1.Association between sunshine duration and hospitalization risk for mental and behavioral disorders in Zigong City, Sichuan Province
Xianyan JIANG ; Fengyuan TIAN ; Yang LI ; Shijuan RUAN ; Yue WEN ; Chunli SHI
Journal of Environmental and Occupational Medicine 2026;43(4):485-492
Background Sunshine duration is closely associated with population mental health and emotional states, although its relationship with mental and behavioral disorders (MBD) remains insufficiently studied. Objective To analyze the effect of sunshine duration on hospital admissions for MBD in Zigong City, Sichuan Province. Methods Hospital admission records for MBD from 10 medical institutions, meteorological data, and ambient air pollutant concentrations were collected in Zigong City from January 1, 2019 to December 31, 2024. A distributed lag non-linear model (DLNM) was employed to calculate single-day and cumulative lag effects of different sunshine duration exposures—0 h (P0, P5, P25), 6 h (P75), and 10.4 h (P95)—on hospitalization risks for MBD, stratified by diagnostic category, sex, and age groups. Results This study analyzed
2.Mechanism of MEK/Ras/Raf/ERK Signaling Pathway Modulated by Mimenghua Prescription on Inflammatory Response in Dry Eye Animal Model
Shi TAN ; Pei LIU ; Yuan ZHONG ; Sainan TIAN ; Pengfei JIANG ; Genyan QIN ; Qinghua PENG ; Jun PENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):211-221
ObjectiveThis paper aims to investigate the effects and mechanism of Mimenghua prescription in modulating the mitogen-activated protein kinase kinase (MEK)/rat sarcoma viral oncogene homolog (Ras)/rapidly accelerated fibrosarcoma kinase (Raf)/extracellular signal-regulated kinase (ERK) signaling pathway to inhibit inflammatory responses in a dry eye animal model. MethodsA total of 60 C57BL/6J mice (eight weeks old, half male and half female) were used in the experiment. Ten mice were randomly selected as the blank control group, while the remaining 50 were exposed to a controlled dry system and received instillation of 0.2% benzalkonium chloride (BAC) into the eyes for four weeks to establish a dry eye mouse model. After successful modeling, the mice were randomly divided into five groups: Model group, sodium hyaluronate group, and Mimenghua prescription groups with low dose (4.83 g·kg-1), medium dose (9.67 g·kg-1), and high dose (19.34 g·kg-1). The mice in the model group received an equal volume of normal saline via gavage for four weeks. The mice in the sodium hyaluronate group received instillation of sodium hyaluronate eye drops twice daily for 14 consecutive days. The tear secretion volume, tear film break-up time (TBUT), and corneal fluorescein staining were evaluated once every two weeks. After four weeks of administration, mice were euthanized, and their lacrimal gland tissues and corneas were harvested. Hematoxylin-eosin (HE) staining was used to assess histopathological morphology. Western blot was performed to detect the protein expression levels of MEK, Ras, Raf, and ERK. Enzyme-linked immunosorbent assay (ELISA) was used to measure the contents and expressions of MEK, Ras, Raf, ERK, and interleukin (IL)-1β in lacrimal gland and corneal tissues of the mice in each group. Quantitative real-time polymerase chain reaction (Real-time PCR) was employed to determine mRNA expression levels of MEK, Ras, Raf, and ERK. ResultsThe Mimenghua prescription groups and the sodium hyaluronate group exhibited significantly increased tear secretion volume (P<0.05) and prolonged TBUT (P<0.05) after treatment. Ocular surface damage of mice was visibly recovered. Western blot results indicated that protein expression levels of MEK, Ras, Raf, and ERK in the lacrimal gland and corneal tissues were significantly downregulated in the sodium hyaluronate group and Mimenghua prescription group with high dose (P<0.05). ELISA results showed that IL-1β levels were highest in the model group but significantly reduced in the sodium hyaluronate group and Mimenghua prescription groups (P<0.05). Both ELISA and Real-time PCR results demonstrated that the expression levels of MEK, Ras, Raf, and ERK in the lacrimal glands and corneal tissues were significantly elevated in the model group (P<0.05), but markedly downregulated in the sodium hyaluronate group and Mimenghua prescription groups (P<0.05), suggesting that Mimenghua prescription can decrease the expressions of MEK, Ras, Raf, and ERK in the lacrimal glands and corneal tissues. ConclusionMimenghua prescription can reduce inflammatory responses, increase tear secretion, prolong TBUT, and promote corneal recovery by inhibiting the MEK, Ras, Raf, and ERK signaling pathways in lacrimal gland and corneal tissues.
