As a third major discipline on par with internal medicine and surgery,interventional radiology is one of the key branches of modern medicine.The unique practicality and innovation of interventional radiology make it play an irreplaceable role in the diagnosis and treatment of diseases.In recent years,with the rapid development of technology and the updating of educational concepts,the teaching mode of interventional radiology is facing new challenges and opportunities.This article combines the clinical training methods adopted by interventional physicians in Europe and Germany,integrates imaging,anatomy and pathology teaching,strengthens the foundation,uses virtual reality(VR),augmented reality(AR)technology,and simulation training to enhance the practical ability of medical students.At the same time,with the help of online education platforms,the innovative methods and optimization strategies such as personalized learning program are implemented,which can greatly improve the teaching effectiveness of interventional radiology and provide useful references for teaching reform in this field.

Objective:To analyze the distribution and drug resistance of pathogens of bacterial bloodstream infection in patients with hematological diseases in the Department of Hematology of Tianjin Medical University General Hospital, and to provide etiological data for clinical empirical anti-infection treatment.Methods:A retrospective analysis was conducted on the general clinical information, pathogenic bacteria and drug susceptibility test results of patients with hematological diseases diagnosed with bacterial bloodstream infection by menstrual blood culture in our center from January 2016 to December 2022.Results:Patients included 498 inpatients, with a total of 639 bacterial strains. Among the patients, 86.9% patients had malignancies, and 76.7% had agranulocytosis. Symptoms of concurrent infections, including those of the respiratory tract, oral mucosa, skin and soft tissues, and abdominal sources were observed in 68.3% patients. Gram-negative bacteria (G -) accounted for 79.0% of the isolated bacteria, and gram-positive bacteria (G +) accounted for 21.0%. The top five isolated pathogens were Klebsiella pneumoniae (22.5%), Escherichia coli (20.8%), Pseudomonas aeruginosa (15.0%), Enterococcus faecium (5.5%), and Stenotrophomonas maltophilum (5.0%). Escherichia coli exhibited a decreasing trend of resistance to quinolones, cephalosporins, and carbapenems. Klebsiella pneumoniae exhibited increasing rates of resistance to quinolones and cephalosporins between 2016 and 2018, but the rated decreased after 2019. The resistance rate to carbapenems exhibited by Pseudomonas aeruginosa was approximately 20%. Carbapenem-resistant strains of Pseudomonas aeruginosa strains were first detected in 2017, with a peak resistance rate of 35.7%, detected in 2019. A 60.0% resistance rate to methicillin was observed in methicillin-resistant coagulase-negative staphylococci (MRCNS), and one case of linezolid-resistant MRCNS was detected. Conclusions:Pathogenic bacteria of bacterial bloodstream infections were widely distributed in our center, and precautions are warranted against carbapenem resistant P. aeruginosa and Klebsiella pneumoniae.

Objective:Compared to imprecisely repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC), this study aimed to explore whether localizing the DLPFC precisely or targeting on the right orbital frontal cortex (rOFC) can improve the rTMS efficacy for the treatment of depressive disorder.Methods:From January 2018 to March 2021, this study recruited patients who met the DSM-Ⅳ diagnostic criteria for depressive disorder in Shanghai Mental Health Center. Nineteen patients were located in the imprecise DLPFC group, 19 patients in the precise DLPFC group, and 14 patients in the rOFC group. All patients were assessed by the 17-item Hamilton Depression Scale (HAMD 17) and Hamilton Anxiety Scale (HAMA) at baseline and after 10-session rTMS treatments. The primary outcome of this study was the HAMD 17 response rate, and the second outcome included the reduction score and reduction ratio of the HAMD 17/HAMA. Results:At baseline, there was no significant group difference in HAMD 17 or HAMA scores among the three groups. After the rTMS treatment, the HAMD 17 response rate was significantly different among the three groups (χ2=6.86, P=0.032). The HAMD 17 response rate in the precise DLPFC group (74%) was significantly higher than that in the imprecise DLPFC group (32%, χ2=6.76, P=0.011), but was comparable with that in the rOFC group (57%, χ2=2.16, P=0.133). HAMD 17 response rate did not significantly differ between the precise DLPFC group and the rOFC group (χ2=0.99, P=0.266). The HAMD 17 reduction score tended to be significantly different among the three groups ( F=2.95, P=0.062), with the precise DLPFC group presented the highest HAMD 17 reduction score. There were no significantly differences in the reduction score of HAMD and the reduction ratio of HAMA and HAMD 17 among the three groups. Conclusions:Precisely localizing the DLPFC target may be helpful to improve the rTMS efficacy for the treatment of depressive disorder, while rOFC may be a candidate target for rTMS treatment of the depressive disorder.

Objective:Compared to imprecisely repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC), this study aimed to explore whether localizing the DLPFC precisely or targeting on the right orbital frontal cortex (rOFC) can improve the rTMS efficacy for the treatment of depressive disorder.Methods:From January 2018 to March 2021, this study recruited patients who met the DSM-Ⅳ diagnostic criteria for depressive disorder in Shanghai Mental Health Center. Nineteen patients were located in the imprecise DLPFC group, 19 patients in the precise DLPFC group, and 14 patients in the rOFC group. All patients were assessed by the 17-item Hamilton Depression Scale (HAMD 17) and Hamilton Anxiety Scale (HAMA) at baseline and after 10-session rTMS treatments. The primary outcome of this study was the HAMD 17 response rate, and the second outcome included the reduction score and reduction ratio of the HAMD 17/HAMA. Results:At baseline, there was no significant group difference in HAMD 17 or HAMA scores among the three groups. After the rTMS treatment, the HAMD 17 response rate was significantly different among the three groups (χ2=6.86, P=0.032). The HAMD 17 response rate in the precise DLPFC group (74%) was significantly higher than that in the imprecise DLPFC group (32%, χ2=6.76, P=0.011), but was comparable with that in the rOFC group (57%, χ2=2.16, P=0.133). HAMD 17 response rate did not significantly differ between the precise DLPFC group and the rOFC group (χ2=0.99, P=0.266). The HAMD 17 reduction score tended to be significantly different among the three groups ( F=2.95, P=0.062), with the precise DLPFC group presented the highest HAMD 17 reduction score. There were no significantly differences in the reduction score of HAMD and the reduction ratio of HAMA and HAMD 17 among the three groups. Conclusions:Precisely localizing the DLPFC target may be helpful to improve the rTMS efficacy for the treatment of depressive disorder, while rOFC may be a candidate target for rTMS treatment of the depressive disorder.