Objective:To explore the implementation and effectiveness evaluation of an online-offline blended teaching method based on Outcome-Based Education(OBE)concept in integrated curriculum.Methods:A total of 28 students from Class 1 of the grade 2017 Information Management program,who underwent the traditional classroom teaching method before the reform of the Basic Medical Concepts course,were selected as the control group.Their evaluation was based on final exam scores(70%)and experimental scores(30%).In contrast,29 students from Class 1 of the grade 2019 Information Management program,who experienced the OBE teaching concept combined with online-offline blended teaching after the reform,were selected as the experimental group.Their evaluation included final exam scores(60%),experimental scores(20%),regular performance(10%),and online course performance(10%).The total scores,excellence rates,and course satisfaction were compared between the two groups.Result:The experimental group showed higher total scores,excellence rates,and course satisfaction compared to the control group(P＜0.01).Conclusion:In the teaching of integrated curriculum,optimizing and integrating online resources and offline classroom teaching based on the OBE concept,reforming the teaching evaluation method,and forming a scientific and reasonable comprehensive evaluation system are important ways and measures to achieve better teaching results in blended teaching.

Pharmaceutical patents,as a critical mechanism to incentivize medical innovation,carry complex ethical considerations due to their close association with humans'basic rights to life and health.The conflicts between rights to life and health and patent rights,the imbalance in drug accessibility caused by patent protection,the abuse of the patent system in practice,and the ethical risks of patent information asymmetry together constitute the primary obstacles to the healthy development of pharmaceutical patent ethics.Responsible innovation,as a comprehensive governance strategy,provides theoretical support for the ethical governance of pharmaceutical patents through its framework of anticipation,reflection,deliberation,and responsiveness.Drawing on the practical cases of the Supplementary Protection Certificate system in the European Union and the drug patent linkage system in the United States,this paper explored the methodology for implementing ethical balance under the framework of responsible innovation.Based on these,recommendations were proposed to improve China's pharmaceutical patent ethical governance system,including improving the pharmaceutical patent linkage system and presetting a new patent licensing framework to enhance the orderliness and predictability of pharmaceutical market access;establishing a social impact assessment system and an ethics review committee to continuously reflect on the effects of the pharmaceutical patent system on price,accessibility,and ethics;creating a multi-party consultation platform to promote information sharing and technical cooperation and ensure a balance of interests among all parties;and establishing an emergency response team and optimizing the compulsory licensing procedures to flexibly respond to changes in public health needs.

Insufficient future liver remnant volume remains a critical limitation for single-stage resection in patients with hepatic malignancies. The techniques for promoting future liver remnant hypertrophy to realize two-stage hepatectomy include portal vein embolization， associating liver partition and portal vein ligation for staged hepatectomy， and portal vein ligation. In recent years， the application of auxiliary liver transplantation has further facilitated two-stage total hepatectomy. This article systematically reviews the clinical applications of these techniques and analyzes their advantages and limitations， so as to provide a reference for optimizing clinical decision-making.

Objective To investigate the effect of miR-206 on LPS-induced apoptosis and inflamma-tory response in H9c2 cardiomyocytes.Methods An inflammatory injury model was established in H9c2 cells with treatment of 10 μg/ml LPS.Then the cells were divided into control group,LPS group,LPS1 group(LPS+anti-negative control),LPS2 group(LPS+anti-miR-206),LPS3 group(LPS+miR-206 negative control),and LPS4 group(LPS+miR-206 mimic).The LPS1,LPS2,LPS3,and LPS4 groups(n=3)were transfected with anti-negative control,anti-miR-206 se-quence,miR-negative control,or miR-206 mimic sequence,using Lipofectamine 3000 reagent.CCK-8 and EdU assays were used to detect cell proliferation,Caspase-Glo 3/7 activity kit was em-ployed to measure Caspase-3/7 activity,and ELISA was utilized to test the secretion of inflamma-tory cytokines,TNF-α,IL-1β,and IL-6 in the cells.Results Compared with the control group,the LPS group had significantly reduced cell survival rate and EDU-positive cell rate,while elevated miR-206 expression,Bax/Bcl-2,activated Caspase-3,Caspase-3/7,TNF-α,IL-1β,IL-6,p-p38 and p-p65(P＜0.05,P＜0.01).The expression of miR-206,Bax/Bcl-2,activated Caspase-3,Caspase-3/7,TNF-α,IL-1β,IL-6,p-p38 and p-p65 were obviously reduced,while the cell survival rate and EDU-positive cell rate were notably increased in the LPS 2 group than the LPS group(P＜0.05).In the LPS 4 group,the activity of Caspase-3/7 was remarkably stronger than the LPS group(1586±58 vs 816±51,P＜0.05).Conclusion Suppression of miR-206 can effectively inhibit LPS-induced apoptosis and inflammatory response in H9c2 cardiomyocytes.

