Objective:To analyze the role of learning engagement and learning burnout in the relationship between supervisors' guidance and the personal ability of postgraduates in the Professional Master's Program in Clinical Medicine.Methods:A total of 4 016 postgraduates in the Professional Master's Program in Clinical Medicine from 61 colleges were surveyed in 2020. Common method bias was assessed using the Harman's single factor test and total score was determined by the entropy weight method. Causality and mediation effect were analyzed by linear regression, and mediation effect was tested by Bootstrapping.Results:The average scores of supervisors' guidance, learning burnout, learning engagement and personal ability were (4.13±0.87), (2.49±1.11), (3.88±0.83), and (3.71±0.78), respectively. Supervisors' guidance significantly and positively impacted learning engagement ( β=0.689, P<0.001) and personal ability ( β=0.504, P<0.001). Learning engagement played a partial mediating role (89.30% of mediation effect) between supervisors' guidance and personal ability. Learning burnout (interaction term β=0.078, P<0.001) positively regulated the relationship between supervisors' guidance and learning engagement. Conclusions:Learning engagement can mediate the effect of supervisors' guidance on the personal ability of postgraduates in the Professional Master's Program in Clinical Medicine, and learning burnout positively regulates the effect of supervisors' guidance on learning engagement. Strengthened supervisors' guidance, increased attention to students' learning burnout, and enhanced learning engagement can further improve the personal abilities of postgraduates in the Professional Master's Program in Clinical Medicine.

Objective:To investigate the "burnout-engagement continuum" status of postgraduate supervisors of the Professional Master's Program in Clinical Medicine and to identify key populations.Methods:From October to November 2023, an anonymous online questionnaire survey was conducted to determine the "burnout-engagement continuum" status of postgraduate supervisors of the Professional Master's Program in Clinical Medicine. The scores of different dimensions of job burnout are expressed as mean±standard deviation, and the distribution of supervisors of different status is presented in frequency and percentage. All data analyses were performed in R 4.3.1. Distribution of the five profiles among supervisors of different status was compared using the chi-square test and compared pairwise using the Bonferroni method.Results:A total of 2 664 valid questionnaires were collected. The scores of emotional exhaustion, cynicism and personal accomplishment were（2.46±0.95),（1.74±0.89), and（4.23±0.90), respectively. The prevalence of job engagement, inefficacy, overexertion, disengagement, and burnout among the supervisors were 42.76%（1 139/2 664), 43.54%（1 160/2 664), 33.03%（880/2 664), 14.71%（392/2 664), and 13.66%（364/2 664), respectively. In terms of demographics, the distribution of the "burnout-engagement continuum" was significantly different by age, sex, marital status, and highest education level（ P<0.05). In terms of work-related characteristics, the distribution of the "burnout-engagement continuum" was significantly different by income, professional title, administrative position, and working hours on weekdays and holidays（ P<0.05). The distribution of engagement, inefficacy, and overexertion was significantly different between the eastern and western regions（ P<0.05). Conclusions:There is a high percentage of individuals with burnout among postgraduate supervisors of the Professional Master's Program in Clinical Medicine, and inefficacy is a common negative state. Supervisors who work in the western regions, are under 45 years of age, are male, are married, have a doctorate degree, hold associate senior professional title, have lower relative income, are not holding administrative duties, and work more than 10 hours on workdays and more than 4 hours on holidays are key populations that require increased attention. The psychological state of supervisors can be improved by providing them with more resources, work benefits, and incentives.

Objective:To investigate the satisfaction with team construction and occupational burnout among postgraduate supervisors in clinical medicine in China, and to analyze the relationship of the above two factors with the willingness to hold a position again in the school.Methods:A survey covering 3 409 postgraduate supervisors in clinical medicine across 33 colleges and universities was conducted. Analysis of variance, multiple linear regression analysis, and logistic regression analysis were performed to explore the relationship of satisfaction with team construction and occupational burnout with the willingness to hold a position again in the school among supervisors.Results:In various dimensions of satisfaction with team construction among postgraduate supervisors in clinical medicine, the mechanism of selection scored the highest (4.74±0.53), followed by indicators for selection (4.71±0.56), supervisor training (4.66±0.58), supervisor assessment (4.64±0.65), incentives for teaching (4.61±0.65), and career development (4.56±0.74). Indicators for selection ( OR=2.121) and career development ( OR=2.461) were positively correlated with supervisors' willingness to hold a position again in the school. The degree of being cynical, one of the assessment dimensions of occupational burnout, played a partially mediating role between satisfaction with supervisor team construction and the willingness to hold a position again in the school. Conclusions:Postgraduate supervisors in clinical medicine in China are generally satisfied with supervisor team construction. The degree of their satisfaction and occupational burnout influence their willingness to hold a position again in the school. Therefore, colleges and universities should optimize indicators for selection and provide more diverse career development opportunities for supervisors to enhance supervisors' satisfaction and loyalty.

