ObjectiveTo evaluate the safety, efficacy and economy of equine tetanus immunoglobulin F(ab')_2, so as to provide reference for its clinical application.MethodsPatients who were admitted to six research centers for trauma from November 23, 2021 to October 31, 2022 and required a tetanus immunoglobulin injection were selected as the research subjects to observe the positive rate of skin sensitization test of equine tetanus immunoglobulin F(ab')_2 and the incidence of adverse events(AEs) after injection. In addition, one of the study centers was selected to evaluate the incidence of tetanus in patients receiving equine tetanus immune globulin F(ab')_2 injection in this center. Meanwhile, a pharmacoeconomic model per 10 000 patients was constructed to compare the difference in drug costs of switching to human tetanus immunoglobulin(TIG) due to a positive skin sensitization test when patients preferred tetanus antitoxin(TAT) or equine tetanus immunoglobulin F(ab')_2.ResultsA total of 422 patients were enrolled in the study, of whom 419 underwent an equine tetanus immunoglobulin F(ab')_2 skin sensitization test and 416 received a test result, with a positive skin sensitization test rate of 5. 05%(21/416). Among the 395 patients who had a negative skin sensitization test and completed equine tetanus immunoglobulin F(ab')_2 injection, five(1. 27%) patients developed AEs related to equine tetanus immunoglobulin F(ab')_2, mainly including rash and pruritus, and two(0. 51%) patients had grade ≥ 3 AEs related to equine tetanus immunoglobulin F(ab')_2, including one case of immediate anaphylaxis and one case of pruritus. None of the patients developed anaphylactic shock or death related to equine tetanus immunoglobulin F(ab')_2. None of the patients in the selected research center developed tetanus after administration of equine tetanus immunoglobulin F(ab')_2. In addition, the pharmacoeconomic evaluation model showed that equine tetanus immunoglobulin F(ab')_2 had a higher drug economic value compared to TAT and TIG.Conclusion Equine tetanus immunoglobulin F(ab')_2 has shown good efficacy and safety in preventing tetanus in the real world with high pharmacoeconomic value.

The success of"New Medical Sciences"in higher education requires effective tools in evalua-ting students'performance in courses.Previously,we reported a teamwork(T),critique(C)and ap-preciation(A)(TCA)ideological and political model,a teaching model widely applied in Basic Medical courses.TCA is an abbreviation derived from Tricarboxylic Acid Cycle in Biochemistry as an analogy for nurturing the abilities of thinking and teamwork(T),critique(C)and appreciation(A),which hope-fully could provide students with moral norms for cognition,science and life.This paper further explores the tools to assess the educational outcomes of the TCA model,by which teachers can collect feedback and reflect on teaching quality and effectiveness.Addressing the challenges of individual differences in large classes,fragmented learning feedback,and the difficulty of measuring meta-cognition in educational evaluation,this study employs strategies of value-added assessment,matrix assessment and norm-transfer-able assessment to evaluate the TCA abilities from the aspects of thinking quality,thinking creativity,co-operation ability,iterative thinking,dialectical thinking and job responsibility.By modifying/using 18 e-valuation tools in Education and Psychology,we have established a rubric system composed of 30 primary indicators(with 11 newly designed,10 partly modified and 9 directly adopted),along with 49 secondary indicators and 98 tertiary indicators to enhance the feasibility of the evaluation process.This rubric sys-tem was applied to Biochemistry teaching among the five-year-program undergraduates at Air Force Medi-cal University.Specifically,thinking and teamwork are evaluated by creative works from"the magic bio-chemical-circle",while critiques are assessed in large classes under the guidance of basic and clinical teachers,coupled with appreciation measured by job responsibility in a task-driven virtual reality(VR)project.The results indicate that Biochemistry teaching not only accumulates knowledge in students,but also achieves the goals in nurturing values and cognition.The inclusion of creative performance evalua-tion,cooperative learning and clinical case studies,can enhance students'interpersonal skills,coopera-tion,quality of thinking,creative thinking,iterative thinking and dialectical thinking to varying degrees.TCA-based Biochemistry teaching has a long-lasting impact on character education,and is capable of in-ducing positive long-term changes in students'cognition and lifestyle.Taken together,with the help of this rubric system,teachers can promptly acknowledge the effectiveness of their teaching,thereby facilita-ting their teaching strategies.

