Basic & Clinical Medicine

Psychological stress disorder during the outbreak of COVID-19 and intervention strategies

TANG Jun-jie, FENG Shuang, WANG Hai-yan, LI Sen, LU Xiu-min, WANG Yong-tang

2020, 40(6): 737-740.

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During the outbreak of COVID-19, the pathogenic virus SARS-CoV-2, characterized by highly infectious, lethal and unpredictable outcomes has brought a variety of psychological shocks to the general public including the ordinary people, patients with confirmed diagnosis and suspected cases. Harmful psychological stress often causes panic to the society. For individuals, it can not only lead to the occurrence of psychological stress disorders such as anxiety, depression and post-traumatic stress disorder(PTSD), but also is not conducive to the recovery of patients with COVID-19.Intervention of psychological stress during the pandemic is necessary. This article analyzes the psychological stress disorders of different populations during the COVID-19 pandemic and discusses their intervention strategies, which help to treat individuals in time and avoid the occurrence of psychological stress disorders, facilitate rehabilitation of patients with COVID-19.

Investigation on sleep status of medical staff in neurology departments of Hunan Province during the pandemic of COVID-19

WEI Min-ping, NING Xian-jun, ZHANG Lin, HUANG Qin, XIA Jian, CHEN Hua

2020, 40(6): 741-745.

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Objective To investigate the sleep status of medical staff in neurology departments of Hunan Province during the pandemic of COVID-19. Methods The Pittsburgh Sleep Quality Index (PSQI) was used to design questionnaire, which was randomly distributed to the medical staff of neurology departments in Hunan Province, and the results were compared with data from other areas of China. Results The PSQI score from neurology department in Hunan Province was significantly higher than controls during the pandemic period(P＜0.001). The PSQI score of nurses was remarkable higher than that of the doctors (P＜0.05). The PSQI score of junior staff was higher(P＜0.05). Conclusions During the pandemic of COVID-19, the sleep quality of medical staff in neurology departments of Hunan Province was poor, especially the clinical nurses and juniors. It is necessary to improve psychological counseling and provide them with sleep hygiene guidance.

Establishment and operation of buffer quarantine area in designated hospital during the pandemic of COVID-19

HU Xiao-yan, YANG Qiong-xiu, XIAO Chun-qiao, QUAN Li-li, CHEN Dong-yun

2020, 40(6): 746-749.

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Objective To ensure the newly admitted patients with non-COVID-19 infection to be well protected through setting up buffer quarantine area in designated hospitals. Methods For safety of the admission of patients with infectious diseases in Yichang Third People's Hospital, a buffer quarantine area was set up,pathway for outpatient and emergency patients entering management process of diagnosis and treatment was established. Through the outpatient pre-screening and triage, the non-COVID-19 and COVID-19 patients were preliminarily identified. Newly admitted patients with non-coronavirus infectious diseases were managed in separated rooms. Then they were divided into specialized infectious disease areas through a six-day health monitoring and standardized screening. Results The establishment and operation of the buffer quarantine area ensured the regular treatment of patients with other infectious diseases during the COVID-19 pandemic, and prevented cross-infection to medical staff and other patients. At the same time, by buffering and isolating the ward, centralized treatment reduced the investment of human resources and protective materials, which was more conducive to standardized management. Conclusions The setting up of the centralized management of the buffer quarantine area can protect the patients with other infectious diseases and provide them with qualified treatment.

Exploration on standardized training of pediatric residents during the COVID-19 pandemic

CHEN Ting-ting, SHI Kun, YANG Yan-feng, LIU Yi-ling, LI Yan, GUO Yong-hong, WANG Xian-min

2020, 40(6): 750-752.

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This article discussed how to train standardized pediatric residents during the COVID-19 pandemic, which included the knowledge and capacity building for infection prevention and control, standardized residents training and psychological intervention and so on. It ought to be useful to improve the professional competence of pediatric residents.

Construction and expression verification of mouse spermatogenic cell-specific expression vector AAV-Dazl-RFP-Flag

LI Ya-hui, LI Kai, LUO Yan-yun, LI Meng-zhen, MANG Xin-yu, SONG Wei, YANG Tao

2020, 40(6): 753-758.