Objective:To understand the evaluation of graduate education quality by medical graduate supervisors in China, to identify the shortcomings of graduate education quality, and to put forward corresponding suggestions.Methods:From October to November 2023, a self-designed questionnaire was used to investigate the evaluation of school management, supervisor team construction, graduate training process, and graduate training results by 6 025 medical graduate supervisors from 37 universities in China. SPSS 26.0 was used to conduct t-test and analysis of variance to explore the differences in scores given by different supervisor groups for various aspects. Results:The scores given by medical graduate supervisors for school management, supervisor team construction, graduate training process, and graduate training results were (4.63±0.60), (4.59±0.62), (4.58±0.59), and (4.54±0.62), respectively. Supervisors who work in clinical medicine, aged 46-55 years, with 5 or fewer years of teaching experience, supervising master's students, instructing only professional degree students, instructing three or fewer students, holding a bachelor's degree as their highest degree, with the title of professor, holding an administrative position, and working an average of 8-9 hours per day on weekdays and 4 or fewer hours per day on holidays, gave higher scores on all aspects of graduate education quality ( P<0.05). Conclusions:The supervisors gave high scores on the quality of medical graduate education. It is suggested that the quality of graduate education should be continuously improved by optimizing school management systems, strengthening the construction of supervisory teams, and focusing on the process and results of graduate education.

Objective:To analyze the scores and differences of various aspects of public health graduate education management in China, and to provide suggestions for universities to enhance graduate education management.Methods:Based on the data from the 2021 National Survey on Education Satisfaction and Job Evaluation of Medical Graduate Supervisors, we described the public health graduate education management in China from the five perspectives of student enrollment, curriculum, practice, research, and school management. The t-test and analysis of variance were used to analyze the differences in individual characteristics. Multiple linear regression was used to analyze factors influencing the scores of public health graduate education management. Results:Supervisors gave the highest score to curriculum and teaching (mean score, 4.00±0.77), followed by management system and input (mean score, 3.97±0.87), research conditions and achievements (mean score, 3.93±0.80), practical education conditions and effects (mean score, 3.80±0.91), and discipline attractiveness and enrollment quality (mean score, 3.70±0.84). Supervisors who supervised professional degrees, doctoral students, and located in the eastern region gave relatively high scores to public health graduate education, and those with associate professor titles gave relatively low scores.Conclusions:The quality of students recruited for public health graduate education needs to be improved, curriculum design and teaching method need to be adjusted, practice conditions need to be improved, research funding is insufficient, and the construction of academic communication platforms needs to be improved. The relevant universities/colleges need to strengthen the management and increase the investment to promote the high-quality development of public health graduate education.

Objective:To observe the relationship between early quality of life symptom clusters and psychological stress and its influencing factors,so as to lay a foundation for clinical timely control of symptom clusters,improving of psychological stress state,and improving the early quality of life after lung cancer surgery.Methods:A total of 248 patients with lung cancer who received surgical treatment in our hospital from Oct 2021 to Oct 2023 were selected to evaluate their general condition,quality of life,symptom clusters,and psychological stress by general situation questionnaire,Functional Assessment of Cancer Therapy(FACT),Anderson Symptom Assessment Scale,and Symptom Self-Rating Scale(SCL-90).Pearson method was used to analyze the correlation between FACT score symptom clusters and SCL-90 score.On the basis of multivariable logistic regression analysis,cumulative ratio regression model was used to analyze the early quality of life after lung cancer surgery.Results:A total of 239 patients with lung cancer were enrolled.FACT-L score was(53.66±6.85),SCL-90 score was(109.24±11.97),symptom clusters score was(104.03±16.83),including 117 patients in low group,69 patients in middle group,and 53 patients in high group,48.95%,28.87%and 22.18%,respectively.Pearson analysis showed that FACT score was negatively correlated with SCL-90 score and symptom clusters(r value was-0.779 and-0.737,respectively,P＜0.05).Multivariate cumulative ratio logistic regression analysis showed that seven factors including clustered airway management and sleep quality were protective factors for early quality of life after lung cancer surgery(P＜0.05),and malnutrition,pain degree,operation duration,SCL-90 score and symptom clusters score were risk factors for early quality of life after lung cancer surgery(P＜0.05).Conclusions:The influencing factors of early postoperative quality of life of lung cancer patients come from many aspects.Clinical prevention and control strategies can be formulated according to the influencing factors to improve the level of early postoperative quality of life of lung cancer patients.

