Pinellia ternata， belonging to the Pinellia genus within the Araceae family， is a medicinal plant due to its tubers. There are severe issues with unclear germplasm and mixed varieties in its cultivation， necessitating urgent new variety protection efforts. The distinctness， uniformity， and stability （DUS） testing of the plant variety is the basis for protecting new plant varieties， and the DUS test guidelines are the technical basis for DUS testing. To develop the DUS test guidelines for P. ternata， agronomic traits of 229 germplasm of P. ternata were observed and measured during its two growth stages over the years， and each character was graded and described. A total of 38 traits were selected as the test traits of the DUS test guideline for P. ternata. There were three plant traits， 19 leaf traits， six flower traits， two fruit traits， two tuber traits， five bulbil traits， and one ploidy trait. These traits could be divided into 22 quality characters， 12 quantitative characters， and four pseudo-quantitative characters， as well as seven groups， including plants， leaves， flowers， fruit， tubers， bulbils， and ploidy. By searching for standard traits， 10 standard varieties were ultimately determined. Preparing these guidelines will have great significance for reviewing and protecting P. ternata varieties， safeguarding breeders' rights， and promoting the development of the P. ternata industry.

ObjectiveTo explore the genetic relationship and reveal the genetic variations of 45 germplasm accessions of Artemisia argyi. MethodGenotyping-by-sequencing （GBS） was employed to mine single nucleotide-polymorphisms （SNPs） from the 45 germplasm accessions. Principal component analysis， phylogenetic analysis， population genetic structure analysis， and genetic variation analysis were conducted based on the SNPs. ResultA total of 111.91 Gb of data were obtained， with the Q20， Q30， and average GC content of 96.39%， 90.33%， and 39.37%， respectively. The comparison rate between clean reads and the reference genome was 70.24%-98.97%. A total of 22 399 Indels and 170 539 SNPs were obtained， and the 10^th pair of chromosomes had the most variation sites. The results of principal component analysis， cluster analysis， and genetic diversity analysis classified the 45 germplasm accessions into three groups. Group Ⅰ contained three germplasm accessions from Qichun County. The germplasm accessions in group Ⅱ were all wild. Group Ⅲ contained 31 germplasm accessions， with the most complex sources. Moreover， the 45 germplasm accessions can be classified into 3 subtypes， containing the genetic information from three ancestors. The results indicated rich genetic diversity of A. argyi from different sources， especially the germplasm accessions from Qichun County， Hubei province. ConclusionThis study provides theoretical support for breeding new varieties， developing specific SNP markers， and revealing the genetic relationship of A. argyi.

Aiming at the current situation of insufficient integration of medical humanities teaching and clinical practice,as well as the need for further research and improvement in the teaching system,guided by the concept of medicine and humanistic literacy integration advocated by the new medical science,this paper deeply discussed the construction of clinical medical humanities teaching system from four aspects,including the selection of clinical medical humanities teachers and team building;the teaching path that combines theoretical education,narrative medicine,and clinical skill training infused with medical humanities content;curriculum ideological and political construction with the goal of establishing the core concept and value orientation of"patient-centered";the teaching assessment and evaluation method characterized by formative evaluation.The clinical medical humanities teaching system emphasizes the practicality,experiential,and emotional aspects of medical humanities teaching,deeply integrating medical humanities with clinical practice teaching content throughout the clinical internship period of medical education,with a view to enhancing the humanistic practice ability and literacy of medical students.

