Objective To evaluate the efficacy of WeChat platform conbined with problem-based learning (PBL) teaching method when applied to the standardized training for residents in a department of anesthesiology.Methods Ninety-six residents who were undergoing the standardized training in the Department of Anesthesiology of our hospital were divided into 3 groups (n =32 each) using a random number table:lecture-based learning teaching method group,PBL teaching method group and WeChat platform plus PBL teaching method group.The examination scores after the end of teaching,satisfaction with teaching and scores of interest in anesthesiology were recorded.Results The total scores of examination,scores of comprehension memory problems,clinical application problems and comprehensive analysis problems,rate of satisfactory teaching and scores of interest in anesthesiology were significantly higher in WeChat platform plus PBL teaching method group than in the other two groups (P＜0.05).Conclusion WeChat platform combined with PBL teaching method can improve the teaching quality of the standardized training for residents in a department of anesthesiology and win praise from residents,and it is worth promoting the application.

Objective To promote professional training aid on healthcare talents in western China,this paper aims to explore methods and to evaluate the effectiveness of a new training system for underprivileged medical professionals from hospitals of western China.Methods Questionnaires and interviews were conducted to 115 trainees and their employers took part in the Counterpart Support Project.A retrospective analysis was done to evaluate key indicators of the trainees' professional competence.Results More than 90％ of the trainees have seen great improvement on basic healthcare knowledge,clinical skills,and diagnosis and treatment practice.About 80％ the participating hospitals have enjoyed varied degrees of growth in outpatient visits,surgical volume,number of inpatient and operational efficiency.(Increase level from 0％ to 50％) Conclusions Within the frist 3 years of implementation,this new model has been proven effective to enhance participants' overall professional competence,and by tapping into the significant resource of first class hospitals,this model will help greatly promoting the development of healthcare talents in Western China.

Acute pancreatitis (AP) is an inflammatory disease of the pancreas. Its pathogenesis is not only related to abnormal activation of trypsinogen, but also related to calcium overload, mitochondrial dysfunction, impaired autophagy and endoplasmic reticulum stress. However, the mechanism has not been fully elucidated and needs to be further studied. Currently, there is no effective treatment for AP. It is difficult to prevent the loss of pancreatic function. An in-depth understanding of the pathophysiological mechanisms of AP may help to identify the potential therapeutic targets. Therefore, the purpose of this study is to review recent advances in the mechanism of AP in order to provide more research direction for treatment.

Malignant tumors usually have no obvious clinical symptoms in the early stage. Most patients are already in the advanced stage when they are diagnosed. Some patients have lost the opportunity for operation, resulting in poor prognosis. Therefore, how to find the best therapeutic target for such patients and improve the prognosis of patients has gradually become the focus of scholar′s attention. Recently, Kruppel-like factor (KLF) is a transcriptional regulator that can bind to the target DNA, and its family plays an important role in the occurrence and development of malignant tumors. It has also been confirmed that the KLF family affects the proliferation, differentiation and migration of tumor cells, but the specific mechanism is still not fully elucidate. Consequently, in order to further explored the effect of the KLF family on tumors, this study intends to briefly review the roles and regulatory mechanisms of the KLF family in the cell proliferation, differentiation and migration of malignant tumors, hoping to provide new target for the biological treatment of tumors.

The trends of age-associated change regarding lower facial fat compartments were different. The lower facial rejuvenation should be comprehensively evaluated according to the specific changes of the fat compartments, and master the anatomy of the lower blood vessels and nerves to improve the safety of clinical application. In recent years, the application of imaging methods in the study of facial fat compartments has helped to better understand the changes related to the aging of the lower part and provide new ideas for the effectiveness and safety of the volume recovery of the lower part. This article reviews the aging changes and applied anatomy of the fat compartments in the process of aging of the lower part, which helps surgeons to understand the related changes of aging of the lower part more deeply, and provides new theoretical basis and clinical enlightenment for the rejuvenationof the lower part based on the theory of fat rebalance.

