In recent years, the convergent media environment, which integrates text, video, audio, animation, and other media forms, has become indispensable in higher education. Online teaching within this environment leverages a " cloud-based, multi-screen" dissemination model, effectively integrating various forms of media resources to accommodate mobile and ubiquitous learning scenarios. This approach meets the diverse needs of different learners, and makes course content delivery more dynamic while enhancing teacher-student interaction. As a result, it fosters innovation in course instruction, shifting teaching methods from " standardization" to " differentiation" , thereby providing a platform and resources for personalized learning. This paper analyzes the design and resource development strategies for Nuclear Medicine online courses within the convergent media environment from three perspectives: constructing a high-quality online course system centered on learning outcomes, driving innovation in online teaching focused on the learning experience, and highlighting the efficacy of cultivating high-quality nuclear medicine professionals through a top-tier online course. By systematically summarizing the implementation experience in building the Nuclear Medicine online course, this article aims to provide strategies and pathways to enrich the content supply and cross-platform integration of online medical courses in China.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Objective:To explore the risk factors of blood pressure fluctuations during the dialysis period in maintenance hemodialysis (MHD) patients and their impact on long-term survival.Methods:A total of 100 cases of MHD patients admitted to Anhui Linquan People′s Hospital from September 2020 to May 2022 were selected and divided into high fluctuation group (coefficient of variation in systolic blood pressure>8.64%) and non-high fluctuation group (coefficient of variation in systolic blood pressure ≤ 8.64%). The clinical data of the two groups were compared, and the LASSO model was used to conduct the preliminary screening for each risk factor. The nomogram prediction model of blood pressure fluctuation during the dialysis period was drawn, and the receiver operating characteristic (ROC) curve and calibration curve was drawn to obtain the prediction efficiency and calibration degree of the nomograph model. Kaplan-Meier survival curve was drawn to compare the 1-year survival status of the two groups.Results:The results of single factor analysis showed that body mass index, dialysis age, urea clearance index, ultrafiltration volume, serum calcium, serum albumin, serum phosphorus, serum sodium, total parathyroid hormone (iPTH), serum uric acid, serum creatinine, C-reactive protein, alkaline phosphatase, early diastolic maximum blood flow in the left ventricle (peak E)/atrial systolic maximum blood flow of mitral valve (peak A), and left ventricular ejection fraction (LVEF) were risk factors for blood pressure fluctuation during dialysis ( P<0.05). The prediction model of nomograph was drawn, and the consistency index (C-index) was 0.941, the prediction sensitivity was 88.40%, and the specificity was 91.20%. Kaplan-Meier survival curve analysis showed that the 1-year survival rate in the high fluctuation group was lower than that in the non-high fluctuation group ( P<0.05). Conclusions:Blood pressure fluctuation during dialysis in MHD patients is related to blood sodium, calcium and phosphorus, iPTH, blood uric acid, albumin, peak E/peak A, and LVEF, and can affect the prognosis of patients, and attention should be paid to the monitoring and control of above indexes of the patients in order to improve the prognosis.

Anti-neutrophil cytoplasmic antibody-associated small-vessel vasculitis（ANCA-AAV） is an autoimmune disease that can involve multiple systems throughout the body， and approximately 15% of patients with AAV have central nervous system involvement. Hypertrophic spinal pachymeningitis （HSP） is a rare clinical form with nervous system involvement characterized by thickening of the dura mater， inflammatory response，and fibrosis. This article reports a case of HSP associated with myeloperoxidase antibody and ANCA and summarizes its clinical features and imaging characteristics with reference to the latest literature，so as to enhance the understanding of HSP among clinicians and reduce missed diagnosis or misdiagnosis.

