Objective The Hybrid Education Competence Instrument(HybridEduCom)was sinicized,and its reliability and validity were tested.Methods The translation,cultural adjustment and pre-investigation of HybridEduCom were followed by the Brislin translation model.The reliability and validity of the HybridEduCom was tested by surveying 553 educators in medical and nursing related fields by convenience sampling from March to April 2024.Results The Chinese version of HybridEduCom consisted of 46 items in 5 dimensions:planning and resourcing competence,technology competence,interaction competence,digital pedagogy competence,and ethical competence in the hybrid education.The confirmatory factor analysis resulted in the second-order five-factor model,with the chi-square and degree of freedom ratio being 1.274,approximate root mean square error being 0.022,goodness of fit index being 0.913,and standard fit index(NFI)being 0.934,and Tucker-Lewis and comparative fit index being 0.985.All main evaluation indexes were within the acceptable range of the judgment criteria.The item-content validity index was 0.833-1.000,and the scale-content validity index was 0.968.The Cronbach's α for the whole scale was 0.982,while varied from 0.892 to 0.936 for each dimension.The test-retest reliability of the scale was 0.978.Conclusion The reliability and validity of the Chinese version of HybridEduCom were satisfactory,and it can serve as a valid assessment instrument for the implementation of hybrid education competence of Chinese higher medical and nursing educators.

Objective:To compare the clinical characteristics of patients with cryptogenic cirrhosis and hepatitis B cirrhosis in order to provide a basis for the diagnosis of cryptogenic cirrhosis.Methods:A retrospective study was performed. The clinical data of inpatients with cryptogenic cirrhosis from 2010 to 2020 were collected from Peking University First Hospital. The clinical baseline data were analyzed. Patients with hepatitis B cirrhosis hospitalized during the same period were used as the control group, and 1:1 matching was performed according to the age range (±5 years) and the same year of admission. The basic clinical data between the groups were analyzed. The t-test, X2-test or Mann-Whitney U test was used for intergroup comparison.Results:A total of 232 cases with cryptogenic cirrhosis were collected. A total of 207 cases were collected after excluding cases with missing data, including 95 males (45.9%) and 112 females (54.1%), with a median age of 66 (57-76) years. A total of 182 pairs were matched according to the matching criteria for the control study. Compared with the hepatitis B cirrhosis group, the patients with cryptogenic cirrhosis had higher blood triglycerides (0.89 mmol/L vs. 0.80 mmol/L, P=0.002)and total cholesterol (3.73 mmol/L vs. 3.55 mmol/L, P=0.048), alanine transaminase (21.0 U/L vs. 24.5 U/L, P=0.003) and aspartate transaminase (29.5 U/L vs. 33.0 U/L, P=0.008) were lower, the prothrombin time was shorter (12.4 s vs. 13.0 s, P=0.003), and the INR was lower (1.18 vs. 1.21, P=0.015) with statistically significant differences ( P<0.05). The proportion of patients with cryptogenic cirrhosis combined with hepatocellular carcinoma (15.9% vs. 35.7%, P<0.001), hepatic encephalopathy (2.7% vs. 7.7%, P=0.034), and hepatorenal syndrome (1.6% vs. 5.5%, P=0.048),were relatively low, and the differences were statistically significant ( P<0.05). Conclusions:Cryptogenic cirrhosis at our hospital may be associated with metabolic syndrome and cannot be excluded as a cause of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis in some of these patients.