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Objective To study the effect of spermatogenic cell-specific promoter Dazl in Spermatogenic cells. Constructing the eukaryotic reporter gene expression vector AAV-Dazl-RFP-Flag containing spermatogenic cell-specific promoter Dazl. Methods The Adeno-associated virus vector AAV-CMV-RFP-Flag was modified by homologous recombination to construct mouse permatogenic cell-specific expression vector AAV-Dazl-RFP-Flag. In vitro, GC1-spg wild-type cells and HEK-293T cells were transfected, and the expression specificity of AAV-Dazl-RFP-Flag in vitro was verified by immunofluorescence, q-PCR, and Western blot. In vivo, AAV-Dazl-RFP-Flag was packaged with adeno-associated virus (AAV), and AAV was injected into the testes of mouse through microinjection technology, then the expression specificity of AAV-Dazl-RFP-Flag in vivo was detected by q-PCR. Results Mouse Sper- matogenic cell-specific expression vector AAV-Dazl-RFP-Flag is specifically expressed in spermatogenic, cells thus provid providing a more efficient tool for gene therapy of male reproductive infertility.

Comparison of intensive immunosuppressive therapy with haploidentical transplantation for young severe aplastic anemia

CHEN Miao, WU Ya-mei, ZHOU Dao-bin, DUAN Ming-hui, ZHUANG Jun-ling, HAN Bing, WU Xiao-xiong

2020, 40(6): 759-764.

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Objective A retrospective study was performed to compare intensive immunosuppressive therapy (IST) and haploidentical donor hematopoietic stem cell transplantation (HID-HSCT) for young patients with severe aplastic anaemia(SAA). Methods Fifty-five SAA patients aged 14-30 years were included. The patients were treated with anti-thymocyte immunoglobulin(ATG) combined with cyclosporine A(CsA)(29 cases, IST group) or HID-HSCT(26 cases, HID-HSCT group). Results The complete response(CR) rates in the IST and HID-HSCT groups were 58.6% vs 84.6%(P=0.034), and the overall response(OR) rates were 86.2% vs 84.6%. No significant difference was found in estimated 5-year overall survival(IST 77.9%±11.7% vs HID-HSCT 82.1%±8.4%) and event-free survival(IST 67.6%±11.7% vs HID-HSCT 69.2%±9.1%). The relapse rate of the IST group was 3.4%, and the clonal transformation rate was 13.8%. In HID-HSCT group, the relapse and clonal transformation rates were both 0%, and the incidence rates of grades 2-4 aGVHD and cGVHD were 19.2% and 15.4% respectively. The hospitalization expenses were significantly less in the IST group than in that of HID-HSCT group(median 168 000 yuan vs 378 000 yuan, P＜0.001). Conclusions IST shows similar OR, OS and EFS but much less expense comparing with that of HID-HSCT. IST remains an appropriate choice for young SAA patients without sibling donors.

RNA localization in cytoplasm and nucleus of human embryonic stem cells

ZHOU Fan-qi, FENG Wen-xin, TAN Pu-wen, MA Yan-ni, WANG Dong, YU Jia

2020, 40(6): 765-770.

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Objective To investigate the localization of RNA in cytoplasm and nucleus of human embryonic stem cells (hESCs). Methods After separating cytoplasm and nucleus of hESCs, RNAs were extracted for sequencing, and the localization characteristics of RNAs were analyzed by bioinformatics. RT-qPCR was used to verify the localization of these RNAs. Results More RNA types were found in the cytoplasm than nucleus, as well as specifically locational RNAs (2 952 in the cytoplasm and 634 in the nucleus, respectively). Conclusions The localization map of RNA in cytoplasm and nucleus of hESCs is described,and the localization of many RNAs is verified.

Expression and mechanism of gp73 in liver tissue of mouse liver fibrosis

MA Ling-yu, ZHEN Yi-ning, LUO Yun-ping, DUAN Zhao-jun

2020, 40(6): 771-776.

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Objective To investigate the changes and mechanism of golgi protein 73 (gp73) in mouse with liver fibrosis. Methods The model of hepatic fibrosis was developed by intraperitoneal injection of CCl₄ in C57BL6/J mice. Serum level of gp73 was determined by ELISA. The expression of gp73 in liver tissues was detected by immuno-histochemical staining. Hepatic stellate cell (HSC) was isolated by density gradient centrifugation and gp73 expression was detected. The expression of insulin like growth factor 2 mRNA binding protein 3 (IGF2BP3) in liver tissues was detected by immuno-histochemical staining. Next, IGF2BP3 over-expression and knock down plasmids were transfected, and the changes of GOLM1, which encodes gp73, were detected by RT-PCR. Furthermore, the expression of gp73 in hepatic stellate cells of fibrotic IGF2BP3 knockout mice was detected by flow cytometry. Results A higere expression of gp73 protein increased in serum(P＜0.01), liver (P＜0.05) and primary hepatic stellatecells (P＜0.001) in the fibrotic mice model was found as compared to the control animals. Along with that, the protein level of IGF2BP3 in the liver was also increased (P＜0.05). After over-expressing or knocking down IGF2BP3 by transient transfection, the mRNA expression of GOLM1 was also up-regulated (P＜0.001) and down-regulated (P＜0.01). Respectively, compared with the wide type group, the expression of gp73 was decreased in the hepatic stellate cells of fibrotic IGF2BP3 conditional knockout mice (P＜0.01). Conclusions In the CCl₄ induced liver fibrosis mice, the protein level of gp73 protein in hepatic stellate cells is increased, and RNA binding protein IGF2BP3 is a potential regulatory factor to promote its expression.

