Table of Content

05 September 2020, Volume 40 Issue 9

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Original Articles

1α,25-Dihydroxyvitamin D₃ inhibits β-catenin transcriptional activity in human colon cancer cell line SW480

XIN Yu, HE Long-mei, YANG Hong, LYU Hong, TAN Bei, WANG Hong-ying, QIAN Jia-ming

2020, 40(9):  1169-1174. 

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Objective To explore the inhibitory effect and mechanism of 1α,25-dihydroxyvitamin D₃ [1,25(OH)₂D₃]on β-catenin transcriptional activity in human colon cancer cells. Methods Colon cancer cell line SW480 was treated with either 1,25(OH)₂D₃ (100 nmol/L) or vehicle (control) for 48 hours, then several parameters were measured: the transcriptional activity of β-catenin by Dual-Luciferase? Reporter Assay System; the nuclear protein expression level of β-catenin by Western blot; mRNA coding for β-catenin and forkhead box M1 (FOXM1) and the protein expression by RT-qPCR and Western blot. SW480 cells were subjected to transfecting siRNA to knock down FOXM1, followed by 1,25(OH)₂D₃ treatment and measurement of the transcriptional activity of β-catenin by Dual-Luciferase? Reporter Assay System. Results 1) 1,25(OH)₂D₃ significantly repressed the transcriptional activity of β-catenin in SW480 cells (P＜0.05), while did not affect its mRNA and protein expression; 2)1,25(OH)₂D₃ increased the protein expression of FOXM1(P＜0.05); 3)The inhibitory effect of the transcriptional activity of β-catenin by 1,25(OH)₂D₃ in SW480 cells was decreased when FOXM1 was knocked down(P＜0.05). Conclusions 1,25(OH)₂D₃ represses the transcriptional activity of β-catenin via increasing FOXM1 expression.

HUVECs with KNDC1 knockout mediated by CRISPR/Cas9 have anti-aging ability

SUN Jing-yu, YAO He, HU Gang, WEI Jie, GUO Jun, ZHANG Xin, LIN Ya-jun

2020, 40(9):  1175-1181. 

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Objective To knock out the KNDC1 of human umbilical vein endothelial cells (HUVECs) by CRISPR/Cas9 gene editing technology and observe its anti-aging ability. Methods Five sgRNAs targeting KNDC1 Exon1, Exon2 and Exon3 were designed by online software and were constructed into CRISPR/Cas9 vector. After sequence confirmation, the recombinant plasmids were transfected into HeLa cells and HUVECs. After 48 h, KNDC1 mRNA levels and protein expression levels were detected by real-time PCR and Western blot; cell senescence was measured by SA-β-gal staining; intracellular reactive oxygen species were detected by 2′,7′-dichlorodihydrofluorescein diacetate (DCFH-DA) fluorescent probe. Results The sequencing results showed that all the 5 sgRNAs were inserted into the CRISPR/Cas9 vector, the sequence was correct and these vectors were successfully constructed. After transfecting 5 recombinant vectors into HeLa cells, it was found that the knockout efficiency of vectors No. 4 and No. 5 was higher, and then the recombinant vectors of No. 4 and 5 were transfected into HUVECs. Compared with the control plasmid, the KNDC1 mRNA level and protein expression level in HUVECs transfected with recombinant plasmids 4 and 5 were significantly decreased (P＜0.05). The number of senescent HUVECs and the level of intracellular reactive oxygen species were significantly reduced. Conclusions The KNDC1 of HUVECs can be effectively knocked out by CRISPR/Cas9 technology, and HUVECs with KNDC1 knockout have anti-aging ability.

Characterizing stage-specific transcriptome of terminal erythroid differentiation in bone marrow of β-654 thalassemia mice

SHI Li-fang, YU Dong-lin, LIU Xue-hui, LYU Xiang

2020, 40(9):  1182-1189. 

