Objective:In alignment with the practical teaching objectives of Diseases of the Locomotor System and the competency requirements for graduates of military medical universities, this study conducted a multidimensional modification of the traditional objective structured clinical examination (OSCE) to provide a novel training mode that enhances the effectiveness of practical teaching of this course.Methods:The traditional OSCE was modified from the four dimensions of integration, individuality, immersion, and intelligence. The first three stations were set as "diagnosis" and the last three stations were set as "operation" to reflect the "integration" of diagnosis and treatment. The last station of "operation" was set as "medical cares of combat and training injuries" to reflect "individuality" of military medical training. The method of situation creation was used to reflect "immersion", and the application of intelligent terminals reflected "intelligence". The study involved 50 trainees who were assigned to either a modified OSCE group or a traditional teaching group through a random drawing process. The teaching effectiveness was assessed through evaluation of theoretical knowledge, practical skills, and participant satisfaction. The statistical analysis was conducted by SPSS 22.0, with parametric data assessed by t-tests and non-parametric data assessed by chi-square tests. Results:Before entering the department, there were no statistically significant differences in theoretical ( P=0.832) and practical ( P=0.513) scores between the two groups of trainees. However, after the internship, the modified OSCE group demonstrated significantly enhanced scores compared to the traditional teaching group, both in theory assessment [(93.88±1.92) vs. (90.76±2.85), P=0.001] and skill assessment [(94.32±1.25) vs. (91.68±2.82), P=0.001]. Additionally, the self-assessment of clinical capability improvement by the modified OSCE group was markedly higher across all dimensions than the traditional teaching group ( P=0.001). Furthermore, the evaluation conducted by basic combat unit on the job competency of graduated trainees indicated that the modified OSCE group outperformed the traditional teaching group in basic clinical diagnosis and treatment [(4.72±0.46) vs. (3.44±0.71), P=0.001], emergency management of combat and training injuries [(4.72±0.46) vs. (3.52±0.71), P=0.001], application of information technology [(4.44±0.71) vs. (3.91±0.80), P=0.029], basic military qualities [(4.40±0.71) vs. (3.92±0.91), P=0.043], mental health and resilience [(4.36±0.70) vs. (3.68±0.85), P=0.003], and the capacity for continuous learning [(4.64±0.70) vs. (3.83±0.76), P=0.001]. Conclusions:The modified OSCE teaching mode can better meet the practical teaching requirements for Diseases of the Locomotor System in the military medical university and thus holds promise for further application.

Pathogenic microorganisms are direct causative agents of zoonotic infectious diseases,po-sing severe threats to the livestock industry by inducing massive animal mortality,economic losses in livestock products,and significant risks to human health.The CRISPR/Cas system has been widely adopted in nucleic acid detection of pathogenic microorganisms due to its unique trans-cleavage activity.By leveraging the superior optical properties of nanomaterials,researchers have integrated them with CRISPR/Cas systems to develop numerous visual biosensors,which not only significantly enhance signal output but also substantially reduce detection time and cost.This re-view focuses on five nanomaterials-graphene oxide(GO),gold nanoparticles(AuNPs),MoS2 nanosheets,metal-organic frameworks(MOFs),and quantum dots(QDs)—that have been exten-sively integrated with CRISPR/Cas systems in recent years.We systematically summarize their distinct physical characteristics and specific applications in CRISPR/Cas-based pathogen detection,followed by a concise comparison of the advantages and limitations of different methodologies.Fi-nally,we discuss the prospects for nanomaterials in CRISPR/Cas detection systems,aiming to pro-vide a valuable reference for advancing molecular diagnostics of pathogenic microorganisms.

