O2O互动型教学模式在住院医师规范化培训中的应用

目的探讨线上线下（online to offline，O2O）互动型教学模式在住院医师规范化培训中的应用效果。方法以首都医科大学宣武医院医师规范化培训的36名学生作为试验组，每组成员6〖FGS〗~〖FGN〗8人，另外36名前期住院医师作为对照组，试验组采用O2O互动教学法，对照组按照传统教学模式。教学完成后比较两组理论和临床实践技能成绩以及问卷调查结果。结果试验组理论和临床实践技能成绩均优于对照组（P<0.05）,且各项效果评价也优于对照组（P<0.05）。结论O2O互动型教学模式能够为住院医师规范化培训教学提供更优化的教学。     

Melatonin promotes sorafenib‐induced apoptosis through synergistic activation of JNK/c‐jun pathway in human hepatocellular carcinoma

Melatonin has been shown to exert anticancer activity on hepatocellular carcinoma (HCC) through its antiproliferative and pro‐apoptotic effect in both experimental and clinical studies, and sorafenib is the only approved drug for the systemic treatment of HCC. Thus, this study was designed to investigate the combined effect of melatonin and sorafenib on proliferation, apoptosis, and its possible mechanism in human HCC. Here, we found that both melatonin and sorafenib resulted in a dose‐dependent growth inhibition of HuH‐7 cells after 48 hours treatment, and the combination of them enhanced the growth inhibition in a synergistic manner. Colony formation assay indicated that co‐treatment of HuH‐7 cells with melatonin and sorafenib significantly decreased the clonogenicity compared to the treatment with single agent. Furthermore, FACS and TUNEL assay confirmed that melatonin synergistically augmented the sorafenib‐induced apoptosis after 48 hours incubation, which was in accordance with the activation of caspase‐3 and the JNK/c‐jun pathway. Inhibition of JNK/c‐jun pathway with its inhibitor SP600125 reversed the phosphorylation of c‐jun and the activation of caspase‐3 induced by co‐treatment of HuH‐7 cells with melatonin and sorafenib in a dose‐dependent manner. Furthermore, SP600125 exhibited protective effect against apoptosis induced by the combination of melatonin and sorafenib. This study demonstrates that melatonin in combination with sorafenib synergistically inhibits proliferation and induces apoptosis in human HCC cells; therefore, supplementation of sorafenib with melatonin may serve as a potential therapeutic choice for advanced HCC.     

A Novel Method for Three-Dimensional Analysis of Endoscopic Spatial Relationships of Pterygopalatine Fossa Structures and Associated Regions

Background: The spatial orientation rules of the important skull base structures are essential for performing endoscopic surgery. However, there is no satisfactory three-dimensional (3-D) anatomy study available to the surgeon at present. The aims of this study are to construct a new method to learn the spatial orientation of anatomical features under endoscopy and to help the surgeon establish a 3-D image of skull base structures in his mind. Methods: A modified MicronTracker navigation system was used to measure the pitch angle, direction angle and distance from the reference points to various anatomical landmarks of the pterygopalatine fossa and related structures (PPFRS) at the skull base in 10 fresh cadavers (20 sides). Results: The location data of the positions of the major landmarks were acquired and a digital model of the anatomical structures of the PPFRS was built, which can be moved, whirled or demonstrated easily. Conclusion: It is practical to measure the positions of the anatomical structures of the PPFRS with a modified binocular vision-based MicronTracker navigation system. It is a valuable exploration tool to help the surgeon establish the orientation of surgical landmarks in his mind by the 3-D parameters and model.     

Comparative Evaluation of Two Hemagglutinating Encephalomyelitis Coronavirus Vaccine Candidates in Mice

