Objective To investigate the effects of treatment with nicorandil after Percutaneous Coronary Intervention(PCI)in patients with Acute Coronary Syndrome(ACS)on inflammation-related markers,and to assess its effects on vascular endothelial function.Methods Sixty-six ACS patients who underwent PCI in the Department of Cardiovascular Medicine of the Second Affiliated Hospital of Dalian Medical University from August 2022 to January 2023 were used as the study sample,and were divided into the control group and the experimental group according to the method of completely randomized design,with 33 cases in each group.The control group was treated with conventional therapy,and the experimental group was treated with nicorandil.Inflammatory indexes,homocysteine(Hcy)and adverse reactions in serum were compared between the two groups.Results After nicorandil treatment,the levels of postoperative inflammation-related factors in the control group were higher than that in the experimental group,and the difference was statistically significant(P<0.05);The levels of Hcy after nicorandil treatment were lower than that in the control group,and the difference was statistically significant(P<0.05);and the rate of adverse reactions in the experimental group was higher than that in the control group,and there was no statistical difference(P>0.05).Conclusion Nicorandil application in elderly ACS patients after PCI has a definite efficacy,can optimize the vascular-related inflammatory indexes,reduce homocysteine levels to improve coronary vascular endothelial function,and is suitable for further promotion.

To implement the strategy of healthy China and promote the construction of "new medicine science", it is urgent to focus on new needs and challenges to advance the reform of medical education curricula in China. Using literature research methods, we summarize the process of modern medical education curriculum reforms in the United States, and discuss the main features of the third-round reforms—introducing the concept of value-based medicine, offering health systems science courses, and promoting the curriculum system reform from the perspectives of learning time, curriculum integration, and learning methods. Based on these features, we put forward the enlightenment for the reform of medical education curricula in China.

Objective To summarize the experience of integrative palliative care at Peking Union Medi-cal College Hospital and provide a reference for promoting the integrative palliative care model.Methods Twenty cases receiving integrative palliative care at Peking Union Medical College Hospital were collected.The clinical characteristics,reasons for initiating integrative palliative care,the process of integrative palliative care,and feedback from these cases were summarized.Results Insomnia(11 cases,55％)and pain(9 cases,45％)were the most common symptoms requiring control in the 20 cases.The integrative palliative care team assisted in medical decision-making for 17 cases(85％),prepared end-of-life for 9 cases(45％),assisted in the transfer for 3 cases(15％),and provided comfort care for all the 20 cases(100％).Conclusions The integrative palliative care model can help alleviate suffering in end-of-life patients and provide support to patients'families and the original medical teams.This model is worth further promotion within class A tertiary hospitals.

Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.

