Objective To explore the effectiveness of integrating virtual simulation technology with case-based learning(CBL)in the teaching of clinical blood transfusion testing technology.Methods From January to June 2024,99 undergraduate students majoring in medical laboratory science at our university were selected and divided into an observation group(50 students)and a control group(49 students)based on their classes.The control group followed a traditional theoretical teaching model,while the observation group employed virtual simulation technology combined with CBL.Results The study compared as-sessment scores for theory learning,practical skills,case analysis,and comprehensive quality,teaching effects such as coordina-tion and cooperation abilities,self-efficacy measured by the GSES scale,and teaching satisfaction between the two groups.The results indicated that the observation group had significantly higher scores in all assessment categories,teaching effect abilities,and total GSES scores compared to the control group(P＜0.05).The total teaching satisfaction rate in the observation group reached 100%,significantly higher than the 80% in the control group(P＜0.05).Conclusion The integration of virtual simu-lation technology with CBL innovates the teaching model for clinical blood transfusion testing courses,effectively enhancing students'professional skills and comprehensive quality,boosting self-efficacy,and achieving high student satisfaction,demon-strating significant potential for broader application.

Objective:To gain a understanding of the current situation and influencing factors of poor vision in 6-year-old children in Heilongjiang Province, and to provide a reference basis for formulating effective prevention and control strategies for poor vision.Methods:From August to October 2024, a non probability sampling method was used to select 6-year-old children in Heihe City, Jiamusi City, Hegang City, Suifenhe City, Dongning City, and Dorbod Mongol Autonomous County for vision examination and questionnaire survey. The questionnaire survey included electronic screen usage, close range eye habits, outdoor activities and sleep conditions, vision examination results, interests and dietary habits, and the influencing factors of poor vision were analyzed.Results:A total of 6 342 6-year-old children were surveyed, with a detection rate of 29.234% (1 854/6 342) for poor vision. Five thousand seven hundred and twenty-one valid questionnaires were recovered, with a valid questionnaire rate of 90.208%. Logistic multivariate analysis showed that daily TV viewing time (≥2 h), daily computer usage time (≥1 h), daily use of mobile electronic devices (≥1 h), turning off lights when watching electronic screens after dark, resting frequency when using close range eyes (≥0.5 h rest once), parental myopia, frequent picky eating habits, and a preference for sweet foods (desserts, fruits, ice cream) were independent risk factors for poor vision in 6-year-old children ( P < 0.05). The distance between the eyes and the computer display screen exceeding 66 cm, the distance between the eyes and the TV display screen exceeding 3 m, and the daily outdoor activity time (≥3 h) were independent protective factors ( P < 0.05). Conclusions:The detection rate of poor vision in 6-year-old children in Heilongjiang Province is relatively high, and factors such as electronic screen usage, close range eye habits, outdoor activities, and dietary habits are all influencing factors. In the future, we should raise children's awareness of vision protection and develop scientific and effective prevention and control strategies to reduce the incidence of poor vision in children and adolescents.

Objective To explore the effectiveness of integrating virtual simulation technology with case-based learning(CBL)in the teaching of clinical blood transfusion testing technology.Methods From January to June 2024,99 undergraduate students majoring in medical laboratory science at our university were selected and divided into an observation group(50 students)and a control group(49 students)based on their classes.The control group followed a traditional theoretical teaching model,while the observation group employed virtual simulation technology combined with CBL.Results The study compared as-sessment scores for theory learning,practical skills,case analysis,and comprehensive quality,teaching effects such as coordina-tion and cooperation abilities,self-efficacy measured by the GSES scale,and teaching satisfaction between the two groups.The results indicated that the observation group had significantly higher scores in all assessment categories,teaching effect abilities,and total GSES scores compared to the control group(P＜0.05).The total teaching satisfaction rate in the observation group reached 100%,significantly higher than the 80% in the control group(P＜0.05).Conclusion The integration of virtual simu-lation technology with CBL innovates the teaching model for clinical blood transfusion testing courses,effectively enhancing students'professional skills and comprehensive quality,boosting self-efficacy,and achieving high student satisfaction,demon-strating significant potential for broader application.

