[Objective]To elaborate and summarize the teaching reform in formulas of traditional Chinese medicine(TCM)of"four gradients and three dimensions"based on outcomes-based education(OBE)concept,so as to provide reference for the development of TCM education.[Methods]Based on OBE education concept,according to the existing problems targeted from the teaching objective,teaching content,teaching resources,teaching methods,as well as assessment and evaluation,the following teaching practices were carried out,including the four gradients of"understanding formulas-knowing formulas-distinguishing formulas-making formulas",and three dimensions of"studying formulas intensively-improving the medical technology-refining the medical skills",and the physician qualification examination was taken as a medium and long-term measurement index.[Results]Teaching reform based on OBE concept mainly includes clarifying teaching objective,adjusting teaching content,utilizing online resources,innovating teaching methods,exploring assessment and evaluation,and other aspects.Data analysis of the TCM Physician Qualification Examination scores of full-time undergraduate students in formulas of TCM showed that the mastery rate of it at our school was consistently higher than the national average for ten consecutive years from 2012 to 2021.Our school's Formulas of TCM was awarded as the First-Class Course in Zhejiang Province in 2021.The online course Exploring Prescription Pharmacology was awarded the First-Class Course in Zhejiang Province in 2022.The course Formulas of TCM was awarded the National First-Class Course in 2023.[Conclusion]The"four gradients and three dimensions"teaching reform model of pharmacology based on OBE concept can improve student performance and course evaluation,which is conducive to the development of the cause of TCM education.

Medical insurance fund is the foundation for the healthy operation of the medical insurance system, which is related to the well-being of the people and social stability. Medical institutions, as important entities in the implementation of medical insurance policies and the use of medical insurance funds, should continuously improve and optimize their self-management, and strengthen the prevention and control of clean risks in the use of medical insurance funds. This is not only a necessary response measure in the context of strict supervision of national medical insurance funds, but also an inevitable choice for hospitals under the trend of high-quality development. This article took a certain hospital as an example to illustrate the practice of sorting out the relevant authority directory for the use of medical insurance funds, analyze the integrity risk points of doctors, patients, and medical insurance reimbursement auditors; And introduced the practice of using a clean risk prevention and control grid to strengthen the hospital′s medical insurance fund, including improving the medical insurance management system, cultivating a sustainable culture of integrity, optimizing process design, improving information system construction, and improving medical insurance service modes, so as to provide reference for other medical institutions.

Objective:To transfect the non-viral vector polyethylenimine (PEI)mediated miR-2861 mimic into the MC3T3-E1 cell line,and to explore the transfection efficiency of PEI/miR-2861 complex and its effects on the proliferation and osteogenesis differentiation in pre-osteoblasts. Methods:The proper amount of PEI was blended with miR-2861 mimic and negative control (NC)separately in a ratio of N∶P=10∶1,and they were divided into experiment group and NC group. The NC/PEI complex acted as the NC group was used to eliminate the interference of osteogenesis from the addition of double-stranded RNA mimic.MTT assay was used to determine the optimal concentration of PEI/miR-2861 mimic complex.The fluorescence imaging technique and bulge-loop RT-PCR were used to detect the transfection efficiency and mRNA expression of miRNA-2861 in the cells with different concentrations (10,30, 50,and 100 nmol · L-1 ), separately.The osteogenesis ability of MC3T3 cells was identified with RT-PCR and Alizarin red staining with the selected concentration of PEI/miR-2861 by transient transfection.Results:Compared with blank control group,the proliferation rates of MC3T3 cells in 100 nmol·L-1 PEI/miR-2861 group was decreased significantly at 72 h (P < 0. 05 ). With the increasing of transfected concentration the transfection efficiency of miRNA/PEI complex was increased gradually.The results of Alizarin red staining and quantitative analysis showed that calcium deposits were more and bigger in experiment group after induced for 21 d,while both in blank control group and NC group they were less.Conclusion:The miRNA-2861 mimic can be effectively transfected into the MC3T3-E1 cell line and expresses with a high level,which is mediated by PEI as the gene vector.miR-2861 mimic has a certain ability of promoting osteogenesis differentiation of MC3T3-E1 cells.

Objectives To observe the frequencies of mutations at glycophorin A(GPA)of erythro-cytes in patients with high arsenic coal poisoning(HACP)in comparison with normal controls.Methods The peripheral erythrocytes were isolated and immunolabelled,and were detected by flow cytometry in40patients and18normal adults.Results The mutation frequencies(MF)were(21.23?13.97)?10 -6 for type NN,(33.13?25.72)?10 -6 for type NO,(110.90?63.58)?10 -6 for type MM,and(20.35?21.26)?10 -6 for type MO of erythrocytes in patients with HACP,which were significantly higher than those in normal controls.The mutation frequencies were(31.50?16.13)?10 -6 for type NN,(54.50?38.13)?10 -6 for type NO,(159.33?66.22)?10 -6 for type MM,and(45.16?12.69)?10 -6 for type MO of erythrocytes in tumor group of HACP patients,which were significantly higher than those of non-tumor group of the patients.Conclusions Arsenic poisoning may induce the mutation at the glycophorin-A locus of erythrocytes,sug-gesting that arsenic may be one of potential mutagens.GPA-MF may serve as a parameter for the detection of patients with HACP.