Objective:To investigate the impact of internationalization at home medical education on clinical medical undergraduate abilities based on value-added assessment, and to provide a reference for deepening education and teaching reform in medical colleges and universities.Methods:The study subjects consisted of undergraduate students enrolled in 2020 at Chongqing Medical University majoring in clinical medicine (five-year program) and clinical medicine (Sino-foreign cooperative education program). The questionnaire in the 2023 China Medical Students Survey, initiated by the National Medical Education Development Center, was used in this study. SPSS 27.0 was used for independent samples t-test and hierarchical linear regression. Results:Compared with the control group, the clinical medical undergraduates who received internationalization at home medical education had higher scores in academic article writing ability [(3.89±0.73) vs. (2.87±0.80)], literature retrieval and information management ability [(3.98±0.64) vs. (3.43±0.65)], and international communication and global health concept [(3.81±0.68) vs. (3.52±0.69)]. Controlling for individual-level student variables, internationalization at home medical education had a positive effect on clinical medicine undergraduate abilities based on value-added assessment ( β=5.003, P<0.001). Conclusions:The internationalization at home medical education in Chongqing Medical University enhances the abilities of clinical medical undergraduates, and provides a reference for the comprehensive improvement of the education quality of medical talents.

Objective: To analyze the characteristics of alcohol poisoning cases among minors receiving pre hospital 120 emergency services in Zhengzhou, providing evidence for regional management strategies of alcohol poisoning among minors. Methods: A retrospective study was conducted on 1 630 alcohol poisoning cases (aged 0-18 years) from Zhengzhou s 120 emergency system during 2017-2019 and 2023. Data on gender, age, occurrence timeframes were analyzed using t-test and χ 2 test for intergroup comparisons. Results: Annual cases were 291 (2017), 353 (2018), 483 (2019), and 503 (2023). Compared with 2017, male alcohol poisoning cases increased by 66.94% while female cases surged 104.35% by 2023. The peak incidence of alcohol poisoning among minors occurred among 16-18 year olds (85.40%), followed by 13-15 year olds (13.74%). Most cases clustered between 21:01-03:00 (60.43%), with male cases peaking at 22:01-23:00 (12.73%) and female cases peaking at 02:01-03:00 ( 11.25 %). Between 00:01-03:00, male cases progressively decreased while female cases increased. Severity distribution showed 355 mild cases (21.78%), 1 035 moderate cases (63.50%), and 240 severe cases (14.72%). Conclusions Zhengzhou region has experienced sustained growth in underage alcohol poisoning cases, predominantly occurring from evening to early morning with moderate severity, female cases demonstrate faster growth rates. Multifaceted regulatory measures should be implemented to strengthen supervision of underage drinking behaviors.

