[Objective]To analyze the academic characteristics in Verse on Jade-Dragon Acupoints(Yulong Ge)from Great Compendium of Acupuncture and Moxibustion(Zhenjiu Dacheng).[Methods]Taking Zhenjiu Dacheng:Yulong Ge as the research object,the academic characteristics of Zhenjiu Dacheng:Yulong Ge are explored by comparing it longitudinally with Bianque Shenying Zhenjiu Yulongjing:Great Hundred and Twenty Points Yulong Ge and the independent book Yulong Ge.[Results]Comparison showed Zhenjiu Dacheng:Yulong Ge supplemented details diseases and syndromes,emphasized tonification and sedation,with more advocates of"tonifying first and then sedating,more tonification and less sedation";added two new cases of trans-acupoint needling based on Yulong Jing,corrected the error of"Touwei through Xuanzhong"in Yulongjing;paid attention to acupuncture and moxibustion contraindications;standardized the size of moxa cones,proposed"twenty-one moxa cones"for Gaohuang moxibustion,which was in line with clinical practice;composed Shengyu Ge,simplifying the content,condensing the length,diseases and acupoints,which has an advantage in dissemination.[Conclusion]Rooted in clinical practice,combining his own academic ideas and clinical experience,integrating disease and syndrome differentiation,trans-acupoint needling techniques and standardization of moxibustion dosage,YANG made revisions to the Yulong Ge,which not only inherited the essence of DOU's acupuncture method,but also innovated to meet clinical needs and reflected YANG's academic characteristics.

Objective To explore the application of case-based learning(CBL)approach in the basic medical stage for eight-year clinical medical program.Methods A total of 320 students from the eight-year clinical medicine pro-gram at Peking Union Medical College in the grades of 2014-2015 and 2019-2020 were selected as the study subjects.These students were divided into two groups,162 students in the classes of 2014 and 2015 as the control group,and 158 students in the classes of 2019 and 2020 as the experimental group.The students in the control group received classic teaching in the basic medicine stage characterized by traditional lectures as the main teaching method.The students in the experimental group received traditional lectures supplemented by CBL.In this study,the cardiovascular system was taken as an example,and the assessment scores and questionnaires of the two groups of students were collected in order to evaluate the teaching effectiveness and to obtain timely teaching feedback.Results Traditional lecture combined with CBL method significantly improved the theory assessment scores of students in the experimental group,stimulated learning interest and intrinsic motivation,and enhanced team learn-ing and problem-solving ability.Students believed that CBL teaching could effectively improve the ability to link theory to clinical practice.In addition,CBL teaching method encouraged the interaction between teachers and students and improved teaching efficiency.Conclusions Well-designing and well-organized CBL teaching from multiple levels,including teachers,students,and curricula,can be better accepted and acknowledged by students from eight-year clinical medical program at the stage of basic medical education.

[Objective]To analyze the academic characteristics in Verse on Jade-Dragon Acupoints(Yulong Ge)from Great Compendium of Acupuncture and Moxibustion(Zhenjiu Dacheng).[Methods]Taking Zhenjiu Dacheng:Yulong Ge as the research object,the academic characteristics of Zhenjiu Dacheng:Yulong Ge are explored by comparing it longitudinally with Bianque Shenying Zhenjiu Yulongjing:Great Hundred and Twenty Points Yulong Ge and the independent book Yulong Ge.[Results]Comparison showed Zhenjiu Dacheng:Yulong Ge supplemented details diseases and syndromes,emphasized tonification and sedation,with more advocates of"tonifying first and then sedating,more tonification and less sedation";added two new cases of trans-acupoint needling based on Yulong Jing,corrected the error of"Touwei through Xuanzhong"in Yulongjing;paid attention to acupuncture and moxibustion contraindications;standardized the size of moxa cones,proposed"twenty-one moxa cones"for Gaohuang moxibustion,which was in line with clinical practice;composed Shengyu Ge,simplifying the content,condensing the length,diseases and acupoints,which has an advantage in dissemination.[Conclusion]Rooted in clinical practice,combining his own academic ideas and clinical experience,integrating disease and syndrome differentiation,trans-acupoint needling techniques and standardization of moxibustion dosage,YANG made revisions to the Yulong Ge,which not only inherited the essence of DOU's acupuncture method,but also innovated to meet clinical needs and reflected YANG's academic characteristics.

