Membranous nephropathy (MN) is a common glomerular disease characterized by podocyte injury. Although previous studies highlighted the leucine-rich repeat-containing 55/big potassium (LRRC55/BK) channel axis in Ang II-induced apoptosis, our study further investigates the upstream regulation by nuclear factor of activated T-cells 3 (NFATc3) and its role in extracellular matrix (ECM) remodeling. Using an Ang II-induced podocyte injury model, we found that NFATc3 overexpression promoted LRRC55 transcription, increased BK channel activity, and elevated intracellular calcium, thereby exacerbating podocyte apoptosis and impairing migration. RNA-seq and functional assays revealed significant upregulation of ECM-related genes, with enhanced fibronectin and collagen I deposition. Patch-clamp experiments confirmed BK channel activation was LRRC55-dependent. In vivo, NFATc3 knockdown attenuated renal injury, restored podocyte markers (nephrin, WT1, synaptopodin), and alleviated proteinuria and fibrosis, whereas LRRC55 overexpression or BK agonist NS1619 reversed these effects. These findings reveal that NFATc3 aggravates Ang II-induced podocyte injury through transcriptional regulation of LRRC55 and activation of the BK channel, contributing to ECM remodeling and glomerular dysfunction. Our results offer mechanistic insight into MN progression and suggest the NFATc3/LRRC55/BK axis as a potential therapeutic target.

Syphilis, a sexually transmitted disease, presents with a wide range of clinical manifestations. As the global rate of syphilis infection continues to rise, so does the incidence of syphilis-associated nephritis. Characterized by diverse clinical and pathological features, the disease shows a good response to penicillin treatment. This article presents the case of a 46-year-old Chinese male patient exhibiting edema, hematuria, proteinuria, and a tendency towards rapidly progressive glomerulonephritis (RPGN). The patient was diagnosed with membranoproliferative glomerulonephritis (MPGN), with syphilis being a likely etiology and co-infection with Hepatitis B virus (HBV). He was treated with benzathine penicillin for three weeks, followed by low-dose glucocorticoids and mycophenolate mofetil (MMF) for subsequent treatment, leading to a significant improvement in his condition. Highlighting the significance of syphilis as a cause of nephritis and emphasizing the importance of timely diagnosis and treatment can greatly alleviate the patient’s condition. Additionally, the role of Hepatitis B virus as a contributing factor in the development of nephritis should not be overlooked. Not applicable.

Primary membranous nephropathy (PMN) is a prevalent renal disorder characterized by immune-mediated damage to the glomerular basement membrane, with recent studies highlighting the significant role of pyroptosis in its progression. In this study, we investigate the molecular mechanisms underlying PMN, focusing on the role of Tumor necrosis factor receptor-associated factor 6 (TRAF6) in promoting disease advancement. Specifically, we examine how TRAF6 facilitates PMN progression by inducing the ubiquitination of Transforming growth factor-beta-activated kinase 1 (TAK1), which in turn activates the Gasdermin D (GSDMD)/Caspase-1 axis, leading to podocyte pyroptosis. Utilizing transcriptomic data from the gene expression omnibus database, we identified key regulatory factors involved in pyroptosis and validated these findings through the establishment of a C3a-induced podocyte injury model and a Sprague–Dawley (SD) rat model of PMN. Our findings reveal that TRAF6 is significantly upregulated in PMN, and its interaction with TAK1 is crucial for the activation of the GSDMD/Caspase-1 axis, ultimately driving podocyte pyroptosis. Further biochemical and molecular analyses confirmed the pivotal role of the TRAF6/TAK1 signaling pathway in the pathogenesis of PMN. These results underscore the importance of TRAF6-mediated signaling in the progression of PMN and suggest that targeting the TRAF6/TAK1/GSDMD/Caspase-1 axis may offer a novel therapeutic strategy for the treatment of this debilitating renal disease.