OBJECTIVE: To investigate the regulatory effects of miR-30e-5p on biological behaviors of colorectal cancer cells and the role of PTEN/CXCL12 axis in mediating these effects. METHODS: Bioinformatic analysis was performed to explore the differential expression of miR-30e-5p between colorectal cancer tissues and normal tissues. RT-qPCR was used to detect the differential expression of miR-30e-5p in intestinal epithelial cells and colorectal cancer cells. Bioinformatics and dual luciferase assay were used to predict and validate the targeting relationship between miR-30e-5p and PTEN. Human and murine colorectal cancer cell lines were transfected with miR-30e-5p mimics, miR-30e-5p inhibitor, miR-30e-5p mimics+LV-PTEN, or miR-30e-5p inhibitor + si-PTEN. The changes in biological behaviors of the cells were detected using plate clone formation assay, CCK-8 assay, flow cytometry, scratch healing and Transwell assays. PTEN and CXCL12 expressions in the cancer cells were detected by Western blotting. The effects of miR-30e-5p inhibitor on colorectal carcinogenesis and development were observed in nude mice. RESULTS: Bioinformatic analysis showed that miR-30e-5p expression was significantly elevated in colorectal cancer tissues compared with the adjacent tissue (P < 0.01). Higher miR-30e-5p expression was detected in colorectal cancer cell lines than in intestinal epithelial cells (P < 0.01). Dual luciferase assay confirmed the targeting relationship between miR-30e-5p and PTEN (P < 0.05). Transfection with miR-30e-5p mimics significantly enhanced proliferation and metastasis and inhibited apoptosis of the colorectal cancer cells (P < 0.05), and co-transfection with LV-PTEN obviously reversed these changes (P < 0.05). MiR-30e-5p mimics significantly inhibited PTEN expression and enhanced CXCL12 expression in the cancer cells (P < 0.01), and miR-30e-5p inhibitor produced the opposite effect. Transfection with miR-30e-5p inhibitor caused cell cycle arrest in the cancer cells, which was reversed by co-transfection with si-PTEN (P < 0.05). In the in vivo experiments, the colorectal cancer cells transfected with miR-30e-5p inhibitor showed significantly lowered tumorigenesis. CONCLUSION Overexpression of miR-30e-5p promotes the malignant behaviors of colorectal cancer cells by downregulating PTEN to activate the CXCL12 axis.
Humans ; Animals ; Mice ; MicroRNAs/metabolism* ; Cell Line, Tumor ; Cell Proliferation/physiology* ; Mice, Nude ; Cell Movement/physiology* ; Colorectal Neoplasms/pathology* ; Luciferases/metabolism* ; Gene Expression Regulation, Neoplastic ; PTEN Phosphohydrolase/metabolism* ; Chemokine CXCL12/metabolism*

Objective:To investigate the value of a deep learning method based on MobileNet in classification of bedside chest radiograph and improvement of the work efficiency.Methods:A total of 6, 320 bedside chest radiographs from January 2017 to December 2022 in the Second Peoples′ Hospital of Changzhou were retrospectively collected. The included cases were divided into normal group (885 images), pneumonia group (1 927 images), pleural effusion group (373 images), and pneumonia with pleural effusion group (3 135 images). Three hundred and fifty images were selected as a validation set, while the remaining images were divided into a train set (4 775 images) and a test set (1 195 images) using simple randomization, by 8∶2 ratio. Two lightweight convolutional neural network models (MobileNetV1 and MobileNetV2) were used to construct a bedside chest radiograph classification model, based on which two fine-tuning strategies were designed. Four models were generated namely MobileNetV1_False (V1_False), MobileNetV1_True (V1_True), MobileNetV2_False (V2_False) and MobileNetV2_True (V2_True). In the first stage, a binary classification model was established to divide the images into normal and lesion groups; then a four-class classification model was established in the second stage, with which the images were divided into four groups: normal, pneumonia, pleural effusion and pneumonia with pleural effusion. Metrics for model performance evaluation including accuracy (Ac), precision (Pr), recall rate (Rc), F1 score (F1) and area under the receiver operating characteristic curve (AUC) were calculated.Results:In both the first and second stages, V1_True and V2_True had higher Ac, Pr, Rc, and F1 than V1_False and V2_False in both the training set and validation set; and the V1_True model outperformed the other three models in classification. The classification Ac of the V1_True model in the validation set was higher than that of radiologists in the first stage [95.71% (335/350) vs. 90.29% (316/350)] and in the second stage [93.43% (327/350) vs. 87.14% (305/350)]. The recognition time of V1_True model′s in the validation set of 350 bedside chest radiographs was significantly less than that of the radiologists (mean: 17 s vs. 300 min).Conclusions:V1_True is an optimal MobileNet model for classifying bedside chest radiographs. The application of this model in clinical practice may help to accurately identify the information of lung lesions from bedside chest radiographs in time, and may improve the work efficiency in the radiology department.

ObjectiveTo investigate the effects of different potassium application rates on the growth， yield and quality of two-year-old Belamcanda chinensis and to provide a basis for potassium application to achieve high yield and quality of B. chinensis. MethodOn the basis of nitrogen and phosphorus fertilization at 120 kg·hm^-2， we designed five potassium treatments of 0 （K₀）， 60 （K₆₀）， 120 （K₁₂₀）， 180 （K₁₈₀） and 240 （K₂₄₀） kg·hm^-2 in a field experiment to study the effects of different potassium application rates on the agronomic traits， rhizome yield， flavonoid content and potassium fertilizer utilization efficiency of the two-year-old B. chinensis. ResultThe application of potassium fertilizer promoted the root development and tillering， which significantly improved the yield of B. chinensis. Compared with the K₀ treatment， the other potassium treatments increased the rhizome yield by 16.0%-44.0% and K₁₈₀ had the highest yield. The application of potassium fertilizer increased the accumulation of flavonoids in the rhizomes of B. chinensis. The total accumulation of six flavonoids （mangiferin， tectoridin， iridin， tectorigenin， irigenin and irisflorentin） increased by 33.2% in the K₁₂₀ treatment compared with that in the K₀ treatment. Furthermore， the application of potassium fertilizer promoted the accumulation of N， K， Mg， Fe and Zn. With the increase in potassium application rate， the potassium accumulation of B. chinensis first increased and then decreased， while the partial productivity and the absorptivity of roots and leaves gradually decreased. The agronomic efficiency of potassium fertilizer was higher at low to medium potassium application rates and decreased significantly at high potassium application rates. The results of the principal component analysis indicated that the ranking of the overall quality score of B. chinensis was K₁₂₀>K₁₈₀>K₂₄₀>K₆₀>K₀. ConclusionConsidering factors such as yield， quality and potassium utilization efficiency of two-year-old B. chinensis， the potassium application at 120-166 kg·hm^-2 is recommended for the production of B. chinensis in Tuanfeng County.

