[Objective] To validate and optimize the platelet transfusion refractoriness (PTR) prediction model for patients with hematological disorders established by our center. [Methods] The data of patients with hematological diseases who received platelet transfusions from December 2021 to December 2022 were used as the training set, and data from January 2023 to December 2023 as the validation set. The validation set data was used to validate the predictive model constructed on the training set. Relevant risk factors for PTR were collected through literature review and preliminary studies。 The patients were divided into effective and ineffective groups according to the corrected count increment (CCI) of platelet counts. Predictive factors were screened using univariate and multivariate logistic regression. The calibration of the model were assessed via calibration curves, while discrimination, accuracy, sensitivity, and specificity were evaluated using receiver operating characteristic (ROC) curves Clinical utility was further analyzed with decision curve analysis (DCA). [Results] The Hosmer-Lemeshow (H-L) goodness-of-fit test for the validation set yielded S: P=0.000, indicating that the original model needs optimization. Baseline comparisons and logistic regression identified the number of red blood cell units (RBCU) and platelet units (PLT-U) transfused as key predictors for the optimized model. The H-L goodness-of-fit test S: P values for the training and validation sets were 0.930 and 0.056, respectively; the ROC areas were 0.793 5 and 0.809 4, specificities 90.95% and 84.21%, sensitivities 59.26% and 70.04%, and accuracies 78.14% and 74.10%, respectively. DCA demonstrated clinical net benefit within a prediction probability threshold range of 0.2-0.8. [Conclusion] Transfusion volumes of RBC-U and PLT-U were inversely associated with PTR in hematological patients. The resulting PTR prediction model exhibits moderate predictive efficacy and clinical benefit.

Objective: To analyze the acute effects of exposure to fine particulate matter (PM2.5) components on primary school students lung function, so as to provide a scientific basis for protecting childrens respiratory health. Methods: From 2019 to 2021, the study selected a total of 2 120 primary school students from grades 3 to 5 in Tianjin using a stratified random sampling method to undergo lung function tests. At the same time, the shortterm exposure levels were simulated by combining PM2.5 components and student addresses, and the acute impact of PM2.5 exposure on primary school students lung function was analyzed by generalized linear models (GLM) and weighted quantile sum (WQS) regression models. Results: The average daily concentration of PM2.5 in the air of Tianjin from 2019 to 2021 was 81.14 μg/m3, which was higher than the national standard. The results of lung function testing showed that there was no statistically significant difference in lung function measurement indicators such as forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), peak expiratory flow (PEF), 75% forced expiratory volume in 75 (FEF75), and 25% forced expiratory volume in 25 (FEF25) among primary school students in different regions of Tianjin (F=1.23, 0.87, 2.34, 1.56, 0.98, P>0.05). But the GLM analysis results showed that all components of PM2.5 in the air had adverse effects on the lung function indicators of primary school students. When the concentrations of fluorene (FLU) and pyrene (PYR) increased by 10 ng/m3, the FVC of primary school students decreased by 166.44 and 61.94 L respectively. The WQS regression model analysis results showed that the mixed exposure of PM2.5 components particularly significant damaging effects on lung function indicators in primary school students, especially the FLU and PYR components in polycyclic aromatic hydrocarbons, as well as the heavy metal lead. Conclusions Both single and mixed exposure to various PM2.5 components in the air have adverse effects on the lung function of primary school students. Among them, the influences of FLU and PYR in polycyclic aromatic hydrocarbons, as well as heavy metal Pb, are particularly significant.Potential pollution sources should be controlled to protect the respiratory health of primary school students by comprehensive prevention and control measures.

The application of platelet-rich plasma (PRP) in wound repair is progressively garnering attention. However, certain patients, owing to relative or absolute contraindications, encounter impediments in the acquisition or application of autologous PRP. The utilization of homologous allogeneic PRP, sourced through rigorous donor selection and standardized preparation methodologies, as a substitute for autologous PRP, may hold favorable implications for such individuals. This article endeavors to succinctly delineate and forecast the mechanisms, advantages, limitations, efficacy and safety of allogeneic PRP in the context of wound healing, furnishing a foundation for its implementation in wound repair.

