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25 December 2016, Volume 15 Issue 06 Previous Issue    Next Issue

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Influence of Tacr2 on ulcerative colitis in mice MAO Yulei, ZHOU Tao, TANG Lingyun, ZHANG Hongxin, WANG Zhugang 2016, 15 (06):  578-581.  DOI: 10.16150/j.1671-2870.2016.06.007 Abstract ( 131 )   PDF (773KB) ( 77 )   Objective: Using Tacr2(tachykinin receptor 2) gene knockout mice and induction of ulcerative colitis (UC) to study the influence and mechanism of Tacr2 on development of ulcerative colitis(UC). Methods Tacr2 knockout mice and wild type mice were treated with oral dextran sodium sulfate（DSS）solution for a week to induce UC, non-treated Tacr2 knockout mice and wild type mice were served as blank controls. Activity index and pathological change of colonic mucosa were studied, and the inflammation score, NF-κB expression in colonic tissue were detected. Results Tacr2 knockout mice showed higher susceptibility to DSS solution. When compared with wild type mice, Tacr2 knockout mice had a significantly decreased level of immunocompetence, presenting with decreased levels of IL-1β, TNF-α, IL-6 and NF-κB. Conclusions Tacr2 has an inhibitory effect on the development of ulcerative colitis in mice. References | Related Articles | Metrics

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Clinical value of heart-type fatty acid-binding protein in early diagnosis of acute myocardial infarction WAN Yinglei, NI Yimin, GU Zhidong 2016, 15 (06):  582-585.  DOI: 10.16150/j.1671-2870.2016.06.008 Abstract ( 159 )   PDF (451KB) ( 93 )   Objective: To investigate the clinical value of heart-type fatty acid-binding protein (H-FABP) in early diagnosis of acute myocardial infarction (AMI). Methods: Serum concentration of H-FABP was measured with latex agglutination assay in 105 cases of suspected AMI because of chest pain. Cardiac troponin I (cTnI), myoglobin (MYO) and creatine kinase isoenzyme MB(CK-MB) were detected simultaneously. According to final clinical diagnosis, patients were divided into AMI group (n=45) and non-AMI group (control group, n=60). Related data between the two groups was compared. Results: The concentration and positive rate of H-FABP, cTnI, MYO and CK-MB were (49.32±10.29) ng/mL and 84.4%, (1.62±0.76) ng/mL and 44.4%, (156.14±54.23) ng/mL and 82.2%, (13.01±6.08) ng/mL and 42.2%, respectively, and all were higher in AMI group than those in control group (P<0.05). The difference in positive rate between H-FABP and MYO in AMI group was not significant (P>0.05), however, the positive rate of H-FABP and MYO was significantly higher than cTnI and CK-MB (P<0.05). The specificity of H-FABP was similar to that of CK-MB (P>0.05), and both of them were lower than cTnI (P<0.05) and higher than MYO (P<0.05). The positive predictive value of H-FABP was equal to cTnI (P>0.05), and both of them were significantly higher than MYO and CK-MB (P<0.05). The negative predictive value between H-FABP and MYO was not significantly different (P>0.05), and both of them were significantly higher than cTnI and CK-MB (P<0.05). Combinedly, the sensitivity of H-FABP+ cTnI, H-FABP+ CK-MB, H-FABP+ MYO, H-FABP+ cTnI+MYO, H-FABP+ cTnI+CK-MB and H-FABP+ cTnI+MYO+CK-MB were all of 100.0%, and the specificity were 82.0%, 72.0%, 61.2%, 59.3%, 68.1% and 56.5%, respectively. Conclusions: H-FABP has a moderately high sensitivity and specificity for early diagnosis of AMI. Furthermore, H-FABP in combination with cTnI can significantly improve the efficacy in early diagnosis of AMI. References | Related Articles | Metrics

