Objective To explore the application and effectiveness of the apprenticeship education model in Chinese herbal medicine teaching at Western medical college.Methods By comparing classic lecture-based teaching with a combined approach integrating apprenticeship education,the study assesses the impact on student learning outcomes.Participants included students from the 2018 cohort of the eight-year clinical medicine program and the 2022 cohort of the"4+4"pilot program at Peking Union Medical College,who received classic teaching methods and apprenticeship case-based teaching methods,respectively.Upon course completion,students completed a 14-item multiple-choice questionnaire covering essential theory of Chinese medicine,as well as specific categories such as qi-regulating,blood-activating herbs,among others.Results The overall accuracy rate in the apprenticeship case-based teaching group was significantly higher than that in the classic teaching group(P＜0.01).Conclusions The apprenticeship education model of Traditional Chinese Medicine has a positive effect on teaching of Chinese herbal medicine at West-ern medical college and warrants further promotion and application.

Objective To explore the effectiveness of the"apprenticeship case-based teaching"method in the in-struction of traditional Chinese medicine(TCM)formulas for nursing students.Methods A quasi-experimental study was conducted with 135 undergraduate nursing students from the 2023 cohort at Peking Union Medical Col-lege.Participants were randomly assigned to an experimental group(receiving apprenticeship case-based teaching)or a control group(receiving conventional teaching).Teaching effectiveness was evaluated through classroom in-struction followed by a routine test.The test covered the indications and key diagnostic points of eight representative TCM formulas.Results The experimental group overruns the control group on most test items.Statistically signifi-cant differences(P＜0.05)were observed in questions related to Ma Huang Tang,Xiao Chai Hu Tang,Da Cheng Qi Tang,Liu Wei Di Huang Wan,and Ba Zheng San.Conclusions The apprenticeship case-based teaching meth-od significantly enhances students'learning gain about key diagnostic principles in TCM formulas and improves ca-pacity building of clinical reasoning.This method should be shared by schools of nursing in the teaching reformation of TCM curriculum.

Objective To explore the application value of predictive model based on nutritional status combined with clinical data in infectious complications after radical gastrectomy for gastric canc-er.Methods The clinical data on 394 gastric cancer patients who underwent radical gastrectomy at Suzhou Ninth Hospital Affiliated to Soochow University from January 2017 to July 2024 were retrospec-tively collected.According to whether the patients developed infection after surgery,they were divided into infection group(n=73)and non-infection group(n=321)based on whether they developed postoperative infections or not.The least absolute shrinkage and selection operator(LASSO)method was used to obtain the optimal related features associated with infectious complications after radical gas-trectomy for gastric cancer.Multivariate Logistic regression analysis was conducted to screen for risk factors of infectious complications after radical gastrectomy.R software was used to randomly select 70％of data as training set(for establishing the nomogram model)and 30％of data as test set.The area under the curve(AUC)of the receiver operating characteristic(ROC)curve,Bootstrap sampling validation,and decision curve analysis(DCA)were used to assess the value of the predictive model.Results of the 394 gastric cancer patients,73 developed postoperative infectious complications,in-cluding 53.42％with lung infections,17.81％with intra-abdominal infections,16.44％with uri-nary tract infections,and 12.33％with wound infections.Age,diabetes mellitus,preoperative nu-tritional risk,high preoperative PIV,combined organ resection,and prolonged operation time were identified as risk factors for infectious complications after radical gastrectomy(P＜0.05).In the training set,the AUC of the nomogram model was 0.898,and the AUC validated in the test set was 0.891.Bootstrap sampling validation with 1,000 iterations showed that the average errors between the predicted probabilities and actual values in the training and test sets were 0.019 and 0.024,re-spectively.DCA results indicated that the model had clinical utility.Conclusion Infectious com-plications after gastrectomy for gastric cancer are common,and the predictive model based on nutri-tional assessment combined with clinical data has high value in predicting the risk of infectious com-plications after gastrectomy.

Purpose To investigate the correlation between molecular typing of urothelial carcinoma(UC)and its clinicopathologic features and prognosis,in order to explore the prognostic markers and therapeutic targets for UC.Methods 115 patients with UC were retrospectively analyzed.Immunohistochemical markers GATA-3,CK20,CK5/6 and CD44 were used for molecular typing of UC(luminal-like type,basal-like type and null).Correlations between molecular typing and clinicopathological features were analyzed using the Chi-square test and Fisher precise test.Sur-vival analysis was performed using the Kaplan-Meier test and Log-rank test.Results The expression of GATA-3 and CK20 was negatively correlated with the clinical stage of UC,while the expression of CD44 was positively correlated with the clinical stage of UC(both P＜0.05).CK20 was a marker of good prognosis(P=0.03).The proportion of clinically advanced UC with basal-like type was significantly higher than that of luminal-like type(78.4％vs 53.4％,P=0.033).Among the histologic variants,UC with neuroendocrine differentiation(100％),sarcomatoid carcinoma(80.0％)and squamous differentiation(77.8％)were basal-like type.All plasmacytoid and lymphoepithelioma-like types,as well as 81.8％of micropapillary UC.Among the null phenotypes,the differential variant predominated(66.7％).Compared with the luminal-like type,although the prognosis of basal-like UC was worse,there was no sta-tistically significant difference(P＞0.05).Conclusion Patients with CK20-expressing UC had a significantly better prognosis.The main histologic variants types of basal-like type and coelomofacial type are different.Molecular typing of UC using immunohistochemical markers is suggestive of clinical staging and prognosis of patients.