Up-regulated expression of NHE1 and Netrin-1 in atherosclerotic plaque of ApoE^-/-mice

YANG Hui, MO Xian-gang, WANG Lan, ZHANG Shi-yue

2020, 40(6): 777-783.

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Objective To investigate whether ApoE^-/- mouse atherosclerotic plaque tissue and RAW 264.7 simultaneously express sodium hydrogen exchanger 1 (NHE1) and neurite guidance factor-1 (netrin-1), and their co-localization and interaction. Methods The atherosclerotic plaque model of mice was established, and the formation of atherosclerotic plaque was detected by HE staining; the expression and co-localization of NHE1 and netrin-1 in atherosclerotic plaque were detected by immunofluorescence and confocal microscopy; Oxidized low density lipoprotein (Ox-LDL) was used to interfere with RAW264.7 cells in mice, then Western blot assay was used to detect the expression of NHE 1 and netrin-1 proteins in samples with different concentrations and time intervention. Small interfering RNA (siRNA) targeting NHE1 gene was designed and transfected into RAW264.7 cells by liposome. The inhibition efficiency of small interfering RNA (siRNA) targeting NHE1 gene was detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) and Western blot. Results The expression of NHE1 was up-regulated in atherosclerotic plaque of mice, and partly co-localized with netrin-1. Ox-LDL up-regulated the expression of NHE1 and netrin-1 in RAW264.7 cells in a time-concentration dependent manner (P＜0.05); the constructed NHE1 siRNA effectively inhibited the expression of NHE1 in RAW264.7 cells (P＜0.05); effective knockdown of NHE1 expression in RAW264.7 cells down-regulated the expression of increased NHE1 and netrin-1 proteins as a results of intervention by Ox-LDL(P＜0.05). Conclusions The expression of NHE1 and netrin-1 in atherosclerotic plaque and Ox-LDL-treated mouse macrophage line (RAW264.7) is up-regulated and co-localized. The expression of netrin-1 is affected by the expression of NHE1.

miR-107 inhibits the proliferation, migration and invasion of glioma cells in vitro

SUN Mao-cang, LI Xin

2020, 40(6): 784-789.

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Objective To investigate the regulation mechanism of miR-107 on proliferation, migration and invasion of glioma cells. Methods RT-qPCR was used to detect the expression of miR-107 and FOXK1 in human normal astrocytes NHA, glioma cell lines U87, A172 and U251. miR-NC(miR-NC group), miR-107 mimics(miR-107 group), si-NC(si-NC group), si-FOXK1(si-FOXK1 group), miR-107+pcDNA3.1(miR-107 mimics and pcDNA3.1 group), miR-107 +pcDNA3.1-FOXK1(miR-107 mimics and pcDNA3.1-FOXK1 group), were transfected respectively into U87 cells by liposome method. The proliferation of the cells was detected by CCK-8 method.The migration and invasion of the cells were detected by Transwell chamber assay. The protein expression of FOXK1 in the cells was detected by Western blot.The fluorescence activity of the cells was detected by the dual luciferase reporter assay. Results Compared with normal astrocyte NHA, the expression of miR-107 was down-regulated and the expression of FOXK1 was up-regulated in glioma cell lines U87, A172 and U251(P＜0.05). Over-expression of miR-107 and knockdown of FOXK1 inhibited U87 cell proliferation, migration and invasion. MiR-107 can inhibit the cytosolic activity of wild-type FOXK1 and negatively regulate the expression of FOXK1; over-expression of FOXK1 can reverse the inhibitory effect of miR-107 on proliferation and migration of U87 cells. Conclusions The mechanism of miR-107 inhibiting proliferation, migration and invasion of glioma cells may be related to the targeted negative regulation of FOXK1, which will provide a basis for the diagnosis and targeted therapy of glioma.

miR-135b-3p regulates XAF1 expression and affects migration, invasion and radio sensitization of thyroid cancer cells

CAO Deng-han, CHEN Kui-sheng

2020, 40(6): 790-796.

