Objective To explore the integration value of mobile virtual reality devices in the classroom teaching of human anatomy,and to evaluate their potential impact on the in-depth construction of human anatomy knowledge,the cultivation of spatial cognitive ability,and the transformation of teaching paradigms from the perspectives of cognitive load theory and situated learning.Methods The undergraduate students majoring in clinical medicine in Peking University were selected as the research objects.Among them,students in grade 2019 were the control group,and students in grade 2022 were the experimental group,introducing movable virtual anatomy equipment and other teaching auxiliary method in theory and practice courses.The final exam scores of the two groups of students were compared,and a questionnaire survey was conducted for the experimental group after the course,and the survey result were statistically analyzed.Results The final examination result showed that the average score of the experimental group was 82.47±10.19,and the average score of the control group was 74.82±16.56,which was significantly higher in the experimental group than in the control group,with statistical significance(P＜0.05).The questionnaire survey result showed that compared with traditional classroom teaching,94.62％of students preferred the new auxiliary teaching mode such as VR,96.77％of students believed that VR assisted teaching could achieve the traditional teaching effect or better,95.7％of them think that it improved students' interest in learning human anatomy,and 98.92％thought that it improved students' knowledge of anatomy.Conclusion The application of mobile virtual reality devices in anatomy classroom teaching provides immersive and interactive 3D visualization teaching scenarios,effectively reducing students' cognitive load on abstract and complex anatomical structures,promoting spatial understanding and knowledge internalization,significantly improving teaching effectiveness and self-learning ability,thus changing the traditional anatomy teaching mode and laying a solid foundation for the development of future medical education and the cultivation of medical talents.

Objective To investigate influenza awareness of community residents in Nanchang under routine epidemic management using the Knowledge-Attitude-Practice(KAP)framework.Methods A structured questionnaire,including four do-mains(disease overview,prevention,diagnosis,and treatment),was designed and administered via street and online surveys from December 2023 to February 2024.Statistical analyses,including chi-square tests and logistic regression,were performed to identify determinant factors.Results A total of 303 valid questionnaires were retrieved,with an effective rate of approximately 94.7％.Community residents in Nanchang demonstrated a certain degree of understanding of the overview,prevention,diagno-sis,and treatment of influenza,although some gaps were identified.Univariate analysis revealed statistically significant differ-ences in influenza cognition scores among urban and rural residents(P＜0.05),residents with different educational levels(P＜0.05)and exposure levels to influenza education(P＜0.05).Multivariate regression analysis identified these as influencing fac-tors for influenza awareness.Conclusion Collaborative efforts from the government,individuals,and various societal sectors are essential to enhance the public's overall ability to prevent and control influenza.

Objective:To investigate the association of serum levels of myoglobin(Myo)and reticulocyte(Ret)with cardiac function class in patients with chronic heart failure(CHF).Methods:A total of 106 CHF patients treated in First Rongjun Special Care Hospital of Hebei Province between February 2020 and February 2024 were retrospec-tively selected as the observation group.According to New York Heart Association(NYHA)cardiac function class,patients were divided into class Ⅱ group(n=61)and class Ⅲ～Ⅳ group(n=45),and 107 healthy people with nor-mal physical examination results were selected from our hospital simultaneously as control group.The Myo and Ret levels were compared between control group and observation group,class Ⅱ group and class Ⅲ～Ⅳ group.Spearman correlation analysis was used to analyze the association of Myo and Ret levels with NYHA class in CHF patients.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of Myo,Ret and their combined detection for NYHA class Ⅲ～Ⅳ in CHF patients.Results:Compared to participants in the control group,those in the observation group had significant higher Myo level[(50.42±9.98)μg/ml vs.(35.22±5.36)μg/ml]and significant lower Ret level[(2.24±0.68)％vs.(2.91±0.61)％](P＜0.001 all).Compared to those in class Ⅱ group,those in class Ⅲ～Ⅳ group had significant higher Myo level[(60.77±5.94)μg/ml vs.(42.79±2.97)μg/ml]and significant lower Ret level[(1.73±0.31)％vs.(2.62±0.62)％](P＜0.001 all).Spearman correlation analysis showed that Myo(r=0.654)was positively correlated with NYHA cardiac function class in CHF patients,while Ret(r=-0.589)was inversely correlated with it(P＜0.001 all).ROC analysis showed that a combination of Myo and Ret had significant higher predictive efficacy(AUC=0.926,95％CI 0.858～0.968)for NYH A class Ⅲ～Ⅳ in CHF patients than Myo(AUC=0.804,95％CI 0.716～0.875)and Ret(AUC=0.701,95％CI 0.604～0.786)alone(Z=2.745,4.183,P＜0.01 both).Conclusion:Our study showed that Myo and Ret levels were significantly correlated with NYHA class in CHF patients.Moreover,a combination of Myo and Ret levels showed better diagnostic value for NYHA class Ⅲ～Ⅳ in this population.