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Validation and meta-analysis of various severity scale system for predicting mortality and ICU admission in community-acquired pneumonia patients FENG Yun, CHENG Ting, LIU Jialin, WAN Huanying, CHENG Qijian 2016, 15 (06):  586-594.  DOI: 10.16150/j.1671-2870.2016.06.009 Abstract ( 165 )   PDF (707KB) ( 84 )   Objective: To review and analyze the value of various severity scale system for predicting 30 day mortality and ICU admission in community acquired pneumonia (CAP) patients via meta-analysis. Methods: MEDLINE and EMBASE (2004-2015) were retrieved and 48 papers were collected. Altogether 51 639 CAP patients were enrolled for predicting 30 day mortality, and 10 590 CAP patients were enrolled for predicting ICU admission. The values of five severity scale system: CRB-65, CURB-65, PSI, 2007 IDSA/ATS, SMART-COP for predicting 30 day mortality and ICU admission were meta-analyzed. Results: For predicting 30 day mortality, CRB-65 had a sensitivity of 98%; specificity of 33% and area under summary receiver operator characteristic (sROC) curve (AUC) 0.56. For CURB-65, the above mentioned indices were 84%, 55% and 0.78, respectively. PSI(pneumonia severity index) had a sensitivity of 90%, specificity of 57% and area under sROC curve 0.88; the above mentioned indices for 2007 IDSA/ATS were 76%, 90% and 0.89, respectively. For predicting ICU admission. CURB-65 had a sensitivity of 52%, specificity of 77% and area under sROC 0.67; the above mentioned indices for PSI were 70%, 61%and 0.69, respectively. The SMART-COP had a sensitivity of 84%, specificity of 70%, and area under sROC curve 0.74. Conclusions: PSI, CURB-65 could be used as important references for predicting 30 day mortality in patients with CAP. For ICU admission, the prediction value of SMART-COP is relatively better than PSI and CURB-65 scale systems. References | Related Articles | Metrics

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Dietary fat and risk of endometrial cancer: A meta-analysis WANG Jin, WANG Songtao, LIU Xiaoyang, HONG Yongzhi, ZHAO Peng 2016, 15 (06):  595-601.  DOI: 10.16150/j.1671-2870.2016.06.010 Abstract ( 161 )   PDF (630KB) ( 32 )   Objective: To evaluate the relationship between dietary fat and risk of endometrial cancer (EC). Methods: This meta-analysis was a systematic review of literature published up to June, 2016. Data from PubMed, Web of Science, EMbase, CBM, VIP, and WanFang Data were retrieved and analyzed the relationship between dietary fat and risk of endometrial cancer. All literatures retrieved were screened and extracted according to the inclusion and exclusion criteria by two researchers independently using Stata 11.0 software. The meta-analysis was performed by study design of fat types (total fat, saturated fat, monounsaturated fat and polyunsaturated fat). Results: A total of 15 studies involving 6 480 participants were included. Compared with low intake of fat, high intake of total fat, saturated fat led to a higher risk of endometrial cancer [OR=1.22, 95%CI: 1.02-1.46; OR=1.21, 95%CI: 1.00-1.41]. According to subgroup analysis, the OR for case-control studies were 1.39 (95%CI: 1.14-1.70) in total fat and 1.34 (95%CI: 1.13-1.60) in saturated fat. The summarized RR based on cohort studies was 0.80(0.65-0.98) for total fat. Positive correlation between dietary saturated fat intake and risk of endometrial cancer was observed in studies in United States (OR=1.39, 95%CI: 1.00-1.93), also with high total energy intake（OR=2.17, 95%CI: 1.57-2.99) and smokers(OR=1.30, 95%CI: 1.04-1.62). Conclusions: The meta-analysis of case-control studies reveal that high intake of total fat and saturated fat increase the risk of endometrial cancer. The results of subtype analysis also indicate that high saturated fat intake might increase the risk of endometrial cancer in smoking and high energy intake group. Additional experimental and epidemiological studies with larger participants worldwide are necessary to validate the association between fat intake and risk of endometrial cancer. References | Related Articles | Metrics

