Table of Content

05 August 2019, Volume 39 Issue 8

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PTEN regulates primordial follicular initiation and growth in rats

2019, 39(8):  1077-1084. 

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Objective To investigate the regulatory mechanism of PTEN on the activation and growth of primitive follicles in rat. Methods Ovaries from 2-day-old rats were cultured in Waymouth culturing system in vitro for 0, 4 and 8 days. PCR, Western blotting and primordial follicle development were assessed for the silencing efficiency of the lentivirus PTEN siRNA and its effect on primordial follicle onset. PTEN mRNA and protein expression in primary follicular proliferation was detected by PCR and immunohistochemical staining. Furthermore, the PI3K inhibitor LY294002 was used to explore the possible signaling pathways of PTEN in primordial folliculogenesis. Results Our results showed that PTEN mRNA and protein were detected in the primordial follicles, and the expression levels were reduced with the development of primordial follicles（P<0.01）. After PTEN-shRNA lentiviral transfection, there can be seen that lentivirus was successfully delivered to the ovarian tissue in vitro by fluorescence imaging. And the number of primordial follicles was reduced（P<0.01）, indicating that PTEN participates in the initiation of primordial follicles. Conclusion PTEN can promote primordial follicle development through the PI3K signaling pathway and by regulating estrogen and progesterone secretion. PTEN plays an important role in the initiation and development of primordial follicles.

Effect of recombinant SHH adenovirus fibrin slow-release scaffold on proliferation and differentiation of neural stem cells

2019, 39(8):  1085-1090. 

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Objective To study the effects of fibrin scaffold that can release recombinant SHH adenovirus slowly on the proliferation and differentiation of neural stem cells (NSCs) . Methods Experimental group: NSCs were planted in recombinant SHH adenovirus-scaffold group, culture plate, recombinant SHH adenovirus transfection group, fibrin scaffold group as control group(Controls). The neural stem cells were isolated, cultured and identified in vitro ; Construction of fibrin scaffold that can release recombinant SHH adenovirus slowly. The efficiency of transfection was determined by immunofluorescence and Western blotting. The cell proliferation was tested by MTT. Immunofluorescence and immunoblotting were used to detect the expression of β-tubulin III, and MBP and GFAP in NSCs after inducing in each group. Results NSCs cultured in vitro expressed nestin highly. Data shows, NSCs stably expressed SHH after transfection with recombinant SHH adenovirus; FG-SHH scaffold can promote the proliferation of NSCs, and the positive rates and protein expression.

Inhibition of the expression of HSP70 in HEPG-2 and ORSC-2 cell lines by liposome quercetin after hyperthermia

2019, 39(8):  1091-1096. 

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Objective To investigate the effects and mechanisms of the expression of heat shock protein 70 (HSP70) on human hepatocellular carcinoma HEPG-2 cells and renal cell carcinoma ORSC-2 of different concentrations of liposomal quercetin (LQ) after hyperthermia. Methods The method of rotary evaporation was used to prepare quercetin.The cells were divided into 37℃ control group, 42℃ hyperthermia group and quercetin intervention group.Two kinds of tumor cells were treated with LQ at 10, 15 and 30mg/L. The tumer cells were incubated at 42℃ for 2h, and cells were removed at 2, 4, 6, and 10h after hyperthermia.Flow cytometry analysis was applied to determine the apoptosis of tumer cells,and the changes of mRNA and protein level of HSP70 were detected by real-time PCR and Western blot, respectively. Results After hyperthermia, the expression of HSP70 in HEPG-2 cells and ORSC-2 cells were significantly increased at both gene and protein levels (P<0.05).With the increase of the concentration of LQ, the expression of HSP70 gradually decreased. Conclusion Liposome quercetin can induce apoptosis of hepatocellular carcinoma and renal carcinoma cells by inhibiting the expression of HSP70 in tumor cells after hyperthermia.

Establishment of T lymphocyte cell strain secreting ephrinAl-caspase-3

2019, 39(8):  1097-1101. 

