Massive Open Online Courses （MOOCs） in medical ethics play a significant role in cultivating the humanistic quality of medical students. Through quantitative analysis， this paper compared the commonalities and differences in “medical ethics” MOOC courses in different types of colleges and universities， as well as proposed new paths for optimizing the cultivation of medical students’ humanistic quality. By searching and analyzing course data from “medical ethics” offered on mainstream MOOC platforms in China from 2013 to 2024， this paper explored new paths for the integration of MOOCs and humanistic quality from the perspectives of course content， faculty construction， student participation， and comparison between traditional Chinese medicine （TCM） universities and comprehensive universities. This study found that medical MOOCs focused on theoretical foundations and medical professional ethics and spirit， medical equity and social responsibility， as well as end-of-life care and medical humanistic care， forming a multidimensional curriculum system. Faculty teams reflected interdisciplinary characteristics， gathering teachers from disciplines such as medicine， philosophy， and education. Differences were observed between TCM universities and comprehensive universities. The former focused more on the origins and inheritance of humanistic care in TCM culture and ancient Chinese medical classics， while the latter emphasized more on Western ethical spirit. This paper can provide valuable insights for the diversified development of medical humanistic quality education， contribute to the integration of TCM ethics with modern medical ethics， provide references for online medical ethics education， implement new medical concepts， promote interdisciplinary integration of medicine and the humanities， and assists the reform and development of medical education.

Microalgae possess high photosynthetic efficiency, robust adaptability, and substantial biomass, serving as excellent biological resources for large-scale cultivation. Malic enzyme (ME), a ubiquitous metabolic enzyme in living organisms, catalyzes the decarboxylation of malate to produce pyruvate, CO₂, and NAD(P)H, playing a role in multiple metabolic pathways including energy metabolism, photosynthesis, respiration, and biosynthesis. In this study, we identified the Scenedesmus quadricauda malic enzyme gene (SqME) and its biological functions, aiming to provide excellent target genes for the genetic improvement of higher plants. Based on the RNA-seq data from S. quadricauda under the biofilm cultivation mode with high CO₂ and light energy transfer efficiency and small water use, a highly expressed gene (SqME) functionally annotated as ME was cloned. The physicochemical properties of the SqME-encoded protein were systematically analyzed by bioinformatics tools. The subcellular localization of SqME was determined via transient transformation in Nicotiana benthamiana leaves. The biological functions of SqME were identified via genetic transformation in Nicotiana tabacum, and the potential of SqME in the genetic improvement of higher plants was evaluated. The ORF of SqME was 1 770 bp, encoding 590 amino acid residues, and the encoded protein was located in chloroplasts. SqME was a NADP-ME, with the typical structural characteristics of ME. The ME activity in the transgenic N. tabacum plant was 1.8 folds of that in the wild-type control. Heterologous expression of SqME increased the content of chlorophyll a, chlorophyll b, and total chlorophyll by 20.9%, 26.9%, and 25.2%, respectively, compared with the control. The transgenic tobacco leaves showed an increase of 54.0% in the fluorescence parameter NPQ and a decrease of 30.1% in Fo compared with the control. Moreover, the biomass, total lipids, and soluble sugars in the transgenic tobacco leaves enhanced by 20.5%, 25.7%, and 9.5%, respectively. On the contrary, the starch and protein content in the transgenic tobacco leaves decreased by 22.4% and 12.2%, respectively. Collectively, the SqME-encoded protein exhibited a strong enzymatic activity. Heterologous expressing of SqME could significantly enhance photosynthetic protection, photosynthesis, and biomass accumulation in the host. Additionally, SqME can facilitate carbon metabolism remodeling in the host, driving more carbon flux towards lipid synthesis. Therefore, SqME can be applied in the genetic improvement of higher plants for enhancing photosynthetic carbon fixation and lipid accumulation. These findings provide scientific references for mining of functional genes from S. quadricauda and application of these genes in the genetic engineering of higher plants.
Nicotiana/genetics* ; Photosynthesis/physiology* ; Malate Dehydrogenase/biosynthesis* ; Plant Leaves/genetics* ; Scenedesmus/enzymology* ; Carbon Cycle/genetics* ; Lipid Metabolism/genetics* ; Plants, Genetically Modified/metabolism*

