Objective:To evaluate the application effect of improved problem-based learning (PBL) based on 5W2H thinking in the course of "massage therapy".Methods:The undergraduate students in Class 1 and Class 2 of Acupuncture and Massage in the first semester of the 2023-2024 academic year at Heilongjiang University of Chinese Medicine were selected as the research subjects. The "massage therapy" was taught in Class 1 with the traditional method (control group, n=66) and in Class 2 with the method of improved PBL with 5W2H thinking (observation group, n=68). The two groups of students were compared in terms of theoretical knowledge of massage therapy, the assessment of massage skills, comprehensive ability, innovation ability, and practical ability, as well as the procedural evaluation indicators of massage. SPSS 25.0 was used for normality test and t test χ2 test. Results:After the completion of the study, the observation group showed higher scores in theoretical knowledge (90.56±11.73), massage skill proficiency [(87.22±11.57) vs. (78.23±9.45)], massage skill demonstration [(84.56±11.20) vs. (74.69±9.13)], mannequin usage [(82.98±10.75) vs. (72.66±8.89)], and massage skill mechanics [(86.38±11.45) vs. (73.35±8.94)] compared to the control group. The observation group also outperformed the control group in medical humanities [(85.53±10.64) vs. (64.86±7.33)], teacher-student and student-student interaction [(85.35±8.67) vs. (80.15±7.46)], clinical thinking and operation [(90.05±12.13) vs. (74.26±8.94)], and team coordination and cooperation [(85.60±10.06) vs. (81.53±9.33)]. In addition, the observation group scored higher than the control group in learning participation rate [(18.20±3.75) vs. (13.15±2.93)], error correction rate [(27.56±5.85) vs. (22.11±4.62)], operational stability [(48.43±7.79) vs. (42.06±6.60)], and total score [(94.19±7.56) vs. (77.32±6.78)].Conclusions:The application of improved PBL based on 5W2H thinking in the course of "massage therapy" has significant clinical implications. It can not only improve the teaching quality and effect, but also cultivate students' clinical thinking, teamwork, learning interest, and innovation ability, making it suitable for further promotion and application.

Objective:To evaluate the application effect of improved problem-based learning (PBL) based on 5W2H thinking in the course of "massage therapy".Methods:The undergraduate students in Class 1 and Class 2 of Acupuncture and Massage in the first semester of the 2023-2024 academic year at Heilongjiang University of Chinese Medicine were selected as the research subjects. The "massage therapy" was taught in Class 1 with the traditional method (control group, n=66) and in Class 2 with the method of improved PBL with 5W2H thinking (observation group, n=68). The two groups of students were compared in terms of theoretical knowledge of massage therapy, the assessment of massage skills, comprehensive ability, innovation ability, and practical ability, as well as the procedural evaluation indicators of massage. SPSS 25.0 was used for normality test and t test χ2 test. Results:After the completion of the study, the observation group showed higher scores in theoretical knowledge (90.56±11.73), massage skill proficiency [(87.22±11.57) vs. (78.23±9.45)], massage skill demonstration [(84.56±11.20) vs. (74.69±9.13)], mannequin usage [(82.98±10.75) vs. (72.66±8.89)], and massage skill mechanics [(86.38±11.45) vs. (73.35±8.94)] compared to the control group. The observation group also outperformed the control group in medical humanities [(85.53±10.64) vs. (64.86±7.33)], teacher-student and student-student interaction [(85.35±8.67) vs. (80.15±7.46)], clinical thinking and operation [(90.05±12.13) vs. (74.26±8.94)], and team coordination and cooperation [(85.60±10.06) vs. (81.53±9.33)]. In addition, the observation group scored higher than the control group in learning participation rate [(18.20±3.75) vs. (13.15±2.93)], error correction rate [(27.56±5.85) vs. (22.11±4.62)], operational stability [(48.43±7.79) vs. (42.06±6.60)], and total score [(94.19±7.56) vs. (77.32±6.78)].Conclusions:The application of improved PBL based on 5W2H thinking in the course of "massage therapy" has significant clinical implications. It can not only improve the teaching quality and effect, but also cultivate students' clinical thinking, teamwork, learning interest, and innovation ability, making it suitable for further promotion and application.

Objective:To determine the predictive value of atherogenic index of plasma (AIP) on the long-term prognosis of patients with coronary artery disease (CAD).Methods:A total of 2 500 patients with coronary heart disease who underwent coronary angiography in Affiliated Hospital of Jining Medical University from May 2013 to November 2015 were retrospectively analyzed. According to the AIP value, the subjects were divided into low AIP group (AIP<0.06) and high AIP group (AIP≥0.06). The incidence of major adverse cardiovascular events (MACE) was compared between the two groups. Kaplan-meier method was used to evaluate the MACE-free survival rate, and multivariate Cox survival analysis was used to evaluate the independent predictors of MACE.Results:A total of 2 427 patients were followed up, with a follow-up rate of 97.08% and a median follow-up time of 4.29 years. There were 1 123 cases in the low AIP group and 1 304 cases in the high AIP group, among which 624 patients (25.7%) had MACE. The total incidence of MACE in the high AIP group was higher than that in the low AIP group ( HR=1.43, 95% CI: 1.22-1.68, P<0.01). Kaplan-meier curves showed that the MACE-free survival rate was significantly lower in the high AIP group ( P<0.01). After adjusting for multiple confounding factors, AIP was still associated with the prognosis of CHD patients. Increased AIP (≥0.06) was an independent predictor of MACE in CHD patients within 4 years ( HR=1.34, 95% CI: 1.14-1.58, P<0.01). Conclusions:AIP (≥0.06) was an independent predictor of MACE occurrence in patients with CAD within 4 years. AIP has a certain value in the long-term prognosis of patients with CAD.

