ObjectiveTo reveal the changing pattern of fungal communities and isoflavone content during the fermentation of Sojae Semen Praeparatum. MethodsInternal transcribed spacer （ITS） amplicon sequencing was used to analyze the changes in fungal communities during the fermentation. High-performance liquid chromatography （HPLC） was employed to determine the composition and content of isoflavones. Spearman correlation analysis was conducted to identify fungal communities positively correlated with isoflavone content. ResultsDuring the fermentation of Sojae Semen Praeparatum， the abundance of Penicillium continued to increase and became the dominant genus from the "yellow cladding" to the early "secondary fermentation" stage （9 days）. However， in the mid-to-late "secondary fermentation" stage （12-21 days）， the abundance of Penicillium decreased， while the abundance of Barnettozyma increased rapidly， becoming the dominant genus during the later stages （18-21 days）. Alpha diversity analyses showed that fungal diversity was higher in the "secondary fermentation" stage than in the "yellow cladding" stage. Beta diversity analyses showed greater variability in fungal communities during the "yellow cladding" stage， with relatively stable fungal communities during the "secondary fermentation" stage. The aglycone isoflavone content exhibited a gradual increase， rising from 5.56% at the start of fermentation to 96.84% by the end. In contrast， the glucoside isoflavone content experienced a corresponding decline， decreasing from 94.44% to 3.16%. Spearman analysis showed that Penicillium， Barnettozyma， and Ilyonectria were positively correlated with the contents of daidzein， glycitein， and genistein， and promoted the conversion of isoflavones from glucoside to aglycone forms. ConclusionThe fungal communities of Penicillium， Barnettozyma， and Ilyonectria promote the conversion of isoflavones from glucoside to aglycone forms during the fermentation of Sojae Semen Praeparatum. The findings provide an important reference for improving the scalability and quality of Sojae Semen Praeparatu fermentation.

Objective: To identify the phenotypes, antibodies and explore the molecular mechanisms of a patient who carries antibodies to RBC high-frequency antigens and his family members. Methods: The antibody identification test was performed for the proband by serological methods, and targeted NGS was subsequently used to detect mutations that occurred in blood group genes. Blood samples were collected from the proband and his family members. Sanger sequencing was used to verify the mutation of the XK gene. The expression of Kell blood group antigens was detected by serological methods and flow cytometry. K cells were used to detect the antibody specificity of the proband. The morphology of red blood cells was detected by the scanning electron microscopy. The serum creatine kinase levels of the proband and his family members were analyzed by colorimetric methods. Results: The results of the antibody identification test suggested that the proband might have antibodies to high-frequency antigens. NGS results suggested a homozygous mutation (c. 107G>A) in exon 1 of the XK gene in the proband, resulting in a truncated XK protein. The Sanger sequencing results of the proband were consistent with the NGS results, and the mutation was not found in other family members. The expression of Kell blood group antigens of the proband was not found by serological methods and flow cytometry. The results of the antibody specificity test showed that the proband had anti-Km antibodies. Spike-like changes were identified on red blood cells, and serum creatine kinase level was elevated in the proband. Conclusion: In this study, the McLeod phenotype caused by homozygous mutation (c. 107G>A) of XK gene was identified in Chinese individuals for the first time by the phenotype and molecular mechanism studies. The results of genotyping and phenotyping suggested that the McLeod phenotype caused by the mutation was compatible with the phenotypes of McLeod and K .

Objective: To investigate the prevalence of dyslipidemia among adult professional athletes in Guangdong Province, so as to provide insights into dyslipidemia screening and health management among professional athletes. Methods: In 2019, active athletes at ages of 18 to 30 years were recruited from 12 provincial sports teams in Guangdong Province using a cluster sampling method. A self-designed questionnaire survey was conducted to collect gender, age and sport items, and the levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were detected. The non-HDL-C level was calculated, and the gender- and sport item-specific prevalence of dyslipidemia was estimated. Results: Totally 460 athletes were investigated, including 245 males (53.26%) and 215 females (46.74%), with a mean age of (21.91±2.77) years. The overall detection of dyslipidemia was 25.87%, and the detection rates of high TG, high TC, high LDL-C, low-HDL-C and high non-HDL-C were 20.22%, 5.87%, 13.04%, 3.26% and 9.57%, respectively. The detection rates of high TG (9.39% vs. 1.86%; χ2=11.743, P<0.05), low HDL-C (5.31% vs. 0.93%; χ2=6.951, P<0.05) and high non-HDL-C (12.24% vs. 6.51%; χ2=4.351, P<0.05) were significantly greater in men than in women, and the detection of high TC was lower in men than in women (17.96% vs. 22.79%; χ2=8.627, P<0.05). There was a significant difference in the detection of dyslipidemia among athletes engaging in different sport items (χ2=47.552, P<0.05), and a high detection rate of dyslipidemia was seen in baseball athletes (34.29%), softball athletes (37.04%), shooting/archery athletes (52.73%). Conclusion The prevalence of dyslipidemia was 25.87% among adult professional athletes in Guangdong Province, and high TC in combination with high LDL-C were the predominant type of dyslipidemia. The management of blood lipids should be given a high priority to male athletes and baseball, softball and shooting/archery athletes.