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Objective To characterize the stage-specific transcriptome of terminal erythroid differentiation in bone marrow of β-654 thalassemia mice. Methods Genotyping and blood smear Wright-Giemsa staining were carried out to identify β-654 thalassemia mice and wild-type littermates. Bone marrow cells of β-654 thalassemia and wild-type littermates were then sorted by flow cytometry. ProE, BasoE, PolyE and OrthoE erythroblasts were collected respectively for RNA-seq; The sequencing data were filtered and subjected to differential expression analysis and subsequent GO analysis. Finally, protein-protein interaction network and hub of the up-regulated genes were depicted using STRING database and Cytoscape software. Results The quantity of differentially expressed genes between the β-654 thalassemic and stage-matched control erythroid cells increased gradually during terminal erythroid differenti- ation. GO analysis showed that chaperone-mediated protein folding process was gradually activated in thalassemic erythroid cells. Specifically, oxidoreductase activity was increased at BasoE to PolyE stages, and ubiquitin protein ligase binding was enhanced from PolyE to OrthoE stages; Protein-protein interaction analysis showed that heat shock protein (Hsp) family members were at the core of the thalassemic erythroid network and that more Hsp members join the network at later stages. Conclusions The thalassemic terminal erythroid differentiation shows stage-specific transcriptome characteristics. Protein folding mediated by Hsp family members is gradually activated during the whole process of terminal erythroid differentiation, oxidoreductase activity is selectively enhanced at BasoE and PolyE stages, while ubiquitin mediated-protein degradation is dominant during PolyE and OrthoE stages.

Whole-exome sequencing for a rare case of aldosterone-producing adrenocortical carcinoma

WANG Hui-ping, CHANG Xiao-yan, MA Xiao-sen, TONG An-li

2020, 40(9):  1190-1194. 

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Objective Aldosterone-producing adrenocortical carcinoma(ACC) is an uncommon disease.In this paper, the genetic mutations of aldosterone-producing ACC are studied by whole-exome sequencing. Methods Clinical data of the patient with aldosterone-producing ACC were collected. DNA was extracted from paraffin-embedded tissues and peripheral blood, then the whole-exome sequencing was carried out to identify germline and somatic mutations. Results There was no mutation associated with hereditary adrenocortical tumors and familial hyperaldosteronism in peripheral blood DNA. A total of 349 somatic mutations were found in tumor tissues, which were mainly enriched in tumorigenesis and calcium signaling pathways. Mutations related to the growth of adrenocortical tumor, CTNNB1, CDKN2A and MSH6, were detected, while no mutation related to aldosterone synthesis as KCNJ5, ATP1A1, ATP2B3 and CACNA1D was found in the tumor tissue. Conclusions The tumor- igenesis of aldosterone-producing ACC is related to CTNNB1, CDKN2A and MSH6, but the mechanism of promoting aldosterone production is still uncertain.

Predictive research of 5-hydroxytryptamine in severity of severe community-acquired pneumonia

HE Quan, LIU Dan-yu, YE Jun, ZHANG Yan-li, ZHU Hua-dong, JIANG Cheng-yu, XU Jun

2020, 40(9):  1195-1200. 

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Objective To search for potential prognostic markers for severe community-acquired pneumonia (SCAP) using non-targeted metabolomics. Methods Testing plasma samples from 30 healthy people and 68 SCAP patients (all collected from January 2015 to June 2019 at Peking Union Medical College Hospital) by liquid chromatography mass spectrometry (LC-MS). According to clinical prognosis, patients were divided into survive group (n=49) and non-survive group (n=19). OPLS-DA (multivariate statistical analysis) and Kruskal Wallis Test (single variable statistical analysis) were used to identify differential metabolites. Correlation analysis of clinical indicators and prognostic analysis were also used for differential metabolites. Results Totally 3 463 metabolites were detected in healthy people and SCAP patients by LC-MS. Among them, 126 metabolites were screened out by OPLS-DA andKruskal Wallis Test analysis methods. Prognostic analysis showed that the quantity of 5-hydroxytryptamine(5-HT) was significantly different between survive group and non-survive group (P＜0.05, AUC＞0.75). Correlation analysis of clinical indicators showed that 5-HT was positively correlated with oxygenation index (OI) and negatively correlated with acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score. Conclusions The 5-HT as a potential prognostic marker for SCAP, may predict the prognosis of SCAP patients.

Prospective observation of metoclopramide in preventing nausea and vomiting induced by oxycodone

CUI Li, YU Zhuang

2020, 40(9):  1201-1205. 

