The scientific research and innovation capabilities of medical students are intrinsically linked to the sustained and high-quality development of national healthcare initiatives.Cultivating outstanding medi-cal students with independent scientific capabilities and innovative consciousness is a critical component in the education and training of high-level medical professionals.Our investigation revealed that within the imperfections of the cultivating model,some faculty and students at medical schools have an insufficient understanding of scientific research and innovation and lack motivation for engaging in such activities,which hinder the progression of scientific research activities.Consequently,we initiated a teaching practice and exploratory study on the"tutorial system"aimed at fostering medical students'scientific research and innovation abilities.Based on the principle of"research informing teaching,teaching and research advan-cing together,"this study implements a"tutorial system"coordinated by tutors,supplemented by graduate and undergraduate student mentors,to cultivate innovative thinking,stimulate interest in scientific re-search,and enhance practical and research skills among medical students.Through collaborative efforts within"scientific research innovation teams,"various educational methods—including preliminary re-search,in-class and extracurricular activities,intra-group and inter-group interactions,and theoretical and practical applications—are employed to improve and strengthen the cultivation of medical students'scientif-ic research and innovation abilities.This study aims to provide valuable references for optimizing medical education management systems and enhancing the quality of medical student training.

Purpose To investigate the role of combined immunohistochemical expression of SATB2 and p16 and pathological histomorphological features in the diagnosis and differential diagnosis of atypical polypoid adenomyoma(APAM),myometrial infiltrating endometrioid carcinoma(MIEC)and interstitial fibrotic endometrial polyps(IFEP).Methods A total of 32 cases of APAM,20 cases of MIEC and 25 cases of IFEP were collected.The expression of SATB2 and p16 in the stromal cells of the three groups of cases was detected by immunohistochemical EnVision two-step method.Four morphological features were evaluated in the three groups:complex glandular structure,squamous and mulberry metaplasia,fibromuscular stroma and cellular atypia.Results The expression of SATB2 in the stroma of APAM(31/32)was significantly higher than that of MIEC(1/20)and IFEP(0/25),and the difference was statisti-cally significant.The expression of p16 in APAM(32/32)stroma was significantly higher than that in MIEC(3/20),and the difference was statistically significant,while compared with IFEP(21/25),the difference was not statistically significant.Histomorphological characteristics:compared with the MIEC group,APAM had obvious squamous and mul-berry metaplasia(APAM group 31/32,MIEC group 4/20),and the difference was statistically significant;However,there was no statistically significant difference between the two groups in terms of complex glandular structure(APAM group 22/32,MIEC group 20/20),fibromuscular stroma(APAM group 32/32,MIEC group 20/20),and cellular at-ypia(APAM group 32/32,MIEC group 20/20).Compared with the IFEP group,APAM had typical complex glandu-lar structure(APAM group 20/32,IFEP group 0/25),squamous and mulberry metaplasia(APAM group 32/32,IF-EP group 2/25),and cellular atypia(APAM group 32/32,IFEP group 0/25),and the difference was statistically sig-nificant.However,there was no statistically significant difference in fibromuscular stroma(APAM group 32/32,IFEP group 25/25)between the two groups.Conclusion The combined immunohistochemical analysis of SATB2 and p16 and histomorphological features is helpful for the diagnosis of APAM and the differential diagnosis of MIEC and IFEP.

The scientific research and innovation capabilities of medical students are intrinsically linked to the sustained and high-quality development of national healthcare initiatives.Cultivating outstanding medi-cal students with independent scientific capabilities and innovative consciousness is a critical component in the education and training of high-level medical professionals.Our investigation revealed that within the imperfections of the cultivating model,some faculty and students at medical schools have an insufficient understanding of scientific research and innovation and lack motivation for engaging in such activities,which hinder the progression of scientific research activities.Consequently,we initiated a teaching practice and exploratory study on the"tutorial system"aimed at fostering medical students'scientific research and innovation abilities.Based on the principle of"research informing teaching,teaching and research advan-cing together,"this study implements a"tutorial system"coordinated by tutors,supplemented by graduate and undergraduate student mentors,to cultivate innovative thinking,stimulate interest in scientific re-search,and enhance practical and research skills among medical students.Through collaborative efforts within"scientific research innovation teams,"various educational methods—including preliminary re-search,in-class and extracurricular activities,intra-group and inter-group interactions,and theoretical and practical applications—are employed to improve and strengthen the cultivation of medical students'scientif-ic research and innovation abilities.This study aims to provide valuable references for optimizing medical education management systems and enhancing the quality of medical student training.