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Objective Development of T cell strains infected by pAd-ephrinAl-caspase-3 recombinant adenovirus. Methods T lymphocytes were cultured . The constructed recombinant adenovirus infected T lymphocytes, Indirect immunofluorescence was used to detect the infection efficiency of T lymphocytes, The proliferation and toxicity of T lymphocytes were detected by MTT assay. The RT-PCR and ELISA were performed to detect expression of ephrinAl-caspase-3. Results T lymphocytes were successfully cultured and infected with recombinant adenovirus, the expression of ephrinAl and caspase3 increased. With the increase of MOI, the number of cell survival decreased and cell proliferation activity decreased（P<0.05）, and it showed time and dose dependence. Conclusion A T lymphocyte cell strain secreting ephrinA1-caspase-3 is successfully established.

Adenosine A2b receptor activation attenuates lung injury induced by renal ischemia-reperfusion in mice

2019, 39(8):  1102-1107. 

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Objective To study the protective effect and mechanisms of adenosine A2b receptor activation on lung injury induced by renal ischemia-reperfusion. Methods 30 male C57BL /6J mice were randomly divided into control group (group C), ischemia-reperfusion group (I/R group), ischemia-reperfusion+A2bR agonist Bay606583 group (I/R+Bay group, 1mg/kg Bay i.p. 15min before sugery), ischemia-reperfusion + A2bR agonist Bay606583 +Akt inhibitor LY294002 group (I/R+Bay+LY group, 1mg/kg Bay+7.5 mg/kg LY i.p. 15min before sugery), ischemia-reperfusion + A2bR antagonist MRS1754 group (I/R+MRS group, 1mg/kg MRS i.p. 15min before sugery). After renal ischemia-reperfusion surgery and sham operation for 24 hours, blood samples were taken for renal function test (serum creatinine, blood urea nitrogen); the expression of A2bR mRNA in lung tissue of mice was detected; the expression of p-Akt and A2bR in lung tissue was detected by Western blot. The ratio of wet weight/dry weight and the concentrations of protein, TNF-α and IL-6 in bronchoalveolar lavage fluid (BALF) of each group were detected. Moreover, pathological changes in lung tissue were observed and arterial blood was acquired to perform the arterial blood gas analysis. Results The serum creatinine and blood urea nitrogen was increased and the mRNA expression of A2bR was significantly decreased after renal ischemia-reperfusion (P <0.05), and the protein level of p-Akt was also decreased obviously after reperfusion. In addition, compared with the control group, the ratio of wet weight / dry weight, the alveolar lavage fluid protein, TNF-α and IL-6 concentrations were significantly increased (P <0.05), and the lung pathological injury score and oxygenation level were significantly damaged seriously (P< 0.05), and 1 mg/kg Bay606583 preoperative intraperitoneal injection can significantly alleviate the above damage and increase the expression of p-Akt, however this effect disappeared after the application of the Akt inhibitor LY294002. Conclusions Activation of adenosine A2b receptors attenuates the inflammatory response of lung tissue, which ultimately reducing lung tissue damage and improving oxygenation after renal ischemia-reperfusion and this effect may be caused by enhancing the PI3K/Akt signaling pathway.

Item analysis and evaluation of geriatric knowledge, attitude and practice scale based on item response theory

2019, 39(8):  1108-1113. 

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Objective To analyze and evaluate the items of geriatric knowledge, attitude and practice scale by using item response theory. Methods The subjects were selected from eight-year medical undergraduates and nursing undergraduates of Peking Union Medical College. Two-parameter logistic model was used to analyze items of knowledge dimension, and grade response model was used to analyze items of attitude and practice dimensions. The degree of discrimination, difficulty and information of each item were calculated, and the item characteristic curve was drawn to evaluate the quality of items. Results The maximum information function of the scale was 18.810, and the potential ability parameter corresponding to the maximum information function was -0.4. Of the 34 items, 23 items performed well, and 11 items were not up to the standard due to difficulty or discrimination parameters. Conclusion Most items of the Geriatric Knowledge, Attitude and Practice Scale have good performance, but some items need to be further revised and validated.

Change of T lymphocyte subsets in patients of non-surgical hypoparathyoidism

2019, 39(8):  1114-1118. 