Objective:Using lasso regression analysis to screen out the blood lipid indexes closely related to coronary heart diseaseMethods:The clinical data of 3 062 patients with coronary heart disease who were hospitalized in the Department of Cardiology, Affiliated Hospital of Jining Medical College from May 2013 to November 2015 were retrospectively analyzed.They were divided into control group ( n=2 427) and coronary angiography group ( n=635). R language was used for statistical analysis.Multiple logistic regression models were established for indicators of blood lipid related to CAD, and their multicollinearity severity was assessed.LASSO regression was used to screen out the representative lipid parameters in the CAD prediction model. Results:A total of 3 062 patients were enrolled, including 2 427 patients in coronary heart disease group and 635 patients in control group.The inclusion of lipid parameters into multiple logistic regression model leads to serious multicollinearity.Stepwise regression can only partially reduce multicollinearity severity, while LASSO regression model significantly reduces multicollinearity severity.Low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) were found to be the representative lipid indexes for predicting coronary heart disease by LASSO regression analysis.Conclusion:LASSO regression has advantages in processing multicollinearity data.LASSO regression showed that LDL-C, HDL-C and non-HDL-C were representative lipid indicators for predicting coronary heart disease..

Objective To measure the parameters of bronchus and peripheral pulmonary small vessel in the early simple pulmonary contusion, and to explore the changes of bronchial and pulmonary small blood vessels after pulmonary contusion.Methods The chest CT images of 30 patients with early simple pulmonary contusion were collected retrospectively,images were then automatically segmented using FACT-Digital lung TM software.Ipsilateral,contralateral bronchial parameters (luminal cross-sectional area,wall thickness,internal and external diameter,inner and outer circumference and luminal density)and pulmonary small vessel parameters (number of vessels in the visual area,total blood vessel area)for 33 pulmonary contusion cases were measured respectively,finally,correlation between lung contusion area and bronchial and small vessel parameters were analyzed.Results Ipsilateral bronchial parameters (luminal cross-sectional area, wall thickness,internal and external diameter,inner and outer circumference and luminal density)and pulmonary small vessel parameters (number of vessels in the visual area,total blood vessel area)were greater than those in the contralateral(P<0.05).The area of pulmonary contusion was not associated with bronchial parameters nor pulmonary small vessel parameters.Conclusion Quantitative CT analysis can intuitively show the changes of bronchial and pulmonary small blood vessels in patients with early simple pulmonary contusion.

Objective To investigate the effect of liver depression (Liver Qi Stagnation) on Th17,Treg,IL-17,IL-10 and airway inflammation in asthmatic rats,and to clarify the immune mechanism of asthma with liver depression.Methods Established the combined with disease and syndrome model of asthma with liver depression.Collected the bronchoalveolar lavage fluid (BALF) to count the total and differential cell.Lung tissue was observed in microscope; the proportion of Th17 cells and Treg cells of CD4 +T cells in peripheral blood was measured by flow cytometry; the levels of IL-17 and IL-10 were determined by ELISA.Results The total number of inflammatory cells[(96.86±4.43)× 107/L,(88.22±3.22)× 107/L],the proportion of eosinophils [(27.58 ±4.65) ％,(22.67±2.43) ％],Th17 cells[(6.86±0.98) ％,(6.01 ±0.77) ％] and IL-17 level [(48.88± 8.06)pg/ml,(43.24± 6.32) pg/ml] of asthma in liver depression group and asthma group were significantly higher than the control group [(30.58 ± 2.49) × 107/L,(0.78 ± 0.12) ％,(2.80± 0.82) ％,(24.11 ±3.40)pg/ml]; Treg cells [(3.09±0.55) ％,(3.96±0.66) ％] and IL-10 level [(19.79±2.80) pg/ml,(20.29±3.12) pg/ml] were significantly lower than the control group [(8.02± 1.26) ％,(30.79 ± 4.01) pg/ml].The total number of inflammatory cells (96.86 ±4.43) × 107/L,the proportion of eosinophils (27.58±4.65) ％ and Th17 cells(6.86±0.98) ％ and IL-17 level (48.88±8.06)pg/mL of asthma in liver depression group were significantly higher than the asthma group (88.22 ± 3.22) × 107/L,(22.67 ± 2.43) ％,(6.01 ± 0.77) ％,(43.24 ± 6.32) pg/ml;the proportion of Treg cells (3.09 ±0.55)％ was significantly lower than the asthma group (3.96± 0.66)％; and the lung histopathology symptoms was more severe than asthma group.Conclusion Liver Qi Stagnation can promote the inflammation of asthma,the imbalance of Th17/Treg and IL-17 level to aggravate the asthma.Liver depression is one of the major internal factors in recurrent episodes of asthma.

