Objective To explore the application effect of a mobile learning platform for tumor diagnosis and treatment combined with the case-based learning method(CBL)in the standardized training of oncology residents.Methods Fifty-two 2022-level trainees who underwent the resident physician standardized training in the Oncology Department of the First Affiliated Hospital of Kunming Medical University from August to December 2024 were selected as the research subjects.Using the random number table method,they were divided into the observation group and the control group,with 26 trainees in each group.The control group adopted the CBL teaching method,while the observation group adopted the tumor diagnosis and treatment mobile learning platform combined with the CBL teaching method.During the graduation assessment,the mastery degree of basic knowl-edge in the oncology specialty,the analysis ability of clinical cases,the performance level of clinical operation skills,and the sat-isfaction with the standardized training in oncology for the two groups of trainees were compared.Results The scores of the obser-vation group students in terms of their mastery of basic knowledge in oncology,their ability to analyze clinical cases,and their satis-faction with the oncology residency training teaching were[(84.42±3.43)points,(85.08±2.94)points,(7.50±1.03)points],which were significantly higher than those of the control group[(82.15±4.32)points,(82.12±3.82)points,(5.89±1.28)points](P＜0.05).There was no significant difference in the clinical operation skills scores between the two groups of students(P＞0.05).Conclusion The application of our mobile learning platform for tumor diagnosis and therapy combined with CBL can effectively enhance the educational outcomes and satisfaction in medical oncology standardized residency training.

Objective To explore the application effect of a mobile learning platform for tumor diagnosis and treatment combined with the case-based learning method(CBL)in the standardized training of oncology residents.Methods Fifty-two 2022-level trainees who underwent the resident physician standardized training in the Oncology Department of the First Affiliated Hospital of Kunming Medical University from August to December 2024 were selected as the research subjects.Using the random number table method,they were divided into the observation group and the control group,with 26 trainees in each group.The control group adopted the CBL teaching method,while the observation group adopted the tumor diagnosis and treatment mobile learning platform combined with the CBL teaching method.During the graduation assessment,the mastery degree of basic knowl-edge in the oncology specialty,the analysis ability of clinical cases,the performance level of clinical operation skills,and the sat-isfaction with the standardized training in oncology for the two groups of trainees were compared.Results The scores of the obser-vation group students in terms of their mastery of basic knowledge in oncology,their ability to analyze clinical cases,and their satis-faction with the oncology residency training teaching were[(84.42±3.43)points,(85.08±2.94)points,(7.50±1.03)points],which were significantly higher than those of the control group[(82.15±4.32)points,(82.12±3.82)points,(5.89±1.28)points](P＜0.05).There was no significant difference in the clinical operation skills scores between the two groups of students(P＞0.05).Conclusion The application of our mobile learning platform for tumor diagnosis and therapy combined with CBL can effectively enhance the educational outcomes and satisfaction in medical oncology standardized residency training.

To explore the relationship of neutrophil/lymphocyte ratio(NLR),25-hydroxyvitamin D3[25-(OH)D3]and periostin levels with immune function in children with Henoch-Sch?nlein purpura(HSP)and their prognostic value,120 children with HSP admitted to our hospital from January 2021 to June 2023 were selected as observation group,and 120 healthy children underwent physical examination during the same period were included as control group.Corresponding methods were used to detect the levels of NLR,serum 25-(OH)D3,periostin and peripheral blood lymphocyte subsets(CD3+,CD4+,CD8+,CD19+,CD56+),IgA,IgM,IgG,C3 and C4,and Spearman correlation analysis was used to analyze the correlation among them.After discharge,the children were followed up for 6 months to observe the prognosis and divided into favorable prognosis group and poor prognosis group,and the levels of NLR,25-(OH)D3 and periostin in the two groups were analyzed and compared.The risk factors for poor prognosis in HSP children were analyzed by logistic regression,and ROC curve was drawn to analyze the predictive value of the three indicators for prognosis.Compared with the control group,the NLR and periostin level in observation group were significantly increased,the 25-(OH)D3 level was significantly decreased(t value ranged from 10.604 to 19.332,P＜0.05),the levels of lymphocyte subsets CD3+,CD4+,CD4+/CD8+,CD19+and CD56+were decreased,the levels of CD8+were increased(t value ranged from 9.368 to 23.587,P＜0.05),the levels of IgA and IgG in peripheral blood were increased,while the levels of IgM,C3 and C4 were significantly decreased(t value ranged from 6.376 to 26.048,P＜0.05).Compared with the HSP children in the good prognosis group,poor prognosis group demonstrated significant differences in disease duration,respiratory tract infection,the levels of white blood cells,NLR,25-(OH)D3 and periostin(t values ranged from 3.006 to 10.806,χ2=5.133,P＜0.05),and all were risk factors affecting the prognosis.The AUC value,sensitivity and specificity of NLR,25-(OH)D3 and periostin combination for predicting the prognosis of HSP children were 0.937,91.86%and 76.47%,respectively,which were higher than the prediction efficacy of the above indexes alone(P＜0.05).In conclusion,NLR,25-(OH)D3 and periostin are related to immune function in children with HSP,and NLR,25-(OH)D3 and periostin are independent influencing factors of HSP poor prognosis,thus combination detection of the three indicators has certain predictive value for prognosis of HSP.

