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Team-based learning (TBL) is gradually being integrated into Chinese medical education. This study reports its current application status in Chinese medical schools, as well as the underlying challenges and strategies to improve TBL application. We screened publication databases and surveys to investigate TBL usage and concerns regarding TBL application by Chinese medical educators. Articles published by 79 Chinese medical schools include 163 articles among 20 topic areas of basic medicine and 226 articles among 16 clerkship disciplines. The opinions of 123 Chinese medical teachers were solicited from 46 medical schools in 26 provinces/municipalities. Approximately less than half of Chinese medical schools used TBL in basic medicine or clerkship disciplines. Among these, only 10% of schools reported TBL usage in both clerkship disciplines and basic medicine. Both quantitative and qualitative results revealed that public awareness of TBL, executive support, professional training, sharing of resources and integration of multiple disciplines are critical factors in facilitating TBL application, and in recruiting and developing TBL teachers. TBL application in Chinese medical education is limited. Executive/financial support and establishment of a platform to provide technical support, share resources and regulate TBL practice quality will facilitate TBL application in Chinese medical education. [ABSTRACT FROM AUTHOR]

Objective Chondrocyte hypertrophy and mineralization are considered to be important pathologic factors in osteoarthritis (OA). We previously reported that Rac1 was aberrantly activated to promote chondrocyte hypertrophy, mineralization, and expression of matrix metalloproteinase 13 and ADAMTS in OA. However, the underlying mechanism of aberrant Rac1 activation in OA is unclear. The present study was undertaken to identify the specific molecular regulator controlling Rac1 activity in OA, as well as to investigate its function in chondrocyte hypertrophy, mineralization, and OA development. Methods Expression levels of 28 upstream regulators of Rac1 activity, including 8 GTPase-activating proteins (GAPs) and 20 guanine nucleotide exchange factors, in OA and normal cartilage were assessed by quantitative polymerase chain reaction. Chondrocytes were transduced with lentiviral vectors encoding OCRL1, GAP, non-GAP, CA-Rac1, and DN-Rac1, either alone or in combination. Alkaline phosphatase staining was used as a marker of chondrocyte hypertrophy. Rac1 activity was analyzed by pulldown assay. Finally, OA was established in mice by surgical transection of the anterior cruciate ligament and cutting of the medial meniscus. The mice were injected intraarticularly with OCRL1-encoding lentivirus, and whole joints were assessed histologically 6 weeks after surgery. Results OCRL1 was abundantly expressed in normal cartilage and was the only significantly down-regulated RacGAP in OA cartilage. Overexpression of OCRL1 inhibited interleukin-1β-induced Rac1 activity, chondrocyte hypertrophy, and expression of hypertrophy-related genes. Conversely, knockdown of OCRL1 elevated Rac1 activity and promoted chondrocyte hypertrophy and mineralization. Further, OCRL1 modulated Rac1 activity via its GAP domain. Finally, intraarticular injection of OCRL1-encoding lentivirus protected against destruction and degeneration of cartilage in the mouse OA model. Conclusion OCRL1 acts as a RacGAP in cartilage to impede chondrocyte hypertrophy and OA development through modulating Rac1 activity. This regulatory pathway might provide potential targets for the development of new therapies for OA. [ABSTRACT FROM AUTHOR]

Currently in China, health regulations permit oocyte donation only from IVF/ICSI patients who have 20 or more mature oocytes retrieved from a single cycle, of which at least 15 must be kept for their own treatment. Oocyte donation from non-patients and commercial transaction of human gametes are strictly prohibited by law. Additionally, embryos derived from donated oocytes must be cryopreserved and cannot be transferred to prospective recipients, until donors have been screened to be free of communicable diseases after 6 months. Such overly stringent regulation has in turn led to a severe shortage of available donor oocytes in China. The situation is made worse by a cultural aversion to oocyte donation by the majority of patients, because biological kinship and blood relations are viewed as sacrosanct in traditional Chinese culture. The harsh social stigmatization of childlessness in Chinese society, increasing incidence of age-related female infertility in recent years and growing numbers of bereaved older women who have lost their only child to accidents, natural disasters and suicides would make it imperative to reconsider liberalizing the regulation of oocyte donation in China. In particular, the blanket ban on oocyte donation by non-patients should be lifted, as it is anticipated that there are many young healthy women in China who are generous and open-minded enough to consider altruistically donating their oocytes to childless couples.