Porcine hemagglutinating encephalomyelitis virus(PHEV)is one of the coronaviruses susceptible to swine populations.The non-structural protein 2(NS2)encoded by its genome is fre-quently deleted during the epidemic transmission of the virus,but its biological significance re-mains unclear.In order to explore the structure and function of the NS2 protein,this study utilized platforms such as ProtParam,TMHMM,NetPhos3.1,and ExPASy to analyze its physicochemical properties,spatial structure,genetic evolution,and post-translational modification characteristics.Meanwhile,the NS2 protein was expressed in eukaryotes and transcriptome sequencing was per-formed to clarify the biological processes it participates in.The results showed that the NS2 protein consists of 233 amino acids,with a molecular weight of 26.735 kDa,and a half-life of approximately 30 hours in mammals.It includes 13 phosphorylation sites,2 N-glycosylation sites,and 1 O-glyco-sylation site,with no signal peptide and strong hydrophilicity.The a-helix accounts for the highest proportion in NS2(43.78％),followed by random coils(36.05％).The homology of the NS2 pro-tein between the epidemic strains PHEV-CC14 and PHEV-JL/2008 in Northeast China is 99.57％.The NS2 protein is widely involved in the regulation of nerve-related functions,such as axon guid-ance and synaptic development.This study preliminarily clarified the biological function of the NS2 protein,providing a new perspective for understanding the pathogenic mechanism of PHEV.

Porcine hemagglutinating encephalomyelitis virus(PHEV)is one of the coronaviruses susceptible to swine populations.The non-structural protein 2(NS2)encoded by its genome is fre-quently deleted during the epidemic transmission of the virus,but its biological significance re-mains unclear.In order to explore the structure and function of the NS2 protein,this study utilized platforms such as ProtParam,TMHMM,NetPhos3.1,and ExPASy to analyze its physicochemical properties,spatial structure,genetic evolution,and post-translational modification characteristics.Meanwhile,the NS2 protein was expressed in eukaryotes and transcriptome sequencing was per-formed to clarify the biological processes it participates in.The results showed that the NS2 protein consists of 233 amino acids,with a molecular weight of 26.735 kDa,and a half-life of approximately 30 hours in mammals.It includes 13 phosphorylation sites,2 N-glycosylation sites,and 1 O-glyco-sylation site,with no signal peptide and strong hydrophilicity.The a-helix accounts for the highest proportion in NS2(43.78％),followed by random coils(36.05％).The homology of the NS2 pro-tein between the epidemic strains PHEV-CC14 and PHEV-JL/2008 in Northeast China is 99.57％.The NS2 protein is widely involved in the regulation of nerve-related functions,such as axon guid-ance and synaptic development.This study preliminarily clarified the biological function of the NS2 protein,providing a new perspective for understanding the pathogenic mechanism of PHEV.

Objective:To construct a finite element analysis model for the application of sustentaculum tail sustentacular screw in the treatment of calcaneal fracture of Sanders type Ⅱ. The finite element analysis method was used to study the effectiveness of the simulation treatment of Sanders type Ⅱ calcaneal fracture.Methods:A complete adult calcaneal specimen that was not affecting the normal quality of bone after teaching in the Department of Human Anatomy, Kangda College of Nanjing Medical University from 2021 to 2022 second semester was selected. A micro CT scan was performed to obtain data. The three-dimensional model of the calcaneus was reconstructed by the software of Mimics and Geomagic Wrap. The internal fixation and fracutre model were drawn using SolidWorks software. The obtained data were imported into the finite element analysis software for material assignment and meshing to obtain a three-dimensional finite element model. The load and boundary constraints were applied to each model to perform finite element analysis and calculation, and the stress and displacement of the model were extracted. Finally, the experimental screw placement of the calcaneus loading process was verified.Results:The three-dimensional model of calcaneal fracture had a high degree of appearance simulation, complete morphological structure, no defect, and was consistent with the size of the solid calcaneus. After surgical treatment, the anatomical reduction of each fracture model was good, the steel plate fit to the bone surface, and the screw did not protrude outside the model. There was no deformation or damage to the whole internal fixation, the grid division was clear, and the number was relatively uniform and consistent. The maximum stress in each type of calcaneal fracture model was in the internal fixation, and the overall stress was uniformly distributed in each component. The maximum displacement distance of each type of calcaneal fracture was less than 0.13 mm, and the angles and lengths of nails were accurate. The tip of the Kirschner wires was located in the sustentaculum tail. There was no rupture of the sustentaculum tali and no protrusion of the Kirschner wires.Conclusions:The internal fixation is an effective method to treat the Sanders type Ⅱ calcaneal fractures by using sustentaculum tail sustentacular screws.

Hospital medical record is not only the summary of clinical practice, but also the legal basis for exploring the original data of disease law and dealing with medical troubles. The author discussed the statistics and management of medical records from the perspective of big medical data through on-the-spot investigation and literature review, explained the significance of using big data in statistical management of medical records, introduced the current situation and existing problems of information management of medical records in hospitals, and explored the development of statistical information from the perspective of big medical data. It is pointed out that informationized means are necessary for increasing the specialized institutions for information management of medical record and managing medical record rooms. And also, the cultivation of quality of staff in the hospital is a problem to be solved, and the prospects of development have been predicted.

