Objective To introduce a traceability closed-loop management system for the entire process of drug dispensing in the inpatient department.Methods In line with the requirements for intelligent healthcare construction and six-level electronic medical records development,a paperless drug dispensing process for the inpatient department was designed.A traceability closed-loop management system was established by improving both hardware equipment and software function.The system's practical effectiveness was evaluated from multiple perspectives.Results With process transformation,the workflow efficiency of doctors,nurses,pharmacists and clinical support staff has been significantly improved.Costs in terms of human resources and materials have been reduced,and the safe and rational use of medication has been promoted.Conclusions The improved process,which is based on the construction of intelligent devices and information technology,achieves a closed-loop and traceable management system for the entire drug dispensing process in the inpatient department.This system offers the benefits of safety,standardization,efficiency,and closed-loop traceability.It reduces the risk of dispensing mistakes,improves the safety of medication and has strong scalability.

Objective:To investigate the changes of thickness and area of the ligamentum flavum after lateral lumbar interbody fusion (LLIF) for lumbar degenerative diseases.Methods:From 2019 to 2021, a total of 54 patients with lumbar degenerative diseases who underwent LLIF combined with percutaneous pedicle screw internal fixation were retrospectively analyzed. There were 9 males and 45 females, aged 59.46±6.91 years (range, 45-76 years), followed up for 14.69±6.87 months (range, 12-33 months). The disc height (DH), midsagittal canal diameter (CD), dural sac axial cross-sectional area (DCSA), ligamentum flavum area (LFA) and ligamentum flavum thickness (LFT) before and after surgery and at the last follow-up were evaluated and compared. Pearson correlation analysis was used to assess the relationship between the amount of change in the DCSA and LFA in the immediate postoperative period and at the last follow-up, as well as the correlation between the two and the amount of change in the DH. The data of patients at the last follow-up of 12 months after operation were extracted. Pearson correlation was used to evaluate the changes in DCSA and LFA at the last follow-up and the visual analogue scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI) at 1 year after surgery.Results:All patients were followed up for 14.69±6.87 months (range, 12-33 months). The differences in DH ( F=354.93, P<0.001), sagittal CD ( F=44.78, P<0.001) and DCSA ( F=130.97, P<0.001) before, immediately after surgery and at the last follow-up were statistically significant. The DH, sagittal CD, and DCSA immediate after surgery and last follow-up were higher than those before surgery ( P<0.05). The differences in LFA ( F=51.59, P<0.001) and bilateral LFT ( F=53.49, P<0.001; F=50.53, P<0.001) before and after surgery and at the last follow-up were statistically significant, and both LFA and bilateral LFT at immediate after surgery and last follow-up were smaller than those before surgery ( P<0.05). Pearson correlation analysis showed that the change of DH immediately after surgery was moderately correlated with the change of DCSA ( r=0.57, P<0.001), and was strongly correlated with the change of LFA ( r=0.65, P<0.001). The change of DH at the last follow-up was moderately correlated with the change of DCSA ( r=0.43, P<0.001), and was weakly correlated with the change of LFA ( r=0.25, P=0.042). The differences in VAS-leg ( F=199.51, P<0.001), VAS-low back ( F=233.90, P<0.001), and ODI ( F=199.17, P<0.001) were statistically significant in patients before operation, 3 months after operation and 12 months after operation. There was no correlation between the changes of DCSA and LFA at the last follow-up and the changes of VAS and ODI at 1 year after operation ( P>0.05). Conclusion:LFA and LFT decrease and DCSA increase in patients with lumbar degenerative diseases after LLIF. LFA and LFT gradually decrease with time, and VAS and ODI are significantly improved compared with those before surgery. The DH loss caused by a certain degree of cage subsidence after surgery does not affect the clinical efficacy. There is no correlation between the improvement of DCSA and LFA and the improvement of clinical symptoms.