Objective To develop a quality evaluation indicator system for"Internet+indwelling tubes home nursing services"for a standardised evaluation process.Methods Based on the structure-process-outcome(SPO)model,a quality assessment indicator system for"Internet+indwelling tubes home nursing services"was developed.This system was refined via a comprehensive literature review,semi-structured interviews,clinical expertise,and a two-round Delphi consultation involving 20 experts from clinical nursing,nursing management,human resource management,public health and information technology.Results The effective recovery rate from both rounds of Delphi consultation was 100.00%.The authority coefficients for two-rounds of expert consultation were both at 0.785.Kendall's W coefficients for secondary indicators were 0.201 and 0.280,and 0.214 and 0.226 for tertiary indicators,all were statistically significant(P<0.05).After 2 rounds of expert consultation,the system demonstrated strong reliability:mean importance weights for all indicators exceeded 4.0,coefficients of variation were below 0.2,and full score rates included or surpassed 20%.The finalised quality evaluation indicator system for"Internet+indwelling tubes home nursing services"included 3 primary indicators(allocation of pipeline nursing service resources,implementation of pipeline nursing service resources,and feedback on the effectiveness of pipeline nursing service resources),12 secondary indicators,and 70 tertiary indicators.Conclusion The quality evaluation indicator system for"Internet+indwelling tubes home nursing services"developed in this study is scientifically reliable,practical and applicable for evaluation of the quality of"Internet+"pipeline home nursing services.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Efficient drug response prediction is crucial for reducing drug development costs and time, but current computational models struggle with limited experimental data and out-of-distribution issues between in vitro and in vivo settings. To address this, we introduced drug response prediction meta-learner (metaDRP), a novel few-shot learning model designed to enhance predictive accuracy with limited sample sizes across diverse drug-tissue tasks. metaDRP achieves performance comparable to state-of-the-art models in both genomics of drug sensitivity in cancer (GDSC) drug screening and in vivo datasets, while effectively mitigating out-of-distribution problems, making it reliable for translating findings from controlled environments to clinical applications. Additionally, metaDRP's inherent interpretability offers reliable insights into drug mechanisms of action, such as elucidating the pathways and molecular targets of drugs like epothilone B and pemetrexed. This work provides a promising approach to overcoming data scarcity and out-of-distribution challenges in drug response prediction, while promoting the integration of few-shot learning in this field.

Methods: This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed. Results: Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05). Conclusions UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.

Methods: This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed. Results: Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05). Conclusions UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.

The construction of a new cultural system for high-quality development in public hospitals serves as a crucial pillar for achieving their high-quality advancement.During this developmental processe stablishing a cultural framework that aligns with the new development model holds particular significance.Through content analysis methodology,it identifies 18 core elements of the new cultural system for high-quality development in public hospitals.Furthermore it synthesizes seven implementation pathways across three dimensions-organizational patientand employee perspectives:digital leadership organizational reform capability talent innovation capability resource integration capability normative constraint force value co-creation capability and employee support capability.These findings provide both theoretical and practical references for cultivating new cultural constructs that facilitate high-quality development in public hospitals.

