Objective:To investigate the application effect of team-based learning (TBL) versus lecture-based learning (LBL) in the first aid skill training of peacekeeping forces.Methods:A total of 326 officers and soldiers who had not participated in first aid skill training from various peacekeeping units in the Gao area of the Eastern Theater of United Nations Multidimensional Integrated Stabilization Mission in Mali from September 2022 to June 2023 were selected and divided into groups A and B using numerical randomization, with 163 individuals in each group. The individuals in group A received LBL teaching, and those in group B received TBL teaching. Questionnaire survey, theoretical assessment, and operational skill assessment were performed for all officers and soldiers after the end of the course. SPSS 19.0 was used for the t-test and the chi-square test. Results:Compared with the LBL group, the TBL group had significantly better first aid awareness, first aid skills, team collaboration ability, and humanistic concern and a significantly higher degree of satisfaction with the training mode. The LBL group had a slightly higher theoretical assessment score than the TBL group [(86.73±8.57) vs. (85.92±7.66)], with no significant difference between the two groups. Compared with the LBL group, the TBL group had significantly better scores of each operational skill and the total score of operational skill assessment [(86.71±11.25) vs. (81.14±10.05)].Conclusions:As a relatively effective training mode, the TBL teaching method has significant advantages in improving the first aid awareness, team collaboration ability, and practical operation ability of peacekeeping personnel, and therefore, it holds promise for application in Mali and other peacekeeping task areas.

Objective The mechanism of Huazhuo xingxue decoction(HZXXD)in the treatment of ischemic stroke was explored through network pharmacology,molecular docking and cell validation.Methods TCMSP,TCMID,BATMAN-TCM database and literature search were used to get the chemical components and related target proteins of Huazhuo Xingxue Decoction,and the targets of dementia,stroke and amnesia were obtained from Genecards database and OMIM database.The traditional Chinese medicine-active components-target-network and protein interaction map were constructed by using Cytoscape,and the target was enriched by KEGG pathway by David database.Western blot was used to investigate the effect of HZXXD on inflammation-related core targets expression using oxygen and glucose deprivation/reoxygenation cell model.Finally,Autodock was used for molecular docking of key active ingredients and important targets to evaluate their binding activity.Results 76 active molecules and 33 common targets of herb-disease were screened out.KEGG bioaccumulation results involve multiple inflammatory signal pathways such as TNF,chemical carcinogenesis-reactive oxygen species and HIF-1.TNF-α was found to be the core target of HZXXD by oxygen glucose deprivation/reoxygenation cell experiments.Five compounds with the strongest binding ability to TNF-α,kaempferol,apigenin,aloe-emodin,baicalein and stigasterol,were screened by traditional Chinese medicine-active ingredient-target network map and molecular docking.Conclusion Huazhuo Xingxue Decoction may down regulate the expression of core target TNF-α,kaempferol,apigenin,aloe emodin,baicalein and stigasterol may be the main active substances for TNF-α binding.

