Objective:Chronic obstructive pulmonary disease(COPD)is a significant global public health issue.Modern medical treatments have both benefits and limitations,prompting increasing attention from scholars worldwide on traditional ethnic medicine,and the Zangsiwei Qingfei Mixture is a newly developed formula derived from the effective components of classical Tibetan medicine to treat chronic respiratory diseases.This study aims to investigate the clinical efficacy and safety of the Zangsiwei Qingfei Mixture combined with conventional treatment in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods:Sixty AECOPD patients admitted to the Second Xiangya Hospital of Central South University from May 2021 to May 2023 were enrolled and randomly divided into 2 groups,with 30 patients in each group.The control group received conventional treatment,including bronchodilators,anti-infection agents,expectorants,and oxygen therapy.The experimental group received the Zangsiwei Qingfei Mixture in addition to conventional treatment.The treatment duration was 7 d for both groups.Baseline data such as gender,age,body mass index(BMI),smoking status,Global Initiative for Chronic Obstructive Lung Disease(GOLD)classification,COPD course,and the number of COPD exacerbations in the past year were collected.The primary efficacy indicators were assessed using the modified Medical Research Council(mMRC)dyspnea scale and the modified Borg scale.Secondary indicators included arterial lactic acid(LAC)and serum tumor necrosis factor alpha(TNF-α)levels.Safety indicators included liver and kidney function[alanine transaminase(ALT),aspartate transaminase(AST),serum creatinine(SCr),serum uric acid(SUA)],coagulation function[activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB),and D-dimer].The generalized linear mixed model(GLMM)was used to evaluate the clinical efficacy and safety of the Zangsiwei Qingfei Mixture. Results:Before treatment,there were no statistically significant differences in general baseline data,grading of mMRC dyspnea scale,score of modified Borg scale,arterial LAC,ALT,AST,SCr,SUA,APTT,FIB,and D-dimer between the 2 groups(all P＞0.05).However,serum TNF-α and PT levels in the experimental group were significantly lower than those in the control group(both P＜0.05).GLMM analysis showed that after adjusting for pre-and post-treatment,gender,age,BMI,smoking status,GOLD classification,COPD course,and the number of COPD exacerbations in the past year,the experimental group demonstrated significantly lower grading of mMRC dyspnea scale(coefficient=-0.329,P=0.036),score of modified Borg scale(coefficient=-1.077,P=0.001),serum TNF-α level(coefficient=-14.378,P＜0.001),and arterial LAC level(coefficient=-0.409,P=0.012)compared to the control group.The Zangsiwei Qingfei Mixture had no significant effect on liver,kidney,or coagulation function indicators(all P＞0.05). Conclusion:The Zangsiwei Qingfei Mixture combined with conventional treatment can improve clinical symptoms and promote homeostasis in AECOPD patients,demonstrating safety and reliability.Combining modem medicine with traditional ethnic medicine offers a feasible approach to treating chronic respiratory diseases in the future.

Objective Exploring the effectiveness of blended learning based on the BOPPPS model applied to the education of medical students in professionalism.Methods A total of 96 clinical medical students in the 2023 grade of Harbin Medical University were selected as the research subjects.The control group was taught using traditional teaching methods,while the experimental group was taught using blended teaching methods based on the BOPPPS model.The teaching effectiveness of the two groups was compared using scale assessment and process evaluation methods.Results The experimental group scored significantly higher than the control group in terms of theoretical knowledge,professional awareness,professional ethics,communication skills,teamwork,and other indicators(P＜0.05).Conclusion The BOPPPS-based teaching model has shown significant application effects in the education of professionalism for medical students,which can effectively promote the cultivation of professionalism for medical students.

Objective Exploring the effectiveness of blended learning based on the BOPPPS model applied to the education of medical students in professionalism.Methods A total of 96 clinical medical students in the 2023 grade of Harbin Medical University were selected as the research subjects.The control group was taught using traditional teaching methods,while the experimental group was taught using blended teaching methods based on the BOPPPS model.The teaching effectiveness of the two groups was compared using scale assessment and process evaluation methods.Results The experimental group scored significantly higher than the control group in terms of theoretical knowledge,professional awareness,professional ethics,communication skills,teamwork,and other indicators(P＜0.05).Conclusion The BOPPPS-based teaching model has shown significant application effects in the education of professionalism for medical students,which can effectively promote the cultivation of professionalism for medical students.

Objective Exploring the effectiveness of blended learning based on the BOPPPS model applied to the education of medical students in professionalism.Methods A total of 96 clinical medical students in the 2023 grade of Harbin Medical University were selected as the research subjects.The control group was taught using traditional teaching methods,while the experimental group was taught using blended teaching methods based on the BOPPPS model.The teaching effectiveness of the two groups was compared using scale assessment and process evaluation methods.Results The experimental group scored significantly higher than the control group in terms of theoretical knowledge,professional awareness,professional ethics,communication skills,teamwork,and other indicators(P＜0.05).Conclusion The BOPPPS-based teaching model has shown significant application effects in the education of professionalism for medical students,which can effectively promote the cultivation of professionalism for medical students.

Objective Exploring the effectiveness of blended learning based on the BOPPPS model applied to the education of medical students in professionalism.Methods A total of 96 clinical medical students in the 2023 grade of Harbin Medical University were selected as the research subjects.The control group was taught using traditional teaching methods,while the experimental group was taught using blended teaching methods based on the BOPPPS model.The teaching effectiveness of the two groups was compared using scale assessment and process evaluation methods.Results The experimental group scored significantly higher than the control group in terms of theoretical knowledge,professional awareness,professional ethics,communication skills,teamwork,and other indicators(P＜0.05).Conclusion The BOPPPS-based teaching model has shown significant application effects in the education of professionalism for medical students,which can effectively promote the cultivation of professionalism for medical students.