Objective:To investigate the effects of knockdown and overexpression of melanoma-associated antigen-A3(MAGE-A3)gene on the biological behavior and cisplatin resistance of ovarian cancer cells.Methods:The expression level of MAGE-A3 mRNA and protein in ovarian cancer cells was detected.The knockdown cell lines were constructed and divided into control group,no-load(NC)group and sh MAGE-A3 group.The overex-pression cell lines were divided into control group,no-load(NC)group and OE-MAGE-A3 group.The effects of knockdown and overexpression of MAGE-A3 gene on the proliferation,migration,invasion and apoptosis of tumor cells were compared.The expression of p53,Survivin,breast cancer susceptibility gene 1(BRCA1)and MAGE-A3 protein was detected.The high expression cell lines were divided into control group,cisplatin group,shMAGE-A3 group and cisplatin+shMAGE-A3 group.The low expression cell lines were divided into control group,cisplatin group,OE-MAGE-A3 group and cisplatin+OE-MAGE-A3 group.The cell proliferation,invasion ability of each group of cells,as well as their effects on the mRNA and protein expression level of each gene were compared.Results:The mRNA and protein expression of MAGE-A3 was high in SKOV3 cells and low in A2780 cells.Com-pared with the control group and NC group,the shMAGE-A3 group had lower OD450 value,migration rate and in-vasion numbers,higher apoptosis rate,lower expression of MAGE-A3 and Survivin protein,and higher expression of BRCA1 and p53 protein.The results of OE-MAGE-A3 group compared with control group and NC group were opposite to those of shMAGE-A3 group.Compared with the control group,cisplatin group and sh-MAGE-A3 group,the cisplatin+sh-MAGE-A3 group had lower OD450 value and invasion number higher levels of p53 and BRCA1 mRNA and protein expression,and lower levels of Survivin mRNA and protein.The OD450 value and in-vasion number of cells in cisplatin+OE-MAGE-A3 group were higher than those in cisplatin group,but lower than those in control group and OE-MAGE-A3 group.The mRNA and protein expression levels of p53 and BRCA1 were higher than those in the control group and the OE-MAGE-A3 group,but lower than those in the cisplatin group.The expression levels of Survivin mRNA and protein were lower than those in the control group and the OE-MAGE-A3 group,and higher than those in the cisplatin group.Conclusions:Knockdown of MAGE-A3 expression can effectively inhibit the proliferation,migration and invasion of ovarian cancer cells,promote apoptosis and en-hance cisplatin sensitivity.On the contrary,overexpression of MAGE-A3 increases cell proliferation,migration and invasion,and reduced apoptosis,thereby conferring cisplatin resistance.

Volumes 9 and 10 of Sun Simiao's Supplement to Important Formulas Worth a Thousand Gold Pieces record part of Trea-tise on Cold Damage,which contain Sun Simiao's unique thoughts on six-meridian treatment.Sun Simiao's treatment of Taiyang me-ridian emphasizes the classification of prescriptions and syndromes,advocates the correct treatment methods,and establishes three guidelines;Yangming meridian emphasizes the differentiation of cold and heat syndromes;except Taiyang meridian,all meridians em-phasize the differentiation of outline syndromes.It has made important contributions to the inheritance and development of the six-me-ridian thought of Treatise on Cold Damage in later generations.

Objective:To investigate the effects of knockdown and overexpression of melanoma-associated antigen-A3(MAGE-A3)gene on the biological behavior and cisplatin resistance of ovarian cancer cells.Methods:The expression level of MAGE-A3 mRNA and protein in ovarian cancer cells was detected.The knockdown cell lines were constructed and divided into control group,no-load(NC)group and sh MAGE-A3 group.The overex-pression cell lines were divided into control group,no-load(NC)group and OE-MAGE-A3 group.The effects of knockdown and overexpression of MAGE-A3 gene on the proliferation,migration,invasion and apoptosis of tumor cells were compared.The expression of p53,Survivin,breast cancer susceptibility gene 1(BRCA1)and MAGE-A3 protein was detected.The high expression cell lines were divided into control group,cisplatin group,shMAGE-A3 group and cisplatin+shMAGE-A3 group.The low expression cell lines were divided into control group,cisplatin group,OE-MAGE-A3 group and cisplatin+OE-MAGE-A3 group.The cell proliferation,invasion ability of each group of cells,as well as their effects on the mRNA and protein expression level of each gene were compared.Results:The mRNA and protein expression of MAGE-A3 was high in SKOV3 cells and low in A2780 cells.Com-pared with the control group and NC group,the shMAGE-A3 group had lower OD450 value,migration rate and in-vasion numbers,higher apoptosis rate,lower expression of MAGE-A3 and Survivin protein,and higher expression of BRCA1 and p53 protein.The results of OE-MAGE-A3 group compared with control group and NC group were opposite to those of shMAGE-A3 group.Compared with the control group,cisplatin group and sh-MAGE-A3 group,the cisplatin+sh-MAGE-A3 group had lower OD450 value and invasion number higher levels of p53 and BRCA1 mRNA and protein expression,and lower levels of Survivin mRNA and protein.The OD450 value and in-vasion number of cells in cisplatin+OE-MAGE-A3 group were higher than those in cisplatin group,but lower than those in control group and OE-MAGE-A3 group.The mRNA and protein expression levels of p53 and BRCA1 were higher than those in the control group and the OE-MAGE-A3 group,but lower than those in the cisplatin group.The expression levels of Survivin mRNA and protein were lower than those in the control group and the OE-MAGE-A3 group,and higher than those in the cisplatin group.Conclusions:Knockdown of MAGE-A3 expression can effectively inhibit the proliferation,migration and invasion of ovarian cancer cells,promote apoptosis and en-hance cisplatin sensitivity.On the contrary,overexpression of MAGE-A3 increases cell proliferation,migration and invasion,and reduced apoptosis,thereby conferring cisplatin resistance.