The trends of age-associated change regarding lower facial fat compartments were different. The lower facial rejuvenation should be comprehensively evaluated according to the specific changes of the fat compartments, and master the anatomy of the lower blood vessels and nerves to improve the safety of clinical application. In recent years, the application of imaging methods in the study of facial fat compartments has helped to better understand the changes related to the aging of the lower part and provide new ideas for the effectiveness and safety of the volume recovery of the lower part. This article reviews the aging changes and applied anatomy of the fat compartments in the process of aging of the lower part, which helps surgeons to understand the related changes of aging of the lower part more deeply, and provides new theoretical basis and clinical enlightenment for the rejuvenationof the lower part based on the theory of fat rebalance.

Objective: To explore the relationship between sedentary behavior with cardiorespiratory fitness and executive function in adolescents, and to provide some references for sedentary behavior prevention and executive function improvement. Methods: From September to December 2022, a total of 5 018 adolescents aged 13 to 18 years were selected by stratified random sampling method in Shanghai, Suzhou, Taiyuan,Wuyuan, Xingyi, and Urumqi to conduct physical activity survey, as well as cardiorespiratory fitness and executive function assessment. Pearson s correlation was used to analyze the relationship between sedentary behavior, cardiorespiratory fitness and executive function. The mediation effect model was fitted by the bootstrap mediation procedure in the PROCESS (version 3.3 ) SPSS macro compiled by Haves, and the mediation effect of adolescents cardiorespiratory fitness in the relationship between static behavior and executive function was examined using model 4 in the PROCESS SPSS macro, where Boosrap method was used to compute the mediation effect of adolescents cardiorespiratory fitness. where the Boosrap method was used to calculate confidence intervals for the mediating effects. Results: Adolescents daily sedentary time was positively correlated with both the refreshing function (1-back and 2-back) and the switch function reaction time ( r =0.05, 0.07, 0.05, P <0.01). Adolescent VO 2max was negatively correlated with both the refreshing function (1-back,2-back) and the switching function ( r =-0.09, -0.14 , -0.11, P <0.01). Adolescents daily sedentary time was negatively correlated with VO 2max ( r =-0.04, P <0.01); cardiorespiratory fitness mediated effect values between sedentary behavior and refreshing function (1-back and 2-back) and converted function were 0.20(95% CI =0.06-0.36), 0.43(95% CI =0.14-0.74) and 0.13 (95% CI =0.04-0.22), with mediating effect shares of 6.87%, 8.33% and 8.59%, respectively. Conclusion The duration of sedentary behavior in adolescents is related to executive function performance, and cardiorespiratory fitness may serve as a mediator to mediate the association between sedentary behavior and executive function in adolescents.

Objective To investigate the correlations among homocysteine(Hcy)level,serum cystatin C (Cys-c)and diabetic peripheral neuropathy(DPN).Methods Two hundred and three diagnosed cases of type 2 diabetes were enrolled,including 123 DPN patients(DPN+)and 80 non-DPN(DPN-)patients.Levels of serum Hcy,Cys-c,high-sensitivity C-reactive protein(hs-CRP)and fiber fibrinogen(Fg)were detected.The above indi-cators and the baseline data such as sex,age,duration,BMI,WHR,HOMA-IR(CP),HOMA-islet(CP)were statistically analyzed. Results Hcy,Cys-c,and the duration of the DPN+ group were significantly higher than those in the DPN-group(P<0.05,respectively).HOMA-islet(CP)in the DPN-group was markedly higher than that in the DPN+group(P<0.01).The prevalence of DPN in the high level of Hcy group was much higher than that in the low and the normal level of Hcy group.Hcy was still significantly correlated with the Cys-c after taking the controlled procedure such as duration and fibrinogen. Conclusion High levels of Hcy and Cys-c are the criti-cal risk factors of DPN,collaborative determination of Hcy and Cys-c level might be of quitevaluable in early diag-nosis of DPN.