Purpose To investigate the relationship between the expression of POSTN and NECTIN-3 in urothelial carcinoma(UC)and its clinicopathologic features and prognosis.Methods Clinical data of 115 UC patients were col-lected.EnVision two-step method was used for immunohistochemical analysis to determine the expression of POSTN and NECTIN-3 in UC and their correlation with clinicopathological features and prognosis.Transcriptomic data from TCGA database were used to analyze the correlation between the expression of POSTN and NECTIN-3 in bladder cancer and the pathological stage and prognosis of bladder cancer.qPCR and Western blot were used to detect the expression levels of POSTN and NECTIN-3 in tumor tissues and adjacent tissues of patients.Results TCGA database analysis showed that the expression level of NECTIN-3 in urinary bladder urothelial carcinoma(UBUC)was significantly lower than that in paracancer tissues,and POSTN expression was positively correlated with pathological stage.Prognostic a-nalysis showed that POSTN expression was negatively correlated with the overall survival of UBUC(P＞0.05),and NECTIN-3 expression was negatively correlated with disease-free survival of UBUC(P＞0.05).The experimental re-suits showed that patients with positive POSTN expression were more prone to perineural invasion[25 cases(86.2％)vs 4 cases(13.8％),P=0.019],vascular invasion[36 cases(83.7％)vs 7 cases(16.3％),P=0.007],and lymph node metastasis[24 cases(88.9％)vs 3 cases(11.1％),P=0.033].Additionally,the positive expression rate of POSTN in UBUC was significantly higher than that in upper tract urothelial carcinoma(UTUC)(75.0％vs 54.3％,P=0.028).Higher expression levels of POSTN and NECTIN-3 were associated with shorter overall survival,but the difference was not statistically significant(P＞0.05).Conclusion There is no significant correlation between NECTIN-3 and the clinicopathological features and prognosis of urothelial carcinoma,while the expression of POSTN is correlated with the invasive clinicopathological features of UC,which has certain suggestive significance for clinical stage and prognosis.

Purpose To investigate the clinical pathological features and treatment strategies of adult pineoblasto-ma(PB).Methods The clinical data of 11 cases of adult PB were retrospectively analyzed.Their imaging,histologi-cal morphology,and immunohistochemical characteristics were evaluated,and the relevant literature was reviewed.Re-sults Among the 11 PB cases,5 cases were female and 6 were male,aged 18-63 years with a median age of 39 years.Microscopically,the tumors were composed of dense small to medium-sized cells,showing a diffuse and sheet-like distribution.Rosette-like structures could be seen in some cases.The tumor cell nuclei were round or irregular with a high nuclear-cytoplasmic ratio.The mitotic figures and apoptosis were extremely common to see,and necrosis was observed in some cases.The tumor cells were uniformly positive for CD56(11/11),Syn(11/11),and CgA(11/11),with retained expression of INI-1(11/11).Some cases were positive for CD99(3/11)and S-100(1/11),while negative for BCOR,CKpan,GFAP,PLAP,CD3,and CD20.The Ki67 proliferation index ranged from 20％to 80％.Five patients were followed up for 2 to 39 months:1 patient developed spinal metastasis 26 months after postop-erative chemotherapy;1 patient had spinal metastasis 4 months after postoperative radiotherapy and temozolomide treat-ment;and 3 patients died.Conclusion PB is a rare,highly malignant tumor in the pineal gland region,even rarer in adults.Its morphology is similar to that of childhood PB,and its prognosis is slightly better than that in children.

Purpose To investigate the clinical pathological features and treatment strategies of adult pineoblasto-ma(PB).Methods The clinical data of 11 cases of adult PB were retrospectively analyzed.Their imaging,histologi-cal morphology,and immunohistochemical characteristics were evaluated,and the relevant literature was reviewed.Re-sults Among the 11 PB cases,5 cases were female and 6 were male,aged 18-63 years with a median age of 39 years.Microscopically,the tumors were composed of dense small to medium-sized cells,showing a diffuse and sheet-like distribution.Rosette-like structures could be seen in some cases.The tumor cell nuclei were round or irregular with a high nuclear-cytoplasmic ratio.The mitotic figures and apoptosis were extremely common to see,and necrosis was observed in some cases.The tumor cells were uniformly positive for CD56(11/11),Syn(11/11),and CgA(11/11),with retained expression of INI-1(11/11).Some cases were positive for CD99(3/11)and S-100(1/11),while negative for BCOR,CKpan,GFAP,PLAP,CD3,and CD20.The Ki67 proliferation index ranged from 20％to 80％.Five patients were followed up for 2 to 39 months:1 patient developed spinal metastasis 26 months after postop-erative chemotherapy;1 patient had spinal metastasis 4 months after postoperative radiotherapy and temozolomide treat-ment;and 3 patients died.Conclusion PB is a rare,highly malignant tumor in the pineal gland region,even rarer in adults.Its morphology is similar to that of childhood PB,and its prognosis is slightly better than that in children.