Objective To investigate correlations of dynamic changes in serum C-reactive pro-tein(CRP),procalcitonin(PCT),and neutrophil-to-lymphocyte ratio(NLR)before and after symptomatic treatment with prognosis of neonates with neonatal respiratory distress syndrome(NRDS)of different etiologies.Methods A total of 110 premature infants were selected as study subjects and divided into neonatal infection group(group A)and fetal intrauterine distress group(group B)based on different causes of NRDS.Additionally,30 neonates with NRDS caused solely by prematurity were selected as control group.Serum CRP and PCT levels and NLR were compared among the three groups before and after treatment.Results There were statistically significant differences in oxygen therapy duration,ventilation duration,the proportion of infants requiring re-intubation,hospital stay,and the number of apnea episodes among three groups(P＜0.006).Before treatment,there was no sta-tistically significant difference in serum CRP levels between group A and group B(P＞0.05).Ser-um CRP levels in group B were higher than those in the control group.Moreover,serum PCT levels was lower than the group A,and NLR in the group B were higher than those in the group A and the control group.CRP,PCT levels,and NLR in the group A were higher than those in the control group(P＜0.05 or P＜0.006).After treatment,serum CRP levels in all three groups decreased compared to before treatment.Serum PCT levels in the group A decreased compared to before treat-ment.NLR in both group A and group B decreased compared to before treatment,with statistically significant differences(P＜0.006).There were statistically significant differences in serum CRP and PCT levels between the group A and the control group after treatment(P＜0.006).After treat-ment,there was a statistically significant difference in serum CRP levels between the group B and the control group(P＜0.006),but no statistically significant differences in PCT levels and NLR(P＞0.05).Compared with group A,there was a statistically significant difference in PCT levels in the group B(P＜0.006).Multivariate Logistic regression results showed that CRP,PCT,and NLR were independent influencing factors for the prognosis of infants in the group A.The receiver operat-ing characteristic curve analysis results showed that the areas under the curve(AUC)after treatment for serum CRP,PCT,and NLR alone in predicting prognosis in the group A were 0.789,0.738,and 0.758,respectively,and the AUC for combined prediction was 0.934.In the group B,the AUC for serum CRP,PCT,and NLR alone in predicting prognosis after treatment were 0.719,0.772,and 0.768,respectively,and the AUC for combined prediction was 0.886.The sensitivity and specificity of combined prediction in both groups were higher than those of each indicator alone,and the predictive value of their combined detection for the prognosis of premature infants in group A was higher than that in the group B.Conclusion There are differences in PCT levels and NLR before treatment among neonates with NRDS of different etiologies.After symptomatic treatment,CRP,PCT levels and NLR decrease in all three groups,indicating a good prognosis.

Objective:To explore the related factors and independent risk factors of radiation pneumonitis (RP) in breast cancer patients after radiotherapy, and to guide the optimization of treatment plan for BC and reduce the incidence of RP.Methods:A retrospective analysis was conducted on 770 female breast cancer patients who received postoperative radiotherapy at Deyang People's Hospital between July 2021 and September 2024. The occurrence of RP was observed, and potential clinical and dosimetric factors were analyzed. Continuous variables were assessed using the t-test, categorical variables with the chi-square test, and univariate analysis was used to identify factors associated with RP. Multivariate logistic regression analysis was used to find out the independent risk factors of RP, and receiver operating characteristic (ROC) curves were used to evaluate the predictive value of each factor. Results:Among 770 patients, 46 developed RP (34 grade 1, 12 grade 2). Univariate analysis showed that surgical method, chemotherapy regimen, interval between chemotherapy and radiotherapy, age, planning target volume, and maximum dose of the ipsilateral lung were not associated with RP (all P>0.05). Clinical stage ( χ2=7.84, P=0.020), chest wall + supraclavicular + internal mammary lymph node irradiation ( χ2=104.50, P<0.001), supraclavicular + internal mammary lymph node irradiation ( χ2=8.90, P=0.003), number of chemotherapy cycles ( t=9.88, P<0.001), and ipsilateral lung V 5 Gy( t=16.47, P<0.001), V 10 Gy( t=18.70, P<0.001), V 15 Gy( t=20.23, P<0.001), V 20 Gy( t=23.39, P<0.001), V 25 Gy( t=21.68, P<0.001), V 30 Gy( t=21.67, P<0.001), V 35 Gy( t=20.67, P<0.001), V 40 Gy( t=19.96, P<0.001), V 45 Gy( t=18.59, P<0.001), V 50 Gy( t=11.69, P<0.001), D mean( t=30.76, P<0.001) were significantly correlated with the occurrence of RP. Multivariate analysis revealed that ipsilateral lung V 5 Gy ( OR=1.258, 95% CI: 1.143-1.384, P<0.001), number of chemotherapy cycles ( OR=2.767, 95% CI: 1.781-4.299, P<0.001), and chest wall + supraclavicular + internal mammary lymph node irradiation ( OR=7.926, 95% CI: 2.943-21.349, P<0.001) were independent risk factors for RP. Using V 5 Gy=51.65% as the diagnostic cutoff, the sensitivity and specificity for predicting RP were 0.870 and 0.804, respectively. Taking the number of chemotherapy cycles=6.50 as the cutoff, the sensitivity and specificity of predicting RP were 0.891 and 0.586, respectively. Taking 0.50 as the diagnostic cutoff point, the sensitivity and specificity of chest wall + supraclavicular + internal mammary lymph node irradiation for RP were 0.870 and 0.797, respectively. Conclusions:The number of chemotherapy cycles, ipsilateral lung V 5 Gy, and chest wall + supraclavicular + internal mammary lymph node irradiation are independent risk factors for RP in postoperative female breast cancer patients.