Objective:To explore the application effect of immersive experiential teaching strategies in the teaching of clinical anesthesiology for undergraduates.Methods:Undergraduates majoring in 5-year clinical medicine in Air Force Medical University from January 2022 to May 2022 were enrolled as the research objects. Students were randomly divided into the immersive teaching group and the traditional teaching group, with 35 students in each. Students in the immersive teaching group underwent immersive experiential teaching strategies and the traditional teaching group received lecture-based teaching strategies. After classes, all students in these two groups took the same theoretical and operational examination, and conducted a teaching satisfaction survey and a comprehensive ability evaluation. The results were analyzed by t-test and Chi-square test using SPSS 22.0 software. Results:Students in the immersive teaching group were more satisfied with teaching (88.32±7.28 vs.70.15±7.11) ( P=0.001), and had higher scores of theorical examination (86.34±7.42 vs. 77.31±5.32) ( P=0.020) and operational examination (92.23±5.33 vs. 81.21±4.98) ( P=0.022) than those in the traditional teaching group. In addition, the scores of communication ability ( P=0.026), response ability ( P<0.001) adaptability ( P=0.007), and critical thinking ( P<0.001) in the immersive teaching group were higher than those in the traditional teaching group. Conclusion:The immersive experiential teaching strategies can effectively improve the theoretical and practical operational ability of undergraduates after completing courses of clinical anesthesiology, and can effectively stimulate the enthusiasm of students. It is worthy to be popularized in subsequent teaching abilities.

Objective : To investigate the influences of circ_WBSCR17 on high glucose-induced fibrosis and inflammation in human mesangial cells by regulating the miR-30a-5p /JAK1 axis． Methods : Human mesangial cells HMCL were grouped into : NG group (5．5 mmol / L glucose-treated HMCL cells) ，HG group (30 mmol / L glucose- treated cells) ，si-NC group (30 mmol / L glucose + transfected with si-NC) ，si-circ_WBSCR17 group (30 mmol / L glucose + transfected with si-circ _ WBSCR17 ) ，si-circ _ WBSCR17 + inhibitor-NC group ( 30 mmol / L glucose + co-transfected with si-circ_WBSCR17 and inhibitor-NC) ，and si-circ_WBSCR17 + miR-30a-5p inhibitor group (30 mmol / L glucose + co-transfected with si-circ_WBSCR17 and miR-30a-5p inhibitor) ; RT-qPCR was performed to detect the expression of circ_WBSCR17 and miR-30a-5p in cells ; CCK-8 assay was performed to detect cell prolifer- ation ; flow cytometry was performed to detect apoptosis ; ELISA was performed to detect the expression levels of tumor necrosis factor-α (TNF-α) ，interleukin (IL) -6 and IL-8 ; Western blot was performed to detect the expression of JAK1，proliferating cell nuclear antigen ( PCNA) ，Bax，transforming growth factor-β1 ( TGF-β1 ) ，fibronectin (FN) ，collagen IV，and α-smooth muscle actin ( α-SMA) ; distribution of WBSCR17 was detected by fluorescence in situ hybridization (FISH) ; dual-luciferase reporter gene experiment was performed to verify the relationship between circ _ WBSCR17 and miR-30a-5p，miR-30a-5p and JAK1，respectively. Results : Compared with the NG group，the HMCL cell proliferation ability of the HG group decreased，the levels of TNF-α , IL-6 and IL-8，the pro- tein expressions of p-JAK1 /JAK1，p-STAT1 / STAT1，p-STAT3 / STAT3，TGF-β1，FN，collagenIV and α-SMA，and the apoptosis ability increased (P＜0. 05) ; compared with HG group and si-NC group，the expression of miR-30a- 5p，OD450 value and PCNA expression in HMCL cells of si-circ_WBSCR17 group increased，the levels of TNF-α , IL- 6 and IL-8，the expressions of circ_WBSCR17，p-JAK1 /JAK1，p-STAT1 / STAT1，p-STAT3 / STAT3，Bax，TGF-β1， FN，collagenIV and α-SMA decreased ( P ＜0. 05 ) ; inhibition of miR-30a-5p attenuated the promoting effect of knockdown of circ_WBSCR17 on proliferation of HMCL cells，and enhanced apoptosis，cellular fibrosis and inflammatory responses ; FISH experiment confirmed that WBSCR17 was mainly distributed in the cytoplasm ; dual-luciferase reporter gene experiment confirmed that circ_WBSCR17，JAK1 and miR-30a-5p had a targeted regulatory rela- tionship． Conclusion Knockdown of circ_WBSCR17 can reduce high glucose-induced fibrosis and inflammation in human mesangial cells by regulating the miR-30a-5p /JAK1 axis.