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Objective To investigate the effects of miR-135b-3p on migration, invasion and radio sensitivity of thyroid cancer cells and its possible regulatory mechanisms. Methods Normal thyroid cells Nthy-ori 3-1, thyroid cancer cells K1 and TPC-1 were cultured. The expression of miR-135b-3p was detected by RT-qPCR. The expression of XAF1 protein was detected by Western blot. Anti-miR-135b-3p was transfected to TPC-1 cells to inhibit the expression of miR-135b-3p. Transwell, Western blot and cloning formation assay were used to detect the effect of inhibition of miR-135b-3p expression on migration and invasion of TPC-1 cells, and the expression of E-cadherin and MMP-2 protein and radio sensitivity, respectively. The dual luciferase reporter gene assay verified the targeted regulatory relationship between miR-135b-3p and XAF1. Results Compared with Nthy-ori 3-1 cells, the expression of miR-135b-3p was significantly increased in K1 and TPC-1 cells (P＜0.05), and the expression of XAF1 protein was significantly decreased (P＜0.05). Inhibition of miR-135b-3p expression could inhibit the migration and invasion of TPC-1 cells (P＜0.05), promote the expression of E-cadherin protein in TPC-1 cells (P＜0.05), inhibit the expression of MMP-2 protein (P＜0.05), and enhance the radio sensitivity of TPC-1 cells (P＜0.05). miR-135b-3p targeted negative regulation of XAF1 expression. Inhibition of XAF1 expression partially reduced the effect of inhibiting miR-135b-3p expression on TPC-1 cell migration and invasion as well as the enhanced radio sensitivity. Conclusions R-135b-3p promotes the migration and invasion of thyroid cancer cells by down-regulating the expression of XAF1, and reduces its radio sensitization. It is a potential therapeutic target for thyroid cancer.

miR-29b inhibits LPS-induced apoptosis of alveolar epithelial cell line A549 through regulating Bax gene

PAN Shu, WEN Dan-ning, LI Hua-dong

2020, 40(6): 797-802.

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Objective To investigate the effect of miR-29b on LPS-induced apoptosis of alveolar epithelial cell line A549 and its mechanism. Methods A549 cells were divided into control group, LPS group (treated with 10 mg/L LPS), LPS+miR-NC group (treated with LPS after transfection of miR-29b mimics negative control), LPS+miR-29b group(treated with LPS after transfection of miR-29b mimics), the expression level of miR-29b in each group was detected by RT-qPCR, cell viability was detected by MTT assay, and apoptosis rate was detected by flow cytometry.The expressions of Bcl-2, Bax and cleaved caspase-3 protein were detected by Western blot, and the dual luciferase reporter gene assay was used to detect the targeting relationship between Bax and miR-29b. Results Compared with the control group, the expression levels of miR-29b and Bcl-2 proteins and cell viability in the LPS group, LPS+miR-NC group and LPS+miR-29b group were significantly decreased, while the apoptosis rate was decreased. The expression of Bax and cleaved caspase-3 proteins significantly increased (P＜0.05). Compared with LPS group, the expression of miR-29b and Bcl-2 proteins and cell survival rate in LPS+miR-29b cells were significantly higher, while the apoptotic rate, the expression of Bax and cleaved caspase-3 protein were all significantly lower(P＜0.05). Dual luciferase reporter assays confirmed that Bax could be a potential target gene for miR-29b. Conclusions miR-29b can inhibit the apoptosis of alveolar epithelial cells A549 induced by LPS, and its mechanism may be related to the targeted regulation of Bax expression.

Expression of Opa interacting protein 5 in pancreatic cancer and its effect on the proliferation of PANC-1 cells

ZHOU Hong-ming, TANG Xiao-niu, GUO Wei, LYU Ye-chao, JIANG Yu-xin

2020, 40(6): 803-810.

