TBL (Team-based learning) model is a new teaching method.By evaluating the effect of TBL model in theory teaching on Chinese orthodontic postgraduate program in the department of Orthodontics,Guanghua School of Stomatology,Sun Yat-sen University,and comparing the traditional teaching model which centered on teachers,we have probed into the application experience of TBL teaching method in curriculum setting of preclinical theoretic learning in orthodontics postgraduate education.The result shows TBL has significantly enhanced students' enthusiasm for learning,sense of collaboration,and has improved the quality of education.TBL method is better,even though there is something that needs to be improved.

Purpose To investigate the role of SOCS3 on diabetic renal injury. Methods Male CD-1 mice were randomly divided into four groups:control group, diabetic group, empty plasmid vector transfection group and SOCS3 plasmid transfection group. The diabet-ic mice were induced by intraperitoneal injection of STZ at a dose of 150 mg/kg body weight. The mice of transfection group were re-ceived an injection of SOCS3 plasmid or empty vector at every 7 days thereafter. Specimens were collected at 12 week after STZ injec-tion. The morphological changes of tubular epithelial cells were observed by transmission electron microscope. RT-PCR and immuno-histochemistry were used to determine the mRNA and protein expression of CK18 and α-SMA. Western blotting analysis was used to determine the protein expression of SOCS3, p-STAT3, CK18 and α-SMA. Results SOCS3 overexpression in kidney down-regulated the levels of p-STAT3 andα-SMA but up-regulated the expression of CK18. Conclusion Overexpression of SOCS3 can ameliorate the tubular epithelial-mesenchymal transdifferentiation of diabetic mice via inhibiting the phosphorylation of STAT3.

In order to improve the quality of the clinical teaching of postgraduates in burn surgery and cultivate high-quality interdisciplinary talents , this study explores the significance and role of the concept of holistic integrative medicine in the clinical teaching of postgraduates in burn surgery. By cultivating the thinking of holistic integrative medicine among teachers and students, a variety of teaching methods are used to integrate burn surgery with multiple disciplines such as rehabilitation medicine, plastic surgery, psychology , and pathophysiology in the clinical teaching of postgraduates . The results show that the introduction of the concept of holistic integrative medicine in the clinical teaching of postgraduates can enhance their enthusiasm for learning, improve the quality of teaching, and provide a reference for exploring the training model for high-quality talents in burn surgery.

Objective To explore the roles of iron overload in pro-atherogenic activation of foam cells.Methods RAW264.7 and MOVAS cells were stimulated by oxLDL,ferrimine citrate and deferoxamine respectively.Prussian Blue and Oil Red O staining were used to detect iron deposition and foam cell.CCK-8 test,DHE probe,ELISA,RT-qPCR were performed to detect the cell death rate,reactive oxygen species(ROS)generation,lipid peroxidation molecules[glutathione peroxidase(GSH),glutathione peroxidase 4(GPX4),malondialdehyde(MDA)content]and the mRNA level of ATP binding cassette transporter A1(ABCA1),ATP binding cassette transporter G1(ABCG1),inductible nitris oxide synthase(iNOS),arginase-1(Arg-1),α-smooth muscle actin(α-SMA),smooth muscle 22 alpha(SM22a),osteopontin(OPN),Interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α).Results Iron overload could reduced reverse cholesterol transporters(ABCA1 and ABCG1),promote foam cells generation,increased cell death rate,induced the expression of lipid peroxidation molecules(GSH,GPX4,MDA),and promoted pro-inflammatory M1 marker of macrophage and synthetic marker expression of vascular smooth muscle cell(VSMC)and inflammatory cytokines(IL-1β,TNF-α).Conclusion Iron overload promotes the generation of foam cells derived from macrophages and smooth muscle cells and transform them into pro-atherosclerotic phenotype,aggravates cell lipid peroxidation and inflammatory reaction,which contributes to the progress of atherosclerosis.

