Objective: To explore an approach to improve social competence deficit of children. Methods: 85 pupils with social competence deficit in grade 3 to 5 were divided into two groups: intervention group(n=45) and control group(n= 40). The intervention group received comprehensive therapies for one year. Results: After one year, 80% pupils in the intervention group had obvious improvement, especially the sub- scores of YSR, which were higher in intervention group than in control. Conclusion: The comprehensive intervention for children with social competence deficit is an effective and practical management.

OBJECTIVETo determine the composition, structure, trace elements and thermal stability of Tibetan medicine Nanhanshuishi.

METHODThe trace elements, the structure, and the thermal stability of Nanhanshuishi were assayed and calculated by X-ray fluorescence spectrometry (XRF), inductively coupled plasma optical emission spectrometer (ICP-OES), atomic fluorescence spectrometry (AFS), inductively coupled plasma mass spectrometry (ICP-MS), X-ray power diffraction (XRD), TG-DTA.

RESULTThe results indicated that the phase is mainly made up of CaCO3 (Rhombohedral, R-3c) in Nanhanshuishi. The analysis of elements show that Nanhanshuishi is rich in Ca and O, and contains other more than 20 minor elements, such as Si, Mg, Fe, Al, Na, K, Zn, Mn, Pb, As, Hg etc. The result of TG-DTA show that the weight of Nanhanshuishi starts to decline from near 700 degrees C and get steady above 850 degrees C.

CONCLUSIONThe study provided scientific data for the establishment of quality standards of Tibetan medicine Nanhanshuishi.

Drug Stability ; Mass Spectrometry ; Medicine, Tibetan Traditional ; Minerals ; Spectrometry, X-Ray Emission ; Spectrophotometry, Atomic ; Trace Elements ; analysis

OBJECTIVETo develop an HPLC method for determination of gallic acid, hydroxysafflor yellow A, cinnamic aldehyde and piperine in Tibetan medicine Dangzuo, and to compare the content of four active components in Dangzuo of different Tibetan regions.

METHODThe separation was carried out on a Waters XTerra RP-C18 column ( 4.6 mm x 250 mm, 5 microm). The mobile phases were methanol and water, all contained 0.1% glacial acetic acid, for gradient elution. The gradient program was as follows: 0-22.5 min, methanol was changed from 5% to 50%; 22.5-40 min, changed to 80% 80:20. The flow rate was 1.0 mL x min(-1). The detection wavelength was 270 nm. The reference wavelength was 500 nm.

RESULTThe linear ranges of gallic acid, hydroxysafflor yellow A, cinnamic aldehyde and piperine were 0.040-0.640 microg (r = 0.999 8), 0.090-1.440 microg (r = 0.999 9), 0.031-0.500 microg (r = 0.999 9 ) and 0.092-41.477 microg (r = 0.998 9), respectively. The average recoveries (n = 6) were 97.42% (RSD 1.9%), 97.55% (RSD 2.9%), 98.69% (RSD 0.96%) and 96.72% (RSD 4.0%), respectively. The content ranges of gallic acid, hydroxysafflor yellow A, cinnamic aldehyde and piperine in Dangzuo samples of different Tibetan regions were 0.11341.69 mg x g(-1), 0.889-1.51 mg x g(-1), 0.000-40.606 mg x g(-1) and 1.96-2.73 mg x g(-1), respectively.

CONCLUSIONThe method is a simple and effective for quality control of Tibetan medicine Dangzuo.

