To improve the effect of teaching practice of blood cell morphology,typical cases of peripheral blood erythrocyte,granulocyte and platelet were chosen,case show and problem-based teaching way were applied to encourage students to find information of autonomous learning.Then teacher organized the class discussion,and the information was analyzed and summarized.In the implementation of the case teaching,we should pay attention to improving students' learning initiative.At the same time,teachers need to have knowledge,comprehensive ability and ability in organization and leadership,to promote students' active participation in discussion in the teaching,pay attention to the information feedback,and improve the teaching details

With the development of tumor molecular biology and genomics, it has been recognized that there are great heterogeneity in the biological characteristics, molecular typing and reactivity of the same tumor species among different individuals. In order to achieve true tumor individualized and precise therapy, a new concept of human tumor tissue xenograftmodel (patient derived tumor xenograft, PDTX) is proposed. The previous study has revealed that PDTX model can truly reflect the biological characteristics of tumor tissue and drug efficacy. And PDTX model could be used to select individual che-motherapy regime, evaluate drug resistance and explore efficacy and safety of new drug. PDTX model has been used in clinical practice of several type of cancer including lung cancer. In this paper, the current research progress of lung cancer PDTX is reviewed.

Objective To explore the investigation of current self-management and influencing factors for patients with first percutaneous coronary artery stent implementation ( PCI ) . Methods Behavior self-management questionnaire of coronary disease and general information scale were used in 140 patients within a week after first time of PCI, and all data was analyzed by two independent samples t test, single factor analysis of variance and multiple liner regression analysis. Results Total score of self-management after first PCI was (73. 11 ± 14. 81), with a scoring average of 54. 16%. Patient′s self-management was affected by following factors including age, occupation, education smoking, and so on. Conclusions Patient′s self-management after PCI remains at low to medium level and was influenced by multiple factors. Nursing staffs should strengthen patients and relative′s health education, make out countermeasure for self-management health education, especially for the long term cornerstone of postoperative self-management.

Objective:To elucidate the cytopathological characteristics,molecular subtypes,and clinical prognoses of metastatic breast car-cinoma with serosal effusions.Methods:Seventeen cases that included effusion cytology and clinical data were retrospectively analyzed.Two patients were diagnosed between April 2016 and September 2023 at the Suzhou Ninth Hospital Affiliated to Soochow University,and 15 patients were diagnosed at The First Affiliated Hospital of Soochow University.Cytopathological characteristics,molecular subtypes,and prognoses were analyzed.Results:The cytopathological features of metastatic breast carcinoma in serosal effusions were as follows:1)In-vasive ductal carcinoma:one cell type was relatively densely arranged in nests or colored spheres,which displayed an elevated nuclear/cyto-plasmic ratio,irregular nuclear membrane,and cytoplasmic mucin vacuoles.The other cell type was tiled,single scattered,and varied in size and shape,with enlarged nuclei and elevated nuclear/cytoplasmic ratio.2)Invasive lobular carcinoma:cells were scattered and uniform in size and shape.The nuclei had a relatively regular shape,but displayed an elevated nuclear-to-cytoplasmic ratio.Among the 17 breast can-cer cases,6 had transitioned in molecular subtyping,including 1 case from Luminal A to triple-negative type,1 case from Luminal B to hu-man epidermal growth factor receptor 2(HER-2)-overexpressing type,and 4 cases from Luminal B to triple-negative type.Conclusions:The cytopathological characteristics of serous effusion cells combined with immunocytochemical staining and fluorescence in situ hybridization(FISH)suggest that it is important to determine the origin and molecular typing of tumor cells.This provides an important basis for precise clinical treatment and prognosis.

As medical advances and surgical techniques have improved the survival rates of children with congenital heart disease (CHD), more and more studies have begun to focus on the quality of survival and long-term development of children with CHD. Cognitive and psychological developmental deficits in children with CHD have been well documented. With the development of brain function assessment and neuroimaging techniques in recent years, it has become possible to elucidate the mechanisms of neurocognitive impairment in patients with CHD from a brain science perspective. Providing targeted early follow-up interventions for the population with CHD and promoting their social adaptation have a great clinical significance. This review summarized recent research findings on neurocognitive developmental outcomes in children with CHD from the perspective of behavioral medicine and brain science. This paper focuses on reviewing the mechanisms of brain microstructure damage and brain network dysfunction which may explain neurocognitive impairment in children with CHD, and further explores the early monitoring and intervention programs suitable for clinical development, aiming to suggest possible directions for improving long-term neurocognitive developmental outcomes for CHD population.

Objective To observe the effect of compound iodine alcohol skin disinfectant heated to 40℃using among operation patients .Methods 100 operation patients were randomly divided into two groups:the test group (n=50 cases, accepting heated Anerdian) and the control group (n=50 cases, accepting no heated Anerdian ) .Effectiveness of the iodine content , alcohol content , of bacterial culture and the rate of chill were compared between the two groups .Results In the test group accepting heated Anerdian , the effectiveness of the iodine content was (0.102 ±0.0015)%(g/ml), the effectiveness of the alcohol content was (68.1 ± 1.54)%(g/ml).The differences were significant (t =-12.88, -4.594, respectively;P <0.05).No bacterial culture of the skin sample had been found between the two groups .10min after the sterilization, 4.0%patients in the test group and 24.0%patients in the control group had chill .There was a significant difference between groups (χ2 =8.306,P<0.01).Conclusions Compound iodine alcohol skin disinfectant heated to 40℃can conveniently and effectively increase the degree of comfort of the operation patients .