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Objective To investigate the proportion of regulatory T lymphocyte (Tregs), T helper cells type 1(Th1) and Th17 subsets in non-surgical hypoparathyroidism (ns-HP). Methods A total of 20 patients with ns-HP , 20 patients with Hashimoto's thyroiditis were included, all patients were followed up during July 2018 to March 2019 at Peking Union Medical College Hospital (PUMCH). Twenty healthy participants were included as control group. The three groups were matched according to gender and age. Flow cytometry were used to test the proportion of Tregs, Th1 and Th17. Multiple linear regression model was used to investigate the predictors of percentage of abnormal T lymphocyte subsets. Results The proportion of Tregs in ns-HP group and Hashimoto's thyroiditis group were lower than that in healthy controls (p＜0.05 and p＜0.01, respectively), but no difference of Tregs proportion between ns-HP group and Hashimoto's thyroiditis group were found. The proportion of Th17 were higher in nsHP and Hashimoto's thyroiditis group than that in healthy controls（p＜0.05 and p＜0.01）No linear correlation was found between the proportion of Tregs, Th17 and other factors. Conclusions The pathology of ns-HP may be associated with changes of lymphocytes subsets distribution.

Effects of Cabozantinib, Crizotinib and AZD9291 on subsets and apoptosis of mouse MDSCs

2019, 39(8):  1119-1124. 

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Objective To investigate the effects of Cabozantinib, Crizotinib and AZD9291 on the percentage of subsets, apoptosis and proliferation of myeloid-derived suppressor cells (MDSCs) from normal mouse bone marrow and spleen. Methods Bone marrow G-MDSCs and M-MDSCs of BALB/c mouse were isolated by immunomagnetic beads and co-cultured with different dosages of Cabozantinib, Crizotinib and AZD9291 for 24 h. The effects of three targeted drugs on MDSCs subtypes were detected by flow cytometry (FCM), the proliferation of MDSCs was detected by CCK-8; The apoptosis of Gr-1+CD11b+ cells was detected by flow cytometry. Results We found that percentage of spleen G(granulocytic) -MDSCs was significantly decreased after treated with Cabozantinib; the percentage of bone marrow G-MDSCs and M(monocytic)-MDSCs was decreased after treated with Crizotinib; Early apoptosis rate of bone marrow MDSCs was increased after treated with Cabozantinib and Crizotinib. There was no obvious change for cell apoptosis after treated with AZD9291. Conclusions Cabozantinib and Crizotinib may reduce the percentage of MDSCs by inducing apoptosis of MDSCs.

Resveratrol attenuates LPS-induced acute lung injury of mice

2019, 39(8):  1125-1130. 

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Objective To observe the effect of resveratrol in lipopolysaccharide (LPS)-induced acute lung injury (ALI) mice and the effect of resveratrol on the expression of NLRP3 in lung tissue of mice. Methods The mice were divided into normal group, ALI model group (ALI model was established by tracheal instillation with 5 mg/kg LPS ), resveratrol intervention group (mice were intraperitoneally injected with 30 mg/kg resveratrol, and then injected into the trachea for 5 mg/kg LPS after 2 h.).Effect of resveratrol on the respiratory function was detected. Effects of resveratrol on the morphological changes of lung tissue were observed by HE staining and pathological scoring. Total protein, total cell number and neutrophil number in BALF were observed. ELISA were used to detect IL-1β and IL-18 expression in BALF. The mRNA expression of IL-1β ,IL-18 NLRP3, ASC, pro-caspase-1 and IκB in mouse lung tissue were detected by Real-time PCR and Western blot. Results Resveratrol could improve the respiratory function of ALI mice, reduce LPS-induced lung pathological damage, and decrease the protein levels of IL-1β and IL-18 in BALF of ALI mice（P<0.05）. Resveratrol can reduce the expression of NLRP3, ASC, pro-caspase-1, and increase IκB protein expression in lung tissue of ALI mice（P<0.05）. Conclusion Resveratrol may inhibit the activation of NLRP3 inflammasome in the lung tissue of ALI mice, and ultimately reducing LPS-induced ALI.

Analysis of thin-section CT signs of peripheral non-small cell lung cancer below 3 cm

2019, 39(8):  1131-1135. 