Acrolein ; analogs & derivatives ; analysis ; isolation & purification ; Alkaloids ; analysis ; isolation & purification ; Benzodioxoles ; analysis ; isolation & purification ; Chalcone ; analogs & derivatives ; analysis ; isolation & purification ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; Gallic Acid ; analysis ; isolation & purification ; Medicine, Tibetan Traditional ; Piperidines ; analysis ; isolation & purification ; Plant Components, Aerial ; chemistry ; Plant Extracts ; analysis ; isolation & purification ; Polyunsaturated Alkamides ; analysis ; isolation & purification ; Quality Control ; Quinones ; analysis ; isolation & purification ; Reference Standards ; Spectrophotometry, Ultraviolet ; methods

Background and objective Pulmonary sarcomatoid carcinoma(PSC)is a rare subtype of non-small cell lung cancer(NSCLC),which is featured by low incidence,high malignancy rate,robust aggressive behavior and inferior prognosis.To date,there is no standardized treatment.The aim of this study is to better understand and accumulate more clini-cal experience of the disease by summarizing the clinicopathological features,diagnosis methods,therapeutic regimen and prognostic factors of PSC.Methods A total of 39 patients with PSC who diagnosed and received treatment in Beijing Chest Hospital from December 2013 to December 2023 were retrospectively recruited,and information including demographic char-acteristics,clinicopathological features,tumor-node-metastasis(TNM)stage,diagnosis method and therapeutic regimen were carefully collected.Meanwhile,follow-up was conducted.Kaplan-Meier method was used to analyze the prognostic factors of the disease.Results The PSC patients in this study ranged in age from 45 to 76 years old,including 35 males and 4 females.There were no specific clinical manifestations of PSC at initial diagnosis.Among the 39 patients,20 underwent surgical resec-tion and 19 received palliative chemoradiation or symptomatic supportive treatment.The 1-year and 5-year survival rates were 61.90％and 35.20％respectively.Univariate analysis indicated that family history of carcinoma,primary tumor site,TNM stage,lymph node metastasis,distant metastasis,whether or not received surgical resection,surgical method,treatment regimens,tumor tissue programmed cell death ligand 1(PD-L1)expression＞1％and mesenchymal-epithelial transition factor(MET)pathway abnormalities were correlated with the overall survival(OS)of patients(P＜0.05).In the subsequent multivariate analysis,lymph node metastasis emerged as the only independent prognosticator in predicting inferior OS(P=0.037).Conclu-sion PSC is rarely seen in clinical practice and commonly occurs in elder men with smoking history.Tumor tissue PD-L1 ex-pression＞1％and MET abnormalities may predict inferior prognosis of PSC and lymph node metastasis was determined as the independent prognosticator of PSC.Surgical resection along with adjuvant medical treatment is the cornerstone for early and locally advanced patients,and the clinical utility of molecular targeting therapy and immunotherapy in PSC needs to be further investigated.

Objective:To investigate the role and mechanism of PM(2.5)exposure on airway inflammation in juvenile rats based on macrophage recruitment induced by JNK/CCl2 signaling pathway.Methods:A total of 50 juvenile SD rats were randomly divided into 5 groups(n=10).The control group received no treatment,the PM(2.5)group received PM(2.5)particulate matter expo-sure,and the PM(2.5)+Anisomycin group received PM(2.5)exposure and Anisomycin,an activator of JNK,intravenously.Rats in the PM(2.5)+SP600125 group received PM(2.5)exposure and intravenous administration of the JNK inhibitor SP600125,and rats in the PM(2.5)+Pirfenidone group received PM(2.5)exposure and intravenous administration of Pirfenidone,a CCl2 inhibitor.The rats were euthanized and lung tissue was harvested.JNK,phosphorylated JNK(p-JNK)and CCl2 protein expressions were detected by Western blot.Hematoxylin-eosin(HE)staining was used to detect the pathological changes of lung airway tissue and score the pulmo-nary bronchial inflammation.The number of macrophages in alveolar lavage fluid was analyzed by flow cytometry.The levels of IL-6,IL-1β,and TNF-α in alveolar lavage fluid were determined by ELISA.Results:The expression levels of JNK,p-JNK,and CCl2 among all groups(F=205.296,950.408,260.019;all P<0.001)and macrophage content(F=48.414;P<0.001),pulmonary bronchial inflammation score(F=101.703;P<0.001)and IL-6(H=44.890;P<0.001),IL-1β(H=42.071;P<0.001),TNF-α(F=297.154;P<0.001)were statistically significant.Compared with the control group,the expressions of JNK/CCl2 pathway proteins JNK,p-JNK,and CCl2 in PM(2.5)group were significantly up-regulated(all P<0.05),while the content of macrophages was increased(P<0.05),and the pulmonary and bronchial inflammation score was significantly increased(P<0.05).The levels of IL-6,IL-1β,and TNF-α were up-regulated(all P<0.05).Compared with PM(2.5)group,the content of macrophages in PM(2.5)+Anisomycin group was sig-nificantly increased(P<0.05),the pulmonary bronchial inflammation score was significantly increased(P<0.05),and the levels of IL-6,IL-1β,and TNF-α were increased(all P<0.05).The expression levels of JNK,p-JNK,and CCl2 were increased(all P<0.05).Compared with PM(2.5)group,the content of macrophages in PM(2.5)+SP600125 group and PM(2.5)+Pirfenidone group were signifi-cantly decreased(P<0.05),and the pulmonary bronchial inflammation score was significantly decreased(P<0.05).In addition,the levels of IL-6,IL-1β,and TNF-α were significantly decreased(all P<0.05).Compared with PM(2.5)group,the expression levels of JNK,p-JNK,and CCl2 in PM(2.5)+SP600125 group were down-regulated(all P<0.05),and the expression level of CCl2 in PM(2.5)+Pirfenidone group was down-regulated(all P<0.05).Conclusion:JNK/CCl2 pathway induces macrophage recruitment and pro-motes allergic airway inflammation induced by PM(2.5)particulate matter exposure in juvenile rats.

