Objective:To explore the learning experience of medical students in digital storytelling teaching,providing a theoretical basis for the practice and research of digital storytelling teaching.Methods:Qualitative research and mixed-method research containing qualitative studies on medical students'experiences in digital storytelling teaching were retrieved from domestic and foreign databases,with a retrieval time limit from database establishment to January 2024.The quality evaluation criteria for qualitative research from JBI Evidence-Based Healthcare Center were used to evaluate the quality of the included literature,and the meta-integration method was used to systematically integrate and analyze the results.Results:A total of 12 articles were included,44 research results were extracted,and 11 new categories were summarized and integrated into 3 integration results,including medical students benefit greatly from digital storytelling teaching;the unique advantages of digital storytelling as an emerging teaching tool;and the obstacles of digital storytelling in education.Conclusion:Medical students hold a positive attitude towards the teaching mode of digital storytelling and have gained a good learning experience from it.However,there are shortcomings such as the uneven quality of digital storytelling resources,and some medical students'unsuitability for the learning mode of digital storytelling.Further research is needed on ethical issues arising from the teaching mode of digital storytelling.

Cellular immune responses as well as generalized and periarticular bone loss are the key pathogenic features of rheumatoid arthritis (RA). Under the pathological conditions of RA, dysregulated inflammation and immune processes tightly interact with skeletal system, resulting in pathological bone damage via inhibition of bone formation or induction of bone resorption. Single-cell omics technologies are revolutionary tools in the field of modern biological research.They enable the display of the state and function of cells in various environments from a single-cell resolution, thus making it conducive to identify the dysregulated molecular mechanisms of bone destruction in RA as well as the discovery of potential therapeutic targets and biomarkers. Here, we summarize the latest findings of single-cell omics technologies in osteoimmunology research in RA. These results suggest that single-cell omics have made significant contributions to transcriptomics and dynamics of specific cells involved in bone remodeling, providing a new direction for our understanding of cellular heterogeneity in the study of osteoimmunology in RA.
Humans ; Osteoclasts/physiology* ; Arthritis, Rheumatoid/pathology* ; Inflammation/pathology* ; Bone and Bones/pathology* ; Bone Resorption/pathology*

【Objective】 To investigate the establishment of multi-center haemovigilance (HV) and the monitoring of adverse reactions to blood donation (ARBD), in order to provide basis for the management of blood donors. 【Methods】 The operation of HV was investigated by questionnaire. The total number of blood donations (including plateletpheresis) and ARBD cases occurred in each blood center from 2014 to 2018 were analyzed. 【Results】 Among the 24 blood centers in this survey, only nine got HV operated. The incidence of ARBD of 19 blood centers that fulfilled the questionnaire was in the range of (0.003~1.151) %. The change trend of number and incidence of ARBD cases were indeterminate. 【Conclusion】 Most blood centers did not got HV established. The incidence of ARBD varied greatly and was indeterminate. The application of HV should be further improved to strengthen ARBD management.

OBJECTIVE：To establish the microwave processing technology of yellow wine-processed Curculigo orchioides ， and compare it with traditional technology. METHODS ：HPLC method was adopted to determine the contents of curculigoside ， orcinol glucoside and orcinol gentiobioside in C. orchioides . Based on the single factor tests ，microwave processing technology was optimized and validated with orthogonal test combined with comprehensive weighted scoring method ，with the amount of yellow wine，microwave power ，wetting time and microwave time as factors ，using the contents of curculigoside ，orcinol glucoside ， orcinol gentiobioside and ethanol soluble extract as the indexes. The contents of C. orchioides decoction pieces and processed products were compared. RESULTS ：The optimal microwave processing technology included that the amount of yellow wine was 20％（the weight of C. orchioides decoction pieces was 20％），microwave power was 300 W，wetting time was 3 h，microwave time was 2 min. After 3 times of validation tests ，average contents of curculigoside，orcinol glucoside ，orcinol gentiobioside and ethanol soluble extract were 0.095 6％，0.723 9％，0.406 6％，10.115 3％，and RSD were 0.71％，0.54％，0.99％，1.44％（n＝3）. Average comprehensive score were 99.08（RSD＝0.69％，n＝3）. Except for the content of ethanol soluble extract in traditional wine-processed product ，the contents of curculigoside and orcinol gentiobioside in traditional wine-processed product and microwave processed product as well as the content of ethanol soluble extract in microwave processed product were all significantly higher than C. orchioides decoction pieces ；the contents of curculigoside and orcinol gentiobioside in microwave processed product were both significantly higher than traditional wine-processed product （P＜0.05）. The contents of orcinol glucoside in 2 processed product were significantly lower than C. orchioides decoction pieces ，while the microwave processed product was significantly higher than traditional wine-processed product （P＜0.05）. CONCLUSIONS ：Optimized microwave processing technology is stable and feasible ，and can be used for the processing of yellow wine-processed C. orchioides .