Objective:To gain a understanding of the current situation and influencing factors of poor vision in 6-year-old children in Heilongjiang Province, and to provide a reference basis for formulating effective prevention and control strategies for poor vision.Methods:From August to October 2024, a non probability sampling method was used to select 6-year-old children in Heihe City, Jiamusi City, Hegang City, Suifenhe City, Dongning City, and Dorbod Mongol Autonomous County for vision examination and questionnaire survey. The questionnaire survey included electronic screen usage, close range eye habits, outdoor activities and sleep conditions, vision examination results, interests and dietary habits, and the influencing factors of poor vision were analyzed.Results:A total of 6 342 6-year-old children were surveyed, with a detection rate of 29.234% (1 854/6 342) for poor vision. Five thousand seven hundred and twenty-one valid questionnaires were recovered, with a valid questionnaire rate of 90.208%. Logistic multivariate analysis showed that daily TV viewing time (≥2 h), daily computer usage time (≥1 h), daily use of mobile electronic devices (≥1 h), turning off lights when watching electronic screens after dark, resting frequency when using close range eyes (≥0.5 h rest once), parental myopia, frequent picky eating habits, and a preference for sweet foods (desserts, fruits, ice cream) were independent risk factors for poor vision in 6-year-old children ( P < 0.05). The distance between the eyes and the computer display screen exceeding 66 cm, the distance between the eyes and the TV display screen exceeding 3 m, and the daily outdoor activity time (≥3 h) were independent protective factors ( P < 0.05). Conclusions:The detection rate of poor vision in 6-year-old children in Heilongjiang Province is relatively high, and factors such as electronic screen usage, close range eye habits, outdoor activities, and dietary habits are all influencing factors. In the future, we should raise children's awareness of vision protection and develop scientific and effective prevention and control strategies to reduce the incidence of poor vision in children and adolescents.

Objective: To investigate the outbreak of mumps in a remote village school of Zhaoqing City, to evaluate and vaccine effectiveness ( VE ) of mumps containing vaccine (MuCV), so as to provide reference for the formulation of epidemic prevention and control strategies. Methods: Through on site case investigations and interviews, case data and epidemic related epidemiological information were obtained. Descriptive and retrospective cohort studies were used to analyze the epidemic characteristics, explore risk factors, and evaluate the protective effect of vaccines. Results: Totally 166 cases of mumps were found, and all of them were students. The total attack rate was 7.79% and the outbreak lasted for 60 days. The first case occurred on October 11th and the last case occurred on December 9th in 2018. Most of the cases aged from 10 to 13 years old, accounting for 66.27%. There were 96 male patients and 70 female patients, with no statistically significant sex difference in the incidence rate ( χ 2=2.40, P >0.05). Involving 28 classes, 11 of which had an incidence rate more than 10%, mainly distributed in grades 2, 4 and 6. There were statistically significant differences in incidence rates among different grades ( χ 2=96.89, P <0.01) and different floors ( χ 2=67.35, P < 0.01 ), with the third floor higher than the other floors. Twelve out of 58 boarding pupils were cases, and boarding pupils were 1.89 times higher in risk of contracting mumps than day students ( RR=1.89, 95%CI =1.10-3.23). Pupils without being given the shot of MuCV were higher in the infection rate than those having the shot ( χ 2=5.70, P <0.05), and the VE % was 35% (95% CI = 7%- 55%). The VE % of one dose was 34% (4%-54%), while the effectiveness of protection was declined with time ( χ 2 trend =6.53, P < 0.05). The effectiveness of vaccine almost diasappeared six years after the shot ( χ 2=1.12, P >0.05). Conclusion Delayed case report and isolation, low rate of receiving MuCV, and decreasing effectiveness of one shot MuCV are closely assocaited with the outbreak and ongoing spread of the epidemic.