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Objective To observe the preventive effect of metoclopramide tablets on opioid-induced nausea and vomiting(OINV)caused by oxycodone sustained-release tablets during the treatment of cancer pain. Methods The method of prospective observation was used by collecting 120 patients with malignant tumors who were treated with oxycodone sustained-release tablets for the first time. According to the NRS scores, the patients were divided into two groups: moderate pain (4-6 points) and severe pain (7-10 points). The patients were treated with oxycodone sustained-release tablets with an initial dose of 10 mg and 20 mg q12 h respectively, and then titrated according to the pain control. The patients were divided into observation group (n=60) and control group (n=60) by using the method of random number table. The observation group received oral oxycodone sustained release tablets and metoclopramide tablets of 10 mg tid for preventive treatment, and ondansetron tablets of 8 mg antiemetics when OINV reaching degree Ⅱ. The control group did not receive preventive antiemetic treatment until OINV reached grade Ⅱ when metoclopramide tablet of 10 mg tid for antiemetic treatment was added. If the symptoms did not relieve, ondansetron tablets of 8 mg for intensive treatment would be added. The differences between the incidence of adverse reactions such as OINV, constipation, urinary retention, drowsiness, respiratory depression, QOL score, and NRS score were compared between the two groups after the observation period of 14 days. Results The incidence of OINV of the observation group was significantly lower than that of the control group (P＜0.05) on days 1, 2, 3, and 7. There was no significant difference in the prescription frequence of ondansetron between the two groups (10.0% vs 15.0%).The incidence of constipation in the observation group was significantly lower than in the control group (45.0% vs 65.0%)(P＜0.05). There was no significant difference in NRS scores on day 14 between the observation group and the control group. The QOL scores of the observation group were significantly higher than those of the control group (P＜0.05) on days 1, 2, 3, and 14. There was no significant difference in the incidence of other adverse events between the two groups. Conclusions The preventive application of metoclopramide tablets in the treatment of cancer pain can effectively reduce the early incidence of OINV and the constipation without affecting the analgesic effect of oxycodone sustained-release tablets or producing other adverse events which can effectively improve the life quality of the patients.

Kidney injury molecule-1 is involved in the apoptosis of renal tubular cell line HK-2 induced by iodine contrast

YU Rui, ZHANG Xin-ru, WANG Dan-dan, HE Ping, BAI Yu, TIAN Mi, ZHANG Bei-ru

2020, 40(9):  1206-1211. 

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Objective To explore the role and the possible mechanism of kidney injury molecule-1(KIM-1) in the contrast-induced apoptosis of renal tubular epithelial cell. Methods Renal tubular epithelial cells line HK-2 was treated with contrast iohexol (75 mg/mL) and the expression of KIM-1 was examined by Western blot. The siRNA sequences were designed to interfere with KIM-1 gene expression. HK-2 cells were divided into four groups: control group (A), contrast group (B), contrast/vehicle group (C) and contrast/KIM-1-siRNA group (D). Each group was treated with 75 mg/mL iohexol for 2 h except control group. Flow cytometry and Bax and Bcl-2 protein expression were used to evaluate cell apoptosis. MDA, ROS,SOD,MDA, and MCP-1 were also examined in each group to evaluate the possible mechanism of KIM-1 involving in renal tubular epithelial cell injury induced by contrast agent. Results The expression of KIM-1 in HK-2 cells increased under iohexol exposure and reached the peak at 2 h. Iohexol treatment induced the apoptosis of HK-2 cells significantly. Meanwhile, the up-regulation of ROS and MCP-1 as well as the down-regulation of SOD and MDA was found(P＜ 0.05). Knockdown of KIM-1 by siRNA relieved the iohexol-induced apoptosis of HK-2 cells and partly dampened the up-regulation of ROS and MCP-1 and the down-regulation of SOD and MDA. Conclusions Iohexol can stimulate the expression of KIM-1 in renal tubular epithelial cells. KIM-1 may function in contrast-induce apoptosis of renal tubular epithelial cells by promoting oxidative stress and inflammatory reaction.

Secreted frizzled-related protein 2 inhibits the proliferation and migration of human colorectal cancer cell line SW480

ZHOU Jing, LI Suo-ni

2020, 40(9):  1212-1217. 

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Objective To explore the molecular mechanism by which secreted frizzy-related protein 2 (SFRP2) inhibits proliferation and migration of human colorectal cancer cell line SW480. Methods The expression of SFRP2 was detected by Western blot and RT-qPCR in human normal colonic epithelial cells HCoEpiC and colorectal cancer cell line SW480. The shSERP2 SW480 cell strain was constructed. Western blot and RT-qPCR were used to detect the expression of SFRP2, hypoxia inducible factor-1α (HIF-1α), and Twist in shNC SW480 and shSFRP2 SW480 cells. After shSFRP2 SW480 cells were stimulated by HIF-1α inhibitor (IDF-11774), CCK-8 assay detected cell proliferation and Transwell detected cell migration and invasion. Results The expression level of SFRP2 in SW480 cells was lower than that in HCoEpiC cells (P＜0.01). After SFRP2 knockout, the proliferation, migration and invasion ability of SW480 cells were significantly improved (P＜0.001). The expression of HIF-1α and Twist in SW480 cells was increased (P＜0.01). After HIF-1α inhibitor (IDF-11774) treatment of shSFRP2 SW480 cells, compared with the untreated group, the proliferation, migration and invasion ability of shSFRP2 SW480 cells were significantly decreased (P＜0.001). Conclusions SFRP2 exerts certain anticancer effects through regulation of the HIF-1α/Twist signaling axis.