Pathogenic microorganisms are direct causative agents of zoonotic infectious diseases,po-sing severe threats to the livestock industry by inducing massive animal mortality,economic losses in livestock products,and significant risks to human health.The CRISPR/Cas system has been widely adopted in nucleic acid detection of pathogenic microorganisms due to its unique trans-cleavage activity.By leveraging the superior optical properties of nanomaterials,researchers have integrated them with CRISPR/Cas systems to develop numerous visual biosensors,which not only significantly enhance signal output but also substantially reduce detection time and cost.This re-view focuses on five nanomaterials-graphene oxide(GO),gold nanoparticles(AuNPs),MoS2 nanosheets,metal-organic frameworks(MOFs),and quantum dots(QDs)—that have been exten-sively integrated with CRISPR/Cas systems in recent years.We systematically summarize their distinct physical characteristics and specific applications in CRISPR/Cas-based pathogen detection,followed by a concise comparison of the advantages and limitations of different methodologies.Fi-nally,we discuss the prospects for nanomaterials in CRISPR/Cas detection systems,aiming to pro-vide a valuable reference for advancing molecular diagnostics of pathogenic microorganisms.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Objective:In alignment with the practical teaching objectives of Diseases of the Locomotor System and the competency requirements for graduates of military medical universities, this study conducted a multidimensional modification of the traditional objective structured clinical examination (OSCE) to provide a novel training mode that enhances the effectiveness of practical teaching of this course.Methods:The traditional OSCE was modified from the four dimensions of integration, individuality, immersion, and intelligence. The first three stations were set as "diagnosis" and the last three stations were set as "operation" to reflect the "integration" of diagnosis and treatment. The last station of "operation" was set as "medical cares of combat and training injuries" to reflect "individuality" of military medical training. The method of situation creation was used to reflect "immersion", and the application of intelligent terminals reflected "intelligence". The study involved 50 trainees who were assigned to either a modified OSCE group or a traditional teaching group through a random drawing process. The teaching effectiveness was assessed through evaluation of theoretical knowledge, practical skills, and participant satisfaction. The statistical analysis was conducted by SPSS 22.0, with parametric data assessed by t-tests and non-parametric data assessed by chi-square tests. Results:Before entering the department, there were no statistically significant differences in theoretical ( P=0.832) and practical ( P=0.513) scores between the two groups of trainees. However, after the internship, the modified OSCE group demonstrated significantly enhanced scores compared to the traditional teaching group, both in theory assessment [(93.88±1.92) vs. (90.76±2.85), P=0.001] and skill assessment [(94.32±1.25) vs. (91.68±2.82), P=0.001]. Additionally, the self-assessment of clinical capability improvement by the modified OSCE group was markedly higher across all dimensions than the traditional teaching group ( P=0.001). Furthermore, the evaluation conducted by basic combat unit on the job competency of graduated trainees indicated that the modified OSCE group outperformed the traditional teaching group in basic clinical diagnosis and treatment [(4.72±0.46) vs. (3.44±0.71), P=0.001], emergency management of combat and training injuries [(4.72±0.46) vs. (3.52±0.71), P=0.001], application of information technology [(4.44±0.71) vs. (3.91±0.80), P=0.029], basic military qualities [(4.40±0.71) vs. (3.92±0.91), P=0.043], mental health and resilience [(4.36±0.70) vs. (3.68±0.85), P=0.003], and the capacity for continuous learning [(4.64±0.70) vs. (3.83±0.76), P=0.001]. Conclusions:The modified OSCE teaching mode can better meet the practical teaching requirements for Diseases of the Locomotor System in the military medical university and thus holds promise for further application.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Objective To establish a HPLC method for simultaneous determination of neochlorogenic acid,chlorogenic acid,cryptochlorogenic acid,puerarin,polydatin,isochlorogenic acid A,isochlorogenic acid C,resveratrol,glycyrrhizic acid and emodin in Yinhua Pinggan Granules.Methods The analysis was performed on Thermo Acclaim-C18 column(250 mm×4.6 mm,5 μm)by gradient elution of acetonitrile-0.1%phosphoric acid solution at a flow rate of 1.0 mL·min-1.The detection wavelength was set at 327 nm for detecting neochlorogenic acid,chlorogenic acid,cryptochlorogenic acid,polydatin,isochlorogenic acid A,isochlorogenic acid C and resveratrol,at 252 nm for detecting puerarin,glycyrrhizic acid and emodin.The column temperature was 30℃and the injection volume was 10 μL.Results Good resolution of 10 constituents of Yinhua Pinggan Granules was obtained.The linear ranges of neochlorogenic acid,chlorogenic acid,cryptochlorogenic acid,puerarin,polydatin,isochlorogenic acid A,isochlorogenic acid C,resveratrol,glycyrrhizic acid and emodin were 1.744-17.44,10.75-107.5,1.863-18.63,14.62-146.2,4.784-47.84,1.208-12.08,4.427-44.27,1.971-19.71,3.624-36.24 and 4.142-41.42 μg·mL-1,respectively.The results showed good linear relationships(r≥0.999 4).The average recoveries ranged from 99.17%to 102.97%(RSD≤2.65%).The content ranges of ten constituents in five batches were 1.065-3.238,20.11-25.14,1.785-2.973,23.60-35.55,7.157-9.469,1.224-2.421,6.430-7.879,1.354-2.006,4.907-8.052,4.387-9.484 mg·g-1,respectively.Conclusion This method is simple and accurate,which can be used for the quality control and evaluation of Yinhua Pinggan Granules.