ObjectiveTo clarify the accumulation and distribution characteristics of dry matter and mineral elements in Artemisia argyi var. argyi cv. Qiai， and to provide technical support for the high yield of and efficient utilization of nutrients in this medicinal species. MethodTwo cultivars of this species， Qiqing 1 and Qihuang 1 were selected， and the composition of dry matter in different organs， the content， accumulation， and distribution of mineral elements in each organ of the two cultivars， and the dynamic changes of volatile oil content and index components eucalyptol and borneol in leaves of the two cultivars were monitored at different growth stages. ResultThe period from February to March marked the early growth stage of Qiai， and the dry matter was mainly distributed in the leaves. It accelerated the growth in April， and the period from April to mid-June witnessed the vigorous vegetative growth of Qiai， during which the dry matter was mainly found in the stems and leaves. It began the reproductive growth from late June and the dry matter was mainly distributed in the stems. In the flowering stage in August， no dry matter accumulation occurred. As for the volatile oil， the content was high （> 1.10%） at the vigorous vegetative growth stage and peaked on June 14 （1.33% in Qiqing 1， and 1.23% in Qihuang 1）. The relative mass fraction of eucalyptol was the maximum at the vegetative growth stage （8.67% in Qiqing 1， and 13.07% in Qihuang 1）. The relative mass fraction of borneol peaked at the early growth stage （2.63% in Qiqing 1， and 5.94% in Qihuang 1）. The content of nitrogen， phosphorus， potassium， and zinc in leaves was in significantly positive correlation with the content of volatile oil and the relative content of eucalyptol and borneol. The content of macroelements nitrogen， phosphorus， potassium， and calcium and trace elements iron and zinc peaked at the early growth stage， and the content was the highest in stem and leaf. The content of macroelement magnesium and trace elements manganese and copper was the highest at vegetative growth stage when the content of other elements decreased and the nutrients were gradually transferred to the buds， flowers and other organs. In the whole growth period， the distribution of potassium， calcium， and zinc was in the order of leaf > stem > root， and the distribution of nitrogen， phosphorus， copper， magnesium， and manganese followed the order of leaf > root > stem. The distribution of iron was in the order of root > leaf > stem. There was a significantly positive correlation between the total amount of dry matter and the absorption of nutrients in 'Qiai'. The absorption of macroelements by Qiai was in the order of potassium > nitrogen > calcium > phosphorus > magnesium， and the ratio of absorbed elements was about 2.66∶2.51∶0.6∶0.11∶0.04. The absorption of trace elements followed the order of manganese > iron > zinc > copper， and the ratio of absorbed elements was about 0.25∶0.17∶0.05∶0.04. In terms of the production of medicinal materials， 'Qiai' needed about 4.11 kg potassium， 3.58 kg nitrogen， 0.91 kg phosphorus， 0.18 kg calcium， 0.06 kg magnesium， about 6.64 g manganese， 2.56 g iron， 1.30 g zinc， and 0.92 g copper to produce 100 kg medicinal materials. ConclusionEnough organic fertilizer and phosphorus and potassium fertilizers should be applied as base fertilizers for Qiai. The vegetative growth stage （April-June） marks the high accumulation of dry matter and large demand of nutrients， during which topdressing should be conducted timely and early， especially nitrogen fertilizer， and appropriate amount of micro-element fertilizer should be added. Qiai needs a large amount of calcium and magnesium fertilizers from the mid-vegetative growth stage， and they should be applied in time in the late stage to ensure the vegetative growth of the plants for seeds and the quality of the medicinal material of Qiai.

