The knowledge and experience of medical practitioners in the diagnosis and treatment of diseases throughout history are mostly reflected in the description and analysis of relevant clinical events.The diagnosis and treatment thinking and cognitive reasoning process among the knowledge has dynamic and complex characteristics in time and space.However,the current exploration of ancient doctors' diagnosis and treatment experience of diseases and syndromes is mainly focuses on the academic evolution of the entire historical time line,and lacks the exploration of the concept of time and its medical relevance in ancient books.It mainly focuses on entity knowledge,and lacks the presentation of temporal dynamic cognitive logic.Moreover,the research primarily focuses on the study of specific terms in ancient Chinese medicine books,without fully covering ancient medical events.To address this issue,this research proposes to construct the evolution model of diagnosis and treatment experience based on time-series dynamic perspective:according to the time series of diagnosis and treatment events,it covers the time system module,the"coming disease"module,the"already sick"module,and the"after sick"module,which involves the dynamic risk assessment of disease occurrence by ancient medical practitioners,the grasp of the dynamic evolution of the already sick state and the treatment plan,and the dynamic health plan for the after sick state.

Objective To investigate the expression levels and diagnostic value of long non coding RNA(lncRNA)DNA damage inducible transcript 4 like protein 4 antisense RNA1(lncRNA DDIT4-AS1)and long chain non coding RNA(lncRNA)radial spoke head protein 9 homolog 4(RSPH9-4)in serum of patients with bacterial meningitis.Methods A total of 94 patients with meningitis in the Fifth Hospital of Deyang City from May 2022 to May 2024 were regarded as the bacterial meningitis group.According to the severity of damage to the central nervous system caused by bacterial meningitis,they were further separated into a general group(n=63)and a severe group(n=31).94 patients with suspected meningitis upon admission but excluded meningitis after examination were selected as the non bacterial meningitis group.A total of 94 patients diagnosed with bacterial meningitis in the Fifth Hospital of Deyang City from May 2022 to May 2024 were selected as the bacterial meningitis group 94 healthy volunteers who underwent physicalexamination were as the control group.Real-time fluorescence quantitative PCR(qRT-PCR)method was applied to detect the expression levels of lncRNA DDIT4-AS1 and lncRNA RSPH9-4 in serum samples of all personnel.Spearman analysis was applied to analyze the correlation between serum levels of lncRNA DDIT4-AS1 and lncRNA RSPH9-4 with the severity of bacterial meningitis.Multivariate Logistic analysis was applied to analyze the influencing factors of bacterial meningitis.Receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 levels for bacterial meningitis.Results Compared with the control group,the expression levels of serum lncRNA DDIT4-AS1(1.35±0.27,1.67±0.35 vs 1.01±0.18)and lncRNA RSPH9-4(1.30±0.25,1.56±0.32 vs 1.00±0.19)were increased in non bacterial meningitis group and bacterial meningitis group(t=10.159,16.259;9.263,14.589),compared with the non bacterial meningitis group,the expression levels of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 in the bacterial meningitis group were increased(t=7.019,6.208),and the differences were statistically significant(all P<0.05),respectively.Compared with the general group,the expression levels of serum lncRNA DDIT4-AS1(1.88±0.38 vs 1.56±0.31)and lncRNA RSPH9-4(1.79±0.35 vs 1.45±0.28)were increased in the severe group,and the differences were statistically significant(t=4.361,5.088,all P＜0.05).Spearman correlation analysis results showed that serum levels of lncRNA DDIT4-AS1,lncRNA RSPH9-4 were positively correlated with the severity of bacterial meningitis(r=0.524,0.548,all P<0.05).The expression levels of PCT,LDH and CRP in patients with bacterial meningitis were higher than those in patients without bacterial meningitis,and the differences were statistically significant(t=7.459,4.234,8.565,all P<0.05).Multivariate Logistic analysis showed that PCT,LDH,CRP,lncRNA DDIT4-AS1 and lncRNA RSPH9-4 were influencing factors for bacterial meningitis(Wald χ2=4.768～12.035,all P＜0.05).The receiver operating characteristic(ROC)curve results showed that the combined diagnosis of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 levels for bacterial meningitis had a significantly larger area under the curve(AUC)than the diagnosis of lncRNA DDIT4-AS1 and lncRNA RSPH9-4 alone,and the differences were statistically significant(Z=2.426,2.545,all P<0.05).Conclusion The expression levels of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 are elevated in patients with bacterial meningitis,and the combination of the two has high diagnostic value for the disease.