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The use of p16/Ki-67 double-staining in diagnosis of cervical intraepithelial lesion SHI Ke, LÜ Xinquan 2016, 15 (06):  602-607.  DOI: 10.16150/j.1671-2870.2016.06.011 Abstract ( 277 )   PDF (1163KB) ( 311 )   Objective: To investigate the role of p16/Ki-67 double-staining in diagnosis and grading of cervical intraepithelial lesions. Methods: Immunohistochemical dual stain was used to detect the co-expression of p16 and Ki-67 in 15 cases of cervical immature metaplasia (IM), 32 cases of low-grade squamous intraepithelial lesion（LSIL, CIN Ⅰ）, 90 cases of high-grade squamous intraepithelial lesion (HSIL, CIN Ⅱ and CIN Ⅲ). The correlation of p16 and Ki-67 co-expression with diagnosis and grading of cervical intraepithelial lesion was analyzed. Results: p16 was negative in IM, and was of focal or patchy staining with weak intensity and positive cells restricted to the lower third of squamous epithelium in CIN Ⅰ. In HSIL, diffuse p16 positive immunostaining cells of 2/3 or full thickness of squamous epithelium was seen. The positive rates of p16 protein were 6.67%, 62.50%,88.89%, 95.56% in IM, CIN Ⅰ, CIN Ⅱ,CIN Ⅲ, respectively, and the differences between these 4 groups were statistically significant (P<0.05). For Ki-67, expression only existed in the basal or parabasal cells in IM. In CIN Ⅰ, Ki-67 immunostaining was restricted to the lower third of the squamous epithelium, while diffuse Ki-67 immunostaining in 2/3 or full thickness of the squamous epithelium was seen in HSIL. The Ki-67 indices were 7.21%, 16.41%, 33.54%, 50.32% in IM,CIN Ⅰ, CIN Ⅱ, CIN Ⅲ, respectively, and the differences were statistically significant (P<0.05). Dual staining did not lead to the absence of Ki-67-positive signal. Ki-67 index was 36.47% in p16 positive region, while was 10.53% in p16 negative region. With the increase in grading of cervical epithelial lesion, the cases of p16/Ki-67 co-expression increased. The co-expression rates of p16/Ki-67 were 0, 51.35%, 85.45%, 99.42% in IM、CIN Ⅰ、CIN Ⅱ、CIN Ⅲ, respectively (P<0.05). Conclusions: The expression of p16 and Ki-67 is associated with the increase in grading of cervical squamous intraepithelial lesion. There is a significantly positive correlation between the expression of p16 and Ki-67. Immunohistochemical dual staining is helpful for the diagnosis and grading of cervical intraepithelial lesions. References | Related Articles | Metrics

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Clinicopathological characteristics of adenoid cystic carcinoma in breast: report of 10 cases and review of literature DA Qian, WU Dongmei, XU Haimin, WANG Chaofu 2016, 15 (06):  608-613.  DOI: 10.16150/j.1671-2870.2016.06.012 Abstract ( 179 )   PDF (900KB) ( 85 )   Objective: To investigate the clinicopathological characteristics of adenoid cystic carcinoma(ACC) in breast for improving the recognition and diagnosis of ACC. Method: Ten female patients with ACC were enrolled. Clinical symptoms and pathological characteristics were reviewed, immunohistochemical phenotyping of biopsies of ACC lesions were detected, and the related data were analyzed in combination with relevant references. Results: Patients were female, with mean age of (61±14) years. Six cases had lesions in left-breast and four cases in right, mostly in the upper outer quadrant. The main clinical manifestation was expansive growth, and the ACC tumor size ranged from 1 to 4 cm, and histologically resembled glandular, tubular and solid tumor. The tumor cells were immunohistochemically negative for ER, PR, HER-2 expression and positive for CD117 expression. Proliferation marker Ki67 ranged from 5%-30%. The median follow-up of these 9 cases ranged from 4-110 months. One patient died of multiple organ failure, and the other eight patients were alive and well with no evidence of disease. Conclusions: ACC of breast is a rare subtype of breast cancer and exhibits an indolent clinical behavior. ACC has its own special histologic characteristics, and differentiation with other breast benign and malignant tumor is needed. References | Related Articles | Metrics