Objective:To screen the risk factors of psychology problems and quality of life of patients with inflammatory bowel disease (IBD) by questionnaire, and to explore the impact of anxiety and depression on the quality of life and disease of IBD patients, in order to guide the treatment of IBD.Methods:From June 15 to July 15 in 2019, 171 IBD patients diagnosed in the Department of Gastroenterology, the Tenth People′s Hospital of Tongji University in Shanghai were investigated by internet questionnaire. Finally 136 IBD patients (IBD group) were enrolled. During the same period 121 healthy individuals with no difference in age and gender were selected as healthy control group. IBD clinical questionnaire, the generalized anxiety disorder (GAD)-7, patient health questionnare (PHQ)-9 depression screening and the short form 36-item health survey (SF-36) quality of life evaluation scale were used in IBD group. General situation questionnaire, GAD-7, PHQ-9 and SF-36 scale were conducted in healthy control group. Chi-square test, Binary logistic regression analysis, Ordinal logistic regression analysis, and Pearson correlation analysis were used for statistical analysis.Results:In IBD group, 87(64.0%) were males and 49(36.0%) were females; 25 cases (18.4%) were ulcerative colitis (UC) and 111 cases (81.6%) were Crohn′s disease (CD); and the median age was (32(26, 40)) years old. In healthy control group, 68 (56.2%) were males and 53(43.8%) were females; the median age was (32(26, 37)) years old. The incidence of anxiety in UC patients and CD patients was 64.0%(16/25) and 64.9%(72/111), respectively, and the incidence of depression in UC and CD was 72.0%(18/25) and 58.6%(65/111), respectively. There were no significant differences in the incidence of anxiety and depression between UC patients and CD patients (both P>0.05). Role-emotional (odds ratio ( OR)=0.965, 95% confidence interval ( CI) 0.937 to 0.994, P=0.017) and mental health ( OR=0.940, 95% CI 0.896 to 0.985, P=0.010) may be the independent factors of depression. Physiological function ( OR=1.040, 95% CI 1.010 to 2.730, P=0.022) was the independent factors of depression. There was no significant correlation between the duration of disease and the quality of life ( P>0.05). There was no significant correlation between disease activity and quality of life, however it was related to physiological function ( r=0.15, P=0.046). The physiological function of IBD patients in remission stage was better than that of patients in activity stage. Depression was negatively correlated with quality of life ( r=-0.55, P<0.01), and with a linear relationship ( r=19.429, intercept was 744.455, P<0.01). Anxiety was not correlated with quality of life ( P>0.05). Depression was negatively correlated with changes of physical function, role-physical function, physical pain, general health, vitality, social function, emotional function, mental health, and reported health transition ( r=-0.234, -0.358, -0.454, -0.449, -0.566, -0.485, -0.441, -0.597, and -0.193, all P<0.05). Conclusions:IBD patients are prone to anxiety and depression. Depression is negative correlated with quality of life. It is very important to screen and intervene mental disorders in IBD patients, especially in patients with depression. Controlling the activity of IBD and relieving the clinical symptoms of patients may be effective in improving anxiety and depression. The treatment of IBD itself is the basis of IBD psychotherapy.

Objective    To investigate the effect of artificial colloid on coagulation function in pediatric patients weighing less than 5 kg with congenital heart disease during cardiopulmonary bypass in congenital heart disease surgery by using artificial colloid instead of human serum albumin. Methods    A total of 65 pediatric patients with weight less than 5 kg who underwent congenital heart disease surgery in our hospital from September 2016 to December 2017 were included in the study. They were randomly divided into two groups: an artificial colloid group (the experimental group, n=33) and a human serum albumin combined artificial colloid group (the control group, n=32). Perioperative hemoglobin concentration (Hb), blood products and hemostatic drugs used, postoperative coagulation function index and pleural fluid volume 24 hours after surgery were monitored. Results    There was no significant difference in perioperative Hb and chest tube drainage between the two groups. The platelet utilization rate in the experimental group was significantly lower than that in the control group (P<0.05). No significant difference was found in the dosage of other blood products and hemostatic drugs between the two groups during the perioperative period. There was no significant difference in coagulation parameters between the two groups before and after surgery (P>0.05). Conclusion    The use of artificial colloid as colloid priming solution during cardiopulmonary bypass has no adverse effect on coagulation function in pediatric patients weighting less than 5 kg with congenital heart disease.