Effects of total astragalosides on cardiomyocyte apoptosis and mitochondrial membrane potential in rats with heart failure

YOU Xu, ZHU Xiao-fang, HU Yun-peng, GONG Yang, ZHAO Lei

2020, 40(9):  1218-1223. 

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Objective To study the effect and mechanism of total astragalosides(ASTs) on myocardial cell apoptosis and mitochondrial membrane potential in rats with heart failure. Methods Rats were divided into control group(normal), heart failure group(model), AST low, medium and high intervention group (10, 20 and 40 mg/kg intragastric administration) and 12 rats in each group. Cardiac function was measured in rats. Myocardial tissue was taken from rats, apoptosis was detected by TUNEL assay, the activity of SOD was detected by xanthine oxidze method, the activity of GSH-PX was determined by dithio-dinitromethylbenzene method, MDA content was determined by thiobarbituric acid method, the mitochondrial membrane potential was measured by JC-1 method. Western blot was used to detect the expression levels of c-caspase-3, c-caspase-9, p-AKT, p-p38MAPK and Cyt-C in mitochondria and cytoplasm. Results Compared with normal group, LVSP,+dp/dt_max,-dp/dt_max in model group decreased(P＜0.05),the apoptotic rate and the level of c-caspase-3 and c-caspase-9 protein increased(P＜0.05), the activities of SOD and GSH-PX decreased(P＜0.05), the content of MDA increased(P＜0.05), the mitochondrial membrane potential decreased(P＜0.05), the level of Cyt-C protein in mitochondria decreased(P＜0.05), Cyt-c protein level in cytoplasm increased(P＜0.05), the level of p-AKT decreased, the level of p-p38MAPK increased(P＜0.05). Compared with model group, LVSP, +dp/dt_max,-dp/dt_max increased in AST-L, AST-M and AST-H groups, the apoptotic rate and c-caspase-3,c-caspase-9 protein levels decreased, the activities of SOD and GSH-PX increased, the content of MDA decreased, the mitochondrial membrane potential increased, the level of Cyt-C protein in mitochondria increased, Cyt-c protein level in cytoplasm decreased, the level of p-AKT increased, the level of p-p38 MAPK decreased, the higher the concentration of total astragalosides is, the greater the effect on heart failure rat model. Conclusions Total astragalosides inhibit cardiomyocyte apoptosis in rats with heart failure. The mechanism may be related to the increase of mitochondrial membrane potential and the influence of AKT and p38MAPK signaling pathways.

Over-expression miR-299-3p inhibits proliferation and migration of renal carcinoma cell lines

LI Jiu-ling, ZHANG Zi-gui, GUO Li

2020, 40(9):  1224-1229. 

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Objective To explore the effect and mechanism of miR-299-3p effects on the proliferation, migration and invasion of renal cell carcinoma cell lines. Methods RT-qPCR was used to detect the expression of miR-299-3p in renal cancer cell lines (786-O, 769-P, ACHN and A498) and human normal renal epithelial cell line(HK-2). MTT assay, wound healing assay, and Transwell assay were used to detect the effects of miR-299-3p on proliferation, migration, and invasion of 786-O cells. Online bioinformatics database was used to predict the target genes of miR-299-3p. Western blot analyzed the expression of E-cadherin,N-cadherin,vimentin and MAP3K12 in 786-O cells. Results miR-299-3p was lower expression in renal cancer cell lines and the lowest expression was found in 786-O cells. Over-expression of miR-299-3p significantly inhibited the proliferation, migration, invasion, tumor xenograft and EMT in 786-O cell and four databases predicted MAP3ZK12 as the common target of miR-299-3p. Dual luciferase reporter gene verified the targeting relationship between miR-299-3p and MAP3K12. miR-299-3p+MAP3K12 effectively reversed the inhibition of miR-299-3p mimic induced cell migration and invasion in 786-O cells. Conclusions The mechanism of miR-299-3p in renal cancer cells may be explained by down-regulated MAP3K12 to affect cell proliferation, migration, invasion and EMT pathway.

hsa-miR-4483 promotes the proliferation and migration of breast cancer cell lines

YANG De-quan, LI Chang-you, CUI Jun-wei, WEI Wei, WANG Shao-ping

2020, 40(9):  1230-1236. 