Objective To investigate the differences in blood pressure phenotypes,renal pathological changes,and related pathogenic pathways in genetically diverse hypertensive mice obtained from 13 strains.Methods The genotypes of Cckbr+/+,Cckbr+/-and Cckbr-/-were obtained by hybridization of 13 strains of genetically diverse mice with Cckbr-/-mice.Blood pressure was measured with a noninvasive blood pressure analysis system(BP-2000).The expression of CCKBR protein in mouse kidney tissue was detected by Western Blot,and the pathological changes in mouse kidney tissue were detected by hematoxylin-eosin(HE)staining and immunohistochemistry(IHC).The pathogenic pathways related to essential hypertension were screened by RNA sequencing.Results In three specific mouse strains(A/J,LOT,and FIM),the systolic blood pressure(SBP)was significantly different between the Cckbr-/-and Cckbr+/+groups.HE staining and IHC showed that hypertension caused a certain degree of renal injury in the mice.Gene Ontology(GO)and pathway enrichment analysis showed that differentially expressed genes were enriched in metabolic processes and circadian rhythm regulation.Conclusions Genetically diverse mice can effectively simulate the genetic background of the population and provide a new resource for studying the pathogenic genes related to essential hypertension.

ObjectiveTo explore the effect and possible molecular mechanism of Qinghua Yichang Formula （清化益肠方， QYF） in treating acute radiation-induced intestinal injury mice via NOD-like receptor thermal protein domain associated protein 3 （NLRP3）. MethodsSixty C57BL/6J mice were randomly divided into control group， model group， pre-modeling medication group， post-modeling medication group， inhibitor group， and QYF plus inhibitor group， with 10 mice in each group.Except for the control group， the other five groups were irradiated with a single full dose to establish the acute radiation-induced intestinal injury mice model. The pre-modeling medication group and the QYF plus inhibitor group were continuously given 4 g/ml of QYF decoction by gavage before modeling， 0.2 ml each time， once a day for 7 days. The post-modeling medication group， pre-modeling medication group and QYF plus inhibitor group were given 4 g/ml of QYF decoction for 14 days after modeling. The control group， model group and inhibitor group were given 0.2 ml of normal saline once a day for 14 consecutive days. Two hours after irradiation， the inhibitor group and the QYF plus inhibitor group were given an intraperitoneal injection of 0.2 ml of the NLRP3 inhibitor MCC950 （concentration： 10 mg/kg）， once every two days. To observe the pathological changes in intestinal tissues， hematoxylin-eosin （HE） staining was used. Western blotting and RT-qPCR were used to detect the protein and mRNA expression levels of NLRP3 in intestinal tissues. Immunohistochemistry was used to detect the expression level of NLRP3， Caspase-1 and GSDMD in intestinal tissues. The proportion of CD4⁺ and CD8⁺ T cells in the spleens of mice were detected by flow cytometry. ELISA was used to determine the levels of IFN-γ， IL-18， and IL-1β in mice serum. ResultsHE staining showed no lesions in the intestinal tissue of mice in the control group. The mice in the model group had shortened intestinal villi， thinned mucosal layers， multifocal mucosal necrosis in the lamina propria， and local neutrophil infiltration. The pathological damage of intestinal tissue of mice in each medication group was improved to varied degrees， among which the QYF plus inhibitor group showed most obvious improvement. Compared to those in the control group， the protein and mRNA expression levels of NLRP3 in the intestinal tissue of mice in the model group significantly increased， with higher NLRP3， Caspase-1， and GSDMD protein expression in the intestinal tissue， increased proportion of CD4⁺ T cells in spleen， decreased proportion of CD8⁺ T cells， and increased levels of IFN-γ， IL-18 and IL-1β in serum （P＜0.05）. Compared to those in the model group， the above indicators in the other medication groups were all improved （P＜0.05）.The NLRP3， Caspase-1， and GSDMD proteins in the pre-modeling medication group were lower than those in the post-modeling medication group （P＜0.05）； and the NLRP3 mRNA level in the QYF plus inhibitor group was lower than that in the inhibitor group （P＜0.05）. ConclusionQYF may play a role in preventing and treating acute radiation-induced intestinal injury by inhibiting the expression of NLRP3.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Small for gestational age (SGA) infants are more likely to experience neurocognitive impairments compared to appropriate for gestational age (AGA) infants. This paper reviews recent research on the neurocognitive development of SGA children. SGA can lead to a "brain-sparing effect" due to growth restriction, which may affect cerebral blood flow and brain structure. However, this does not guarantee normal brain development. Restrictive blood flow can result in changes in brain structure, such as reduced total white matter and gray matter volume in various brain regions, including the cerebral cortex, hippocampus and cerebellum, ultimately leading to decreased head circumference. SGA children also exhibit lower scores in all neurocognitive domains, including intelligence, attention, memory, and executive function. This may result in poor academic performance and an increased risk of social, behavioral, and neurological problems, such as cerebral palsy, epilepsy, visual and hearing impairments, as well as comorbidities like attention deficit hyperactivity disorder(ADHD), autism spectrum disorder(ASD), anxiety, depression, and schizophrenia. Several risk factors for SGA-related neurocognitive impairments have been identified, including gestational hypertension, abnormal gestational weight, smoking, and catch-up growth. Studies have shown that the best interventions to improve cognitive dysplasia include nutrient supplementation, continued breastfeeding, high-quality education, and appropriate early intervention (responsive parenting) are effective in improving cognitive outcomes for SGA children.