3.Characteristics and influencing factors of postoperative weight change in patients with esophageal cancer: A prospective longitudinal study
Chengxiang LI ; Yang YANG ; Tian ZHANG ; Ruonan XIE ; Xin JIANG ; Yingjie LENG ; Zhuomiao NIE ; Guorong WANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(02):267-274
Objective To longitudinally investigate the characteristics of postoperative weight changes in patients with esophageal cancer and analyze its influencing factors, which can provide certain guidance for nutritional intervention in patients with esophageal cancer. Methods Patients with esophageal cancer who underwent surgical treatment at the Sichuan Cancer Hospital from December 2020 to February 2022 were prospectively included. The general information questionnaire and body composition analyzer were used to longitudinally investigate the patients’ weight and body composition before surgery (T0), 1 month after surgery (T1), 3 months after surgery (T2) and 6 months after surgery (T3), and the change characteristics were analyzed. The generalized estimating equation was used to analyze the influencing factors for postoperative weight changes in patients with esophageal cancer. Results A total of 130 patients were enrolled, including 110 males and 20 females, aged 42-79 (63.33±8.16) years. The weight and body composition of patients with esophageal cancer showed a continuous slow downward trend within 6 months after surgery. The weight loss rate of patients at 1, 3, and 6 months after surgery was 5.10%, 7.76%, and 9.86%, respectively. The analysis results of the influencing factors for postoperative weight showed that patients with the following characteristics had more weight loss: female (β=−7.703, P=0.001), ≥60 years (β=−3.657, P=0.010), smoking (β=4.622, P=0.010), low tumor differentiation degree (β=4.314, P=0.039), and high frequency of eating (β=−3.400, P=0.008). Conclusion Weight loss is an important health problem for patients with esophageal cancer after surgery, and patients have a continuous downward trend in weight within 6 months after surgery. Medical staff should pay special attention to the patients who are female, ≥60 years, having smoking history and low tumor differentiation degree.
4.Changing trend of benign hepatobiliary and pancreatic diseases among people aged 15—39 years in China in 1990—2021
Wenkai JIANG ; Huiqi SUN ; Junhao FENG ; Ru HE ; Wenrui PENG ; Ming TIAN
Journal of Clinical Hepatology 2026;42(1):160-166
ObjectiveTo investigate the changing trends of the incidence rate, prevalence rate, mortality rate, and disability-adjusted life years (DALYs) of benign hepatobiliary and pancreatic diseases among people aged 15 — 39 years in China in 1990 — 2021. MethodsThe data of 2021 Global Burden of Disease Study were downloaded to obtain the epidemiological data of liver fibrosis/chronic liver disease, benign gallbladder/biliary tract diseases, and pancreatitis among people aged 15 — 39 years in China, and estimated annual percentage change (EAPC) was calculated to assess the changing trends of incidence, prevalence, mortality, and DALY rates. The Bayesian age-period-cohort model was used to predict the incidence and mortality rates from 2022 to 2030. ResultsIn 2021, there were 10 448 778 new cases of benign hepatobiliary and pancreatic diseases among the individuals aged 15 — 39 years in China, which was increased by 3.8% compared with the data in 1990, while the numbers of prevalent cases, deaths, and DALYs were reduced by 20.4%, 59.6%, and 50.2%, respectively. In 2021, the age-standardized incidence rates of liver fibrosis/chronic liver disease, benign gallbladder/biliary tract diseases, and pancreatitis were 1 104.40/100 000, 1 045.05/100 000, and 16.64/100 000, respectively; the age-standardized prevalence rates were 20 592.37/100 000, 2 364.85/100 000, and 9.43/100 000, respectively; the age-standardized mortality rates were 1.61/100 000, 0.04/100 000, and 0.18/100 000, respectively. From 1990 to 2021, there was a tendency of increase in the age-standardized incidence rate of liver fibrosis/chronic liver disease (EAPC=0.43, 95% confidence interval [CI]: 0.23 — 0.63), and there was also a tendency of increase in the age-standardized incidence and prevalence rates of benign gallbladder/biliary tract diseases (incidence rate: EAPC=1.07, 95%CI: 0.91 — 1.24; prevalence rate: EAPC=0.75, 95%CI: 0.59 — 0.89), while there was a tendency of reduction in the age-standardized mortality rate of all three disease categories. Predictions for 2022 — 2030 indicated a potential reduction in the incidence rate of benign gallbladder/biliary tract diseases and an increase in the incidence rate of pancreatitis. ConclusionThere has been an overall upward trend in the incidence rate of liver fibrosis/chronic liver disease and gallbladder/biliary tract diseases over the past three decades, and it is needed to pay attention to the disease burden of benign hepatobiliary diseases among the people aged 15 — 39 years in China.
