Objective:In order to improve medical undergraduates' ability to interpret medical images and clinical application competencies, this study aimed to explore the effects of case-based learning (CBL) combined with seminars for integrated medical imaging teaching as well as its application value.Methods:We assigned 40 medical undergraduates of grade 2016 of Chongqing Medical University to learn imaging of liver diseases using either a traditional teaching model (control group, n=20) or the combined teaching model (experimental group, n=20), in the form of classroom teaching in our hospital. The teaching effects were evaluated through a theoretical assessment, image reading assessment, and questionnaire survey. SPSS 23.0 software was used for statistical analysis. Continuous data were compared using the t test, and categorical data were compared using the chi-square test. Results:The total theoretical score and total image reading score of the experimental group were (76.35±8.63) and (79.80±10.60), respectively, which were significantly higher than those of the control group ( P<0.05). Specifically, for the experimental group, the scores of theoretical analysis and comprehensive application were (22.85±3.63) and (22.15±2.92), respectively; the scores of image interpretation and report writing were (48.55±6.81) and (31.25±4.15), respectively; the scores for medium questions and hard questions in the image reading test were (24.85±3.12) and (22.50±2.91), respectively; and the pass rate and excellence rate for image reading were 100.00% and 50.00%, respectively, all significantly higher than those of the control group ( P<0.05). The degree of satisfaction with teaching in the experimental group was significantly higher than that of the control group ( P<0.05). In terms of improving learning desire, independent learning ability, innovation and expansion ability, literature search ability, communication and collaboration ability, and image interpretation ability, the experimental group showed significantly higher self-evaluated scores than the control group ( P<0.05). Conclusions:The CBL+seminar model can effectively improve students' academic performance in theoretical and image reading assessments, strengthen their ability to analyze and solve difficult problems, increase their enthusiasm and initiative in learning, and improve their comprehensive quality and image interpretation competency, which is worth promotion and application.

Objective To examine the changing antimicrobial resistance profile of Enterobacter spp.isolates in 53 hospitals across China from 2015 t0 2021.Methods The clinical isolates of Enterobacter spp.were collected from 53 hospitals across China during 2015-2021 and tested for antimicrobial susceptibility using Kirby-Bauer method or automated testing systems according to the CHINET unified protocol.The results were interpreted according to the breakpoints issued by the Clinical & Laboratory Standards Institute(CLSI)in 2021(M100 31st edition)and analyzed with WHONET 5.6 software.Results A total of 37 966 Enterobacter strains were isolated from 2015 to 2021.The proportion of Enterobacter isolates among all clinical isolates showed a fluctuating trend over the 7-year period,overall 2.5％in all clinical isolates amd 5.7％in Enterobacterale strains.The most frequently isolated Enterobacter species was Enterobacter cloacae,accounting for 93.7％(35 571/37 966).The strains were mainly isolated from respiratory specimens(44.4±4.6)％,followed by secretions/pus(16.4±2.3)％and urine(16.0±0.9)％.The strains from respiratory samples decreased slightly,while those from sterile body fluids increased over the 7-year period.The Enterobacter strains were mainly isolated from inpatients(92.9％),and only(7.1±0.8)％of the strains were isolated from outpatients and emergency patients.The patients in surgical wards contributed the highest number of isolates(24.4±2.9)％compared to the inpatients in any other departement.Overall,≤ 7.9％of the E.cloacae strains were resistant to amikacin,tigecycline,polymyxin B,imipenem or meropenem,while ≤5.6％of the Enterobacter asburiae strains were resistant to these antimicrobial agents.E.asburiae showed higher resistance rate to polymyxin B than E.cloacae(19.7％vs 3.9％).Overall,≤8.1％of the Enterobacter gergoviae strains were resistant to tigecycline,amikacin,meropenem,or imipenem,while 10.5％of these strains were resistant to polycolistin B.The overall prevalence of carbapenem-resistant Enterobacter was 10.0％over the 7-year period,but showing an upward trend.The resistance profiles of Enterobacter isolates varied with the department from which they were isolated and whether the patient is an adult or a child.The prevalence of carbapenem-resistant E.cloacae was the highest in the E.cloacae isolates from ICU patients.Conclusions The results of the CHINET Antimicrobial Resistance Surveillance Program indicate that the proportion of Enterobacter strains in all clinical isolates fluctuates slightly over the 7-year period from 2015 to 2021.The Enterobacter strains showed increasing resistance to multiple antimicrobial drugs,especially carbapenems over the 7-year period.

