Problem-based learning (PBL) was carried out in general practice residency training program.Interview was used to evaluate the teaching performance.A total of 22 teachers and 198 students participated in evaluations.Among the teachers,17 (77％) were quite satisfied and 5 (23％) relatively satisfied.The overall satisfaction rates of teachers,problems and problem solutions were 87％,75％ and 91％ respectively. PBL stimulated the interests of students and was conducive for the combination of theoretical and practical knowledge.And it might improve the thinking ability of students and would be a good teaching method in general medicine residency training.

Objective:To investigate the efficacy of the Scarf osteotomy in treating adolescents with metatarsus adductus-type hallux valgus.Methods:A retrospective analysis was conducted on 20 patients (30 feet) treated with the Scarf osteotomy for metatarsus adductus-type hallux valgus at the Department of Hand and Foot Surgery, Beijing University of Chinese Medicine Third Affiliated Hospital, from July 2022 to August 2023. This group included 10 patients with bilateral conditions and 10 with unilateral, comprising 4 males and 16 females, with an average of 16.2±2.4 years (range, 14-19 years). The procedure involved the release of the lateral capsule, sesamoid ligaments, and adductor hallucis before osteotomy. After osteotomy, shortening and wedge resection were performed, along with translation and rotation of the distal osteotomy to reposition the first metatarsal beside the second and thereby reduce metatarsus adductus. The outcomes included preoperative, immediate postoperative, and final follow-up angles: hallux valgus angle (HVA), intermetatarsal angle (IMA), metatarsal adduction angle (MAA), and the angle between the second to fifth metatarsals.Results:All 20 patients successfully underwent surgery with good wound healing and no infections; the average clinical healing time of osteotomy site was 5.1±0.7 weeks (range, 4.1-6.6 weeks). Follow-up lasted for 12.0±5.4 months (range, 2-18 months). Significant differences were observed in HVA, which was from 35.40°±5.45° preoperatively to 6.93°±3.60° immediately postoperatively, and 9.83°±2.65° at final follow-up; IMA, which was from 11.50°(9.75°, 14.00°) preoperatively to 1.50°(0.00°, 2.00°) immediately postoperatively, and at final follow-up; MAA, which was from 22.80°±2.60° preoperatively to 20.63°±2.27° immediately postoperatively, and 20.67°±2.20° at final follow-up; the angle between the second to fifth metatarsals,which was from 19.03°±1.85° preoperatively to 15.37°±1.33° immediately postoperatively, and 16.03°±1.73° at final follow-up. Visual analogue scale (VAS) also significantly decreased from 2.60±1.64 preoperatively to 1.30±0.92 at 6-8 weeks postoperatively. No cases of transfer metatarsalgia or recurrence of hallux valgus were reported.Conclusion:The Scarf osteotomy for metatarsus adductus-type hallux valgus effectively corrects the first metatarsal adduction and improves the adduction state of the remaining metatarsals to various degrees.

Synthetic biology aims to establish a complete set of engineering principles, theories, and methods, via the rational design and assembly of basic biological parts, for the goal of effective implementation of complex biological systems with programmable functions. In recent years, with emerging novel classes of programmable genetic parts, in particular, the establishment and optimization of CRISPR and CRISPRi technology platforms, synthetic biology is entering a new era. This review summarizes recent advances on CRISPR genome editing and gene regulation technologies, their applications in constructing programmable biological parts, and their roles in building sophisticated gene circuits. We also provide a future vision on how synthetic biology can transform medicine (named medical synthetic biology, MSB) and therapeutics.

Objective:To study the relationship and the role of leptin in children with biliary atresia and hepatic fibrosis to provide a treatment basis for these patients.Methods:The clinical data of children with biliary atresia or congenital biliary dilatation (CBD) who underwent surgical treatment at the Department of General Surgery of Tianjin Children's Hospital from August 2019 to August 2021 were retrospectively analyzed. Of 31 children included in this study, there were 14 males and 17 females, with age of 60 (30, 63) d. Children with biliary atresia served as the study group ( n=26) and children with CBD served as the control group ( n=5). Leptin protein, α-smooth muscleactin (α-SMA) and phosphorylation of extracellular-regulated protein kinase 1/2 (p-ERK1/2) in liver tissues were detectd by immunohistochemistry (IHC). The expression level of leptin mRNA in liver tissues were detected by quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). Results:The average optical density values of leptin protein, α-SMA protein and p-ERK1/2 protein in the liver tissues of children in the study group were significantly higher than the control group ( P<0.05). The expression levels of leptin, α-SMA and p-ERK1/2 in liver tissues of children with biliary atresia significantly increased with increase in fibrosis degree ( P<0.05). The expression level of leptin in liver tissues of children with biliary atresia was positively correlated with the liver fibrosis grade ( rs=0.876), α-SMA ( r=0.723) and p-ERK1/2 ( r=0.725) ( P<0.01). The results of qRT-PCR showed that the content of leptin mRNA in liver tissues of children with biliary atresia was significantly higher than that of children with CBD ( P<0.05). Conclusion:Expressions of leptin increased with aggravation of degrees of hepatic fibrosis in biliary atresia. Leptin may be involved in activation of HSCs through the ERK1/2 signaling pathway in the process of hepatic fibrosis due to biliary atresia.