The knowledge and experience of medical practitioners in the diagnosis and treatment of diseases throughout history are mostly reflected in the description and analysis of relevant clinical events.The diagnosis and treatment thinking and cognitive reasoning process among the knowledge has dynamic and complex characteristics in time and space.However,the current exploration of ancient doctors' diagnosis and treatment experience of diseases and syndromes is mainly focuses on the academic evolution of the entire historical time line,and lacks the exploration of the concept of time and its medical relevance in ancient books.It mainly focuses on entity knowledge,and lacks the presentation of temporal dynamic cognitive logic.Moreover,the research primarily focuses on the study of specific terms in ancient Chinese medicine books,without fully covering ancient medical events.To address this issue,this research proposes to construct the evolution model of diagnosis and treatment experience based on time-series dynamic perspective:according to the time series of diagnosis and treatment events,it covers the time system module,the"coming disease"module,the"already sick"module,and the"after sick"module,which involves the dynamic risk assessment of disease occurrence by ancient medical practitioners,the grasp of the dynamic evolution of the already sick state and the treatment plan,and the dynamic health plan for the after sick state.

Objective To investigate the expression levels and diagnostic value of long non coding RNA(lncRNA)DNA damage inducible transcript 4 like protein 4 antisense RNA1(lncRNA DDIT4-AS1)and long chain non coding RNA(lncRNA)radial spoke head protein 9 homolog 4(RSPH9-4)in serum of patients with bacterial meningitis.Methods A total of 94 patients with meningitis in the Fifth Hospital of Deyang City from May 2022 to May 2024 were regarded as the bacterial meningitis group.According to the severity of damage to the central nervous system caused by bacterial meningitis,they were further separated into a general group(n=63)and a severe group(n=31).94 patients with suspected meningitis upon admission but excluded meningitis after examination were selected as the non bacterial meningitis group.A total of 94 patients diagnosed with bacterial meningitis in the Fifth Hospital of Deyang City from May 2022 to May 2024 were selected as the bacterial meningitis group 94 healthy volunteers who underwent physicalexamination were as the control group.Real-time fluorescence quantitative PCR(qRT-PCR)method was applied to detect the expression levels of lncRNA DDIT4-AS1 and lncRNA RSPH9-4 in serum samples of all personnel.Spearman analysis was applied to analyze the correlation between serum levels of lncRNA DDIT4-AS1 and lncRNA RSPH9-4 with the severity of bacterial meningitis.Multivariate Logistic analysis was applied to analyze the influencing factors of bacterial meningitis.Receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 levels for bacterial meningitis.Results Compared with the control group,the expression levels of serum lncRNA DDIT4-AS1(1.35±0.27,1.67±0.35 vs 1.01±0.18)and lncRNA RSPH9-4(1.30±0.25,1.56±0.32 vs 1.00±0.19)were increased in non bacterial meningitis group and bacterial meningitis group(t=10.159,16.259;9.263,14.589),compared with the non bacterial meningitis group,the expression levels of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 in the bacterial meningitis group were increased(t=7.019,6.208),and the differences were statistically significant(all P<0.05),respectively.Compared with the general group,the expression levels of serum lncRNA DDIT4-AS1(1.88±0.38 vs 1.56±0.31)and lncRNA RSPH9-4(1.79±0.35 vs 1.45±0.28)were increased in the severe group,and the differences were statistically significant(t=4.361,5.088,all P＜0.05).Spearman correlation analysis results showed that serum levels of lncRNA DDIT4-AS1,lncRNA RSPH9-4 were positively correlated with the severity of bacterial meningitis(r=0.524,0.548,all P<0.05).The expression levels of PCT,LDH and CRP in patients with bacterial meningitis were higher than those in patients without bacterial meningitis,and the differences were statistically significant(t=7.459,4.234,8.565,all P<0.05).Multivariate Logistic analysis showed that PCT,LDH,CRP,lncRNA DDIT4-AS1 and lncRNA RSPH9-4 were influencing factors for bacterial meningitis(Wald χ2=4.768～12.035,all P＜0.05).The receiver operating characteristic(ROC)curve results showed that the combined diagnosis of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 levels for bacterial meningitis had a significantly larger area under the curve(AUC)than the diagnosis of lncRNA DDIT4-AS1 and lncRNA RSPH9-4 alone,and the differences were statistically significant(Z=2.426,2.545,all P<0.05).Conclusion The expression levels of serum lncRNA DDIT4-AS1 and lncRNA RSPH9-4 are elevated in patients with bacterial meningitis,and the combination of the two has high diagnostic value for the disease.