BACKGROUND:The distribution of the necrotic area plays an important role in hip preservation treatment.At present,there are few studies on whether the difference in the three-dimensional spatial distribution of osteonecrosis of the femoral head affects the clinical outcome of fibular support. OBJECTIVE:To explore the relationship between the spatial distribution and clinical outcome at the sites of osteonecrosis of the femoral head and fibular support using CT three-dimensional reconstruction so as to provide a basis for optimizing the applicable conditions of fibular support and improving the hip preservation effect of fibular support. METHODS:Eighty patients with osteonecrosis of the femoral head who were treated with fibular support for hip preservation from January 2010 to January 2021 were selected as the study subjects according to the inclusion criteria.They were followed up for at least 2 years.According to the clinical outcome,the patients were divided into the successful hip preservation group(n=55)and the failure hip preservation group(n=25).3D reconstruction was performed according to the preoperative and postoperative CT images of the patients.According to the three-column theory,the femoral head was divided into outer nine areas,middle nine areas and inner nine areas(L1-9,C1-9,and M1-9)to explore the spatial distribution of necrotic area of the femoral head and fibular support area and its relationship with clinical outcome. RESULTS AND CONCLUSION:(1)Before operation,the necrotic area of the femoral head was mainly distributed in L1,L2,L4,L5,C1,C2,C4,and C5(the upper and middle part of the anterior part of the outer ninth area and the middle part of the middle ninth area).After operation,the fibular support area was mainly distributed in L5,L6,C5,and C6(the middle and lower part of the outer ninth area and the middle and lower part of the middle ninth area).(2)There were significant differences in the distribution of osteonecrosis of the femoral head between the successful hip preservation group and the failure hip preservation group in L8(the posterior middle part of the outer ninth area),C3(the anterior lower part of the middle ninth area),C6(the lower middle part of the middle part of the inner ninth area)and M2(the anterior middle part of the inner ninth area)(P<0.05).There was a significant difference in the distribution of fibular support in L5 and L6(middle and lower part of outer nine)(P<0.05).Among them,the L8 region could be used as an independent predictor of hip preservation failure in fibular support surgery.The area under the curve of the L8 single factor prediction model was 0.698[95%CI(0.575,0.822)];the sensitivity was 76%,and the specificity was 63.6%.(3)It turns out,when the necrotic area involves L8,C3,C6,and M2,especially L8,the failure of fibular support may increase,and when the fibular support involves L5 and L6,the effect of hip preservation is often not ideal.

BACKGROUND:Bone has bioelectric effects.However,bone defects can lead to loss of endogenous bioelectricity in bone.The implantation of bone tissue engineering scaffolds with bioelectric effect into bone defects will replenish the missing electrical signals and accelerate the repair of bone defects. OBJECTIVE:To introduce the bioelectric effect of bone tissue and expound the repair effect of electrical stimulation on bone defects,summarize the research progress of bioelectric effect applied to bone tissue engineering,in order to provide new ideas for the research of bone tissue engineering. METHODS:Relevant articles were searched on CNKI,WanFang,PubMed,Web of Science and ScienceDirect databases,using"bioelectrical effect,bioelectrical materials,electrical stimulation,bone tissue engineering,bone scaffold,bone defect,bone repair,osteogenesis"as the English and Chinese search terms.Finally,87 articles were included for analysis. RESULTS AND CONCLUSION:(1)Bioelectrical effect combined with ex vivo electrical stimulation to design bone tissue engineering scaffolds is an ideal and feasible approach,and the main materials involved include metallic materials,graphene materials,natural bio-derived materials,and synthetic biomaterial.At present,the most widely used conductive material is graphene material,which benefits from its super conductivity,large specific surface area,good biocompatibility with cells and bones,and excellent mechanical properties.(2)Graphene materials are mainly introduced into the scaffold as modified materials to enhance the conductivity of the overall scaffold,while its large surface area and rich functional groups can promote the loading and release of bioactive substances.(3)However,there are still some major challenges to overcome for bioelectrically effective bone tissue engineering scaffolds:not only electrical conductivity but also the overall performance of the bracket needs to be considered;lack of uniform,standardized preparation of bioelectrically effective bone tissue engineering scaffolds;extracorporeal electrical stimulation intervention systems are not yet mature enough;lack of individualized guidance on stent selection to enable the selection and design of the most appropriate stent for patients with different pathologies.(4)When designing conductive scaffolds,researchers have to deeply consider the comprehensive effects of the scaffolds,such as biocompatibility,mechanical properties,and biodegradability.This combination of properties can be achieved by combining multiple materials.(5)Beyond that,clinical translation should be the ultimate consideration for conductive stent design.On the basis of evaluating the safe current threshold for electrical stimulation to act on the human body and facilitate the repair of bone defects,animal experiments as well as basic experiments are designed and then applied to the clinic to achieve the ultimate goal of applying bioelectrical effect bone tissue engineering scaffolds in the clinic.