Microbiology and Immunology is one of core basic curriculums for medical college undergraduates.Combining with characteristics of this course,our teaching comprehension and background calling for curriculum ideological and political education,we consider blending traditional sinology classic"Thirty-Six Stratagems"in teaching of this curriculum.Meanwhile,its practical signif-icance on many aspects will be elucidated.This paper will provide useful reference for blending other sinology classics into ideological and political education of specialized curriculums.

To analyze the clinical characteristics and follow-up data of Chinese patients with calcium-sensing receptor (CaSR) signaling pathway related hypercalcemia. A retrospective analysis was conducted on six children with hypercalcemia admitted to Department of Endocrinology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from July 2017 to November 2022. Summarized the clinical and pathogenic variants, as well as follow-up data. The results showed that 3 were female and 3 were male of the 6 cases, aged from 2 months to 8 years at the consultation. The clinical symptoms varied from asymptomatic hypercalcemia to vomiting, dehydration, and growth retardation,as well as epilepsy and intellectual disability. Except for 1 case, which showed a significant increase in blood calcium (4.63 mmol/L), the blood calcium of other cases ranged from 2.98 to 3.17 mmol/L. Among the 6 patients, 5 had elevated parathyroid hormone, and 1 was normal. Three cases showed a significant decrease in 24-hour urinary calcium to creatinine ratio. Whole exome sequencing revealed that one patient had compound heterozygous variants and four had a heterozygous variants of CaSR gene, one patient had a heterozygous variant of AP2S1 gene. 1 case underwent total parathyroidectomy, followed by calcium supplementation, 3 cases received salmon calcitonin treatment, and 2 cases accepted low calcium diet, blood calcium levels were all controlled well. In conclusion, CaSR signaling pathway related hypercalcemia is rare. Gene detection is essential for children with hypercalcemia. Familial hypocalcemia hypercalcemia (FHH) can be effectively treated with salmon calcitonin.

To analyze the clinical characteristics and follow-up data of Chinese patients with calcium-sensing receptor (CaSR) signaling pathway related hypercalcemia. A retrospective analysis was conducted on six children with hypercalcemia admitted to Department of Endocrinology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from July 2017 to November 2022. Summarized the clinical and pathogenic variants, as well as follow-up data. The results showed that 3 were female and 3 were male of the 6 cases, aged from 2 months to 8 years at the consultation. The clinical symptoms varied from asymptomatic hypercalcemia to vomiting, dehydration, and growth retardation,as well as epilepsy and intellectual disability. Except for 1 case, which showed a significant increase in blood calcium (4.63 mmol/L), the blood calcium of other cases ranged from 2.98 to 3.17 mmol/L. Among the 6 patients, 5 had elevated parathyroid hormone, and 1 was normal. Three cases showed a significant decrease in 24-hour urinary calcium to creatinine ratio. Whole exome sequencing revealed that one patient had compound heterozygous variants and four had a heterozygous variants of CaSR gene, one patient had a heterozygous variant of AP2S1 gene. 1 case underwent total parathyroidectomy, followed by calcium supplementation, 3 cases received salmon calcitonin treatment, and 2 cases accepted low calcium diet, blood calcium levels were all controlled well. In conclusion, CaSR signaling pathway related hypercalcemia is rare. Gene detection is essential for children with hypercalcemia. Familial hypocalcemia hypercalcemia (FHH) can be effectively treated with salmon calcitonin.

[This corrects the article DOI: 10.1016/j.apsb.2021.08.015.].

【Objective】 To determine the value of quality assessment system in supervising standard clinical blood use and improving the quality of clinical blood transfusion medical records. 【Methods】 The clinical blood transfusion records of Children′s Hospital, Zhejiang University School of Medical every quarter from January 2019 to December 2022 were selected and extracted for evaluation by 5% to 10% for the current season. These blood transfusion medical records were scored and graded A(≥90 points)/B(80-89 points)/C(<80 points)according to the Evaluation Table of Clinical Science Rational Use of Blood in Children′s Hospital of Zhejiang University, and the annual A rate was statistically analyzed. After summarizing the deduction points, a rectification plan was submitted to the medical department and publicized on the hospital network. 【Results】 A total of 1 975 blood transfusion medical records were analyzed from January 2019 to December 2022, including 343 in 2019 (17.37%), 517 in 2020 (26.18%), 556 in 2021 (28.15%) and 559 in 2022 (28.30%), with Grade A rates at 67.06%, 92.07%, 93.17% and 91.06%, respectively. According to Pearson Chi-square test, the Grade A rates of blood transfusion records in 2020, 2021 and 2022 were significantly higher than those in 2019 (P<0.000 1). In the assessment, the main reasons for deduction of points were missed pre-transfusion immunization tests and missed blood transfusion course records. From 2019 to 2022, the missed rates of pre-transfusion immunization tests were 22.68%, 6.47%, 1.26% and 2.49%, and the missed rates of blood transfusion course records were 32.21%, 10.59%, 5.57% and 6.61%, respectively. 【Conclusion】 The regular and reasonable assessment and publicity system of blood transfusion medical records is conducive to improving the quality of blood transfusion medical records, promoting rational blood use and ensuring the safety of blood use for children.

