Dura mater is a tough collagen connective tissue attached to inner surface of skull and wrapped around brain.As a buffer bridge between brain tissue and skull,its physiological function and role in skull development and repair have always been a focus of research.Recent studies have found that dura mater not only directly participates in skull development during skull growth,but also secretes a variety of cytokines that control the development of central nervous system.There are abundant material exchange and cell communication between the two.This article reviews the role of dura in development and repair of skull,and provides clues for further discovery of the relevant mechanisms of dura in development and repair of skull.

Objective To explore the clinical efficacy of staged surgery for non-lactating mastitis. Methods A retrospective analysis was conducted on 317 patients with non-lactating mastitis admitted to our department from January 2015 to December 2020, all of whom underwent staged surgical treatment. The recovery time, recurrence rate, and breast appearance score were observed. Results The median follow-up time was 24(17，33) months, the recovery time was (25.5±17.9) days, and the recurrence rate was 4.4%. There were 96.2% of patients satisfied with the breast appearance. Conclusions Staged surgery for non-lactating mastitis can effectively shorten the course of the disease, protect the appearance of breast, and have good clinical efficacy.

Objective To examine the characteristics of the prevalence of congenital cleft lip with/without cleft palate in the ethnic Tibetan population and to provide support for the precise prevention and treatment of cleft lip with/without cleft palate in the Tibetan population.Methods The clinical data of Tibetan patients with cleft lip with/without cleft palate were collected and the clinical characteristics of the patients were analyzed.The patients'age ranged from 2 months to 51 years old.All the subjects were admitted to West China Stomatology Hospital,Sichuan University for the treatment of cleft lip with/without cleft palate between January 2016 and August 2023.Most of the subjects came from Sichuan Province and the Tibet Autonomous Region.Results A total of 1 051 patients were enrolled and children aged under 12 months(460 cases)accounted for the largest proportion.Among the subjects,383 had cleft lip only(36.44%),140 had cleft palate only(13.32%),and 528 had cleft lip with cleft palate(50.24%).The male-to-female ratios of patients with cleft lip only(0.99∶1),cleft palate only(0.54∶1),and cleft lip with cleft palate(1.67∶1)exhibited significant differences(P＜0.001).However,there was no significant difference in the male-to-female ratio in patients with cleft lip only or those with cleft lip with cleft palate when the subjects were divided into two groups according to whether they had unilateral or bilateral cleft lip with/without cleft palate.Most of the patients with bilateral cleft lip were female,while most of the patients with unilateral cleft lip and unilateral or bilateral cleft lip with cleft palate were male.The unilateral cleft lip with/without cleft palate was located predominantly on the left side.Syndromic cleft lip with/without cleft palate accounted for 3.43%of all the cases and the most common concomitant deformity was congenital heart disease.3.81%(40 cases)of the patients had a family history.In the patients with cleft lip only and those with cleft palate only,the proportion of patients having parents with corresponding phenotypes was higher than those of other phenotypes of cleft lip with/without cleft palate.Regarding the birth time distribution of the children with cleft lip with/without cleft palate,Spring saw the highest number of births of these children(311 cases,29.59%),while Winter saw the lowest number of births(231 cases,21.98%).Conclusion The cases of cleft lip with/without cleft palate in the ethnic Tibetan population are predominantly cleft lip and palate.Unilateral cleft lip only or cleft lip with palate is predominantly located on the left side.Lip disease phenotypes may be more heritable.