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Objective To explore the expression of OPA interacting protein 5 (OIP5) in pancreatic cancer and its effect on the proliferation of PANC-1 cells. Methods The expression of OIP5 in pancreatic cancer and adjacent tissues was evaluated by database; the expression of OIP5 mRNA and protein in human pancreatic cancer cell lines like MIAPaCa-2, PANC-1, KP-3 and BxPC-3 was detected by real-time quantitative PCR (RT-qPCR) and Western blot, respectively; the expression of OIP5 gene silencing plasmid (pGCSIL-shOIP5)and control plasmid(pGCSIL-shCtrl)were observed, respectively infected with PANC-1 cells, then divided into OIP5 gene silencing group and shctrl control group. 5 days later, RT-qPCR and Western blot were used to detect slow virus knockdown efficiency, and flow cytometry was used to detect cell apoptosis. MTT and cell count were carried out in OIP5 gene silencing group and shctrl control group for 5 consecutive days. OIP5 gene silencing group and shctrl control group were incubated for 10 days to form colonies, then Giemsa staining was used to count total number of sets. Results The expression of OIP5 mRNA in pancreatic cancer was significantly higher than that in normal pancreatic tissue(P＜0.05), and the overall survival rate in patients with high expression of OIP5 was significantly lower than that in patients with low expression of OIP5 (P＜ 0.05), and the disease-free survival rate was also significantly lower (P＜0.05); the expression of OIP5 was higher in MIAPaCa-2, PANC-1 and KP-3, but lower in BXPC-3 cell line; the results of MTT showed that OIP5 was silenced in the 4th day. The proliferation rate of PANC-1 cells was significantly decreased on the 4th and the 5th day (P＜0.01); the number of cell colonies (9 on average) after OIP5 silencing was significantly lower than that in shctrl control group (40 on average) (P＜0.01); the apoptosis rate of PANC-1 cells after OIP5 silencing was 8.3% and 4.5% higher than that of shctrl (P＜0.01). Conclusions OIP5 is highly expressed in pancreatic cancer cell lines. OIP5 gene can regulate the proliferation, apoptosis and clonal formation of PANC-1 cells, suggesting that OIP5 may play a role as a oncogene in the pathogenesis of pancreatic cancer, thus providing a potential biomarker for targeted treatment of pancreatic cancer.

miR-195 inhibitor reduces liver oxidative stress injury in type 1 diabetic mice

HU Su-qin, WANG Sheng-kai, WU Hang-fei, ZHENG Jing-yu, LI Jian-min

2020, 40(6): 811-816.

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Objective To investigate the effects of miR-195 on the expression of Sirt1 and its downstream oxidative stress and mitochondrial apoptosis-related proteins in the liver of type 1 diabetic C57BL/6 mice. Methods Mice were divided into control group (Control group), diabetes group (DM group), and miR-195 inhibitor group (DM+antago group). The DM group model was replicated according to the conventional method, and miR-195 inhibitor (2.5 mg/kg) was transfected into DM + antago group mice. The DM group and the control group were injected with scrambled shRNA (2.5 mg/kg) only as a control.Observe and record the increase and decrease of body weight and blood glucose of mice every week. Take fresh liver tissue, one part is processed and made by HE staining for histopathological observation; the part is used to determine the MDA content and T-SOD activity in liver tissue.RT-qPCR and Western blot were used to detect the mRNA and protein content of related indicators in the liver tissue of the three groups of mice. Results 1)Compared with the control group, the leaflets of the liver tissue in the DM group showed structural disorders, hepatocytes were significantly edema, and the cytoplasm was loose; compared with the DM group, the hematocyte edema in the DM+antago group was reduced. 2)Compared with the control group, miR-195 mRNA expression, MDA content and AcFoxo1/Foxo1 protein expression in the DM group were significantly increased (P＜0.05), while Sirt1, Foxo1 mRNA and protein expression, and T-SOD activity were significantly reduced (P＜0.05); Compared with the DM group, miR-195 mRNA expression, MDA content and AcFoxo1/Foxo1 protein expression in the DM + antago group decreased significantly (P＜0.05), while Sirt1, Foxo1 mRNA and protein expression, and T-SOD activity were all Significantly increased (P＜0.05). Conclusions The expression of miR-195 is increased in liver oxidative stress in type 1 diabetic rats. Sirt1 seems to be potential target of miR-195.

Apparent diffusion coefficient in the evaluation of the therapeutic effect of radiotherapy for pancreatic cancer

WANG Zi-han, MA Xiao-xuan, SUN Peng, QI Zhao-yue, ZHOU Hua, YAN Xiao-bin, SHI Hui-ping

2020, 40(6): 817-821.

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Objective To investigate the role of apparent diffusion coefficient (ADC) value in the evaluation of therapeutic effect of radiotherapy for pancreatic cancer. Methods Twenty six patients with pancreatic cancer received radiotherapy were examined with magnetic resonance imaging (MRI) before radiotherapy, one month after radiotherapy, three months after radiotherapy, and six months after radiotherapy,and ADC value of diffusion weighted imaging(DWI) was measured. The patients were divided into remission group and non-remission group according to the change rate before and after radiotherapy, SPSS17.0 software was used to analyze the change of apparent diffusion coefficient before and after radiotherapy and the relationship between the change rates of tumor maximum diameter. Results The ADC value of 26 patients with pancreatic cancer increased significantly after radiotherapy (P＜ 0.001); the ADC value of the remission group was significantly lower than that of the non-remission group before radiotherapy (P＜ 0.05); the ADC value of 26 patients before radiotherapy was negatively correlated with the tumor maximum diameter reduction rate (P＜0.01). Conclusions The change of ADC value before and after radiotherapy is of great value to the radiotherapy for pancreatic cancer, especially to the evaluation of the curative effect when the volume of the focus has not changed significantly. It is also of certain value to predict the degree of volume reduction after radiotherapy and to judge the effect of radiotherapy for pancreatic cancer.