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Objective To explore the expression and function of hsa-miR-4483 in breast cancer cells. Methods Using TargetScan to find out how can-miR-4483 act on the c-Myc gene, and RT-qPCR verified the expression of hsa-miR-4483. Transfected MCF-7 and MDA-MB-231 and set up NC-negative controls, Western blot was used to detect the expression of the hsa-miR-4483 gene, MTT assay and Transwell chamber experiment were applied to verify the proliferation and migration of breast cancer cells. Results The expression of hsa-miR-4483 was significantly lower (P＜0.001, P＜0.01) in MCF-7 and MDA-MB-231(P＜0.001, P＜0.01) The up-regulation of c-myc in MCF-7 and MDA-MB-231 promoted cell proliferation and migration (P＜0.001). Conclusions hsa-miR-4483 can promote the proliferation and migration of breast cancer cell lines, which plays a regulatory role in the development of breast cancer and its prognosis.

Number increase of Cajal interstitial cells in bladder of rats with recurrent cystitis

GAO Feng, ZHANG Shi-geng, ZHANG Nan, WEN Jia-ming, YU Qi-qi, HUANG Ya-sheng

2020, 40(9):  1237-1241. 

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Objective To explore the changes of interstitial cells of Cajal(ICCs) in the over active bladder(OAB) rats caused by recurrent cystitis. Methods Rats were divided into control group and experimental group(E.coli 1×10⁸~1.2×10⁸ CFU/mL, 100 μL bladder perfusion), The OAB model was confirmed by urine test, urine flow dynamics and HE staining of bladder tissue. The immunofluorescence staining method was performed to detect c-kit positive ICCs in bladder tissue. Western blot was used to determine the expression of SCF/c-kit protein. Results Compared with the control group, the quantity of ICCs in the experimental group increased significantly (P＜0.05), and the protein expression of SCF and c-kit increased significantly (P＜0.05). Conclusions ICCs increase significantly in the bladder with recurrent cystitis.

Incidence of hypoxemia in a post-anesthesia care unit and relevant risk factors

ZHANG Liang-yan, TANG Shuai, ZHANG Xiu-hua, HAN Wei, XUE Yang, TIAN Yi, HUANG Yu-guang

2020, 40(9):  1242-1246. 

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Objective To investigate the incidence and potential risk factors of postoperative hypoxemia in a post-anesthesia care unit (PACU). Methods The retrospective cohort assessed 14 604 postoperative patients who were admitted to PACU in a period of one year. Clinical data were collected, the incidence and potential risk factors for postoperative hypoxemia were statistically analyzed. Results The incidence of hypoxemia was 2.79%. Multiple regression analysis indicated that the risk factors were age (≥65-year old), body mass index (BMI≥25), American Society of Anesthesiologists (ASA ≥Ⅱ), limb surgery, and thoracic surgery. Conclusions Hypoxemia is common in postoperative patients in PACU. Age, BMI, ASA classification, and surgical site are associated with postoperative hypoxemia. Doctors should pay attention and give timely treatment to high-risk patients to prevent hypoxemia in PACU.

Clinical Sciences

Clinical characteristics of patients with pituitary gigantism during puberty

YANG Ying-ying, LUO Yun-yun, CHEN Shi, WANG Lin-jie, YAO Yong, DENG Kan, ZHU Hui-juan, PAN Hui

2020, 40(9):  1247-1251. 

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Objective To compare the clinical characteristics between pituitary gigantism patients with different age of onset. Methods This study retrospectively summarized the clinical data of patients diagnosed with pituitary gigantism in Peking Union Medical College Hospital from 1990 to 2018. Patients were divided into two groups according to the age of disease onset: patients with the age range of onset between 10～15 years old and the rest of patients. Results A total of 28 patients with pituitary gigantism were included in the study. Among them, 22 patients were male, with a median duration of 11.0 years (7.0, 13.8). 78.5% of the patients had a rapid growth in height at the first consultation, with an average height of (190.2±17.5)cm and an average height SDS(Ht SDS) of +4.5± 1.6 at the time of diagnosis. The pituitary MRI of 92.9% of patients demonstrated pituitary macroadenomas, of which 42.9% were pituitary giant adenomas. This study showed that the maximum diameter of the tumor in group with the age of onset between 10 to 15 years was significantly higher than that of control group (the age of onset between 10 to 15 years old: 2.9±1.3 cm vs. control group: (1.9±0.8)cm, P＜0.05), the proportion of pituitary giant adenoma was also significantly higher than control group (the age of onset between 10 to 15 years old: 62.5% vs control group: 16.7%, P＜0.05). Long-term follow-up data showed that the proportion of combined treatment (surgery & medication & radiotherapy) in group with onset of age between 10 to 15 years old was higher than that of control group (the age of onset between 10 to 15 years old: 31.2% vs control group: 8.3%). However, the cure rate between two groups in the long-term follow-up did not reach statistical significance. Conclusions This study shows that pituitary gigantism patients during puberty are prone to have larger adenoma and are more likely to develop into a giant pituitary adenoma. It is recommended to focus on this population in clinical practice and more aggressive treatment should be considered if necessary.