Objective To investigate the relationship among the concentration of plasma interleukin (IL)-10 and plasma IL-13 and the clinical therapeutic effect in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods Thirty-six AECOPD inpatients were enrolled in this study.Blood samples of the subjects were collected as soon as hospitalization, and plasma IL-10 and IL-13concentrations were analyzed by enzyme-linked immunosorbent assay.The clinical manifestations of subjects were quantified by a special designed score standard, and were evaluated at the time points of hospitalization, 48 hours treatment and 96 hours treatment.The therapeutic effect was evaluated by clinical manifestations score combined with pulmonary ventilation functional parameter.Eventually, the correlation among the concentration of IL-10 concentration and IL-13 and the clinical therapeutic effect were analyzed.Results The correlation coefficients between clinical manifestations score decrease and pulmonary ventilation function improvement with plasma IL-10 concentration after 48 hours treatment were 0.85 and 0.48 respectively,then, 0.64 and 0.52 after 96 hours treatment.The correlation coefficients between clinical manifestations score decrease and pulmonary ventilation function improvement with plasma IL-13 concentration after 48hours treatment were -0.41 and -0.34, after 96 hours treatment , correlation coefficients between clinical manifestations score decrease with plasma IL-13 concentration was -0.36.All of the above correlation coefficients were statistically significant.Conclusion Plasma IL-10 concentration was positively, whereas, IL-13 concentration was negatively correlated with the therapeutic effect in AECOPD patients.

Growth hormone (GHRH) and pitutary adenylate cyclase activating peptide (PACAP) are the members of the PACAP/Glucagon superfamily,who are related in both sequence and function.Their stimulation of GH secretion and animal growth is concerned.A series of expression plasmid,pIRES1-GHRH-PACAP (P-G-P),plRESI-GHRH (P-G) and plRESI-PACAP(P-P),were constructed,extracted and purified,then transfected into CHO cell line with Lipofectamine.The expression was examined by RT-PCR,dot-ELISA and Western blotting.The biological activity of expression products was detected in rats.At 8 h after injection of transfection supematant,serum IGF-I concentrations in P-G-P group were significantly higher than that in other groups(P ＜ 0.05).PLGA encapsulating plasmid microspheres were prepared and injected intramuscularly into rabbit legs.Growth behavior and IGF-1 level were measured at day 0,15,30 and 45 after injection.Greater body weights gain and higher serum 1GF- [ levels were observed in three plasmid microsphere injection groups,compared with control group.At day 30,the body weight gain in P-G-P group was greater than saline group (81%,P＜ 0.01),P-G mierosphere group (15%,P＜ 0.05) and P-P microsphere group (7%,P＞ 0.05),serum IGF-I concentration in P-G-P microsphere group showed a 16.68% increase to P-G microsphere (P ＞ 0.05),a 17.14% increase to P-P microsphere(P ＞ 0.05) and a 50.46% increase to control (P ＜ 0.05).These results suggest that co-expression of GHRH and PACAP in one expression plasmid might exert an additive stimulation of GH secretion and growth when delivered into rabbit skeletal muscle with PLGA mierosphere.The results may provide a new approach to regulate animal growth.

Objective To establish a multiple PCR method that can be used to spontaneously detect five kinds ofpathogens such as NG,MH,MG,CT and UU.Method With the fluorescence-quantitative PCR technique in conjunction with another detection technique as the golden standard,evaluation was conducted on the sensitivity,specificity,accuracy and repeatability on the detection of 5 kinds of STD pathogens using single-tube multiplex PCR.Result The sensitivity,specificity and match rate of the method ale 10-9fg/μl,100%,97.8%respectively,and the repeatability of 5 continuous days of 20 clinical specimens is good.Conclusion Single-tube multiplex PCR technique provides a new method to detect 5 kinds of STD pathogens.

Objective To investigate the biological effect of transforming growth factor-?1(TGF-?1) on inducing myofibroblast formation in hypoxic pulmonary vascular remodeling.Methods Forty male Wistar rats were exposed to hypoxia for 0,3,7,14 or 21 days.Mean pulmonary arterial pressure(mPAP),vessel morphometry,right ventricle hypertrophy index(RVHI) were measured.Immunocytochemistry was used to measure the expression of ?-Smooth-muscle actin(?-SMA) and TGF-?1 in pulmonary artery walls and in situ hybridization was used to measure the expression of TGF-?1 mRNA in pulmonary artery walls.Ultrastructure alveolar wall vessels were observed by electron microscopy.Human embryonic lung fibroblasts(KMB17) phenotype after induction of hypoxiaand TGF-?1 were recorded through cell culture.Results(1) mPAP increased significantly after 7-day of hypoxia(P