Objective To evaluate the efficacy of MOOC combined with flipped classroom teaching in clinical train-ing of urology.Methods A total of 100 clinical medical students from Peking Union Medical College were randomly assigned to either an experimental group or a control group.The experimental group adopted the teaching mode of MOOC combined with flipped classroom,while the control group adopted classic teaching method.The two groups were compared in terms of their theoretical exam scores,case analysis skills and teaching satisfaction level.Results There were no significant difference in theoretical examination scores between experimental group and con-trol group(the mean value of scores are 45.12 and 44.50,respectively).However,the interview scores from ex-perimental group was significant higher than that of control group(the mean value of scores are 42.28 and 40.10,respectively,P＜0.001).The MOOC combined with flipped classroom mode significantly improved students'capacity building of clinical reasoning for diagnosis and communication skills.Students were more willing to continue receiving this teaching mode.Conclusions The integration of MOOC with the flipped classroom model sig-nificantly enhances the quality and efficacy of urology teaching.

Objective:To analyze the categories, characteristics, and clinical symptoms of adverse reactions associated with thalidomide treatment for oral mucosal diseases, providing a reference for the safe use of this medication in patients.Methods:A cross-sectional study was conducted to retrospectively analyze the adverse reactions to thalidomide treatment in 44 patients with oral mucosal diseases who received treatment at the Third Affiliated Hospital of Air Force Medical University from January 2019 to December 2023. The correlation between the age and sex of patients experiencing adverse reactions, the timing of these reactions in relation to sex, the organs and their appendages affected by the adverse reactions, and the outcomes of these reactions were statistically analyzed.Results:The incidence of adverse reactions associated with thalidomide treatment at the hospital was 0.21% (44/21 329), with a higher prevalence among female patients. Multiple organs were affected in 50.00% (22/44) of the cases, though the reactions were relatively concentrated, primarily involving the skin and its appendages, the central and peripheral nervous systems, and the gastrointestinal system. The main manifestations included rash and dizziness.Conclusion:In the treatment of oral mucosal diseases with thalidomide, it is essential to monitor adverse drug reactions, particularly those affecting the nervous system. Special attention should be given to the potential teratogenicity of thalidomide in individuals of childbearing age. In addition, it is vital to consistently investigate strategies to ensure the safety of patients using medication at home.

Although the development of COVID-19 vaccines has been a remarkable success, the heterogeneous individual antibody generation and decline over time are unknown and still hard to predict. In this study, blood samples were collected from 163 participants who next received two doses of an inactivated COVID-19 vaccine (CoronaVac®) at a 28-day interval. Using TMT-based proteomics, we identified 1,715 serum and 7,342 peripheral blood mononuclear cells (PBMCs) proteins. We proposed two sets of potential biomarkers (seven from serum, five from PBMCs) at baseline using machine learning, and predicted the individual seropositivity 57 days after vaccination (AUC = 0.87). Based on the four PBMC's potential biomarkers, we predicted the antibody persistence until 180 days after vaccination (AUC = 0.79). Our data highlighted characteristic hematological host responses, including altered lymphocyte migration regulation, neutrophil degranulation, and humoral immune response. This study proposed potential blood-derived protein biomarkers before vaccination for predicting heterogeneous antibody generation and decline after COVID-19 vaccination, shedding light on immunization mechanisms and individual booster shot planning.
Humans ; COVID-19 Vaccines ; Leukocytes, Mononuclear ; Proteomics ; COVID-19/prevention & control* ; Vaccination ; Antibodies ; Antibodies, Viral ; Antibodies, Neutralizing

