Objective:To explore the application of "flipped classroom + PBL + CBL" in clinical teaching of ultrasound medicine.Methods:Sixty undergraduate students enrolled in the internship of ultrasound medicine at the Department of Ultrasound in The University-Town Hospital of Chongqing Medical University were randomly divided into two groups: 30 in the control group (traditional teaching mode) and 30 in the experimental group (flipped classroom + PBL + CBL teaching mode). After internship, the theoretical knowledge, operational skills, and teaching satisfaction of the two groups of students were compared and analyzed. Moreover, the importance and satisfaction of "flipped classroom + PBL + CBL" teaching mode were analyzed using the importance-satisfaction quadrant chart.Results:The experimental group outperformed the control group in theoretical knowledge scores, medical history collection, equipment adjustment, operation skills, image quality, report writing, and teaching satisfaction ( t values: -22.35, -19.45, -18.65, -18.32, -19.16, and -18.67, respectively; All P<0.001). In the importance-satisfaction quadrant chart of "flipped classroom + PBL + CBL" teaching mode, students attached importance to and were satisfied with courseware making and course difficulty. However, improvements are needed in Mandarin proficiency, ultrasound image selection, and divergent thinking. Conclusions:In the clinical teaching of ultrasound medicine, the "flipped classroom + PBL + CBL" teaching mode is useful to improve the ability of students to identify and solve problems and lifelong self-study. This mode improves the quality of teaching ultrasound medicine and is worthy of promotion and exploration.

Objective To investigate the effects of super early enteral nutrition support on postoperative serum miR-124 levels,inflammatory markers,immune function,nutritional status,and short-term and long-term rehabilitation outcomes in patients with severe traumatic brain injury(STBI).Methods A total of123 STBI patients admitted to our hospital from January 2021 to December 2022 were selected.According to the start time of enteral nutrition,patients were divided into super early enteral nutrition group,late enteral nutrition group and parenteral nutrition group.We collect clinical data from each group and detected serum miR-124 and inflammatory factors,immune indicator,nutritional indicators levels before and after treatment,as well as postoperative complications and prognosis.Results Compared with the parenteral group and the late intestinal group,the levels of miR-124,inflammatory factors and the proportion of CD8+T cells in the super early intestinal group were significantly reduced,while the proportion of CD4+/CD8+cells was significantly increased,with statistical differences(all P＜0.05).Compared with the parenteral group,the levels of albumin,prealbumin,and transferrin in intestinal groups were significantly increased with statistical differences(both P＜0.05).Compared with the late intestinal group,the levels of albumin and prealbumin in the super early intestinal group were significantly increased,with statistical differences(both P＜0.05),while there was no significant difference in transferrin levels between two groups(P＞0.05).There was no significant difference in the incidence of various complications during hospitalization among all groups(all P＞0.05).The total incidence of complications in the super early intestinal group was significantly lower than that in the parenteral group and late intestinal group with statistical differences(both P＜0.05).During the follow-up period,there was no significant difference in prognosis,disability,and mortality among three groups(all P＞0.05).Compared with the parenteral group,the GOS scores of the intestinal groups were significantly reduced with statistical differences(P＜0.05).There was no statistically significant difference in GOS scores between two groups(P＞0.05).Conclusion Super early enteral nutrition support is effective in treating patients with STBI,which can effectively improve the patient's nutritional status,enhance immune function,suppress inflammatory reactions,help repair nerve injuries,and enhance rehabilitation effects.