Objective:To evaluate the effects of berberine on necroptosis of non-alcoholic fatty liver disease in mice and its relationship with adenosine monophosphate-activated protein kinase(AMPK)/ signal transducer and activator of transcription 6(STAT6) pathway.Methods:Twenty-five 8-week-old male C57BL/6N mice were divided into control group, steatotic liver group, berberine treatment group(200 mg·kg -1·d -1), AMPK inhibitor Compound C treatment group(0.2 mg·kg -1·d -1), and STAT6 inhibitor AS1517499 treatment group(10 mg·kg -1·d -1). After 12 weeks of intervention, the mice and liver tissue were weighed, and serum aspartate aminotransferase(AST), alanine aminotransferase(ALT), triglyceride, tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β) as well as liver malondialdehyde and superoxide dismutase were measured; liver tissue HE, Masson, and oil red O staining were performed. Western blotting was used to detect the expressions of necroptosis related proteins[receptor interaction protein kinase 3(RIPK3), phosphorylated(p-) mixed lineage kinase domain-like(MLKL)], AMPK, p-AMPK, and p-STAT6. Results:Compared with control group, the steatotic liver group had higher quality of liver and liver index, and higher levels of serum AST, ALT, triglyceride, TNF-α, IL-1β, and oxidative stress( P<0.05); Liver tissue was full of cavity changes and inflammatory cell infiltration, widely distributed red lipid droplets and obvious blue fiber dyeing; The expressions of RIPK3 and p-MLKL were up-regulated ( P<0.05), but the levels of p-AMPK and p-STAT6 were relatively reduced ( P<0.05). Compared with the steatotic liver group, berberine intervention decreased liver quality and liver index, improved liver function, reduced blood lipid levels, pro-inflammatory factor expression and oxidative stress level, and significantly alleviated the degree of liver steatosis and fibrosis, the levels of RIPK3 and p-MLKL ( P<0.05), while the expressions of p-AMPK and p-STAT6 were increased significantly ( P<0.05). As compared with the berberine treatment, AMPK and STAT6 inhibitor treatment could offset the protective effect of berberine on steatotic liver, moreover, the expressions of RIPK3 and p-MLKL were increased ( P<0.05). There was no statistical difference in AMPK total protein content among the five groups ( P>0.05). Conclusion:Berberine can activate AMPK/STAT6 pathway to inhibit the necroptosis of hepatocyte, thus plays a protective role on non-alcoholic fatty liver disease in mice.