Objective To evaluate the effect of iron metabolism of preoperation on the length of intensive care unit (ICU) stay in liver transplant recipients.Methods A retrospective study was conducted. 120 adult liver transplant recipients admitted to Tianjin First Central Hospital from September 2015 to September 2017 were enrolled. The basic data, model of end-stage liver disease (MELD) evaluation system score at admission; iron metabolism index, routine blood test, blood biochemistry, coagulation time and C-reactive protein (CRP) level within 24 hours after admission; intraoperative clinical indicators such as operation time, operation bleeding volume, red blood cells and fresh frozen plasma input volume, hot ischemia time, cold ischemia time, urine volume; and the length of ICU stay were collected. All patients were divided into iron deficiency group (ID group; serum ferritin < 100μg/L, or serum ferritin 100-300μg/L and transferrin saturation < 0.20) and non-iron deficiency group (non-ID group; serum ferritin > 300μg/L, or serum ferritin 100-300μg/L and transferrin saturation > 0.20) according iron deficiency standard. The indexes of iron metabolism, basic data and clinical indicators of two groups were compared. The correlation between serum ferritin level and the length of ICU stay was analyzed by Pearson correlation.Results Compared with non-ID group, the levels of serum iron concentration and serum ferritin were significantly decreased in ID group [serum iron concentration (μmol/L): 3.50±1.62 vs. 14.50±2.31, serum ferritin (μg/L): 67.00±31.54 vs. 315.00±36.73, bothP < 0.01], infusion volume of intraoperative red blood cells and fresh frozen plasma were significantly increased, and the length of ICU stay was significantly prolonged (days: 6.5±2.4 vs. 3.3±0.5,P < 0.01). There was no significant difference in transferrin saturation, CRP and other clinical indicators between the two groups. Correlation analysis showed that serum ferritin level was negative correlated with the length of ICU stay (r = -0.768,P < 0.001).Conclusion Preoperative iron deficiency in liver transplant recipients will lead to increased blood transfusion and prolonged length of ICU stays.

Objective To observe the effect of different explosion impulse on rabbit lung injury and decide the death curve,so as to provide a reference for the prediction of lung injury.Methods Six healthy male New Zealand white rabbits with weight of 2.0-2.5 kg and age of (6 ± 1)months were selected.The rabbits were put 0.5 m,0.6 m,0.7 m,0.9 m,1.0 m,and 1.2 m away from 90 g TNT to carry out the blast injury experiment.The characteristic parameters of blast shock wave and general lung injury were recorded.Based on the experimental results combined with theoretical analysis,the changes of rabbit lung injury depending on the explosion distance as well as the rabbit death curve were determined.Results After the 90 g TNT explosion,the peak overpressure of shock wave and the corresponding specific impulse decreased quickly with the increase of explosion distance.The peak overpressure was 0.79 MPa and the specific impulse was 82 Pa · s at the explosion distance of 0.5 m.The peak overpressure was 0.1 MPa and the specific impulse was 34 Pa · s at the explosion distance of 1.2 m.The rabbits at 0.5 m and 0.6 m died,the rabbit at 0.7 m was severely injured,and the rabbits at 0.9 m,1.0 m,and 1.2 m were slightly injured.The dependence of lung injury degree on the explosion distance under 90 g TNT explosion was established based on dimensional analysis theory.The lung injury degree was exponentially attenuated with the explosion distance:φ =(R/0.6)-5.64(φ represented lung injury degree,and R represented the explosion distance).Considering the combined injury effects of peak overpressure of shock wave and its specific impulse on rabbit lung,the death curve of rabbit was determined:(p-0.1) (I-59) =2.6 (p represented peak overpressure,and I represented specific impulse).The criterion of "overpressure-specific impulse" was used to estimate the death of rabbit,and the death curve of rabbit was determined as (p-0.1)(I-59) =2.6(p represented peak overpressure and I represented specific impulse).The critical overpressure was 0.1 MPa and the critical specific impulse was 59 Pa · s.Conclusions Under the explosion condition of 90 g TNT,the relationship between degree of lung injury in rabbits and explosion distance is established.Death curve of rabbits is determined based on the damage effect of shock wave peak overpressure and specific impulse on the lungs of rabbits,which is significant for predicting the blast injury.

Objective To explore the effect of sequential nursing management on quality of life of patients with dementia Louis's disease.Methods A total of 56 patients with Lewy bodies were randomly divided into control group and intervention group,with 28 cases per group.The two groups were given conventional medication,the control group adopted general nursing,while the intervention group conducted sequential nursing management.Patients of two groups were evaluated by simple intelligence state Checklist (MMSE),daily living capacity scale (ADL) and health status questionnaire (SF-36) before intervention and after 6 months of intervention.Results The MMSE score and SF-36 comprehensive score in the intervention group were higher than that in the control group (P ＜0.05);Significant differences were observed in scores of 8 dimensions such as physical health and social function compared with the control group (P ＜ 0.05).Conclusion Sequential nursing management can improve daily life ability and quality of life for patients with dementia of Louis bodies,delay progress of disease and improve quality of life of patients.

Objective To explore the effect of sequential nursing management on quality of life of patients with dementia Louis's disease.Methods A total of 56 patients with Lewy bodies were randomly divided into control group and intervention group,with 28 cases per group.The two groups were given conventional medication,the control group adopted general nursing,while the intervention group conducted sequential nursing management.Patients of two groups were evaluated by simple intelligence state Checklist (MMSE),daily living capacity scale (ADL) and health status questionnaire (SF-36) before intervention and after 6 months of intervention.Results The MMSE score and SF-36 comprehensive score in the intervention group were higher than that in the control group (P ＜0.05);Significant differences were observed in scores of 8 dimensions such as physical health and social function compared with the control group (P ＜ 0.05).Conclusion Sequential nursing management can improve daily life ability and quality of life for patients with dementia of Louis bodies,delay progress of disease and improve quality of life of patients.