Background:China's accelerating development and increasingly important role in global health engagement create a great demand for global health professionals including international consulting experts.This study reported the detailed development and evaluation of an international consulting training for global health workforce.Methods:Based on Kirkpatrick's model,a mixed-methods approach was used to evaluate the effectiveness of the training.Quantitative and qualitative data on participants' reaction,learning,and application of the learned knowledge and skills were collected by a training evaluation survey at the ending of training and a follow-up interview in three months after the training.Results:Thirty-six participants attended the training and 34 of them completed quantitative investigation.The training satisfaction evaluations were positive,for which participants rated the training program highly and over 90％ of them agreed with the usefulness of the training.About knowledge and skills change,participants showed improved consulting knowledge and skills from pre-to post-training (P ＜ 0.001).A total of 23 participants accepted follow-up interview,and most participants applied knowledge and skills learned from the training in their daily work or study.However,only 30.4％ of participants applied their learning in the consulting program.The largest barrier of application was the lack of consulting opportunities.In addition,almost all the participants reported that they would be glad to attend more training courses in the future.Conclusion:The international consulting training program was well-received,and was feasible to improve the consulting service competence of global health professionals.According to participants' feedback,it is essential to develop and expand consulting training in the field of global health.

Objective:To explore the assessment value of ultrasound images for the curative effect of placed umbrella-shaped filters in treating deep vein thrombosis in the lower limbs.Methods:A retrospective analysis was conducted on the clinical data of 85 patients with deep vein thrombosis of the lower extremities who admitted to Peking University Third Hospital Yanqing Hospital from October 2018 to October 2022.Based on the treatment effect and the improvement of clinical symptoms,the patients were divided into a cure group(38 cases),a significant effect group(27 cases)and an effective group(20 cases).All patients underwent the placement of an umbrella-shape filter and popliteal vein puncture on the affected side,and the urokinase was pumped into the body after a thrombolytic catheter was connected to micro pump.All patients underwent contrast-enhanced ultrasound examination,and the diluted ultrasound contrast agent was injected through a thrombolytic catheter on the 1st,3rd and 5th day after surgery,so as to analyze the perfusion situation of ultrasound contrast.Time intensity curve(TIC),time to peak(TTP),density peak intensity(DPI)and ascending branch slope(C)of the curve were obtained by using ultrasound contrast quantitative analysis software.And then,the quantitative parameters of patients among the 1st,3rd and 5th day after surgery were compared.Results:Compared with these before treatment,the reduction of the intima of the wall(82 cases),the better vascular compression(58 cases)and the clear echo in the lumen(61 cases)were significantly improved after treatment,and the differences were statistically significant(x2=52.407,61.917,74.518,P<0.05),respectively.The total effective rate was 100%.The TTP,DPI and C of the cure group,the significant effect group and the effective group were respectively(14.02±5.41)s,(-10.77±3.22)s and(4.91±1.33)dB/s on the 5th day after surgery.The TTP,DPI and C of the significant effect group[(17.95±7.41)s,(-13.87±4.01)s and(4.11±1.20)dB/s]on the 5th d after surgery were significantly different from those on the 1st day after surgery(cure group:t=11.615,-22.122,-16.112,P＜0.001,significant effect group:t=8.820,-13.073,-10.804,P＜0.001,effective group:t=6.791,-7.725,-6.633,P＜0.05),respectively.The DPI and C of the three groups on the 3rd day after surgery were significantly higher than those on the 1st d after surgery,while the TTP was significantly lower than that on the 1st day after surgery,and the differences were statistically significant(cure group:t=-18.857,-12.387,-7.254,-7.435,P＜0.001,effective group:t=-5.076,-6.919,P＜0.05),respectively.The DPI and C on the 5th d after surgery in the cure group and the significant effect group were significantly higher than those in the effective group(tDPI=12.219,7.457,tC=4.826,2.530,P＜0.05),respectively.Conclusion:The deep vein thrombosis of the lower extremities can choose the method of thrombolysis treatment after the umbrella-shape filter is placed,which can effectively intercept the thrombosis and can be indwelled in the vein in a long time,and which can also observe perfusion during inferior vena cava contrast,and which can also intuitive appear the recanalization of the veins after umbrella-shape filter is placed in patients with deep vein thrombosis of the lower extremities after the treatment of catheter thrombolysis.

