Objective To explore the effectiveness of"near peer learning"(NPL)in the electromyo-graphy(EMG)teaching module for neurology residents.Methods The Department of Neurology,Peking Union Medical College Hospital implemented an NPL instructional design for a course on EMG for residents from November 2020 to March 2024.This teaching session was held annually,in which senior residents in-structed juniors who were 1 or 2 years earlier in their training.The residents participated in the pre-course/post-course tests and completed a feedback survey at the end of the session.This evaluation method was used to un-derstand the effectiveness of the NPL intervention in EMG teaching.Results Over four years,a total of 83 residents participated.Among them,there were 24 postdoctoral students,52 postgraduates and 7 junior resi-dents.The results showed that the post-course test scores were significantly improved compared with pre-course test scores(74.33±2.43 vs.70.11±2.49,P=0.005),with the most remarkable improvements seen for"tu-tees"(73.84±20.53 vs.70.29±21.46,P=0.020),postgraduates(74.04±22.51 vs.68.97±21.40,P=0.009),first-year residents(70.19±4.02 vs.63.59±3.59,P=0.040)and first-time participating resi-dents(65.23±3.24 vs.60.97±3.21,P=0.030).The post-program feedback showed that both tutors and tu-tees thought highly of NPL,believing that it enabled them to gain knowledge and helped them to improve teaching skills.Conclusions The NPL intervention is suitable for the teaching of EMG,because of its contri-bution to knowledge acquisition and basic clinical skills improvement.The NPL is worth replicating in other teaching and learning programs.

Objective: To review the current development of artificial intelligence (AI) technology in the field of transfusion medicine. Methods: A systematic search was conducted in the Clarivate Web of Science Database from inception to December 2024 for literature related to AI and transfusion. A total of 4 775 publications were identified. Based on inclusion and exclusion criteria, 133 original studies were ultimately included and analyzed using a narrative synthesis approach. Results: Research on AI in transfusion has surged since 2020 (accounting for 77% of all publications), with China ranking second globally in publication volume. Among the included studies, 69.2% focused on predicting individual transfusion needs, followed by inventory management (8.3%), diagnosis and prediction of adverse transfusion reactions (6.0%), factors influencing transfusion outcomes (5.3%), blood group identification (5.3%), blood quality testing (4.5%), and precise blood volume measurement (1.5%). Additionally, 4.5% of the studies were published in journals with an impact factor greater than 10; 19.5% developed software or applications; 31.5% were multi-center studies; 48.1% utilized decision tree methods, while 31.5% employed neural network approaches; and 14.2% conducted external validation of the algorithms. Conclusion: AI demonstrates significant potential in transfusion risk prediction, decision support, and blood management. However, challenges remain, including limited model generalizability, insufficient algorithm interpretability, and barriers to clinical translation. The deep integration of AI with transfusion medicine will accelerate the advent of precision transfusion era, maximizing blood resource utilization, reducing waste, and ensuring transfusion safety.

Resident training is a necessary path to cultivate excellent clinical doctors. Based on the Consensus on Core Competency Framework for Residency Education Among China Consortium of Elite Teaching Hospitals for Residency Education, Department of Neurology from Peking Union Medical College Hospital has established a training program for neurology residents with a graded evaluation system and a progressive clinical responsibility concept guided by core competency. Overcoming the teaching difficulties of neurology and considering the clinical characteristics of neurology, we have established a series of replicable and promotable neurology residency training curriculum through inheritance and innovation, which provides reference for the continuous improvement of China's neurology residency training program.