Objective To explore the effect of Internet+cardiac rehabilitation on hypertension patients with coronary heart disease.Methods 80 patients with hypertension and coronary heart disease admitted to our hospital from January 2022 to April 2023 were randomly divided into the combined group(n=40)and the conventional group(n=40).Both groups were given routine cardiac rehabilitation interventions.The combined group combined adoptionof the Internet for continuous interventionson the basis of routine cardiac rehabilitation interventions.Compare the oxygen uptake,blood pressure,compliance,and self-management scores between two groups before intervention and three months after discharge.Results The AT Mets,AT VO2,peak VO2,and expected value compliance ratio in the combined group were all higher than those in the conventional group(P<0.05);The systolic and diastolic blood pressure in the combination group were lower than those in the control group,and the proportion of complete compliance was significantly higher than that in the control group(P<0.05);The self-management scores of the joint group were higher than those of the conventional group(P<0.05).Conclusion The continuous interventions of Internet plus cardiac rehabilitation can control the blood pressure of patients with hypertension and coronary heart disease,and patients'compliance behavior is significantly im-proved,andthus improving patients'self-management ability,which can be used for reference and promotion in clinical practice.

Objective:To investigate the value of 18F-FDG PET/CT combined with conventional imaging modalities in the evaluation of the depth of tumor invasion, regional lymph node metastasis, distant organ and lymph node metastasis (TNM staging), and the adjacent structure invasion of rectal cancer. Methods:Fifty-four patients (28 males, 26 females, age (65.8±11.0) years) with pathologically confirmed rectal cancer admitted to the Affiliated Qingdao Central Hospital of Qingdao University between September 2019 and June 2021 were retrospectively analyzed. 18F-FDG PET/CT examination, conventional imaging modalities including high-resolution MRI (HR-MRI), chest CT plain scan, upper abdominal MRI or CT plain scan+ enhanced examination were performed within 2 weeks before or after the rectal cancer being confirmed. The TNM staging and adjacent structural invasions including circumferential resection margin (CRM), extramural vascular invasion (EMVI), anal sphincter complex involvement were evaluated by 18F-FDG PET/CT and conventional imaging modalities separately or in combination, and those results based on imaging were compared with the pathological results or clinical follow-up results. χ2 test was used to compare the differences of diagnostic sensitivity, specificity and accuracy between the 18F-FDG PET/CT or conventional imaging modalities and combined examination. Results:The accuracy for T staging and the sensitivity and accuracy for N staging of the combined examination were 96.30%(52/54), 98.65%(73/74) and 93.91%(185/197), respectively, which were significantly higher than those of 18F-FDG PET/CT (85.19%(46/54), 66.22%(49/74), 81.73%(161/197); χ2 values: 3.97, 26.88, 13.66, all P<0.05). The specificity (91.06%, 112/123) and accuracy of the combined examination for N staging were higher than those of the conventional imaging modalities (77.24%(95/123), 83.76%(165/197); χ2 values: 8.81, 10.23, both P<0.05). The sensitivity and accuracy of the combined examination for M staging were higher than those of the conventional imaging modalities (97.01%(65/67) vs 73.13%(49/67), 95.95%(71/74) vs 68.92%(51/74); χ2 values: 15.05, 18.66, both P<0.001). The sensitivities of the combined examination in evaluating CRM and EMVI were 100%(22/22) and 95.00%(19/20), and the accuracies were 98.15%(53/54) and 96.30%(52/54), all of which were higher than those of 18F-FDG PET/CT (CRM: 54.55%(12/22), 74.07%(40/54); EVMI: 30.00%(6/20), 74.07%(40/54); χ2 values: 12.94, 13.08, 18.03, 10.56, all P<0.01). The accuracy of the combined examination in evaluating EMVI was higher than that of the conventional imaging modalities (85.19%(46/54); χ2=3.97, P=0.046). Conclusion:18F-FDG PET/CT combined with conventional imaging modalities can improve the diagnostic efficacy for TNM staging and assessment of adjacent structural invasion in rectal cancer.