ObjectiveTo evaluate the animal model of rheumatoid arthritis （RA） induced by inactivated Mycobacterium tuberculosis （Mtb） from inflammation， apoptosis and autophagy， compare the rat RA model of wind-damp-heat arthralgia （FSR） induced by Mtb with the rat RA model of adjuvant arthritis （AA）， and provide experimental evidence for improving the disease-syndrome combined model and developing drugs for the prevention and treatment of RA. MethodThirty 6-week-old SD rats were randomly assigned into 3 groups： a normal group， an AA group and a FSR group， with 10 rats in each group. The RA rat model was established by injection of Mtb suspension （1 mg/rat）， and the rats in the normal group were injected with the same volume of normal saline. The invention in the FSR group lasted for 16 days. The general conditions， body weight， spleen index， swelling of ankle joints， arthritis index （AI）， and the symptoms of arthritis in the hind feet of the rats in each group were observed and measured. The expression levels of serum interleukin-1β （IL-1β） and tumor necrosis factor-α （TNF-α） were detected by enzyme-linked immunosorbent assay （ELISA）. The expressions of IL-1β， TNF-α， apoptosis-related protein B cell lymphoma-2 （Bcl-2） and Bcl-2 associated X protein （Bax）， autophagy-related protein 1 light chain 3 （LC3）， autophagy key molecule yeast Atg6 （Beclin1），and p62 mRNA expression levels were detected by Real-time polymerase chain reaction （Real-time PCR）. The protein expression levels of Bcl-2， Bax， LC3， Beclin1 and p62 were detected by Western blot. ResultCompared with those of the normal group， the rats of AA and FSR groups grew slowly and presented dull hair， soft or loose stool， slow movement， swelling of spleen， redness and swelling of ankle joints， increased AI， and histopathologic changes in the synovium and ankle joints. Moreover， the modeling elevated the levels of IL-1β and TNF-α in the serum， up-regulated the mRNA levels of IL-1β and TNF-α in the synovium， up-regulated the mRNA and protein levels of Bcl2， LC3， Beclin1， and down-regulated the mRNA and protein levels of Bax and p62. Compared with the AA group， the FSR group showed severe symptoms， slowly increased body weight （P<0.01）， early appearance of obvious redness and swelling of ankle joints， increased AI （P<0.05）， increased spleen index （P<0.05）， and obvious pathologic changes of synovial tissue and ankle joints， the inflammatory infiltration in the synovial tissue， and the damage of joint structure. Moreover， the FSR group had higher expression levels of IL-1β， TNF-α， Bcl-2， LC3， and Beclin1 （P<0.05） and lower expression levels of Bax and p62 than the AA group （P<0.05）. ConclusionThe animal model of RA （syndrome of wind-damp-heat arthralgia） can be induced successfully with the symptoms consistent with clinical manifestations of RA. The FSR group has lower apoptosis level and higher autophagy level than the AA group， which indicates that the FSR group is more appropriate for the research on the RA with the syndrome of wind-damp-heat arthralgia.

ObjectiveTo explore the mechanism of Danggui Niantongtang （DGNT） against adjuvant arthritis （AA） rats with wind-dampness-heat arthralgia by quantitative proteomics. MethodSixty SD rats were randomly divided into normal group， model group， angelica came pain soup low， medium and high dose group and methotrexate （MTX） group， each group of 10， only the rat tail root subcutaneously inactivated mycobacterium tuberculosis （Mtb） of adjuvant to build model of AA， artificial climate box intervention 16 d rheumatic fever bi syndrome model is set up， building the day began to drug intervention， The intervention lasted for 28 days. The proteins of synovial tissues in experimental rats were extracted. The differential proteins in the medium-dose DGNT group and the model group were detected and analyzed by 4D label-free quantification （4D-LFQ） proteomics. The differentially expressed proteins associated with mitochondrial pathway apoptosis were verified by immunohistochemistry and Western blot. ResultA total of 4 756 proteins were identified from rat synovial tissues， of which 4 234 proteins contained quantitative information. There were 814 differential proteins between the model group and the DGNT group. As revealed by Gene Ontology （GO） and Kyoto Encyclopedia of Gene and Genome （KEGG） enrichment analyses， DGNT had an effect on the synovial proteome of AA rats with wind-dampness-heat arthralgia， and the differential proteins were enriched in the regulation of the immune system， response to acute inflammation， and apoptosis regulation. As demonstrated by the results of immunohistochemistry and Western blot， compared with the model group， the DGNT groups and the MTX group showed increased protein expression of B-cell lymphoma 2 （Bcl-2）-associated X protein （Bax） and cytochrome C （Cyt C）（P<0.05， P<0.01）， reduced Bcl-2 level （P<0.05， P<0.01）， elevated level of cleaved cysteinyl aspartate-specific protease 9 （Caspase-9）/Caspase-9 （P<0.01）， and decreased level of phosphorylated protein kinase B （p-Akt）/Akt（P<0.05， P<0.01）. ConclusionDGNT involved multiple targets in the treatment of AA with wind-dampness-heat arthralgia and it may exert its effect in the prevention and treatment by regulating the Akt/Bax/Bcl-2 pathway and promoting the cell apoptosis in the mitochondrial pathway.