Institute of Medical Education

Dalian, China

Institute of Medical Education

Dalian, China

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Ma L.-J.,Chi Mei Foundation Medical Center | Lee S.-W.,Chi Mei Foundation Medical Center | Lin L.-C.,Chi Mei Foundation Medical Center | Chen T.-J.,Chi Mei Foundation Medical Center | And 8 more authors.
Tumor Biology | Year: 2014

Despite recent improvements in the diagnosis and treatment, the final outcomes in patients with nasopharyngeal carcinomas (NPC) still remain suboptimal. Through data mining from published transcriptomic database with further bioinformatic validation, fibronectin (FN1) was identified as a differentially upregulated gene in NPC tissues, which implicates the transition from epithelial to mesenchymal phenotype (EMT) and promotes metastasis. Given the roles of fibronectin in risk stratification and in the frontline therapeutics of common carcinomas, such as renal cell cancer, we explored fibronectin immunoexpression status and its associations with clinicopathological variables and survival in a well-defined cohort of NPC patients. Fibronectin immunohistochemistry was retrospectively performed and analyzed using H-score for 124 biopsy specimens from NPC patients who received standard treatment without distant metastasis at initial diagnosis. Those cases with H-score higher than the median value were regarded as fibronectin overexpression. The findings were correlated with clinicopathological variables, EBV latent membrane protein 1 (LMP1) expression, disease-specific survival (DSS), distant metastasis-free survival (DMFS), and local recurrence-free survival (LRFS). Fibronectin overexpression was significantly associated with American Joint Committee on Cancer (AJCC) stages III-IV (p=0.019) and LMP1 expression (p=0.004), and univariately predictive of adverse outcomes for DSS, DMFS, and LRFS (all p<0.0001). In the multivariate comparison, fibronectin overexpression still remained prognostically independent to portend worse DSS (p<0.01, hazard ratio=5.958), DMFS (p<0.01, hazard ratio=5.728), and LRFS (p<0.01, hazard ratio=5.411) together with advanced AJCC stages III-IV. Fibronectin is upregulated in a subset of NPCs, and its increased immunoexpression significantly correlated with advanced features, justifying the potentiality of fibronectin as a theragnostic biomaker of NPC. © International Society of Oncology and BioMarkers (ISOBM) 2013.


Zhang S.,Dalian Medical University | Qi Y.,Dalian Medical University | Xu Y.,Dalian Medical University | Han X.,Dalian Medical University | And 3 more authors.
Neurochemistry International | Year: 2013

The neuroprotective effect and mechanism of the flavonoid-rich extract (FRE) from Rosa laevigata Michx fruit on cerebral ischemia-reperfusion (I/R) injury were investigated. The contents of flavonoids, saponins and tannin were determined, and ten chemicals including chlorogenic acid, 4-hydroxy-3- methoxybenzoic acid, apigenin, luteolin, kaempferol, querce-tin, kaempferide-3-O-glucoside, quercetin-3-rhamnoside, rutin and isorhamnetin-3-O-β-rutinoside from the crude extract were separated. Oral administration of FRE obviously improved the survival rate and prevented I/R-induced disability and histological damage. Further works showed that the natural product had excellent antioxidant activity, significantly decreased DNA fragmentation, up-regulated the expression of Bcl-2, and down-regulated the expressions of p53, Apaf1, Fas, FasL, Bax, Bid, cytochrome C and active Caspase-3, -9 and -8. Moreover, the FRE decreased the expressions of NF-κB, iNOS, MMP-9, COX-2, TNF-α, IL-1β, IL-4, IL-6, and down-regulated the levels of p-JNK, p-ERK and p-p38 in MAPK pathways. Therefore, the flavonoid-rich extract from R. laevigata Michx fruit has the potential actions for treatment of ischemic stroke due to its anti-oxidant, anti-apoptosis and anti-inflammatory properties. © 2013 Elsevier Ltd. All rights reserved.