Objective:To compare the clinical efficacy of femoral distraction and homeopathic double reverse traction reduction assisted internal fixation in the treatment of Schatzker type IV-VI tibial plateau fractures.Methods:A total of 51 patients (28 males and 23 females) with Schatzker IV-VI tibial plateau fractures treated with femoral distraction or homeopathic double reverse traction reduction from January 2017 to June 2021 in the Second Affiliated Hospital of Wenzhou Medical University were retrospectively analyzed. The average age was 49.6±11.9 years (range, 28-71 years). The time from injury to operation was 4.5±3.0 days (range, 1-15 days). There were 5 cases with combined anterior cruciate ligament injuries and 9 cases with posterior cruciate ligament injuries. Twenty-five cases were treated with femoral distraction reduction (distraction reduction group) and 26 cases with homeopathic double reverse traction reduction (traction reduction group). The operation time, intraoperative blood loss, visual analogue scale (VAS) on the first day after operation, hospitalization time, fracture healing time, and incidence of complications were compared between the two groups. Hospital for Special Surgery (HSS) knee function score at 1, 3, 6, 12 months after operation were also compared.Results:All patients were operated successfully. The operation time was 125.9±35.1 min (range, 60-220 min), and the intraoperative blood loss was 138.4±85.4 ml (range, 30-400 ml). 15 patients received autologous iliac bone grafting and 36 patients received allogeneic bone grafting. The VAS score on the first day after operation was 2.4±0.7 (range, 1-4), the hospital stay was 12.6±3.6 days (range, 7-24 days), and the fracture healing time was 14.6±2.2 weeks (range, 12-21 weeks). All patients were followed up for 16.8±2.8 months (range, 13-25 months). The operation time, intraoperative blood loss and hospital stay in the traction reduction group were 106.2±21.7 min, 86.9±42.6 ml and 11.6±3.3 days, respectively, which were less than 146.4±34.9 min, 192.0±86.2 ml and 13.7±3.6 days in the distraction reduction group. The differences were statistically significant ( P<0.05). The HSS scores of traction reduction group at 1 month and 3 months after operation were 83.8±1.7 and 86.7±2.0, which were higher than those of distraction reduction group (81.0±2.6 and 84.9±2.6), and the differences were statistically significant ( P<0.05). There was no significant difference in HSS score between the two groups at 6 and 12 months after operation ( P>0.05). Conclusion:The internal fixation treatment of Schatzker type IV-VI tibial plateau fracture assisted with homeopathic double reverse traction reduction can reduce the amount of intraoperative blood loss, operation time and hospital stay, and improve the knee function in the early postoperative period.

Objective:This study aims to explore the predictive value of T2-weighted imaging (T2WI), apparent diffusion coefficient (ADC), and early-delayed phases enhanced magnetic resonance imaging (DCE-MRI) radiomics prediction model in determining human epidermal growth factor receptor 2 status in breast cancer.Methods:A retrospective study was conducted, involving 187 patients with confirmed breast cancer by postsurgical pathology at Zhenjiang First People's Hospital during January 2021 and May 2023. Immunohistochemistry or fluorescence in situ hybridization was used to determine the HER-2 status of these patients, with 48 cases classified as HER-2 positive and 139 cases as HER-2 negative. The training set was used to construct the prediction models and the validation set was used to verify the prediction models. Layers of T2WI, ADC, and early-delayed phase DCE-MRI images were used to delineate the volumeof interest and 960 radiomic features were extracted from each case using Pyradiomic. After screening and dimensionality reduction by intraclass correlation coefficient, Pearson correlation analysis, least absolute shrinkage, and selection operator, the radiomics labels were established. Logistic regression analysis was used to construct the T2WI radiomics model, ADC radiomics model, DCE-2 radiomics model, DCE-6 radiomics model, and the joint sequence radiomics model to predict the HER-2 expression status of breast cancer, respectively. Based on the clinical, pathological, and MRI image characteristics of patients, univariate and multivariate logistic regression analysis wasused to construct a clinicopathological MRI feature model. The radscore of every patient and the clinicopathological MRI features which were statistically significant after screening were used to construct a nomogram model. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of each model and the decision curve analysis wasused to evaluate the clinical usefulness.Results:The T2WI, ADC, DCE-2, DCE-6, and joint sequence radiomics models, the clinicopathological MRI feature model, and the nomogram model were successfully constructed to predict the expression status of HER-2 in breast cancer. ROC analysis showed that in the training set and validation set, the areas under the curve (AUC) of the T2WI radiomics model were 0.797 and 0.760, of the ADC radiomics model were 0.776 and 0.634, of the DCE-2 radiomics model were 0.804 and 0.759, of the DCE-6 radiomics model were 0.869 and 0.798, of the combined sequence radiomics model were 0.908 and 0.847, of the clinicopathological MRI feature model were 0.703 and 0.693, and of the nomogram model were 0.938 and 0.859, respectively. In the training set, the combined sequence radiomics model outperformed the clinicopathological features model ( P＜0.001). In the training and validation sets, the nomogram outperformed the clinicopathological features model ( P＜0.05). In addition, the diagnostic performance of the nomogram was better than that of the four single-modality radiomics models in the training cohort ( P＜0.05) and was better than that of DCE-2 and ADC models in the validation cohort ( P＜0.05). Decision curve analysis indicated that the value of individualized prediction models was higher than clinical and pathological prediction models in clinical practice. The calibration curve showed that the multimodal radiomics model had a high consistency with the actual results in predicting HER-2 expression. Conclusions:T2WI, ADC and early-delayed phase DCE-MRI imaging histology models for HER-2 expression status in breast cancer are expected to provide a non-invasive virtual pathological basis for decision-making on preoperative neoadjuvant regimens in breast cancer.