Objective:To evaluate the role of silencing information regulator 1 (SIRT1)/nuclear factors E2-related factor2 (Nrf2) signaling pathway in berberine-induced reduction of renal ischemia-reperfusion (I/R) injury in mice.Methods:Thirty SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 18-22 g, were divided into 5 groups ( n=6 each) using a random number table method: sham operation group (S group), renal I/R group (RIR group), berberine+ I/R group (B group), berberine+ I/R+ SIRT1 inhibitor EX527 group (BE group) and berberine+ I/R+ Nrf2 inhibitor ATRA group (BA group). After the right kidney was removed, the left renal artery was clamped for 45 min followed by reperfusion to establish the model of renal I/R injury.In B, BE, and BA groups, berberine 100 mg·kg -1·d -1 was given for intragastric administration at 14 days before surgery.In group BE and group BA, EX527 5 mg·kg -1·d -1 and ATRA 10 mg·kg -1·d -1 were injected intraperitoneally at 3 days before surgery, respectively.The equal volume of normal saline was given for 14 consecutive days in group S and group RIR.Blood samples were collected from orbital vein at 24 h of reperfusion for measurement of serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations, for determination of the interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) contents (by enzyme-linked immunosorbent assay) and expression of SIRT1, Nrf2, apoptosis-associated speck-like protein containing CARD (ASC), caspase-1, nucleotide-binding oligomerization domain-like receptor containing pyrin domain (NLRP3) (by Western blot) and for examination of the pathological changes of renal tubules (with a light microscope). The damage to the renal tubules was scored. Results:Compared with group S, the concentrations of serum Cr and BUN, the contents of renal IL-1β and TNF-α and renal tubular injury score were significantly increased in RIR, B, BE and BA groups, the expression of SIRT1, Nrf2, ASC, caspase-1 and NLRP3 was up-regulated in RIR, BE and BA groups, and the expression of SIRT1, Nrf2, caspase-1 and NLRP3 was up-regulated in group B ( P<0.05). Compared with group RIR, the concentrations of serum Cr and BUN, the contents of renal IL-1β and TNF-α and renal tubular injury score were significantly decreased in B, BE and BA groups, the expression of SIRT1 and Nrf2 in group B, Nrf2 and ASC in BE group and SIRT1, ASC and caspase-1 in BA group was up-regulated, and the expression of ASC, caspase-1 and NLRP3 in group B, SIRT1 and NLRP3 in BE group and Nrf2 in BA group was down-regulated ( P<0.05). Compared with group B, the serum concentrations of Cr and BUN, the contents of IL-1β and TNF-α and renal tubular injury score were significantly increased in BE and BA groups, the expression of ASC, caspase-1 and NLRP3 in BE and BA groups was up-regulated, and the expression of SIRT1 in BE and Nrf2 in BA groups was down-regulated ( P<0.05). Conclusion:SIRT1/Nrf2 signaling pathway is involved in the process of berberine-induced reduction of renal I/R, which is related to inhibiting pyroptosis in mice.

Objective:To explore the risk factors of intensive care unit-acquired weakness (ICU-AW), and to establishment and verify its risk prediction model.Methods:A modeling group of 231 patients who met the inclusion criteria and were admitted to the intensive care unit (ICU) of the First Hospital of Jiaxing from July 2019 to June 2020 was collected by convenience sampling method. According to whether they developed ICU-AW, they were divided into ICU-AW group (55 cases) and non ICU-AW group (176 cases). The clinical data were collected concerning patients' individual information, disease-related factors, treatment-related factors and laboratory indicators, and the differences of the above indexes between two groups were compared. Logistic regression was used to analyze the ICU-AW risk factors and a risk prediction model was constructed. Calculate the area under ROC curve (AUC) to test the prediction effect of the model. At the same time, 60 patients who admitted to ICU from July to October 2020 and met the standards were collected to verify the model.Results:Compared with non ICU-AW group, there were more males in ICU-AW group [61.8% (34/55) vs. 44.3% (78/176), P < 0.05], with higher levels of systemic inflammatory response syndrome (SIRS), sepsis, immobilization and the use of neuromuscular blockers [SIRS: 30.9% (17/55) vs. 3.4% (6/176), sepsis: 12.7% (7/55) vs. 2.3% (4/176), immobilization: 72.7% (40/55) vs. 39.2% (69/176), the use of neuromuscular blockers: 50.9% (28/55) vs. 14.2% (25/176), all P < 0.05], and acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, blood lactic acid level and duration of mechanical ventilation, length of hospital stay were all increased [APACHEⅡ score: 18 (15, 24) vs. 12 (8, 17), blood lactic acid (mmol/L): 2 (1, 2) vs. 1 (1, 2), duration of mechanical ventilation (days): 7 (4, 12) vs. 2 (2, 5), length of hospital stay (days): 10 (6, 16) vs. 5 (3, 9), all P < 0.05]. SIRS, APACHEⅡ score, duration of mechanical ventilation and blood lactic acid were included to construct a risk prediction model [odds ratio ( OR) values were 4.835, 1.083, 1.210, 1.790, P values were 0.018, 0.013, 0.015, 0.013]. The model equation was P = exp [-5.207+(1.576×SIRS)+(0.079×APACHEⅡ)+(0.191×duration of mechanical ventilation)+(0.582×blood lactic acid)]. Internal verification: Calibration diagram showed the calibration curve above the ideal curve, AUC = 0.888, 95% confidence interval (95% CI) was 0.839-0.938; when the cut-off value was 0.166, the sensitivity was 89.1%, the specificity was 75.6%, and the maximum index was 0.649. External verification: Calibration diagram showed that the calibration curve was above the ideal curve, and the plotted AUC = 0.853, 95% CI was 0.753-0.953. When the cut-off value of the corresponding predictive risk value was 0.367, the sensitivity was 68.8%, the specificity was 86.4%, and the maximum approximate index was 0.552. Conclusion:The risk prediction model of ICU-AW constructed in this study has good consistency and prediction efficiency, which can provide reference for medical personnel to identify high-risk groups of ICU-AW patients in the early stage and provide targeted interventions in advance.