Value of ultrasound-guided wire localization resection for non-palpable breast lesions

ZHANG Lu, LI Zhi, SUI Hao, SHI Li-hui

2020, 40(6): 822-824.

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Objective To evaluate the clinical value of ultrasound-guided wire localization resection for non-palpable breast lesions. Methods One hundred and thirty-three cases of breast lesions which were detected by ultrasonography but negative palpation were selected. Under the guidance of ultrasound, the localized guide wire was placed into the breast lesion, and the whole lesion and part of the surrounding normal tissue were removed according to the position of the localized guide wire, and the lesions were sent for pathological examination. Results Total of 136 nodules were found in 133 patients, including 9 cases of intraductal papilloma, 25 cases of mammary hyperplasia with fibroadenomatous structure formation, 4 cases of atypical hyperplasia, 35 cases of mammary hyperplasia, 53 cases of fibroadenoma, 8 cases of invasive breast cancer and 2 cases of ductal carcinoma in situ. Conclusions Ultrasound-guided wire localization resection for the treatment of non-palpable breast lesions has the advantages of accurate positioning, simple operation and non-invasive, etc. The application of this technique is of great value for the early diagnosis and treatment of breast cancer.

Clinical characteristics and analysis of one case of LIG4 syndrome due to gene mutation

ZHANG Xiao-xiao, LU Min, GU Hao-xiang, WU Bei-rong

2020, 40(6): 825-830.

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Objective To explore the clinical characteristics of DNA ligase Ⅳ(LIG4) syndrome. Methods The clinical data of one case of LIG4 syndrome were analyzed, and the second-generation high-throughput gene sequencing was applied for the infant and his parents to identify the causative mutation. The clinical features of the disease were summarized with the relevant literatures. Results The case reported here had clinical manifestations of microcephaly, special face, growth retardation, immunodeficiency, recurrent respiratory infections, chronic diarrhea. The high-throughput sequencing showed the patient has carried mutation of LIG4 gene: c.833G＞T (p.R278L), the diagnosis of LIG4 syndrome was established. The features of LIG4 syndrome were analyzed from archived 42 cases, including this study. Conclusions Microcephaly, immunodeficiency, special facial features, hematocytopenia and growth retardation are the main clinical symptoms of LIG4 syndrome. Children with recurrent respiratory infections, microcephaly and immunodeficiency should be vigilant for this disease. Gene testing would be helpful to confirm the diagnosis.

Analysis of clinical characteristics and health economic indicators of inpatients in emergency ward

LIU Yan-ping, LIANG Xiao, HE Jing-yu, WANG Tao, LI Si-jie

2020, 40(6): 831-834.

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Objective To explore the clinical characteristics of 2 668 inpatients in emergency ward, and to provide reference for emergency management. Methods Total of 2 668 patients hospitalized in the emergency department of xuanwu hospital from January 2015 to June 2018 were selected and the study data were retrospectively collected, including gender, age, comorbidities involvement system, hospitalization cost, length of hospital stay, and self-care ability score before hospitalization and before discharge. Results 1)The average age of male patients was younger than that of females (67.2±17.1 vs 70.7±17.2 years old)(P＜0.01). 2)2 408(90.25%) patients admitted to the hospital with more than 3 kinds of co-morbidities, and the co-morbidities involved mainly in respiratory, circulation, and endocrine systems. 3)The immediate living ability score was significantly lower than that before discharge (69.42±25.09 vs 78.12±26.13) (P＜0.001). 4)Barthel score was negatively correlated with length of stay, cost of hospitalization, decreased albumin, and anemia. Conclusions The types of diseases in the emergency ward are complicated, involving multiple disciplines and specialties, and the critical condition is variabl. Comprehensive and comprehensive evaluation is necessary in the process of clinical diagnosis, treatment and nursing care to improve the clinical outcomes of patients.

Nursing experience of one case of brain abscess patient with complex diseases

HAN Hua

2020, 40(6): 835-837.