IgA nephropathy is characterized by the deposition of IgA and complement C3 in the glomerular mesangial region. Recent research has pointed out the critical role of mitochondrial damage during the occurrence and development of IgAN. During IgAN progression, elevated myc promotes the transcription of HRD1, which in turn induces the ubiquitination of MFN1, leading to mitochondrial dysfunction. We found that the expression levels of myc and HRD1 were elevated in IgAN. Down-regulation of HRD1 and myc successfully alleviated IgAN progression by promoting cell survival, reducing renal injury and improving mitochondrial homeostasis. Additionally, we observed reduced levels of MFN1 expression in IgAN. Overexpression of MFN1 significantly inhibited IgAN progression, while the deficiency of MFN1 exacerbated IgAN injury. In summary, our findings revealed that myc plays a critical role in regulating mitochondrial function in IgAN by promoting HRD1 transcription and inducing MFN1 ubiquitination. These results suggested that targeting myc/HRD1/MFN1 axis may offer a novel therapeutic strategy to combat IgAN progression.

Purpose:The glucagon-like peptide-1 receptor agonist (GLP-1RA) is a pharmacological agent utilized for the treatment of diabetes, known for its significant reno protective effects. This study aims to investigate the impact of liraglutide, a representative GLP-1RA medication, on early endothelial dysfunction in diabetic rats and elucidate its underlying mechanisms. Methods:The present study employed a high-fat, high-sugar diet in combination with a single intraperitoneal injection of streptozotocin (STZ) to establish an experimental rat model of diabetes. Subsequently, the therapeutic efficacy of liraglutide on renal injury in this model was evaluated using various doses. Results:Compared to the DKD rats, the rats treated with Liraglutide exhibited significant reductions in levels of blood glucose (Glu), serum creatinine (Scr), and blood urea nitrogen (BUN) (P < 0.05). Furthermore, there was a dose-dependent decrease in urinary protein levels, including 24-hour urinary protein excretion rate and microalbuminuria (m-ALB), with higher doses demonstrating more pronounced therapeutic effects (P <0.05). In addition, treatment with Liraglutide effectively improved glomerular and interstitial damage, and suppressed the expression of CD31, CD34, and VE-cadherin associated with endothelial cell injury (P < 0.05). Furthermore, Liraglutide administration significantly increased nitric oxide (NO) production (P < 0.05). Moreover, Liraglutide treatment resulted in decreased expression of vascular endothelial growth factor (VEGF), Delta-like ligand-4(Dll4), and Notch2 protein in the Notch2 signaling pathway (P < 0.05). Conclusion:The findings indicate that Liraglutide has a substantial effect on decreasing urinary protein excretion and improving vascular microinflammation, thus alleviating endothelial dysfunction in diabetic nephropathy. This observed mechanism can be attributed to the inhibition of the Dll4/Notch2 signaling pathway.

Objective: Serum-specific antibodies as a non-invasive means to effectively diagnose idiopathic membranous nephropathy and assess clinicopathology. Methods: Immunofluorescence of anti-PLA2R and THSD7A antibodies and kidney tissue PLA2R, THSD7A and IgG4 expression in IMN and non-IMN (2020-2021) was detected to assess the efficacy of diagnosing IMN. IMN patients were divided into two groups, anti-PLA2R antibody positive (161 cases) and negative (26 cases), and two groups, kidney tissue PLA2R (40 cases) and PLA2R +THSD7A (6 cases), to compare the clinical and pathological features, and to carry out a prognostic analysis of THSD7A-positive patients, with a focus on correlation with malignancy. Results: The positive rate of anti-PLA2R antibodies was significantly higher in IMN (P<0.05); anti-PLA2R antibodies, kidney tissue PLA2R and IgG4 and THSD7A had some diagnostic value. Anti-PLA2R antibodies correlated with proteinuria levels in IMN patients, and their levels were negatively correlated with blood albumin (r=-0.146, P=0.042); correlated with pathological stage and C3 and IgG4 immunodeposition; there was no significant difference in clinical pathology between kidney tissue THSD7A+PLA2R positive compared to kidney tissue PLA2R positive patients, but the probability of achieving complete remission was low and time longer, and no malignancy events were detected during follow-up. Conclusion: Anti-PLA2R antibodies, kidney tissue PLA2R, THSD7A and IgG4 have high diagnostic efficacy for IMN; anti-PLA2R antibodies can be used as diagnostic markers to assist in the assessment of clinical and pathological features; co-expression of kidney tissue PLA2R and THSD7A is not significantly different from kidney tissue PLA2R in assessing the clinical features, pathological manifestations and prognosis, but requires long-term. However, long-term follow-up is needed to monitor the potential risk, and a larger multicentre study with long-term follow-up is expected to be conducted to comprehensively assess IMN characteristics.