Objective:To explore the implementation and effectiveness evaluation of an online-offline blended teaching method based on Outcome-Based Education(OBE)concept in integrated curriculum.Methods:A total of 28 students from Class 1 of the grade 2017 Information Management program,who underwent the traditional classroom teaching method before the reform of the Basic Medical Concepts course,were selected as the control group.Their evaluation was based on final exam scores(70%)and experimental scores(30%).In contrast,29 students from Class 1 of the grade 2019 Information Management program,who experienced the OBE teaching concept combined with online-offline blended teaching after the reform,were selected as the experimental group.Their evaluation included final exam scores(60%),experimental scores(20%),regular performance(10%),and online course performance(10%).The total scores,excellence rates,and course satisfaction were compared between the two groups.Result:The experimental group showed higher total scores,excellence rates,and course satisfaction compared to the control group(P＜0.01).Conclusion:In the teaching of integrated curriculum,optimizing and integrating online resources and offline classroom teaching based on the OBE concept,reforming the teaching evaluation method,and forming a scientific and reasonable comprehensive evaluation system are important ways and measures to achieve better teaching results in blended teaching.

Pharmaceutical patents,as a critical mechanism to incentivize medical innovation,carry complex ethical considerations due to their close association with humans'basic rights to life and health.The conflicts between rights to life and health and patent rights,the imbalance in drug accessibility caused by patent protection,the abuse of the patent system in practice,and the ethical risks of patent information asymmetry together constitute the primary obstacles to the healthy development of pharmaceutical patent ethics.Responsible innovation,as a comprehensive governance strategy,provides theoretical support for the ethical governance of pharmaceutical patents through its framework of anticipation,reflection,deliberation,and responsiveness.Drawing on the practical cases of the Supplementary Protection Certificate system in the European Union and the drug patent linkage system in the United States,this paper explored the methodology for implementing ethical balance under the framework of responsible innovation.Based on these,recommendations were proposed to improve China's pharmaceutical patent ethical governance system,including improving the pharmaceutical patent linkage system and presetting a new patent licensing framework to enhance the orderliness and predictability of pharmaceutical market access;establishing a social impact assessment system and an ethics review committee to continuously reflect on the effects of the pharmaceutical patent system on price,accessibility,and ethics;creating a multi-party consultation platform to promote information sharing and technical cooperation and ensure a balance of interests among all parties;and establishing an emergency response team and optimizing the compulsory licensing procedures to flexibly respond to changes in public health needs.

Objective To investigate the effect of miR-206 on LPS-induced apoptosis and inflamma-tory response in H9c2 cardiomyocytes.Methods An inflammatory injury model was established in H9c2 cells with treatment of 10 μg/ml LPS.Then the cells were divided into control group,LPS group,LPS1 group(LPS+anti-negative control),LPS2 group(LPS+anti-miR-206),LPS3 group(LPS+miR-206 negative control),and LPS4 group(LPS+miR-206 mimic).The LPS1,LPS2,LPS3,and LPS4 groups(n=3)were transfected with anti-negative control,anti-miR-206 se-quence,miR-negative control,or miR-206 mimic sequence,using Lipofectamine 3000 reagent.CCK-8 and EdU assays were used to detect cell proliferation,Caspase-Glo 3/7 activity kit was em-ployed to measure Caspase-3/7 activity,and ELISA was utilized to test the secretion of inflamma-tory cytokines,TNF-α,IL-1β,and IL-6 in the cells.Results Compared with the control group,the LPS group had significantly reduced cell survival rate and EDU-positive cell rate,while elevated miR-206 expression,Bax/Bcl-2,activated Caspase-3,Caspase-3/7,TNF-α,IL-1β,IL-6,p-p38 and p-p65(P＜0.05,P＜0.01).The expression of miR-206,Bax/Bcl-2,activated Caspase-3,Caspase-3/7,TNF-α,IL-1β,IL-6,p-p38 and p-p65 were obviously reduced,while the cell survival rate and EDU-positive cell rate were notably increased in the LPS 2 group than the LPS group(P＜0.05).In the LPS 4 group,the activity of Caspase-3/7 was remarkably stronger than the LPS group(1586±58 vs 816±51,P＜0.05).Conclusion Suppression of miR-206 can effectively inhibit LPS-induced apoptosis and inflammatory response in H9c2 cardiomyocytes.