Objective:To evaluate the clinical efficacy and safety of fecal microbiota transplantation(FMT)for the treatment of chronic functional constipation in the elderly.Methods:A total of 33 elderly patients with chronic functional constipation were included and given three sessions of FMT.Changes in fecal characteristics, constipation, mood and quality of life in these patients were evaluated using the Bristol stool form scale(BSFS), the constipation assessment scale(CAS), patient assessment of constipation symptoms(PAC-SYM), the Zung self-rating anxiety scale(SAS), the Zung self-rating depression scale(SDS), and the patient assessment of constipation quality of life(PAC-QOL)before and 12 weeks after treatment.The clinical efficacy was based on comparison between pre-and post-treatment results for each patient.Results:Clear improvement was achieved in 33 patients 12 weeks after treatment, compared with before transplantation.Post-treatment scores of the constipation assessment scale and symptom self-assessment questionnaire for patients with constipation were(8.9±1.2)scores and(26.5±2.4)scores, respectively, significantly lower than pre-transplantation scores of(12.2±1.1)scores and(32.4±2.4)scores( t=15.034, 13.904, both P<0.001). Similarly, post-treatment scores were also lower than pre-transplantation levels for the self-rating anxiety scale[(50.4±8.4)scores vs.(57.5±9.0)scores, t=10.333, P<0.001], the self-rating depression scale[(50.6±8.4)% vs.(55.0±10.5)%, t=5.301, P<0.001], and self-assessment questionnaire for quality of life[(88.2±7.3)scores vs.(103.7±7.3)scores, t=23.300, P<0.001]. Conclusions:FMT can improve fecal characteristics and constipation symptoms, relieve anxiety and depression, improve the quality of life, and provide a new option for the treatment for elderly patients with chronic functional constipation.

Objective:To study the influence of environmental radiation of radiotherapy workplace on the stereotactic radiation therapy(SRT) plan absolute dose verification with plastic scintillator detector Exradin W1.Methods:The computed tomography (CT) image of the stereotactic dose verification phantom (SDVP) was scanned and imported into the treatment planning system. Three schemes, including 3 cm × 3 cm to 20 cm × 20 cm square gradient field irradiation, virtual planning target volume(PTV) non-coplanar arcs irradiation and 10 cases of volumetric modulated arc radiotherapy SRT (VMAT SRT) clinical plan verification, were measured with or without a home-made shield over the photodiode. Measurements were recorded to analyze the impact of environmental radiation on dose measurement under different conditions.Results:The noise effect of the photodiode increased with the the lager open field size, and decreased with the reduced distance between the photodiode and isocenter. The contribution of photodiode noise effect increase with the lager non-coplanar arc field size, with the largest up to 4.16%. As for the clinical SRT plan verification measurement, the relative difference between the SRT plan measurements and treatment planning system(TPS) before and after shielding were (1.39±1.05)% and (0.59±1.03)%, respectively ( t=-5.343, P < 0.05). and for W1 vs. A16 microchamber was (1.22±1.56)% and (0.42±1.42)%, respectively ( t=-5.414, P < 0.05). Conclusions:The measurements of Exradin W1 are in good agreement with the TPS result and the ionization chamber measurements, but its accuracy is easily affected by the environmental radiation of radiotherapy workplace. To measure non-coplanar radiation, the photodiode should be placed as far away as possible from the isocenter and be properly shielded, which can effectively improve the accuracy and stability of the measurement and provide a strong guarantee for clinical precision radiotherapy.

Objective To explore the personality characteristics of patients with chronic migraine complicating drugs overuse.Methods A total of 67 cases of migraine (control group) and 175 cases of medication overused migraine (MOH) were treated in the neurology department of this hospital from March to December 2016.The patients conformed to the migraine diagnostic criteria of the International Classification of Headache Disorders Third Edition (ICHD-3) formulated by the International Headache Society.The personality assessment adopted an internationally used Minnesota Personality Questionnaire.Results The scores of suspected disease,depression,rickets and social introgression in the observation group were higher than those in the control group,the difference was statistically significant (P＜0.05).In the observation group,there was a negative correlation between personality suspicion,rickets,neurasthenia,social introversion and education (P＜ 0.05).In the personality traits aspect of the observation group,hypochondriasis,hysteria,neuradynamia and social introversion were negatively correlated with the cultural degree (P＜0.05).Conclusion The personality changes in the four aspects of hypochondria,depression,hysteria and social introversion in the patients with MOH are more obvious than those in the patients with simple chronic migraine.