Objective To evaluate the effects of problem-based learning (PBL) teaching model in breast cancer medical imaging education based on multidisciplinary treatment (MDT). Methods The PBL teaching practice of breast cancer imaging based on MDT was carried out in the 192 clinical medicine students in Grade 2014 of Guangzhou Medical University. The students were randomly divided into four groups (group A, B, C and D) and each group was further divided into 1 to 5 teams, with 9 to 11 students in each team. The MDT teaching team consisted of clinical physicians in medical imaging, radiation oncology, surgery (specialized in breast tumor), and other disciplines. The formative assessment method was used to evaluate the teaching effects and the problems involved wereanalyzed. Results Firstly, with a full score of 100 points, the quantitative evaluation of each teaching team on the performance of students in PBL were (86.6±7.8), (87.1±8.1), (83.9±6.5), (88.1±4.5), and (85.1±8.2), respectively. No significant difference was found among each tutor team’s quantitative evaluation (F=1.014, P=0.388). Secondly, the whole posi-tive evaluation rate of students for tutors was 96.28%, with the highest and lowest positive rates as 98.36% and 94.08%, respectively. Significant difference was found among parts of the tutors ( χ2=10.554, P=0.032), specifically between team 1 and 5 (Z=2.245,P=0.025), 3 and 4 (Z=2.217,P=0.027) and 3 and 5 (Z=2.761,P=0.006) respectively. Lastly, the positive and negative evaluation rates of student's self-assessment were 87.33% and 12.67% respectively. Conclusion The effects of PBL based on MDT in breast cancer imaging teaching practice is encouraging, and the formative assessment method can objectively and effectively evalu-ate the effects of this kind of teaching model. However, the standards of evaluation still need to be further perfected and improved.