Objective Congenital cleft lip and palate is a common birth defect that seriously affects the lives of the afflicted children and their families.Previously,no research has been done to investigate the pathogenic characteristics of cleft lip and palate among ethnic minorities,for example,Tibetans,a minority ethnic group with a large population in China.This study aims to investigate the relationship between the occurrence of cleft lip and palate in Tibetans and Han Chinese in western China and the distribution of ABO blood groups and Rh blood groups to provide a theoretical basis for the precise prevention and treatment of cleft lip and palate.Methods In this study,statistics on Tibetan patients with cleft lip and palate,some Han patients with cleft lip and palate,and normal controls from western China were retrospectively collected.All participants were patients from West China Stomatology Hospital,Sichuan University.All patients with cleft lip and palate received treatment at the hospital between January 2016 and September 2023.The normal controls were outpatients or inpatients who did not have cleft lip and palate,and who received treatment at the hospital between January 2020 and October 2023.Information on the A,B,O,and AB blood groups and Rh positive and negative blood groups of the patients was collected and compared with that of the normal controls.The incidence of different phenotypes,including cleft lip alone,cleft palate alone,and cleft lip with cleft palate,in patients of blood groups A,B,O and AB were statistically analyzed by Chi-square test.Results A total of 1227 Tibetan patients with cleft lip and palate,4064 Han patients with cleft lip and palate,and 5360 normal controls were included in the study.Among all the patients with cleft lip and palate,1863 had cleft lip alone,1425 had cleft palate alone,and 2003 had cleft lip with cleft palate.The ABO blood group distribution of Tibetan patients with cleft lip and palate was characterized as O＞B＞A＞AB,with Rh positive blood group accounting for 100%,blood type O accounting for 41.15%,and blood type B accounting for 30.64%.The blood group distribution of the Han patients with cleft lip and palate was characterized as O＞A＞B＞AB,with Rh positive blood group accounting for 99.58%,blood type O accounting for 35.78%,and type A accounting for 30.54%.There was a significant difference in ABO blood groups between Tibetan and Han patients with cleft lip and palate(P＜0.005),but no significant difference in Rh blood groups.The ABO blood group distribution of the Tibetan patients with cleft lip and palate showed an obvious difference from that of the control group,while those of the Han patients with cleft lip and cleft palate and the control group did not show obvious differences.In the analysis of the subtypes,it was found that the blood group distribution in the subtypes of cleft lip alone,cleft palate alone,and cleft lip with cleft palate in the Tibetan population was O＞B＞A＞AB,while that in the Han Chinese population was O＞A＞B＞AB.There were differences in blood group distribution between Tibetans and Hans of the subtypes of cleft lip alone and cleft lip with cleft palate(P＜0.001),but there was no difference in blood group distribution in the population of cleft palate-only subtype.The proportion of blood type O in Tibetan patients with cleft lip and palate was significantly higher than that in the Han patients with cleft lip and palate.The blood group distribution of Tibetan patients with cleft lip and palate in Sichuan Province,Xizang Autonomous Region,and Qinghai Province was always O＞B＞A＞AB.Tibetan patients from Shiqu County and Baiyu County,Ganzi Tibetan Autonomous Prefecture and Chaya County,Qamdo City were predominantly of blood type B,and those from other regions were mainly of blood type O.Conclusion There were significant differences in the phenotype composition and ABO blood group distribution between the Tibetan and Han populations with cleft lip and palate in western China.The distribution of blood group O in the population with cleft lip and palate was higher than that in the normal population,and the same trend was observed for different phenotypes.However,differences between Tibetan and Han populations in ABO blood group distribution were only found in the phenotypes of cleft lip only and cleft lip with palate.Tibetans with blood type O are more prone to cleft lip deformity than Han people,and the effect in the phenotype of cleft lip with palate is less pronounced than that in the phenotype of cleft lip only.

Objective:To explore the application effect of massive open online course (MOOC) combined with peer mutual assistance in cardiopulmonary resuscitation teaching.Methods:A total of 140 students in the same class of Batch 2015 were divided into the experimental group and the control group. In the teaching of cardiopulmonary resuscitation, the experimental group was based on the MOOC teaching platform, watched videos and topic tests before class, and used the peer mutual assistance in class. While the control group adopted traditional classroom teaching mode. The teaching effect of the two groups were evaluated by comparing the operation assessment scores and questionnaire survey of students' satisfaction with teaching. SPSS 22.0 was used for t-test and Chi-square test. Results:The operating assessment score of the experimental group was (82.20±2.31), and the operating assessment score of the control group was (75.80±1.72). The difference was statistically significant ( t=3.27, P<0.05). The questionnaire survey showed that the course satisfaction and learning motivation of the experimental group were better than those of the control group. In learning burden, the two groups had similar results ( P=0.739). Conclusion:MOOC combined with peer mutual assistance in cardiopulmonary resuscitation teaching can help students better master skills, improve students' course satisfaction and learning motivation, without increasing their learning burden.

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.

Ulcerative colitis （UC） is a chronic non-specific digestive disease with abdominal pain， diarrhea， and blood and mucus in stool as the main clinical manifestations and inflammatory injury of colorectal mucosa and submucosa as the main pathological changes. With the change in living habits and dietary structure of people， the incidence and cancer morbidity in UC are rising rapidly all over the world， which has seriously reduced the quality of life and caused a huge social burden. Till now， the pathogenesis has not been elucidated. In western medicine， aminosalicylates， corticosteroids， and immunosuppressors are commonly used to relieve symptoms. However， the long-term application will lead to problems such as decreased efficacy and increased adverse reactions. There are more studies of traditional Chinese medicine （TCM） in the treatment of UC by reducing the inflammatory response， alleviating oxidative stress， protecting the intestinal mucosal barrier， and regulating intestinal microecological imbalance by virtue of the advantages of integrated regulation based on multiple links， levels， and targets. In view of this， the present study reviewed the effect and mechanism of active ingredients of TCM， TCM extracts， TCM pairs， classic TCM compounds， and TCM combined with chemical agents in the treatment of UC based on relevant research articles in recent 10 years to provide references for seeking effective drugs.