BACKGROUND:Tendinopathy is a musculoskeletal disorder characterized by pain and decreased mobility,with pathological changes of disturbed collagen and hyperplasia of the vasculature.Tendinopathy tends to occur in athletes,physical workers,and the elderly.One of the mechanisms of tendinopathy is the"failed healing response",and part of what causes the failed healing response is the erroneous differentiation of tendon stem/progenitor cells. OBJECTIVE:By reviewing the relevant literature,we introduce the characteristics of tendon stem/progenitor cells,summarize the factors that affect the differentiation of tendon stem/progenitor cells to tendon cells and those that lead to mis-differentiation of tendon stem/progenitor cells(differentiation to adipocytes,osteocytes and chondrocytes),and also describe the limitations of tendon stem/progenitor cells in clinical applications. METHODS:PubMed and Web of Science databases were searched for the terms"tendon stem/progenitor cells,tendinopathy,tendon injury,differentiation".The relevant literature was screened by reading and 109 articles were included for the analysis of the results. RESULTS AND CONCLUSION:(1)Tendon stem/progenitor cells are a type of stem cells that can spontaneously differentiate into tendons and have the ability to self-renew,clone,and multi-differentiate.Various external conditions acting on tendon stem/progenitor cells can lead them to differentiate in diverse directions.The specific factors that regulate the fate of tendon stem/progenitor cells are not known with certainty.When stem cell renewal and differentiation in tendons becomes abnormal,it can lead to failure of tendon healing and consequently to tendinopathy.(2)Aging,changes in extracellular matrix composition,excessive mechanical stimulation,prostaglandin E2 and interleukin-6 as well as interleukin-10 and some systemic diseases may be important in regulating the mis-differentiation of tendon stem/progenitor cells.(3)Possible favorable factors that promote the differentiation of tendon stem/progenitor cells to tenocytes are:some growth factors and cytokines,moderate mechanical stimulation and topography of the extracellular matrix,low oxygen tension,drugs,and several transcriptional genes and proteins.(4)The most desirable therapeutic tools are the regulation of endogenous tendon stem/progenitor cells or the stimulation of endogenous tendon stem/progenitor cell proliferation and differentiation by exogenous tendon stem/progenitor cells.(5)Understanding the factors that regulate mis-differentiation of tendon stem/progenitor cells may provide insight into the pathogenesis of tendinopathy and identify therapeutic targets.Elaborating on the induction of tendon stem/progenitor cell differentiation into tendons could facilitate their use in tissue engineering.

Payment by diagnosis related groups(DRG)is an important research direction in China's current medical insurance payment reform.However,it limits the clinical development and utilization of innovative medicines to a certain extent.Additional payments for innovative medicines have been thoroughly studied in many countries.This paper conducted an analysis and summary of the global experience regarding additional payment for innovative medicines under the DRG payment system.U-sing the United States,France,and Germany as case studies,this paper also examined the current state of medical insurance pay-ment for innovative medicines in China and the influence of DRG payment on the development of such medicine.In addition,it has put forward explicit policy recommendations,including the establishment of inclusion criteria,the selection of appropriate payment modes,the implementation of dynamic adjustment mechanisms,the enhancement of payment methods,etc.This paper aims to provide references to comprehensively promote DRG payment reform while further establishing and enhancing medical in-surance payment mechanisms related to innovative medicines in the context of China's national conditions.

Objective To explore Professor Wu Liqun's medication law for treating tic disorders in children.Methods Medical records of tic disorders children treated by Professor Wu Liqun from September 2016 to October 2022 were collected,and a database was established.SPSS Statistics 23 was used for frequency statistics,and Liquorice software was used for multi-scale backbone network analysis and multi-layer core network analysis to summarize the medication law.Results Totally 709 medical records were included,involving 834 prescriptions and 203 kinds of Chinese materia medica.The drug categories were mostly tonic drugs,heat-clearing drugs,and liver-pacifying and wind-relieving drugs.The properties of the drugs were mainly warming,cold,and mild,and the meridians were mostly in the lung,liver,and spleen meridians.Complex network analysis showed that the core prescription consisted of 20 kinds of Chinese materia medica,such as Angelicae Sinensis Radix,Paeoniae Radix Alba,Chuanxiong Rhizoma,Codonopsis Radix,and 30 groups of commonly used medicine pairs and commonly used medicines with different symptoms and commodities were obtained.Conclusion Professor Wu Liqun's treatment for tic disorders in children focuses on treating"liver wind",evacuating external wind to cut off the course of the disease,soothing the liver and subduing yang to extinguish internal wind,paying attention to regulating liver qi,nourishing yin and soothing the liver,nourishing blood and extinguishing wind.

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.