Purpose To explore the imaging features and clinical pathology characteristics of extraskeletal Ewing sarcoma(EES).Materials and Methods The clinical and imaging data and pathological findings of 14 patients with EES confirmed by operation and pathology were retrospectively analyzed.CT examination was performed in 7 cases(including 5 enhanced)and MRI was performed on 9 cases(including 8 enhanced).Results The anatomic locations of the 14 patients included paraspinal area(n=3),mediastinum(n=1),right supraclavicular(n=1),left thigh(n=1),left parapubic region(n=1),retroperitoneal(n=1),pelvic cavity(n=1),prostate(n=2),left kidney(n=1),pancreas(n=1)and liver(n=1).All 14 cases of EES showed single solid mass,13 cases were lumpy,and the maximum diameter of the lesion ranged from 48.0 mm to 180.0 mm.8 cases showed uneven density or signal,cystic degeneration and necrosis was seen.one case had calcification.After enhancement,8 cases showed uneven enhancement,12 cases showed severe or moderate enhancement.10 cases were irregular in shape,11 cases had peripheral organ or tissue invasion,3 cases had no peripheral organ or tissue invasion.5 cases had peripheral bone destruction.One case had left renal vein and inferior vena cava tumor thrombus and thrombus,iliac vein thrombus.Conclusion The clinical symptoms of EES are nonspecific.The imaging manifestations of EES are mostly massive solid masses in extraosseous soft tissue,with uneven density or signal,irregular shape,often accompanied by cystic degeneration and necrosis and invasion of surrounding organs or tissues.Imaging is of great value in preoperative diagnosis,clinical staging,treatment and efficacy evaluation.

OBJECTIVE:Cement-augmentation pedicle screws have been widely used in spinal internal fixation surgery combined with osteoporosis in recent years,which can significantly improve the fixation strength,but compared with conventional methods,whether it has more advantages is still inconclusive of evidence-based medicine.To systematically evaluate the efficacy and safety of cement-augmented pedicle screw in the treatment of thoracolumbar degenerative diseases with osteoporosis. METHODS:Clinical controlled trials concerning the cement-augmented pedicle screw and the traditional pedicle screw placement for thoracolumbar degenerative diseases with osteoporosis were retrieved from the electronic databases such as CNKI,CBM,WanFang,VIP,PubMed,Cochrane Library,Web of Science and Embase.According to the unified criteria,we performed literature screening and quality evaluation.The meta-analysis was performed using RevMan 5.4 software. RESULTS:(1)Totally 20 articles were selected eventually,involving 2 randomized controlled studies and 18 retrospective cohort studies,totally 1 566 patients.Among them,789 cases were in the cement-augmented screw group and 777 cases in the conventional screw group.(2)Meta-analysis results showed that Japanese Orthopaedic Association score,intervertebral space height and fusion rate were higher in the cement-augmented screw group than those in the conventional screw group(MD=1.60,95%CI:1.14,2.07,P<0.000 01;MD=1.26,95%CI:0.62,1.90,P=0.000 1;OR=11.24,95%CI:2.86,44.14,P=0.000 5).Operation time was longer in the cement-augmented screw group than that in the conventional screw group(SMD=0.82,95%CI:0.42,1.23,P<0.000 1).Postoperative visual analog scale score,Oswestry dysfunction index score and incidence of screw loosening were lower in the cement-augmented screw group than those in the conventional screw group(MD=-0.50,95%CI:-0.78,-0.21,P=0.000 7;SMD=-0.49,95%CI:-0.88,-0.10,P=0.01;OR=0.08,95%CI:0.05,0.12,P<0.000 01).Hospitalization time,intraoperative blood loss,and postoperative drainage volume were not significantly different between the two groups(P>0.05). CONCLUSION:Compared with conventional pedicle screw placement,cement-augmented pedicle screw is more effective in the treatment of osteoporotic thoracolumbar degenerative disease by improving fusion rate and interbody height,reducing the incidence of screw loosening,and elevating long-term efficacy.

AIM:The paper is to explore a rapid and simple method for the culture of mouse primary thyroid cells.METHODS:Mouse thyroid cells were isolated by enzyme digestion and cultured with improved medium,and their morphology,characteristics and secretory function were observed within 14 d.RESULTS:In the cultures,the active pri-mary cells were obtained from the thyroid tissue after digestion for 25 min;adherent growth was observed on the 2nd day.And secondary follicles appeared from the 5th to 7th day.Over 95%cells were detected with thyroglobulin.The secretion of total triiodothyronine and total thyroxine maintains over 60%in 7 d.The expression levels of specific genes can still maintain more than 50%in 10 d.CONCLUSION:Mouse thyroid primary cells can be rapidly cultured by this method,and the cells can be used for studying thyroid endocrine secretion within 7 d and studying thyroid genes within 10 d.