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A case of brain abscess with various underlying diseases in our hospital was treated with all-round nursing management, including health education, psychological counseling, close observation of the disease, symptomatic nursing management, strengthening the self-management of patients and their families, and rehabilitation guidance, etc. The patient was safe during period of hospitalization and showed high satisfaction with nursing work.

Effects of melatonin on circadian rhythm and lipid metabolism

WANG Xiu-heng, LIU Yao, WU Jie, HU Heng-jing

2020, 40(6): 838-841.

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Melatonin is a neuroendocrine hormone secreted mainly by the pineal gland, which plays pivotal role in circadian rhythm and inhibiting fat ectopic deposition. Nevertheless,The effect of melatonin on circadian rhythm and lipid metabolis have not been fully elucidated.

Progress in research on mitophagy and pulmonary diseases

TAN Shi-Yi, CHEN Shi

2020, 40(6): 842-846.

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Mitophagy is one of the important forms of selective autophagy, which affects the occurrence and development of lung diseases by regulating the quality of mitochondria in vivo. Mitophagy has different functions in different lung diseases. In idiopathic pulmonary fibrosis and acute lung injury, excessive or low levels of mitophagy can aggravate the diseases; while in pulmonary hypertension, excessive mitophagy levels play the adverse effect in the progress of the disease. Additionally, in chronic obstructive pulmonary disease, mitophagy can regulate cell necrosis and control cellular inflammation. Therefore, it is important to understand the mechanism of mitophagy to prevent and treat lung diseases.

Practice of teaching round from orthopaedic department based on SOP

ZHAI Ji-liang, YANG Bo, LIU Sen, YU Ke-yi, LIN Jin, WANG Wei, ZHAO Jun

2020, 40(6): 847-850.

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Objective To compare the teaching quality between traditional and SOP (standard operation procedure)-based orthopedic teaching rounds. Methods Postgraduates and clinical postdoctors who were enrolled into orthopedic standardized training in 2017 and 2018 grade were included in this study. Thirty postgraduates and 20 clinical post doctors were in each group, with traditional or SOP-based teaching rounds were used respectively. The two groups were evaluated subjectively and objectively. Results The subjective and Objective evaluation scores of SOP-based teaching rounds were significantly higher than those of the traditional teaching group (P＜0.01,P＜0.05). Conclusions SOP-based method significantly improves the quality of teaching rounds.

Investigation on the ideological and political theory course reform in Peking Union Medical College

LIU Jun-xiang, GUO Xu-fang, GAO Chuan, ZHANG Xu-ping, HE Zhong

2020, 40(6): 851-855.

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Objective To learn about past experiences in studying ideological and political theory courses of doctoral students in Peking Union Medical College and the actual teaching outcomes of Selected Readings of Marxist Classics after the implementation of the teaching reform. Methods Two sets of questionnaires were distributed to 530 MD candidates of Grade 2019 before and after the course in order to investigate and compare their cognition, attitude and evaluation. Results In the pre-course survey, 462 valid questionnaires were recovered, and the recovery rate was 87.17%. In the after-course survey, 466 effective questionnaires were recovered, and the recovery rate was 87.92%. Most students' recognized the significance of this course and were satisfied with the teaching methods and assessment methods. Conclusions Medical students have a good reading and learning experience in this course. However, it is required to continuously strengthen humanistic care in ideological and political teaching to enhance students' sense of gain and further improve their political and moral qualities from the perspective of cognition, feeling and action.

Mentor training program improves the self-confidence and skills of mentors in clinical and translational medicine

LI Yue, WEI Yi-zhen, ZHANG Ding-ding, ZHU Hui-juan, LIU Ji-hai, LUO Lin-zhi, ZHANG Shu-yang

2020, 40(6): 856-862.

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Objective Peking Union Medical College Hospital (PUMCH) introduced the Mentor Training Program (MTP) since 2018 to strengthen the system of faculty development. This study aims to investigate the effects of MTP training. Methods Questionnaire of pre-course, 1-week post-course, and 3-month post-course were collected among 18 trainees, the questions cover the degree of confidence, feedback and mentor behavior change after training. Non-parametric Kruskal-Wailis H test was used to assess confidence in mentoring skill, applying open coding to analyze the open questions. Results All trainees reported a significant increase in confidence in improving mentoring skills, becoming excellent mentors, strengthening contact among mentors and increasing career satisfac- tion. A variety of mentoring skill such as communication, long term career goals, making aligned goals with trainees, role modeling, and time managing significantly increased. The mentor's practice changes are reflected in the practical process of applying the instructor's philosophy, communication methodology, and personal development tools learned during MTP. Conclusions MTP training contributes to innovating mentoring concepts and improving mentoring skills,expansion and further progress are needed to develop the next generation of clinical-translational research mentors.

