Objective:To explore the teaching effectiveness of BOPPPS (bridge-in, objective, pre-assessment, participatory-learning, post-assessment, and summary) teaching model in the undergraduate education of pediatric surgery, compare the BOPPPS teaching model with the traditional teaching model, and examine the differences in students' understanding and mastery of knowledge, as well as their ability improvement.Methods:A total of 621 undergraduate students majoring in pediatrics at Chongqing Medical University in the 2021-2023 academic years were selected as the experimental group, and 552 undergraduate students majoring in pediatrics at Chongqing Medical University in the 2018-2020 academic years were selected as the control group. The traditional teaching method was used in the pediatric surgery teaching of the control group, while the BOPPPS teaching model was used in the experimental group. The two groups were compared based on theoretical examination scores, routine assessment scores, overall performance, and teaching satisfaction. A statistical analysis was conducted using SPSS 24.0 software. Continuous data conforming to a normal distribution were expressed as ( x?±s). Two independent samples mean t test was used for analysis. Results:The experimental group demonstrated significantly higher theoretical examination scores [(70.21±10.03) vs. (62.58±8.40)], routine assessment scores [(96.38±2.10) vs. (84.11±2.02)], and total scores [(80.68±11.30) vs. (71.19±9.50)] compared to the control group ( P<0.05). The overall satisfaction with teaching was significantly higher in the experimental group than in the control group [(91.60±1.75) vs. (90.57±0.80)] ( P<0.05). Conclusions:The application of BOPPPS teaching model in pediatric surgery teaching can improve undergraduate students' self-learning ability, clinical thinking ability, and team cooperation ability, thereby enhancing teaching quality.

Objective To investigate the efficacy,safety and operation time of ultrasound-guided percutaneous polidocanol injection chemical ablation through 17 G coaxial needle for predominantly cystic thyroid nodules.Methods The clinical data of 176 patients with predominantly cystic thyroid nodules,who received ultrasound-guided percutaneous polidocanol injection chemical ablation at authors'hospital from January 2020 to June 2023,were retrospectively analyzed.Of the 176 patients,20 mL syringe needle was used in 96(control group)and 17 G coaxial needle was used in 80(study group).The clinical safety,efficacy,and operation time were compared between the two groups.Results After the chemical ablation therapy,the volume of thyroid nodules was obviously decreased in both groups,but the difference in the volume reduction ratio(VRR)between the two groups was not statistically significant(P＞0.05).The incidence of complications and the operation time in the study group were remarkably lower than those in the control group(both P＜0.05).Conclusion In treating predominantly cystic thyroid nodules with ultrasound-guided percutaneous polidocanol injection chemical ablation,the use of 17 G coaxial needle is superior to the use of 20 mL syringe needle in reducing the incidence of complications and in shortening the operation time,therefore,this technique is suitable for beginners to adopt.

Objective To explore the constituent elements of patients'sense of gain experience and provide theoretical insights for improving patient satisfaction with healthcare services.Methods Purposive sampling and convenience sampling were employed to select 46 experts in health management from universities,hospitals,government agencies,and academic societies across China for semi-structured interviews.Qualitative analysis of the interview data was conducted using grounded theory.Results Through three-level coding,159 initial concepts,19 categories,7 main categories,and 2 core categories were identified.A conceptual framework for the constituent elements of patients'sense of gain experience was constructed,centered on two core dimensions:micro-level experience and macro-level acquisition.Conclusion The concept of"patients'sense of gain experience"enriches the theoretical framework of"sense of gain"and breaks through the unidimensional approach to evaluating medical service quality.Its enhancement requires collaborative efforts from multiple stakeholders,including medical institutions,governments,policymakers,and other actors.