Objective To investigate the clinical efficacy and aesthetic outcome of liposuction combined with mammary adenectomy through a periareolar small incision in the management of gynecomastia(GYN).Methods From January 2019 to June 2023,18 patients with GYN were admitted.All of them were treated with small incision through the areola combined with liposuction.The postoperative aesthetic effect,occurrence of complications and patient satisfaction of the patients were evaluated.Results All 18 patients in this study were follwed up for a period of 3 to 18 months.No serious complications such as wound infection or necrosis of the nipple-areola occurred.Pathological examinations were consistent with the diagnosis of GYN.Except for one patient,who exhibited slight skin folds in the surgical area at the 12-month follow-up,the other patients all achieved symmetrical and smooth chest contours with noticeable aesthetic improvement,resulting in a 100％patient satisfaction rate.Conclusion The combined approach of liposuction combined with mammary adenectomy through a periareolar small incision for the treatment of GYN is straightforward,minimally invasive,and yields satisfactory therapeutic and aesthetic outcomes.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Objective:To compare the effectiveness of sacral nerve electric stimulation (SNES) and sacral nerve magnetic stimulation (SNMS) in treating patients with refractory neurogenic bladder (NB).Methods:Forty-six patients with NB after a spinal cord or cauda equina injury were randomly divided into an SNMS group and an SNES group, each of 23. In addition to basic bladder intervention, the SNMS group was treated with SNMS in the sacral 3 (S3) nerve root area once a day for 21 minutes, 5 days a week for 4 weeks. The SNES group received 24h uninterrupted SNES treatment for 4 consecutive weeks. The bladder pressure-volume assessment indexes, voiding diary indexes, and scores on the Chinese version of the Simplified Health Assessment Scale (SF-Qualiveen) were compared between the two groups before and after 4 weeks of treatment.Results:After the treatment, the safe bladder capacity, average daily number of micturitions, average daily single micturition volume, average daily single maximum micturition volume, average daily number of catheterizations, and average daily single maximum catheterization volume of both groups had improved significantly. After the treatment, the maximum intravesical pressure of the bladder (storage period), bladder compliance, average daily single catheterization volume, and SF-Qua-liveen scores of the SNES group had improved significantly. And that group′s average safe bladder capacity, bladder compliance, daily number of micturitions and average daily single catheterization volume were significantly better than the SNMS group′s averages. The SNES group′s average maximum intravesical bladder pressure and average SF-Qualiveen score were also significantly better.Conclusion:Both SNMS and SNES can improve urine storage and voiding for those with refractory NB in the short term, but SNES is clinically more effective and better improves patients′ life quality.

Objective To investigate the effect and mechanism of zanthoxylum bungeanum seed oil on autophagy and apoptosis of laryngeal cancer cells.Methods Human bronchial epithelial cells BEAS-2B and human laryngeal cancer cells Hep-2 were treated with different volume fractions(v/v)of Zanthoxylum bungeanum seed oil(0,0.02%,0.04%,0.06%,0.08%,0.10%),respectively,cell viability was detected by cell counting kit-8 method(CCK-8).Hep-2 cells in logarithmic growth phase were randomly divided into control group,Zanthoxylum bungeanum seed oil low,medium and high dose groups and Zanthoxylum bungeanum seed oil high dose+insulin-like growth factor 1(IGF-1)(PI3K agonist)group,cell apoptosis and cell cycle progression were detected by flow cytometry(FCM)assay,the formation of autophagic vesicles was detected by monodansyl cadaverine(MDC)staining,the expression of apoptosis,autophagy and phosphatidylinositide 3-kinases(PI3K)/protein kinase B(AKT)/mechanistic target of rapamycin(mTOR)pathway-related proteins were detected by Western blotting(WB).Results Compared with the control group Hep-2(99.03%±0.82%),treatment with zanthoxylum bungeanum seed oil(0.02%,0.04%,0.06%,0.08%,0.10%)(v/v)could reduce cell survival rate(84.63%±0.73%,57.34%±0.84%,19.76%±0.62%,17.22%±0.72%,12.19%±0.81%),and the differences were statistically significant(t=22.718～133.559,all P<0.001),while it has no inhibitory effect on BEAS-2B activity(t=0.283～1.980,all P>0.05).Compared with the control group,the Hep-2 apoptosis rate,G1/G0 phase cell proportion,autophagic vesicle integrated optical density(IOD)value,Cleaved-caspase-3,Bcl-2 associated X protein(Bax),microtubule-associated protein 1A/1B 1ight chain 3I/Ⅱ(LC 3I/Ⅱ)and Beclin-1 expression were all increased in the low,medium,and high-close groups of zantheoxylum bungeanum seed oil(t=4.270～58.425);the proportion of G2/M phase cells,ubiquitin-binding protein P62,Bcl-2 expression and p-PI3K/PI3K,p-AKT/AKT and p-mTOR/mTOR expression were all decreased(t=3.041～58.765),and the differences were statistically significant(all P<0.05).Compared with the high-dose zanthoxylum bungeanum seed oil group,the apoptosis rate of Hep-2,the proportion of G1/G0 phase cells,the expression of Cleaved-caspase-3,Bax,LC3Ⅱ/I and Beclin-1,the IOD value of autophagic vesicles(t=4.931～39.507),the expression of Bcl-2 and ubiquitin-binding protein P62,the proportion of G2/M phase cells,the ratio of p-PI3K/PI3K,p-AKT/AKT and p-mTOR/mTOR in the high-dose zanthoxylum bungeanum seed oil+IGF-1 group were decreased(t=3.402～14.207),and the differences were statistically significant(all P<0.05).Conclusion Zanthoxylum bungeanum seed oil can promote autophagy and apoptosis of Hep-2 cells,and its mechanism may be related to the inhibition of PI3K/AKT/mTOR pathway activation.

