The organ system-integrated curriculum system overcomes the limitations of single teaching methods and the drawbacks of neglecting holism and interconnectedness, effectively transforming knowledge into competency. Tianjin Medical University has pioneered the "double-track integrated teaching reform" to align with the objective of training undergraduate clinical medical talents. This system is centered on the eight major human body systems, breaking traditional disciplinary boundaries and achieving systematic integration of basic medical and clinical courses. First implemented in 2019 in the "5+3" clinical and pediatric programs, the system has undergone three rounds of teaching practice since 2021, forming a distinctive integrated curriculum system. Using the circulatory system as a model, the reform reorganized teaching content, developed specialized textbooks, and assembled interdisciplinary teaching teams, fostering a shared instructional approach through cross-disciplinary training. The teaching model integrates theoretical and practical learning with curriculum-based ideological and political education, employing problem-based learning to encourage self-directed study and leveraging an online-offline mixed approach to enhance teaching effectiveness. An innovative closed-loop assessment system incorporating formative evaluation has been established, integrating multidimensional feedback from exam analysis, student and faculty questionnaire surveys, and teaching supervision to continuously optimize curriculum development. The reform has significantly enhanced medical students' professional competencies and overall capabilities, providing an innovative paradigm for training high-level medical professionals in the new era.

At present,indocyanine green(ICG)is intraoperative imaging agent with the most of advantages,and the ICG fluorescence imaging technique that derived from it has been widely developed in surgery with laparoscope for colorectal cancer.This technique can effectively realize tumor localization,assessment for resection margin,imaging of lymph node and lymphatic vessel,which has important value in judging the blood supply of the anastomosis,and can further effectively improve surgical safety and reduce the risk of postoperative complications.In addition,ICG fluorescence imaging technique can also powerfully promote the development of minimally invasion and individualization of colorectal surgery.With the advancement of laparoscopic equipment,deepening of medical theory,progress of surgical techniques,and the integration of artificial intelligence and medicine,the application scenarios of ICG imaging technique are gradually expanding.This article reviewed the imaging principles,current status of application,and current existing issues of ICG fluorescence imaging technique in surgery for colorectal cancer,which conducted preliminarily exploration for its value in guiding the practice of the theory of membrane anatomy.

Objective To investigate the effect and mechanisms of celecoxib on right heart function in mice with acute high-altitude hypoxia exposure.Methods Male C57BL/6J mice(7 weeks old)were housed in a hypobaric chamber simulating an altitude of 5 800 m for 2 d to establish an animal model of acute hypobaric hypoxia.①Eighteen mice were randomly assigned to plain+saline(P+S),high-altitude hypoxia exposure+saline(H+S),and high-altitude hypoxia exposure+celecoxib(H+Cel).Body weight and routine blood indicators were measured,and cardiac ultrasound examination were performed for heart rate(HR),pulmonary artery acceleration time to ejection time ratio(AT/ET),tricuspid annular plane systolic excursion(TAPSE),tricuspid annular systolic velocity(S'),and left ventricular ejection fraction(LVEF)and fractional shortening(FS).Targeted metabolomic profiling was applied to detect the cardiac arachidonic acid(AA)metabolite levels.The contents of 12,13-dihydroxy-9Z-octadecenoic acid(12,13-diHOME)in the heart,liver,brown adipose tissue,and plasma were quantified by ELISA.② Eighteen mice were randomly assigned into plain+saline(P+S),high-altitude hypoxia exposure+saline(H+S)and high-altitude hypoxia exposure+12,13-diHOME(H+di)groups.Body weight,routine blood tests,and echocardiography were performed as above.③ Thirty-two mice were randomly divided into high-altitude hypoxia exposure+saline(H+S),high-altitude hypoxia exposure+celecoxib(H+Cel),high-altitude hypoxia exposure+soluble epoxide hydrolase inhibitor(sEHI)(H+sEHI),and high-altitude hypoxia exposure+sEHI+celecoxib(H+sEHI+Cel)groups.Body weight,routine blood tests,and echocardiography were performed as above.Cardiac and plasma contents of 12,13-diHOME and epoxyeicosatrienoic acids(EETs)were measured by ELISA.Results ① Compared to the P+S group,the H+S group exhibited significantly reduction of cardiac 12,13-diHOME level(P<0.001),increased counts of white blood cells(WBC)and neutrophils(P<0.01)and decreased TAPSE,S'and AT/ET both at resting state and under stress(P<0.01,P<0.001).Compared to the H+S group,the H+Cel group exhibited significantly increase of cardiac 12,13-diHOME level(P<0.05),reduced WBC and lymphocyte counts(P<0.01,P<0.05)and improved TAPSE and S'levels at resting state and under stress(P<0.01,P<0.001).② Compared to the H+S group,the H+di group demonstrated significantly improvement of TAPSE at basal and under stress(P<0.001)and a trend towards improved TAPSE at resting state(P=0.0532),but no obvious differences was observed in WBC and neutrophil counts between the H+di group and the H+S group.③ Compared to the H+Cel group,both the H+sEHI and H+sEHI+Cel groups exhibited significantly reduction of cardiac 12,13-diHOME level(P<0.01,P<0.05)though no statistical changes in cardiac function indicators.Compared to the H+S group,WBC counts and lymphocyte were decreased,and serum EETs level was incrased in the H+Cel group,H+sEHI group and H+sEHI+Cel group(P<0.01,P<0.001).Conclusion Celecoxib can elevate cardiac level of 12,13-diHOME and improves right heart function in mice after acute high-altitude hypoxia exposure through the CYP450-sEH metabolic pathway.