Objective:To explore the teaching effectiveness of BOPPPS (bridge-in, objective, pre-assessment, participatory-learning, post-assessment, and summary) teaching model in the undergraduate education of pediatric surgery, compare the BOPPPS teaching model with the traditional teaching model, and examine the differences in students' understanding and mastery of knowledge, as well as their ability improvement.Methods:A total of 621 undergraduate students majoring in pediatrics at Chongqing Medical University in the 2021-2023 academic years were selected as the experimental group, and 552 undergraduate students majoring in pediatrics at Chongqing Medical University in the 2018-2020 academic years were selected as the control group. The traditional teaching method was used in the pediatric surgery teaching of the control group, while the BOPPPS teaching model was used in the experimental group. The two groups were compared based on theoretical examination scores, routine assessment scores, overall performance, and teaching satisfaction. A statistical analysis was conducted using SPSS 24.0 software. Continuous data conforming to a normal distribution were expressed as ( x?±s). Two independent samples mean t test was used for analysis. Results:The experimental group demonstrated significantly higher theoretical examination scores [(70.21±10.03) vs. (62.58±8.40)], routine assessment scores [(96.38±2.10) vs. (84.11±2.02)], and total scores [(80.68±11.30) vs. (71.19±9.50)] compared to the control group ( P<0.05). The overall satisfaction with teaching was significantly higher in the experimental group than in the control group [(91.60±1.75) vs. (90.57±0.80)] ( P<0.05). Conclusions:The application of BOPPPS teaching model in pediatric surgery teaching can improve undergraduate students' self-learning ability, clinical thinking ability, and team cooperation ability, thereby enhancing teaching quality.

Objective To explore the constituent elements of patients'sense of gain experience and provide theoretical insights for improving patient satisfaction with healthcare services.Methods Purposive sampling and convenience sampling were employed to select 46 experts in health management from universities,hospitals,government agencies,and academic societies across China for semi-structured interviews.Qualitative analysis of the interview data was conducted using grounded theory.Results Through three-level coding,159 initial concepts,19 categories,7 main categories,and 2 core categories were identified.A conceptual framework for the constituent elements of patients'sense of gain experience was constructed,centered on two core dimensions:micro-level experience and macro-level acquisition.Conclusion The concept of"patients'sense of gain experience"enriches the theoretical framework of"sense of gain"and breaks through the unidimensional approach to evaluating medical service quality.Its enhancement requires collaborative efforts from multiple stakeholders,including medical institutions,governments,policymakers,and other actors.

Objective To analyze the influencing factors for intestinal colonization and secondary infection of car-bapenem-resistant Klebsiella pneumoniae(CRKP)in neonates,and provide a basis for formulating prevention and control strategies for CRKP infection.Methods Neonates who were admitted to the neonatal ward of a hospital from January 2021 to October 2022 were selected as the study subjects,and the first screening of CRKP was con-ducted within 48 hours after admission.In addition,active anal swab screening for carbapenem-resistant Ente-robacterales(CRE)was performed weekly during hospitalization,and the infection status of CRKP strains was mo-nitored.Clinical data of neonates in the colonization group,non-colonization group,and infection group were ana-lyzed.Intestinal colonized strains and the non-repetitive CRKP strains isolated from clinical specimens of neonates with secondary infection after colonization were performed carbapenemase gene detection,multilocus sequence ty-ping(MLST)and pulsed-field gel electrophoresis(PFGE)analysis.Results A total of 1 438 neonates were active-ly screened for CRE,174 were CRKP positive,CRKP colonization rate was 12.1％.Among 174 neonates,35 were with secondary infection,with the incidence of 20.1％.The independent risk factors for neonatal CRKP intestinal colonization were cesarean section(OR=2.050,95％CI:1.200-3.504,P=0.009),use of cephalosporins(OR=1.889,95％CI:1.086-3.288,P=0.024),nasogastric tube feeding(OR=2.317,95％CI:1.155-4.647,P=0.018).Protective factors were breast-feeding(OR=0.506,95％CI:0.284-0.901,P=0.021),oral probiotics(OR=0.307,95％CI:0.147-0.643,P=0.002),and enema(OR=0.334,95％CI:0.171-0.656,P=0.001).Independent risk factors for secondary infection after intestinal colonization of neonatal CRKP were carbapenem anti-biotic use(OR=19.869,95％CI:1.778-222.029,P=0.015)and prolonged hospital stay(OR=1.118,95％CI:1.082-1.157,P＜0.001).The detection results of drug resistance genes showed that carbapenemase-producing genes of CRKP strains were all blaKPC-2,all belonged to type ST11.Homologous analysis showed that intestinal CRKP colonization was highly homologous with the secondary infection strains after colonization.Conclusion CRKP intestinal colonization during neonatal hospitalization may increase the risk of CRKP infection.Risk and pro-tective factors of neonatal intestinal colonization and secondary infections after colonization should be paid attention,and corresponding preventive and control measures should be taken,so as to reduce the occurrence and transmission CRKP healthcare-associated infection.