Status quo and evaluation of graduate medical education in University of Chicago and University of Hong Kong

BAI Qiong, LI Zong-shi

2020, 40(6): 863-866.

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Taking the examples of University of Chicago Medical Center and Hong Kong University Queen Mary Hospital, graduate medical education system, evaluation, and examination are introduced in this paper. Through the comparison among American, Hong Kong's and Chinese graduate medical education systems, it is important to improve graduate education by optimizing the graduate medical education and evaluation system and developing residents' research capacity in Chinese mainland.

Combination of the preliminary research training and experimental courses in the same stage is feasible

ZHANG Ze-ying, CHEN Shi-fan, LIU Quan-yue, CHEN Peng, CHENG Ke

2020, 40(6): 867-871.

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Objective To study preliminary research training of eight-year program of clinical medicine through student evaluation. Methods A total of 202 students from the 2016 and 2017 grades of eight-year program of clinical medicine of xiangya school of medicine were given a corresponding questionnaire to describe the relevant problems and conduct analysis. Results Among the students from grade 2017,70.0% believe the course schedule is reasonable, 52.5% think the preliminary research training is meaningful and does stimulate students' interests. 77.5% of students are willing to enter the medical school earlier. However, 57.5% of them disagreed with the evaluation of students learning results by scores and 85.0% believe that the basic course is beneficial. Totally 92.5% of students think that there is little inspiration in the experiment class, 67.5% have little new understanding of the research process. And 50.0% are willing to study non-medical issues. As high as 97.5% of students will re-select eight-year program of clinical medicine. Students believe that it is the most important to focus on experimental ability and that the lack of medical knowledge impedes selecting research fields the most. Among students from grade 2016, 51.2% think the course schedule is unreasonable, 51.2% have little new understanding of the research process. 80.5% are satisfied with the implementation of preliminary research training. Students think that it is most important to build capacity of innovation and that the lack of information about frontier progress impedes selecting research fields interested. Conclusions The combination of the preliminary research training and experimental courses in the same stage is feasible.

Application of 3D printing technology in clinical teaching about jaw bones tumor and tumor-like lesions

ZHANG Bi-han, FANG Chang-yun, LI Jia-da, YUAN Shan-shan, HUAN Jing-jing, LIANG Ye

2020, 40(6): 872-876.

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Objective To explore the effect of 3D printing technology applying into clinical teaching about jaw bones tumor and tumor-like lesions. Methods In order to proceed the contrastive teaching experiment, we divided 92 students who participated in the jaw bones tumor and tumor-like lesions class into 2 groups randomly. Students in group 1 took traditional teaching method including the basics of knowledge, case analysis and CBCT test at the first period. After that, they took new teaching method assisted by 3D printing technology at the second period. Students in group 2 were taught in reverse order by the same teacher. The questionnaire survey was conducted after each period in each group so as to evaluate the role new teaching method assisted by 3D printing technology played in the jaw bones tumor and tumor-like lesions clinical teaching. Results The questionnaire surveys showed that traditional teaching method predominated in the students' grasp of basic knowledge about jaw bones tumor and tumor-like lesions(P＜0.05). With regard to showing the details and spatial forms of lesions as well as teaching vividly, new teaching method assisted by 3D printing technology was better than the traditional one(P＜0.05).The order didn't concern a lot about the final learning effectiveness. However, when it came to the memorizing of knowledge and the understanding of lesions' spatial forms, students who took the new teaching method first had higher average scores(P＜0.05). Conclusions To some extent, carrying on new teaching method assisted by 3D printing technology first among the class may leads students to a better understanding and mastering about the anatomic features of jaw bones tumor and tumor-like lesions.

Teaching research on a competence-based prenatal ultrasound training in the resident standardized training

HU Wei-xi, ZHAN Xin, BAI Jao

2020, 40(6): 877-880.

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Objective Discussion on the application value of a competence-based teaching mode in the teaching of prenatal ultrasound. Methods Eighty-seven people from a teaching hospital from July 2015 to December 2019 in the ultrasound were selected.Forty-five students in the experimental group were trained with a new model targeted at “post competence”, while forty-two students in the control group were trained on the traditional teaching mode. Results The theoretical and technical scores of the experimental group are higher than those of the control group.The total theoretical and technical scores of the students with working experience are higher than those of the non-experienced group.The total theoretical and skills scores of master candidates are higher than the undergraduate group. Conclusions The teaching mode targeting at“post competence” can achieve good results in prenatal ultrasound teaching.

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