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Background Although traditional diagnostic techniques of infection are mature and price favorable at present, most of them are time-consuming and with a low positivity. Metagenomic next⁃generation sequencing (mNGS) was studied widely because of identification and typing of all pathogens not rely on culture and retrieving all DNA without bias. Based on this background, we aim to detect the difference between mNGS and traditional culture method, and to explore the relationship between mNGS results and the severity, prognosis of infectious patients. Methods 109 adult patients were enrolled in our study in Shanghai Tenth People’s Hospital from October 2018 to December 2019. The diagnostic results, negative predictive values, positive predictive values, false positive rate, false negative rate, pathogen and sample types were analyzed by using both traditional culture and mNGS methods. Then, the samples and clinical information of 93 patients in the infected group (ID) were collected. According to whether mNGS detected pathogens, the patients in ID group were divided into the positive group of 67 cases and the negative group of 26 cases. Peripheral blood leukocytes, C-reactive protein (CRP), procalcitonin (PCT) and neutrophil counts were measured, and the concentrations of IL-2, IL-4, IL-6, TNF-α, IL-17A, IL-10 and INF-γ in the serum were determined by ELISA. The correlation between the positive detection of pathogens by mNGS and the severity of illness, hospitalization days, and mortality were analyzed. Results 109 samples were assigned into infected group (ID, 92/109, 84.4%), non-infected group (NID, 16/109, 14.7%), and unknown group (1/109, 0.9%). Blood was the most abundant type of samples with 37 cases, followed by bronchoalveolar lavage fluid in 36 cases, tissue, sputum, pleural effusion, cerebrospinal fluid (CSF), pus, bone marrow and nasal swab. In the ID group, the majority of patients were diagnosed with lower respiratory system infections (73/109, 67%), followed by bloodstream infections, pleural effusion and central nervous system infections. The sensitivity of mNGS was significantly higher than that of culture method (67.4% vs 23.6%; P P = 0.002), blood (P < 0.001) and sputum (P = 0.037), while the specificity of mNGS was not significantly different from culture method (68.8% vs 81.3%; P = 0.41). The number of hospitals stays and 28-day-motality in the positive mNGS group were significantly higher than those in the negative group, and the difference was statistically significant (P Conclusions The study found that mNGS had a higher sensitivity than the traditional method, especially in blood, bronchoalveolar lavage fluid and sputum samples. And positive mNGS group had a higher hospital stay, 28-day-mortality, which means the positive of pathogen nucleic acid sequences detection may be a potential high-risk factor for poor prognosis of adult patients and has significant clinical value. MNGS should be used more in early pathogen diagnosis in the future.

Background Currently, the integrated curriculum of urology is still on the road of complete integration. Co-teaching, an existing concept in education, however, may be used to promote the integration of urology. Therefore, the present study was designed to explore the effect of co-teaching method compare with the traditional teaching method.Methods Co-teaching and traditional teaching in the topics hematuria and acute kidney injure (AKI) were prepared and validated. 98 undergraduate medical students of Tongji University were randomly assigned to groups A and B. Group A was taught hematuria by Co-teaching (CT) and AKI by traditional teaching (TT) and Group B was taught hematuria by TT and AKI by CT. A knowledge assessment tool of 20 multiple choice items was administered to assess the pre, post and retention knowledge scores. Change between knowledge scores was analyzed using inferential statistics. One students’ questionnaire and one tutors’ questionnaire were designed and used to investigate the perception on teaching-learning experience.Results Both traditional teaching and co-teaching were significantly effective in increasing the knowledge scores with no significant difference in learning outcomes between these two methods. However, co-teaching showed better knowledge retention compared to conventional teaching. At the same time, the feedback from students’ questionnaire showed co-teaching method better than traditional teaching; otherwise, the feedback from tutors’ questionnaire showed it needs more time and cooperation for the co-teaching. ConclusionsCo-teaching can promote the curriculum to be deeply integrated, achieve comparatively better retention of knowledge and improve the teaching effect as revealed by the findings.