Objective To investigate the effect of rapid ultrasonic tissue processing on breast biopsy tissue.Methods Totally 100 breast puncture samples from the Department of Pathology at Shengjing Hospital of China Medical University in 2023 were randomly selected and dehydrated using rapid ultrasound tissue processing technology(the rapid group).Paired surgical samples(0.3 cm×0.3 cm×0.3 cm)that did not undergo neoadjuvant therapy before surgery were collected and subjected to routine pathological tissue treat-ment(the conventional group).The two groups of samples were subjected to routine sectioning after dehydration.The dehydration time,hematoxylin and eosin(HE)staining effect,and fluorescence in situ hybridization(FISH)results of the two groups were compared.Next,the estrogen receptor(ER),progesterone receptor(PR),and human epidermal growth factor receptor 2(HER2)immunohistochemical(IHC)detection results of the two groups were compared using the kappa test with paired counting data.Results Dehydration time in the rapid group(46.70±1.42 min)was significantly shorter than that in the conventional group(659.25±6.03 min,t=987.44,P<0.001).No significant differences were observed between the HE staining scores of the rapid group(10.13±1.12)and that of the conventional group(10.15±0.97).The consistency rate of ER expression between the two groups was 92.5%(Kappa=0.794,P<0.05),that of PR expres-sion between the two groups was 76.25%(Kappa=0.639,P<0.05),and that of HER2 expression between the two groups was 72.5%(Kappa=0.610,P<0.05).The FISH results were consistent between the two groups.Conclusion Rapid ultrasonic tissue treatment has the advantages of a short procedure time,less pollution,and simple operation.The present study showed no statistically significant differences between the effect of rapid tissue treatment on tissue sections and that of routine dehydration.Therefore,this method can be widely used in pathology for the analysis of small samples.

Objective To develop an expert consensus on subcutaneous injection nursing for allergic asthma in children,standardize nursing practice to reduce the occurrence of related adverse reactions.Methods The clinical guideline,expert consensus,systematic review,evidence summary and original research on subcutaneous injection of monoclonal antibody drug for children with allergic asthma were comprehensively searched in domestic and foreign databases.The time limit for retrieval was from the establishment of databases until August 2023.Combined with clinical practice experience,the first draft of the consensus was formed.From December 2023 to February 2024,27 experts were invited to conduct 2 rounds of expert letter consultation,revise and improve the contents of the first draft,and expert demonstration was conducted,and finally a consensus final draft was formed.Results The effective recovery rate of the 2 rounds of letter consultation questionnaires was 100％;the authority coefficient of experts was 0.88;the judging basis coefficient was 0.93;the familiarity coefficient was 0.83.In the 2 rounds of correspondence,the Kendall concordant coefficients of expert opinions were 0.241 and 0.252,respectively(P＜0.001 for both).The consensus includes 6 parts,including personnel management,environmental layout,indications and contraindications,subcutaneous injection operation norms,identification and treatment of adverse reactions,and health education.Conclusion The consensus is strongly scientific and practical,and can provide guidance for nursing practice of subcutaneous injection of monoclonal antibodies in children with allergic asthma.

