Objective:To explore the effect of preoperative visits based on lean management theory in the preoperative psychological state of patients undergoing cardiopulmonary bypass surgery.Methods:According to the coin toss method,72 patients undergoing cardiopulmonary bypass surgery admitted to the Cardiothoracic Surgery Department of Chenzhou First People's Hospital from May 2024 to August 2024 were randomly divided into control group and observation group,with 36 cases in each group.The control group was given routine preoperative visits,and the observation group was given preoperative visits based on lean management theory on the basis of the control group.The psychological state,information demand level,vital signs and satisfaction of the patients were compared between the two groups 1 day before operation and when entering the room.Results:After intervention,the scores of State Anxiety Scale(S-AI)and Amsterdam Preoperative Anxiety and Information Scale(APAIS)were decreased in both groups,and the observation group were significantly lower than control group(P＜0.05).The vital signs(heart rate,systolic blood pressure and diastolic blood pressure)in observation group were lower than control group(P＜0.05).After intervention,the satisfaction of patients in observation group was significantly increased(P＜0.05).Conclusion:The implementation of preoperative visit based on lean management theory can help improve the preoperative psychological state of patients undergoing cardiopulmonary bypass surgery,eliminate anxiety,provide patients with more targeted surgical information support for patients,stabilize patients 'vital signs,and improve patients' satisfaction.

Objective:To assess the professional knowledge proficiency of mainstream large language models (LLMs) in medical laboratory education and to explore their potential as educational aids for medical laboratory technology students.Methods:A comprehensive evaluation was conducted using 400 authentic questions from the 2023 Chinese National Clinical Medical Laboratory Technician Qualification Examination. Five LLMs (Copilot, Grok, Yuanbao, Doubao, and Kimi) were tested through two-round interactions using zero-shot prompting and interaction-optimized prompting strategies. The accuracy of answers and the quality of generated content were evaluated. Performance disparities were analyzed using Cochran's Q test. Content quality was scored through the CLEAR framework (completeness, lack of false information, evidence-based reasoning, appropriateness, relevance).Results:In the first-round test, Doubao achieved the highest overall accuracy rate (375/400). The overall accuracy rates of Doubao and Yuanbao significantly outperformed Copilot and Kimi ( P<0.001). After the second-round interactive optimization, the accuracy rate of Kimi significantly improved ( P<0.05), whereas other LLMs showed slight improvements ( P>0.05). Doubao still had the highest overall accuracy rate (380/400). The overall accuracy rates of Doubao and Yuanbao significantly outperformed Copilot ( P<0.005). Evaluation based on the CLEAR framework revealed that Yuanbao, Doubao, and Kimi significantly outperformed foreign models in the dimensions of evidence-based reasoning ( P<0.003) and completeness ( P<0.05), demonstrating standardized citation of authoritative evidence and superior content quality. Conclusions:The tested LLMs possess extensive medical laboratory knowledge. The accuracy of their answers and the quality of the generated content can be improved through single-question input, specifying evidence requirements, and enabling advanced reasoning functions. Domestic LLMs are comparable to foreign LLMs in terms of accuracy, and have significant advantages in the dimensions of evidence-based reasoning and completeness. LLMs can serve as auxiliary tools for learning professional knowledge in medical laboratory technology.

Objective:To assess the professional knowledge proficiency of mainstream large language models (LLMs) in medical laboratory education and to explore their potential as educational aids for medical laboratory technology students.Methods:A comprehensive evaluation was conducted using 400 authentic questions from the 2023 Chinese National Clinical Medical Laboratory Technician Qualification Examination. Five LLMs (Copilot, Grok, Yuanbao, Doubao, and Kimi) were tested through two-round interactions using zero-shot prompting and interaction-optimized prompting strategies. The accuracy of answers and the quality of generated content were evaluated. Performance disparities were analyzed using Cochran's Q test. Content quality was scored through the CLEAR framework (completeness, lack of false information, evidence-based reasoning, appropriateness, relevance).Results:In the first-round test, Doubao achieved the highest overall accuracy rate (375/400). The overall accuracy rates of Doubao and Yuanbao significantly outperformed Copilot and Kimi ( P<0.001). After the second-round interactive optimization, the accuracy rate of Kimi significantly improved ( P<0.05), whereas other LLMs showed slight improvements ( P>0.05). Doubao still had the highest overall accuracy rate (380/400). The overall accuracy rates of Doubao and Yuanbao significantly outperformed Copilot ( P<0.005). Evaluation based on the CLEAR framework revealed that Yuanbao, Doubao, and Kimi significantly outperformed foreign models in the dimensions of evidence-based reasoning ( P<0.003) and completeness ( P<0.05), demonstrating standardized citation of authoritative evidence and superior content quality. Conclusions:The tested LLMs possess extensive medical laboratory knowledge. The accuracy of their answers and the quality of the generated content can be improved through single-question input, specifying evidence requirements, and enabling advanced reasoning functions. Domestic LLMs are comparable to foreign LLMs in terms of accuracy, and have significant advantages in the dimensions of evidence-based reasoning and completeness. LLMs can serve as auxiliary tools for learning professional knowledge in medical laboratory technology.