Background::Breast cancer (BC) risk-stratification tools for Asian women that are highly accurate and can provide improved interpretation ability are lacking. We aimed to develop risk-stratification models to predict long- and short-term BC risk among Chinese women and to simultaneously rank potential non-experimental risk factors.Methods::The Breast Cancer Cohort Study in Chinese Women, a large ongoing prospective dynamic cohort study, includes 122,058 women aged 25-70 years old from the eastern part of China. We developed multiple machine-learning risk prediction models using parametric models (penalized logistic regression, bootstrap, and ensemble learning), which were the short-term ensemble penalized logistic regression (EPLR) risk prediction model and the ensemble penalized long-term (EPLT) risk prediction model to estimate BC risk. The models were assessed based on calibration and discrimination, and following this assessment, they were externally validated in new study participants from 2017 to 2020.Results::The AUC values of the short-term EPLR risk prediction model were 0.800 for the internal validation and 0.751 for the external validation set. For the long-term EPLT risk prediction model, the area under the receiver operating characteristic curve was 0.692 and 0.760 in internal and external validations, respectively. The net reclassification improvement index of the EPLT relative to the Gail and the Han Chinese Breast Cancer Prediction Model (HCBCP) models for external validation was 0.193 and 0.233, respectively, indicating that the EPLT model has higher classification accuracy.Conclusions::We developed the EPLR and EPLT models to screen populations with a high risk of developing BC. These can serve as useful tools to aid in risk-stratified screening and BC prevention.

OBJECTIVE: To demonstrate the mechanism of mechanical ventilation (MV) induced endoplasmic reticulum stress (ERS) promoting mechanical ventilation-induced pulmonary fibrosis (MVPF), and to clarify the role of angiotensin receptor 1 (AT1R) during the process. METHODS: The C57BL/6 mice were randomly divided into four groups: Sham group, MV group, AT1R-shRNA group and MV+AT1R-shRNA group, with 6 mice in each group. The MV group and MV+AT1R-shRNA group mechanically ventilated for 2 hours after endotracheal intubation to establish MVPF animal model (parameter settings: respiratory rate 70 times/minutes, tidal volume 20 mL/kg, inhated oxygen concentration 0.21). The Sham group and AT1R-shRNA group only underwent intubation after anesthesia and maintained spontaneous breathing. AT1R-shRNA group and MV+AT1R-shRNA group were airway injected with the adeno-associated virus one month before modeling to inhibit AT1R gene expression in lung tissue. The expressions of AT1R, ERS signature proteins [immunoglobulin heavy chain-binding protein (BIP), protein disulfide isomerase (PDI)], fibrosis signature proteins [collagen I (COL1A1), α-smooth muscle actin (α-SMA)] in lung tissues were detected by immunofluorescence and Western blotting. Hematoxylin-eosin (HE) staining was used to evaluate lung injury and Masson staining was used to evaluate pulmonary fibrosis. RESULTS: Compared with the Sham group, the degree of pulmonary fibrosis and lung injury were more significant in the MV group. In the MV group, the protein expressions of AT1R, BIP, PDI, COL1A1 and α-SMA were increased (AT1R/β-actin: 1.40±0.02 vs. 1, BIP/β-actin: 2.79±0.07 vs. 1, PDI/β-actin: 2.07±0.02 vs. 1, COL1A1/α-Tubulin: 2.60±0.15 vs. 1, α-SMA/α-Tubulin: 2.80±0.25 vs. 1, all P < 0.01). The number of E-cad⁺/AT1R⁺ and E-cad⁺/BIP⁺ cells in lung tissue increased, and the fluorescence intensity of COL1A1 and α-SMA increased. Compared with the MV group, the degree of pulmonary fibrosis and lung injury were significantly relieved in the MV+AT1R-shRNA group. In the MV+AT1R-shRNA group, the protein expressions of AT1R, BIP, PDI, COL1A1 and α-SMA were decreased (AT1R/β-actin: 0.53±0.03 vs. 1.40±0.02, BIP/β-actin: 1.73±0.15 vs. 2.79±0.07, PDI/β-actin: 1.04±0.07 vs. 2.07±0.02, COL1A1/α-Tubulin: 1.29±0.11 vs. 2.60±0.15, α-SMA/α-Tubulin: 1.27±0.10 vs. 2.80±0.25, all P < 0.01). The number of E-cad⁺/AT1R⁺ and E-cad⁺/BIP⁺ cells in lung tissue decreased, and the fluorescence intensity of COL1A1 and α-SMA decreased. There was no statistically significant difference in the indicators between AT1R-shRNA group and Sham group. CONCLUSIONS MV up-regulate the expression of AT1R in alveolar epithelial cells, activate the AT1R pathway, induce ERS and promote the progression of MVPF.
Mice ; Animals ; Pulmonary Fibrosis/chemically induced* ; Lung Injury ; Respiration, Artificial/adverse effects* ; Actins/metabolism* ; Tubulin ; Mice, Inbred C57BL ; Endoplasmic Reticulum Stress ; RNA, Small Interfering