Objective To explore the role of breast/ovarian cancer susceptibility gene 1 associated protein 1(BAP1)in the occurrence and progression of human malignant glioma and the feasibility of BAP1 as a clinical diagnostic marker for malignant glioma.Methods The differential expression of BAP1 in normal and glioma tissue was analyzed based on the GSE4290 and GSE90598 sub-datasets from the gene expression omnibus(GEO)database.Receiver operating characteristic(ROC)curve analysis was conducted to assess the early diagnostic value of BAP1 for malignant glioma.Primary lesion tissues from 28 nonpaired malignant glioma patients and non-tumor brain tissues removed by internal decompression surgery in 5 patients with traumatic brain injury collected independently were collected,and the expression levels of BAP1 were measured using quantitative real-time polymerase chain reaction(qRT-PCR).Specific small interfering RNAs(siRNAs)targeting BAP1 were transiently transfected into U251 cells to further evaluate their interference efficiency.Flow cytometry was employed to analyze changes in the cell cycle and apoptosis of U251 cells with BAP1 knockdown.Results The results of bioinformatics showed that the expression of BAP1 in malignant glioma tissues was lower than that in normal brain tissues(GSE 4290:1 209±18.49 vs 1 476±53.90,GSE 90598:5.19±0.10 vs 5.65±0.21),and the differences were significant(t=5.115,2.267,all P<0.05).ROC curve showed that BAP1 could efficiently differentiate malignant glioma tissue from normal brain tissue(GSE4290:AUC=0.78,GSE90598:AUC=0.75,all P<0.05).The expression level of BAP1 in primary malignant glioma tissue was lower than that in normal brain tissue(0.27±0.04 vs 1.06±0.07),and the difference was significant(t=10.22,P<0.001).After down-regulating the expression of BAP1 in U251 cells,the proportion of S phase cells increased from 17.59%to 27.21%(siBAP1-1)and 25.79%(siBAP1-2),respectively,and the differences were significant(t=6.576,6.642,all P<0.01).However,the apoptosis levels decreased from 10.17%to 2.70%(siBAP-1)and 3.00%(siBAP-2),respectively,and the differences were significant(t=10.31,9.428,all P<0.01).Conclusion Histone H2A deubiquitinase BAP1 could exert the function of tumor suppressor genes by inhibiting rapid cell cycle progression and promoting apoptosis in malignant glioma,and could serve as a potential clinical diagnostic biomarker for malignant glioma.

BACKGROUND:Intervertebral disc degeneration is clinically considered to be the main cause of low back pain,but due to the unclear pathogenesis of intervertebral disc degeneration,there is still a lack of effective means to delay the progression of the disease.Single-cell RNA sequencing technology can amplify and sequence mRNA at the single-cell level,reveal the gene expression intensity of a single cell,discover different cell subsets in tissues according to the heterogeneity of cells,study the pathogenesis of intervertebral disc degeneration at the molecular level,and provide a new theoretical basis for its early diagnosis and treatment. OBJECTIVE:To introduce the basic principles of single-cell RNA sequencing technology and review the research progress of single-cell RNA sequencing technology in intervertebral disc degeneration in recent years. METHODS:A computer was used to search PubMed,Web of Science,CNKI and WanFang databases for the literature published from 2012 to 2022.Key words were"single-cell RNA sequencing,intervertebral disc degeneration,sequencing Technology"in Chinese and English.Duplicate,poor-quality and irrelevant articles were excluded;a total of 70 articles were eventually included. RESULTS AND CONCLUSION:(1)We identified new cell subsets such as homeostatic chondrocytes,hypertrophy chondrocyte-like nucleus pulposus cells and fibrous nucleus pulposus cells,identified the marker genes and transcription factors of these cell subsets,and described the functions,differentiation paths and cell fate of these cell subsets during the development and progression of intervertebral disc degeneration,and proposed the concept of progenitor nucleus pulposus cells.A cell subpopulation with progenitor nucleus pulposus cells properties was identified and its effectiveness in treating intervertebral disc degeneration was verified in mice.(2)Fibro chondrocyte-like annulus fibrosus cells and annulus fibrosus stem cells with both cartilage and fiber properties were identified,and a new type of composite hydrogel was prepared by combining fibrous cartilage inducers silk fibroin and hyaluronic acid in vitro.Experiments in mice demonstrated that this hydrogel could repair both annulus fibrosus tissue and cartilage matrix,and was remarkably effective in the treatment of intervertebral disc degeneration.(3)Regulatory chondrocytes were found in endplate cartilage.Two distinct fates in the progression of intervertebral disc degeneration were analyzed and the differential genes in the two fates were identified.Intercellular communication analysis indicated that regulatory chondrocytes interact with endothelial cells to promote angiogenesis.(4)Immune cells such as macrophages,T cells,myeloid progenitor cells and neutrophils were identified in the degenerated intervertebral disc tissues,demonstrating the existence of immune response during intervertebral disc degeneration.It was found that apolipoprotein induced the polarization of macrophages M1 and M2 subtypes,and this polarization process affected the activity of progenitor nucleus pulposus cells by amplifying the inflammatory response through the MIF signaling pathway.