Objective:To explore the related factors and independent risk factors of radiation pneumonitis (RP) in breast cancer patients after radiotherapy, and to guide the optimization of treatment plan for BC and reduce the incidence of RP.Methods:A retrospective analysis was conducted on 770 female breast cancer patients who received postoperative radiotherapy at Deyang People's Hospital between July 2021 and September 2024. The occurrence of RP was observed, and potential clinical and dosimetric factors were analyzed. Continuous variables were assessed using the t-test, categorical variables with the chi-square test, and univariate analysis was used to identify factors associated with RP. Multivariate logistic regression analysis was used to find out the independent risk factors of RP, and receiver operating characteristic (ROC) curves were used to evaluate the predictive value of each factor. Results:Among 770 patients, 46 developed RP (34 grade 1, 12 grade 2). Univariate analysis showed that surgical method, chemotherapy regimen, interval between chemotherapy and radiotherapy, age, planning target volume, and maximum dose of the ipsilateral lung were not associated with RP (all P>0.05). Clinical stage ( χ2=7.84, P=0.020), chest wall + supraclavicular + internal mammary lymph node irradiation ( χ2=104.50, P<0.001), supraclavicular + internal mammary lymph node irradiation ( χ2=8.90, P=0.003), number of chemotherapy cycles ( t=9.88, P<0.001), and ipsilateral lung V 5 Gy( t=16.47, P<0.001), V 10 Gy( t=18.70, P<0.001), V 15 Gy( t=20.23, P<0.001), V 20 Gy( t=23.39, P<0.001), V 25 Gy( t=21.68, P<0.001), V 30 Gy( t=21.67, P<0.001), V 35 Gy( t=20.67, P<0.001), V 40 Gy( t=19.96, P<0.001), V 45 Gy( t=18.59, P<0.001), V 50 Gy( t=11.69, P<0.001), D mean( t=30.76, P<0.001) were significantly correlated with the occurrence of RP. Multivariate analysis revealed that ipsilateral lung V 5 Gy ( OR=1.258, 95% CI: 1.143-1.384, P<0.001), number of chemotherapy cycles ( OR=2.767, 95% CI: 1.781-4.299, P<0.001), and chest wall + supraclavicular + internal mammary lymph node irradiation ( OR=7.926, 95% CI: 2.943-21.349, P<0.001) were independent risk factors for RP. Using V 5 Gy=51.65% as the diagnostic cutoff, the sensitivity and specificity for predicting RP were 0.870 and 0.804, respectively. Taking the number of chemotherapy cycles=6.50 as the cutoff, the sensitivity and specificity of predicting RP were 0.891 and 0.586, respectively. Taking 0.50 as the diagnostic cutoff point, the sensitivity and specificity of chest wall + supraclavicular + internal mammary lymph node irradiation for RP were 0.870 and 0.797, respectively. Conclusions:The number of chemotherapy cycles, ipsilateral lung V 5 Gy, and chest wall + supraclavicular + internal mammary lymph node irradiation are independent risk factors for RP in postoperative female breast cancer patients.