Objective: To propose the concept of a novel regional control and prevention (RCP) system for the outbreak of COVID-19 infectious disease, design an emergency epidemic prevention information system based on the existing network architecture and information system in the region, and a remote intelligent medical consultation and remote office platform, research and develop the technology of risk assessment and early warning for people in the region, and improve the regions’prevention and control ability facing emergency of major infectious diseases. Methods: Taking colleges, affiliated (teaching) hospitals, and cloud applications as typical RCP regional units, the existing local area network interaction methods between the cloud and universities and affiliated (teaching) hospitals are established to realize remote work in the network environment, remote medical imaging, psychological and ethical consultation and interaction; applying multi-agent propagation model based on complex network, combining Global Positioning System (GPS), Radio Frequency Identification (RFID), and electronic fence technology, to realize the risk classification and early warning of units and personnel in the area. Results: In the RCP, a system architecture combining campus network, affiliated (teaching) hospital intranet, and the Internet is used. Dynamic connection is made using distributed technology and cloud storage. The data buffer mechanism of the intermediary database in the network realized telemedicine consultation and telecommuting. Relying on the platform, multi-agent propagation model based on complex network and cellular automaton model are used to realize the score and early warning of population exposure risk in the region by using GPS, RFID and electronic fence technology. Conclusions In the epidemic phase of major infectious diseases, the construction of RCP can improve the response speed of wartime epidemic prevention, provide reasonable data-based warnings and risk ratings, and reduce the exposure risk of susceptible people. The design and development of RCP is a systematic project that needs to combine regional structural and functional characteristics, and the foundation of the early informatization work in the region and the level of the emergency development team determine the development progress, maintenance, and actual application effects. It is recommended to establish a peacetime and wartime combined RCP mode and incorporate it into the government's disease control system to improve the national and regional level of prevention and control of major infectious diseases.

Objective:To investigate the effect of MCC950 (a NLRP3 inflammasome inhibitor) on cognitive impairment in mice with radiation-induced inflammatory brain injury.Methods:Mice were divided into normal (NS) group, whole body irradiation (IR) group and MCC950 intervention post irradiation (IR+ MCC950) group according to the random number table method, with 15 mice in each group. The mice in IR group and IR+ MCC950 group were irradiated with a single dose of 4.0 Gy. The radiation source was 137Cs and the dose rate was 1.118 Gy/min. The mice in NS group were not irradiated. Mice in IR+ MCC950 group were injected intraperitoneally with MCC950 once a day (10 mg/kg each time) from 3 weeks after irradiation. Behavioral tests such as new and old things recognition experiment and social cognition experiment were used to detect the cognitive function of mice. Immunohistochemistry was used to detect the expression of NeuN protein in CA3 area of mouse hippocampus. PCR and Western blot were used to detect the expression of NLRP3 inflammatory body related protein. Results:Compared with NS group, the short-term and long-term recognition index of new and old things in the IR group decreased significantly ( t=4.321, 5.473, P<0.01), and the social cognitive recognition index of the IR group also decreased significantly ( t=2.097, P<0.05). MCC950 treatment reversed the above changes (short-term and long-term new and old thing recognition test: t=5.860, 4.598, P<0.05; new and old position recognition test: t=3.040, P<0.05; social cognition test: t=4.021, P<0.01). The expression of NLRP3, Caspase-1, IL-1 β and IL-18 in mice hippocampus of the IR group was significantly higher than that of the control group ( t=2.699, 8.515, 3.340, 3.950, P<0.05). Compared with NS mice, radiation significantly increased the expressions of Bax, Caspase-3 and PARP1 in hippocampus ( t=3.887, 2.742, 3.287, P<0.05), while MCC950 significantly decreased the expressions of Bax, Caspase-3 and PARP1( t=2.852, 4.090, 9.614, P<0.05). Conclusions:NLRP3 inflammasome inhibitor MCC950 could alleviate radiation-induced cognitive impairment, which may be due to the inhibition of hippocampal inflammatory and neuronal death.