Background Occupational pneumoconiosis is the most common occupational disease in Qinghai Province and China. From the perspective of public health, it is important to assess the disease burden using disability-adjusted life years (DALY) and economic losses. Objective To evaluate the disease burden of occupational pneumoconiosis in Qinghai Province, and to provide a basis for the formulation and implementation of relevant prevention and control strategies. Methods Based on the registered data, a database of occupational pneumoconiosis cases confirmed and reported in Qinghai Province was established. The survival status and death dateof occupational pneumoconiosis patients from 2015 to 2019 were confirmed by on-site visit, telephone survey, matching search of Death Information Registration and Management System, and consulting other departments. The life loss due to occupational pneumoconiosis from 2015 to 2019 was assessed using DALY as an indicator and data from the Global Burden of Disease 2019 (GBD 2019) study. Inpatients with officially diagnosed occupational pneumoconiosis from a hospital in Qinghai Province in 2019 were selected as study subjects, the direct economic loss was evaluated with hospitalization expenses, and the indirect economic loss due to occupational pneumoconiosis in Qinghai Province in 2019 was calculated by human capital approach. Results From 2015 to 2019, 505 new cases of occupational pneumoconiosis were reported in Qinghai Province, and there were 348 death cases. Prevalent cases and years lost due to disability (YLD) due to occupational pneumoconiosis were increased, while DALY and years of life lost (YLL) due to occupational pneumoconiosis decreased firstly and then increased. In each year, there were 87% or more of the DALY, YLL, or YLD attributed to silicosis and coal workers' pneumoconiosis. In 2019, the occupational pneumoconiosis-associated DALY was 2173.55 person years. The total hospitalization expense incurred by 42 inpatients with occupational pneumoconiosis was 1256345.19 yuan. The total hospitalization expense and average daily cost of the inpatients with stageⅡand Ⅲ pneumoconiosis were higher than that of the inpatients with stageⅠ (P<0.05), and the hospitalization expense was higher in the ≥60 years age group than in the <60 years age group (P<0.05). In 2019, the indirect economic burden incurred by occupational pneumoconiosis in Qinghai Province was 44108581.65 yuan, and accounted for 0.15‰ of the gross domestic product (GDP) of the province. Conclusion The disease burden associated with occupational pneumoconiosis in Qinghai Province are outstanding. Silicosis and coal workers' pneumoconiosis are the key contributors. Targeted intervention measures including dust hazard control, enterprise management, follow-up and rehabilitation management of pneumoconiosis should be taken to prevent and control the occurrence and progression of pneumoconiosis and alleviate disease burden of pneumoconiosis.

Autism Spectrum Disorder ; Autistic Disorder ; Humans ; Serotonin ; Social Behavior

In order to improve teachers' teaching ability and manage teachers effectively, we try to organize teachers to carry out a series of activities in the form of "teaching club". We set up six teaching clubs according to the key points of teaching work and teaching hot spots. We explore the formation of "teaching club" as a means of modern teacher management model, through the implementation of the teacher-centered concept, establish an efficient and flexible management system, and establish and improve the active development of behavior and other strategies. Through a period of practice and exploration, we have gained benefits and even made breakthroughs in many aspects, such as the construction of teaching team, curriculum construction and teaching competition. The management strategies mentioned above provide new ideas for the development of teacher management.

Objective　To explore the correlations between serum hypoxia inducible factor-1α （HIF-1α），aquaporin-9 （AQP9） and hemorrhagic transformation （HT） in patients with acute ischemic stroke （AIS） and its clinical significance. Methods　183 newly diagnosed patients with acute AIS from October 2017 to April 2019 were divided into HT group （n=84） and non HT group （n=99），the baseline data of gender，age，body mass index （BMI），proportions of hypertension，diabetes，hyperlipidemia，the baseline NIHSS score，baseline systolic blood pressure，baseline diastolic blood pressure，baseline blood glucose，thrombolytic time window and serum samples were collected. The expressions of HIF-1α and AQP9 proteins were detected by Western blot （WB）；Pearson’s method was used to analyze the correlation between HIF-1α and AQP9 levels in patients with AIS in HT group；the risk factors of HT in AIS patients were analyzed by logistic regression；Using NIHSS score，thrombolysis time window，serum HIF-1α，AQP9 levels as independent variables，the working characteristic curve （ROC） of subjects was drawn to analyze the predictive value of HT in AIS patients. Results　Compared with the non HT group，the baseline NIHSS score，baseline systolic blood pressure，baseline diastolic blood pressure，baseline blood glucose，thrombolytic time window，serum HIF-1α，AQP9 levels of AIS patients in HT group were significantly higher （P<0.05）. There was a positive correlation between the levels of HIF-1α and AQP9 proteins in patients with AIS in HT group （r=0.679，P<0.05）. NIHSS score，thrombolysis time window and serum HIF-1α，AQP9 protein levels were independent risk factors for HT in AIS patients after thrombolysis （P<0.05）. The AUCs of NIHSS score，thrombolysis time window，serum HIF-1α and AQP9 in the diagnosis of HT in AIS patients were 0.707，0.790，0.881 and 0.869 respectively，the cutoff values were 13.39 points，296.31 min，0.33 and 0.32 respectively，the sensitivities were 44%，66.70%，86.90% and 83.30% respectively，and the specificities were 91.90%，87.90%，87.90% and 88.90% respectively. The AUC of the combination of four methods in the diagnosis of HT in AIS patients was 0.980，the sensitivity and specificity were 94.00% and 94.90%，respectively，and the diagnostic efficiency of the four methods was significantly higher than that of single index. Conclusion　The elevated levels of HIF-1α and AQP9 were closely related to the occurrence of HT in AIS patients，and the combination of NIHSS score and thrombolysis time window could significantly improve the predictive value of HT in AIS，which may have some clinical reference significance.