【Objective】 To establish a paper-free system of the total whole blood donation flow in constructing intelligent blood stations, and build digitalized whole blood donation system for practice. 【Methods】 A paper-free whole blood collection system was constructed through information process reforming, system frame designing and data network transportation constructing, and was applied in various blood donation scenario. 【Results】 Fixed blood collection sites carried out 49 063 donations via paper-free information system from November 2022 to July 2023, and 24 822 donations( group blood donation) were conducted via paper-free system from April to July 2022. Compared with the traditional paper-based model, paper-free system is safer, more standardized and more convenient, effectively enhancing the experience of blood donors. 【Conclusion】 The construction of paper-free whole blood collection system effectively enhances the experience of blood donors, improves the safety, accuracy, traceability of the data, and has good social value and economic value, which is worth popularizing.

China/epidemiology* ; Humans ; Pemphigoid, Bullous/epidemiology* ; Retrospective Studies

China has made great strategic achievements in the struggle against COVID-19 epidemic, which shows the profound and rich value of the times of the red doctors’ spirit. It not only give noble occupation responsibility and historical mission to the training of medical students in the new era, but also provide value guidance and action guide. Based on the successful experience of COVID-19 prevention and control and the special background of the times, set training objectives guided by the demand of society and universities for medical talents, combined with the ideological reality of medical students at present, actively carry out patriotism education, mental health education, professional ethics education and scientific spirit education for medical students through multiple channels such as strengthen the effectiveness of ideological and political theory curriculum, promote the ideological and political construction of curriculum, give full play to the educational function of various practical activities, and using environmental infiltration method to make red culture "live", with a view to cultivating medical talents with firm politics, superb medical skills, dedication, both ability and political integrity, being able to take on great responsibilities, and helping the construction and development of a healthy China.

Mosaic variants resulting from postzygotic mutations are prevalent in the human genome and play important roles in human diseases. However, except for cancer-related variants, there is no collection of postzygotic mosaic variants in noncancer disease-related and healthy individuals. Here, we present MosaicBase, a comprehensive database that includes 6698 mosaic variants related to 266 noncancer diseases and 27,991 mosaic variants identified in 422 healthy individuals. Genomic and phenotypic information of each variant was manually extracted and curated from 383 publications. MosaicBase supports the query of variants with Online Mendelian Inheritance in Man (OMIM) entries, genomic coordinates, gene symbols, or Entrez IDs. We also provide an integrated genome browser for users to easily access mosaic variants and their related annotations for any genomic region. By analyzing the variants collected in MosaicBase, we find that mosaic variants that directlycontribute to disease phenotype show features distinct from those of variants in individuals with mild or no phenotypes, in terms of their genomic distribution, mutation signatures, and fraction of mutant cells. MosaicBase will not only assist clinicians in genetic counseling and diagnosis but also provide a useful resource to understand the genomic baseline of postzygotic mutations in the general human population. MosaicBase is publicly available at http://mosaicbase.com/ or http://49.4.21.8:8000.