Objective To investigate whether interleukin-37(IL-37)affects macrophage M1 polarization via nu-cleotide oligomerization of structural domain receptor protein 1(NOD1)/nuclear factor κB(NF-κB)in plasma cell mastitis.Methods A total of 15 patients with plasma cell mastitis were recruited according to the collection standard as inflammatory breast tissue and normal breast tissue with a distance of ≥ 3 cm from the edge of the in-flammatory breast tissue.QPCR was performed to detect NOD1 and IL-3.Phorbol ester(PE)was used to induce THP-1 cells to differentiate into resting macrophages(M0).Lipopolysaccharide(LPS)combined with interferon(IFN-γ)was used to induce the polarization of M0 macrophages towards the M1 phenotype.NOD1 lentiviral RNA interference or over-expression vectors were constructed to regulate the expression of NOD1 in M1 macrophages.M0 macrophages were pretreated with IL-37 recombinant protein and then incubated with LPS and IFN-γ for induction.The expression of NOD1,IL-37,M1 markers(IL-6 and iNOS)and M2 markers(IL-10 and Arg-1)was quantified by qPCR.Western blot was employed to assess the protein level of NOD1,NF-κB p65,and p-NF-κB p65.Co-immunoprecipitation was used to detect the interaction between NOD1 and IL-37.Results Up-regulation of NOD1 and down-regulation of IL-37 as were found in inflammatory breast tissues(P＜0.05).Compared to M0 cells,M1 cells showed up-regulated NOD1 and M1 markers and the elevated phosphorylated NF-κB p65 but the down-regulated IL-37(P＜0.05).In M1 macrophages,both NF-κB inhibitor and NOD1 knockdown led to the down-regulation of NOD1 and M1 markers and caused a decrease in the phosphorylated NF-κB p65(P＜0.05).IL-37 recombinant protein decreased phosphorylation of NOD1,M1 marker and NF-κB p65,which was reversed by over-expression of NOD1.IL-37 may interact with NOD1(P＜0.05).Conclusions IL-37 may inhibit M1 polarization in macrophages by down-regulating NOD1/NF-κB pathway thereby preventing plasma cell mastitis progression.

The organ system-integrated curriculum system overcomes the limitations of single teaching methods and the drawbacks of neglecting holism and interconnectedness, effectively transforming knowledge into competency. Tianjin Medical University has pioneered the "double-track integrated teaching reform" to align with the objective of training undergraduate clinical medical talents. This system is centered on the eight major human body systems, breaking traditional disciplinary boundaries and achieving systematic integration of basic medical and clinical courses. First implemented in 2019 in the "5+3" clinical and pediatric programs, the system has undergone three rounds of teaching practice since 2021, forming a distinctive integrated curriculum system. Using the circulatory system as a model, the reform reorganized teaching content, developed specialized textbooks, and assembled interdisciplinary teaching teams, fostering a shared instructional approach through cross-disciplinary training. The teaching model integrates theoretical and practical learning with curriculum-based ideological and political education, employing problem-based learning to encourage self-directed study and leveraging an online-offline mixed approach to enhance teaching effectiveness. An innovative closed-loop assessment system incorporating formative evaluation has been established, integrating multidimensional feedback from exam analysis, student and faculty questionnaire surveys, and teaching supervision to continuously optimize curriculum development. The reform has significantly enhanced medical students' professional competencies and overall capabilities, providing an innovative paradigm for training high-level medical professionals in the new era.