Objective:To investigate the impact of internationalization at home medical education on clinical medical undergraduate abilities based on value-added assessment, and to provide a reference for deepening education and teaching reform in medical colleges and universities.Methods:The study subjects consisted of undergraduate students enrolled in 2020 at Chongqing Medical University majoring in clinical medicine (five-year program) and clinical medicine (Sino-foreign cooperative education program). The questionnaire in the 2023 China Medical Students Survey, initiated by the National Medical Education Development Center, was used in this study. SPSS 27.0 was used for independent samples t-test and hierarchical linear regression. Results:Compared with the control group, the clinical medical undergraduates who received internationalization at home medical education had higher scores in academic article writing ability [(3.89±0.73) vs. (2.87±0.80)], literature retrieval and information management ability [(3.98±0.64) vs. (3.43±0.65)], and international communication and global health concept [(3.81±0.68) vs. (3.52±0.69)]. Controlling for individual-level student variables, internationalization at home medical education had a positive effect on clinical medicine undergraduate abilities based on value-added assessment ( β=5.003, P<0.001). Conclusions:The internationalization at home medical education in Chongqing Medical University enhances the abilities of clinical medical undergraduates, and provides a reference for the comprehensive improvement of the education quality of medical talents.

Objective:To explore the clinical manifestations, pathogenesis, and therapeutic approaches of disseminated intravascular coagulation (DIC) associated with chimeric antigen receptor T-cell (CAR-T) therapy for B-lymphoblastic lymphoma.Methods:Retrospective collection and analysis were conducted on the clinical data of a patient with B-lymphoblastic lymphoma who received CAR-T therapy in the Hematology Department of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, in April 2020. To review the literatures, Chinese databases (CNKI, Wanfang Database) and PubMed were searched form database inception up to November 2024 using the retrieval entries "chimeric antigen receptor T-cell therapy", "CAR-T", "coagulation", "bleeding", and "thrombosis" .Results:The patient, a 32-year-old male, diagnosed with B-lymphoblastic lymphoma for over 10 months, relapsed after three cycles of chemotherapy and allogeneic hematopoietic stem cell transplantation, with bone marrow cytology indicating 20.24% abnormal phenotype B-lineage precursor cells. After CAR-T cell infusion at a dose of 4×10 6/kg, the patient developed grade 2 cytokine release syndrome (CRS) on day 2, nasal bleeding on day 4, high fever again on day 9, with worsening coagulation parameters, DIC and persistent hypofibrinogenemia. After treatment with tocilizumab, corticosteroids to counteract CRS, and active replacement therapy such as administration of blood product and fibrinogen, the patient’s CRS and coagulation abnormalities gradually improved. The patient was followed up for 16 months regularly after CAR-T therapy, with CAR-T cells sustained and minimal residual disease remained negative as assessed by bone marrow flow cytometry. Subsequently, the patient stopped taking oral immunosuppressants on his own, which aggravated rejection reaction complicated with infection. The patient and his family requested to be discharged and lost the follow-up. A total of 20 relevant English articles and 6 Chinese articles were retrieved from the literature search. Conclusion:CAR-T-associated coagulopathy occurs alongside CRS. It is characterized by hypofibrinogenemia, and is life-threatening when progressing to DIC. Anti-CRS and replacement therapies have proven to be effective treatment strategies.