Objective To understand the spectrum and changes of pathogens causing healthcare-associated infec-tion(HAI)in neonatal intensive care unit(NICU).Methods Clinical medical records of neonates with HAI in a hospital from January 2018 to December 2022 were collected,spectrum of pathogens causing HAI were and analyzed retrospectively.Results A total of 7 597 hospitalized neonates were investigated,and 240 of whom had 263 cases of HAI,with an HAI incidence of 3.16％and healthcare-associated case infection incidence of 3.46％.96 cases(36.50％)were bloodstream infection,70(26.62％)were respiratory system infection,and 57(21.67％)were in-fection without clear sites.A total of 170 pathogens were detected from specimens,78(45.88％)of which were Gram-positive bacteria,with Staphylococcus spp.accounting for the highest proportion,78(45.88％)were Gram-negative bacteria,mainly Klebsiella pneumoniae,and 14(8.24％)were fungi.The detection rate of Gram-negative bacteria showed an upward trend from 2018 to 2022(P＜0.01).Conclusion The majority of HAI in NICU is bloodstream infection.In recent years,the detection rate of Gram-negative bacteria has been increasing year by year,and it is necessary to streng-then the prevention and control of HAI in clinical practice.

AIM To investigate the effects of Zhuangyao Shuanglu Tongnao Formula on neuronal apoptosis in rats with cerebral ischemia-reperfusion injury based on the study of oxidative stress and inflammatory response.METHODS The rats were randomly divided into the sham operation group,the model group,the edaravone group(3.0 mg/kg),the low,medium and high dose groups(9.0,18.0,36.0 g/kg)of Zhuangyao Shuanglu Tongnao Formula,with 18 rats in each group.The middle cerebral artery occlusion/reperfusion was conducted by thread embolism method to simulate cerebral ischemia reperfusion injury in rats followed by 6 days corresponding drugs administration.Subsequently,the rats had their neurological function deficit scored by Zeal Longa scoring method;their sizes of cerebral infarction areas measured by TTC staining;their pathological damage and apoptosis of neurons in hippocampal CA1 area of ischemic penumbra of the brain tissue detected by HE staining and TUNEL staining;their SOD activity and levels of GSH,MDA,IL-6,IL-1β,TNF-α in brain tissue detected by kits;and their protein expressions of Bax,Bcl-2,caspase-3,cleaved-capase-3,TLR4,NF-κB p65,Nrf2,HO-1 in rat brain tissue determined by Western blot.RESULTS Compared with the model group,the groups intervened with edaravone,medium and high dose of Zhuangyao Shuanglu Tongnao Formula displayed improvements in the scores of nerve function defects,the rate of cerebral infarction,the rate of neuronal apoptosis,the levels of IL-6,IL-1β,TNF-α and MDA in the ischemic penumbra of brain tissues,the protein expressions of Bax and TLR4,the ratio of cleaved-capase-3/caspase-3 and p-NF-κB p65/NF-κB p65(P＜0.05),the levels of GSH,the activity of SOD and the protein expressions of Bcl-2,Nrf2 and HO-1(P＜0.05).CONCLUSION Being an inhibitor of oxidative stress and inflammatory response,Zhuangyao Shuanglu Tongnao Formula can alleviate brain injury in rats with cerebral ischemia reperfusion injury through the inhibition of neuronal apoptosis and improvement of neural function mediated by the inhibition of TLR4/NF-κB signal pathway and activation of Nrf2/HO-1 signal pathway.

Objective To evaluate the efficacy and safety of brexpiprazole in treating acute schizophrenia.Methods Patients with schizophrenia were randomly divided into treatment group and control group.The treatment group was given brexpiprozole 2-4 mg·d-1 orally and the control group was given aripiprazole 10-20 mg·d-1orally,both were treated for 6 weeks.Clinical efficacy of the two groups,the response rate at endpoint,the changes from baseline to endpoint of Positive and Negative Syndrome Scale(PANSS),Clinical Global Impression-Improvement(CGI-S),Personal and Social Performance scale(PSP),PANSS Positive syndrome subscale,PANSS negative syndrome subscale were compared.The incidence of treatment-related adverse events in two groups were compared.Results There were 184 patients in treatment group and 186 patients in control group.After treatment,the response rates of treatment group and control group were 79.50％(140 cases/184 cases)and 82.40％(150 cases/186 cases),the scores of CGI-I of treatment group and control group were(2.00±1.20)and(1.90±1.01),with no significant difference(all P＞0.05).From baseline to Week 6,the mean change of PANSS total score wese(-30.70±16.96)points in treatment group and(-32.20±17.00)points in control group,with no significant difference(P＞0.05).The changes of CGI-S scores in treatment group and control group were(-2.00±1.27)and(-1.90±1.22)points,PSP scores were(18.80±14.77)and(19.20±14.55)points,PANSS positive syndrome scores were(-10.30±5.93)and(-10.80±5.81)points,PANSS negative syndrome scores were(-6.80±5.98)and(-7.30±5.15)points,with no significant difference(P＞0.05).There was no significant difference in the incidence of treatment-related adverse events between the two group(69.00％vs.64.50％,P＞0.05).Conclusion The non-inferiority of Brexpiprazole to aripiprazole was established,with comparable efficacy and acceptability.