Objective:To analyze the neurocognitive abnormalities and related emotional and behavioral problems in 410 adolescent patients with Turner syndrome (TS) managed in Henan Children′s Hospital in the past 5 years, and to explore the relationship between neurocognitive abnormalities and chromosome karyotype, pubertal development, hormone replacement therapy.Methods:A retrospective case series study.A total of 410 adolescent patients who were diagnosed with TS by karyotype or fluorescence in situ hybridization in the outpatient or inpatient Department of Endocrinology, Genetics and Metabolism at Henan Children′s Hospital from June 2018 to June 2023 were selected and divided into 2 groups according to age: < 12 years old and 12-18 years old.Neurocognitive assessments were performed based on the results of the Wechsler Intelligence Scale (4 th edition) for children and behavior scales for children, SPSS 22.0 software was used for data processing and statistical analysis, and chi-square test was used to analyze the correlation between chromosome karyotype, intelligence development level, pubertal development status, hormone therapy status and the occurrence of neuropsychiatric diseases. Results:Among the 410 TS patients, 207 cases had the karyotype of 45, X0/46, XX, accounting for 50.49%, 94 cases had the monosomic karyotype of 45, X0, accounting for 22.93%.Forty-six patients completed the Wechsler intelligence test, with the intelligence quotient (IQ) score ranging from 70 to 105, with high verbal comprehension and perceptual reasoning scores and low processing speed and working memory scores on all assessments.Fifty-two patients completed the hyperactivity scale assessment, and 43 cases had a predisposition to attention deficit hyperactivity disorder (ADHD).There were no significant differences in total IQ, perceptual reasoning and processing speed among the children with karyotype 45, X0, chimeric, and X chromosome structural abnormalities ( H=3.161, 1.955, 5.890, all P>0.05), while there were significant differences in verbal comprehension and working memory among the three groups ( H=7.697, 9.694, all P<0.05).Among TS patients 12-18 years old, 68 cases completed the depression scale self-assessment, of which 23 cases had depressive tendencies.There was no correlation between depressive tendency and chromosome karyotype, pubertal development and hormone replacement therapy ( P>0.05). Conclusions:TS patients generally have low intelligence levels and tend to have ADHD in childhood.TS patients in the pubertal development have a high incidence of depression.Pubertal development status and hormone replacement therapy show no correlation with the occurrence of neuropsychiatric diseases in TS patients.

Objective : To analyze the application value of metagenomic next-generation sequencing (mNGS) in the detection of pathogenic bacteria in pulmonary infection ，and to provide a theoretical basis for clinical diagnosis. Methods : A retrospective study was conducted on 161 patients with suspected pulmonary infection，and samples of bronchoalveolar lavage fluid ，sputum and lung tissue were collected specimens ，pleural effusion and blood were simultaneously subjected to routine culture，respiratory pathogen nucleic acid detection and pathogenic microorgan- ism mNGS detection．The sensitivity ，specificity，positive predictive value ，and negative predictive value of the three detection methods were calculated respectively to evaluate the clinical application value of mNGS. Results: Among 161 patients with suspected pulmonary infection，113 cases were finally confirmed as pulmonary infection. Among the 161 patients enrolled，the sensitivity and negative predictive value of mNGS were improved compared with routine culture and nucleic acid detection of respiratory pathogens，and the difference was statistically signifi- cant(P＜0. 001) ．Although the specificity of mNGS was higher than that of respiratory pathogen nucleic acid de- tection，the difference was not statistically significant．The positive predictive value of mNGS was the highest，and was higher than that of respiratory pathogen nucleic acid detection，but had no statistical significance compared with conventional culture． Conclusion The sensitivity of mNGS in the diagnosis of pathogenic microorganisms in pul- monary infection is higher than that of conventional culture and nucleic acid detection of respiratory pathogens， which reduces the false negative rate of diagnosis and has a better comprehensive evaluation ; conventional culture detection has low sensitivity，but high specificity ; respiratory pathogen nucleic acid detection compared with con- ventional culture，the sensitivity is improved，but the specificity decreased.

ObjectiveTo investigate the demographic characteristics， high-risk behavior and first CD4⁺T cell（CD4 cell） counts among newly reported HIV-infected Burmese in Dehong Dai Jingpo Autonomous Prefecture （Dehong Prefecture） from 2019 to 2020. MethodsA cross-sectional survey was conducted among newly reported HIV-infected Burmese cases in Dehong Prefecture from 2019 to 2020 to collect related information and measure their first CD4 cell counts. ResultsAmong 1 228 HIV-infected Burmese cases， 846 （68.9%） were males and 382 （31.1%） were females； 445 （36.2%） were from Kachin， and 210（17.1%） were from Shan. Of them， 960 cases （78.2%） had participated in the first CD4 cell counts testing， and 405 cases （42.2%） had a first CD4 cell counts <350 cells·μL^-1. In the multivariable logistic regression analysis， age ≥30 years （adjusted OR=1.44， 95%CI： 1.07‒1.92） and history of illicit drug use in Myanmar （adjusted OR=0.41， 95%CI： 0.21‒0.79） were independently associated with first CD4 cell counts <350 cells·μL^-1. ConclusionThe first CD4 cell counts are generally low among newly reported HIV-infected Burmese in Dehong Prefecture， especially those aged ≥ 30 years and with a history of intravenous drug use in Myanmar. Therefore， early detection of HIV infection should be strengthened for timely intervention and treatment management among Burmese.