The crime of impairing the prevention and treatment of infectious diseases was "activated" in the COVID-19 epidemic that broke out in early 2020. However, the scope of infectious diseases involved in the relevant crimes of the Criminal Law of the People’s Republic of China before the revision was only limited to Category A infectious diseases, and the scope of application should be expanded when used for infectious diseases such as COVID-19. The revised Criminal Law "expands" the scope of infectious diseases involved in the crime from Category A to Category B controlled according to Category A, providing a legal basis for related cases, while the expressions in the new laws are repeated and ambiguous. Whether the criminal subject causes others to be infected is closely related to the sentencing of the crime, but it is still impossible to draw an exclusive conclusion on the causality leading to infection at the technical level. In summary, this paper proposed to correct the cases of inappropriate expansion of the application scope before the amendment of the Criminal Law, revise the improper expression of the new laws while cleaning up the relevant normative documents, clarify the unidentifiable part in the causal relationship of relevant cases and consider it in sentencing process.

Objective:To observe any effect of electroacupuncture (EA) on the expression of phosphorylated extracellular signal-regulated protein kinase (p-ERK1/2) and phosphorylated cyclic adenosine monophosphate response element binding protein (p-CREB) in the spinal dorsal horns of diabetics experiencing neuropathic pain.Methods:Eight rats were randomly selected from 30 healthy male Sprague-Dawley rats as the normal group (N), and the remaining twenty-two rats were treated with a single high-dose intraperitoneal injection of streptozotocin (STZ) to establish a neuropathic pain model. The rats modeled successfully were randomly divided into a model group (M, n=8) and an EA group ( n=8). In the EA group, electroacupuncture was applied at the bilateral Hou san li and Kunlun acupoints starting on the 15th day after the STZ injection. The daily sessions lasted 30 minutes for 1 week. Body weight (BW), fasting blood glucose (FBG) and paw withdrawal latency (PWL) were observed before the STZ injection and on the 7th, 14th, and 21st days afterward. The expression of p-ERK1/2 and p-CREB in the dorsal horns of the rats′ spinal cords was detected using western blotting. The count of p-CREB-positive cells in the dorsal horns and their co-localization with neurons was detected using immunofluorescence. Results:In comparison with the N group, the average BW of the M group on the 7th, 14th and 21st days after the STZ injection was significantly lower, while the average FBG was significantly higher. There was no significant difference between the M and N groups in the average PWL on the 7th day after the STZ injection, but it had decreased significantly in the M group on the 14th and 21st days. Compared with the M group, the average PWL of the EA group was significantly longer on the 21st day after the injection. The expression of p-ERK1/2 and p-CREB protein in the spines of the M group was significantly higher than in the N group. p-CREB positive cells were more numerous in the M group compared with the N group, while in the EA group they were fewer. P-CREB was co-located with neurons in the spinal dorsal horn.Conclusion:EA can alleviate neuropathic pain effectively, perhaps by inhibiting the expression of p-ERK1/2 and p-CREB in the dorsal horns of the spinal cord.

Objective To investigate the clinical efficacy of intermittent liver-nourishing and mind-regulating acupuncture in preventive treatment of migraine. Method One hundred and twenty migraine patients were randomly allocated to treatment and control groups, 60 cases each. The treatment group received intermittent liver-nourishing and mind-regulating acupuncture and the control group took flunarizine hydrochloride capsules orally. The migraine score, the visual analogue scale (VAS) score and the headache severity rating score were recorded in the subjects before treatment and at the end of treatment and the 4-week, 8-week, 12-week, 16-week and 20-week follow-ups. The Self-Rating Anxiety Scale (SAS) score and the Self-Rating Depression Scale (SDS) were recorded before and after treatment.Result After one course of treatment, the total efficacy rate was 98.3% in the treatment group and 89.5% in the control group; there was a statistically significant difference between the two groups (P<0.05). There was a statistically significant difference in the migraine score between before treatment and at the end of treatment in the two groups (P<0.05) and between the two groups at the same follow-ups (P<0.05). There was a statistically significant difference in the VAS score between before treatment and at the end of treatment in the two groups (P<0.05) and between the two groups at the same follow-ups (P<0.05). There were statistically significant differences in the SAS and SDS scores between before treatment and at the end of treatment in the two groups (P<0.05) and between the two groups after treatment (P<0.05).Conclusion Intermittent liver-nourishing and mind-regulating acupuncture has marked efficacy in preventive treatment of migraine. It can increase the total efficacy rate and reduce the number of relapses.