5.Evaluation of CARIFS Score and Negative Antigen Conversion Rate of Qingxuan Daozhi Formula in Treatment of Influenza in Children (Heat Accumulation in Lung and Stomach Syndrome):A Multi-center Randomized Controlled Clinical Study
Jing WANG ; Liqun WU ; Tiegang LIU ; Yongning CAO ; Jing QIU ; Jing LI ; Huaqing TAN ; Ying ZHANG ; Xulei GOU ; Jia WANG ; Jing LI ; Haipeng CHEN ; Xueying QIN ; Yuanshuo TIAN ; Yang WANG ; Chen BAI ; Zhendong WANG ; Qianqian LI ; He YU ; Xueyan MA ; Fei DONG ; Lin JIANG ; Yingqi XU ; Jianping LIU ; Xiaohong GU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):188-196
ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children (heat accumulation in the lung and stomach syndrome). MethodsThrough a multi-center randomized controlled methodology design,confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals,such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days,and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale (CARIFS) and the incidence of complications,severe cases, and critical cases. Follow-up observation was conducted on the day of enrollment,48 hours after medication,72 hours after medication, and (6+1) d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group (90 cases) or the control group (90 cases). All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was (5.29±1.25) d,and that in the control group was (5.40±1.68) d,without a statistically significant difference. After five days of intervention,52 cases in the experimental group and 51 cases in the control group converted to negative,without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention,there were statistically significant differences between the experimental group and the control group in three dimensions, including headache,muscle soreness, and the need for extra care (P<0.05). On the (6+1) days after the intervention,the differences in both the experimental group and the control group were statistically significant in 10 dimensions, including sore throat,bad sleep,uncomfortable feeling,poor spirit and fatigue,crying more than usual,the need for extra care,symptom,function,influence on parents,and total score (P<0.05). The comparison results within the group in the dimensional scores of symptom, function, and influence on parents,as well as the CARIFS total score showed that with the delay of follow-up time,scores of both groups decreased significantly,with a statistically significant difference (P<0.01). Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention,the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up,the mean score of the experimental group was lower than that of the control group,with no statistically significant difference. In terms of the incidence of complications,severe cases, and critical cases, there were no complications,severe cases, and critical cases in the two groups,without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children (heat accumulation in the lung and stomach syndrome) are not inferior to Oseltamivir Phosphate granules, and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children (heat accumulation in the lung and stomach syndrome).
6.Banxia Baizhu Tianmatang Regulates NLRP3 Inflammasomes to Ameliorate Cognitive Impairment in Epilepsy
Xingdan ZHU ; Yinhua KAI ; Rong TIAN ; Xin YANG ; Jiayi HE ; Xiangxin GUO ; Yadong MU ; Cui JIANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(14):308-316
ObjectiveTo explore the mechanism through which Banxia Baizhu Tianmatang ameliorates cognitive impairment in epileptic rats induced by lithium chloride-pilocarpine by regulating the neuroinflammatory reaction mediated by NOD-like receptor protein 3 (NLRP3) inflammasomes. MethodsSixty male SD rats were randomly allocated into blank, model, carbamazepine (0.125 g·kg-1·d-1), Banxia Baizhu Tianmatang (1.04 g·kg-1·d-1), and carbamazepine (0.125 g·kg-1·d-1) + Banxia Baizhu Tianmatang (1.04 g·kg-1·d-1) groups (n=12). After the modeling of epilepsy, rats were administrated with corresponding agents by gavage for 12 weeks. At the 6th and 12th week of the intervention, the rats’ hyper-excited behavior was evaluated by the stylus experiment, and at the 12th week of intervention, the cognitive function was evaluated by Barnes maze. At the same time, the seizure frequency and severity grade (Racine score) were recorded. The serum and hippocampus tissue samples were collected after anesthesia for the following tests. Nissl staining was used to evaluate the degree of neuronal damage in the hippocampal CA1 area. The content of malondialdehyde (MDA) in the hippocampus was determined by the thiobarbituric acid (TBA) method. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-18 (IL-18) were quantified by enzyme-linked immunosorbent assay (ELISA). Immunohistochemical method was adopted to detect the expression of apoptosis-associated speck-like protein containing a card (ASC) in the hippocampus. Western blot was employed to quantitatively analyze the protein levels of NLRP3, cysteinyl aspartate-specific proteinase-1 (Caspase-1), and brain-derived neurotrophic factor (BDNF) in the hippocampus. ResultsThe model group showed increased stylus scores at the 6th and 12th week after modeling, a decreased Barnes maze strategy score at the 12th week, a prolonged incubation period (P<0.05), elevated serum levels of inflammatory factors (P<0.05), decreased neurons with scattered arrangement and large gaps in the hippocampus, increased content of MDA in the hippocampus (P<0.05), an increased positive expression of ASC, and up-regulated protein levels of Caspase-1, NLRP3, and BDNF (P<0.05). Compared with the model group, the intervention with Banxia Baizhu Tianmatang for 12 weeks was accompanied by a decreased stylus score, epileptic seizures with a decreased score, a decreased number, and shortened duration, an increased Barnes maze strategy score, shortened escape latency (P<0.01), declined serum levels of inflammatory factors (P<0.05), regular morphology of hippocampal neurons, reduced MDA content in the hippocampus (P<0.05), a decreased positive expression of ASC, and down-regulated protein levels of Caspase-1, NLRP3, and BDNF (P<0.05, P<0.01). In addition, compared with the carbamazepine group, Banxia Baizhu Tianmatang + carbamazepine showed improved performance in controlling the seizure, improved the cognitive behavior score and morphology of hippocampal neurons, alleviated the oxidative stress products, lowered the levels of inflammatory factors, reduced the positive expression of ASC in the hippocampus, and down-regulated the expression of Caspase-1, NLRP3 and BDNF, with no significant differences. ConclusionBanxia Baizhu Tianmatang may reduce neuroinflammation, control epileptic seizures, and ameliorate cognitive impairment by inhibiting the expression of NLRP3 inflammasomes.
7.Effect of Wenyang Huazhuo Formula (温阳化浊方) on Reproductive Aging,Ovarian Mechanical Micro-environment,and Offspring Reproductive Potential in Aged Model Mice
Jiaqi XU ; Xiaoli ZHAO ; Nan JIANG ; Kaixi LI ; Yafei DING ; Zimu WEN ; Yingying JIA ; Mengjun JIANG ; Tian XIA
Journal of Traditional Chinese Medicine 2025;66(6):612-620
ObjectiveTo explore the possible mechanisms of Wenyang Huazhuo Formula (温阳化浊方, WHF) in improving reproductive aging from the perspective of the ovarian mechanical microenvironment. MethodsThe experiment included five groups, 3-month group (20 female mice at 3 months of age), 6-month group (20 female mice at 6 months of age), 6-month + WHF group (20 female mice at 5 months of age treated with WHF), 9-month group (20 female mice at 9 months of age), and 9-month + WHF group (20 female mice at 8 months of age treated with WHF). The 6-month + WHF group and 9-month + WHF group were orally administered WHF 41.2 g/(kg·d) once daily for 4 consecutive weeks. The other three groups received no intervention. Reproductive hormone levels were measured by ELISA. HE staining was used to count the numbers of various stages of follicles. Ovarian hyaluronic acid (HA) content and collagen fiber content were measured to evaluate the ovarian mechanical microenvironment. Superovulation was performed to observe the number of eggs obtained, as well as the number of offspring and birth weight to assess fertility. The in vitro fertilization and blastocyst culture of oocytes from female offspring in each group were observed to evaluate the effect of WHF on offspring reproductive potential. ResultsCompared with the 3-month group, the 6-month group and 9-month group showed significantly decreased serum levels of gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), and luteinizing hormone (LH), decreased ovarian collagen content, and reduced numbers of primordial and secondary follicles. In contrast, the numbers of primary follicles, antral follicles, and atretic follicles increased. The levels of anti-Müllerian hormone (AMH), ovarian HA content, and the fertilization rate, cleavage rate, and blastocyst formation rate of oocytes from offspring were significantly lower (P<0.05). Compared with the 6-month group, the 6-month + WHF group showed significantly reduced serum levels of GnRH, FSH, and LH, with a significant decrease in primary follicles, antral follicles, and atretic follicles as well as increase of AMH levels, ovarian HA content, number of primordial and secondary follicle, egg count, and offspring birth weight (P<0.05). Compared with the 9-month group, the 9-month + WHF group exhibited reduced GnRH, FSH, and collagen fiber content, as well as reduced number of primary follicles, antral follicles, and atretic follicles. However, AMH levels, ovarian HA content, number of primordial and secondary follicle, egg count, offspring numbers, birth weight, fertilization rate, cleavage rate, and blastocyst formation rate of oocytes from offspring all significantly increased (P<0.05). ConclusionWHF can significantly improve the ovarian reserve, fertility, and reproductive potential in offspring during reproductive mid-life and late-life stages. Its effect may be related to the remodeling of the mechanical microenvironment of aging ovaries. Moreover, the effect on the mechanical microenvironment remodeling of late-stage ovaries and the improvement of the offspring reproductive potential is more significant.