Liu M.,Dalian Medical University | Xu Y.,Dalian Medical University | Han X.,Dalian Medical University | Liang C.,Dalian Medical University | And 6 more authors.
Molecules | Year: 2014

Oxidative stress-induced neuronal death has an important role in the pathogenesis of neurodegenerative disorders. The effects and mechanisms of action of the total flavonoids (TFs) from Rosa laevigata Michx fruit against hydrogen peroxide (H2O2)-induced oxidative injury in PC12 cells were investigated in this study. The results demonstrated that the TFs protected against cell apoptosis, DNA and mitochondrial damage caused by H 2O2 based on single cell gel electrophoresis, in situ terminal deoxynucleotidyltransferase dUTP nick end labeling (TUNEL), flow cytometry and transmission electron microscope (TEM) assays. In addition, the TFs notably decreased cytochrome C release from mitochondria into the cytosol and intracellular Ca2+ levels, and diminished intracellular generation of reactive oxygen species (ROS). Furthermore, the TFs inhibited the phosphorylation levels of JNK, ERK and p38 MAPK as well as down-regulated the expressions of IL-1, IL-6, TNF-α, Fas, FasL, CYP2E1, Bak, caspase-3, caspase-9, p53, COX-2, NF-κB, AP-1, and up-regulated the expressions of Bcl-2 and Bcl-xl. In conclusion, these results suggest that the TFs from R. laevigata Michx fruit show good effects against H2O 2-induced oxidative injury in PC12 cells by adjusting oxidative stress, and suppression of apoptosis and inflammation, and could be developed as a potential candidate to prevent oxidative stress in the future. © 2014 by the authors.


Montgomery A.L.,Li Ka Shing Knowledge Institute | Ram U.,Li Ka Shing Knowledge Institute | Ram U.,International Institute for Population Sciences | Kumar R.,Institute of Medical Education | And 2 more authors.
PLoS ONE | Year: 2014

Background: Data on cause-specific mortality, skilled birth attendance, and emergency obstetric care access are essential to plan maternity services. We present the distribution of India's 2001-2003 maternal mortality by cause and uptake of emergency obstetric care, in poorer and richer states. Methods and Findings: The Registrar General of India surveyed all deaths occurring in 2001-2003 in 1.1 million nationally representative homes. Field staff interviewed household members about events that preceded the death. Two physicians independently assigned a cause of death. Narratives for all maternal deaths were coded for variables on healthcare uptake. Distribution of number of maternal deaths, cause-specific mortality and uptake of healthcare indicators were compared for poorer and richer states. There were 10 041 all-cause deaths in women age 15-49 years, of which 1096 (11.1%) were maternal deaths. Based on 2004-2006 SRS national MMR estimates of 254 deaths per 100 000 live births, we estimated rural areas of poorer states had the highest MMR (397, 95%CI 385-410) compared to the lowest MMR in urban areas of richer states (115, 95%CI 85-146). We estimated 69 400 maternal deaths in India in 2005. Three-quarters of maternal deaths were clustered in rural areas of poorer states, although these regions have only half the estimated live births in India. Most maternal deaths were attributed to direct obstetric causes (82%). There was no difference in the major causes of maternal deaths between poorer and richer states. Two-thirds of women died seeking some form of healthcare, most seeking care in a critical medical condition. Rural areas of poorer states had proportionately lower access and utilization to healthcare services than the urban areas; however this rural-urban difference was not seen in richer states. Conclusions: Maternal mortality and poor access to healthcare is disproportionately higher in rural populations of the poorer states of India. Copyright: © 2014 Montgomery et al.


Russell D.,RCGP | Etherington C.,GP Tutor North West London | Hawthorne K.,Institute of Medical Education
Education for Primary Care | Year: 2012

Candidates sitting UK postgraduate clinical assessments in general practice see 'patients' in a 'simulated surgery'. These simulated patients (SP) are actors specifically trained for this role. Aim To describe SP experiences of postgraduate clinical exams in UK general practice. Method Focus-group discussions and questionnaires of SP attending the RCGP's Simulated Surgery examinations were conducted in 2006/2007, followed by in-depth, one-to-one, semi-structured interviews with nine SP attending the MRCGP Clinical Skills Assessment (CSA) in 2010. Results SP opinions about the assessments, their ability to portray a range of 'patients' realistically and their opinions of candidate performance were explored. 392 D Russell, C Etherington and K Hawthorne They were confident they could play a wide range of different cases, and had clear views as to what made 'good' or 'poor' candidates. The most frequently mentioned positive characteristic was 'listening'. Owing to the clinical nature of the examination, they did not feel able to mark or give feedback to candidates. They made general observations about consulting behaviour in the examination, and suggested some novel approaches to improving performance. Conclusions Further research on the information SP glean about candidates could help guide learning and preparation prior to clinical examinations. This will be of particular importance in preparing candidates identified as performing less well in their training posts. © 2012 Radcliffe Publishing Limited.

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