At present,indocyanine green(ICG)is intraoperative imaging agent with the most of advantages,and the ICG fluorescence imaging technique that derived from it has been widely developed in surgery with laparoscope for colorectal cancer.This technique can effectively realize tumor localization,assessment for resection margin,imaging of lymph node and lymphatic vessel,which has important value in judging the blood supply of the anastomosis,and can further effectively improve surgical safety and reduce the risk of postoperative complications.In addition,ICG fluorescence imaging technique can also powerfully promote the development of minimally invasion and individualization of colorectal surgery.With the advancement of laparoscopic equipment,deepening of medical theory,progress of surgical techniques,and the integration of artificial intelligence and medicine,the application scenarios of ICG imaging technique are gradually expanding.This article reviewed the imaging principles,current status of application,and current existing issues of ICG fluorescence imaging technique in surgery for colorectal cancer,which conducted preliminarily exploration for its value in guiding the practice of the theory of membrane anatomy.

Objective:To investigate the application value of laparoscopic-assisted total liver transplantation.Methods:The retrospective and descriptive study was conducted. The clinical data of 9 pairs of donors and recipients who underwent laparoscopic-assisted total liver transplanta-tion in People′s Hospital of Guangxi Zhuang Autonomous Region from January to April 2024 were collected. Of the donors, there were 8 males and 1 female, aged (39±18)years and with body mass index (BMI) of (20±4)kg/m 2. Of the recipients, there were 7 males and 2 females, aged (41±13)years and with BMI of (24±4)kg/m 2. Measurement data with normal distribution were represented as Mean± SD. Count data were described as absolute numbers. Results:(1) Surgical conditions. Of the 9 recipients, 7 recipients underwent laparoscopic-assisted total liver transplantation successfully, 1 recipient with severe portal hypertension converted to open surgery with reverse L-shaped incision due to the hemorrhage during the dissection of the first hepatic portal after completing liver mobilization under laparoscopy, and 1 recipient underwent trans-umbilical extension incision through the middle of the epigastric region due to the limited space for operation in the implantation of the donor liver. The total operation time for 7 recipients who successfully underwent laparoscopic-assisted total liver transplantation was (648±31)minutes, with a time of anhepatic phase of (57±5)minutes, the volume of intraoperative blood loss of (1 322±627)mL, the donor liver mass of (1 195±232)g, and the ratio of donor liver mass to recipient body mass of 1.86%±0.42%. The operation time for laparoscopic liver dissection and porta hepatis dissection in 8 recipients during surgery was (212±35)minutes. (2) Postoperative conditions. All 9 recipients recovered smoothly after surgery, without any vascular or biliary related complications, and the surgical incision recovered well. The duration of postoperative hospital stay of 7 recipients who successfully underwent laparoscopic-assisted total liver transplantation was (14.2±2.0)days. (3) Follow-up. All 9 recipients were followed up for 3 months after surgery. During the follow-up period, there was no vascular or bile duct related complication.Conclusion:Laparoscopic-assisted total liver transplantation can be applied to recipients who meet surgical conditions and achieve good short-term clinical efficacy.

Aging and age-related ailments have emerged as critical challenges and great burdens within the global contemporary society.Addressing these concerns is an imperative task,with the aims of postponing the aging process and finding effective treatments for age-related degenerative diseases.Recent investigations have highlighted the significant roles of nicotinamide adenine dinucleotide(NAD+)in the realm of anti-aging.It has been empirically evidenced that supplementation with nicotinamide mononucleotide(NMN)can elevate NAD+levels in the body,thereby ameliorating certain age-related degenerative diseases.The principal anti-aging mechanisms of NMN essentially lie in its impact on cellular energy metabolism,inhibition of cell apoptosis,modulation of immune function,and preservation of genomic stability,which collectively contribute to the deferral of the aging process.This paper critically reviews and evaluates existing research on the anti-aging mechanisms of NMN,elucidates the inherent limitations of current research,and proposes novel avenues for anti-aging investigations.