OBJECTIVE To design and synthesize mono-carbonyl curcumin analogues(MCACs)and investigate the activities of them against breast cancer.METHODS The analogues F1,F2,and F3 were obtained by aldol condensation reaction,and their antitumor activities(including the activities of human breast cancer cell MCF-7 and human lung cancer cell A549)were detected by MTT assay[evaluated with half inhibitory concentration(IC50)].The results of MTT assay were compared with those of curcumin.Bioinformatics methods were used to collect the core targets of analogues F1,F2 and F3 acting on breast cancer,and then molecular docking verification was carried out.The cell experiments were conducted to investigate the effects of high,medium and low concentrations(16,8,4 μmol/L)of F1,F2 and F3 on the expression of the first core target protein as well as the effects of medium concentration of F1,F2 and F3 on the expression of cleaved-caspase-3.RESULTS Compared with curcumin,IC50 of analogues F1,F2 and F3 to A549 and MCF-7 cells(except for IC50 of analogue F2 to A549 cells)were decreased significantly(P＜0.05 or P＜0.01);among them,IC50of analogue F2 to MCF-7 cell was the lowest,being(9.67±1.27)μmol/L.Bioinformatics analysis showed that index of affinity of analogues F1,F2 and F3 with the first core target epidermal growth factor receptor(EGFR),protein kinase B(AKT)and AKT were 5.909 2,8.402 5 and 6.486 6,respectively;high concentration of F1 could significantly reduce the phosphorylation level of EGFR protein in MCF-7 cells(P＜0.01),while low,medium,and high concentrations of F2 and high concentration of F3 could significantly reduce the phosphorylation level of AKT protein in MCF-7 cells(P＜0.05 or P＜0.01).Medium concentration of F1,F2,and F3 could significantly increase the expression level of cleaved-caspase-3 protein in MCF-7 cells(P＜0.01).CONCLUSIONS Designed and synthesized MCACs F1,F2 and F3 all have good anti-breast cancer activity,and F2 has better anti-breast cancer activity.

Objective:To investigate the predictive value of transabdominal uterine electromyography for pre-term labor after tocolysis in women with threatened preterm labor.Methods:A total of 48 pregnant women at 28-34 weeks of gestation diagnosed with threatened preterm labor and admitted to The Fourth Affiliated Hospital of Soo-chow University from January to September 2023 were included.According to the response to tocolysis and whether the pregnancy was prolonged for at least 48 h,women were divided into two groups:non-preterm birth within 48 h(n=35)and preterm birth within 48 h(n=13).Uterine electromyography parameters and difference were compared before and after tocolytic therapy in two groups.Univariate Logistic regression was performed to predict the related factors of preterm birth within 48 h after the using of tocolysis in pregnant women with threat-ened preterm birth by uterine electromyography,and receiver operating characteristic(ROC)curve was per-formed to evaluate their performance.Results:Compared to before treatment with tocolysis,after therapy,in the non-preterm birth within 48 h group,significant reductions in contraction frequency,area,duration and amplitude were observed(P<0.05).In the preterm birth within 48 h group,only contraction frequency decreased significant-ly(P<0.05).Univariate Logistic regression indicated that contraction frequency,contraction duration,and contrac-tion area were predictive factors for premature birth within 48 h after tocolysis(P<0.05).When the duration of u-terine contractions lasting for 104.55 s or more the sensitivity and specificity of predicting premature birth within 48 h are 92.3％and 68.6％,respectively.Conclusions:Uterine electromyography may predict the premature birth within 48 h after tocolytic treatment in preterm labor,which may provide reference for subsequent corticosteroid therapy or transfer of high-risk pregnant patients.