Objective To investigate influenza awareness of community residents in Nanchang under routine epidemic management using the Knowledge-Attitude-Practice(KAP)framework.Methods A structured questionnaire,including four do-mains(disease overview,prevention,diagnosis,and treatment),was designed and administered via street and online surveys from December 2023 to February 2024.Statistical analyses,including chi-square tests and logistic regression,were performed to identify determinant factors.Results A total of 303 valid questionnaires were retrieved,with an effective rate of approximately 94.7％.Community residents in Nanchang demonstrated a certain degree of understanding of the overview,prevention,diagno-sis,and treatment of influenza,although some gaps were identified.Univariate analysis revealed statistically significant differ-ences in influenza cognition scores among urban and rural residents(P＜0.05),residents with different educational levels(P＜0.05)and exposure levels to influenza education(P＜0.05).Multivariate regression analysis identified these as influencing fac-tors for influenza awareness.Conclusion Collaborative efforts from the government,individuals,and various societal sectors are essential to enhance the public's overall ability to prevent and control influenza.

Objective:To investigate the association of serum levels of myoglobin(Myo)and reticulocyte(Ret)with cardiac function class in patients with chronic heart failure(CHF).Methods:A total of 106 CHF patients treated in First Rongjun Special Care Hospital of Hebei Province between February 2020 and February 2024 were retrospec-tively selected as the observation group.According to New York Heart Association(NYHA)cardiac function class,patients were divided into class Ⅱ group(n=61)and class Ⅲ～Ⅳ group(n=45),and 107 healthy people with nor-mal physical examination results were selected from our hospital simultaneously as control group.The Myo and Ret levels were compared between control group and observation group,class Ⅱ group and class Ⅲ～Ⅳ group.Spearman correlation analysis was used to analyze the association of Myo and Ret levels with NYHA class in CHF patients.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of Myo,Ret and their combined detection for NYHA class Ⅲ～Ⅳ in CHF patients.Results:Compared to participants in the control group,those in the observation group had significant higher Myo level[(50.42±9.98)μg/ml vs.(35.22±5.36)μg/ml]and significant lower Ret level[(2.24±0.68)％vs.(2.91±0.61)％](P＜0.001 all).Compared to those in class Ⅱ group,those in class Ⅲ～Ⅳ group had significant higher Myo level[(60.77±5.94)μg/ml vs.(42.79±2.97)μg/ml]and significant lower Ret level[(1.73±0.31)％vs.(2.62±0.62)％](P＜0.001 all).Spearman correlation analysis showed that Myo(r=0.654)was positively correlated with NYHA cardiac function class in CHF patients,while Ret(r=-0.589)was inversely correlated with it(P＜0.001 all).ROC analysis showed that a combination of Myo and Ret had significant higher predictive efficacy(AUC=0.926,95％CI 0.858～0.968)for NYH A class Ⅲ～Ⅳ in CHF patients than Myo(AUC=0.804,95％CI 0.716～0.875)and Ret(AUC=0.701,95％CI 0.604～0.786)alone(Z=2.745,4.183,P＜0.01 both).Conclusion:Our study showed that Myo and Ret levels were significantly correlated with NYHA class in CHF patients.Moreover,a combination of Myo and Ret levels showed better diagnostic value for NYHA class Ⅲ～Ⅳ in this population.