Objective:To investigate the application value of laparoscopic-assisted total liver transplantation.Methods:The retrospective and descriptive study was conducted. The clinical data of 9 pairs of donors and recipients who underwent laparoscopic-assisted total liver transplanta-tion in People′s Hospital of Guangxi Zhuang Autonomous Region from January to April 2024 were collected. Of the donors, there were 8 males and 1 female, aged (39±18)years and with body mass index (BMI) of (20±4)kg/m 2. Of the recipients, there were 7 males and 2 females, aged (41±13)years and with BMI of (24±4)kg/m 2. Measurement data with normal distribution were represented as Mean± SD. Count data were described as absolute numbers. Results:(1) Surgical conditions. Of the 9 recipients, 7 recipients underwent laparoscopic-assisted total liver transplantation successfully, 1 recipient with severe portal hypertension converted to open surgery with reverse L-shaped incision due to the hemorrhage during the dissection of the first hepatic portal after completing liver mobilization under laparoscopy, and 1 recipient underwent trans-umbilical extension incision through the middle of the epigastric region due to the limited space for operation in the implantation of the donor liver. The total operation time for 7 recipients who successfully underwent laparoscopic-assisted total liver transplantation was (648±31)minutes, with a time of anhepatic phase of (57±5)minutes, the volume of intraoperative blood loss of (1 322±627)mL, the donor liver mass of (1 195±232)g, and the ratio of donor liver mass to recipient body mass of 1.86%±0.42%. The operation time for laparoscopic liver dissection and porta hepatis dissection in 8 recipients during surgery was (212±35)minutes. (2) Postoperative conditions. All 9 recipients recovered smoothly after surgery, without any vascular or biliary related complications, and the surgical incision recovered well. The duration of postoperative hospital stay of 7 recipients who successfully underwent laparoscopic-assisted total liver transplantation was (14.2±2.0)days. (3) Follow-up. All 9 recipients were followed up for 3 months after surgery. During the follow-up period, there was no vascular or bile duct related complication.Conclusion:Laparoscopic-assisted total liver transplantation can be applied to recipients who meet surgical conditions and achieve good short-term clinical efficacy.

Objective:This study aims to study the mental health status of people with different identities during the fight against COVID-19. Further, we propose psychological intervention strategies for people with different identities.Methods:857 participants from Guangdong province (215 identified as first-level population referring to the impact severity of the outbreak, 91 as second-level population, 120 as third-level population, and 431 as fourth level population) were cross-sectionally surveyed online from January 30 to February 28, 2020. The Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Perceived Stress Scale (PSS-10) were used to evaluate the mental health status of different populations. The Kruskal-Wallis H test was used to test the differences of the total scores of these three scales across populations at different levels, and the groups were compared pairwise with the Bonferroni method. Finally, the Wilcoxon rank sum test was used to further analyze the dimensions between the scales. Results:In all 857 subjects, the total scores of GAD-7, PHQ-9, and PSS-10 were 4(1,8), 4(1,9), and 16(11,19), respectively. There were statistically significant differences in the scores of GAD-7 ( H=15.235, P<0.01), PHQ-9 ( H=9.265, P=0.026), and PSS-10 ( H=8.435, P=0.049) among different levels of the population. For the score of GAD-7, the anxiety severity of the first-level crowd was higher than that of the second-level crowd and the fourth-level crowd. The pairwise comparisons were statistically significant ( Z=-2.932, -4.012, -2.949, P<0.005); there were significant between-group differences in domains of "becoming easily annoyed or irritable" and "seemingly terrible things will happen". For the score of PHQ-9, the depression severity of the first-level crowd and the second-level crowd was higher than that of the fourth-level crowd, and the pairwise comparisons were statistically significant ( Z=-3.387, -2.682, P<0.005). There were significant between-group differences in domains of "difficult to fall asleep or not awake", "feeling depressed" and other related domains. For the score of PSS-10, the stress severity of the third-level crowd was higher than that of the first-level crowd and the fourth-level crowd ( Z=-2.702, -3.693, -2.735, P<0.005). There were significant between-group differences in domains of "feel confident", "life is as expected", "the ability to control anger", "the things are all under control", and other related domains. Conclusion:The impact of the COVID-19 on mental health in people with different identities is different, and appropriate psychological interventions should be provided for different populations according to their mental health status.