The success of"New Medical Sciences"in higher education requires effective tools in evalua-ting students'performance in courses.Previously,we reported a teamwork(T),critique(C)and ap-preciation(A)(TCA)ideological and political model,a teaching model widely applied in Basic Medical courses.TCA is an abbreviation derived from Tricarboxylic Acid Cycle in Biochemistry as an analogy for nurturing the abilities of thinking and teamwork(T),critique(C)and appreciation(A),which hope-fully could provide students with moral norms for cognition,science and life.This paper further explores the tools to assess the educational outcomes of the TCA model,by which teachers can collect feedback and reflect on teaching quality and effectiveness.Addressing the challenges of individual differences in large classes,fragmented learning feedback,and the difficulty of measuring meta-cognition in educational evaluation,this study employs strategies of value-added assessment,matrix assessment and norm-transfer-able assessment to evaluate the TCA abilities from the aspects of thinking quality,thinking creativity,co-operation ability,iterative thinking,dialectical thinking and job responsibility.By modifying/using 18 e-valuation tools in Education and Psychology,we have established a rubric system composed of 30 primary indicators(with 11 newly designed,10 partly modified and 9 directly adopted),along with 49 secondary indicators and 98 tertiary indicators to enhance the feasibility of the evaluation process.This rubric sys-tem was applied to Biochemistry teaching among the five-year-program undergraduates at Air Force Medi-cal University.Specifically,thinking and teamwork are evaluated by creative works from"the magic bio-chemical-circle",while critiques are assessed in large classes under the guidance of basic and clinical teachers,coupled with appreciation measured by job responsibility in a task-driven virtual reality(VR)project.The results indicate that Biochemistry teaching not only accumulates knowledge in students,but also achieves the goals in nurturing values and cognition.The inclusion of creative performance evalua-tion,cooperative learning and clinical case studies,can enhance students'interpersonal skills,coopera-tion,quality of thinking,creative thinking,iterative thinking and dialectical thinking to varying degrees.TCA-based Biochemistry teaching has a long-lasting impact on character education,and is capable of in-ducing positive long-term changes in students'cognition and lifestyle.Taken together,with the help of this rubric system,teachers can promptly acknowledge the effectiveness of their teaching,thereby facilita-ting their teaching strategies.

Objective To investigate the role of CISD1 in gefitinib-resistant non-small cell lung cancer(NSCLC),so as to provide a potential therapeutic target for the treatment of gefitinib-resistant NSCLC.Methods Bioinformatics online platforms TIMER2.0 and HPA were used to analyze the expression level of CISD1 in lung cancer.TIMER2.0 and GEPIA2.0 were used to analyze the correlation between the expression levels of CISD1 and SLC7A11 in lung cancer.The correlation between CISD1 and overall survival rate of lung cancer patients was analyzed using KMPLOT.Human lung carcinoma cell line PC9 and gefitinib-resistant cell line PC9/GR were treated with gefitinib,and cell viability was detected using the CCK8 method.shCISD1 lentivirus infection was used to knockdown CISD1 in PC9/GR cells.Western blotting was employed to detect the protein expression levels of CISD1 and SLC7A11.PC9/GR cells were divided into shNC+DMSO group,shNC+gefitinib group,shCISD1 group,shCISD1+ferrostatin-1 group,and shCISD1+gefitinib group.Plate clone formation assay was used to detect cell proliferation capacity.FerroOrange fluorescent probe and C11-BODIPY fluorescent probe were used to detect intracellular free Fe2+content and intracellular lipid peroxide level,respectively.Results CISD1 was significantly overexpressed in lung carcinoma(P＜0.001).The expression level of CISD1 was negatively correlated with the overall survival rate of lung cancer patients and negatively correlated with the expression level of SLC7A11.Compared with the DMSO control group,gefitinib treatment significantly reduced clone formation and CISD1 protein expression levels in both PC9 and PC9/GR cells(P＜0.05),but the reduction was less pronounced in PC9/GR cells.shCISD1 infection significantly inhibited the protein expression levels of CISD1 and SLC7A11 in PC9/GR cells(P＜0.05)and enhanced the sensitivity of PC9/GR cells to gefitinib.Compared with the shNC+DMSO group,both the shNC+gefitinib group and the shCISD1 group showed significantly reduced clone formation ability(P＜0.05),but increased Fe2+and lipid peroxidation levels(P＜0.05).Compared with the shCISD1 group,the shCISD1+ferrostatin-1 group showed significantly increased clone formation ability(P＜0.05),but decreased Fe2+and lipid peroxidation levels(P＜0.05).Compared with the shNC+gefitinib group,the shCISD1+gefitinib group showed significantly reduced clone formation ability(P＜0.05),but increased Fe2+and lipid peroxidation levels(P＜0.05).Conclusion Knockdown of CISD1 promotes the sensitivity of NSCLC to gefitinib by inducing ferroptosis,which provides a new potential therapeutic target for the treatment of gefitinib-resistant NSCLC.