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Use of standardized clinical skill instruction video in teaching of clinical skills for medical students DUAN Baohua 2016, 15 (06):  614-618.  DOI: 10.16150/j.1671-2870.2016.06.013 Abstract ( 124 )   PDF (584KB) ( 54 )   Objective: To evaluate the efficacy of using standardized clinical skills instruction video in teaching of clinical skills and investigate the role of clinical instructor in teaching clinical skills for finding a more effective method to improve the teaching of clinical skills. Methods: Sixty third-year grade medical students taking the elective course of clini-cal skills and other 40 students from junior grades volunteered for taking self-taught instruction video training course of clinical skills were enrolled. The 60 third-year grade students were divided into clinical skill instruction video teaching group and conventional teaching group. The 40 junior grade students were categorized into freshman and sophomore grade groups and all received self-taught instruction video training course of clinical skills. Resultsof teaching were evaluated and compared between these groups, and a questionnaire survey was conducted in both the students and tutors. Results: The average score in instruction video teaching group was significantly higher than that of conventional teaching group (P<0.05) with a difference of 8.4 counts (a full of 100 counts). Eight weeks later the scores of the two groups were significantly decreased, and the decrease was more significant in conventional teaching group (P<0.05). In groups of self-taught instruction video training, the average score of freshman grade group was lower than that of sophomore grade group (P<0.05), with a difference of 8.8 counts. The scores in freshman and sophomore grade self-taught instruction video training groups had lower scores than those in clinical skill instruction video teaching group, which got help from instructor (P<0.05); the differences were 18.9 and 10.1 counts, respectively. The results of questionnaire showed that all students had a strong interest for the clinical skill course, and 95.02% of the students believed that the clinical skill instruction video was helpful for the learning of clinical skills. All teachers agree that standardized clinical skill instruction video can reduce the error and difference in teaching evaluation. Conclusions: The teaching results of clinical skill instruction video teaching group are superior to that of conventional teaching group. The efficacy of self-taught clinical skill instruction video training in freshman grade students is lower than that in sophomore grade students and the help from instructor is more needed. References | Related Articles | Metrics

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Investigation and evaluation on quality of postgradusate training in pediatrics WU Jingyan, ZHENG Shan, ZHOU Wenhao, CHEN Chao, HUANG Guoying 2016, 15 (06):  619-622.  DOI: 10.16150/j.1671-2870.2016.06.014 Abstract ( 88 )   PDF (478KB) ( 40 )   Objective: To investigate and evaluate the curriculum system and clinical skill training of pediatric masterate and doctorate course for finding an approach to improve the quality of postgraduate training in pediatrics. Methods: Pediatric masterate and doctorate students of 2005 to 2012 at Children Hospital of Fudan University receive a survey of self-designed questionnaire before graduation. The questionnaire consisted of two parts: curriculum system and clinical skill training. The evaluation for curriculum system consisted of three sections: practicability of curriculum, content of curriculum and implemental efficacy of curriculum; the overall efficacy consisted of benefits for research project and benefits for ability of clinical skill. Evaluation of clinical skill training included the frequency of teaching, responsibility grade of clinical instructors, pattern of clinical rotation and self-assessment of clinical skill mastering after training. Results: For curriculum system, the content and implemental efficacy of senior course was the most effective. Clinical skill courses got high scores for their utility, content and implementing effect. Of the tutors 92.9% gave the students instructions every month, and 1.79% neither gave their students instructions nor provided supervision. Attending clinical case conference and following the ward general round by senior physicians were the best approaches for improving the clinical skill ability during clinical rotation. Conclusions: Teaching hospital could improve the quality of postgraduate training through adjusting the courses, setting up new courses that meet the needs of clinical students, and adopting effective teaching methods to reinforce the clinical rotation education. References | Related Articles | Metrics