Objective:This study aims to explore the predictive value of T2-weighted imaging (T2WI), apparent diffusion coefficient (ADC), and early-delayed phases enhanced magnetic resonance imaging (DCE-MRI) radiomics prediction model in determining human epidermal growth factor receptor 2 status in breast cancer.Methods:A retrospective study was conducted, involving 187 patients with confirmed breast cancer by postsurgical pathology at Zhenjiang First People's Hospital during January 2021 and May 2023. Immunohistochemistry or fluorescence in situ hybridization was used to determine the HER-2 status of these patients, with 48 cases classified as HER-2 positive and 139 cases as HER-2 negative. The training set was used to construct the prediction models and the validation set was used to verify the prediction models. Layers of T2WI, ADC, and early-delayed phase DCE-MRI images were used to delineate the volumeof interest and 960 radiomic features were extracted from each case using Pyradiomic. After screening and dimensionality reduction by intraclass correlation coefficient, Pearson correlation analysis, least absolute shrinkage, and selection operator, the radiomics labels were established. Logistic regression analysis was used to construct the T2WI radiomics model, ADC radiomics model, DCE-2 radiomics model, DCE-6 radiomics model, and the joint sequence radiomics model to predict the HER-2 expression status of breast cancer, respectively. Based on the clinical, pathological, and MRI image characteristics of patients, univariate and multivariate logistic regression analysis wasused to construct a clinicopathological MRI feature model. The radscore of every patient and the clinicopathological MRI features which were statistically significant after screening were used to construct a nomogram model. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of each model and the decision curve analysis wasused to evaluate the clinical usefulness.Results:The T2WI, ADC, DCE-2, DCE-6, and joint sequence radiomics models, the clinicopathological MRI feature model, and the nomogram model were successfully constructed to predict the expression status of HER-2 in breast cancer. ROC analysis showed that in the training set and validation set, the areas under the curve (AUC) of the T2WI radiomics model were 0.797 and 0.760, of the ADC radiomics model were 0.776 and 0.634, of the DCE-2 radiomics model were 0.804 and 0.759, of the DCE-6 radiomics model were 0.869 and 0.798, of the combined sequence radiomics model were 0.908 and 0.847, of the clinicopathological MRI feature model were 0.703 and 0.693, and of the nomogram model were 0.938 and 0.859, respectively. In the training set, the combined sequence radiomics model outperformed the clinicopathological features model ( P＜0.001). In the training and validation sets, the nomogram outperformed the clinicopathological features model ( P＜0.05). In addition, the diagnostic performance of the nomogram was better than that of the four single-modality radiomics models in the training cohort ( P＜0.05) and was better than that of DCE-2 and ADC models in the validation cohort ( P＜0.05). Decision curve analysis indicated that the value of individualized prediction models was higher than clinical and pathological prediction models in clinical practice. The calibration curve showed that the multimodal radiomics model had a high consistency with the actual results in predicting HER-2 expression. Conclusions:T2WI, ADC and early-delayed phase DCE-MRI imaging histology models for HER-2 expression status in breast cancer are expected to provide a non-invasive virtual pathological basis for decision-making on preoperative neoadjuvant regimens in breast cancer.

