BACKGROUND: While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients. METHODS: This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS ( n = 178,883) and non-BS-GPS ( n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively. RESULTS: The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge. CONCLUSION Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.
Humans ; Retrospective Studies ; Male ; Length of Stay/statistics & numerical data* ; Female ; Middle Aged ; Adult ; Psychological Distress ; Inpatients/psychology* ; Aged ; Anxiety/diagnosis* ; Depression/diagnosis*

The connection between tendons and bones is called the tendon bone connection. With the continuous improvement of national sports awareness, excessive exercises and the related intensity are prone to damage the tendon bone connection. Tendon bone healing is a complex repair and healing process involving multiple factors, and good tendon bone healing is a prerequisite for its physiological function. The complexity of tendon bone structure also poses great challenges to the repair of tendon bone injuries. In recent years, researches have found that stem cells, growth factors, macrophages, and other factors are closely related to the healing process of tendon bone injuries, among which macrophages play an important role in the healing process. The authors reviewed relevant research literature in recent years and summarized the role of macrophages in tendon bone healing, in order to provide new ideas and directions for treatment strategies to promote tendon bone healing.
Humans ; Macrophages/metabolism* ; Wound Healing ; Animals ; Tendons/physiology* ; Bone and Bones/injuries* ; Tendon Injuries

Osteoarthritis(OA)is a common joint disease in clinical practice,and cartilage damage is a typical pathological change.The pathogenesis of OA is complex,and various adverse factors can lead to the occurrence of OA.Mitochondria are im-portant organelles within cells and play important roles in cellular physiological and pathological activ-ities.Mitochondrial quality control is an important regulatory mechanism in the body to maintain nor-mal mitochondrial structure and function,mainly including mitochondrial biogenesis,mitochondrial dynamics,mitochondrial autophagy,mitochondrial oxidative stress,and other forms.The imbalance of mitochondrial quality control in chondrocytes is closely related to the occurrence and development of osteoarthritis,and regulating the balance of mi-tochondrial quality control is a potential therapeu-tic point for osteoarthritis.The author reviewed rel-evant research literature in recent years to provide a review of the relationship between mitochondrial quality control and the occurrence and develop-ment of osteoarthritis,in order to provide new ideas and directions for the research and diagnosis and treatment strategies of osteoarthritis.

Objective:To investigate the effect of a blended teaching mode based on medical knowledge graph and artificial intelligence (AI) teaching assistant on students' learning effectiveness and systematic thinking ability in teaching of pathogens and immunology.Methods:A controlled experimental design was employed, involving 114 clinical medical students ("5+3" integrated) enrolled in 2023 at Tianjin Medical University. They were divided into experimental group ( n=57) and control group ( n=57) based on their classes. A blended online-offline teaching mode based on medical knowledge graph and AI teaching assistant was used in the experimental group, and a blended online-offline teaching mode based on the online resources of this course was used in control group. Teaching effectiveness was assessed by comparing the scores of four chapter quizzes and the final exam between the two groups, as well as by analyzing student questionnaire responses. Data were analyzed using t test and χ2 test. Results:The experimental group achieved significantly higher scores in all four chapter quizzes and the final exam compared to the control group [(78.77±19.65) vs. (69.47±22.95), (84.56±14.02) vs. (76.49±16.20), (81.89±13.60) vs. (73.13±16.52), (81.56±21.28) vs. (73.16±16.27), (69.75±13.30) vs. (64.10±14.93), all P<0.05]. The questionnaire survey showed that 74.07% students ( n=40) believed that this blended teaching model stimulated their learning interest, 74.07% ( n=40) students believed that this blended teaching model enhanced their learning initiative, 81.48% ( n=44) students believed that this blended teaching model could help them construct the relationship between the old and new knowledge and thus improved memory retention, and 81.48% students b( n=44) elieved that this blended teaching model helped them integrate and summarize knowledge and construct systematic knowledge framework to improve their learning effectiveness. Conclusions:The blended teaching mode based on medical knowledge graph and AI teaching assistant is beneficial for cultivating students' systematic thinking ability and is helpful to improve their learning efficiency and effectiveness.

The organ system-integrated curriculum system overcomes the limitations of single teaching methods and the drawbacks of neglecting holism and interconnectedness, effectively transforming knowledge into competency. Tianjin Medical University has pioneered the "double-track integrated teaching reform" to align with the objective of training undergraduate clinical medical talents. This system is centered on the eight major human body systems, breaking traditional disciplinary boundaries and achieving systematic integration of basic medical and clinical courses. First implemented in 2019 in the "5+3" clinical and pediatric programs, the system has undergone three rounds of teaching practice since 2021, forming a distinctive integrated curriculum system. Using the circulatory system as a model, the reform reorganized teaching content, developed specialized textbooks, and assembled interdisciplinary teaching teams, fostering a shared instructional approach through cross-disciplinary training. The teaching model integrates theoretical and practical learning with curriculum-based ideological and political education, employing problem-based learning to encourage self-directed study and leveraging an online-offline mixed approach to enhance teaching effectiveness. An innovative closed-loop assessment system incorporating formative evaluation has been established, integrating multidimensional feedback from exam analysis, student and faculty questionnaire surveys, and teaching supervision to continuously optimize curriculum development. The reform has significantly enhanced medical students' professional competencies and overall capabilities, providing an innovative paradigm for training high-level medical professionals in the new era.