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Objective To investigate the thin-section CT signs of peripheral non-small cell lung cancer below 3 cm with solid nodule, and to improve the accuracy of its histopathological type prediction. Methods We retrospectively analyzed the 218 cases of solid nodules 3cm or less with non-small cell lung cancer (including 76 cases of squamous cell carcinoma, 142 cases of adenocarcinoma) confirmed by surgical pathology. The patient's clinical pathology included gender, age, and pathological type of tumor, as well as location, diameter, morphology, marginal features, and enhancement of nodules. The measurement data were expressed as x ± s. The count data were expressed as a percentage. Chi-square test was used to compare differences between groups of signs. Results There was a statistically significant difference in the prevalence of p-SqCC and adenocarcinoma solid nodules between men and women. The p-SqCC and adenocarcinoma solid nodules at the focal necrosis, air bronchogram sign, vacuolar sign, burr sign, pleura indentation, and enhancement pattern were statistically significant (P＜0.05). There was no statistical difference in nodule shape, lobulated sign, hole sign, and bronchial vascular bundle sign. Conclusion The specificity of diagnosis for adenocarcinoma solid nodules is 89.7% based on air bronchogram sign, bronchus encapsulated air sign, pleura indentation, and short burr sign. Focal necrosis is specific for p-SqCC diagnosis. Thin-section CT signs have certain value in the differential diagnosis of peripheral adenocarcinoma solid nodules and p-SqCC.

Down-regulating integrin-linked kinase expression inhibits the proliferation of human nasopharyngeal carcinoma cell lines CNE1 and 5-8f

2019, 39(8):  1136-1140. 

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Objective To investigate the expression levels of integrin-linked kinase in human nasopharyngeal carcinoma cell lines CNE1 and 5-8f. The effect of ILK expression on the proliferation of nasopharyngeal carcinoma cells. Methods IHC was used to exam ILK expression in NPC and normal nasopharyngeal epithelium. qRT-PCR and Western blot experiments were used to detect the RNA expression levels and protein expression level of ILK in nasopharyngeal carcinoma cell lines CNE1 and 5-8f..and measure the knock down efficiency of ILK Small interfering RNA. MTT assay was used to evaluate the cell proliferation of nasopharyngeal carcinoma cells. Data analysis was performed using SPSS 22.0 statistical software. The T-test was used for comparison between groups. P<0.05 was considered statistically significant. Results ILK expressed in NPC tissue but not normal nasopharyngeal epithelium. siILK significantly decreased ILK expression in nasopharyngeal carcinoma cell lines CNE1 and 5-8f, (P<0.05). Down-regulation of ILK expression by siRNA can inhibit the proliferation of nasopharyngeal carcinoma cells, ILK-specific small molecule inhibitor (Cdp22) inhibits the proliferation of nasopharyngeal carcinoma cells(P<0.05). Conclusion Down-regulating ILK expression inhibits the proliferation of nasopharyngeal carcinoma cells and can be used as a new target for treatments of patients with nasopharyngeal carcinoma (NPC).

ALDH18A1 regulates MYCN expression in neuroblastoma

Yu-Qing ZHANG wen liu

2019, 39(8):  1141-1145. 

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Objective To investigate the role of ALDH18A1 in the promotion of neuroblastoma malignancy. Methods Immunohistochemical was applied to examine the expression levels of ALDH18A1 and MYCN in patients with neuroblastoma. Afterwhile, the correlation was confirmed by Western blot and RT-qPCR in the SH-SY5Y neuroblastoma cell transfected with ALDH18A1 shRNA-expression and over-expression vectors. Results ALDH18A1 was closely related with the age of onset, stage and metastasis in neuroblastoma patients (P<0.001). Meanwhile, patients with up-regulated ALDH18A1 showed the high expression of MYCN (P<0.001). Besides, the Western blot confirmed the promotion of MYCN in the SH-SY5Y transfected with ALDH18A1 overexpression vector, while the expression of MYCN reduced in the SH-SY5Y transfected with ALDH18A1 shRNA-expression vector. Finally, the RT-qPCR indicted that the up-regulation of MYCN was induced in the transcriptional level. Conclusions ALDH18A1 is closely related with malignancy of neuroblastoma. The mechanism involved is the up-regulation of MYCN in transcriptional level induced by ALDH18A1.

Application of bone marrow mesenchymal stem cells attached poly(lactic-co-glycolic acid)-collagen I scaffold patch in rat inguinal hernia model

2019, 39(8):  1146-1151. 