To explore the relationship of neutrophil/lymphocyte ratio(NLR),25-hydroxyvitamin D3[25-(OH)D3]and periostin levels with immune function in children with Henoch-Sch?nlein purpura(HSP)and their prognostic value,120 children with HSP admitted to our hospital from January 2021 to June 2023 were selected as observation group,and 120 healthy children underwent physical examination during the same period were included as control group.Corresponding methods were used to detect the levels of NLR,serum 25-(OH)D3,periostin and peripheral blood lymphocyte subsets(CD3+,CD4+,CD8+,CD19+,CD56+),IgA,IgM,IgG,C3 and C4,and Spearman correlation analysis was used to analyze the correlation among them.After discharge,the children were followed up for 6 months to observe the prognosis and divided into favorable prognosis group and poor prognosis group,and the levels of NLR,25-(OH)D3 and periostin in the two groups were analyzed and compared.The risk factors for poor prognosis in HSP children were analyzed by logistic regression,and ROC curve was drawn to analyze the predictive value of the three indicators for prognosis.Compared with the control group,the NLR and periostin level in observation group were significantly increased,the 25-(OH)D3 level was significantly decreased(t value ranged from 10.604 to 19.332,P＜0.05),the levels of lymphocyte subsets CD3+,CD4+,CD4+/CD8+,CD19+and CD56+were decreased,the levels of CD8+were increased(t value ranged from 9.368 to 23.587,P＜0.05),the levels of IgA and IgG in peripheral blood were increased,while the levels of IgM,C3 and C4 were significantly decreased(t value ranged from 6.376 to 26.048,P＜0.05).Compared with the HSP children in the good prognosis group,poor prognosis group demonstrated significant differences in disease duration,respiratory tract infection,the levels of white blood cells,NLR,25-(OH)D3 and periostin(t values ranged from 3.006 to 10.806,χ2=5.133,P＜0.05),and all were risk factors affecting the prognosis.The AUC value,sensitivity and specificity of NLR,25-(OH)D3 and periostin combination for predicting the prognosis of HSP children were 0.937,91.86%and 76.47%,respectively,which were higher than the prediction efficacy of the above indexes alone(P＜0.05).In conclusion,NLR,25-(OH)D3 and periostin are related to immune function in children with HSP,and NLR,25-(OH)D3 and periostin are independent influencing factors of HSP poor prognosis,thus combination detection of the three indicators has certain predictive value for prognosis of HSP.

Objective:To preliminarily explore the related factors that affect chimera mosaicism in in vitro fertilization (IVF) treatment. Methods:A case-control study was conducted to retrospectively analyze the clinical data of 2252 blastocysts in 579 preimplantation genetic testing (PGT) cycles in the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from January 2017 to December 2020. Biopsy cells were analyzed by next generation sequencing (NGS). According to the analysis results, all embryos were divided into mosaicism group and non-mosaicism group. Mosaicism types included euploid-aneuploid mosaicism, aneuploid-aneuploid mosaicism and complex mosaicism. The population characteristics and laboratory-related parameters of the two groups of embryos were compared, and single-factor and multi-factor analysis of the incidence of mosaicism were performed to evaluate the related factors that affect the development of mosaic embryos.Results:A total of 2252 blastocysts in 579 cycles were included in this study, 905 embryos (40.2%) were euploid, 923 (41.0%) were aneuploid, and 424 (18.8%) were mosaicism. Among them, 228 (10.1%) were euploid-aneuploidy mosaicism, 59 (2.6%) were aneuploidy-aneuploidy mosaicism, and 137 (6.1%) were complex mosaicism. NGS technology was performed in 4 institutions, and the mosaicism rate fluctuated between 7.6% and 26.2%. After adjusting the confounding factors (the age of the male and female partners, the quality of the male partner's sperm, the ovarian stimulation protocols, the type of culture medium, the indications of PGT, the different biopsy operators and the developmental stage of the blastocyst), it was found that the blastocyst trophectoderm cell (TE) score (grade C vs. grade A, P=0.014) and the genetic testing institutions (institution 2 vs. early stage of institution 1, P<0.001; late stage of institution 1 vs. early stage of institution 1, P<0.001) had a significant effect on the occurrence of mosaicism. Compared with the TE score of grade A, the chance of mosaicism in grade C increased by 66% (a OR=1.66, 95% CI=1.11-2.50, P=0.014). Compared with the early stage of institution 1, the incidence of mosaicism in institution 2 and late stage of institution 1 was 2.28 times (a OR=2.28, 95% CI=1.71-3.04, P<0.001), and late stage of institution 1 was 2.17 times that of the early stage (a OR=2.17, 95% CI=1.41-3.34, P<0.001). Conclusion:The incidence of mosaicism during IVF treatment is related to NGS genetic testing institutions and the quality of trophectoderm cells

