Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

Objective·To explore EDAR(ectodysplasin A receptor)gene variants that lead to congenital tooth agenesis,and preliminarily analyze the reasons why variants in EDAR can cause both syndromic and non-syndromic tooth agenesis.Methods·Patients with congenital tooth agenesis admitted to the Department of 2nd Dental Center,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine and their family members were included,and genomic DNA from their peripheral blood was extracted for whole exome sequencing(WES).After preliminary screening,PolyPhen-2,Mutation Taster,and Provean were used to predict the harmfulness of potential variants.The screened variants in patients and their families were verified by Sanger sequencing.Conservation analysis of variants was performed,and Swiss-Model was used to analyze the changes in the three-dimensional structure of EDAR.The teeth and syndromic phenotype of the patients and their family members were investigated.Results·Among the included congenital tooth agenesis patients,five patients with EDAR mutations were found,one with EDAR frameshift mutation c.368_369insC(p.L123fs)and the other four with EDAR missense mutations.Two of these four patients were diagnosed as non-syndromic tooth agenesis(NSTA),resulted from c.77C＞A(p.A26E)homozygous mutation and c.380C＞T(p.P127L)heterozygous mutation,respectively.The other two patients with two variants were diagnosed as hypohidrotic ectodermal dysplasia(HED).One compound heterozygous missense mutation patient carried EDAR c.77C＞T(p.A26V)from her father andEDAR c.1281G＞C(p.L427F)from her mother;the other patient with both EDAR and EDA mutations carried EDAR c.1138A＞C(p.S380R)heterozygous mutation and EDA c.1013C＞T(p.T338M)hemizygous mutation.Both variants were from his mother and were reported to be related with NSTA.Two of these missense mutations,EDAR c.1281G＞C(p.L427F)and EDAR c.77C＞A(p.A26E),had not been reported before.The missense mutations affected the protein's spatial conformation by altering the polarity,charge,or volume of the amino acid residues.The frameshift mutation caused a non-triplet base addition,which probably led to protein truncation or degradation.Conclusion·Two new EDAR missense mutations are discovered.An NSTA patients with EDAR homozygous mutations and an HED patient with both EDA and EDAR mutations are reported.It expands the understanding of pathogenic mechanisms of EDAR mutations causing HED and NSTA.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective: To study the adaptive response and time effect of A549 cell apoptosis induced by low-dose X-ray irradiation, and to preliminarily explore the possible mechanism of adaptive effect.  Methods: A549 cells were irradiated with X-ray of 50 mGy, 200 mGy and 500 mGy, respectively, and then irradiated with an effect dose of 20 Gy after intervals of 3 h, 6 h, 12 h, 24 h and 48 h, respectively, for cell apoptosis detection. The cell cycle distribution and DNA damage were detected after an interval of 6 h between the initial dose and the effect dose. 20 Gy and 0 Gy were set as the control. Results: After irradiation at 20 Gy at intervals of 3 h, 6 h, 12 h and 24 h from the low- dose irradiation, the apoptosis rates of the 50 mGy～20 Gy, 200 mGy～20 Gy, and 500 mGy~ 20 Gy groups were significantly lower than that of the 20 Gy group (P < 0.05); after an interval of 48 h, there was no significant difference in the apoptosis rate between the 50 mGy～20 Gy, 200 mGy～20 Gy, and 500 mGy～20 Gy groups and the 20 Gy group. After an interval of 6 h between the low-dose irradiation and the effect dose irradiation, the percentage of cells at G0/G1 phase in the 50 mGy～20 Gy and 200 mGy～20 Gy groups was significantly lower than that in the 20 Gy group (P < 0.05); the percentage of cells at G2/M phase in the 50 mGy～20 Gy and 200 mGy~20 Gy groups were significantly reduced compared with the 20 Gy group (P < 0.05). There was no significant difference in the percentage of cells at G0/G1 and G2/M phases between the 500 mGy～20 Gy and 20 Gy groups. Compared with the 20 Gy group, the cell DNA damage in the 50 mGy～20 Gy, 200 mGy～20 Gy and 500 mGy~20 Gy groups were decreased, but without significant difference.  Conclusion Low-dose X-ray irradiation can induce the adaptive response of A549 cells apoptosis, which is related to the time interval between the initial dose and the effect dose. The adaptive effect may be related to the changes in cell cycle induced by low-dose X-ray.