Objective: To identify potential relationship between single uncoding RNA-25-3p (miR-25-3p) expression level and the sertraline efficacy in patients with panic disorder. Methods: Sixty cases of patients with panic disorder(case group) and sixty healthy-controls(control group) were collected with demographic data and peripheral venous blood before and after treatment.All the patients were evaluated using the 14-item Hamilton Anxiety Rating Scale (HAMA) and Panic Disorder Severity Scale (PDSS) at baseline, and then received sertraline treatment for 6 weeks.After six-week treatment, each patient was evaluated again with HAMA and PDSS.RT-PCR was used to detect the level of miR-25-3p expression. Results: There was no significant difference in the miR-25-3p levels between control group (1.27±0.32) and case group (1.73±1.09) before treatment(t=1.53, P=0.14), but the levels in case group were much higher than that in control group after the treatment (5.72±4.13 vs 1.73±1.09, t=-2.15, P=0.04). Besides, the changes of the miR-25-3p levels were positively related with both the changes of PDSS3 and PDSS7 items before and after the treatment (r=0.60, P=0.02 for PDSS3 and r=0.61, P=0.02 for PDSS7). Conclusions miR-25-3p is associated with the drug efficacy and the outcome of some clinical symptoms of panic disorder.These findings might provide some evidence for the individualized treatment of patients with panic disorder according to regulation of gene expression in the future.

Objective To assess the expression of T cell subset in patients with hepatitis B virus-associated primary liver cancer (HBV-PLC) and its influence on the clinical outcome.Methods 136 cases with PLC were selected, and divided into HBV-PLC group (78 cases) and non-HBV-PLC group (58 cases) according to HBV infection.The percentage of CD4+T cells, CD8+T cells and Treg cells in serum was tested by flow cytometry.After 6 months of follow-up, HBV-PLC patients were divided into death group and survival group.Binary logistic regression analysis was performed to explore the factor and degree affecting clinical outcome of HBVPLC patients.Results As compared with non-HBV-PLC group, dysregualted T cell subset was observed in the HBV-PLC group, percentage of CD4+T cells and Treg cells in HBV-PLC patients was higher (P＜0.05), while CD8+T cell percentage was decreased (P＜0.05).The percentage of CD4+T cells and Treg cells was higher in death group than survival group (P＜0.05), but CD8+T cell percentage was lower than that of survival group (P＜0.05).T-lymphocyte subset (CD4+T cells and Treg cells) was a strong risk factor for adverse clinical outcome of HBV-PLC (OR values were 3.765 and 2.238, respectively, P＜0.05), but CD8+T cell was a protective factor (OR value was-3.537, P＜0.05).Conclusion Obvious dysfunction of T cellular immune function exists in HBV-PLC patients, and T cell subset may be a predictive factor for clinical outcome of HBV-PLC patients.

Objective To investigate the protective effect and mechanism of environmental enrichment(EE)on radiation induced cognitive dysfunction in mice.Methods A total of 45 female Kunming mice(2-month old)were randomly divided into control group,irradiation group and irradiation plus EE group with 15 in each group.Irradiation group and irradiation plus EE group were treated with a single dose of 4 Gy whole body irradiation,irradiation plus EE group were housed in EE condition for 35 d after irradiation.The object recognition task was used to evaluate the cognitive function of mice.The expression of microglial marker IBA-1 in hippocampus was determined by immunohistochemical staining.The expressions of CD68 and synaptophysin(SYP)proteins in hippocampus were assayed by Western blot.Results Compared with control group,the irradiation group had a low discrimination ratio in object recognition task and had a remarkable low level of SYP expression in hippocampus(t＝3.66,6.84,P＜0.05).In addition,radiation activated microglia in hippocampus by increasing the number of IBA-1-positive cells and enhancing the expression of CD 68(t ＝6.83,5.79,P ＜0.05).Compared with irradiation group,irradiation plus EE group increased the discrimination ratio and the expression of SYP in hippocampus(t＝3.56,4.06,P＜0.05),while the number of IBA-1-positive cells and the expression of CD68 were significantly reduced(t＝7.69,4.59,P＜0.05).Conclusions A single dose of 4 Gy whole body irradiation leads to cognitive dysfunction in mice,while EE could effectively improve the animals′cognitive behavior possibly by inhibiting microglial activation and preventing synapse loss in hippocampus.