Objective The Hybrid Education Competence Instrument(HybridEduCom)was sinicized,and its reliability and validity were tested.Methods The translation,cultural adjustment and pre-investigation of HybridEduCom were followed by the Brislin translation model.The reliability and validity of the HybridEduCom was tested by surveying 553 educators in medical and nursing related fields by convenience sampling from March to April 2024.Results The Chinese version of HybridEduCom consisted of 46 items in 5 dimensions:planning and resourcing competence,technology competence,interaction competence,digital pedagogy competence,and ethical competence in the hybrid education.The confirmatory factor analysis resulted in the second-order five-factor model,with the chi-square and degree of freedom ratio being 1.274,approximate root mean square error being 0.022,goodness of fit index being 0.913,and standard fit index(NFI)being 0.934,and Tucker-Lewis and comparative fit index being 0.985.All main evaluation indexes were within the acceptable range of the judgment criteria.The item-content validity index was 0.833-1.000,and the scale-content validity index was 0.968.The Cronbach's α for the whole scale was 0.982,while varied from 0.892 to 0.936 for each dimension.The test-retest reliability of the scale was 0.978.Conclusion The reliability and validity of the Chinese version of HybridEduCom were satisfactory,and it can serve as a valid assessment instrument for the implementation of hybrid education competence of Chinese higher medical and nursing educators.

Volumes 9 and 10 of Sun Simiao's Supplement to Important Formulas Worth a Thousand Gold Pieces record part of Trea-tise on Cold Damage,which contain Sun Simiao's unique thoughts on six-meridian treatment.Sun Simiao's treatment of Taiyang me-ridian emphasizes the classification of prescriptions and syndromes,advocates the correct treatment methods,and establishes three guidelines;Yangming meridian emphasizes the differentiation of cold and heat syndromes;except Taiyang meridian,all meridians em-phasize the differentiation of outline syndromes.It has made important contributions to the inheritance and development of the six-me-ridian thought of Treatise on Cold Damage in later generations.

Objective:To compare the clinical characteristics of patients with cryptogenic cirrhosis and hepatitis B cirrhosis in order to provide a basis for the diagnosis of cryptogenic cirrhosis.Methods:A retrospective study was performed. The clinical data of inpatients with cryptogenic cirrhosis from 2010 to 2020 were collected from Peking University First Hospital. The clinical baseline data were analyzed. Patients with hepatitis B cirrhosis hospitalized during the same period were used as the control group, and 1:1 matching was performed according to the age range (±5 years) and the same year of admission. The basic clinical data between the groups were analyzed. The t-test, X2-test or Mann-Whitney U test was used for intergroup comparison.Results:A total of 232 cases with cryptogenic cirrhosis were collected. A total of 207 cases were collected after excluding cases with missing data, including 95 males (45.9%) and 112 females (54.1%), with a median age of 66 (57-76) years. A total of 182 pairs were matched according to the matching criteria for the control study. Compared with the hepatitis B cirrhosis group, the patients with cryptogenic cirrhosis had higher blood triglycerides (0.89 mmol/L vs. 0.80 mmol/L, P=0.002)and total cholesterol (3.73 mmol/L vs. 3.55 mmol/L, P=0.048), alanine transaminase (21.0 U/L vs. 24.5 U/L, P=0.003) and aspartate transaminase (29.5 U/L vs. 33.0 U/L, P=0.008) were lower, the prothrombin time was shorter (12.4 s vs. 13.0 s, P=0.003), and the INR was lower (1.18 vs. 1.21, P=0.015) with statistically significant differences ( P<0.05). The proportion of patients with cryptogenic cirrhosis combined with hepatocellular carcinoma (15.9% vs. 35.7%, P<0.001), hepatic encephalopathy (2.7% vs. 7.7%, P=0.034), and hepatorenal syndrome (1.6% vs. 5.5%, P=0.048),were relatively low, and the differences were statistically significant ( P<0.05). Conclusions:Cryptogenic cirrhosis at our hospital may be associated with metabolic syndrome and cannot be excluded as a cause of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis in some of these patients.