8.Analysis of echinococcosis in the population and canine Echinococcus infection in Yushu City, Qinghai Province in 2023
Xiaojin MO ; Chunhua GONG ; Wentao GUO ; Gengcheng HE ; Bin JIANG ; Qiufeng LAN ; Xiao MA ; Yufang LIU ; Guirong ZHENG ; Tian TIAN ; Shijie YANG ; Shusheng WU ; Ting ZHANG ; Xiaonong ZHOU
Chinese Journal of Endemiology 2025;44(8):668-673
Objective:To study echinococcosis in the population and canine Echinococcus infection in Yushu City, Qinghai Province, and to explore the current epidemic situation and main transmission species of Echinococcus. Methods:In June 2023, a multi-stage sampling method was used to select 2 villages each in Shanglaxiu Township and Longbao Town, Yushu City, Qinghai Province. Each village included at least 100 permanent residents who had lived locally for at least 1 year and were 2 years old or older as the survey subjects. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum antibodies against Echinococcus larvae in the population, and B-mode ultrasound was used for abdominal organ scanning. Meanwhile, on the main roads of Shanglaxiu Township and Longbao Town, canine feces were collected in designated areas at intervals. ELISA was used to detect the antigen of canine fecal Echinococcus, and PCR was used to detect the types of parasites ( Echinococcus multilocularis, Echinococcus granulosus and Echinococcus shiquicus). Results:A total of 511 residents were investigated in Yushu City, and the positive rate of serum Echinococcus larvae antibodies in the population was 26.22% (134/511), and the detection rate of echinococcosis B-mode ultrasound was 1.37% (7/511). Among them, the detection rates of B-mode ultrasound for cystic echinococcosis (CE) and alveolar echinococcosis (AE) were 1.17% (6/511) and 0.20% (1/511), respectively. The positive rate of Echinococcus antigen in 543 canine feces detected by ELISA was 12.89% (70/543). PCR was used to test 497 canine feces, and the detection rate of Echinococcus was 3.02% (15/497). Among them, the detection rate of Echinococcus multilocularis was higher than that of Echinococcus granulosus [2.82% (14/497) vs 0.20% (1/497)], and the difference was statistically significant (χ 2 = 11.44, P < 0.001). No Echinococcus shiquicus was detected. Conclusions:The positive rates of Echinococcus larvae antibodies in the population and canine Echinococcus antigen in Yushu City, Qinghai Province are both relatively high. There is a mixed epidemic of CE and AE, with Echinococcus multilocularis being the main species.