Objective:To study the effect of heating skin disinfectant during peripherally inserted central catheter (PICC) in preterm infants.Methods:Premature infants were retrospectively analyzed who received PICC catheterization during hospitalization in the Department of Neonatology of the Affiliated Hospital of Southwest Medical University from April 2020 to March 2021. They were divided into the control and heating groups according to different disinfection methods in two different periods. The skin of premature infants in the heating group was disinfected with disinfectant at 37℃, and the control group was disinfected with room temperature disinfectant. The rate of successful primary catheterization, operation duration, and catheter-associated infection were compared between the two groups.Results:The rate of successful primary catheterization in the heating group was higher than that of the control group [80.2% (65/81) vs. 66.7% (56/84)], and the operation time was shorter than that of the control group [(45.0±9.0) min vs. (48.4±11.9) min] ( P<0.05). There was no statistical difference in catheter keeping time, unplanned extubation rate, the rate of positive catheter tip cultures, and the blood cultures. Conclusions:During PICC puncture in premature infants, heating skin disinfectant can increase the success rate of one-time PICC catheterization, reduce the operation duration, and not increase the risk of catheter-associated infection.

The training effects of experimental courses determine the practical abilities of undergraduate students. Therefore, it is essential to establish a comprehensive experimental course system that adapts to the undergraduate education of environmental science. Here, we introduce the "basic-specialized-comprehensive" experimental course system of Xiamen University, which is established following the principles of being systematic, comprehensive, and modular. To establish this course system, we first increased the investment of lab facilities and enhanced the management of student labs. Then, we improved the contexts of teaching and training according to the requirements of industry and society. Showing how this course system is developed stepwise and the training effects of this system, we hope to provide a reference for the experimental courses of environmental science in colleges and universities.
Curriculum ; Environmental Science ; Humans ; Students ; Universities

Objective: To understand the concern of freshmen with different characteristics on sexual knowledge in Sichuan province and to provide evidence for comprenensive sex education in colleges. Methods: A survey was conducted among 2 532 freshmen from 13 universities in Sichuan Province in September 2018. Attention to specific sexual knowledge among students with different characteristics was analyzed. Results: Sexual knowledge that the freshmen concerned included partner communication (39.25%~55.10%), STD and AIDS (37.78%~44.85%) and gender equality (33.33%~43.34%). Logistic regression results showed that male students payed more attention to partner communication(OR=0.77,95%CI=0.65-0.91), masturbation (OR=0.36，95%CI=0.27-0.47) and sexual minorities (OR=0.61,95%CI=0.41-0.90), while female students payed more attention to gender equality (OR=1.31,95%CI=1.10-1.57), sexual harassment and violence (OR=1.65,95%CI=1.37-1.98). Rural students pay. more attention to partner communication (OR=0.79,95%CI=0.65-0.94), while urban students pay. more attention to masturbation (OR=1.50,95%CI=1.08-2.08), sexual harassment and sexual violence (OR=1.30,95%CI=1.07-1.58). Students who had sex were more concerned about contraception and unwanted pregnancy than those who had not (OR=0.53,95%CI=0.39-0.72). Sexual minority students were more concerned about topic of sexual minorities than heterosexual students (OR=3.50,95%CI=2.30-5.33). Conclusion College freshmen with different characteristics varied in their concern on sexual knowledge, which is related to their needs. It is suggested that schools set up comprehensive education courses according to the needs of students, the content of sex education knowledge can be focused, and carry out comprehensive and targeted sex education.

Virtual simulation experiments use the virtual simulation technology to simulate the exper-imental process and experimental instrument,which is intuitive, sharing and cost-saving. Due to the single form of traditional experiment of sanitary chemicals in cosmetics testing and the limitation of experimental time, place and funding, this paper attempts to apply the virtual simulation experiment to sanitary chemicals in cosmetics testing experiment teaching. From the aspects of optimizing experimental items, organizing virtual simulation experiments and evaluating teaching effects, this paper discusses the application of virtual simulation experiment in sanitary chemicals in cosmetics testing experiment teaching.