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Objective To study the repair effect of PLGA-collagen I patch on inguinal hernia. Methods First, the PLGA-collagen I patch was prepared. Then, the rat bone marrow mesenchymal stem cells were extracted, and the rat model of abdominal wall defect was made. Bone marrow mesenchymal stem cells (BMSCs) bearing tissue engineering patches (experimental group) and cell-free tissue engineering patches (control group) were implanted into the groin respectively. The changes of pro-inflammatory factor IL-6 (interleukin -6) and IL-10 (interleukin -10) were detected by ELISA kit after operation. Immunohistochemistry was used to detect the change of macrophage surface antigen to analyze the inflammatory reaction. HE staining was used to observe the regeneration of tissue in the patch and the degradation state of the material. SEM was used to observe the integrity of peritoneum. The angiogenesis state was detected by immunohistochemistry. The formation of collagen fiber was detected by trichrome staining of Masson. Results After a week, the macrophages invasion in the patch of both the experimental group and the control group were significantly increased. For one month, the inflammatory reaction gradually subsided and the number of macrophages decreased. Long term tests showed that the BMSCs patch could promote the synthesis of collagen fibers, regeneration of blood vessels, and repair of abdominal wall injury. One month after surgery, there was no swelling in the abdominal wall of the experimental group and the control group. The rats were healthy. In one month, two months and six months after the operation, the tissue morphology and SEM electron microscope were observed. The PLGA-collagen I patch of BMSCs can promote cell infiltration, angiogenesis and tissue regeneration. The degradation rate of PLGA material was faster. In sixth months, the cell - based patch was almost completely degraded. However, PLGA-collagen I patches that were not planted cells were degraded, though. It degraded to pieces and remained in the body as a foreign body. Conclusions In this study, PLGA-collagen I tissue engineering materials planted with BMSCs can repair the defects more quickly and reliably, so as to achieve the purpose of treatment of hernia.

Effect of total glucosides of paeonia on Treg/Th17 immune balance in EAT mice

2019, 39(8):  1157-1162. 

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Objective An experimental autoimmune thyroiditis (EAT) model in mice was established to evaluate the proportion and function of regulatory T cells (Tregs) and Th17 cells in the splenocytes from the treatment group with different doses of total glucosides of paeony (TGP) . Methods The EAT model mice were randomly divided into 5 groups: model group, TGP high-dose group, TGP medium-dose group,TGP low-dose group and Tripterygium glycosides group. Real-time PCR was performed to detect the expression of Foxp3 mRNA and ROR?t mRNA in the splenocytes of each group. Flow cytometry was performed to detect the percentage of Treg and Th17 cells in the mice splenocytes of each group. Serum levels of TGF-?1 and IL-17 in each group were measured by ELISA. Serum levels of TGAb in each group were detected by chemiluminescence assay.Results Foxp3 mRNA expression in the mice splenocytes in the medium-dose and the high-dose TGP group were significantly higher than that in the model group(P< 0.05). The percentages of Treg cells in the medium-dose and the high-dose TGP group were significantly higher than that in the model group( P<0.01,P<0.05). The percentages of T cells secreting IL-17 in the low-, medium- and high-dose groups of TGP were significantly lower than that in the model group(P<0.001). Serum levels of TGF-?1 in the TGP medium-dose group and the TGP high-dose group were significantly higher than that in the model group( P<0.01).Serum levels of IL-17 in the TGP medium-dose group and the TGP high-dose group were significantly lower than that in the model group (P<0.01,P<0.05). Serum levels of TGAb in the TGP medium-dose group and the TGP high-dose group were significantly lower than that in the model group (P<0.05). Conclusions TGP can regulate the Treg/Th17 immune balance, which can be beneficial to the prognosis of EAT disease. The TGP medium-dose group and the TGP high-dose group had obvious curative effect.

Effect of tolvaptan on aquaporin in inner medullary collecting duct cell line and renal tubule function

2019, 39(8):  1163-1167. 

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Objective To explore the effect of tolvaptan on aquaporin 2 and cell apoptosis in inner medullary collecting duct cells, to research the influence of tolvaptan on renal tubular function. Methods The cells were treatment with different concentrations of tolvaptan, then the expression of aquaporin 2 was detected by Western blot, the caspase 3 activity was tested by the kit, the cell apoptosis was determined by MTS and flow cytometry; the model mice were treatment with different concentrations of tolvaptan, the β2-MG and NAG were tested by the kit. Results Tolvaptan significantly decreased the protein expression of aquaporin 2（p<0.05）, and had no effect on the caspase 3 activity and cell apoptosis. Tolvaptan had no effect on the concentration of the β2-MG and NAG. Conclusions Tolvaptan decreases meaningfully the protein expression of aquaporin 2 and has no effect on apoptosis and renal tubular function.