Objective:To explore the effect of preoperative visits based on lean management theory in the preoperative psychological state of patients undergoing cardiopulmonary bypass surgery.Methods:According to the coin toss method,72 patients undergoing cardiopulmonary bypass surgery admitted to the Cardiothoracic Surgery Department of Chenzhou First People's Hospital from May 2024 to August 2024 were randomly divided into control group and observation group,with 36 cases in each group.The control group was given routine preoperative visits,and the observation group was given preoperative visits based on lean management theory on the basis of the control group.The psychological state,information demand level,vital signs and satisfaction of the patients were compared between the two groups 1 day before operation and when entering the room.Results:After intervention,the scores of State Anxiety Scale(S-AI)and Amsterdam Preoperative Anxiety and Information Scale(APAIS)were decreased in both groups,and the observation group were significantly lower than control group(P＜0.05).The vital signs(heart rate,systolic blood pressure and diastolic blood pressure)in observation group were lower than control group(P＜0.05).After intervention,the satisfaction of patients in observation group was significantly increased(P＜0.05).Conclusion:The implementation of preoperative visit based on lean management theory can help improve the preoperative psychological state of patients undergoing cardiopulmonary bypass surgery,eliminate anxiety,provide patients with more targeted surgical information support for patients,stabilize patients 'vital signs,and improve patients' satisfaction.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To explore the mechanism by which paeoniflorin improves trabecular meshwork(TM)cell dysfunction.Methods C57BL/6J mice were randomly divided into the following groups:Control group(no treatment),model group(glaucoma model constructed by ocular perfusion)and paeoniflorin group(glaucoma model followed by treatment with 50 mg·kg-1 paeoniflorin).Each group consisted of 12 mice.After 14 days of treatment,intraocular pressure was measured;and trabecular meshwork tissue was collected.TdT mediated dUDP nick end labeling(TUNEL)assay was performed to detect cell apoptosis.Western blot was used to measure protein expression levels.HTMC cells were randomly divided into the following groups:Normal group(cultured under standard conditions),rapamycin group(50 μmol·L-1 rapamycin as an autophagy inducer),experimental-L group(50 μmol·L-1 rapamycin+10 μmol·L-1 paeoniflorin)and experimental-H group(50 μmol·L-1 rapamycin+30μmol·L-1 paeoniflorin).Western blot was used to measure protein expression levels.Methyl thiazolyl tetrazolium(MTT)assay and flow cytometry were applied to evaluate cell proliferation and apoptosis.Results After 14 days of treatment,the intraocular pressure in the control,model and paeoniflorin groups were(12.81±0.83),(26.31±1.85)and(20.64±1.77)mmHg,respectively;the positive cell rate detected by the TUNEL assay were(4.86±0.44)％,(30.32±5.15)％and(15.08±1.92)％,respectively;the levels of microtubule associated protein 1 light chain 3(LC3)Ⅱ/LC3 Ⅰ protein were 0.51±0.06,1.33±0.13 and 0.72±0.08,respectively;Collagen Ⅰ protein levels were 0.45±0.07,1.11±0.12 and 0.72±0.05,respectively.The above indexes of the model group were statistically significant compared with the control group,and the above indexes of the paeoniflorin group were statistically significant compared with the model group(P＜0.001,P＜0.01).The LC3 Ⅱ/LC3 Ⅰ protein levels in the normal,rapamycin,experimental-L,experimental-H groups were 0.40±0.03,1.54±0.10,0.98±0.10 and 0.64±0.06,respectively;the cell viability rates were(100.00±6.25)％,(65.96±6.16)％,(75.22±5.54)％and(82.15±5.14)％,respectively;the apoptosis rates were(4.80±0.37)％,(19.64±0.97)％,(16.10±0.93)％and(13.16±0.94)％,respectively.The above indexes in the rapamycin group were significantly different from those in the normal group,and the above indexes in the experimental-L,-H groups were significantly different from those in the rapamycin group(P＜0.001,P＜0.05).Conclusion Paeoniflorin may improve trabecular meshwork cell dysfunction by regulating autophagy and reducing cell apoptosis,which may provide potential therapeutic strategies for glaucoma.