OBJECTIVE: To explore the clinical characteristics and genetic basis for three children with Congenital chlorine diarrhea (CCD). METHODS: Three children with CCD who attended the Affiliated Children's Hospital of Capital Pediatric Institute from June 2014 to August 2020 were selected as the research subjects. Peripheral blood samples of the three children and their parents were collected for genetic testing. And the results were verified by Sanger sequencing. RESULTS: The clinical manifestations of the three children have included recurrent diarrhea, with various degrees of hypochloremia, hypokalemia and refractory metabolic alkalosis. Genetic testing revealed that the three children have all carried variants of the SLC26A3 gene, including homozygous c.1631T>A (p.I544N) variants, c.2063_1G>T and c.1039G>A (p.A347T) compound heterozygous variants, and c.270_271insAA(p.G91kfs*3) and c.2063_1G>T compound heterozygous variants. Sanger sequencing confirmed that all of the variants were inherited from their parents. CONCLUSION The variants of the SLC26A3 gene probably underlay the CCD in these children. Above finding has enriched the spectrum of SLC26A3 gene variants.
Humans ; Child ; Chlorine ; Genetic Testing ; Hypokalemia/genetics* ; Homozygote ; Diarrhea/genetics* ; Mutation

Objective:To evaluate the effect of the improved team-based learning (TBL) teaching method in the undergraduate probation course of ophthalmology based on the goal of cultivating excellent doctors.Methods:The undergraduates of clinical medicine were randomly divided into experimental group and control group. The control group ( n=50) was given conventional ophthalmology probation teaching, while the experimental group ( n=50) was given ophthalmology probation teaching of improved TBL teaching method. The theoretical examination performance and skill assessment results of students in the two groups were compared, and the subjective evaluation of the students on the teaching was also compared. SPSS 23.0 was used to conduct t-test and Wilcoxon's rank sum test. Results:The theoretical examination performance of experimental group (29.68±4.52) was better than that of control group (27.84±4.33), with significant differences ( P<0.05); the skill assessment results of experimental group (32.88±5.05) were also better than those of the control group (30.88±6.99), with significant differences ( P<0.05); the subjective evaluation of teaching effect in each item of experimental group was better than that of control group ( P<0.05). Conclusion:The improved TBL teaching method can not only improve students' theoretical knowledge and experimental skills, but also improve students' self-study and teamwork ability, which will provide a feasible educational reform plan for achieving the goal of cultivating excellent doctors.

Osteosarcoma is a kind of bone tumor with highly proliferative and invasive properties, a high incidence of pulmonary metastasis and a poor prognosis. Chemotherapy is the mainstay of treatment for osteosarcoma. Currently, there are no molecular targeted drugs approved for osteosarcoma treatment, particularly effective drugs for osteosarcoma with pulmonary metastases. It has been reported that fibroblast activation protein alpha (FAPα) is upregulated in osteosarcoma and critically associated with osteosarcoma progression and metastasis, demonstrating that FAPα-targeted agents might be a promising therapeutic strategy for osteosarcoma. In the present study, we reported that the FAPα-activated vinblastine prodrug Z-GP-DAVLBH exhibited potent antitumor activities against FAPα-positive osteosarcoma cells in vitro and in vivo. Z-GP-DAVLBH inhibited the growth and induced the apoptosis of osteosarcoma cells. Importantly, it also decreased the migration and invasion capacities and reversed epithelial-mesenchymal transition (EMT) of osteosarcoma cells in vitro and suppressed pulmonary metastasis of osteosarcoma xenografts in vivo. Mechanistically, Z-GP-DAVLBH suppressed the AXL/AKT/GSK-3β/β-catenin pathway, leading to inhibition of the growth and metastatic spread of osteosarcoma cells. These findings demonstrate that Z-GP-DAVLBH is a promising agent for the treatment of FAPα-positive osteosarcoma, particularly osteosarcoma with pulmonary metastases.

Presbyopia, a progressive visual difficulty caused by weakened physiological regulation, is one of the main causes of visual impairment in people over 40 years old. Currently, the main methods of correction of presbyopia include optical correction, surgical correction, and drug treatment, which can improve the visual nearness disorder to some extent. Optical correction is the most common way with advantages of safety, which can adjust the lens parameters at any time, while cause kinds of inconvenience in life by wearing and taking off glasses frequently. Surgical intervention, including corneal surgery, lens surgery and scleral surgery, with certain advantages and disadvantages in each operation style. New pharmaceutical agents are expected to be a new and effective method for the treatment of presbyopia, but it lacks multicenter randomized controlled trials and evidence-based medicine evidence to evaluate the safety and effectiveness.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.