Mini Reviews

Research progress of artificial ovary

WU Si-ting, LI Na, WEI Min-li, ZHENG Li-ping

2020, 40(9):  1252-1255. 

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As a response to the challenge from the aging of female reproductive organs, how to delay the ovarian function decline and even reconstruct the ovarian function has become a research hotspot in the field of reproductive medicine.With the development of biomedical engineering, the emergence of artificial ovaries provides a new option for the reconstruction of ovarian function.

Role of SDF-1/CXCR4 in cancer-associated fibroblasts

YU Biao, LIU Qing, WU Xiao-ming

2020, 40(9):  1256-1260. 

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Cancer-associated fibroblasts (CAFs), important component of tumor microenvironment, secrete a variety of factors that play an important role in the occurrence and development of malignant tumors. Stromal cell derived factor-1(SDF-1) secreted by CAFs and its specific receptor CXCR4 can promote the activation and maintenance of CAFs, regulate tumor biological behaviors including tumor proliferation and survival, tumor angiogenesis, invasion and metastasis, and drug resistance in autocrine or paracrine manner. Therefore, research targeting at SDF-1/CXCR4 may provide a new strategy for inhibiting tumor progression and clinical treatment.

Disinfection of ultrasonic equipment in non-isolated diagnosis area in COVID-19 epidemic situation

MENG Wei, WANG Ruo-jiao, LYU Ke, ZHANG Yi-xiu, LI Jian-chu, LI Wen-bo, WANG Ming

2020, 40(9):  1261-1265. 

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During coronavirus disease 2019(COVID-19) pandemic, hospitals adopt effective measures including cleaning, disinfection, isolation and personal protection, aiming to prevent nosocomial infections and control the epidemic spread. In order to minimize the risk of cross-contamination associated with ultrasound examinations, ultrasound practitioners carry out strict infection control in the isolated area, and implement standardized procedures of equipment disinfection in the non-isolated area. After cleaning and drying the equipment, ultrasound practitioners should select an appropriate disinfection method based on the respective examination or intervention. Low level disinfection, such as wiping with quaternary ammonium salt disinfecting wipes, is sufficient for standard ultrasound examinations on intact skin. High level disinfection is mandatory after endo-cavity ultrasound examinations, intervention procedures, or ultrasound examinations on infected/broken skin. In addition, disposable transducer covers and needle guides are recommended to use in such situation. Furthermore, infection risk can be reduced through adequate use of ultrasound gel, as well as decontamination of other equipment components.

Medical Education

Application of literature presentation in physiology teaching

YA Bai-liu, CHENG Hong-ju, YU Ting, LIU Wen-yan

2020, 40(9):  1266-1268. 

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Objective To explore the teaching effects of paper presentation in physiology. Methods 179 undergraduate students were selected from Jining Medical College as the research object and divided into the experiment group using the teaching method of paper presentation,and control group using the traditional lecture based learning teaching methods. At the end of the curriculum, an examination and a questionnaire were used to evaluate the teaching effects of students in the two groups. Results The performance of the students in the experiment group was statistically better than the control group (P＜0.05,P＜0.01)in terms of learning capacity and reasoning logic and capacity to solve problems. Conclusions In the physiology teaching, the paper presentation method is superior to the traditional method.

Effect of transvaginal mesh pelvic floor reconstructive surgery structured training based on the fresh cadaver specimens

CHEN Juan, SHI Hong-hui, ZHANG Lin, ZHANG Guo-rui, WANG Nai-li, ZHU Lan

2020, 40(9):  1269-1272. 