【Objective】 To objectively evaluate the quality control level of blood testing process in blood banks through quantitative monitoring and trend analysis, and to promote the homogenization level and standardized management of blood testing laboratories in blood banks. 【Methods】 A quality monitoring indicator system covering the whole process of blood collection and supply, including blood donation service, blood component preparation, blood testing, blood supply and quality control was established. The questionnaire Quality Monitoring Indicators for Blood Collection and Supply Process with clear definition of indicators and calculation formulas was distributed to 17 blood banks in Shandong province. Quality monitoring indicators of each blood bank from January to December 2022 were collected, and 31 indicators in terms of blood testing were analyzed using SPSS25.0 software. 【Results】 The proportion of unqualified serological tests in 17 blood bank laboratories was 55.84% for ALT, 13.63% for HBsAg, 5.08% for anti HCV, 5.62% for anti HIV, 18.18% for anti TP, and 1.65% for other factors (mainly sample quality). The detection unqualified rate and median were (1.23±0.57)% and 1.11%, respectively. The ALT unqualified rate and median were (0.74±0.53)% and 0.60%, respectively. The detection unqualified rate was positively correlated with ALT unqualified rate (r=0.974, P<0.05). The unqualified rate of HBsAg, anti HCV, anti HIV and anti TP was (0.15±0.09)%, (0.05±0.04)%, (0.06±0.03)% and (0.20±0.05)% respectively. The average unqualified rate, average hemolysis rate, average insufficient volume rate and the abnormal hematocrit rate of samples in 17 blood bank laboratories was 0.21‰, 0.08‰, 0.01‰ and 0.02‰ respectively. There were differences in the retest concordance rates of four HBsAg, anti HCV and anti HIV reagents, and three anti TP reagents among 17 blood bank laboratories (P<0.05). The usage rate of ELISA reagents was (114.56±3.30)%, the outage rate of ELISA was (10.23±7.05) ‰, and the out of range rate of ELISA was (0.90±1.17) ‰. There was no correlation between the out of range rate, outrage rate and usage rate (all P>0.05), while the outrage rate was positively correlated with the usage rate (r=0.592, P<0.05). A total of 443 HBV DNA positive samples were detected in all blood banks, with an unqualified rate of 3.78/10 000; 15 HCV RNA positive samples were detected, with an unqualified rate of 0.13/10 000; 5 HIV RNA positive samples were detected, with an unqualified rate of 0.04/10 000. The unqualified rate of NAT was (0.72±0.04)‰, the single NAT reaction rate [(0.39±0.02)‰] was positively correlated with the single HBV DNA reaction rate [ (0.36±0.02) ‰] (r=0.886, P<0.05). There was a difference in the discriminated reactive rate by individual NAT among three blood bank laboratories (C, F, H) (P<0.05). The median resolution rate of 17 blood station laboratories by minipool test was 36.36%, the median rate of invalid batch of NAT was 0.67%, and the median rate of invalid result of NAT was 0.07‰. The consistency rate of ELISA dual reagent detection results was (99.63±0.24)%, and the median length of equipment failure was 14 days. The error rate of blood type testing in blood collection department was 0.14‰. 【Conclusion】 The quality monitoring indicator system for blood testing process in Shandong can monitor potential risks before, during and after the experiment, and has good applicability, feasibility, and effectiveness, and can facilitate the continuous improvement of laboratory quality control level. The application of blood testing quality monitoring indicators will promote the homogenization and standardization of blood quality management in Shandong, and lay the foundation for future comprehensive evaluations of blood banks.