Objective To analyze and summarize the clinical presentation of spontaneous and secondary intracranial hypotension syndrome(IHS).Methods Patients diagnosed with spontaneous or secondary IHS from September 2022 to May 2023 were retrospectively analyzed.The clinical data,imaging features,treatment methods and prognosis were collected.The correlation between intracranial pressure values and clinical characteristics of the patients was statistically analyzed.Results A total of 30 patients were enrolled,and the proportion of spontaneous and secondary IHS was 63%(19 cases)and 37%(11 cases),respectively.In terms of clinical features,orthostatic headache was the most common type(29 cases,96.7%)and most commonly involved occipital region(12 cases,40.0%),followed by frontoparietal region(9 cases,30.0%).Among the brain imaging features,dural enhancement was the most common(17 cases,56.7%).According to CT angiography of spinal cord findings,cerebrospinal fluid leakage is one of the most common location of cervical spine segments(10 cases),and on the thoracic segments(9 cases),followed by the thoracic segments(4 cases)and lumbar segments(4 cases).After conservative treatment and surgical treatment,the total effective rate was 90%.Conclusion Orthostatic headache and cranial MRI"dural enhancement"have strong indication on the definitive diagnosis of IHS.CT myelography is helpful to precisely localize the site of cerebrospinal fluid leakage.Targeted epidural blood patch therapy is an effective method to cure IHS when conservative treatment is ineffective.

Objective:To explore the related factors of thrombocytopenia (TCP) occurrence in patients with cirrhosis.Methods:A cross-sectional study was conducted. Inpatients with an initial diagnosis of cirrhosis at Peking University First Hospital from January 1, 2010 to December 31, 2020 were included. Clinical data such as demographic characteristics, etiology of cirrhosis, complications of cirrhosis, laboratory indicators, Child-Pugh grade, invasive procedures, and mortality during hospitalization were collected. A logistic regression model was used to explore the related factors of TCP occurrence in patients with cirrhosis. Categorical variables were compared by the χ2 test. The inter-group comparison was performed using continuous variables, a t-test, one-way analysis of variance (ANOVA), or a nonparametric test. Results:There were a total of 2 592 cases of cirrhosis. 75 cases with incomplete clinical data were excluded. 2 517 cases were included for analysis. The median age was 58 (50, 67) years. Males accounted for 64%. 1 435 cases (57.0%) developed TCP, and 434 cases (17.2%) had grade 3-4 TCP. Gender, primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and concomitant esophagogastric varices (EGV) were the major factors associated with TCP. Females were more prone to combine with TCP ( OR=1.32, 95% CI: 1.12-1.56, P=0.001). Patients combined with EGV ( OR=3.09, 95% CI: 2.63-3.65, P<0.001) were more prone to develop TCP, which was associated with the increased incidence of hypersplenism ( P<0.001). Patients with PBC ( OR=0.64, 95% CI: 0.50-0.82, P<0.001) and PSC ( OR=0.23, 95% CI: 0.06-0.65, P=0.010) were less prone to develop TCP, which was due to the shorter prothrombin time and better coagulation function of PBC patients ( P<0.001), and the lower proportion of hypersplenism in combined PSC patients ( P=0.004). Patients with TCP and grade 3-4 TCP had a higher rate of hemostatic procedures ( P<0.05), but a lower rate of liver biopsy ( P<0.05). Patients with grade 3-4 TCP had a higher nosocomial mortality rate compared to those without ( P=0.004). Conclusion:TCP is common in patients with cirrhosis. However, TCP occurrence is higher in female patients with EGV and lower in patients combined with PBC and PSC. TCP affects invasive procedures and is associated with adverse outcomes.