Senescence of activated hepatic stellate cells (aHSCs) is a stable growth arrest that is implicated in liver fibrosis regression. Senescent cells often accompanied by a multi-faceted senescence-associated secretory phenotype (SASP). But little is known about how alanine-serine-cysteine transporter type-2 (ASCT2), a high affinity glutamine transporter, affects HSC senescence and SASP during liver fibrosis. Here, we identified ASCT2 is mainly elevated in aHSCs and positively correlated with liver fibrosis in human and mouse fibrotic livers. We first discovered ASCT2 inhibition induced HSCs to senescence in vitro and in vivo. The proinflammatory SASP were restricted by ASCT2 inhibition at senescence initiation to prevent paracrine migration. Mechanically, ASCT2 was a direct target of glutaminolysis-dependent proinflammatory SASP, interfering IL-1α/NF-κB feedback loop via interacting with precursor IL-1α at Lys82. From a translational perspective, atractylenolide III is identified as ASCT2 inhibitor through directly bound to Asn230 of ASCT2. The presence of -OH group in atractylenolide III is suggested to be favorable for the inhibition of ASCT2. Importantly, atractylenolide III could be utilized to treat liver fibrosis mice. Taken together, ASCT2 controlled HSC senescence while modifying the proinflammatory SASP. Targeting ASCT2 by atractylenolide III could be a therapeutic candidate for liver fibrosis.

Objective:To establish the quality evaluation method of Astmgali Radix based on three-dimensional fluorescence spectroscopy. Methods:The three-dimensional fluorescence spectra of Astmgali Radix extract was measured by fluorescence spectrum analysis technology, and the characteristics of fluorescence components of three-dimensional fluorescence spectrum of Astmgali Radix were analyzed by parallel factor analysis. The three-dimensional fluorescence spectra of Astmgali Radix samples from 23 different places were measured for quality discriminant analysis. Results:After the optimization, the three-dimensional fluorescence spectrum of 80% ethanol extract of Astmgali Radix showed that three groups of characteristic excitation/emission (λex/λem) peak, which located at 305 nm/420 nm (Peak 1), 280 nm/315 nm (Peak 2) and 265 nm/475 nm (Peak 3), respectively. The results of parallel factor analysis showed that Peak 1 and Peak 3 both contained one isoflavones fluorescent component, and Peak 2 contained two amino acid fluorescent components. There were differences in the number of characteristic peaks and fluorescence intensity of three-dimensional fluorescence spectra of Astmgali Radix samples from different origins. Conclusion:The three-dimensional fluorescence spectrum could evaluate the consistency of Astmgali Radix from different places. The method is simple, fast, and efficient. This method is accurate, which could provide reference for the quality evaluation of Astmgali Radix.

Objective:To explore the methods to improve the professional core competencies of medical students in the standardized residency training.Methods:A total of 82 medical students who participated in the standardized residency training ("resident students" for short) in the same period were selected in this study, and the self-edited professional core competencies textbooks were used for regular theoretical study, and at the same time, clinical practice cases were collected for regular scenario reduction teaching. When the resident students entered the department and after 12 months of the standardized training, the professional core competencies training evaluation scale was used to evaluate and compare the scores of the resident students, and the value of the above-mentioned training model to improve the professional core competencies of the resident students was evaluated. SPSS 18.5 was performed for t test between groups. Results:After being trained by the above model, the selected students had significantly improved such competencies as communication, cooperation and problems solving ( P<0.05). Compared with the scores of resident students before and after the training, there was no significant difference in communication and cooperation with other students ( P>0.05), with low satisfactory communication with the leader ( P>0.05), but the problem-solving ability had been significantly improved ( P<0.05), while the score of which was low and it should be pay more attention to in the future training. Conclusion:In the process of standardized residency training, the application of the above-mentioned training model can significantly improve the professional core competencies of resident students, and at the same time, it's necessary to strengthen the cultivation of satisfactory communication with leaders and problem solving ability.