Objective:To evaluate the objective imaging markers of cognitive impairment in patients with end-stage renal disease by MRI intravoxel incoherent motion.Methods:A total of 40 patients with ESRD were enrolled in the Department of Nephrology, Changzhou Second Hospital Affiliated to Nanjing Medical University from January 2019 to August 2020, and 24 healthy controls were prospectively enrolled at the same time.All subjects performed with MRI scan were collected, and the slow apparent diffusion coefficient (ADC slow) of the corresponding brain regions were obtained .The cognitive function was evaluated by the Montreal cognitive assessment scale (MoCA). Two-sample t test was used to analyze the difference of ADC slow and cognitive score between the two groups.Pearson correlation analysis was performed among the cognitive function score of end-stage renal disease and ADC slow value. Results:(1) The score of the intelligence test scale in the ESRD group (23.30±1.76) was significantly lower than that of the healthy control group (27.92±1.00) ( P<0.01). The ADC slow values of bilateral frontal lobe, hippocampus, and insula brain areas (respectively(0.648±0.035), (0.633±0.043), (0.762±0.043), (0.756±0.042), (0.792±0.048), (0.776±0.054))in the ESRD group were significantly higher than those in the healthy control group ((0.600±0.039), 0.610±0.037, (0.725±0.059), (0.711±0.054), (0.740±0.063), (0.716±0.051)) ( P<0.01). (2) Pearson correlation analysis showed that the ADC slow values of bilateral insula and right hippocampus in the ESRD group were negatively correlated with MoCA scales ( r=-0.38, -0.38, -0.66, all P<0.05). Conclusion:ADC slow value in IVIM can better reflect the changes of cognitive function impairment in ESRD patients.

Objective:To investigate the effects of ultrasound-guided thoracic paravertebral block on the changes of analgesic efficacy and inflammatory response in patients with multiple rib fractures.Methods:A retrospective case-control study was performed in 48 patients with multiple rib fractures admitted to 909th Hospital of Joint Logistics Support Force from July 2016 to December 2018. There were 30 males and 18 females, with the age range of 18-69 years[(41.1±10.4)years]. The number of fractured ribs was 3-9 (5.7±1.9). All patients were stabilized with the memory alloy embracing fixator. Thoracic paravertebral block group received ultrasound-guided thoracic paravertebral block and intravenous analgesia group received patient controlled intravenous analgesia, with 24 patients in each group. The visual analogue scale (VAS) was observed and recorded in the resting/cough state before induction of anesthesia(T1), and 1 h (T2), 6 h (T3), 24 h (T4) and 48 h (T5) after surgery. Blood samples were taken simultaneously from the vein for determination of plasma neutrophil elastase (NE), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) concentrations by ELISA method.Results:In the resting state, there was no significant difference between two groups in VAS at T1 ( P>0.05); the VAS in two groups at T2-T5 decreased significantly compared with T1 ( P<0.01); the VAS at T2-T4 in thoracic paravertebral block group [(3.4±0.7)points, (3.2±0.8)points, (3.1±0.7)points] was significantly lower than that in intravenous analgesia group [(4.8±0.9)points, (4.4±0.7)points, (3.9±0.8)points]( P<0.01 ). In the cough state, there was no significant difference between two groups in VAS at T1 ( P>0.05); the VAS at T2-T5 in intravenous analgesia group was all higher than 6 points[(7.7±1.0)points, (7.6±1.3)points, (7.4±1.2)points, (7.1±0.9)point], and was significantly higher than those in thoracic paravertebral block group [(3.6±0.7)points, (3.3±0.7)points, (3.2±0.6)points, (2.9±0.7)points] ( P<0.01). There was no significant difference between two groups in plasma levels of NE, TNF-α and IL-6 at T1 ( P>0.05). Their levels at T2 in two groups were significantly increased, but were decreased at T5 compared with those at T1 ( P<0.01). The plasma levels of NE, TNF-α and IL-6 were significantly lower in thoracic paravertebral block group at T2-T5 [NE: (65.5±19.0)ng/ml, (42.5±12.5)ng/ml, (26.3±9.3)ng/ml, (20.9±7.9)ng/ml; TNF-α: (8.7±1.9)pg/ml, (6.0±1.3)pg/ml, (3.9±0.9)pg/ml, (2.8±0.8)pg/ml; IL-6: (11.5±3.6)pg/ml, (6.7±1.8)pg/ml, (3.6±1.0)pg/ml, (2.5±0.7)pg/ml] than those in intravenous analgesia group[NE: (76.7±18.2)ng/ml, (51.4±15.1)ng/ml, (35.5±10.0)ng/ml, (28.6±9.0)ng/ml; TNF-α: (10.0±2.1)pg/ml, (6.8±1.5)pg/ml, (4.7±1.1)pg/ml, (3.6±1.0)pg/ml; IL-6: (16.2±4.2)pg/ml, (8.7±2.1)pg/ml, (5.7±1.2)pg/ml, (3.5±0.7)pg/ml] ( P<0.05 or 0.01). Conclusion:Compared with intravenous analgesia, ultrasound-guided thoracic paravertebral block can provide better analgesic effect, reduce the plasma levels of inflammatory cytokines that result from trauma and surgery, and down-regulate inflammatory response.