Background: Genetic defects in the human thyroid-stimulating hormone (TSH) receptor (TSHR) gene can cause congenital hypothyroidism (CH). However, the biological functions and comprehensive genotype–phenotype relationships for most TSHR variants associated with CH remain unexplored. We aimed to identify TSHR variants in Chinese patients with CH, analyze the functions of the variants, and explore the relationships between TSHR genotypes and clinical phenotypes. Methods: In total, 367 patients with CH were recruited for TSHR variant screening using whole-exome sequencing. The effects of the variants were evaluated by in-silico programs such as SIFT and polyphen2. Furthermore, these variants were transfected into 293T cells to detect their Gs/cyclic AMP and Gq/11 signaling activity. Results: Among the 367 patients with CH, 17 TSHR variants, including three novel variants, were identified in 45 patients, and 18 patients carried biallelic TSHR variants. In vitro experiments showed that 10 variants were associated with Gs/cyclic AMP and Gq/11 signaling pathway impairment to varying degrees. Patients with TSHR biallelic variants had lower serum TSH levels and higher free triiodothyronine and thyroxine levels at diagnosis than those with DUOX2 biallelic variants. Conclusions We found a high frequency of TSHR variants in Chinese patients with CH (12.3%), and 4.9% of cases were caused by TSHR biallelic variants. Ten variants were identified as loss-of-function variants. The data suggest that the clinical phenotype of CH patients caused by TSHR biallelic variants is relatively mild. Our study expands the TSHR variant spectrum and provides further evidence for the elucidation of the genetic etiology of CH.

Objective The long-term epidemiological and etiological characteristics of hand, foot and mouth disease (HFMD) in Huai’an, Jiangsu were analyzed to provide scientific evidence for the prevention of HFMD. Methods The data of HFMD reports, etiological diagnosis and in Huai’an from 2009 to 2022 were described and analyzed. Results A total of 78 535 cases were reported from 2009 to 2022 , with 14-year average annual incidence rate of 114.71/100 000. Before 2020, the incidence rate of HFMD in Huai’an showed the epidemic intensity increased every other year on the whole, and the average annual incidence rate during the COVID-19 pandemic (2020-2022) (55.69/100 000) was significantly lower than that in previous years (2009-2019) (129.95/100 000). The joinpoint regression analysis showed that the best fitting model from 2009 to 2022 had no joinpoints, APC=AAPC=-1.24%. The overall trend showed a monotonously decreasing trend, but the trend was not statistically significant. The male-to-female distribution ratio was 1.53:1, and the age distribution was mainly under 5 years old, especially in scattered children. The epidemic season was from April to July. The results of etiological surveillance showed that the co-epidemic of Coxsackievirus A16 (CV-A16) and Enterovirus A71 (EV-A71) during the early stages had changed to the co-epidemic of CV-A16 and CV-A6 in the current period. Conclusion The burden of HFMD in Huai’an was large, and the epidemic intensity increased every other year was affected by the COVID-19 pandemic. The epidemiological features after the COVID-19 pandemic should be further monitored.

