OBJECTIVETo investigate and study the endangered Tibetan medicinal plant species, their moisture content, biomass and resources reserves in Lhasa region.

METHODThe rare and endangered Tibetan medicinal plant resources were investigated by plot-quadrat method, walking and inquiry ways, sampling and drying method.

RESULTThere were 37 species of rare and endangered plants, belonging to 22 families and 34 genera in Lhasa region. The moisture content of aerial part was higher than that of underground part in many plants. The moisture content of Przewalskia tangutica was the highest (91.97%), and the lowest one was Fritillaria delavayi (only 25.99%). The mean biomass of Rubus biflorus was the highest (1 830.480 g), that of Cordyceps sinensis was the lowest (0.291 g). The root-shoot ratio of Asparagus filicinus was the maximum (5.313), the minimum was Aconitum gymnandrum (0.286). The largest output was 18.000 kg x hm(-2) for Berberis agricola, the output of Saxifraga pasumensis was the lowest (0.007 kg x hm(-2)). The resources reserves of the rare and endangered plants were 15683.697 t in Lhasa region, the maximum was 7690.230 t for B. agricola, 49.03% of the total reserves, the minimum was 2.393 t for S. pasumensis, only 0.015%.

CONCLUSIONThe characteristics of rare and endangered plants were as follows: abundant species and complex habitats, widely distribution but uneven, rich reserves and high economic value. We suggested to update the endangered level of medicinal plants, strengthen the scientific research on these plants, maintain sustainable utilization of the rare and endangered plants in Lhasa region.

Conservation of Natural Resources ; Endangered Species ; Medicine, Tibetan Traditional ; Plants, Medicinal ; chemistry ; growth & development ; Tibet

A total of 40 patients with COPD (excluding those with correlated/relevant diseases)were measured for inflammation parameters of erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) after hospital admission and some coagulation/fibrinolysis parameters including D-dimer,thrombinantithrombin (TAT),prothrombin fragment 1 + 2,(tissue plasminogen activator) tPA,plasminogen activator inhibitor 1 (PAI-1),von Willebrand factor (von WF),endothelin receptor A,thromboxane B2,P-selectin and pulmonary arterial pressure (PAP) by ultrasonic cardiography after the settling of the symptons of acute period.All patients were then divided into 2 groups according to PAP [＜ 40 mm Hg (1 mmHg=0.133 kPa) (n=24),＞40 mm Hg (n=16)].The values of CRP and ESRin the group with PAP ＞ 40 mm Hg were significantly higher than those in another group (P =0.044 and P =0.002respectively) while tPA was lower (P =0.04).A moderate positive correlation existed between tPA and TXB2 (r =0.547).Moreover,a highly positive correlation was found between TXB2 and PAl-1 (r =0.929).The results indicated that the COPD patients with pulmonary arterial hypertension (PAH) tend to have a higher level of inflammation,and their fibrinolysis becomes impaired leading to a prothrombotic state.

The competency-based medical education has formed a global trend, and puts forward a greater challenge for educational design of resident training. The traditional curriculum cannot meet the goal of competency-based education as the curriculum design is lack of theoretical support. Curriculum design is the core of training content, and serves as a significant contributing factor of training outcome. Based on the six-step approach curriculum design, the theory and practice are integrated to form a curriculum design based on theoretical guidance. Through feedback evaluation, the current curriculum design is continuously improved in order to achieve a higher competency-based training quality. With the 5-year experiences and practice, preliminary reform demonstrates effectiveness. The current study hopes to share the teaching reform experiences of residency training base and provide references for colleagues of medical education.