CCAAT enhancer binding protein β (C/EBPβ), as a nuclear transcription factor necessary for the development of liver, airway epithelium, and adipose tissue, plays a vital role in physiological processes related to cell proliferation, apoptosis, and differentiation. However, the up-regulation of C/EBPβ activates signal pathways related to inflammatory response, epithelial-mesenchymal transition, cell proliferation and invasion, immune response, and angiogenesis by regulating a series of downstream genes transcription promotes the development of lung diseases. Therefore, targeting C/EBPβ may be a potential treatment strategy for lung diseases. This paper summarizes the regulatory effects of C/EBPβ and related signaling pathways in lung infection, asthma, chronic obstructive pulmonary disease, lung injury, pulmonary fibrosis, and lung cancer to provide a theoretical basis for the precision medicine of lung diseases.

In order to ensure the normal teaching order during the prevention and control of the COVID-19 epidemic, the second semester of the 2019-2020 academic year in Central South University was devoted to the online teaching. In response to the school's call, the diagnostics teaching team has applied the Tencent classroom software, WeChat mini programs, analog teaching software and digital curriculum platform to carry out online teaching activities. On the basis of summarizing the previous online teaching experience, we have made a preliminary discussion and reflection on the online teaching, which will provide ideas and directions for the reform of medical education.

【Objective】 To reveal possible mechanisms of miRNA in diabetic hepatopathy through bioinformatics method. 【Methods】 Subset data of miRNA and their matched mRNAs in the liver of STZ-induced diabetic mice and the normal liver tissues of congenial mice by detecting on microarrays were collected from GEO database； information from the database and bioinformatics analysis were applied to mine a batch of miRNAs in diabetic hepatopathy and targeted mRNAs regulated. Then qRT-PCR was used to verify the expressions of miRNAs in diabetic liver from 20 STZ-treated Kunming mice and 10 normal homologous mice. 【Results】 Via detection and analysis， miRNAs differentially expressed （including 96 up-regulated and 77 down-regulated） were significantly obtained. Groups of miRNAs and their effectors （mRNAs） that may be related to the pathological process of diabetic liver disease in mice were screened by GO and KEGG enrichment analyses， combined with relevant protein annotations in the databases and references. The expressions of miR-200a-3p， miR-200b-3p and miR-222-3p in the mice’s liver tissue detected by qRT-PCR were significantly down-regulated. In addition， the expressions of related effector genes CERS6， MYBL1， SCD2， SLCO1A4 and PLK2 were up-regulated， while the expressions of ACSS2， BCL6 and SLC10A2 were down-regulated. 【Conclusion】 The variation trend of those candidate miRNAs in mouse diabetic liver compared with that in control livers was consistent with that of the previous studies and prediction， which revealed their potential molecular regulation in this disease process.

The special nucleic acid fragments, 5' untranslated region (5' UTR) and internal ribosome entry site (IRES) of foot-and-mouth disease virus (FMDV), which interact with the capsid proteins, were selected as scaffolds to investigate the assembly efficiency of foot-and-mouth disease (FMD) virus-like particles (VLPs). The assembled product was characterized by evaluation of particle size, surface potential, gel retardation assay, nuclease digestion experiments, size-exclusion chromatography, transmission electron microscopy and circular dichroism analysis. The results confirmed that the 5' UTR and IRES of FMDV co-assembled with the FMD VLPs and facilitated the assembly efficiency of FMD-VLPs. It demonstrates that the assembly efficiency of 75S particles of VLPs-5'UTR was significantly higher than those of the VLPs (P<0.001) and VLPs-IRES group (P<0.01). Comparatively the assembly efficiency of 12S particles of VLPs-IRES was significantly higher than those of the VLPs (P<0.000 1) and VLPs-5'UTR (P<0.000 1). It showed that the 5' UTR represented more effective in facilitating the assembly of VLPs. This study proposes an optimized strategy for improving the assembly efficiency of VLPs for the development of VLPs vaccine.
5' Untranslated Regions ; Capsid Proteins/metabolism* ; Foot-and-Mouth Disease Virus/physiology* ; Internal Ribosome Entry Sites ; Nucleic Acids/metabolism* ; Virus Assembly