Objective To assess the efficacy and safety of three treatment modalities (rituximab targeted B-cell therapy, calcium-phosphate inhibitor in conjunction with low-dose corticosteroids, and full-dose corticosteroids combined with cyclophosphamide) for patients at intermediate or high risk of idiopathic membranous nephropathy (IMN) and to analyze the factors impacting the remission rates of IMN. Methods A retrospective cohort study was conducted to analyze patients diagnosed with IMN in our nephrology department via renal biopsy, identifying a total of 148 patients at intermediate or high risk. These patients were categorized into three treatment groups: a RTX group with 60 patients receiving rituximab, a CNI group with 42 patients receiving calcineurin inhibitors, and a CTX group with 46 patients received cyclophosphamide. Baseline measurements of 24-hour urine protein, serum albumin, blood creatinine, uric acid, estimated glomerular filtration rate (eGFR), and serum anti-phospholipase A2 receptor antibody levels were recorded at the onset of the follow-up. Subsequently, changes in 24-hour urine protein, eGFR, remission rates, and occurrence of adverse events among the three patient groups were compared at 6, 12, and 18 months post-treatment. Moreover, COX regression analysis was employed to ascertain factors influencing the remission rate of IMN. Results At the outset of the follow-up period, no significant difference existed in baseline characteristics such as gender, age, 24-hour urine protein quantification, serum albumin, serum creatinine, uric acid, eGFR, serum anti-PLA2R antibody levels, body mass index (BMI), and systolic blood pressure among the patients, indicating the comparability of three groups. After 6 months, there were no notable changes in 24-hour urine protein quantification and eGFR among the three groups; however, remission rates in the RTX and CTX groups were lower than those in the CNI group. By the 12-month mark, 24-hour urine protein quantification in the RTX group significantly decreased compared to the CTX group, with overall remission rates showing no significant differences among the three groups. By the 18-month milestone, 24-hour urine protein quantification in the RTX group remained notably lower than that in the CTX group, with significantly higher eGFR levels. Additionally, the CTX group exhibited lower 24-hour urine protein quantification compared to the CNI group, with both RTX and CTX groups displaying higher remission rates than the CNI group. Predominant adverse reactions in the RTX group included infusion reactions and infections, whereas the CNI group were associated with metabolic syndrome and elevated serum creatinine, and the CTX group primarily experienced hepatic dysfunction. Multifactorial COX regression analysis revealed an association between baseline anti-PLA2R antibodies and remission rates of IMN (HR=1.162, 95% CI 1.078-1.249). Conclusion RTX therapy for IMN exhibits a gradual onset of action, boasting a superior disease remission rate at 18 months in comparison to CNI. It demonstrates a similarity to CTX in this aspect and offers prolonged maintenance of remission. Conversely, CNI demonstrates a rapid onset of action but poses a risk of exacerbating renal impairment in patients. Notably, elevated levels of serum anti-PLA2R antibodies emerge as an independent risk factor influencing remission in IMN.

Background Fruquintinib is a highly selective inhibitor of vascular endothelial growth factor receptor (VEGFR). Currently, there are no reported cases of fruquintinib causing kidney-restrictive thrombotic microangiopathy (TMA) in the available Chinese and foreign literature.Case presentation In this case report, we presented a 73-year-old patient receiving fruquintinib for metastatic colon cancer, manifesting abundant proteinuria, in which kidney-restrictive TMA was also diagnosed through renal biopsy. As far as we were concerned, this was the frst reported in terms of fruquintinib-induced kidney-restrictive TMA confrmed by renal biopsy.Conclusion This case indicates that fruquintinib may result in kidney-restrictive TMA, which is a rare but life-threatening complication of cancer treatment drug. Therefore, regular monitoring of proteinuria and blood pressure is imperative for all patients undergoing anti-VEGF drug therapy. And renal biopsy should be promptly conducted to facilitate early detection of thrombotic microangiopathy.