Objective To explore the mechanism by which paeoniflorin improves trabecular meshwork(TM)cell dysfunction.Methods C57BL/6J mice were randomly divided into the following groups:Control group(no treatment),model group(glaucoma model constructed by ocular perfusion)and paeoniflorin group(glaucoma model followed by treatment with 50 mg·kg-1 paeoniflorin).Each group consisted of 12 mice.After 14 days of treatment,intraocular pressure was measured;and trabecular meshwork tissue was collected.TdT mediated dUDP nick end labeling(TUNEL)assay was performed to detect cell apoptosis.Western blot was used to measure protein expression levels.HTMC cells were randomly divided into the following groups:Normal group(cultured under standard conditions),rapamycin group(50 μmol·L-1 rapamycin as an autophagy inducer),experimental-L group(50 μmol·L-1 rapamycin+10 μmol·L-1 paeoniflorin)and experimental-H group(50 μmol·L-1 rapamycin+30μmol·L-1 paeoniflorin).Western blot was used to measure protein expression levels.Methyl thiazolyl tetrazolium(MTT)assay and flow cytometry were applied to evaluate cell proliferation and apoptosis.Results After 14 days of treatment,the intraocular pressure in the control,model and paeoniflorin groups were(12.81±0.83),(26.31±1.85)and(20.64±1.77)mmHg,respectively;the positive cell rate detected by the TUNEL assay were(4.86±0.44)％,(30.32±5.15)％and(15.08±1.92)％,respectively;the levels of microtubule associated protein 1 light chain 3(LC3)Ⅱ/LC3 Ⅰ protein were 0.51±0.06,1.33±0.13 and 0.72±0.08,respectively;Collagen Ⅰ protein levels were 0.45±0.07,1.11±0.12 and 0.72±0.05,respectively.The above indexes of the model group were statistically significant compared with the control group,and the above indexes of the paeoniflorin group were statistically significant compared with the model group(P＜0.001,P＜0.01).The LC3 Ⅱ/LC3 Ⅰ protein levels in the normal,rapamycin,experimental-L,experimental-H groups were 0.40±0.03,1.54±0.10,0.98±0.10 and 0.64±0.06,respectively;the cell viability rates were(100.00±6.25)％,(65.96±6.16)％,(75.22±5.54)％and(82.15±5.14)％,respectively;the apoptosis rates were(4.80±0.37)％,(19.64±0.97)％,(16.10±0.93)％and(13.16±0.94)％,respectively.The above indexes in the rapamycin group were significantly different from those in the normal group,and the above indexes in the experimental-L,-H groups were significantly different from those in the rapamycin group(P＜0.001,P＜0.05).Conclusion Paeoniflorin may improve trabecular meshwork cell dysfunction by regulating autophagy and reducing cell apoptosis,which may provide potential therapeutic strategies for glaucoma.