Ribosomal protein 25(RPS25) promotes the development of renal transparent cell carcinoma through regulating c-Myc

2019, 39(8):  1168-1174. 

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Objective To investigate the effects of ribosomal protein 25 (RPS25) on development and progression of ccRCC. Methods Quantitative Real-time PCR (qPCR), Western blot analysis, and dual luciferase reporter gene assays were conducted to examine RPS25 expression and c-Myc promoter activity in renal cancer tissue and renal cancer cell lines. Proliferation, migration and invasion of renal cancer cells either exhibiting knockdown of RPS25 or its downstream gene c-Myc were assessed by MTS and Transwell assay. Kaplan-Meier Plotter was used to analyze the survival of ccRCC patients with different RPS25 levels using data from The Cancer Genome Atlas consortia (TCGA). Results qPCR results showed that RPS25 mRNA was significantly increased in renal cancer cell lines and ccRCC samples. Mechanistic studies demonstrated that RPS25 promoted c-Myc expression by both translational control and transcription mechanisms. Particularly, coexpression of c-Myc reversed the depletion of RPS25-mediated tumor suppression. Kaplan-Meier Plotter showed that the increased RPS25 level correlated with poor survival. Conclusion This study demonstrates that RPS25 as an oncogene hae therapeutic potential and clinical values as a prognostic factor in ccRCC.

Application of CBCT to analyze the placement error of abdominal tumors in 157 children and the boundary of the target area

2019, 39(8):  1175-1177. 

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Objective To analyze the placement error of the abdominal tumor in children and the boundary of the target area by CBCT, in order to improve the accuracy of radiation therapy and improve the curative effect. Methods A total of 157 children aged 1-14 years old with abdominal tumors from March 2018 to February 2019 were enrolled in the Department of Radiotherapy of Peking Union Medical College Hospital. The data of 168 groups of CBCT (cone beam computed tomography) were collected during the whole treatment period. Calculate the error in three directions: vertical (VRT), longitudinal (LNG), and lateral(LAT). The planning target volume (PTV) external boundary is calculated by using the external boundary formula = 2.5∑+0.7δ. Results The statistical analysis of SPSS 21.0 showed that the placement errors in three directions were: VRT(-0.05±2.32)mm, LNG(0.11±2.67)mm, LAT(0.17±2.43)mm; calculate the PTV external boundary : VRT = 9.1 mm, LNG = 10.2 mm, and LAT = 9.4 mm. Conclusion The radiotherapy target area of children's abdominal tumors is VRT=9.1mm, LNG=10.2mm, and LAT=9.4mm is the best precision for radiotherapy, which provides a basis for improving the curative effect.

miR-129 inhibits the proliferation of nasopharyngeal carcinoma cell line CNE2

2019, 39(8):  1178-1182. 

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Objective To examine the effect of mir-129 on the biological function of nasopharyngeal carcinoma cells. Methods miR-129 mimics and inhibitor were synthesized and transfected into nasopharyngeal carcinoma cells. Mir-129 expression was detected by RT-PCR. Cell proliferation was detected by CCK8. Cell invasiveness was detected by Transwell test. Cell apoptosis was detected by flow cytometry. Results Compared with the control group, the expression level of mir-129 in the mir-129 mimics group was significantly increased (P < 0.05), and the expression level of mir-129 was significantly reduced in the mir-129 inhibitor group (P < 0.05). Compared with the control group, the proliferation and invasion of CNE2 cells in the mir-129 mimics group were significantly decreased (P < 0.05), and apoptosis was significantly increased (P < 0.05). Correspondingly the proliferation, invasion and apoptosis of CNE2 cells in the mir-129 inhibitor group were significantly increased and decreased respectively (P < 0.05). Conclusion mir-129 inhibites the proliferation and migration in nasopharyngeal carcinoma cells, and promotes apoptosis.

Clinical characteristics of Chinese patients with adult autoimmune enteropathy

2019, 39(8):  1183-1187. 