Objective:To investigate the spontaneous neural activities and the whole-brain functional connectivity(FC) patterns at rest in patients with obsessive-compulsive disorder (OCD).Methods:40 drug-naive patients with OCD matched the diagnostic criteria of ICD-10 (OCD group), and 38 genders, age, education-matched healthy controls (controls group) underwent resting-state functional magnetic resonance imaging scan. The fractional amplitude of low-frequency fluctuations (fALFF) approach was used to explore spontaneous neural activities. The brain region with abnormal fALFF value (right orbitofrontal cortex (OFC)) was used as the interested region to carry out the whole-brain FC analysis. We analyzed the correlation of clinical symptoms with the abnormal fALFF and FC values by partial correlation analysis in patients with OCD.Results:Compared with controls group, increased fALFF were found in the right OFC and right dorsolateral prefrontal gyrus ( t=4.45, 5.25; P<0.05, GRF corrected), and increased FC were observed between the right OFC and left OFC, and left cerebellum crus Ⅱ ( t=5.39, 4.94; P<0.05, GRF corrected) in OCD group. The increased FC between right OFC and left cerebellum crus Ⅱ positively correlated with 17-Items Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale scores ( r=0.401, P=0.015; r=0.389, P=0.019; uncorrected). Conclusions:The local spontaneous neural activities and FC in the cortical-striatal-thalamic-cortical and OFC-cerebellar circuits were abnormal at rest in patients with OCD.

Objective:To investigate the spontaneous neural activities and the whole-brain functional connectivity(FC) patterns at rest in patients with obsessive-compulsive disorder (OCD).Methods:40 drug-naive patients with OCD matched the diagnostic criteria of ICD-10 (OCD group), and 38 genders, age, education-matched healthy controls (controls group) underwent resting-state functional magnetic resonance imaging scan. The fractional amplitude of low-frequency fluctuations (fALFF) approach was used to explore spontaneous neural activities. The brain region with abnormal fALFF value (right orbitofrontal cortex (OFC)) was used as the interested region to carry out the whole-brain FC analysis. We analyzed the correlation of clinical symptoms with the abnormal fALFF and FC values by partial correlation analysis in patients with OCD.Results:Compared with controls group, increased fALFF were found in the right OFC and right dorsolateral prefrontal gyrus ( t=4.45, 5.25; P<0.05, GRF corrected), and increased FC were observed between the right OFC and left OFC, and left cerebellum crus Ⅱ ( t=5.39, 4.94; P<0.05, GRF corrected) in OCD group. The increased FC between right OFC and left cerebellum crus Ⅱ positively correlated with 17-Items Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale scores ( r=0.401, P=0.015; r=0.389, P=0.019; uncorrected). Conclusions:The local spontaneous neural activities and FC in the cortical-striatal-thalamic-cortical and OFC-cerebellar circuits were abnormal at rest in patients with OCD.