目的:观察特发性膜性肾病(idiopathic membranous nephropathy,IMN)患者肾组织中自噬相关蛋白LC3Ⅱ、P62和p-mTOR的表达,了解IMN患者肾组织细胞自噬的溶酶体降解过程是否参与了IMN的发生发展.方法:选取蚌埠医学院第一附属医院2020年11月—2021年06月经肾活检初次确诊的IMN患者42例,免疫组化检测LC3Ⅱ、P62和p-mTOR的表达,分析两组间自噬蛋白表达差异性及IMN组自噬蛋白表达与患者肾间质纤维化及肾功能等临床相关指标的相关性.结果:与正常肾组织相比,IMN组的肾组织自噬相关蛋白LC3Ⅱ、P62和p-mTOR的表达显著增加(均为P<0.01);在IMN组中,与无纤维化组相比,有纤维化组LC3Ⅱ、P62的表达显著增加(均为P<0.05);IMN患者胆固醇(TC)、三酰甘油(TG)、24 h尿蛋白定量与肾组织LC3Ⅱ、P62和p-mTOR的表达成正相关.结论:IMN患者的肾组织中自噬体数量增加,自噬溶酶体数量不增加,自噬体的降解受阻,在IMN患者中,细胞自噬的溶酶体降解阶段受损所导致的自噬通量不足参与了IMN的发生发展.

目的:研究炎症相关因子Toll样受体4(TLR4)、核转录因子-kappa B(NF-κB)在特发性膜性肾病(IMN)患者肾组织的表达水平,探讨炎症因子 TLR4、NF-κB 在 IMN 发病过程中的临床意义.方法:本研究纳入于蚌埠医学院第一附属医院肾病科经肾活检初次诊断为 IMN 的患者 45 例为特发性膜性肾病组(IMN组),同期选取因肾挫伤、肾肿瘤或输尿管肿瘤等行肾脏切除留取健康肾脏组织 20 例为正常对照组(NC组).收集两组相关临床指标并分析比较两组间差异性.采用免疫组化的方法分别检测炎症因子TLR4、NF-κB在两组肾组织中的表达,并进行平均光密度值分析,比较两组间炎症因子表达差异.将IMN组分为纤维化组29 例,无纤维化组16 例,分析比较两组间炎症因子表达的差异性,了解炎症在肾间质纤维化中的作用.应用Pearson相关性分析两组炎症因子之间及其与临床指标间的相关性.结果:IMN组患者肾组织中TLR4、NF-κB的表达水平显著高于NC组(P＜0.01).IMN纤维化组TLR4、NF-κB表达明显强于无纤维化组(P＜0.05).相关性分析显示:TLR4 与NF-κB两者之间密切相关(P＜0.01).TLR4 与血清白蛋白、高密度脂蛋白呈负相关(P＜0.01),与24h 尿蛋白定量、血清胆固醇、低密度脂蛋白呈正相关(P＜0.05、P＜0.01).NF-κB 与血清白蛋白、高密度脂蛋白呈负相关(P＜0.05),与24h尿蛋白定量呈正相关(P＜0.05).结论:炎症因子 TLR4、NF-κB 在 IMN 肾组织中表达水平上调,且两者之间相互作用,引起肾组织细胞损伤,导致肾间质纤维化,参与了IMN的发生、发展.

Objective To investigate the changes of serum alkaline phosphatase（ALP） levels in maintenance hemodialysis（MHD） patients and its clinical application value. Methods A total of 736 patients who underwent MHD in five blood purification centers in Bengbu region from October 2020 to May 2021 were included. The patients were grouped according to the quartile of serum ALP. The general data and laboratory indicators of patients in the four groups were statistically compared. Furthermore, the correlation between serum ALP and calcium and phosphorus metabolism and inflammatory indexes was analyzed. Results The MHD patients included 415 males（56.39%） and 321 females（43.61%）, with an average age of（56.61±13.40） years and a median dialysis age of 44（16,74） months. The prevalence of hypocalcemia, hyperphosphatemia and secondary hyperparathyroidism（SHPT） were 25.54%, 63.59% and 20.11%, respectively. Among ALP groups, there were statistically significant differences in age, dialysis age, systolic blood pressure, serum calcium, serum phosphorus, calcium-phosphorus product, whole parathyroid hormone（iPTH）, creatinine, urea nitrogen, albumin, hs-CRP, white blood cell count（WBC） and ferritin（FER） levels（all P＜0.05）. Pearson correlation analysis showed that serum ALP was significantly positively correlated with serum calcium, iPTH, hs-CRP, WBC and FER（all P＜0.05）. Conclusion Serum ALP combined with blood iPTH monitoring can more accurately identify the types of renal bone disease, and serum ALP level is closely related to inflammatory indicators. Serum ALP can be used as a predictor of cardiovascular disease morbidity and mortality in MHD patients, and is expected to be a new therapeutic target for MHD patients, thereby improving the prognosis of patients.