Objective To investigate the infection status and changing trend of hepatitis C virus(HCV)infection in hospitalized patients in medical institutions,and provide reference for formulating HCV infection prevention and control strategies.Methods HCV infection surveillance results from cross-sectional survey data reported to China Healthcare-associated Infection(HAI)Surveillance System in 2020 were summarized and analyzed,HCV positive was serum anti-HCV positive or HCV RNA positive,survey result was compared with the survey results from 2003.Results In 2020,1 071 368 inpatients in 1 573 hospitals were surveyed,738 535 of whom underwent HCV test,4 014 patients were infected with HCV,with a detection rate of 68.93％and a HCV positive rate of 0.54％.The positive rate of HCV in male and female patients were 0.60％and 0.48％,respectively,with a statistically sig-nificant difference(x2=47.18,P＜0.001).The HCV positive rate in the 50-＜60 age group was the highest(0.76％),followed by the 40-＜50 age group(0.71％).Difference among all age groups was statistically signifi-cant(x2=696.74,P＜0.001).In 2003,91 113 inpatients were surveyed.35 145 of whom underwent HCV test,resulting in a detection rate of 38.57％;775 patients were infected with HCV,with a positive rate of 2.21％.In 2020,HCV positive rates in hospitals of different scales were 0.46％-0.63％,with the highest in hospital with bed numbers ranging 600-899.Patients'HCV positive rates in hospitals of different scales was statistically signifi-cant(X2=35.34,P＜0.001).In 2020,12 provinces/municipalities had over 10 000 patients underwent HCV-rela-ted test,and HCV positive rates ranged 0.19％-0.81％,with the highest rate from Hainan Province.HCV posi-tive rates in different departments were 0.06％-0.82％,with the lowest positive rate in the department of pedia-trics and the highest in the department of internal medicine.In 2003 and 2020,HCV positive rates in the depart-ment of infectious diseases were the highest,being 7.95％and 3.48％,respectively.Followed by departments of orthopedics(7.72％),gastroenterology(3.77％),nephrology(3.57％)and general intensive care unit(ICU,3.10％)in 2003,as well as departments of gastroenterology(1.35％),nephrology(1.18％),endocrinology(0.91％),and general intensive care unit(ICU,0.79％)in 2020.Conclusion Compared with 2003,HCV positive rate decreased significantly in 2020.HCV infected patients were mainly from the department of infectious diseases,followed by departments of gastroenterology,nephrology and general ICU.HCV infection positive rate varies with gender,age,and region.

Objective To explore the predictive value of CT radiomics and morphological features for the prognosis and survival in non-small cell lung cancer(NSCLC)patients.Methods The clinic data of 300 NSCLC patients(300 lesions)were downloaded from the Cancer Imaging Archive,with 210 randomly selected as the training set and 90 as the test set.According to the prognosis and survival,the patients were divided into two groups with survival period≤3 and＞3 years.3D Slicer software was used to delineate the regions of interest layer by layer in CT images,and the radiomics features were extracted from each region of interest.Both t-test and least absolute shrinkage and selection operator were utilized for radiomics feature screening.Three types of prediction models,namely radiomics model,morphological model and combined model,were constructed with Logistic regression,whose performances were evaluated using the receiver operating characteristic(ROC)curve.Results The differences in radiomics labels and mediastinal lymph node metastasis between the training set and the test set were statistically significant.For radiomics model,morphological model and combined model,the area under the ROC curve was 0.784(95%CI:0.722-0.847),0.734(95%CI:0.664-0.804)and 0.748(95%CI:0.680-0.815)in the training set,and 0.737(95%CI:0.630-0.844),0.665(95%CI:0.554-0.777)and 0.687(95%CI:0.578-0.797)in the test set,which demonstrated that radiomics model had the best diagnostic performance.Conclusion The CT radiomics model can effectively predict the prognosis and survival in NSCLC patients.

The assessment of adverse drug events is an important basis for clinical safety evaluation and post-marketing risk control of drugs,and its causality assessment is gaining increasing attention.The existing methods for assessing the causal relationship between drugs and the occurrence of adverse reactions can be broadly classified into three categories:global introspective methods,standardized methods,and probabilistic methods.At present,there is no systematic introduction of the operational details of the various methods in the domestic literature.This paper compares representative causality assessment methods in terms of definition and concept,methodological steps,industry evaluation and advantages and disadvantages,clarifies the basic process of determining the causality of adverse drug reactions,and discusses how to further improve the adverse drug reaction monitoring and evaluation system,with a view to providing a reference for drug development and pharmacovigilance work in China.