A 49-year-old female examinee, employed at a paper company in Guigang, Guangxi (engaged in the production of napkins), visited the Qintang District People′s Hospital in Guigang on June 11, 2023, to apply for a health certificate. Salmonella was isolated during a physical examination screening for enteric pathogens ( Salmonella, Shigella), and repeated use of empirical antibacterial drugs failed to eradicate the pathogen. A reference laboratory identified the two isolates as S. Kentucky ST198 by performing serotyping, drug resistance phenotyping, and whole genome sequencing. Based on the regional serotype database of Salmonella in China, a phylogenetic tree of S. Kentucky ST198 resistance genotypes was constructed, defining both isolated strains as high-level drug-resistant ST198.2-1 subclade clones. Following a multidisciplinary consultation and based on antimicrobial susceptibility test results, the treatment was adjusted to amoxicillin/clavulanate and azithromycin. On August 19, three consecutive negative test results confirmed the eradication of Salmonella Kentucky.

Objective:To analyze the preliminary explorations and practical effects of strengthening the process management of nursing special projects in a tertiary general hospital, so as to explore the refined management strategy of hospital projects and provide reference for improving the management level of the research project.Methods:This article takes a series of refined measures taken by the hospital in the process management of nursing special projects from August 2016 to August 2021 as the research example, including setting up subject directions around key disciplines, setting application conditions at different levels, standardizing selection procedures, strengthening mid-term assessments, strictly controlling final acceptance, establishing integrity files, and promoting the transformation of scientific achievements, etc. and these measures are deeply analyzed and discussed.Results:Through a series of measures, the hospital nursing team has significantly improved in terms of research paper publication, patent authorization, approval of projects above the bureau level, and nursing specialties ranking of Chinese hospital Science and Technology Evaluation Metrics (STEM) in the past six years.Conclusions:By strengthening the process management of nursing special research project, the construction level of nursing disciplines has been significantly improved, and the development of nursing disciplines has been greatly promoted.

Objective To explore the relationship between serum iron(SI)metabolism and glucose and lipid metabolism in patients with type 2 diabetes mellitus(T2DM).Methods A total of 170 T2DM patients hospitalized in the Department of Endocrinology,Lanzhou University First Hospital from 2019 to 2021 were included.During the same period,30 healthy individuals from physical examination center were selected as the normal control(NC)group.Based on HbA1c control,T2DM patients were divided into subgroups with good blood glucose control(H1,HbA1c＜7%,n=39),poor glucose control(H2,7%＜HbA1c＜9%,n=63)and very poor glucose control(H3,HbA1c＞9%,n=68).According to the level of blood lipids,T2DM patients were divided into subgroups with normal blood lipids(L1,n=36)and high blood lipids(L2,n=134).Results Compared with NC group,age,SBP,DBP,BMI,serum ferritin(SF),FPG,FIns,HOMA-IR,TyG,TG,LDL-C and SUA increased inT2DM group(P＜0.05),while SI,TF,total iron binding capacity(TIBC),DI,HDL-C and eGFR decreased(P＜0.05).The levels of TF and TIBC in H3 subgroup were lower than those in H1 subgroup(P＜0.05).LDL-C of L2 subgroup was higher than that of L1 subgroup(P＜0.05),while HDL-C was lower than that of L1 subgroup(P＜0.05).Pearson correlation analysis showed that SF was positively correlated with HbA1c,TyG,TG and SUA(P＜0.05),and negatively correlated with HDL-C and eGFR(P＜0.05).TF was positively correlated with HDL-C and eGFR(P＜0.05),but negatively correlated with age,SBP,DBP,TyG and SUA(P＜0.05).Multiple linear regression analysis showed that SF and FPG were influencing factors for HbA1c in T2DM patients.Conclusion SI metabolism is closely related to glucose and lipid metabolism in T2DM patients.