Objective:To realize the characteristics of postgraduate students applying for Peking University Third Hospital and to explore the strategies to improve the enrollment quality on the background of "Double first-class".Methods:Enrollment data from 2015 to 2019 of the Peking University Third Hospital was statistically analyzed by SPSS 17.0 software. For variables that did not conform to the normal distribution, median and quartile were utilized for description. Mann-Whitney U test was utilized for comparison between admission group and non-admission group. For the counting data, number of cases and proportion were utilized for description. The comparison between groups was performed by chi-square test or Fisher precision test. All tests were two-sided and had a significance level of 0.05. Results:The average enrollment ratio was 4.9∶1. The overall admission rate of first choice was 76.9% (450/585), which kept increased steadily, and the gap between national key clinical specialties and non-key specialties was narrowed. The geographical distribution of students was mainly in north China (30%, 175/585) and east China (28%, 164/585). The admission group had characteristics of high score of CET-6 (505 vs. 480, Z=-5.86, P<0.001) and young age (24 vs. 25, Z=-8.15, P<0.001). The proportion of "985", "211" or "Double first-class" universities, patents invention, conference speeches and high level awards in admission group was higher than that in non-admission group. Conclusion:Sustainable policies should be taken to constantly improve the quality of enrollment including establishing sound mechanism of discipline adjustment and optimization, increasing the publicity of enrollment nationwide, and strengthening the selection of the comprehensive ability of students centered on the construction of first-class disciplines.

Objective:To explore the difficulties and measures of clinical medical postgraduates management during the national prevention of COVID-19 pandemic.Methods:This study mainly used the document review, interview and questionnaire survey methodologies, to investigate the clinical medical postgraduates school situation, online teaching, training, scientific research, psychological state during prevention of COVID-19 emergency.Results:Up to February 14, 2020, the return rate of professional degree postgraduates was 92.8% (256/276). The average score of postgraduates participating in epidemic prevention and control training was 86.59. The effect of online learning was basically the same as that of face-to-face classroom teaching. Up to March 6, 2020, the in-hospital submission rate of postgraduates’ thesis was 50.0% (65/130). Facing the pressures of COVID-19 emergency, 62.6% professional degree postgraduates (124/198) and 35.4% (70/198) academic postgraduates suffered some anxiety or depression, the difference was statistically significant ( P<0.05). Conclusions:During the COVID-19 prevention and control period, it is important to innovate work style, found the linkage system of education department-clinical department-tutor-postgraduates, pay attention to physical and mental health of postgraduates, ensure the quality of teaching, adopt various measures to do well in the education and management of clinical medical postgraduates.

Objective:To evaluate the effect of web-based problem-based learning software on the Clinical Medicine PBL Comprehensive Course. Methods:Thirty-eight students from the pilot class of undergraduate excellent doctors in clinical medicine were selected as the research objects. Based on the test scores of web-based problem-based learning software before the start of the course, the improvement of scores after passing the training of the Clinical Medicine PBL Comprehensive Course were compared, and the students' clinical thinking were quantitatively evaluated. Results:After all students completed the course, their abilities of expression and communication, teamwork and cooperation, problem analysis and clinical reasoning, and knowledge information management of the students increased steadily with the increase in the number of cases, but it was statistically significant after two PBL case trainings ( P<0.05). Learning intentions and attitudes scored the highest in the second PBL case (acute myocardial infarction), with statistical differences ( P<0.05). After training through the PBL course, diagnostic performance, clinical thinking, treatment scores, and overall performance scores of the students were significantly increased than before, with statistical significance ( P<0.05). The scores of case report writing and knowledge acquisition were not obviously improved. Conclusion:The combination of formative evaluation and web-based problem-based learning software can better evaluate the teaching effect and help students to understand their own shortcomings.

The training of residents majoring in ultrasound needs not only to pay attention to the teaching of speculative knowledge,but also to "look at pictures and talk",which is based on a large number of diagnostic ultrasound cases,training the residents to find,discover and discriminate the lesions from the ultrasonic images to finally form a sharp recognition and diagnosis ability.This study used the instant messaging tool WeChat to establish a virtual learning platform and implement a case based teaching process through this platform,which can avoid the limitations of time and space,and make the communication between teachers and students faster.According to the questionnaire survey,residents generally believed that the training mode can effectively improve learning efficiency and professional ability and hope to add this training mode to the basis of traditional teaching mode.The results of resident case analysis showed that the diagnostic accuracy of residents gradually increased during the training process.The model of WeChat platform combined with case teaching can provide new ideas and methods for standardized training of resident doctors in ultrasound specialty.