Osteoarthritis(OA)is a common joint disease in clinical practice,and cartilage damage is a typical pathological change.The pathogenesis of OA is complex,and various adverse factors can lead to the occurrence of OA.Mitochondria are im-portant organelles within cells and play important roles in cellular physiological and pathological activ-ities.Mitochondrial quality control is an important regulatory mechanism in the body to maintain nor-mal mitochondrial structure and function,mainly including mitochondrial biogenesis,mitochondrial dynamics,mitochondrial autophagy,mitochondrial oxidative stress,and other forms.The imbalance of mitochondrial quality control in chondrocytes is closely related to the occurrence and development of osteoarthritis,and regulating the balance of mi-tochondrial quality control is a potential therapeu-tic point for osteoarthritis.The author reviewed rel-evant research literature in recent years to provide a review of the relationship between mitochondrial quality control and the occurrence and develop-ment of osteoarthritis,in order to provide new ideas and directions for the research and diagnosis and treatment strategies of osteoarthritis.

The organ system-integrated curriculum system overcomes the limitations of single teaching methods and the drawbacks of neglecting holism and interconnectedness, effectively transforming knowledge into competency. Tianjin Medical University has pioneered the "double-track integrated teaching reform" to align with the objective of training undergraduate clinical medical talents. This system is centered on the eight major human body systems, breaking traditional disciplinary boundaries and achieving systematic integration of basic medical and clinical courses. First implemented in 2019 in the "5+3" clinical and pediatric programs, the system has undergone three rounds of teaching practice since 2021, forming a distinctive integrated curriculum system. Using the circulatory system as a model, the reform reorganized teaching content, developed specialized textbooks, and assembled interdisciplinary teaching teams, fostering a shared instructional approach through cross-disciplinary training. The teaching model integrates theoretical and practical learning with curriculum-based ideological and political education, employing problem-based learning to encourage self-directed study and leveraging an online-offline mixed approach to enhance teaching effectiveness. An innovative closed-loop assessment system incorporating formative evaluation has been established, integrating multidimensional feedback from exam analysis, student and faculty questionnaire surveys, and teaching supervision to continuously optimize curriculum development. The reform has significantly enhanced medical students' professional competencies and overall capabilities, providing an innovative paradigm for training high-level medical professionals in the new era.

Objective:To investigate the effect of a blended teaching mode based on medical knowledge graph and artificial intelligence (AI) teaching assistant on students' learning effectiveness and systematic thinking ability in teaching of pathogens and immunology.Methods:A controlled experimental design was employed, involving 114 clinical medical students ("5+3" integrated) enrolled in 2023 at Tianjin Medical University. They were divided into experimental group ( n=57) and control group ( n=57) based on their classes. A blended online-offline teaching mode based on medical knowledge graph and AI teaching assistant was used in the experimental group, and a blended online-offline teaching mode based on the online resources of this course was used in control group. Teaching effectiveness was assessed by comparing the scores of four chapter quizzes and the final exam between the two groups, as well as by analyzing student questionnaire responses. Data were analyzed using t test and χ2 test. Results:The experimental group achieved significantly higher scores in all four chapter quizzes and the final exam compared to the control group [(78.77±19.65) vs. (69.47±22.95), (84.56±14.02) vs. (76.49±16.20), (81.89±13.60) vs. (73.13±16.52), (81.56±21.28) vs. (73.16±16.27), (69.75±13.30) vs. (64.10±14.93), all P<0.05]. The questionnaire survey showed that 74.07% students ( n=40) believed that this blended teaching model stimulated their learning interest, 74.07% ( n=40) students believed that this blended teaching model enhanced their learning initiative, 81.48% ( n=44) students believed that this blended teaching model could help them construct the relationship between the old and new knowledge and thus improved memory retention, and 81.48% students b( n=44) elieved that this blended teaching model helped them integrate and summarize knowledge and construct systematic knowledge framework to improve their learning effectiveness. Conclusions:The blended teaching mode based on medical knowledge graph and AI teaching assistant is beneficial for cultivating students' systematic thinking ability and is helpful to improve their learning efficiency and effectiveness.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To explore the effects of Jinghou Zengzhi Granules(JHZZG),on ovarian GDF9 secretion and granulosa cells(GCs)apoptosis in controlled ovarian hyperstimulation(COH)rats through p38MAPK/CK2/IκBα/NF-κB pathway.Methods A model of COH rats was prepared and 18 rats were randomly divided into 3 groups,including natural ovulation group(NO group),COH group,and COH+JHZZG group.The expression of p38MAPK,CK2,IκBα,NF-κB,GDF9 mRNA and protein were detected by qRT-PCR and Western blot,and the apoptosis rate of ovarian GCs by TUNEL.Results Compared with the NO group,the expression of p38MAPK and NF-κB in the ovarian tissue of rats in the COH group increased,while the expression of CK2,IκBα and GDF9 decreased,and the apoptosis rate of ovarian GCs increased(all P<0.01).Compared with the COH group,the expression of p38MAPK and NF-κB in the ovarian tissue of rats in the COH+JHZZG group decreased,while the expression of CK2,IκBα and GDF9 increased(all P<0.01),and the apoptosis rate of ovarian GCs decreased(P<0.05).Conclusion Jinghou Zengzhi Granules could promote the secretion of ovarian GDF9 and inhibit the apoptosis of ovarian GCs of COH rats through p38MAPK/CK2/IκBα/NF-κB signaling pathway,which thereby improve the quality of COH oocytes.