Objective Meta modelling was employed to develop a risk prediction model for intradialytic hypotension(IDH)and validate the model.Methods Literature on risk factors for IDH published up to March 31,2023 was retrieved from 8 databases,including Cochrane Library,PubMed,Web of Science,EBSCO,Scopus,CINAHL,CNKI and Wanfang Database.Random effects model was used to combine ORs,and factors with P＜0.05 were selected to establish the model based on their regression coefficients.286 maintenance hemodialysis patients were selected as a validation cohort to evaluate the model's discrimination,calibration and clinical utility.Results 39 studies were included,involving 25 546 patients.14 factors were identified to establish the risk prediction model.The risk score for IDH occurrence was calculated as-0.301 × male+0.015 × age+0.004 × dialysis vintage+0.988 × diabetes+0.730 × cardiovascular disease-0.042 × predialysis systolic blood pressure+0.666 × dialysis mode of hemodialysis filter+0.076 × temperature+0.159 × ultrafiltration rate+0.476 × ultrafiltration volume+1.024 × weight gain between dialysis+0.053 × serum phosphorus+0.023 × blood urea nitrogen+0.040 ×β2-microglobulin.Definition in the Kidney Disease Outcomes Quality Initiative guideline,nadir intradialytic systolic blood pressure＜90 mmHg(1 mmHg=0.133 kPa),falling intradialytic systolic blood pressure ≥20 mmHg,and definition in the United Kingdom Kidney Association guideline were selected as 4 outcomes.The areas under the curve for the prediction model with respect to these 4 outcomes were 0.830,0.648,0.647,and 0.763,respectively.Calibration curves showed that the model predictive outcomes were consistent with actual outcomes for the first 2 outcomes(x2=14.824,P=0.064;x2=12.016,P=0.149).Decision curve analysis indicated that the model had better net benefit compared to either intervention/no intervention for all definitions.Conclusion The IDH risk prediction model developed by meta-modeling in this study has good predictive performance and certain application value.

Objective:To analyze the factors for low libido in male patients with sexual dysfunction and provide some evidence for the clinical diagnosis and treatment of the condition.Methods:We retrospectively analyzed the clinical data on 111 cases of sex-ual dysfunction(including disorders in erection,ejaculation or libido)treated in the Zhengzhou University First Hospital from June to September 2023.According to the patients'complaints of low libido or accompanied symptoms,we divided them into a normal libido group(n=68)and a low libido(n=43),obtained their scores on IIEF-5,Premature Ejaculation Diagnostic Tool(PEDT),13-1-tem Self-Rating Libido Scale for Males(SRLS-M),Patients'Health Questionnaire-9(PHQ-9)and General Anxiety Disorder-7(GAD-7),examined the levels of the sexual hormones FSH,LH,PRL,T,free testosterone(fT),E2,?insulin-like growth factor 1(IGF-1)and growth hormone(GH),compared the basic parameters between the two groups,and analyzed their correlation with the libido values.Results:The IIEF-5,PEDT and libido scores and IGF-1 level were significantly higher and the GAD-7 score remark-ably lower in the normal than in the low libido group(P＜0.05),but no statistically significant differences were observed between the two groups in the PHQ-9 score and the levels FSH,LH,PRL,T,fT,E2,T/E2 and GH(P＞0.05).The libido value was correla-ted positively with the I1EF-5(r=0.28,P＜0.01)and PEDT scores(r=0.29,P＜0.01)and IGF-1 level(r=0.23,P＜0.05),but negatively with the GAD-7 score(r=-0.21,P＜0.05).Conclusion:Low libido results from multiple factors,which cannot be fully explained by sexual hormone levels but is closely related to the decreased level of IGF-1 and severity of ED and anxiety.

Objective To explore the effects of monocular deprivation(MD)on the expression of astrocytes in the superior colliculus,hippocampus,and visual cortex in mice during the critical period of visual development.Methods Eighteen C57BL/6J mice were randomly divided into the normal control group(CON group)and the MD group,with 9 mice in each group.Mice were bred under the 12 h/12 h dark/light conditions.Mice in the CON group received no treat-ment,while mice in the MD group underwent MD of the right eye on postnatal day 27,and the tissue was removed after 7 days.The mRNA and protein expression levels of glial fibrillary acidic protein(GFAP)in the superior colliculus,hippo-campus and visual cortex of mice in the two groups were detected using the real-time reverse transcription quantitative pol-ymerase chain reaction(RT-qPCR)and Western blot,respectively.The number of astrocytes labeled by GFAP and central nervous system specific protein β(S100β)in the superior colliculus,hippocampus and visual cortex of mice in the two groups was detected using the immunofluorescence staining.Results RT-qPCR and Western blot results showed that compared with the CON group,the mRNA and protein expression levels of GFAP in the superior colliculus,hippocampus(CA1,CA3 and dentate gyrus)and visual cortex of mice in the MD group decreased,and the differences were statistically significant(all P＜0.05).The immunofluorescence staining results showed that compared with the CON group,the number of GFAP and S1OOβ co-labeled astrocytes in the superior colliculus,hippocampus(CA1,CA3 and dentate gyrus)and visual cortex of mice in the MD group decreased,and the differences were statistically significant(all P＜0.05).Conclusion MD of mice during the critical period of visual development can result in a decrease in the number of astrocytes in the supe-rior colliculus,hippocampus and visual cortex.

