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Background Bedside teaching is a primary educational tool to improve the clinical practice of medical students. As a new medical pedagogical approach, team-based learning (TBL) is gradually being integrated into Chinese medical education programmes to promote clinical reasoning, knowledge application, teamwork and collaboration. The aim of this controlled study is to investigate the effects of TBL on pediatric bedside teaching in medical students. Methods Thirty medical students in pediatric clinical practice were randomly assigned to an intervention and a control group. Students in the intervention group exposed bedside teaching activity with TBL while students in the control group received traditional bedside teaching. Teaching for the two groups was conducted biweekly, and the same clinical cases were selected for both groups with the same instructors. After six months of clinical practice, the differences of learning outcomes between the two groups were compared through assessments by computer-based case simulations (CCS) and mini-Clinical Evaluation Exercise (mini-CEX). Student feedback following completion of bedside teaching was collected by questionnaire. Results The CCS scores in the intervention group were significantly higher than that in the control group (p p p Conclusions Application of TBL in bedside teaching not only enhanced clinical practice skills among medical students but also improved their clinical reasoning and counseling skills.

Pre-stack simultaneous inversion is a seismic exploration technology which is widely applied to recognize lithology and detect oil and gas by analyzing the feature of amplitude variation versus offset (AVO). A gas-bearing reservoir can cause an obvious change in P-impedance and density. To effectively discriminate gas-bearing dolomite within Longwangmiao Fm. in Sichuan Basin of China, the pre-stack inversion method is employed by strict quality procedures. These procedures mainly include rock physics analysis, AVO modeling and pre-stack simultaneous inversion. Using the technology, P-impedance, S-impedance and density are obtained simultaneously. The distribution of gas-bearing dolomite is identified by P-impedance versus density cross-plotting from well data. The final prediction result indicates the existence of gas-bearing dolomite in the upper part of Longwangmiao Fm. in the study area, which is consistent with well data. Generally, pre-stack simultaneous inversion represents an effective method to predict gas-bearing dolomite reservoir and should be applicable in other study areas.

Breast cancer stem cells (BCSCs) are essential for cancer growth, metastasis and recurrence. The regulatory mechanisms of BCSC interactions with the vascular niche within the tumor microenvironment (TME) and their self-renewal are currently under extensive investigation. We have demonstrated the existence of an arteriolar niche in the TME of human BC tissues. Intriguingly, BCSCs tend to be enriched within the arteriolar niche in human estrogen receptor positive (ER+) BC and bi-directionally interact with arteriolar endothelial cells (ECs). Mechanistically, this interaction is driven by the lysophosphatidic acid (LPA)/protein kinase D (PKD-1) signaling pathway, which promotes both arteriolar differentiation of ECs and self-renewal of CSCs likely via differential regulation of CD36 transcription. This study indicates that CSCs may enjoy blood perfusion to maintain their stemness features. Targeting the LPA/PKD-1 -CD36 signaling pathway may have therapeutic potential to curb tumor progression by disrupting the arteriolar niche and effectively eliminating CSCs., Jiang, Guo, Hao et al. investigate the role of the tumour microenvironment in breast cancer stem cell regulation and identify an arteriolar niche in which BCSCs tended to be enriched in human estrogen receptor positive breast cancer. Here, BCSCs are found to interact with arteriolar endothelial cells through LPA/PKD-1 signalling-mediated arteriolar differentiation of ECs and self-renewal of BCSCs.

This study examined the expressions of human serum tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in patients with acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and their clinical significance. The serum TF and TFPI levels were detected by ELISA in 28 allo-HSCT recipients before and after the transplantation and the changes of TF and TFPI levels were dynamically monitored at different phases of the disease. No significant differences in the serum TF and TFPI levels were found in allo-HSCT recipients in the absence of aGVHD or with grade I aGVHD before and after the transplantation. The levels of serum TF and TFPI were substantially increased in the patients with gradeII aGVHD at the peak of aGVHD (P0.05) and they were even higher in the patients with grade III-IV aGVHD (P0.01). When the conditions became stable after treatment with immunosuppressive agents, the serum TFPI level was decreased to the baseline level (P0.05) and the TF level was lowered but still higher than the baseline level (P0.05). It was concluded that the levels of serum TF and TFPI were increased significantly in the patients with grade II-IV aGVHD after allo-HSCT and decreased markedly after the treatment. Monitoring the levels of serum TF and TFPI in the patients with allo-HSCT is important to predict the occurrence, outcome and prognosis of aGVHD.