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Objective To identify the clinical features of adult patients with autoimmune enteropathy (AIE) in Chinese. Methods A respective study was conducted with the clinical data of 5 patients with adult AIE in Peking Union Medical College Hospital from 2011 to 2018, including clinical, endoscopic, histologic manifestations, medications and prognosis. Results Among the five patients, four were females, one was male, and their average age was 42 years old. The median disease duration was 2 months. The median hospitalization duration was 56 days. All patient initially presented with refractory diarrhea, with electrolyte disturbance, severe malnutrition, and slight elevation of inflammatory markers. 2 patients had hypovolemic shock and another 2 patients had Wernicke encephalopathy. Abdominal computed tomography findings including bowel-wall thickening, abnormal hyperenhancement of mucosal swelling, luminal dilatation, prominent mesenteric and retroperitoneal lymph nodes were nonspecific for AIE. Endoscopic appearances were mildly abnormal, including mucosal swellings and focal erosions. Specific histological features included villous blunting, absence of goblet or Paneth cells from the epithelium, increased crypt apoptotic bodies, lamina propria mononuclear infiltration, and surface intraepithelial lymphocytosis. Conclusions Clinical presentations and laboratory abnormalities of adult AIE are non-specific with minor endoscopic lesions. Therefore, Endoscopic biopsy, especially duodenal biopsy was important and indispensable in patients with suspected adult AIE.

External beam radiation therapy for relapse/metastases thyroid carcinoma: feasibility and clinical results

2019, 39(8):  1188-1192. 

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Objective To evaluate the clinical results and adverse of external beam radiation therapy (EBRT) on relapse/metastases thyroid carcinoma. Methods A prospective cohort of 64 patients was treated between January 2008 and January 2018 with EBRT. All patients were diagnosis with surgery, 45 females and 19 males, median age was 61 years old. Pathology characters included:34 papillary thyroid carcinoma, 13 follicular thyroid carcinoma, 7 medullary carcinoma and 6 undif-ferentiated thyroid cancer. EBRT use 6MV-X, three-dimensional conformal or intensity modulated radiotherapy, relapse lesions were treated with the total dose and per-friction dose with 50.4Gy-60Gy, 1.8-2Gy/f, metastases lesions were treated according to clinical decision(bone lesions 24-50Gy/6-25f, 2-4Gy/f, brain, lung or liver lesions 48-64Gy/7-8f, 6-8Gy/f(under image-guided radiotherapy). The RECIST 1.1 standard was used to assess the EBRT on 40 evaluable lesions efficiency, the NRS（numerical rating scale） was used to assess pain, response rates to radiotherapy were calculated following the criteria of NRS, accounting for the use of concomitant analgesics. Meanwhile the TG change rate and clinical adverse were also reported. Results 1)40 evaluable lesions of relapse or metastases showed disease control at 1 month(DCR 90.62%), 2)the mean NRS score before treatment was 7.65±0.67, and pain score were reduced to 4.36±1.09 after one month and 2.15±1.28 after three months. NRS-based response categories ranged from 75% to 91.67% respectively, p<0.05. 3)The medium downgrade level of TG-Ab for differential thyroid cancer patients was 56%(0%-99%), all patients showed no serious adverse judging by CTC-3. Conclusion EBRT is a valid option for relapse/metastases thyroid patients with endurable side effects, could be an effective treatment option for clinical trail.

Urantide inhibits collagen type Ⅲ expression in atherosclerotic rat hearts

2019, 39(8):  1193-1195. 

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Advance in the study of exosomes in bone regeneration

2019, 39(8):  1196-1199. 

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Exosomes are a type of extracellular vesicles secreted by cells, it is shapes like cup with a diameter of 30 to 140 nm. at present, exosomes show strong pontential in early diagnosis, drug target transport, tissue regeneration. In bone tissue engineering, exosomes can deliver special proteins, miRNAs, biofactors to stimulate MSCs differentiate into osteoblasts as well as up-regulating the expression of related osteogenic genes for repair bone defect and achieve bone regeneration.

Role of PI3K and Akt in cardiovascular diseases

2019, 39(8):  1200-1204. 

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The PI3K-Akt signaling pathway plays an important role in cell proliferation and metabolism, and the PI3K-Akt signaling pathway plays an important role in cardiac protective mechanisms -- ischemic preconditioning and ischemic postconditioning. In this paper, the effects of PI3K molecule and Akt molecule, as well as PI3K-Akt signaling pathway on cardiac and vascular physiology and pathology were analyzed to understand its role in cardiovascular diseases.

Probe into the reform strategy of medical graduate's teaching practice based on "Internet plus"

2019, 39(8):  1205-1208. 