AIM:To investigate the optimal time of blood collection and the best concentration of Ganlong capsule(GLC)-containing serum for steatohepatitis.METHODS:Sixty C57BL/6J mice were gavaged with GLC at a dose of 90 mg/kg body weight,twice a day for 7 days.Control mice were administered the same volume of 0.9%saline.After 0.5,1,2 and 4 h from the last gavage,blood was collected to prepare GLC-containing serum.The LC-MS/MS was used to detect the inosine content of blank and drug-containing serum at different blood collection times to determine the optimal time.Subsequently,NCTC1469 cells stimulated with palmitic acid(PA)were treated with different concentrations of the GLC-containing serum.Nile Red staining was used to detect lipid droplet formation,and RT-qPCR was employed to as-sess the expression of intracellular fatty acid synthesis(Fabp1,Scd1)and fatty acid β-oxidation gene(Pparα).RE-SULTS:(1)LC-MS/MS detection revealed that the inosine concentration peaked 2 h after the last administration.(2)Nile red staining demonstrated that the GLC-containing serum exerted a dose-dependent decreasing trend of lipid droplets in hepatocytes induced by PA.(3)GLC-containing serum significantly downregulated the mRNA expression levels of lipo-genesis-genes(Fabp1 and Scd1)with a dose-dependent decreasing trend in the PA-induced NCTC1469 cells.The mRNA expression of genes associated with fatty acid β-oxidation(Pparα)were upregulated with a dose-dependent increasing trend.CONCLUSION:The 10%GLC-containing serum collected 2 hours after the last administration in mice has the best therapeutic effect for steatohepatitis.

The early response of plant auxin gene family Aux/IAA (auxin/indole-3-acetic acid) and its interaction with auxin response factor (ARF) are important pattern to regulate plant growth and development. This work identified 28 StoIAA and 24 StoARF members based on the whole genome data of the medicinal plant Senna tora L., which were classified into 10 and 8 subfamilies, respectively. Phylogenetic tree and collinearity analysis showed that S. tora has close evolutionary relationship with the IAA and ARF homologous genes of Glycine max, Medicago truncatula, and the segment duplication events dominate the expansion of StoIAA and StoARF. Gene structure analysis showed that the vast majority of StoIAA and StoARF contain characteristic conserved domain. Transcriptome data showed that StoIAAs and StoARFs were expressed in leaves, roots and seeds, some members had tissue specific expression. The StoIAA and StoARF promoter region most contain functional elements related to stress response, growth and development, hormone induction and secondary metabolism. In addition, gene expression analysis showed that many StoIAAs and StoARFs can quickly respond to drought and salt stress and exhibited same expression patterns under both stress condition. The yeast two-hybrid experiment confirmed that StoARF8 and StoARF10 exhibit varying degrees of interaction with multiple StoIAA proteins, respectively. The above results provide a basis for further biological functional analysis of the Aux/IAA and ARF gene family of S. tora.

italic>Salmonella has emerged as a promising tumor-targeting strategy in recent years due to its good tumor targeting ability and certain safety. In order to further optimize its therapeutic effect, scientists have tried to modify Salmonella, including its attenuation and drug loading. This paper summarizes the mechanism and research progress of Salmonella-mediated targeted tumor therapy, and introduces the strategies and related progress of its modification and optimization. At the same time, the advantages, current challenges and future development directions of Salmonella-mediated tumor therapy are summarized.