Objective:To investigate the application effect of team-based learning (TBL) versus lecture-based learning (LBL) in the first aid skill training of peacekeeping forces.Methods:A total of 326 officers and soldiers who had not participated in first aid skill training from various peacekeeping units in the Gao area of the Eastern Theater of United Nations Multidimensional Integrated Stabilization Mission in Mali from September 2022 to June 2023 were selected and divided into groups A and B using numerical randomization, with 163 individuals in each group. The individuals in group A received LBL teaching, and those in group B received TBL teaching. Questionnaire survey, theoretical assessment, and operational skill assessment were performed for all officers and soldiers after the end of the course. SPSS 19.0 was used for the t-test and the chi-square test. Results:Compared with the LBL group, the TBL group had significantly better first aid awareness, first aid skills, team collaboration ability, and humanistic concern and a significantly higher degree of satisfaction with the training mode. The LBL group had a slightly higher theoretical assessment score than the TBL group [(86.73±8.57) vs. (85.92±7.66)], with no significant difference between the two groups. Compared with the LBL group, the TBL group had significantly better scores of each operational skill and the total score of operational skill assessment [(86.71±11.25) vs. (81.14±10.05)].Conclusions:As a relatively effective training mode, the TBL teaching method has significant advantages in improving the first aid awareness, team collaboration ability, and practical operation ability of peacekeeping personnel, and therefore, it holds promise for application in Mali and other peacekeeping task areas.

Objective·To screen a long non-coding RNA(lncRNA)signature and construct a competing endogenous RNA(ceRNA)network associated with the prognosis of pediatric sepsis based on the Gene Expression Omnibus(GEO)database,and explore their potential application value in the prognosis assessment of children with sepsis.Methods·Microarray data in GSE4607,GSE26440,GSE26378,and GSE9692 in the GEO database were used to compare the differences in lncRNA profiles between the survival and non-survival groups of children with septic shock.Then,multivariate linear regression,LASSO analysis,and receiver operating characteristic(ROC)curves were used to evaluate the capacity of the lncRNA signature for predicting the outcome of pediatric sepsis.The potential targeted microRNAs(miRNAs)and their downstream mRNAs,targeted by the screened lncRNAs,were used to construct a protein-protein interaction(PPI)network and perform pathway enrichment analysis.Results·Transcriptomic data from GSE4607,GSE26440,GSE26378 and GSE9692 revealed 55 differentially expressed lncRNAs associated with prognosis,and miR503 host gene(MIR503HG),TAPT1 antisense RNA 1(TAPT1-AS1),apoptosis-associated transcript in bladder cancer(AATBC),SBF2 antisense RNA 1(SBF2-AS1),MGC16275,and small nucleolar RNA host gene 15(SNHG15)were identified as a 6-lncRNA signature(lncSig6)associated with the prognosis of pediatric septic shock by LASSO regression analysis.The area under the ROC curve(AUC)of lncSig6 was 0.859(95％CI 0.722-0.996)and 0.854(95％CI 0.687-1.000)in internal and external validation,respectively.As lncRNA act as miRNA sponge,a lncRNA-miRNA-mRNA network based on 3 lncRNAs(MIR503HG,SNHG15,and SBF2-AS1)was constructed and involved in the regulation of signaling pathways,including forkhead box O(FoxO)signaling pathway,phosphatidylinositol 3 kinase-protein kinase B(PI3K-AKT)signaling pathway,cell senescence,insulin signaling pathway,hypoxia-inducible protein-1(HIF-1)signaling pathway and advanced glycation end products(AGEs)and receptor of AGEs(RAGE)signaling pathway.Conclusion·The lncSig6 can be used as an evaluation method to predict the prognosis of septic shock in children,and the constructed ceRNA molecular networks can provide an experimental basis for the study of signaling pathways.