Objective Clarify the basis of the commonly used Tibetan medicinal material"YeGexing",the chemical structure and pharmacological activity were investigated,then provide a basis for standardizing clinical medication,quality control,and rational use of resources.Methods Using literature research;plant taxonomy identification summary of chemical composition investigation and pharmacological activity identification,combined with resource distribution,clinical use status investigation and analysis.Results Tibetan medicine"Yegexing"involved 7 species in 2 families,4 genera,that is Sambucus Linn.from Caprifoliaceae,Senecio L.,Synotis(C.B.Clarke)C.Jeffrey et Y.L.Chen,Saussurea DC.from Compositae.The earliest used"Yegexinggabao"or"white"should be Senecio dianthus.and Senecio solidagineus.in the literature;"Yegexingnabao"or"black"should be Saussurea epilobioides.and Sambucus adnate.;S.raphanifolius.(S.diversifolius.),S.chrysanthemoides.(S.laetus.).S.chinensis.are the main substitutes used in Yunnan,Gansu,and western Sichuan,and are commonly used in the market.YeGexing mainly contains terpenes,flavonoids,alkaloids,phenolic acids and other chemical components;YeGexing black is mainly used for"healing",white is mainly used for"anti-inflammatory",which corresponds to modern pharmacological research on anti-inflammatory,antioxidant,antibacterial and other activities.Conclution In view of the fact that the origin of"Yegexing"involves a variety of plants from different families and genera,"Yegexing"has become a collective name for these plant medicinal materials.According to the lextual results and the research progress on chemical structure and pharmacological activity,from the perspective of conducive to standardizing clinical medication,ensuring efficacy and quality of medicinal materials,its name and variety should be standardized as:"??????(???????????????????/)Yegexinggabao"(that is,the white one),the source is S.dianthus.(S.erythropappa.),S.solidagineus.(S.solidaginea.),S.raphalanifolius.(S.diversifolius.),S.chrysanthemoides.(S.laetus.);"(???????????????????????/)Yegexingnabao"(that is,the black one),the source is S.epilobioides.and S.adnata.and S.chinensis are independent medicines.We should strengthen the investigation of the resources and use status of substitutes in various places,the comparative research on the medicinal material basis and biological activity of different resource species,and standardize their varieties-names-bases to make rational use of their resources.

Objective To explore the clinical efficacy of urokinase arterial thrombolysis combined with tirofiban sequential therapy in acute cerebral infarction with digital subtraction angiography(DS A)negative.Methods The clinical data of 82 acute cerebral infarction patients with DSA negative were collected.All patients were divided into the control group(n=41)and the observation group(n=41).The control group received routine treatment such as arterial thrombolysis and dual antiplatelet.The observation group was treated with arterial thrombolysis and intravenous tirofiban treatment for 36 h,and subsequent treatment was the same as the control group.The National Institutes of Health Stroke Scale(NIHSS)scores were analyzed at different time points including before,during,and after interven-tion.The modified Rankin scale(mRS)scores and changes in coagulation function were compared before and 90 d after intervention,and the incidence of complications of all patients were recorded.The differences of all indicators were analyzed.Results The NIHSS scores during and 30 d after intervention in the control group and at various time points during and after intervention in the observa-tion group were lower than those before intervention(P＜0.05).The NIHSS score of the observation group at various time point after intervention was significantly lower than those of the control group(P＜0.05).The clinical effective rate of the observation group 30 d after intervenion was significantly higher than those of the control group(92.68％vs 78.05％).The mRS scores of the two groups 90 d after intervention were significantly lower than those before intervention,and the observation group was significantly lower than the control group(P＜0.05).There were significant differences in prothrombin time(PT),thrombin time(TT),and fibrinogen(FIB)between the two groups 3 d after intervention compared to before intervention(P＜0.05).There was no difference in FIB and PT 7 d after intervention between the two groups(P＞0.05),while TT of the observation group was significantly higher than that of the control group(P=0.038).There was no significant difference in the incidence of complications between the two groups(P=0.073).Conclusion Urokinase arterial thrombolysis combined with tirofiban can effectively improve the neurological function and prognosis of acute cerebral infarction patients with DSA negative,shorten the recovery time,with good clinical safety.