Few studies have focused on the cost of acupuncture treatments although acupuncture has become popular in the United States (U.S.). The purpose of the current study was to examine the out-of-pocket costs incurred from acupuncture services based on an online website, OkCopay.com. We examined descriptive statistics (range, median and 20% intervals) for the cost of acupuncture "first-time visits" and "follow-up visits" in 41 metropolitan regions in the U.S. The acupuncture prices of 723 clinics throughout 39 metropolitan regions were included, except for Birmingham, Alabama and Detroit, Michigan as there was no online data available at the time of the study for these two regions. The cost range for a first-time acupuncture visit was $15-400; the highest median was $150 in Charleston, South Carolina, while the lowest was $45 in St. Louis, Missouri. The top 10 cities for the highest median were: Baltimore, Washington, D.C., New York, San Francisco, San Jose, Boston, Atlanta, Seattle, Portland and Indianapolis, with the median $120, while the median for all 723 clinics was $112. For the follow-up visits, the cost range was $15-300; the highest median was $108 in Charleston, South Carolina, and the lowest $40 in Miami, Florida. The 10 cities with highest median follow-up acupuncture visit costs were: New York, Baltimore, New Orleans, Washington, D.C., Philadelphia, San Francisco, San Jose, Seattle, Boston and Atlanta, with the median $85, while for all 723 clinics the median price was $80. The estimation of the average gross annual income of each acupuncturist from the regions studied was $95,760, while the total annual cost of patients seeking acupuncture services in the U.S. was about $3.5 billion in 2018.

Objective To observe whether Mini-Clinical Evaluation Exercise ( Mini-CEX ) is effective and feasible for improving the clinical competency of residents receiving standardized training. Methods 40 residents receiving standardized training in the Second Affiliated Hospital of Amy Medical university were randomly divided into control group and experimental group, with 20 trainees in each group. From October 2015 to April 2018, the experimental group was trained by the traditional teaching methods combined with Mini-CEX, and the other was trained by traditional teaching method. At least 2 Mini-CEX were conducted for each trainee of the experimental group in each department. The Mini-CEX, defense of case report and OSCE evaluation were carried out to assess the clinical competence of residents after the standardized training. Satisfaction surveys were conducted for teachers and students who had used Mini-CEX . SPSS 18 . 0 was used to analyze the data . Independent samples t test was used for inter-group comparison and paired sample t test was used for intra-group comparison. P<0.05 was statistically significant. Results Mini-CEX showed that the scores of the two groups in the clinical competence assessment were improved; the scores of the experimental group were higher than those of the control group , and the improvement in scores of experimental group was higher than that of the control group (the differences were statistically significant, P<0.05). The average score of defense of case report of the experimental group was (81.16 ±3.75),while that of the control group was (70.13 ±3.88) (t=-9.140, P=0.000). The average total score of OSCE evaluation of the experimental group was (96.300±4.681), while that of the control group was (91.775 ±3.227) (t=-3.559, P=0.001). Satisfaction rate of teachers and students were 95.0％ and 92.5％respectively. Conlusion Mini-CEX can improve the clinical competence of residents receiving standardized training.

Objective To explore the impact of biological big data on clinical study management.Methods To understand the changeof clinical study resulted from big data from the perspectiveof scientific study management.Results Bigdata Clinical Trial (BCT) based on massive clinical study data will turn out to be one of the most important parts of clinical study gradually.General rules target population will be obtained from clinical study model of the whole population.Reality fact will be more closely approached by the results of study on macro factors.Precise trend of dynamic changes can be demonstrated via data of full time linear tracking studies.Data collection will include those unordered data which are potentially inaccurate andregarded as useless in small data time.Conclusions Revolutionary changes will be presented in clinical study model in which data acquisition and info analysis are used as the primary approaches in big data era,and prediction of clinical study developmenttrend based on big data as well as innovation of management model for clinical study will make power ful support for better utilization of big data tools and accomplishment for big data realization and precision technology.

Objective To observe the curative effect and adverse reactions of intercostals nerve block combined with fentanyl transdermal system in treatment of post-thoracotomy pain syndrome (PTPS). Methods Intercostals nerve block combined with fentanyl transdermal system was used for treatment of 141 patients with PIPS. The degree of pain relief was evaluated by numerical rating scale (NRS),the quality of life of patients was evaluated by the quality of life score standard,and the adverse reactions were also observed. Results The overall remission rate was 97.85%,there were 51 cases (36.43%)with complete remission, 80 cases (57.14%)with significant remission,and 6 cases (42.85%) with moderate remission. The adverse reactions included nausea,vomiting, constipation,dizziness,skin pruritus and dysuria,no serious liver and kidney function damage and respiratory inhibition. The quality of life of all patients was improved. Conclusion Multimodal analgesia has better curative effect and less adverse reactions in treatment of PTPS,so it deserves clinical promotion.

In recent years,medical colleges have generally accepted the higher education assessment(evaluation).How to put the good practices and experience we obtained during the educational assessment into the daily teaching management and achieve normalization of teaching evaluation is of great significance to continuously improving the teaching quality.It is the primary condition to establish the evaluation index system for evaluating clinical teaching quality by regular teaching assessment. In this paper,the author constructed a clinical teaching quality evaluation index system through systematic research and exploration.

Objective To improve the informatization of field clinic for quicker and more effective cure of the wounded and the sick.Methods Making the use of the experiences from many years' application of No.1 Military Medical Project,the digital field clinic was set up based on HIS under the circumstances of wireless network.Results The digital field clinic provided convenience for doctors and nurses,optimized the curing procedure,standardized the material management,improved the curing efficiency,and enlarged the curing scope.Conclusion The digital field clinic facilitates the data transmission of medical nursing and assistant diagnosing photos.During the implementing process,the digital field clinic also provides new ways and ideas for the informatization of medical support of other types.