Abstract Mannose-binding lectin (MBL) and autoantibody IgG4 staining against the phospholipase A2 receptor (PLA2R)were correlated. To enquire into the pathogenic effect of MBL in IMN as well as its relevance to clinicopathology and prognosis.Patients with IMN in 2021–2022 at our hospital were divided into positive and negative groups based on glomerular MBL immunofluorescence results and anti-PLA2R antibody characterization, and their clinical, pathological and follow-up data were evaluated.Among 39 patients with IMN, the positive rates of glomerular MBL and IgG4 deposition and serum anti-PLA2R antibodies were 31 (79.5%), 37 (100%) and 26 (70.3%), respectively. There were no notable differences in clinical and pathological features between the MBL-positive and negative groups of patients, but there were differences in IgG4 expression in the renal tissues (p < 0.05). There were no notable differences in MBL deposition between IMN patients grouped qualitatively by blood PLA2R antibodies. Renal tissue MBL was highly expressed (79.5%) and C1q was lowly expressed (15.38%). Kaplan-Meier analysis of clinical remission was similar in both groups. In multivariate COX regression analysis adjusted for sex, age, serum anti-PLA2R antibody concentration and blood pressure, MBL deposition (HR, 0.776; 95% CI, 0.311–1.939; p = 0.587) was not associated with IMN remission in the MBL-negative compared with the positive group.Renal tissue MBL characterization correlates with IgG4 and anti-PLA2R antibodies are involved in the pathogenesis of IMN through the induction of complement activation by the complement agglutinin pathway. No significant clinical, pathological or prognostic differences between patients with positive and negative MBL deposits were found in the study.

AIM:Diabetic kidney disease (DKD) is one of the severe microvascular complications of type 2 diabetes mellitus (T2DM), which eventually leads to irreversible renal damage and develops into end-stage renal disease (ESRD). Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a new class of antidiabetic drugs that act on the kidney to reduce glucose reabsorption. Increasing evidence confirms that dapagliflozin exerts a protective effect on DKD, but the mechanisms have not been reported. The aims of this study were to observe the therapeutic efficacy of dapagliflozin on DKD and investigate the possible immunological mechanism.MATERIALS AND METHODS:T2DM was modeled by a high-sugar and high-fat diet combined with STZ. Then, rats were treated with 10 mg/kg dapagliflozin for 8 weeks. The protective efficacy of dapagliflozin was evaluated by observing body weight, blood glucose, blood serum creatinine, blood urea nitrogen, 24-h urine protein, renal histology and ultrastructure, and oxidative stress levels. The immunological mechanisms were monitored by measuring the levels of TLR2/Myd88/NF-κB by immunohistochemical staining, RT-qPCR and Western blotting.RESULTS:After treatment with dapagliflozin, renal damage was greatly improved. The levels of blood glucose, renal function and proteinuria were significantly decreased, and renal pathological and ultrastructural damage was obviously extenuated, possibly due to the reduction in inflammation and the levels of oxidative stress.CONCLUSIONS:Dapagliflozin has therapeutic potential for DKD. This effect was possibly mediated by inhibiting inflammation and oxidative stress levels.

目的:探讨"1+1+1"临床带教模式在MBBS留学生急诊医学临床实习中的应用效果.方法:将外国留学生和国内实习生分为"1+1+1"临床带教模式组(实验组)及"一对多"的传统临床带教模式组(对照组),对国内实习生的理论考试、操作考试、英语口语和英文文献翻译能力进行考核;考核留学生的出勤天数、理论考试、操作考试和病历书写情况.结果:实验组国内实习生的理论考试、操作考试、英语口语和英文文献翻译成绩均优于对照组,差异均具有统计学意义(P<0.05).实验组外国留学生出勤天数、理论考试、操作考试及病历书写成绩均优于对照组,差异均具有统计学意义(P<0.05).结论:"1+1+1"临床带教模式在急诊医学临床实习中的应用效果良好,全方位提高了国内实习生及MBBS留学生实习质量.