Objective To investigate the effects of super early enteral nutrition support on postoperative serum miR-124 levels,inflammatory markers,immune function,nutritional status,and short-term and long-term rehabilitation outcomes in patients with severe traumatic brain injury(STBI).Methods A total of123 STBI patients admitted to our hospital from January 2021 to December 2022 were selected.According to the start time of enteral nutrition,patients were divided into super early enteral nutrition group,late enteral nutrition group and parenteral nutrition group.We collect clinical data from each group and detected serum miR-124 and inflammatory factors,immune indicator,nutritional indicators levels before and after treatment,as well as postoperative complications and prognosis.Results Compared with the parenteral group and the late intestinal group,the levels of miR-124,inflammatory factors and the proportion of CD8+T cells in the super early intestinal group were significantly reduced,while the proportion of CD4+/CD8+cells was significantly increased,with statistical differences(all P＜0.05).Compared with the parenteral group,the levels of albumin,prealbumin,and transferrin in intestinal groups were significantly increased with statistical differences(both P＜0.05).Compared with the late intestinal group,the levels of albumin and prealbumin in the super early intestinal group were significantly increased,with statistical differences(both P＜0.05),while there was no significant difference in transferrin levels between two groups(P＞0.05).There was no significant difference in the incidence of various complications during hospitalization among all groups(all P＞0.05).The total incidence of complications in the super early intestinal group was significantly lower than that in the parenteral group and late intestinal group with statistical differences(both P＜0.05).During the follow-up period,there was no significant difference in prognosis,disability,and mortality among three groups(all P＞0.05).Compared with the parenteral group,the GOS scores of the intestinal groups were significantly reduced with statistical differences(P＜0.05).There was no statistically significant difference in GOS scores between two groups(P＞0.05).Conclusion Super early enteral nutrition support is effective in treating patients with STBI,which can effectively improve the patient's nutritional status,enhance immune function,suppress inflammatory reactions,help repair nerve injuries,and enhance rehabilitation effects.

Objective To evaluate the application value of superb microvascular imaging(SMI)in pre-dicting ovarian cancer staging.Methods One hundred and thirty-six patients with ovarian cancer who under-went surgical treatment in our hospital from March 2019 to May 2024 were enrolled.Transvaginal,transab-dominal low-frequency,and transabdominal high-frequency two-dimensional grayscale imaging,Color Doppler Flow Imaging(CDFI),and SMI were performed before surgery for staging prediction.Taking surgical-patho-logical staging as the gold standard,the sensitivity,specificity,and accuracy of the combined application of transvaginal SMI,transabdominal low-frequency SMI,and transabdominal high-frequency SMI for predicting ovarian cancer staging were calculated.The receiver operating characteristic(ROC)curve was established,the area under the ROC curve(AUC)was calculated,and the diagnostic efficacy of SMI for predicting ovarian cancer staging was determined.Results The combined application of transvaginal SMI,transabdominal low-frequency SMI,and transabdominal high-frequency SMI for predicting ovarian cancer staging showed that sen-sitivity was 89.35%,92.36%,81.65%,and 83.21%for stages Ⅰ,Ⅱ,Ⅲ,Ⅳ,respectively;specificity was 86.93%,84.29%,83.39%,and 82.88%;accuracy was 92.50%,94.38%,80.15%,and 84.96%;and AUC was 0.799,0.760,0.695,and 0.727.Conclusion SMI has a high application value in predicting the stage of ovarian cancer,especially for stage Ⅰ and stage Ⅱ ovarian cancer.

Objective:To explore the application of "flipped classroom + PBL + CBL" in clinical teaching of ultrasound medicine.Methods:Sixty undergraduate students enrolled in the internship of ultrasound medicine at the Department of Ultrasound in The University-Town Hospital of Chongqing Medical University were randomly divided into two groups: 30 in the control group (traditional teaching mode) and 30 in the experimental group (flipped classroom + PBL + CBL teaching mode). After internship, the theoretical knowledge, operational skills, and teaching satisfaction of the two groups of students were compared and analyzed. Moreover, the importance and satisfaction of "flipped classroom + PBL + CBL" teaching mode were analyzed using the importance-satisfaction quadrant chart.Results:The experimental group outperformed the control group in theoretical knowledge scores, medical history collection, equipment adjustment, operation skills, image quality, report writing, and teaching satisfaction ( t values: -22.35, -19.45, -18.65, -18.32, -19.16, and -18.67, respectively; All P<0.001). In the importance-satisfaction quadrant chart of "flipped classroom + PBL + CBL" teaching mode, students attached importance to and were satisfied with courseware making and course difficulty. However, improvements are needed in Mandarin proficiency, ultrasound image selection, and divergent thinking. Conclusions:In the clinical teaching of ultrasound medicine, the "flipped classroom + PBL + CBL" teaching mode is useful to improve the ability of students to identify and solve problems and lifelong self-study. This mode improves the quality of teaching ultrasound medicine and is worthy of promotion and exploration.