2019 novel coronavirus (2019-nCoV) is one of the beta coronaviruses and was identified as the pathogen of the severe "coronavirus disease 2019 (COVID-19)" in 2019. China has formally included the 2019-nCoV in the statutory notification and control system for infectious diseases according to the Law of the People's Republic of China on the Prevention and Treatment of Infectious Diseases. Currently, the national defending actions on the 2019-nCoV in China is in a critical period. Burn Department is also confronted with risk of infection by the 2019-nCoV. According to the guidelines on the diagnosis and treatment of COVID-19 (6^th trial edition), the latest relative literature at home and abroad, the features of the COVID-19, recommendations for the COVID-19 prevention and control issued by the National Health Commission of China, and management experience of diagnosis and treatment in the related disciplines, we put forward recommendations for the medical practices of burn treatment during the outbreak of the COVID-19 in outpatient and emergency treatment, inpatient treatment, operation and ward management, etc. We hope these recommendations could benefit the professionals of the same occupation as us and related hospital managers, improve the treatment of burn during the outbreak of the COVID-19, and avoid or reduce the risk of infection of medical staff .

Objective:To analyze the impact of gender on prognosis in patients with primary hepatocellular carcinoma (HCC) after hepatectomy.Methods:The data of 1 796 patients with HCC who underwent liver resection at the Guangxi Medical University Cancer Hospital from January 2010 to December 2016 were retrospectively analyzed. There were 1 548 males and 248 females, the average age were 49.6 years. Patients were followed up for recurrence and survival. After propensity score matching, the postoperative survival rates of male and female patients were compared. Univariate and multivariate Cox regression was used to analyze independent factors affecting prognosis of patients with HCC after hepatectomy. The age and menopause were analyzed by subgroup analyses.Results:The 1-, 3- and 5-years cumulative overall and recurrence-free survival rates of male patients were significantly lower than that of female patients (all P<0.05). Multivariate analysis showed that female was an independent protective factor affecting postoperative recurrence ( HR=0.777, 95% CI: 0.615-0.982) and overall survival ( HR=0.669, 95% CI: 0.520-0.856). Using a cut-off value of 50 years old, the patients were divided into <50 years old ( n=915) and ≥50 years old ( n=881). In patients who were less than 50 years old, the 1-, 3- and 5-years cumulative overall and recurrence-free survival rates of male patients were significantly lower than those of female patients (all P<0.05). In patients ≥50 years old, there were no significant difference in the cumulative overall and recurrence-free survival rates between male and female patients (all P>0.05). Female patients were then divided into the postmenopausal group ( n=152) and the premenopausal group ( n=96). There were no significant differences in the cumulative overall and cumulative recurrence-free survival rates between the two groups ( P>0.05). Conclusion:The prognosis of female patients with HCC after hepatectomy was significantly better than that of male patients.

Objective According to clinical demand of quantification evaluation on flat foot and high arch, an intelligent and rapid method to diagnose arch shape based on principal component analysis (PCA) of plantar pressure is proposed, and its clinic validity is tested. Methods Volunteers diagnozed as abnormal arch and healthy arch were included in this study, and a portable intelligent arch test system was designed and developed. By adopting thin-firm piezoresistive sensor array with 44 rows, 52 columns of sensing units, the system could collect plantar pressure distribution data from the subjects under static standing. Foot axis could be fitted automatically by using the self-programmed PCA, so that foot diagnosis was completed with diagnostic report. The plantar pressure results from the system were compared with those from the existing plantar pressure acquisition device, so as to verify precision of collected data. The accuracy of the diagnosis algorithm for flat foot, high arch and healthy foot was verified through comparison with clinical diagnosis. Results The result of the system had a good correlation with that of the existing plantar pressure acquisition device, the deviation of contact area acquired by the system was smaller than 3.2%, and the angle deviation of the fitted foot axis with clinically defined angel was less than 1°. The system was capable of making diagnosis on arch shape that was 92.6% consistent with the clinical diagnosis. Conclusions PCA is introduced to automatically fit foot axis to achieve the purpose of fast and accurate extraction of foot arch information. The method can be used to assist clinical diagnosis of flat foot and high arch foot, and contribute to quantative analysis on foot arch deformity and its pathogenesis study.