目的:探讨分层递进式教学法对整形外科住院医师规范化培训(住培)面部创伤教学的效果.方法:选取某院整形外科规培学员30人,随机分成对照组和研究组,每组15人.对照组采用传统教学模式,研究组采用分层递进式教学模式.将整形外科面部创伤分级,在规培结束时对2组学员面部创伤救治的胜任力进行测评,包括理论基础、病史采集、病例分析、操作能力、医患沟通五项指标,同时对教学满意度调查进行评价.结果:研究组胜任力评价总分为(80.67±8.06)分,高于对照组的(67.33±7.78)分,差异有统计学意义(P<0.001);其中病史采集、病例分析、操作能力、医患沟通的评分分别为(16.07±2.25)分、(15.80±2.40)分、(16.80±1.52)分、(15.80±2.04)分,高于对照组的(13.87±2.39)分、(13.60±2.32)分、(12.80±1.32)分、(13.87±1.40)分(P值均<0.05);2组学员理论基础评分比较,差异无统计学意义(P>0.05);2组学员中重度面部创伤的独立完成人数,研究组明显高于对照组(P<0.05);研究组学员教学满意度为(91.00±4.96)分,高于对照组的(85.40±3.14)分(P<0.001).结论:分层递进式教学法能够提高学员的主观能动性,有效梳理规培学员对各类面部创伤的病历特点,提高学员对急创伤治疗的信心,增加学员对教学的满意度.

目的 探讨蚌埠地区维持性血液透析(MHD)患者矿物质和骨异常(MBD)现状,分析其相关影响因素.方法 选择2020年9—12月以蚌埠地区5家血液净化中心收治的MHD患者711例作为研究对象.收集患者一般资料及相关生化指标,分析MHD患者血钙、血磷、全段甲状旁腺激素(iPTH)的达标情况及相关影响因素,进一步探讨影响血磷、iPTH升高的危险因素.结果 711例MHD患者血钙、血磷和iPTH达标率分别为46.7％、40.2％和26.9％.以蚌埠地区质控标准,血钙、血磷和iPTH达标率分别为59.4％、32.9％和52.6％,高达90.7％的患者存在钙磷代谢紊乱.其中,年龄<60岁患者高磷血症、高iPTH的发生率高于年龄≥60岁的患者,透析龄>3年的患者高钙血症、高磷血症及高iPTH发生率较≤3年的患者高,而糖尿病肾病患者高磷血症、高iPTH发生率较非糖尿病肾病患者低,差异均有统计学意义(P<0.05).血红蛋白达标患者的血钙达标率相对较高,血磷达标率相对较低;白蛋白达标的患者血钙、iPTH达标率相对较高;处于微炎症状态的患者血磷、iPTH达标率相对较低,差异均有统计学意义(P<0.05).透析龄、血磷、碱性磷酸酶及血肌酐升高是血iPTH升高的危险因素;超敏C-反应蛋白(hs-CRP)、血红蛋白、血肌酐及血尿素氮升高是高磷血症的危险因素,差异均有统计学意义(P<0.05).结论 蚌埠地区MHD患者MBD各评价指标达标率与国内水平接近.血磷达标率(32.9％)有待进一步提高.透析龄、血磷、碱性磷酸酶及血尿素氮与血iPTH升高密切相关;hs-CRP、血红蛋白、血肌酐及血尿素氮与高磷血症密切相关.

目的:探讨基于思维导图的新型线上教学模式对临床医学专业本科生的教学效果.方法:选取接受临床医学课程理论教学的临床医学专业2个班级学生147人为研究对象,其中临床医学班91名学生设为普通教学班,临床医学实验班56名学生设为实验教学班.教学实施后对2个班级进行问卷调查,包括对目前教学模式的认知感受、新型教学方法和理念接受情况以及对教学模式的效果评价.结果:与传统教学班比较,实验教学班对现今教学模式满意度更低(P<0.05),更希望互动结合讲解的教学方式(P<0.05),对于"学习金字塔"和学习小组或学习社区的知晓率更高(P<0.01).2个班级的学生对于提高学习效率的新型工具均有相对较高知晓率,对于教学效果中有关专业知识的掌握、临床技能提升、协作意识锻炼、逻辑思维拔高等均有较高期待,但班级间差异均无统计学意义(P>0.05).实验教学班学生的课堂思考积极性、专注度、掌握度均优于传统教学班(P<0.05),认为教学对临床实践有帮助比例明显高于传统教学班(P<0.01),尝试思维导图构建知识体系意向比例高于传统教学班(P<0.05).结论:基于思维导图的新型线上教学模式有助于提升学生的课堂积极性和教学效果,值得进一步完善和推广.