Alzheimer's disease(AD)is a degenerative neurological disorder that can lead to cognitive decline,mental behavior abnormalities,and a reduced ability to undertake daily life activities.Tryptophan is an essential amino acid for the human body and is produced by three main metabolic pathways,namely kynurenine,5-hydroxytryptamine,and indole derivatives.Influencing the metabolites of tryptophan can ameliorate neuroinflammation in the brain and significantly improve cognitive ability,while the occurrence and development of AD are reduced.In this paper,we review the research literature on the use of tryptophan metabolism intervention in AD in the last 3 years from CNKI,PubMed,and other databases,and summarize its mechanism of action,with a view to providing a reference for further research on anti-AD drugs.

Alzheimer's disease(AD)is a degenerative neurological disorder that can lead to cognitive decline,mental behavior abnormalities,and a reduced ability to undertake daily life activities.Tryptophan is an essential amino acid for the human body and is produced by three main metabolic pathways,namely kynurenine,5-hydroxytryptamine,and indole derivatives.Influencing the metabolites of tryptophan can ameliorate neuroinflammation in the brain and significantly improve cognitive ability,while the occurrence and development of AD are reduced.In this paper,we review the research literature on the use of tryptophan metabolism intervention in AD in the last 3 years from CNKI,PubMed,and other databases,and summarize its mechanism of action,with a view to providing a reference for further research on anti-AD drugs.

The integrated curriculums of basic medicine in Shanxi Medical University are as follows: nine basic medical courses were integrated into 10 medical modules, with additional training including PBL and TBL case discussion, clinical clerkship, flipped classroom and other non-integrated subjects etc. In order to assess the interest of students for integrated curriculum, their intrinsic motivation, as well as their comprehension and application of medical knowledge, we gave anonymous questionnaire to 149 students, 16 teachers in basic medicine, and 10 teachers in clinical medicine. Results showed that more than 90% students were willing to take the integrated curriculum and participate in PBL and TBL case discussion, and students who were unwilling to take the curriculum were less than 10%, they thought that the knowledge of new curriculum system was incoherent. The proportion of students from higher grade who were unwilling to participate in the flipped classroom was increased from 6.7% to 95.0%. Most of the teachers both in basic and clinic medicine believed that new curriculum system was helpful for students to comprehend basic medical knowledge and strengthen their discriminating ability, but did not function in improving students' practical ability. In the further reform on teaching, details like the coherence of knowledge and the content selected when self-studying should be improved.

Objective To synthesize and identify artificial antigens of lung elastin degradation peptide and for the purpose of preparation of COPD test.Methods The artificial antigens were synthesized by Sulfo-SMCC and KLH.The complete antigens were identified by ultraviolet spectrum and SDS-PAGE.Immunize Balb/c mice was used to prepare antibody.The antiserum activity was evaluated by indirect competitive ELISA.Results The artificial antigens were identified by ultraviolet spectrum and SDS-PAGE. The protein concentration was 1.181 mg/mL.The titer of antiserum was 1∶64 000,and IC50 was 13.7 ng/mL.The antiserum had no cross-reaction with nonsense peptide.Conclusion The artificial antigens were acquired successfully,which had good immunoge-nicity.The results have laid basis for COPD test.

Objective To establish the assay method of hydroxyproline(HYP) level in rat lung tissue for evaluating the lung fi-brosis degree .Methods The impact of different acid hydrolyzable time ,oxidative time ,developing time on the assay results of the HYP level in rat lung tissue was studied .On this basis ,the assay method for determining the HYP level was established and prelim-inarily applied in the detection of the HYP level in rat lung tissue .Results The optimal condition for the HYP level detection in rat lung tissue was as follows :7 .50 mol HCL was hydrolyzed for 16 h at 110 ℃ ,oxidized for 10 min at room temperature and devel-oped for 25min at 60℃ .The sensitivity of this method was 0 .067μg/mL .The recovery rate and the average CV of this method were 88 .85% -110 .88% and 4 .70% -6 .60% ,respectively .In the study of bleomycin induced rat lung fibrosis ,the HYP level of the model group was obviously higher than that of the control group .Conclusion This method has high sensitivity ,high recovery rate and good reproducibility ,and may be used as a reliable quantitative method to judge the lung fibrosis level in clinic .