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Objective To explore the effect of transvaginal mesh structured training on the operation of flesh cadaver specimens. Methods Nine trainees participated in the structured training, they were postgraduates majoring in urogynecology or advanced training doctors in Peking Union Medical College. The courses included theoretical teaching,operation demonstration and fresh cadaveric specimens teaching, and practice operation procedure on the specimens by themselves. The special questionnaire survey was carried out on all the trainees at the end of the training. The self-evaluation indexes before and after the training was compared. Results The theoretical level and operation ability of the trainees after training were significantly improved, and their confidence in surgical anatomy, surgical procedures and complications management was also significantly improved(P＜0.05). Conclusions It is pragmatically feasible and effective to provide structured training based on cadaver specimens for transvaginal mesh surgery.

Practices of BOPPPS mode in microbial genetics teaching guided by an outcome-based education concept

WANG Liang, LIANG Shi-qian, ZHAO Jun-long, HU Yi-yang, WANG Tao, ZHENG Min-hua, QIN Hong-yan

2020, 40(9):  1273-1276. 

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Teacher-led classical instruction lacks interactions feedbacks and thus leads to a low learning efficiency. Serving as advanced educational concept and method, outcome-based education (OBE) and BOPPPS mode gradually become the leading concept in the remodeling of basic medical education. In order to improve the quality of microbial genetics teaching, this article aims to summarize the methods and experience of applying BOPPPS mode to microbial genetics directed by OBE, which hopefully stimulates medical students' interests of initiative learning and active exploration, cultivates students' ability of raising and resolving questions, develops the awareness of cooperative learning, and finally achieves the goal of improved classroom learning.

Application and feedback analysis of blending learning in CMR training

XU Jing, LU Min-jie

2020, 40(9):  1277-1280. 

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Objective To explore the application form and value of blending learning mode in the teaching of cardiovascular magnetic resonance(CMR)training. Methods Combined with blending learning mode, a basic CMR training course was set up according to the international guidelines. Twenty-three postgraduate students, doctoral candidates and residents were trained and gave feedback from 2015 to 2019. Results There were 18 offline class hours in this training, and student's average online self-study time was (27.70±5.66) hours. The feedback showed that students' learning initiative and satisfaction with teaching forms were significantly increased. Although there were still individual differences in the mastery of professional knowledge, the average level was significantly improved. Autonomous learning awareness and attention to cutting-edge medical technology was also significantly enhanced. Conclusions Clinical teaching should be implemented base on clincial needs,and the new blending teaching combined with international guidelines has high application value in the teaching of CMR training.

Safety management of medical neurobiology laboratory

HAN Wen-juan, LUO Ceng, XIE Rou-gang, WANG Wen-ting, WU Sheng-xi

2020, 40(9):  1281-1284. 

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More and more attention has been paid to the safety of laboratory in colleges. The laboratory biosafety management system following the principle of human safety is the pre-condition of a routine laboratory operation.Under the national regulation and technical guidance about laboratory safety management, this paper reviewed the potential risk factors in the neurobiology laboratory, and put forward feasible solutions. Through safety training, the establishment of safety management system,standardized procedurs and extensive supervision system, the medical students in the neurobiology laboratory are constrained in terms of ideology, system and management norms, in order to improve the students'awareness, cultivate training of GOP techonology,so to ensure the safety of medical students in the neurobiology laboratory.

Training of self-regulated capability building in the standardized training for cardiologists

JIA Qian-yu, GAO Xu-bin, LIU Chuan, LYU Hai-lin, WENG Fei-yan, HUANG Lan

2020, 40(9):  1285-1288. 

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The standardized training of cardiologists in china is an important continuing medical education program to improve the individual and national level of clinical diagnosis and treatment. On account of the varying quality of standardized training trainees and the lack of targeted clinical training and assessment system, the current training program is unable to meet the future job demand of cardiologists. From the training base perspective, the study put forward a goal of improving Core Competencies and focus on the development of self-growth capability. Through the elaboration of training system, the development of personalized training programs, the classification of assessment forms and standard, and other measures, the aim to improve trainees' self-growth capability to figure out problems, to think and solve the problems, and to explore a new way to improve the quality of cardiologists standardized training in China.

Exploration and practice of diversity pedagogy on enhanced recovery after surgery (ERAS) in clinical training of anesthesiology performed in Tibet Autonomous Region

LIU Zi-jia, SHEN Le, ZHANG Jie, Labaciren, HUANG Yu-guang

2020, 40(9):  1289-1294. 

