Objective To explore the clinical application of ultrasound-guided transabdominal villus and amniocentesis in the prenatal diagnosis of thalassemia,and to find a suitable method for the prenatal diagnosis of thalassemia in Qinzhou.Methods A total of 531 high-risk pregnant women with severe or intermediate thalassemia during single pregnancy who were treated in the Department of Medical Genetics and Prenatal Diagnosis,Qinzhou Maternal and Child Health Hospital from March 2021 to April 2022 were selected for the study.According to different sampling methods,they were divided into control group(amniocentesis,n=415)and study group(transabdominal villus puncture,n=116).The success rate,complication rate of the two groups were compared.Results The success rate of puncture in the control group was 100％,2 cases were aborted within 2 weeks after surgery,17 cases were diagnosed with severe alpha-thalassemia,10 cases with severe β-thalassemia and 64 cases with intermediate thalassemia,48 cases with moderate and severe thalassemia induced labor.The success rate of puncture in the research group was 100％,10 cases were diagnosed with severe alpha-thalassemia,4 cases with severe β-thalassemia and 17 cases with intermediate thalassemia,and 26 cases with moderate severe thalassemia were induced labor.There was no significant difference in puncture success rate and abortion rate between the two methods(P>0.05).Conclusion Both methods are safe and effective.Transabdominal villus sampling can detect fetal thalassemia in early pregnancy,and it is worth promoting and applying in clinical practice.

[Objective]To explore residents'science popularization status of traditional Chinese medicine(TCM)and its influential factors,and provid scientific suggestions for the formulation of strategies and methods of TCM science popularization,taking Sanfu herbal patch(SHP)as an example.[Methods]Online questionnaires and Logistic regression analysis were applied to study residents'cognition,behavior and willingness on SHP and its influential factors,and explor the effective strategies and methods of TCM science popularization.[Results]Residents'cognitive accuracy rates of SHP's efficacy in treating diseases were 22.9％for bronchitis or chronic obstructive pulmonary disease,21.4％for rhinitis,19.3％for health care and immunity enhancement,and those of treatment methods were 35.0％for the reimbursement by medical insurance and 20.3％for the number of medication per course.Only 7.8％of residents experienced the treatment.Ways of acquiring SHP knowledge were few,namely,personal communication(26.6％)and internet(22.6％).Patients with underlying diseases,with odds ratio(OR)of 2.44(P＜0.05),were the most important factor promoting the cognitive accuracy of diseases that can be treated with SHP.Female(OR=1.70,P＜0.01)and insured residents(OR=2.41,P＜0.01)were factors that promoted the cognitive accuracy of treatment methods.The demand rate of knowledge was 71.7％,and that of the elderly was 100％;and approval rates of SHP science popularization at home and abroad were 78.2％and 80.0％.[Conclusion]Residents'science knowledge and application level of SHP were low,but their passion to try,learn and communicate it was very high.Therefore,it was suggested to increase the micro education of specific TCM treatments,take female,patients with basic diseases,insured residents and the elderly as starting points,expanding the audience,create diversified paths,and improve the precise implementation of science popularization strategies,so as to improve the health literacy of residents and promote the development of healthy China.

Background and purpose:Chimeric antigen receptor T(CAR-T)cell therapy has shown remarkable efficacy in treating hematological and lymphatic system tumors,but its effectiveness in solid tumors is relatively poor,which is partly attributed to target selection.For Ewing sarcoma(ES),CD99 can be a potential target for CAR-T cells.However,due to T cells'endogenous expression of CD99 protein,CAR-T cells targeting CD99 face limitations in their expansion capacity in vitro.This study aimed to identify the optimal conditions for preparing CD99 CAR-T cells by incorporating CD99 knockdown short hairpin RNA(shRNA),optimizing the multiplicity of infection(MOI)for lentiviral transduction,and screening for the best culture medium and container for CAR-T cell expansion.Methods:shRNA sequences were screened to enhance the expansion capacity of CD99 CAR-T cells.Different MOI,culture media,and containers were used to assess CAR-T cell transduction efficiency,cell viability,proliferation capacity,specific killing ability,and interferon-γ(IFN-γ)release levels under various conditions,in order to identify the optimal cell preparation conditions.Results:The expansion level of KO-CD99 CAR-T cells obtained through shRNA knockdown was significantly higher than that of CD99 CAR-T cells[(16.40±0.40)vs(6.33±1.53),P<0.01].The optimal expansion effect was observed when the transduction MOI was between 0.25 and 1.0,and OptiVitro was used as the culture medium.CAR-T cells cultured in ventilated flasks exhibited significantly higher expansion rates compared to cells cultured in bags[MOI=0.25:(50.23±3.32)vs(13.02±4.82);MOI=0.50:(49.96±0.83)vs(18.25±2.88);MOI=1.00:(48.27±5.08)vs(13.16±6.26);P<0.01],with better cell phenotype and higher specific killing ability.Conclusion:KO-CD99 CAR-T cells obtained through shRNA technology can achieve stable expansion.Based on the optimization of expansion conditions,KO-CD99 CAR-T cells exhibit superior expansion capacity and a higher proportion of memory T cells when the MOI is between 0.25 and 1.00,OptiVitro is used as the culture medium,and ventilated flasks are used as the culture container.These findings lay a solid foundation for further clinical trials of CD99 CAR-T cell therapy for ES.