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Teaching practice is the key link of postgraduate training in medical colleges. According to the current situation of postgraduate teaching practice in medical colleges, based on the national "Internet plus" education strategy, a brandew model of teaching practice could thus be eatablished,including the online practical teaching platform and virtual simulation experimental teaching platform ,the online experiment skill assessment system and the laboratory safety study examination system. The WeChat cloud platform, mobile phone app, online learning and offline teaching, are combined to construct this multi-level and multi-dimensional practice teaching new model. It will effectively improve the effectiveness of medical graduate students' teaching practice, help graduate students' scientific research practice, and promote the growth of medical graduate students' high quality scientific research output.

Investigation of the clinical course conduction by examination and feedback in clinical post-doctorial program of internal medicine

2019, 39(8):  1209-1212. 

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Objective To improve the basic clinical courses of internal medicine department in Peking Union Medicine College Hospital (PUMCH). Methods: Students participating the 2017 Basic Clinical Classes were invited to give feedbacks on each course and were required to take exams during and after the courses. Results a total of 50 students took the course, 14 were post-doctors taking the post-doctoral program, and 36 were non-postdoctors. Student type was the major factor influencing the exam results, while class attendances were also significantly associated with some exam results. Student feedback was positive on the curriculum and have contributed to the class adjustment. Conclusions The conduction, exam and feedback circle of the Basic Clinical Courses could effectively help us to know whether students have master the knowledge, to timely improve the courses and teaching quality, and finally to support the post-doctorial program and the internal medicine standardized resident training program.

Obstetrics and gynecology simulation teaching: from the construction of simulated delivery room to the comprehensive development of simulation teaching

2019, 39(8):  1213-1216. 

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Since 2006, the department of obstetrics and gynecology of Peking Union Medical College Hospital has introduced a simulation teaching system, gradually established and improved the simulation delivery room, purchased the corresponding teaching equipment, established the simulation teaching curriculum system of obstetrics, and completed 12 simple skill operations and 8 clinical cases. The simulation training was written and the corresponding simulation teaching courses were opened for teaching practice. At the same time, a number of prospective randomized controlled teaching researches were carried out. It created the first obstetric simulation teaching system that is complete in both hardware and software. The simulation teaching was extended to gynecology, the simulated laparoscopic training center was established, and the continuing education course of luminal qualification training was regularly held, thus establishing a perfect simulation teaching system for gynecology and obstetrics.

Designing of teaching video resource library matching blended learning modes

2019, 39(8):  1217-1220. 

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With the rapid development and wide application of information technology, the learning online depends on video resources has become more and more accepted, which can supplement the traditional classroom teaching. Our goal is to design a teaching video resource library base on blended learning modes, as a teaching aid system and so to create an efficient learning environment for faculty and students through facilitating communication and interaction between teachers and students, and improve learning outcomes.

Investigation of ultrasonic training based on Breast Imaging Reporting and Data System (BI-RADS 4)

2019, 39(8):  1221-1223. 

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Objective To assess breast ultrasonic training based on Breast Imaging Reporting and Data System (BI-RADS 4). Methods Thirty three undergraduate residents were trained for breast ultrasonic training. The positive predictive values of BI-RADS 4a-4c were compared with theoretical values of the second version of BI-RADS lexicon for US. Results The level of diagnostic BI-RADS 4a was good (positive predictive value was slightly higher than theoretical values), and the level of diagnostic BI-RADS 4b-4c was excellent (positive predictive values were both in accordance with the corresponding theoretical values). Conclusions A structured report as BI-RADS can be an effective educational tool, and in favor of standardizing breast imaging reports.

Foundation training for resident in the United Kingdom and its implications to China

2019, 39(8):  1224-1228. 

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Foundation training in the United Kingdom is a transitional stage that connects medical school education and specialty/general-practice training. UK foundation programmes orientate towards training objectives and attach importance to the training of trainee physicians’ diagnosis and therapy competencies as well as self-learning and teaching competencies through varied rotation combinations, supervised learning, and self-learning. In refereeing to the UK experiences, China should rely on nongovernment organizations to strengthen the construction of management entities for resident standardized training, introduce a classified resident registration system in order to avoid the issue of illegal practice by non-registered residents, expand clinical units in rotations to facilitate the training of physicians with comprehensive and solid clinical knowledge and skills, and issue strict and detailed training objectives and facilitate the cultivation of residents’ self-learning and teaching competencies.