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Objective To investigate the effect of diversity pedagogy on enhanced recovery after surgery (ERAS) in anesthesiology training in Tibet Autonomous Region. Methods Twenty-four anesthesiologists from Tibet Autonomous Region received diversity pedagogy education on ERAS, including systematic and rolling theory teaching, question-centered group literature review, and the combination of clinical practice. The teaching effect was evaluated by questionnaire. And the full score for the cognition degree of ERAS was 50. Results The number of anesthesiologists scored 25 or more of the cognition degree on ERAS was increased from 10(41.6%) to 21(87.5%) after ERAS teaching among anesthesiologists in Tibet Autonomous Region (P＜ 0.001), with the scores of several aspects of ERAS improved significantly. The proportion of anesthesiologists applying ERAS in clinical practice, willing to practice ERAS, and desiring ERAS education were all increased significantly (P＜0.05). Conclusions The diversity pedagogy teaching of ERASshowed excellent learning outcomes in terms of improvement of the cogni- tion degree, clinical practice and learning enthusiasm of ERAS among anesthesiologists in Tibet Autonomous Region. So this pedagogy is a feasible education method in the training about ERAS.

Implementation of clinically oriented seminars as a supplementary course in human anatomy curriculum

SHEN Xin-hua, JIA Zi-qi, ZHENG Hua, CAO Yi-han, PAN Hui, LIU Wei, MA Chao

2020, 40(9):  1295-1298. 

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After-class clinical oriented anatomy seminar was an extracurricular course in their spare time organized by medical students. Held in step with the anatomy curriculum, the seminars allowed active involvement of medical students to enhance their understanding of key anatomical knowledge and at the same time stimulate the early development of clinical reasoning capacity.Reshaping the anatomical teaching approach, the seminars now have become a unique teaching program well received by students and faculty in Peking Union Medical College.

Application of PDCA cycle theory in the teaching of physical diagnostics

XIAO Xin, WANG Wei, LI Xiao-kang, SHI Lei, ZHAO Zhi-jing, HUANG Ya-yu, LIANG Rong

2020, 40(9):  1299-1302. 

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Physical diagnostics functions as a bridge connecting basic medicine courses and clinical medicine courses, and is the basis of all clinical skills. Therefore, its teaching quality is of great significance. PDCA cycle is one of the currently acknowledged quality management methods, including four stages: plan, do, check and action, and continuously cycles in this order to manage the quality. This paper implements the concept of PDCA cycle into the teaching of physical diagnostics, formulates the teaching methods under the theory of PDCA and makes a specific analysis, in order to improve learning outcomes of physical diagnostics, enhance the quality of faculty and promote the management of standardized physical diagnostics training, thus providing a reference for optimization the training of physical diagnostics.

Necessity, difficulty and solutions of research training in residency program

MA Lu-lu, TAN Gang

2020, 40(9):  1303-1305. 

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The development of residency training and evaluating system is very important. Besides training in clinical skills, it is necessary to implement a comprehensive training program including the capacity building of scientific research. This review aims to discuss the necessity and the challenges of research training at present and also discuss how to increase residency research productivity, and hope to improve the quality of residency training.

Exploring online teaching of stomatology in eight-year program of clinical medicine

DONG Hai-tao, GUO Chun-lan, WAN Kuo, ZHAO Ji-zhi

2020, 40(9):  1306-1309. 

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Objective To explore the application of online teaching in the education of stomatology for medical students of eight-year program and evaluate the outcomes. Methods A total of 106 students from the eight-year program (enrolled in 2013 and 2014) in Peking Union Medical College applied online teaching of stomatology and a questionnaire-based research was conducted. Results The online teaching of stomatology was carried out smoothly and 77.8% of the students thought that online teaching had achieved the same learning outcome of traditional teaching, 66.7% of the students hoped to continue online teaching in the future. Most students thought 90-120 minutes was suitable for each course. The average score of teaching feedback was (90.1±8.2).But 60.3% of students preferred to a traditional off-line teaching. There were weakness of online teaching that were found. Conclusions On line teaching can guarantee the teaching quality for the medical students, but still has some defects.

A new strategy of teaching medical genetics in the era of precision medicine

LIU Ya-ping, ZHANG Xue

2020, 40(9):  1310-1312. 

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“Harvard Medical School-Peking Union Medical College training to teachers program(T2T training program)” covers topics in andragogical advances of medical education. “Johns Hopkins Medical School-Peking Union Medical College medical education faculty exchange program(JHMI-GTS observation program)” arranges observations of the composition and educational methods of their core integrated new curriculum “genes to society”. As a teacher of medical genetics, the author attended both programs and proposes a new strategy of medical genetics teaching: Pairing andragogy and genomic advances in the era of precision medicine.