Objective:The incidence of infections in patients with malignant hematologic diseases is extremely high and significantly affects their prognosis.Identifying early and precise biomarkers for infection is crucial for guiding the treatment of infections in these patients.Previous studies have shown that procalcitonin(PCT)can serve as an early diagnostic marker for bloodstream infections in patients with malignant hematologic diseases.This study aims to compare serum PCT levels in these patients with different pathogens,disease types,infection sites,and severity levels. Methods:Clinical data and laboratory results of infected patients with malignant hematologic diseases treated at the Department of Hematology,the Third Xiangya Hospital of Central South University from January 2018 to August 2023 were collected.General patient information was retrospectively analyzed.Serum PCT levels were compared among patients with different pathogens,types of malignant hematologic diseases,infection sites,and infection severity;Receiver operator characteristic(ROC)curves were used to determine the cut-off values and diagnostic value of serum PCT levels in diagnosing bloodstream infections versus local infections and severe infections versus non-severe infections.Mortality rates after 4-7 days of anti-infective treatment were compared among groups with rising,falling,and unchanged PCT levels. Results:A total of 526 patients with malignant hematologic diseases were included.The main pathogens were Gram-negative bacteria(272 cases,51.7%),followed by Gram-positive bacteria(120 cases,22.8%),fungi(65 cases,12.4%),viruses(23 cases,4.4%),and mixed pathogens(46 cases,8.7%).The main types of malignant hematologic diseases were acute myeloid leukemia(216 cases,41.1%),acute lymphoblastic leukemia(107 cases,20.3%),and lymphoma(93 cases,17.7%).Granulocyte deficiency was present in 68.3%(359 cases)of the patients during infection,with severe infection in 24.1%(127 cases).Significant differences in serum PCT levels were found among patients with different types of pathogens(P<0.001),with the highest levels in Gram-negative bacterial infections.Significant differences in serum PCT levels were also found among patients with different types of malignant hematologic diseases(P<0.05),with the highest levels in lymphoma patients.Serum PCT levels were significantly higher in systemic infections and severe infections compared to local infections and non-severe infections(both P<0.001).ROC curve analysis showed that the cut-off values for diagnosing bloodstream infections and severe infections were 0.22 and 0.28 ng/mL,with areas under the curve of 0.670 and 0.673,respectively.After 4-7 days of anti-infective treatment,the mortality rates of the PCT declining,PCT unchanged,and PCT rising groups were 11.9%,21.2%,and 35.7%,respectively,and pairwise comparisons were statistically significant(all P<0.05). Conclusion:PCT can be used as an auxiliary indicator for early identification of different pathogens,infection sites,and severity levels in patients with malignant hematologic diseases combined with infections.Dynamic monitoring of PCT levels after empirical antibiotic treatment provides important guidance for assessing patient's prognosis.

To develop a framework for clinical teaching management (CTM) position competencies, and to initiate the preliminary application of this framework.

Key groups comprising clinical teaching coordinators, clinical trainees, teaching administrators, and the educational reform practice and research group at Peking Union Medical College Hospital (PUMCH) were selected as research samples. The nominal group technique (NGT) was employed to generate, integrate, and establish a framework, as well as to describe CTM competencies. Additionally, rankings of competency importance were gathered. The competency framework was then utilized to conduct a self-assessment of CTM through a questionnaire survey, scored using the Likert method (ranging from 1 to 5 points), followed by an analysis of the results.

The initial NGT discussion round among key groups led to a consensus on the primary CTM competency framework, which included professionalism, coordinating ability, teaching ability, and teaching innovation. Divergent views emerged regarding the connotations and importance rankings of each dimension. Following the second NGT discussion by the educational reform practice and research group, a self-assessment was carried out using the CTM competency framework. This second discussion round resulted in a competency framework for clinical teaching management positions that encompassed seven dimensions: medical knowledge and skills, learner-centeredness, communication and cooperation, professionalism and role modeling, reflection and improvement, teaching theory and methods, and teaching coordination and management. The self-assessment revealed that, aside from the dimensions of teaching coordination and management and teaching theory and methods, the scores for the other five dimensions were above 80% (4 points).

A preliminary CTM competency framework has been established and applied. The results provide significant insights for guidiny the enhancement and evaluation of competencies.However, specific items within this framework require further validation and refinement through practical application.