Objective:To adjust the wording and to examine the validity and reliability of the Chinese traditional version of the Body Image Scale (BIS) in patients with rectal cancer.Methods:Totally 180 patients pathologically diagnosed with rectal cancer were selected.The obtained data were divided equally into two parts.Half of them was for item analysis and exploratory factor analysis, and the other half was for confirmatory factor analysis and internal consistency reliability.The criterion validity was tested with the Quality of Life Questionnare-Core30 (QLQ-C30).Twenty-five patients were retested for test-retest reliability with 2 week interval.Results:Two factors were retained after exploratory factor analysis, which could explain 69.1％ of the total variation.And the result of confirmatory factor analysis was that the structure of the scale was stable and achieved goodness of fit (χ2/df=2.32, CFI=0.96, NFI=0.93, IFI=0.96, TLI=0.94, RMSEA=0.078).The scores of total scale and two factors were negatively correlated with the scores of five function domains and overall quality of life of QLQ-C30 (r=-0.27——0.54, Ps＜0.05).In total scale, Cronbach' s α coefficient of total scale was 0.92, while test-retest reliability was 0.88.Conclusion:The Chinese version of BIS showed good validity and reliability for assessment of body image in Chinese patients with rectal cancer.

Objective To evaluate the diagnostic value of MSCT in the differentiation of thymic epithelial tumours (TET)with the maximum diameter equal or less than 3 cm.Methods A retrospective analysis of pathological and imaging data of 56 patients with pathologically confirmed TET with the maximum diameter equal or less than 3 cm was performed.According to the 2004 WHO classification,56 TETs were classified as low-risk thymomas(types A/AB/B1),high-risk thymomas (types B2/B3)and thymic carcinomas (type C).The CT manifestations of TET in each group,including shape of tumor,tumor edge (smooth or spiculate protuberance), presence of small nodule around tumor,enhancement degree,pleura invasion and fat space around tumor,were analyzed retrospectively.The differences in the CT manifestations among three types were compared using chi-square test.If the sample number was too small, Fisher 's exact test was used.Results Compared with high-risk thymomas (23 cases)and thymic carcinomas (6 cases),regular round shape was more often observed in low-risk thymomas (27 cases)(χ2 =73,P <0.001;χ2 =116,P <0.001)and the mediastinum-lung interface was more likely to bulge (χ2 = 3.41,P =0.046;χ2 =7.39,P =0.01).Blurred edge,spiculate protuberance and pleural invasion and so on were significantly more common in high-risk thymomas and thymic carcinomas (P <0.001)and they were the most common in thymic carcinomas (χ2 =11.5,P =0.009).There was a significant difference between type B2 thymomas and thymic carcinomas (χ2 =31.52, P <0.001),however there was no significant difference between type B3 thymomas and thymic carcinomas (χ2 =6.96,P =0.07). Conclusion MSCT can accurately show the shape of tumor,tumor edge,presence of small nodule around tumor,enhancement degree,pleura invasion,which can predict the histologic type of thymomas and also can provide information for preoperative diagnosis and prognosis evaluation.

Objective To explore the method of comparing different hematology analyzer in Sports Biochemistry Laboratories with the median concentration.Methods In accordance with the American Society of Clinical and Laboratory Standards Institute EP9-A2 document requirements,ADVIA120(120) was chosen as a standard comparative instrument,ADVIA2120i(2120) as a test instrument,six different batches of normal and non-normal 2 quality control were monitored continuously for one year,combined with 42 cases of fresh sample which were selected randomly,the author analyzed the precision,accuracy and comparability of the two instruments,and white blood cell(WBC),red blood cell (RBC),hemoglobin(HGB),hematocrit (HCT),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),mean corpuscular hemoglobin concentration(MCHC) and platelet(PLT) were chosen as the test indicators.Results The precision(CV％ values within a range of 0.9-5.0) of the two instruments were all within the CLIA'88 1/4 tolerance accepted range;All indicators' percentage difference between the two instruments are fit with the International Blood Standardization Committee(ICSH) Standard.The test results of 42 blood samples detected by different hematological analyzers were analyzed by regression analysis,which showed that the correlative coefficient (r) was over 0.97.Conclusion The method of continuously monitored the normal and non-normal 2 quality control for one year,combined with 42 cases of fresh sample which were selected randomly can well be used in the study of tests results comparability and consistency of two different hematological analyzers in Sports Biochemistry Laboratories.