Objective: To investigate the pathogen spectrum distribution and drug resistance of febrile neutropenic patients with hematological diseases in Shanghai. Methods: A retrospective study was conducted on the clinical isolates from the febrile neutropenic patients hospitalized in the departments of hematology in 12 general hospitals in Shanghai from January 2012 to December 2014. The drug susceptibility test was carried out by Kirby-Bauer method. WHONET 5.6 software was used to analyze pathogenic bacteria and drug susceptibility data. Results: A total of 1 260 clinical isolates were collected from the febrile neutropenic patients. Gram-positive bacteria accounted for 33.3% and Gram-negative bacteria accounted for 66.7%. Klebsiella pneumoniae (12.5%) , Stenotrophomonas maltophilia (9.5%) , Escherichia coli (9.1%) , Pseudomonas aeruginosa (8.7%) , Acinetobacter baumannii (6.6%) , Staphylococcus aureus (5.6%) and Enterococcus faecium (5.0%) were ranked in the first 7 of all pathogens. In the respiratory tract secretions specimens, non-fermented strains accounted for 56.2%. Stenotrophomonas maltophilia accounted for 15.2%. Enterobacteriaceae and coagulase-negative Staphylococci accounted for 42.3% (104/246) and 32.6% (85/246) respectively in blood samples. Enterobacteriaceae and Enterococcus bacteria accounted for 39.4% (76/193) and 28.5% (55/193) respectively in pus specimens. The detection rates of methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative Staphylococci (MRCNS) were 54.3% and 82.5%, respectively. Staphylococcus bacterial strain was not found to be resistant to linezolid, vancomycin and teicoplanin. The detection rate of Enterococcus vancomycin-resistant strains was 8.9%. Enterococcus was not detected resistance to oxazolidinone strains. Enterobacteriaceae bacteria were highly sensitive to carbapenems. The resistance rate of Pseudomonas aeruginosa to imipenem and meropenem was 34.1% and 15.8%, respectively. Stenotrophomonas maltophilia was more sensitive to minocycline hydrochloride, levofloxacin and sulfamethoxazole. The resistance rate of Acinetobacter baumannii only to cefoperazone-sulbactam was less than 10.0%. The antibiotic resistance rate of Klebsiella pneumoniae, Stenotrophomonas maltophilia, Pseudomonas aeruginosa and Acinetobacter baumanii to most of common antibiotics was lower than that of the CHINET surveillance. Conclusions The pathogenic strain distribution in common infection sites of febrile neutropenic patients was characterized. Bacterial resistance surveillance was better than the CHINET nationwide large sample surveillance in China.

Objective: To build a comprehensive information system of radiological health in Shanghai and provide basic data for prevention and control of radiation hazards factors. Methods: A management information platform of radiological health suitable for Shanghai was constructed by sorting out the historical archives and records, combining with content of current work, and using the information platform in China for reference. All Institutions are responsible for the collection and input of the data generated in the work, and the system judges the nature of the data according to the rules, and then completes the interactive analysis of the data with the municipal platform according to the standards, which forms the three-level platform management mode of the city, districts and medical institutions. Results: Data module platform covering health records, environmental monitoring, business warning and statistical reports was built in one year since its preliminary inception in 2014. In the beginning there were only 468 usersof institutions, and by the end of 2018, about 1 241 users were active. Nearly 300 000 pieces of data were collected. Conclusions The construction of comprehensive management information platform of radiological health in Shanghai promotes the standardization and effectiveness of radiological health information management, provides a monitoring model for sustainable long-term development, and provides basic data for further policy management or decision-making.

Objective To establish an HPLC method for the simultaneous determination of harpagide and harpagoside content in Scrophularia ningpoensis (SN). Methods An Eclipse C₁₈ column was used for determination of methanol extract of S. ningpoensis with a HPLC-PDA method and mobile phase of acetonitrile-0.03% phosphate solution in a gradient elution manner. The flow rate of mobile phase was 1.0 ml/min, and the detection wavelengths were 210 nm and 280 nm. Results Harpagide and harpagoside contents in SN showed good linear relationships within 0.1020-0.5100 mg/ml (r=0.9999) and 0.0340-0.1700 mg/ml (r=0.9999). Their average recovery rates were 97.44% and 97.08%.The RSDs were 0.93% and 1.24%.. There were significant differences in the contents of harpagide and harpagoside in SN from 15 origins (P<0.01). The content of harpagoside in Sichuan Long-dong, Zhejiang Lin-an, Zhejiang Pan-an and Henan Nan-feng is higher. Conclusion This method is stable, accurate and reproducible and can be used for the quality control of SN.

Parkinson's disease (PD) is the second most common neurodegenerative disease, but none of the current treatments for PD can halt the progress of the disease due to the limited understanding of the pathogenesis. In PD development, the communication between the brain and the gastrointestinal system influenced by gut microbiota is known as microbiota-gut-brain axis. However, the explicit mechanisms of microbiota dysbiosis in PD development have not been well elucidated yet. FLZ, a novel squamosamide derivative, has been proved to be effective in many PD models and is undergoing the phase I clinical trial to treat PD in China. Moreover, our previous pharmacokinetic study revealed that gut microbiota could regulate the absorption of FLZ