Objective To analyze the clinical features of secondary gout in glycogen storage disease type Ⅰ a (GSD Ⅰ a),so as to improve the awareness of this disease.Methods The clinical features,laboratory findings,treatments and prognosis of 5 GSD Ⅰ a patients with secondary gout who had been admitted to the Peking Union Medical College Hospital during 2006 to 2016 were collected and analyzed.GSD Ⅰ a was confirmed by liver biopsy and genotyping.Results Among the 5 patients (median age:27 years),3 were males and 2 were females.The mean age of gout onset was 17 ranging from 10 to 22 years old.The common manifestations of GSD included hepatomegaly since childhood,hypoglycemia,growth retardation,anemia,hyperlactacidemia and hyperlipidemia.All the 5 patients were complicated with gouty tophi and kidney stone.Gouty tophi and kidney stone were identified 3.8 years and 10.2 years after the first occurrence of articular symptoms,respectively.Renal damage occurred in 3 cases.All the patients underwent several therapeutic modalities including lifestyle intervention,allopurinol,and raw corn starch treatment.Conclusions Determination of the presence of primary disease should be performed actively for young-onset gout with early occurrence of gouty tophi.GSD should be suspected if there exist clinical manifestations like hepatomegaly,recurrent hypoglycemia,growth retardation.Early management of hyperuricemia and gout in GSD patients is important to prevent complications and improve prognosis.

Objective To investigate the role of mitochondrial respiratory chain (MRC) in induction of reactive oxygen species (ROS) by hyperbaric oxygen (HBO).Methods Superoxide anion (O·-2) specific fluorescence probe DHE and mitochondrial O·-2 probe Mito-SOX were used to label ROS in human umbilical vein endothelium cells(HUVEC) microscopically after HBO exposure.Results After HBO exposure, O·-2 increased (31±8)% and (137±19) % in whole cells and in mitochondria, respectively (P<0.01).These increments were suppressed by MRC complex Ⅱ inhibitor TTFA for (55±11)% in whole cells (P<0.05)and (61±8) % in mitochondria(P<0.01).Conclusion MRC may be the main source of ROS induced by HBO in HUVECs.

To study the abnormal distribution of type Ⅳ collagen and laminin chains in glomerular basement membrane (GBM) in membranous nephropathy (MN).Methods 52 cases of MN were collected and staged according to electron microscopic morphological characteristics,and 10 cases of kidney tissues of minimal change disease were used as normal GBM control.Distribution pattern of or5 (Ⅳ) chain,laminin α5and β2 chains,and laminin α2 and β1 chains were detected using immunofluorescence method.Results In minimal change disease,α5 (Ⅳ) chain,laminin α5 and β2 chains all showed continuously linear positive expression along GBM,and laminin α2 and β1 chains were negatively expressed in GBM.In stage Ⅰ MN,α5 (Ⅳ) chain,laminin α.5 and β2 chains all showed continuous linear positive expression along GBM.In stage ⅡMN,the expression of α5 (Ⅳ) chain was increased and showed abundant spikes on the basis of continuous linear positive staining along GBM,and the expression of laminin α5 and β2chains was increased,and segmental spikes were seen on the basis of continuous linear positive staining along GBM.In stage ⅢMN,the expression of α5 (Ⅳ),laminin α5 and β2 chains was also enhanced and segmental double tracks were seen.The expression of laminin α2 chain was negative in GBM in stage ⅠMN,but granular positive expression along GBM was seen in stage Ⅱ and stage Ⅲ MN.No positive expression of laminin β1chain was seen in GBM in different stages in MN.Conclusion The GBM thickness in MN originates not only from intrinsic type Ⅳ collagen chains and laminin chains,but also from laminin α2chain,which only exist in glomerulus mesangium in normal condition.