presence or development of a memory anti-drug antibody (ADA) response. In this study, a B cell ELISPOT assay method was used to evaluate pre-existing ADA for anti-TNFR1 domain antibody, GSK1995057, an experimental biologic in treatment naive subjects. This assay utilized a 7-day activation of PBMCs by a combination of GSK1995057 (antigen) and polyclonal stimulator followed by GSK1995057-specific ELISPOT for the enumeration of memory B cells that have differentiated into antibody secreting cells (ASC) in vitro. We demonstrated that GSK1995057-specific ASC were detectable in treatment-naïve subjects with pre-existing ADA; the frequency of drug-specific ASC was low and ranged from 1 to 10 spot forming units (SFU) per million cells. Interestingly, the frequency of drug-specific ASC correlated with the ADA level measured using an in vitro ADA assay. We further confirmed that the ASC originated from CD27⁺ memory B cells, not from CD27^?-naïve B cells. Our data demonstrated the utility of the B cell ELISPOT method in therapeutic protein immunogenicity evaluation, providing a novel way to confirm and characterize the cell population producing pre-existing ADA. This novel application of a B cell ELISPOT assay informs and characterizes immune memory activity regarding incidence and magnitude associated with a pre-existing ADA response.     

The study on apatite castable glass-ceramics in composition and physicochemical properties]

The authors reported the result of the study of the glass formation range and physicochemical characteristics of apatite (APA) castable ceramics in the CaO-MgO-Al2O3-SiO2-P2O5 system. The relationship between its component and casting properties, the mechanical property and chemical stability was mainly discussed. The result showed that homogeneous glass could be formed in the experimental scope. This glass crystallized enamel-analogous apatite phase. It has improved mechanical property of parent glass, the bending strength was up to 165 MPa and possessed a fine chemical stability. This investigation could provide a new castable ceramics material for dental restoration.     

牵引弓联合前牵引矫治替牙期前牙反(牙合)的牙颌结构变化

目的探讨牵引弓联合前方牵引对矫治安氏Ⅲ类错     

不同程度矢状向和垂直向不调的安氏Ⅱ~1类错患者的矫治效果分析

目的:评估生长期不同程度矢状向和垂直向骨性不调的安氏Ⅱ类1分类错患者的疗效差异。方法:选择28例治疗后获得Ⅰ类尖牙磨牙关系的中、重度安氏Ⅱ类1分类错患者。以治疗前矢状向和垂直向不调程度分为3组。利用治疗前、后头颅侧位片分析各组治疗前、后软硬组织变化。采用SPSS12.0软件包对数据进行统计学分析。结果:3组患者治疗后ANB角均减小,第2组、第3组较第1组ANB角减小更多(P<0.01)。第3组治疗后SNA角明显减小(P<0.01),第1组(P<0.01)、第2组(P<0.05)治疗后SNB角明显增加。治疗后3组上前牙均变得直立,下前牙位置基本不变,各组间无显著差异(P>0.05)。软组织指标治疗前、后组间无显著性差异(P>0.05),但鼻唇角(P<0.05)、面凸角(P<0.05)、Z角(P<0.01)在第3组治疗前、后有显著差异。结论:对于处于生长期的不同矢状向和垂直向不调的安氏Ⅱ类1分类错患者,单纯正畸治疗结合矫形治疗,可以取得明显牙骨性及软硬组织改善。重度矢状不调伴垂直向异常的患者,能取得更显著的侧貌改变。     

反复烧烤对渗透陶瓷-面瓷复合体颜色的影响

目的 :探讨反复烧烤后渗透陶瓷 饰面瓷复合体的颜色变化规律。方法 :制作直径为 12 .5mm ,厚度为 0 .5mm的VitaIn CeramAlumina和GI Ⅱ型渗透陶瓷片状样本 ,表面烧结 0 .2mm的Vitaduralpha不透明牙本质瓷 ,0 .6mm的牙本质瓷 ,0 .2mm的牙釉质瓷 ,表面打磨后 ,按饰面瓷烧结程序反复烧烤 2、4、6、8、10次 ,用TC PⅡG全自动测色色差仪测量不同烧烤次数以后样品的颜色参数 ( 1976CIEL a b ) ,计算色相值 (hab)、色饱和度 (C ab)参数和色差值 (ΔE)。结果 :反复烧烤以后 ,GI Ⅱ样本的明度值降低 (P <0 .0 5 ) ,色相值和彩度无明显变化 (P >0 .0 5 ) ;VitaIn CeramAlumina样本颜色变化不明显 (P >0 .0 5 )。 10次反复烧烤所引起的颜色变化 (ΔE)最大值为 2 .2 798(GI Ⅱ样本 )和 1.3894(VitaIn CeramAlumina样本 )。两种材料样本 10次以后的色差值最大为 2 .2 95 6。结论 :VitaIn CeramAlumina和GI Ⅱ型渗透陶瓷 饰面瓷复合体在反复烧烤以后 ,具有较好的颜色稳定性 ,10次反复烧烤以后颜色的变化程度处于临床可接受的范围之内     

类骨质羟基磷灰石修复骨缺损的实验研究

目的:了解类骨质羟基磷灰石(OHA)的生物相容性,初步探讨其作为骨替代材料的可行性。方法:12只新西兰白兔随机分为4组,在双侧股骨内侧髁形成9mm×4mm×5mm大小的缺损,分别植入OHA和对照材料,术后2、4、8、12周取标本,进行大体标本、X线、组织学切片、扫描电镜观察及成骨面积的定量分析。结果:实验组成骨细胞易于粘附、生长、增殖,骨小梁形成钙化早,新骨面积百分比高于对照组,差异有统计学意义。结论:类骨质羟基磷灰石是一种良好的骨替代材料,具有广阔的应用前景。     

粉浆涂塑渗透陶瓷烧结线性收缩率的测定

制作４０个渗透陶瓷样本测定粉浆涂塑渗透陶瓷的氧化铝烧结及玻璃料渗透的两个烧结阶段的线性收缩率。结果表明，渗透陶瓷烧结完成后的线性收缩率为０．０８％＿０．３２％。收缩主要发生于氧化铝的烧结过程，此过程的收缩率为０．２０％，而玻璃料的渗透烧烤过程 不引起长度的明显变化。