OBJECTIVE： To establish a method for measuring the paclobutrazol residue in Ophiopogon japonicus from Sichuan and detect the quality of O. japonicus from Sichuan from different sources. METHODS： Totally 50 batches of samples were collected from different origin places， commercial markets and manufacturers. The sample pretreatment method was QuEChERS method， .ie the sample was extracted by aqueous acetonitrile， salted out by QuEChERS extract package （containing anhydrous magnesium sulfate and anhydrous sodium acetate）， the extract solution was purified by QuEChERS purification package （containing anhydrous magnesium sulfate， N-propyl ethylenediamine， octadecylsilane chemically bonded silica， silica gel， graphitized carbon black） and then added into internal standard triphenyl phosphate. The paclobutrazol residue in O. japonicus from Sichuan was determined by GC-MS/MS. The determination was performed on DB-5MS column. The temperature programming was adopted， and the detector was triple quadrupole MS detector. The initial flow rate of carrier gas was 1.3 mL/min； acquisition mode was MRM. Injection method was splitless injection. RESULTS： The linear range of paclobutrazol was 1.01-505 ng/mL （r＝    0.999 7）. RSDs of precision， stability （24 h） and repeatability tests were 3.94％， 13.62％， 7.54％ （n＝6）， respectively. Average method recovery was 111.26％ （RSD＝5.43％， n＝9）. The paclobutrazol residue in 50 batches of sample were 0.02-2.72 mg/kg. CONCLUSIONS： Established method is simple， accurate， sensitive and reproducible. It also can be used for the determination of paclobutrazol residue in O. japonicus from Sichuan. The contents of paclobutrazol residue in O. japonicus from Sichuan from different sources are different greatly.

Objective:To analyze the infection rate of high-risk HPV(hr-HPV) and its relationship with cervical intraepithelial neoplasms in cervical cancer screening population.Methods:The positive rate of HPV 16,18 and other 12 kinds of HPV subtypes from 2015.Jun to 2016 Nov was calculated and the infection rate in CIN Ⅱ+ population were analysed.Results:In the cervical cancer screening population,the total HPV positive rate was 19.0％,the positive rate of HPV 16,HPV 18 and other 12 kinds of HPV were 5.0％,1.6％ and 15.2％ respectively The risk to develop CIN Ⅱ + in HPV 16,HPV 18 and 12 other hr-HPV positive TCT ASCUS/LSlL population was 55.2％,35.5％ and 38.9％ respectively The risk to develop CIN Ⅲ+ was 25.3％,7.7％ and 6.9％ in HPV 16,HPV 18 and other 12 kinds of hr-HPV positive TCT ASCUS/LSIL population respectively In the CIN Ⅱ + population,45.0％ cases were 12 other hr-HPV positive while 46.3％ were HPV 16 positive and the positive rate of HPV 18 was 8.7％.Conclusions:In the cervical cancer screening population,the rate of HPV 18 positive was low,the rate of other 12 kinds of HPV positive was high.It's necessary to establish exact classification for the positive rate of each subtype.hr-HPV genotyping plays an important role in cervical cancer screening.In the referral to colposcope population,the rate of HPV 18 positive was low,the TCT results showed ASCUS/LSIL risk of HPV 18 positive and other 12 kinds of HPV positive was low.Consider using shunt detection to improve screening specificity.