Porcine hemagglutinating encephalomyelitis (PHE) is caused by the coronavirus hemagglutinating encephalomyelitis virus (PHE-CoV), and the recent, rapid spread of PHE-CoV in piglets from many countries emphasizes the urgent need for a PHE-CoV vaccine. Here we use a murine model for evaluation of the induction of humoral and cellular immune responses by inactivated and PHE-CoV DNA vaccines in order to define the immune correlates for protection against PHE-CoV. The inactivated vaccine was composed of purified PHE-CoV and aluminum hydroxide gel (alum), which was chosen as an adjuvant because of its long history of safety for human use. The PHE-CoV DNA vaccine was constructed by subcloning the S1 gene of PHE-CoV into the pVAX1 vector to create the recombinant plasmid pV-S1. Our results showed that the inactivated PHE-CoV vaccine (IPV) elicited a high level of humoral immunity, resulting in good protection efficacy against PHE-CoV challenge. The IPV induced the IgG1 subclass of serum antibodies and expression of the cytokine interleukin-4 (IL-4), suggesting that the IPV generated a predominantly Th2-type immune response. The DNA vaccine was found to mediate primarily a cellular immune response with high levels of IgG2a and the cytokines IL-2 and gamma interferon (IFN-γ). However, mice that were vaccinated twice with the DNA vaccine and boosted with the IPV could mount a sufficient neutralizing antibody response against live PHE-CoV, with little variation in IgG1 and IgG2a levels, and showed high levels of IL-2 and IL-4. This response may activate both B and T cells to mount a specific humoral and cellular immune response that could, in turn, elicit a phagocyte-mediated defense against PHE-CoV infections to achieve viral clearance.     

人乳头瘤状病毒在头颈部鳞状细胞癌中的研究进展

高危型人乳头瘤状病毒是宫颈癌的主要致病因素,近年来研究发现人乳头瘤状病毒感染与头颈部鳞状细胞癌的发生也存在密切关系。本文对人乳头瘤状病毒相关性头颈部鳞状细胞癌的流行病学、致癌机制、诊断方法、治疗及预后等方面的研究进展作一综述。     

普洱市小儿TORCH感染流行病学调查

目的对云南省普洱市小儿TORCH感染情况进行流行病学调查,为小儿TORCH感染的防治提供参考。方法选取2014年1~12月于该院就诊的1 194例患儿,并分为5个年龄组。采用酶联免疫吸附试验(ELISA)检测患儿血清中TORCH特异性免疫球蛋白M(IgM)、免疫球蛋白G(IgG)抗体,分析比较TORCH特异性抗体阳性率和TORCH感染率。结果患儿TORCH特异性抗体IgM阳性率明显低于IgG,IgM阳性率为0.00%~3.10%,IgG阳性率为10.13%~82.24%,TORCH总感染率为96.98%;各年龄组单项TORCH感染率及TORCH总感染率比较,差异均无统计学意义(P0.05);5个年龄组间各单项感染率分布比较,差异有统计学意义(P0.05);不同季节TORCH感染率及各单项感染率分布比较,差异均无统计学意义(P0.05)。结论该地区小儿TORCH感染以CMV为主,其次为RV和HSV,TOX感染少见;TORCH感染率无明显季节性差异,且各年龄小儿TORCH感染率无明显差异。     

Sublobectomy Versus Lobectomy for Stage I Non-Small-Cell Lung Cancer,A Meta-Analysis of Published Studies

Background  

The selection of surgeries for patients with stage I NSCLC remains controversial. We evaluated the effectiveness of different surgeries for stage I NSCLC through a meta-analysis of studies that compared sublobectomy with lobectomy.     

An Approach to Bioactivity Assessment for Critical Quality Attribute Identification Based on Antibody-Antigen Complex Structure

Identification of critical quality attributes (CQAs) is an important step for development of biopharmaceuticals with intended performance. An accurate CQA assessment is needed to ensure product quality and focusing on development efforts where control is needed. The assignment of criticality is based on safety and efficacy. Efficacy is related to PK and bioactivity. Here, we developed a novel approach based on antibody-antigen complex structure and modeling as a complementary method for bioactivity assessment. To validate this approach, common product related quality attributes and mutagenesis data from several IgGs were assessed using available antibody-antigen complex structures, and results were compared with experimental data from bioactivity or binding affinity measurements. A stepwise evaluation scheme for structural based analysis is proposed; based on systematic assessment following the scheme, good correlation has been observed between structural analysis and experimental data. This demonstrates that such an approach can be applied as a complementary tool for bioactivity assessment. Main applications are 1) To decouple multiple attributes to achieve amino acid resolution for bioactivity assessment, 2) To assess bioactivity of attributes that cannot be experimentally generated, 3) To provide molecular mechanism for experimental observation and understand structure function relationship. Examples are provided to illustrate these applications.