Objective To establish a sensitive,accurate and rapid detection method for 10 drugs and metabolites in hair with triple quadrupole tandem mass spectrometry,addressing the identification of drugs in real hair samples.Methods After cryogenic grinding and ultrasonic extraction,hair was separated by Restek Allure PFPP column(100 mm × 2.1 mm,5 μm).The mobile phase A was 20 mmol/L ammonium acetate,0.1％formic acid and 5％acetonitrile aqueous solution.The mobile phase B was acetonitrile.An electrospray ionization source was used for data acquisition in scheduled MRM mode.Results The method showed good linearity for all analytes within the validated range(R2＞0.995),with the limits of detection ranging from 0.5 to 6 pg/mg,the limits of quantification ranging from 2.5 to 10 pg/mg.Accuracy ranged from 89.1％to 114.6％,with intra-day precision ranging from 0.2％to 11.7％,inter-day precision ranging from 4.0％to 15.8％.the matrix effects ranging from 89.4％to 118.4％,the recoveries ranging from 63.6％～112.1％.Totally 20 cases were detected positive in 196 actual hair samples.Conclusion The time-scheduled scanning method exhibits high stability and sensitivity,enabling high-throughput detection,and is suitable for forensic toxicology laboratories to identify drugs in hair.

Purpose To investigate the role of combined immunohistochemical expression of SATB2 and p16 and pathological histomorphological features in the diagnosis and differential diagnosis of atypical polypoid adenomyoma(APAM),myometrial infiltrating endometrioid carcinoma(MIEC)and interstitial fibrotic endometrial polyps(IFEP).Methods A total of 32 cases of APAM,20 cases of MIEC and 25 cases of IFEP were collected.The expression of SATB2 and p16 in the stromal cells of the three groups of cases was detected by immunohistochemical EnVision two-step method.Four morphological features were evaluated in the three groups:complex glandular structure,squamous and mulberry metaplasia,fibromuscular stroma and cellular atypia.Results The expression of SATB2 in the stroma of APAM(31/32)was significantly higher than that of MIEC(1/20)and IFEP(0/25),and the difference was statisti-cally significant.The expression of p16 in APAM(32/32)stroma was significantly higher than that in MIEC(3/20),and the difference was statistically significant,while compared with IFEP(21/25),the difference was not statistically significant.Histomorphological characteristics:compared with the MIEC group,APAM had obvious squamous and mul-berry metaplasia(APAM group 31/32,MIEC group 4/20),and the difference was statistically significant;However,there was no statistically significant difference between the two groups in terms of complex glandular structure(APAM group 22/32,MIEC group 20/20),fibromuscular stroma(APAM group 32/32,MIEC group 20/20),and cellular at-ypia(APAM group 32/32,MIEC group 20/20).Compared with the IFEP group,APAM had typical complex glandu-lar structure(APAM group 20/32,IFEP group 0/25),squamous and mulberry metaplasia(APAM group 32/32,IF-EP group 2/25),and cellular atypia(APAM group 32/32,IFEP group 0/25),and the difference was statistically sig-nificant.However,there was no statistically significant difference in fibromuscular stroma(APAM group 32/32,IFEP group 25/25)between the two groups.Conclusion The combined immunohistochemical analysis of SATB2 and p16 and histomorphological features is helpful for the diagnosis of APAM and the differential diagnosis of MIEC and IFEP.

Objective To establish a sensitive,accurate and rapid detection method for 10 drugs and metabolites in hair with triple quadrupole tandem mass spectrometry,addressing the identification of drugs in real hair samples.Methods After cryogenic grinding and ultrasonic extraction,hair was separated by Restek Allure PFPP column(100 mm × 2.1 mm,5 μm).The mobile phase A was 20 mmol/L ammonium acetate,0.1％formic acid and 5％acetonitrile aqueous solution.The mobile phase B was acetonitrile.An electrospray ionization source was used for data acquisition in scheduled MRM mode.Results The method showed good linearity for all analytes within the validated range(R2＞0.995),with the limits of detection ranging from 0.5 to 6 pg/mg,the limits of quantification ranging from 2.5 to 10 pg/mg.Accuracy ranged from 89.1％to 114.6％,with intra-day precision ranging from 0.2％to 11.7％,inter-day precision ranging from 4.0％to 15.8％.the matrix effects ranging from 89.4％to 118.4％,the recoveries ranging from 63.6％～112.1％.Totally 20 cases were detected positive in 196 actual hair samples.Conclusion The time-scheduled scanning method exhibits high stability and sensitivity,enabling high-throughput detection,and is suitable for forensic toxicology laboratories to identify drugs in hair.

Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards* ; Humans ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Surveys and Questionnaires

OBJECTIVE: To analyze the efficacy and safety of decitabine-based myeloablative preconditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with acute myeloid leukemia (AML). METHODS: The clinical characteristics and efficacy of 115 AML patients who underwent allo-HSCT at the First Medical Center of Chinese PLA General Hospital from August 2018 to August 2022 were retrospectively analyzed, including 37 patients treated with decitabine conditioning regimen (decitabine group) and 78 patients without decitabine conditioning regimen (non-decitabine group). The cumulative incidence of relapse (CIR), overall survival (OS), leukemia-free survival (LFS), non-relapse mortality (NRM) and graft versus host disease (GVHD) were analyzed. RESULTS: For the patients in first complete remission (CR1) state before allo-HSCT, the 1-year relapse rates of decitabine group(22 cases) and non-decitabine group(69 cases) were 9.1% and 29.6%, respectively, the difference was statistically significant(P =0.042). The 1-year cumulative incidence of acute graft-versus-host disease (aGVHD) in decitabine group and non-decitabine group was 62.2% and 70.5%, respectively, and the 1-year cumulative incidence of chronic inhibitor-versus-host disease (cGVHD) was 18.9% and 14.1%, respectively, there were no significant differences in the incidence of aGVHD and cGVHD between the two groups (P >0.05). Of the 115 patients, there were no significantly differences in the 1-year CIR(21.7% vs 28.8%, P =0.866), NRM(10.9% vs 3.9%, P =0.203), OS(75.2% vs 83.8%, P =0.131) and LFS(74.6% vs 69.1%, P =0.912) between the decitabine group(37 cases) and the non-decitabine group(78 cases). CONCLUSION Decitabine-based conditioning regimen could reduce the relapse rate of AML CR1 patients with good safety.
Humans ; Leukemia, Myeloid, Acute/therapy* ; Hematopoietic Stem Cell Transplantation/methods* ; Decitabine/therapeutic use* ; Transplantation Conditioning/methods* ; Retrospective Studies ; Graft vs Host Disease ; Transplantation, Homologous ; Male ; Female ; Adult ; Middle Aged ; Adolescent ; Young Adult

OBJECTIVE: To investigate the characteristics of gut microbiota changes in patients with acute myeloid leukemia (AML) undergoing induction chemotherapy and to explore the relationship between infectious complications and gut microbiota. METHODS: Fecal samples were collected from 37 newly diagnosed AML patients at four time points: before induction chemotherapy, during chemotherapy, during the neutropenic phase, and during the recovery phase. Metagenomic sequencing was used to analyze the dynamic changes in gut microbiota. Correlation analyses were conducted to assess the relationship between changes in gut microbiota and the occurrence of infectious complications. RESULTS: During chemotherapy, the gut microbiota α-diversity (Shannon index) of AML patients exhibited significant fluctuations. Specifically, the diversity decreased significantly during induction chemotherapy, further declined during the neutropenic phase (P < 0.05, compared to baseline), and gradually recovered during the recovery phase, though not fully returning to baseline levels.The abundances of beneficial bacteria, such as Firmicutes and Bacteroidetes, gradually decreased during chemotherapy, whereas the abundances of opportunistic pathogens, including Enterococcus, Klebsiella, and Escherichia coli, progressively increased.Analysis of the dynamic changes in gut microbiota of seven patients with bloodstream infections revealed that the bloodstream infection pathogens could be detected in the gut microbiota of the corresponding patients, with their abundance gradually increasing during the course of infection. This finding suggests that bloodstream infections may be associated with opportunistic pathogens originating from the gut microbiota.Compared to non-infected patients, the baseline samples of infected patients showed a significantly lower relative abundance of Bacteroidetes (P < 0.05). Regression analysis indicated that Bacteroidetes abundance is an independent predictive factor for infectious complications (P < 0.05, OR =13.143). CONCLUSION During induction chemotherapy in AML patients, gut microbiota α-diversity fluctuates significantly, and the abundance of opportunistic pathogens increase, which may be associated with bloodstream infections. Patients with lower baseline Bacteroidetes abundance are more prone to infections, and its abundance can serve as an independent predictor of infectious complications.
Humans ; Gastrointestinal Microbiome ; Leukemia, Myeloid, Acute/microbiology* ; Induction Chemotherapy ; Feces/microbiology* ; Male ; Female ; Middle Aged

Precancerous lesions of gastric cancer(PLGC)is a key pathological stage in the process of inflammation cancer transformation of the gastric mucosa.Early diagnosis and effective intervention in this stage have positive significance in preventing the occurrence of gastric cancer.Numerous studies have confirmed that traditional Chinese medicine can effectively intervene in PLGC by regulating cell proliferation and apoptosis,regulating inflammatory response,anti angiogenesis,inhibiting epithelial mesenchymal transition,inhibiting glycolysis,antioxidant stress,combating helicobacter pylori,regulating autophagy levels,and regulating gut microbiota through various pathways.The article systematically elaborates on the research status of the intervention mechanism of traditional Chinese medicine monomers or extracts,and traditional Chinese medicine formulas in PLGC,aiming to provide reference for the clinical treatment of this disease and related drug development.