Objective The clinical characteristics of 21 cases of nocardiosis were reviewed and antimicrobial resistance of Nocardia strains was analyzed in order to improve the accuracy of clinical diagnosis and treatment of nocardiosis.Methods Clinical data of patients diagnosed with nocardiosis in Zhoukou Central Hospital from 2019-2023 and the corresponding results of antimicrobial susceptibility testing were retrospectively analyzed to summarize the clinical characteristics and outcomes of patients.Results Overall,the 21 cases of nocardiosis included 9 males and 12 females,aged 2-91 years.Underlying disease was reported in 15 patients.Most common type of nocardiosis was pulmonary nocardiosis in 15 cases,followed by skin and soft tissue infection,pleurisy,lymphadenitis,and disseminated nocardiosis.Laboratory tests showed increased levels of WBC,neutrophils percentage,erythrocyte sedimentation rate,C-reactive protein,and procalcitonin.The 21 strains of Nocardia included 4 strains of Nocardia cyriacigeorgica,2 strains each of Nocardia brasiliensis,Nocardia abscessus,Nocardia asiatica,Nocardia otitidiscaviarum and Nocardia beijingensis,and 1 strain each of Nocardia puris,Nocardia asteroides,Nocardia farcinica,Nocardia pneumoniae,Nocardia amamiensis,and 2 strains of unclassified Nocardia.All of the Nocardia strains(100％)were susceptible to linezolid,amikacin,and trimethoprim-sulfamethoxazole,followed by various levels of susceptibility to cefotaxime,moxifloxacin,imipenem and ceftriaxone,and lower susceptibility rate to cefepime,minocycline,ciprofloxacin and clarithromycin.Antimicrobial susceptibility of Nocardia strains varied with different Nocardia species.Of the 21 patients,two were referred to other hospitals,another two died,two patients received unknown treatment,and the remaining 15 patients were improved after antibiotic treatment,including sulfonamides combined with other antibiotics in 11 cases,other antibiotics in 4 cases.Conclusions Immunocompromised patients or those with underlying diseases are more susceptible to nocardiosis.The clinical features are complex and diverse.Antimicrobial susceptibility of Nocardia strains varied with different Nocardia species.Accurate identification and antimicrobial susceptibility test are essential for prescribing effective antibiotic treatment.

Objective The clinical characteristics of 21 cases of nocardiosis were reviewed and antimicrobial resistance of Nocardia strains was analyzed in order to improve the accuracy of clinical diagnosis and treatment of nocardiosis.Methods Clinical data of patients diagnosed with nocardiosis in Zhoukou Central Hospital from 2019-2023 and the corresponding results of antimicrobial susceptibility testing were retrospectively analyzed to summarize the clinical characteristics and outcomes of patients.Results Overall,the 21 cases of nocardiosis included 9 males and 12 females,aged 2-91 years.Underlying disease was reported in 15 patients.Most common type of nocardiosis was pulmonary nocardiosis in 15 cases,followed by skin and soft tissue infection,pleurisy,lymphadenitis,and disseminated nocardiosis.Laboratory tests showed increased levels of WBC,neutrophils percentage,erythrocyte sedimentation rate,C-reactive protein,and procalcitonin.The 21 strains of Nocardia included 4 strains of Nocardia cyriacigeorgica,2 strains each of Nocardia brasiliensis,Nocardia abscessus,Nocardia asiatica,Nocardia otitidiscaviarum and Nocardia beijingensis,and 1 strain each of Nocardia puris,Nocardia asteroides,Nocardia farcinica,Nocardia pneumoniae,Nocardia amamiensis,and 2 strains of unclassified Nocardia.All of the Nocardia strains(100％)were susceptible to linezolid,amikacin,and trimethoprim-sulfamethoxazole,followed by various levels of susceptibility to cefotaxime,moxifloxacin,imipenem and ceftriaxone,and lower susceptibility rate to cefepime,minocycline,ciprofloxacin and clarithromycin.Antimicrobial susceptibility of Nocardia strains varied with different Nocardia species.Of the 21 patients,two were referred to other hospitals,another two died,two patients received unknown treatment,and the remaining 15 patients were improved after antibiotic treatment,including sulfonamides combined with other antibiotics in 11 cases,other antibiotics in 4 cases.Conclusions Immunocompromised patients or those with underlying diseases are more susceptible to nocardiosis.The clinical features are complex and diverse.Antimicrobial susceptibility of Nocardia strains varied with different Nocardia species.Accurate identification and antimicrobial susceptibility test are essential for prescribing effective antibiotic treatment.