Purpose To investigate the correlation between molecular typing of urothelial carcinoma(UC)and its clinicopathologic features and prognosis,in order to explore the prognostic markers and therapeutic targets for UC.Methods 115 patients with UC were retrospectively analyzed.Immunohistochemical markers GATA-3,CK20,CK5/6 and CD44 were used for molecular typing of UC(luminal-like type,basal-like type and null).Correlations between molecular typing and clinicopathological features were analyzed using the Chi-square test and Fisher precise test.Sur-vival analysis was performed using the Kaplan-Meier test and Log-rank test.Results The expression of GATA-3 and CK20 was negatively correlated with the clinical stage of UC,while the expression of CD44 was positively correlated with the clinical stage of UC(both P＜0.05).CK20 was a marker of good prognosis(P=0.03).The proportion of clinically advanced UC with basal-like type was significantly higher than that of luminal-like type(78.4％vs 53.4％,P=0.033).Among the histologic variants,UC with neuroendocrine differentiation(100％),sarcomatoid carcinoma(80.0％)and squamous differentiation(77.8％)were basal-like type.All plasmacytoid and lymphoepithelioma-like types,as well as 81.8％of micropapillary UC.Among the null phenotypes,the differential variant predominated(66.7％).Compared with the luminal-like type,although the prognosis of basal-like UC was worse,there was no sta-tistically significant difference(P＞0.05).Conclusion Patients with CK20-expressing UC had a significantly better prognosis.The main histologic variants types of basal-like type and coelomofacial type are different.Molecular typing of UC using immunohistochemical markers is suggestive of clinical staging and prognosis of patients.

Purpose To investigate the relationship between the expression of POSTN and NECTIN-3 in urothelial carcinoma(UC)and its clinicopathologic features and prognosis.Methods Clinical data of 115 UC patients were col-lected.EnVision two-step method was used for immunohistochemical analysis to determine the expression of POSTN and NECTIN-3 in UC and their correlation with clinicopathological features and prognosis.Transcriptomic data from TCGA database were used to analyze the correlation between the expression of POSTN and NECTIN-3 in bladder cancer and the pathological stage and prognosis of bladder cancer.qPCR and Western blot were used to detect the expression levels of POSTN and NECTIN-3 in tumor tissues and adjacent tissues of patients.Results TCGA database analysis showed that the expression level of NECTIN-3 in urinary bladder urothelial carcinoma(UBUC)was significantly lower than that in paracancer tissues,and POSTN expression was positively correlated with pathological stage.Prognostic a-nalysis showed that POSTN expression was negatively correlated with the overall survival of UBUC(P＞0.05),and NECTIN-3 expression was negatively correlated with disease-free survival of UBUC(P＞0.05).The experimental re-suits showed that patients with positive POSTN expression were more prone to perineural invasion[25 cases(86.2％)vs 4 cases(13.8％),P=0.019],vascular invasion[36 cases(83.7％)vs 7 cases(16.3％),P=0.007],and lymph node metastasis[24 cases(88.9％)vs 3 cases(11.1％),P=0.033].Additionally,the positive expression rate of POSTN in UBUC was significantly higher than that in upper tract urothelial carcinoma(UTUC)(75.0％vs 54.3％,P=0.028).Higher expression levels of POSTN and NECTIN-3 were associated with shorter overall survival,but the difference was not statistically significant(P＞0.05).Conclusion There is no significant correlation between NECTIN-3 and the clinicopathological features and prognosis of urothelial carcinoma,while the expression of POSTN is correlated with the invasive clinicopathological features of UC,which has certain suggestive significance for clinical stage and prognosis.

The apprenticeship education of Traditional Chinese medicine(TCM)is an important pathway for the cultivation of talents in TCM education.The combination of institutional education and apprenticeship education is considered to be the most suitable educational model that aligns with the inherent characteristics of TCM education.The current status of TCM education in western medical institutions and the main challenges include the difficulty in transitioning between western and Chinese medical reasoning and limited clinical internship hours for TCM.The strengths and features of TCM apprenticeship education lie in cultural heritage,classical teachings,mentorship,practice orientation and personalized education.Therefore,integration of TCM apprenticeship education and clinical internships for western medical students represents a new educational model for medical undergraduates.