Objective:To preliminarily explore the related factors that affect chimera mosaicism in in vitro fertilization (IVF) treatment. Methods:A case-control study was conducted to retrospectively analyze the clinical data of 2252 blastocysts in 579 preimplantation genetic testing (PGT) cycles in the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from January 2017 to December 2020. Biopsy cells were analyzed by next generation sequencing (NGS). According to the analysis results, all embryos were divided into mosaicism group and non-mosaicism group. Mosaicism types included euploid-aneuploid mosaicism, aneuploid-aneuploid mosaicism and complex mosaicism. The population characteristics and laboratory-related parameters of the two groups of embryos were compared, and single-factor and multi-factor analysis of the incidence of mosaicism were performed to evaluate the related factors that affect the development of mosaic embryos.Results:A total of 2252 blastocysts in 579 cycles were included in this study, 905 embryos (40.2%) were euploid, 923 (41.0%) were aneuploid, and 424 (18.8%) were mosaicism. Among them, 228 (10.1%) were euploid-aneuploidy mosaicism, 59 (2.6%) were aneuploidy-aneuploidy mosaicism, and 137 (6.1%) were complex mosaicism. NGS technology was performed in 4 institutions, and the mosaicism rate fluctuated between 7.6% and 26.2%. After adjusting the confounding factors (the age of the male and female partners, the quality of the male partner's sperm, the ovarian stimulation protocols, the type of culture medium, the indications of PGT, the different biopsy operators and the developmental stage of the blastocyst), it was found that the blastocyst trophectoderm cell (TE) score (grade C vs. grade A, P=0.014) and the genetic testing institutions (institution 2 vs. early stage of institution 1, P<0.001; late stage of institution 1 vs. early stage of institution 1, P<0.001) had a significant effect on the occurrence of mosaicism. Compared with the TE score of grade A, the chance of mosaicism in grade C increased by 66% (a OR=1.66, 95% CI=1.11-2.50, P=0.014). Compared with the early stage of institution 1, the incidence of mosaicism in institution 2 and late stage of institution 1 was 2.28 times (a OR=2.28, 95% CI=1.71-3.04, P<0.001), and late stage of institution 1 was 2.17 times that of the early stage (a OR=2.17, 95% CI=1.41-3.34, P<0.001). Conclusion:The incidence of mosaicism during IVF treatment is related to NGS genetic testing institutions and the quality of trophectoderm cells

Objective To verify the criteria proposed by National Academy of Clinical Biochemistry(NACB)guidelines in investigating the factors that affect serum TSH determination, and to determine the reference range of serum TSH in iodine-sufficient areas of China. Methods In 2007, 5 348 inhabitants were enrolled from 3 iodine-sufficient areas of Liaoning Province, and were asked to fulfill the questionnaire. Serum TSH, thyroid peroxidase antibody(TPOAb), and thyroglobulin antibody(TgAb)were determined, and thyroid ultrasonography was carried out. Results The distribution of TSH levels was skewed in healthy people and closely fit the curve of Gaussian distribution after logarithmic transformation. The levels of TSH in subjects of 12-19 years of age were significantly higher than those of other age groups(P＜0.01), and no significant difference was found among the latter groups. TSH level in females [(1.68±1.90)mIU/L] was higher than in males[(1.45±1.92)mIU/L, P＜0.01]. The reference range of TSH was 0.43-4.74 mIU/L in males, and 0.48-5.39 mIU/L in females. Family history of thyroid disease, abnormal thyroid ultrasonography, and positive thyroid antibodies were the factors that influenced TSH level. Conclusion The reference range of serum TSH in iodine-sufficient areas of China is established.