Objective:To investigate the application effect of team-based learning (TBL) versus lecture-based learning (LBL) in the first aid skill training of peacekeeping forces.Methods:A total of 326 officers and soldiers who had not participated in first aid skill training from various peacekeeping units in the Gao area of the Eastern Theater of United Nations Multidimensional Integrated Stabilization Mission in Mali from September 2022 to June 2023 were selected and divided into groups A and B using numerical randomization, with 163 individuals in each group. The individuals in group A received LBL teaching, and those in group B received TBL teaching. Questionnaire survey, theoretical assessment, and operational skill assessment were performed for all officers and soldiers after the end of the course. SPSS 19.0 was used for the t-test and the chi-square test. Results:Compared with the LBL group, the TBL group had significantly better first aid awareness, first aid skills, team collaboration ability, and humanistic concern and a significantly higher degree of satisfaction with the training mode. The LBL group had a slightly higher theoretical assessment score than the TBL group [(86.73±8.57) vs. (85.92±7.66)], with no significant difference between the two groups. Compared with the LBL group, the TBL group had significantly better scores of each operational skill and the total score of operational skill assessment [(86.71±11.25) vs. (81.14±10.05)].Conclusions:As a relatively effective training mode, the TBL teaching method has significant advantages in improving the first aid awareness, team collaboration ability, and practical operation ability of peacekeeping personnel, and therefore, it holds promise for application in Mali and other peacekeeping task areas.

Objective·To screen a long non-coding RNA(lncRNA)signature and construct a competing endogenous RNA(ceRNA)network associated with the prognosis of pediatric sepsis based on the Gene Expression Omnibus(GEO)database,and explore their potential application value in the prognosis assessment of children with sepsis.Methods·Microarray data in GSE4607,GSE26440,GSE26378,and GSE9692 in the GEO database were used to compare the differences in lncRNA profiles between the survival and non-survival groups of children with septic shock.Then,multivariate linear regression,LASSO analysis,and receiver operating characteristic(ROC)curves were used to evaluate the capacity of the lncRNA signature for predicting the outcome of pediatric sepsis.The potential targeted microRNAs(miRNAs)and their downstream mRNAs,targeted by the screened lncRNAs,were used to construct a protein-protein interaction(PPI)network and perform pathway enrichment analysis.Results·Transcriptomic data from GSE4607,GSE26440,GSE26378 and GSE9692 revealed 55 differentially expressed lncRNAs associated with prognosis,and miR503 host gene(MIR503HG),TAPT1 antisense RNA 1(TAPT1-AS1),apoptosis-associated transcript in bladder cancer(AATBC),SBF2 antisense RNA 1(SBF2-AS1),MGC16275,and small nucleolar RNA host gene 15(SNHG15)were identified as a 6-lncRNA signature(lncSig6)associated with the prognosis of pediatric septic shock by LASSO regression analysis.The area under the ROC curve(AUC)of lncSig6 was 0.859(95％CI 0.722-0.996)and 0.854(95％CI 0.687-1.000)in internal and external validation,respectively.As lncRNA act as miRNA sponge,a lncRNA-miRNA-mRNA network based on 3 lncRNAs(MIR503HG,SNHG15,and SBF2-AS1)was constructed and involved in the regulation of signaling pathways,including forkhead box O(FoxO)signaling pathway,phosphatidylinositol 3 kinase-protein kinase B(PI3K-AKT)signaling pathway,cell senescence,insulin signaling pathway,hypoxia-inducible protein-1(HIF-1)signaling pathway and advanced glycation end products(AGEs)and receptor of AGEs(RAGE)signaling pathway.Conclusion·The lncSig6 can be used as an evaluation method to predict the prognosis of septic shock in children,and the constructed ceRNA molecular networks can provide an experimental basis for the study of signaling pathways.