Derived from embryonic stem cells, induced pluripotent stem cells, or adult stem cells, liver organoids not only mimic the tissue structure, gene expression patterns, and genetic characteristics of in vivo liver but also demonstrate significant potential in simulating liver diseases, drug screening, precision medicine, and regenerative medicine. This technology is particularly valuable in modeling various conditions such as malignant liver tumors, liver fibrosis, cirrhosis, viral hepatitis, and a range of genetic and metabolic liver diseases. However, challenges remain in enhancing the derivation and proliferation efficiency of organoids, constructing immune microenvironments, developing functional vascular networks, and achieving standardization and automation in the organoid preparation process. Looking forward, with continued technological advancements and innovations, these issues are expected to be resolved, paving the way for liver organoids to play a more substantial role in clinical and research applications, ultimately contributing significantly to public health. This review comprehensively explores the development and extensive applications of liver organoid technology in the field of biomedical science. The aim is to inform subsequent research.

Objective To investigate the potential role of the traditional herbal medicine Datura metel L.in the treatment of psoriasis using TNF-α-induced inflammation in keratinocytes as a model.Methods Keratinocyte cell line HaCaT was used to establish a psoriasis cell model by tumor necrosis factor-alpha(TNF-α)treatment.The ex-periment comprised three groups:a blank control group,TNF-α-induced psoriasis model group,and TNF-α+Datura metel L.intervention group.Level of IL-17 and CCL20 was measured ELISA,expression of nuclear factor kappa B(NF-κB)subunit p65 protein was measured by Western blot.Endothelial cell tube formation experiment was conducted using an in vitro angiogenesis analysis kit.Results Compared to the TNF-α-induced psoriasis model group,the Datura metel L.extract significantly reduced the levels of IL-17 and CCL20 in the cell culture su-pernatant of TNF-α-induced psoriasis model(P＜0.001);Datura metel L.extract markedly decreased the NF-κB subunit p65 protein level in TNF-α-induced psoriasis model cells(P＜0.01);Datura metel L.extract effectively inhibited the induction of endothelial cell tube formation by the cell culture supernatant of the psoria-sis model group.Conclusions The Datura metel L.extract down-regulates NF-κB signaling pathway mole-cules,reducing the production of IL-17 and CCL20 inflammatory factors in inflammatory keratinocytes and in-hibiting angiogenesis.

The development of multi-campus is an effective way to expand and enlarge high-quality medical resources for public hospitals. In view of the problems in the relationship between power, responsibility and benefit, functional positioning, discipline layout, homogenization of medical quality and service, and management of human and financial resources in multi-campus, the authors introduced the integrated management system built by the Second Affiliated Hospital Zhejiang University School of Medicine in the process of multi-campus construction. The system included a standard-oriented quality system, a demand-oriented service system, a position-oriented personnel system, an efficiency-oriented financial system, a sharing-oriented information system and a mutual integration-oriented culture system, and formed an integrated management mode of " hospital-area synergy, differential positioning, and homogeneous development" , which significantly improved the management efficiency, service capacity and operational efficiency of the hospital, and could provide an effective reference for public hospital managers.