9.Analysis of teachers' willingness and influencing factors regarding the adoption of flipped classroom teaching mode in undergraduate pediatrics education
Wenrui XU ; Jianguang QI ; Ying LIAO ; Penghui WU ; Tian SANG ; Jie LIU ; Juan ZHANG ; Yuwu JIANG
Chinese Journal of Medical Education Research 2025;24(4):460-465
Objective:To investigate teachers' evaluation and willingness and the influencing factors regarding the adoption of the flipped classroom teaching mode in undergraduate pediatrics education.Methods:From December 2022 to December 2024, a questionnaire survey was conducted among the teachers who were responsible for teaching Child Health and Disease(Pediatrics) to the eight-year clinical medicine students at Peking University Health Science Center. Their views, evaluation, and willingness of implementing the flipped classroom teaching mode were investigated. Logistic regression analysis was performed using SPSS 26.0 software to explore the factors influencing teachers' willingness to adopt the flipped classroom teaching mode.Results:A total of 102 questionnaires were collected. Among the teachers, 20.59%( n=21) believed that the teaching effect of the flipped classroom was better than that of the traditional class, 58.82%( n=60) considered its effectiveness comparable, and 20.59%( n=21) found it less effective. The most influential factors affecting the effectiveness of flipped classroom were students' self-learning with online videos [(4.39±0.73) points], student participation in the flipped classrooms [(4.26±0.72) points], the adequacy of teachers' pre-class preparation [(4.18±0.65) points], and the suitability of the teaching content for the flipped classroom [(4.11±0.76) points]. Teachers believed that the flipped classroom significantly enhanced students' autonomous learning ability [(4.11±0.63) points], clinical thinking [(4.04±0.58) points], and expression skills [(3.80±0.61) points]. Additionally, 78.43%( n=80) of the teachers expressed willingness to continue participating in flipped classroom teaching. Factors influencing teachers' willingness to adopt the flipped classroom included gender, satisfaction with students' classroom participation, and personal experience with the effectiveness of the flipped classroom( P<0.05). Conclusions:The flipped classroom teaching mode is well-accepted by teachers. Students' classroom participation affects teachers' willingness to continue using the flipped classroom teaching mode. In the future, the content of flipped classroom should be arranged individually according to specific teaching objectives to increase students' classroom participation and promote the cultivation of students' ability.
10.Application and evaluation of the flipped classroom teaching method in pediatric internship for the eight-year clinical medicine program
Shiqi GUANG ; Tian SANG ; Chaomei ZENG ; Tongyan HAN ; Dan WU ; Yuwu JIANG
Chinese Journal of Medical Education Research 2025;24(4):453-459
Objective:To explore the application of the flipped classroom teaching method in pediatric internship, evaluate the feedback from both students and faculty, and provide evidence for optimizing clinical medical education strategies.Methods:Fourth-year students ( n=174) enrolled in 2019 in the eight-year clinical medicine program at Peking University Health Science Center and instructors ( n=42) participated in this study. Questionnaire survey and exit examination scores were used to assess the effectiveness of the flipped classroom method. A statistical analysis was performed using SPSS 26.0. Kruskal-Wallis test and Dunn's multiple comparisons were used to evaluate the differences in satisfaction across teaching components. Chi-square test and Fisher's exact test were applied to compare satisfaction between high-score (top 30%) and low-score (bottom 30%) student groups. Results:①Overall student satisfaction with the flipped classroom reached 91.33% ("very satisfied" + "satisfied"). High satisfaction was reported for pre-class self-learning videos (80.35%), recommended clinical guidelines (82.80%), and English literature (71.10%), while satisfaction with the flipped classroom lectures was comparatively low (52.60%), with significant differences compared to other components ( P<0.05). ②High-score students exhibited significantly lower satisfaction than low-score students across all components (overall evaluation, 84.61% vs. 98.08%, Fisher's exact test, P=0.031; pre-class videos, 53.85% vs. 76.92%, χ2=6.12, P=0.013; preparatory assignments, 61.54% vs. 80.77%, χ2=4.68, P=0.030; English literature, 53.85% vs. 75.00%, χ2=5.80, P=0.016; and flipped class lectures, 36.54% vs. 59.62%, χ2=5.55, P=0.019). ③Enhanced competency in ≥2 core areas was reported in 71.68% of students, including theoretical knowledge acquisition (49.71%), self-directed learning (35.84%), clinical thinking (31.21%), research capabilities (25.43%), and communication skills (22.54%). ④Faculty feedback indicated that 83.33% of instructors perceived the flipped classroom as equivalent or superior to traditional teaching, particularly in cultivating clinical thinking (90.48%), self-directed learning (85.71%), theoretical knowledge acquisition (76.19%), and communication skills (76.19%). ⑤Student participation willingness was primarily influenced by pre-class time investment (46.51% reported excessive effort in preparing discussion materials), while faculty engagement depended on implementation effectiveness (42.86%) and curriculum design (35.71%). Conclusions:The flipped classroom method demonstrated promising initial outcomes in pediatric internship, with high satisfaction among both students and faculty. However, further exploration and practice are required in optimizing teaching components, implementing differentiated instructional strategies, and managing time investment.

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