This study aims to investigate the protective effect of resveratrol against liver injury in hindlimb unloading rats. Thirty 2-month-old male SD rats were randomly divided into normal group (Control), hindlimb unloading model group (Model), and hindlimb unloading+resveratrol administration group (Model+Res). The Model + Res group was injected intraperitoneally with 30 mg/kg of resveratrol, and the Control and Model groups were injected intraperitoneally with an equal volume of 0.9% NaCl. Liver tissues were collected after 28 days and analyzed for oxidative stress, inflammatory factors, energy metabolism indices, Na ⁺-K ⁺-ATPase and Ca ²⁺-Mg ²⁺-ATPase activity, and morphological changes were observed by hematoxylin-eosin staining. The protein expression levels of Bax, Bcl-2, p-PI3K, PI3K, p-AKT, and AKT were detected by Western blotting. Compared with the Control group, hepatocytes in the Model group showed swelling, abnormal morphology, nuclear consolidation, and cell membrane disruption. Oxidative stress, inflammatory factor levels, hepatic glycogen accumulation, and energy metabolism were increased in the liver tissues of the Model group, while resveratrol treatment significantly reversed these changes. The results of Western blotting showed that resveratrol significantly reduced the expression of Bax and increased the expression levels of Bcl-2, and the proteins of p-PI3K/PI3K and p-AKT/AKT expression levels. It is suggested that 28 days of hindlimb unloading treatment could lead to liver tissue injury in rats, which is manifested as oxidative stress, inflammatory response, energy metabolism disorder and increased apoptosis level, and resveratrol has a certain mitigating effect on this.
Animals ; Resveratrol ; Male ; Liver/pathology* ; Rats, Sprague-Dawley ; Rats ; Hindlimb Suspension ; Oxidative Stress/drug effects* ; Phosphatidylinositol 3-Kinases/metabolism* ; Proto-Oncogene Proteins c-akt/metabolism* ; Stilbenes/pharmacology* ; bcl-2-Associated X Protein/metabolism* ; Proto-Oncogene Proteins c-bcl-2/metabolism* ; Apoptosis/drug effects*

ObjectiveTo adapt the Stanford Expectations of Treatment Scale（SETS） into Chinese（C-SETS） and test the feasibility， validity and reliability of its application in patients with diarrhea-predominant irritable bowel syndrome（IBS-D） with liver-constraint and spleen-deficiency syndrome treated with traditional Chinese medicine（TCM）. MethodsWe obtained authorisation from the developer of the SETS， and followed the principle of "two-way translation" to translate the SETS by literal translation and back translation to form the C-SETS. Ninety-six IBS-D patients with liver-constraint and spleen-deficiency syndrome were enrolled as respondents and filled out C-SETS before receiving treatment； the feasibility was assessed by the recall rate， completion rate and the duration of filling out the scale； the reliability was assessed by Cronbach's α； the structural validity was assessed by exploratory and confirmatory factor analysis， and the content validity was assessed by correlation analysis. ResultsThe C-SETS consists of 10 items， with the 1st， 3rd， and 5th rating items constituting the Positive Expectations subscale， and the 2nd， 4th， and 6th rating items constituting the Negative Expectations subscale， each of which is rated on a 7-point Likert Scale. The recall of C-SETS was 100%（96/96）， the completion rate was 89.58%（86/96）； Cronbach's α for the Positive and Negative Treatment Expectations subscales were 0.845 and 0.854， respectively； exploratory factor analysis showed that the coefficient of commonality for all six entries was larger than 0.4， and that the six entries could be used by both factors to explain 77.092% of the total variance； validation factor analysis showed that the goodness-of-fit index， comparative fit index， root mean square of approximation error， canonical fit coefficient， and chi-square degrees of freedom ratio took the values of 0.943， 1.003， 0， 0.943， and 0.626， respectively； and the results of Spearman's analysis suggested that the C-SETS had good content validity. ConclusionThe C-SETS has well feasibility， reliability， and validity， which initially proves that it can be used as a tool to assess the treatment expectation of patients with IBS-D with liver-constraint and spleen-deficiency syndrome before receiving TCM treatment.

Cirrhotic portal hypertension (CPH) is a manifestation of decompensated liver cirrhosis, with ascites, portal collateral circulation formation, hypersplenism and splenomegaly as the typical clinical symptoms. In recent years, the incidence of CPH has been increasing year by year, and the treatment of CPH has gradually become a hot issue in medical research. In order to further explore the diagnosis and treatment scheme of CPH. We briefly describe the pathophysiological mechanism and diagnosis of CPH, and the current situation of CPH treatment and the new progress of internal and external treatment were reviewed.