Objective:In general, patients with seropositive rheumatoid arthritis (RA) are considered to show an aggressive disease course. However, the relationship between the two subgroups in disease severity is controversial. Our study is aimed to compare the clinical characteristics and prognosis of double-seropositive and seronegative RA in China through a real-world large scale study.Methods:RA patients who met the 1987 American College of Rheumatology (ACR) classification criteria or the 2010 ACR/European Anti-Rheumatism Alliance RA classification criteria, and who attended the 10 hospitals across the country from September 2015 to January 2020, were enrolled. According to the serological status, patients were divided into 4 subgroups [rheumatoid factor (RF)(-) anti-cyclic citrullinated peptide (CCP) antibody (-), RF(+), RF(+) anti-CCP antibody(+), anti-CCP antibody(+)] and compared the disease characteristics and treatment response. One-way analysis of variance was used for measurement data that conformed to normal distribution, Kruskal-Wallis H test was used for measurement data that did not conform to normal distribution; paired t test was used for comparison before and after treatment within the group if the data was normally distributed else paired rank sum test was used; χ2 test was used for count data. Results:① A total of 2 461 patients were included, including 1 813 RF(+) anti-CCP antibody(+) patients (73.67%), 129 RF(+) patients (5.24%), 245 RF(-) anti-CCP antibody(-) patients (9.96%), 74 anti-CCP antibody(+) patients (11.13%). ② Regardless of the CCP status, RF(+) patients had an early age of onset [RF(-) anti-CCP antibody(-) (51±14) years old, anti-CCP antibody(+) (50±15) years old, RF(+) anti-CCP antibody(+) (48±14) years old, RF(+)(48±13) years old, F=3.003, P=0.029], longer disease duration [RF(-) anti-CCP antibody(-) 50 (20, 126) months, anti-CCP antibody(+) 60(24, 150) months, RF(+) anti-CCP antibody(+) 89(35, 179) months, RF(+) 83(25, 160) months, H=22.001, P<0.01], more joint swelling counts (SJC) [RF(-) anti-CCP antibody(-) 2(0, 6), Anti-CCP antibody(+) 2(0, 5), RF(+) anti-CCP antibody(+) 2(0, 7), RF(+) 2(0, 6), H=8.939, P=0.03] and tender joint counts (TJC) [RF(-) anti-CCP antibody(-) 3(0, 8), anti-CCP antibody(+) 2(0, 6), RF(+) anti-CCP antibody(+) 3(1, 9), RF(+) 2(0, 8), H=11.341, P=0.01] and the morning stiff time was longer [RF(-) anti-CCP antibody(-) 30(0, 60) min, anti-CCP antibody(+) 20(0, 60) min, RF(+) anti-CCP antibody(+) 30(10, 60) min, RF(+) 30(10, 60) min, H=13.32, P<0.01]; ESR [RF(-) anti-CCP antibody(-) 17(9, 38) mm/1 h, anti-CCP antibody(+) 20(10, 35) mm/1 h, RF(+) anti-CCP antibody(+) 26(14, 45) mm/1 h, RF(+) 28(14, 50) mm/1 h, H=37.084, P<0.01] and CRP [RF(-) anti-CCP antibody(-) 2.3 (0.8, 15.9) mm/L, Anti-CCP antibody(+) 2.7(0.7, 12.1) mm/L, RF(+) anti-CCP antibody(+) 5.2(1.3, 17.2) mm/L, RF (+) 5.2(0.9, 16.2) mm/L, H=22.141, P<0.01] of the RF(+)patients were significantly higher than RF(-) patients, and RF(+) patients had higher disease severity(DAS28-ESR) [RF(-) anti-CCP antibody(-) (4.0±1.8), anti-CCP antibody(+) (3.8±1.6), RF(+) anti-CCP antibody(+) (4.3±1.8), RF(+) (4.1±1.7), F=7.269, P<0.01]. ③ The RF(+) anti-CCP antibody(+) patients were divided into 4 subgroups, and it was found that RF-H anti-CCP antibody-L patients had higher disease severity [RF-H anti-CCP antibody-H 4.3(2.9, 5.6), RF-L anti-CCP antibody-L 4.5(3.0, 5.7), RF-H anti-CCP antibody-L 4.9(3.1, 6.2), RF-L anti-CCP antibody-H 2.8(1.8, 3.9), H=20.374, P<0.01]. ④ After 3-month follow up, the clinical characteristics of the four groups were improved, but there was no significant difference in the improvement of the four groups, indicating that the RF and anti-CCP antibody status did not affect the remission within 3 months. Conclusion:Among RA patients, the disease activity of RA patients is closely related to RF and the RF(+) patients have more severe disease than RF(-) patients. Patients with higher RF titer also have more severe disease than that of patients with low RF titer. After 3 months of medication treatment, the antibody status does not affect the disease remission rate.