Objective To investigate the effect and mechanism of zanthoxylum bungeanum seed oil on autophagy and apoptosis of laryngeal cancer cells.Methods Human bronchial epithelial cells BEAS-2B and human laryngeal cancer cells Hep-2 were treated with different volume fractions(v/v)of Zanthoxylum bungeanum seed oil(0,0.02%,0.04%,0.06%,0.08%,0.10%),respectively,cell viability was detected by cell counting kit-8 method(CCK-8).Hep-2 cells in logarithmic growth phase were randomly divided into control group,Zanthoxylum bungeanum seed oil low,medium and high dose groups and Zanthoxylum bungeanum seed oil high dose+insulin-like growth factor 1(IGF-1)(PI3K agonist)group,cell apoptosis and cell cycle progression were detected by flow cytometry(FCM)assay,the formation of autophagic vesicles was detected by monodansyl cadaverine(MDC)staining,the expression of apoptosis,autophagy and phosphatidylinositide 3-kinases(PI3K)/protein kinase B(AKT)/mechanistic target of rapamycin(mTOR)pathway-related proteins were detected by Western blotting(WB).Results Compared with the control group Hep-2(99.03%±0.82%),treatment with zanthoxylum bungeanum seed oil(0.02%,0.04%,0.06%,0.08%,0.10%)(v/v)could reduce cell survival rate(84.63%±0.73%,57.34%±0.84%,19.76%±0.62%,17.22%±0.72%,12.19%±0.81%),and the differences were statistically significant(t=22.718～133.559,all P<0.001),while it has no inhibitory effect on BEAS-2B activity(t=0.283～1.980,all P>0.05).Compared with the control group,the Hep-2 apoptosis rate,G1/G0 phase cell proportion,autophagic vesicle integrated optical density(IOD)value,Cleaved-caspase-3,Bcl-2 associated X protein(Bax),microtubule-associated protein 1A/1B 1ight chain 3I/Ⅱ(LC 3I/Ⅱ)and Beclin-1 expression were all increased in the low,medium,and high-close groups of zantheoxylum bungeanum seed oil(t=4.270～58.425);the proportion of G2/M phase cells,ubiquitin-binding protein P62,Bcl-2 expression and p-PI3K/PI3K,p-AKT/AKT and p-mTOR/mTOR expression were all decreased(t=3.041～58.765),and the differences were statistically significant(all P<0.05).Compared with the high-dose zanthoxylum bungeanum seed oil group,the apoptosis rate of Hep-2,the proportion of G1/G0 phase cells,the expression of Cleaved-caspase-3,Bax,LC3Ⅱ/I and Beclin-1,the IOD value of autophagic vesicles(t=4.931～39.507),the expression of Bcl-2 and ubiquitin-binding protein P62,the proportion of G2/M phase cells,the ratio of p-PI3K/PI3K,p-AKT/AKT and p-mTOR/mTOR in the high-dose zanthoxylum bungeanum seed oil+IGF-1 group were decreased(t=3.402～14.207),and the differences were statistically significant(all P<0.05).Conclusion Zanthoxylum bungeanum seed oil can promote autophagy and apoptosis of Hep-2 cells,and its mechanism may be related to the inhibition of PI3K/AKT/mTOR pathway activation.