Objective:To explore the feasibility of recoverable fiducial marker implantation guided using the intelligent navigation bronchoscopy technology in the Cyberknife Synchrony-based respiratory tracking.Methods:CT scans of an inflatable pig lung after anti-rot processing were obtained. Then, eight simulated tumor lesion sites were designed in the left and right lung lobes using intelligent navigation software, with four classified as the sputum bronchial environment group and four classified as the wet bronchial environment group. Based on the implantation principle of Cyberknife fiducial markers, 32 recoverable fiducial markers were implanted around various simulated tumor lesions via bronchus under intelligent guidance. Then, the end-expiratory state of the pig lung was simulated, the pig lung was scanned again to obtain CT images of the implanted recoverable fiducial markers, and the number of successfully implanted fiducial markers was recorded. Eight deliverable Synchrony treatment protocols were designed using the Cyberknife planning system (Multiplan v4.6), and then the pig lung with simulated respiratory movements was exposed to radiation. After radiation, the implanted recoverable fiducial markers were retrieved using the bronchoscopy technique, and the number of successfully retrieved fiducial markers was recorded. Moreover, the translational errors, rotational errors, and rigid body errors were extracted from the Cyberknife log file and analyzed.Results:No recoverable fiducial markers slipped or fell during the experiment. Thirty-two recoverable fiducial markers were successfully implanted and recovered under the guidance of intelligent navigation bronchoscopy, with implantation and recovery success rates of both 100%. Moreover, the tracking rate and rigid body errors of the fiducial markers were 100% and less than 5 mm, respectively. The data from the Cyberknife log file indicated that there was no significant difference between the sputum bronchial environment group and the wet bronchial environment group in the translational errors in the left-right direction, the rotational errors in the roll direction, and the rotational errors in the pitch direction ( P>0.05). Compared to the wet bronchial environment group, the sputum bronchial environment group had slightly higher translational errors in front-back ( Z=-3.57, P<0.01) and cranio-caudal ( Z=-2.53, P<0.05) directions, lower rotational errors along the yaw axis ( Z = -3.88, P < 0.01), and lower rigid body error ( Z=-3.32, P<0.01), and the differences were all statistically significant. Conclusions:The recoverable fiducial marker implantation guided using the intelligent navigation bronchoscopy technology is feasible. Recoverable fiducial markers are stable in the bronchus of the phantom, and the Cyberknife tracking precision can meet clinical requirements. Therefore, the recoverable fiducial marker implantation guided using the intelligent navigation bronchoscopy technology has promising prospects in clinical and teaching applications.

The research on human hepatobiliary development and disorders has been constrained by minimal access to human fetal tissue, and low accuracy of animal models. To overcome this problem, we have established a system for the differentiation of human pluripotent stem cells (hPSCs) into functional hepatobiliary organoids (HBOs). We have previously reported that our 45-d approach closely mimics key stages of hepatobiliary development, starting with the differentiation of hiPSC into endoderm and a small part of mesoderm, and subsequently into hepatoblast-like cells, followed by the parallel generation of hepatocyte-like cells and cholangiocyte-like cells, formation of immature HBO expressing early hepatic and biliary markers, and mature HBO displaying hepatobiliary functionality. In this study, we present an updated version of our previous protocol, which only needs 35 days to achieve maturation in vitro. Furthermore, a hepatobiliary culture medium is developed to functionally maintain the HBOs for more than 1.5 months. The capacity of this approach for producing large amounts of functional HBOs and enabling long-term culture in vitro holds promise for applications on developmental research, disease modeling, as well as screening of therapeutic agents.

Objective:To explore the effect of combined orbicularis muscle double stitch operated on blepharoplasty.Methods:A total of 90 patients, 79 females and 11 males, aged 18-49 years, were treated by using combined orbicularis muscle double stitch procedure, that is, to fix upper lifting muscle, to remove partial fat, and to perform blepharoplasty.Results:All 90 cases＇ incisions were healed at the first phase, no obvious swelling and bleeding. Within 3-24 months follow up, all patients＇ upper eyelids were significantly improved. The skin was smoothy when closing eyes, and eyelash was up when opening eyes, and arc was natural and satisfactory.Conclusions:This method can improve the shape of the upper eyelid swelling and get long-lasting and stable physiological eyelid.

Objective:To explore the application effect of objective structured clinical examination (OSCE) in hierarchical training of nurses in emergency and critical care medicine.Methods:By the convenient sampling, a total of 300 nurses who received training in emergency and critical care medicine in a ClassⅢ Grade A hospital in Wenzhou were selected as research objects. They were divided into the control group and the observation group by random number table method, 150 nurses in each group . The control group adopted the traditional training assessment method, while the observation group adopted the nursing practice training assessment model based on the OSCE concept. The scores of comprehensive clinical practice ability assessment and training satisfaction were compared between the two groups.Results:The total score of clinical practice ability of nurses in the observation group was higher than that of the control group, and the difference between the two groups was statistically significant ( P<0.05) . The total scores of clinical practice ability of nurses at all levels in the observation group were higher than those in the control group, and the differences between the two groups were statistically significant ( P<0.05) . The dimensions rates of nursing training satisfaction of the observation group were higher than those of the control group, and the differences between the two groups were statistically significant ( P<0.05) . Conclusions:OSCE model can improve the clinical practice ability of nurses in emergency and critical care medicine, which is conducive to improving the training satisfaction of nurses in emergency and critical care medicine.