目的 探究Mini-CEX与DOPS联合的形成性评价体系在地方高等院校本科生临床实践教学中的应用.方法 选择2018年12月—2020年12月于本院临床实习的160名临床医学专业本科学生为研究对象,随机数表法分为传统教学组与形成性评价教学组(FA教学组)两组,每组各80名.传统教学组采用固定周期的科室讲座、教学查房、病例讨论的常规传统实践教学方式;FA教学组采用迷你临床演练评估(Mini-CEX)与操作技能直接观察评估(DOPS)联合的形成性评价体系教学方式.临床实践教学结束后,对比分析两组学生相关测评成绩及满意度情况.结果 临床实习前FA教学组与传统教学组在理论测评、技能操作、病历书写3个方面成绩未见明显差异(P>0.05),临床实习结束后FA教学组在理论测评、技能操作、病历书写3个方面成绩均明显优于传统教学组(P<0.01),且较自身临床实习前成绩得以明显提升(P<0.01);临床实习结束后,FA教学组于Mini-CEX评估表及DOPS评估表各项目成绩均明显优于临床实习开始前(P<0.05);临床实习结束后FA教学组的教师、护士、患者满意度评分均明显高于传统教学组(P<0.01);针对整个临床实习过程,FA教学组对临床实习教学模式满意度高于传统教学组(P<0.05).结论 Mini-CEX与DOPS联合的形成性评价体系应用于临床医学专业本科生的临床实践教学过程中将有效提升临床实践教学质量,促进学生综合实力发展进步,提高学生对教学模式的满意度.

随着计算机与网络信息的普及和发展,催生出网络教学这一新型的教学方式.中国发展网络教育的目标与中国推进教育信息化的进行是分不开的.早在1998年,教育部开始推出"面向21世纪教育振兴行动计划",从而推动我国现代远程教育的迅速发展.在2000年的全国教育会议上,国务院做出"深化教育改革全面推进素质教育"的决定,在该决定中提到要大力提高教育技术手段的现代化水平和教育信息化程度,国家支持建设以中国教育科研网和卫星视频系统为基础的现代远程教育网络.1998年教育部批准清华大学、浙江大学、北京邮电大学和湖南大学举办现代远程教育试点.网络教学现已经成为各个高校的教学方式之一,同时也被国家教育部门大力倡导和支持.网络教学的发展加快教育改革的速度,整合优化教育资源,使教育与时俱进.为推进教育公平公正提供新的思路.传统的医学教学模式使枯燥乏味的知识难以理解,教学效果不理想,借助医学网络教学可能会更好的传授医学知识.因此,本文针对医学专业的教学特点,介绍目前医学院校线上教学的基本情况以及线上教学的优势,说明线上教学的必要性和重要意义,同时又对医学院校线上教学存在的问题和建议性的解决方法进行全面的阐述和分析,呼吁各方积极改善线上教学环境,希望为医学线上教学的推进与发展提供科学的参考依据.

目的:探讨慢性肾脏病(CKD)3～5D期患者腹主动脉钙化(AAC)与血清OPG、Fetuin-A的相关性,并分析AAC的危险因素.方法:选取95例CKD3～5D期患者为实验组,同时选取64例健康人作为对照组比较一般临床资料,均采用腹部侧位X线片评估腹主动脉钙化情况,并计算钙化积分;ELISA法检测OPG、Fetuin-A水平.结果:实验组中AAC组52例,non-AAC组43例,实验组OPG水平高于对照组、实验组Fetuin-A水平低于对照组,差异有统计学意义(P<0.05);AAC组OPG水平高于non-AAC组,AAC组Fetuin-A水平低于non-AAC组,差异有统计学意义(P<0.05);OPG与年龄、AAC成正相关,Fetuin-A与AAC呈负相关,Logistic回归分析发现年龄、磷、OPG、Fetuin-A是AAC的危险因素;OPG是AAC严重程度分级的危险因素.结论:CKD患者腹主动脉钙化发生率高,年龄、磷、OPG、Fetuin-A是AAC的危险因素,OPG是区分AAC严重程度的独立危险因素.