Objective Exploring the effectiveness of blended learning based on the BOPPPS model applied to the education of medical students in professionalism.Methods A total of 96 clinical medical students in the 2023 grade of Harbin Medical University were selected as the research subjects.The control group was taught using traditional teaching methods,while the experimental group was taught using blended teaching methods based on the BOPPPS model.The teaching effectiveness of the two groups was compared using scale assessment and process evaluation methods.Results The experimental group scored significantly higher than the control group in terms of theoretical knowledge,professional awareness,professional ethics,communication skills,teamwork,and other indicators(P＜0.05).Conclusion The BOPPPS-based teaching model has shown significant application effects in the education of professionalism for medical students,which can effectively promote the cultivation of professionalism for medical students.

Objective Exploring the effectiveness of blended learning based on the BOPPPS model applied to the education of medical students in professionalism.Methods A total of 96 clinical medical students in the 2023 grade of Harbin Medical University were selected as the research subjects.The control group was taught using traditional teaching methods,while the experimental group was taught using blended teaching methods based on the BOPPPS model.The teaching effectiveness of the two groups was compared using scale assessment and process evaluation methods.Results The experimental group scored significantly higher than the control group in terms of theoretical knowledge,professional awareness,professional ethics,communication skills,teamwork,and other indicators(P＜0.05).Conclusion The BOPPPS-based teaching model has shown significant application effects in the education of professionalism for medical students,which can effectively promote the cultivation of professionalism for medical students.

Objective Exploring the effectiveness of blended learning based on the BOPPPS model applied to the education of medical students in professionalism.Methods A total of 96 clinical medical students in the 2023 grade of Harbin Medical University were selected as the research subjects.The control group was taught using traditional teaching methods,while the experimental group was taught using blended teaching methods based on the BOPPPS model.The teaching effectiveness of the two groups was compared using scale assessment and process evaluation methods.Results The experimental group scored significantly higher than the control group in terms of theoretical knowledge,professional awareness,professional ethics,communication skills,teamwork,and other indicators(P＜0.05).Conclusion The BOPPPS-based teaching model has shown significant application effects in the education of professionalism for medical students,which can effectively promote the cultivation of professionalism for medical students.

Objective Exploring the effectiveness of blended learning based on the BOPPPS model applied to the education of medical students in professionalism.Methods A total of 96 clinical medical students in the 2023 grade of Harbin Medical University were selected as the research subjects.The control group was taught using traditional teaching methods,while the experimental group was taught using blended teaching methods based on the BOPPPS model.The teaching effectiveness of the two groups was compared using scale assessment and process evaluation methods.Results The experimental group scored significantly higher than the control group in terms of theoretical knowledge,professional awareness,professional ethics,communication skills,teamwork,and other indicators(P＜0.05).Conclusion The BOPPPS-based teaching model has shown significant application effects in the education of professionalism for medical students,which can effectively promote the cultivation of professionalism for medical students.

Objective To summarize the liver biopsy and clinical features of patients with liver injury of unknown origin,and to investigate the value of ultrasound-guided percutaneous liver biopsy in the diagnosis of liver injury of unknown origin.Methods A retrospective analysis was performed for the clinical data and ultrasound-guided percutaneous liver biopsy results of 94 patients with liver injury of unknown origin who were admitted to Zhongshan Hospital,Xiamen University,from January 2018 to February 2023.According to the proportion of the patients with different final diagnoses,the patients were divided into autoimmune liver disease(AILD)group,metabolic associated fatty liver disease(MAFLD)group,drug-induced liver injury(DILI)group,alcoholic liver disease(ALD)group,and unknown group.An analysis of variance was used for comparison of normally distributed continuous data between multiple groups,and the Bonferroni analysis or the Dunnett'T3 test was used for further comparison between two groups;the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups;the Fisher's exact test was used for comparison of categorical data between multiple groups.Results All 94 patients with liver injury of unknown origin underwent ultrasound-guided percutaneous liver biopsy after admission,among whom 90 patients(95.7%)had a confirmed diagnosis based on liver biopsy and clinical features.There were 43 patients(45.7%)with AILD,21(22.3%)with MAFLD,15(16.0%)with DILI,6(6.4%)with ALD,1(1.1%)with AILD and MAFLD,1(1.1%)with hemochromatosis,1(1.1%)with Budd-Chiari syndrome,1(1.1%)with congenital hepatic fibrosis,and 1(1.1%)with idiopathic portal hypertension,while 4 patients(4.3%)still had an unknown etiology after liver biopsy.There were significant differences between the patients with top five diagnoses in age(F=4.457,P<0.05),body mass index(BMI)(F=3.245,P<0.05),aspartate aminotransferase(AST)(H=11.128,P<0.05),gamma-glutamyl transpeptidase(GGT)(H=24.789,P<0.05),alkaline phosphatase(ALP)(H=26.013,P<0.05),IgG(H=19.099,P<0.05),IgM(H=21.263,P<0.05),AMA-M2 positive rate(P<0.05),and ANA positive rate(P<0.05).Compared with the MAFLD group,the AILD group had significantly higher age,AST,GGT,and ALP and a significantly lower BMI;compared with the MAFLD group and the DILI group,the AILD group had significant increases in IgG and IgM;the AILD group had significant increases in the positive rates of AMA-M2 and ANA compared with the other four groups.Conclusion AILD,MAFLD,and DILI are the most common causes in patients with liver injury of unknown origin.Ultrasound-guided percutaneous liver biopsy plays an important role in determining the cause of liver injury of unknown origin,but it is still needed to make a comprehensive analysis based on clinical history,different types of liver injury,laboratory markers,and imaging data.