To explore the effectiveness of "near peer learning" (NPL) in the electromyography(EMG)teaching module for neurology residents.

Objective To compare the difference between four-axis positioning 3D printing guide assisted puncture and manual puncture percutaneous vertebroplasty,to clarify the clinical efficacy of 3D printing guide assisted percutaneous vertebroplasty,and to explore its clinical application value.Methods A total of 70 patients who underwent single-segment vertebroplasty for osteoporotic vertebral compression fractures in our hospital were randomly divided into a manual group(control group)and a guide plate group(observation group).Thirty-five patients in the control group underwent PVP under the traditional manual puncture,and 35 patients in the observa-tion group underwent PVP under the four-axis positioning 3D printing guide assisted puncture.The general data,perioperative data,imaging data,preoperative and postoperative functional scores of the two groups were collected and compared.Results In terms of intraoperative fluoroscopy times,operation time,and postoperative adverse reactions,the observation group was significantly lower than the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference between the two groups in intraoperative blood loss,bone cement leakage,and whether bone cement perfusion included fracture sites.In terms of clinical efficacy,the ratio of anterior vertebral height,postoperative VAS score and postoperative JOA score of the two groups were significantly better than those before operation,and the difference was statistically significant(P<0.05).At the same time point before and after operation,there was no significant difference in the height ratio of the anterior edge of the injured vertebra,VAS score and JOA score between the two groups(P>0.05).Conclusion The clinical efficacy of four-axis positioning 3D printing guide plate-assisted puncture is the same as that of experienced clinicians with free hand puncture for PVP,which can quickly relieve pain and improve dysfunction.However,guide plate assistance can shorten the operation time,reduce the number of fluoroscopy and postoperative adverse reactions,and make vertebroplasty faster and safer.

The global COVID-19 coronavirus pandemic has infected over 109 million people, leading to over 2 million deaths up to date and still lacking of effective drugs for patient treatment. Here, we screened about 1.8 million small molecules against the main protease (M^pro) and papain like protease (PL^pro), two major proteases in severe acute respiratory syndrome-coronavirus 2 genome, and identified 1851M^pro inhibitors and 205 PL^pro inhibitors with low nmol/l activity of the best hits. Among these inhibitors, eight small molecules showed dual inhibition effects on both M^pro and PL^pro, exhibiting potential as better candidates for COVID-19 treatment. The best inhibitors of each protease were tested in antiviral assay, with over 40% of M^pro inhibitors and over 20% of PL^pro inhibitors showing high potency in viral inhibition with low cytotoxicity. The X-ray crystal structure of SARS-CoV-2 M^pro in complex with its potent inhibitor 4a was determined at 1.8 Å resolution. Together with docking assays, our results provide a comprehensive resource for future research on anti-SARS-CoV-2 drug development.
Humans ; Antiviral Agents/chemistry* ; COVID-19 ; COVID-19 Drug Treatment ; High-Throughput Screening Assays ; Molecular Docking Simulation ; Protease Inhibitors/chemistry* ; SARS-CoV-2/enzymology* ; Viral Nonstructural Proteins

A 68-year-old male patient with lung adenocarcinoma was treated with icotinib 125 mg thrice daily orally and Kanglaite soft capsules (康莱特软胶囊) 2.7 g orally 4 times daily. The patient′s serum creatinine (Scr) was 91 μmol/L before the medication. He developed foamy urine, fatigue, chest tightness, loss of appetite, and red rash on the neck and chest skin 29 days after the medication. No intervention was given and the patient received a total of 76 days of medication. Laboratory tests showed Scr 167 μmol/L, immunoglobulin A (IgA) 4 090 mg/L, urine protein 2 g/L, urinary protein 2.61 g per 24 hours, urinary red blood cells 6.8/high power field, and urine α microglobulin 66.9 mg/L. Through pathological examination, the patient was diagnosed with focal proliferative IgA nephropathy and acute renal tubule injury, which was considered to be related to icotinib. Low protein diet and the symptomatic treatments were given.After 80 days of treatment, the patient′s Scr was 189 μmol/L and urine protein was 2 g/L. After that, the patient was lost to follow-up.