Eleven compounds were isolated from the 95% ethanol extract of the stems of Dendrobium officinale after water extraction by various modern chromatographic techniques, such as silica gel column chromatography(CC), octadecyl-silica(ODS) CC, Sephadex LH-20 CC, preparative thin layer chromatography(PTLC) and preparative high performance liquid chromatography(PHPLC). According to spectroscopic analyses(MS, 1D-NMR, 2D-NMR) combined with optical rotation data and calculated electronic circular dichroism(ECD), their structures were identified as dendrocandin Y(1), 4,4'-dihydroxybibenzyl(2), 3-hydroxy-4',5-dimethoxybibenzyl(3), 3,3'-dihydroxy-5-methoxybibenzyl(4), 3-hydroxy-3',4',5-trimethoxybibenzyl(5), crepidatin(6), alternariol(7), 4-hydroxy-3-methoxypropiophenone(8), 3-hydroxy-4,5-dimethoxypropiophenone(9), auriculatum A(10) and hyperalcohol(11). Among them, compound 1 was a new bibenzyl derivative; compounds 2 and 7-11 have not been previously reported from Dendrobium plants; compound 6 was reported from D.officinale for the first time. Compounds 3-6 exhibited potent antioxidant activity with IC_(50) values of 3.11-9.05 μmol·L~(-1) in ABTS radical scavenging assay. Compound 4 showed significant inhibitory effect on α-glucosidase, with IC_(50) value of 17.42 μmol·L~(-1), indicating that it boasted hypoglycemic activity.
Dendrobium ; Biological Assay ; Chromatography, High Pressure Liquid ; Chromatography, Thin Layer ; Bibenzyls

Objective:To evaluate the effectiveness of the course of Laboratory Medicine and Clinical Sciences in the Laboratory Medicine Faculty of Sun Yat-sen University. Methods:Twenty-four undergraduate students in Batch 2016 of Medical Laboratory Faculty were divided into small groups (4-6 students per group). They learned each case in groups before class. In the first session of each class, the case-based study (CBS) tutor would randomly assign case-related questions to the students. Students were required to present their answers in class. The CBS tutor would guide the students to discuss the case further. In the second session, a lecture associated with the case would be given by a special subject lecturer. After the course, students, tutors and lecturers were given questionnaires and were randomly interviewed to comprehensively understand the course's effectiveness. SPSS 19.0 was used for statistics.Results:Most case discussion tutors agreed that they could guide students to discuss clinical cases well in class and give comments according to students' presentations (93.75%, 15/16). Most of the lecturers agreed that they could well guide students to think about the relationship between laboratory and clinical diagnosis and treatment in class (91.67%, 11/12). Both teachers and students had very positive evaluations of the learning mode, learning content, inspiration to students, and teachers' ability of this course. All the teachers and students agreed that the learning mode of combining CBS with special subject lecture was more helpful for the students to systematically learn medical knowledge compared with a CBS session alone or a lecture alone.Conclusion:The course, Laboratory Medicine and Clinical Sciences, which combines the CBS with the traditional lecture mode, integrates the advantages of the two learning modes. It not only stimulates students' enthusiasm for active learning, deepens clinical knowledge memory, and builds a clinical thinking model, but also enriches the teaching modes of medical laboratory education.

OBJECTIVES: To study the clinical features of intestinal polyps and the risk factors for secondary intussusception in children. METHODS: A retrospective analysis was performed for the medical data of 2 669 children with intestinal polyps. According to the presence or absence of secondary intussusception, they were divided into two groups: intussusception (n=346) and non-intussusception (n=2 323). Related medical data were compared between the two groups. The multivariate logistic regression analysis was used to identify the risk factors for secondary intussusception. RESULTS: Among the children with intestinal polyps, 62.42% were preschool children, and the male/female ratio was 2.08∶1; 92.66% had hematochezia as disease onset, and 94.34% had left colonic polyps and rectal polyps. There were 346 cases of secondary intussusception, with an incidence rate of 12.96% (346/2 669). Large polyps (OR=1.644, P<0.001), multiple polyps (≥2) (OR=6.034, P<0.001), and lobulated polyps (OR=93.801, P<0.001) were the risk factors for secondary intussusception. CONCLUSIONS Intestinal polyps in children often occur in preschool age, mostly in boys, and most of the children have hematochezia as disease onset, with the predilection sites of the left colon and the rectum. Larger polyps, multiple polyps, and lobulated polyps may increase the risk of secondary intussusception, and endoscopic intervention is needed as early as possible to improve prognosis.
Child, Preschool ; Female ; Gastrointestinal Hemorrhage ; Humans ; Intestinal Polyps/complications* ; Intussusception/complications* ; Male ; Retrospective Studies ; Risk Factors