Objective: To study the effect of the modified preparation method with root canal flushing of different solutions on the anti-fracture properties of mechanical nickel-titanium filings. Methods: A transparent resin model of root canal was established. ProTaper Universal (PTU F1) instrument was used to prepare the root canals. The number of prepared root canals by each PTU F1 with the various solutions(n = 20) was recorded and compared among groups. Results: 6. 13 ± 3. 52 root canals were prepared in distilled water group, 6. 25 ± 1. 76 in 0. 9％saline group, 6. 27 ± 2. 07 of 0. 2％ chlorhexidine group, 6. 88 ± 3. 21 in 1％ sodium hypochlorite group, 4. 31 ± 2. 34 in 5％ sodium hypochlorite group and 3. 26 ± 2. 08 in dry drilling group. The number between each 2 of distilled water, 0. 9％saline group, 0. 2％chlorhexidine group and 1％ sodium hypochlorite group, and the number between 5％ sodium hypochlorite group and dry drilling group was not statistically significant(P＞ 0. 05). The number of prepared root canals in the first 4 groups was more than that in the latter 2 groups(P＜ 0. 05). Conclusion: Distilled water, 0. 9％ saline, 0. 2％ chlorhexidine or 1％ sodium hypochlorite for root canal irrigation can improve mechanical nickel-titanium instrument for fatigue resistance in root canal preparation, but 5％ sodium hypochlorite and dry drilling can not.

Objective To evaluate the role of spinal CX3C chemokine receptor 1 (CX3CR1) in inflammatory pain and the relationship with calmodulin (CaM)-calmodulin-dependent protein kinaseⅡ(CaMKⅡ) signaling pathways in mice.Methods Ninety-six pathogen-free healthy male C57BL6 mice,weighing 25-27 g,were divided into 3 groups using a random number table:control group (group C,n=30),inflammatory pain group (group IP,n=36) and CX3CR1 antagonist group (group CA,n=30).Inflammatory pain was induced by injecting complete Freund′s adjuvant (CFA) 50 μl into the plantar surface of right hind paws in IP and CA groups,while the equal volume of normal saline was given instead in group C.In group CA,CX3CR1 antagonist (diluted to 1 μg/5 μl in phosphate buffer solution) was intrathecally injected at 1 h before CFA injection.The thermal paw withdrawal latency (TWL) was measured at 30 min before CFA injection (T0) and 30 min,1 h,2 h and 4 h after CFA injection (T2-4).The animals were then sacrificed,and the spinal cord was removed for determination of the expression of phosphorylated CaMKⅡ (p-CaMKⅡ),phosphorylated cyclic adenosine monophosphate response element-binding protein (p-CREB) and c-fos (by Western blot) and expression of CaMKⅡ,CREB and c-fos mRNA (using real-time polymerase chain reaction).Immunofluorescence was used to determine that p-CAMKⅡ was expressed in microglia.Results Compared with group C,the TWL was significantly shortened at T2-4,and the expression of p-CaMKⅡ,p-CREB and c-fos protein and mRNA was up-regulated at T1-4 in IP and CA groups (P<0.05).Compared with group IP,the TWL was significantly prolonged at T2-4,and the expression of p-CaMKⅡ,p-CREB and c-fos protein and mRNA was down-regulated at T1-4 in group CA (P<0.05).p-CaMKⅡ was co-expressed with the microglial specific biomarker.Conclusion CX3CR1 is involved in the development and maintenance of inflammatory pain through activating CaM-CaMKⅡsignaling pathways in mice.