Recent studies have shown that the occurrence and development of common liver diseases, including non-alcoholic fatty liver disease, cirrhosis, and liver cancer, are related to liver aging(LA). Therefore, to explore the effect and mechanism of Dahuang Zhechong Pills(DHZCP), a traditional classic prescription in improving LA with multiple targets, the present study randomly divided 24 rats into a normal group, a model group, a DHZCP group, and a vitamin E(VE) group, with six rats in each group. The LA model was induced by continuous intraperitoneal injection of D-galactose(D-gal) in rats. For the LA model rats, the general situation was evaluated by aging phenotype and body weight(BW). LA was assessed by the pathological characteristics of hepatocyte senescence, hepatic function indexes, the staining characteristics of phosphorylated histone family 2A variant(γ-H2AX), and the expression levels of cell cycle arrest proteins(P21, P53, P16) and senescence-associated secretory phenotype(SASP) in the liver. The activation of the reactive oxygen species(ROS)-mediated phosphatidylinositol-3 kinase(PI3K)/protein kinase B(Akt)/forkhead box protein O4(FoxO4) signaling pathway was estimated by hepatic ROS expression feature and the protein expression levels of the key signaling molecules in the PI3K/Akt/FoxO4 signaling pathway. The results showed that after the treatment with DHZCP or VE for 12 weeks, for the DHZCP and VE groups, the characterized aging phenotype, BW, pathological characteristics of hepatocyte senescence, hepatic function indexes, relative expression of ROS in the liver, protein expression levels of key signaling molecules including p-PI3K, p-Akt, and FoxO4 in the liver, staining characteristics of γ-H2AX, and the protein expression levels of P16, P21, P53, interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α) in the liver were improved, and the effects of DHZCP and VE were similar. Based on the D-gal-induced LA model in rats, this study demonstrates that DHZCP can ameliorate LA with multiple targets in vivo, and its effects and mechanism are related to regulating the activation of the ROS-mediated PI3K/Akt/FoxO4 signaling pathway in the liver. These findings are expected to provide new pharmacological evidence for the treatment of DHZCP in aging-related liver diseases.
Animals ; Rats ; Proto-Oncogene Proteins c-akt/genetics* ; Phosphatidylinositol 3-Kinases/genetics* ; Reactive Oxygen Species ; Tumor Suppressor Protein p53/genetics* ; Signal Transduction ; Liver ; Aging ; Cell Cycle Proteins ; Interleukin-6

Objective:To explore the effects of cognitive conflict teaching in nursing undergraduate teaching from the perspective of ideological and political education.Methods:The new undergraduate nursing students of Changzhi Medical College admitted in 2019 and 2020 were selected by convenience sampling. The 145 nursing students enrolled in 2020 were included into the research group, while the 145 nursing students enrolled in 2019 were matched by SPSS software as the control group. Nursing students in the research group received cognitive conflict teaching from the perspective of ideological and political education, while those in the control group was given conventional cognitive conflict teaching. The scores of socialist core values, professional identity, caring ability, and humanistic quality were compared between the two groups.Results:After one year of teaching, the scores of socialist core values, professional identity, caring ability, and humanistic quality of nursing students in the research group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Cognitive conflict teaching from the perspective of ideological and political education can improve nursing students' socialist core values, professional identity, caring ability, and humanistic quality, and realize the effective integration of ideological and political education with professional theoretical knowledge.

Objective:To investigate the expression of programmed death ligand 1 (PD-L1) in rectal cancer tissues and the correlation of PD-L1 expression with clinicopathological characteristics and overall survival of patients.Methods:The clinical data of 200 newly treated rectal cancer patients in Shanxi Provincial Cancer Hospital from January 2014 to December 2015 were retrospectively analyzed. The expression of PD-L1 in rectal cancer tissues was detected by immunohistochemistry. The correlations of PD-L1 expression with gender, age, tumor T stage, lymph node metastasis, tumor differentiation, histological type, tumor TNM stage, neutrophil-to-lymphocyte ratio (NLR) and overall survival of patients were analyzed.Results:The positive expression rate of PD-L1 was 24% (48/200). The positive expression rate of PD-L1 was high in patients with lymph node metastasis and high NLR (≥ 3.5) (both P < 0.05). The 5-year overall survival rate in PD-L1-positive group was 42%, and the PD-L1-negative group was 59%, and the difference between the two groups was statistically significant ( P < 0.05). The results of multivariate analysis showed that lymph node metastasis ( HR = 3.456, 95% CI 2.148-5.556, P < 0.01), NLR ≥ 3.5 ( HR = 1.871, 95% CI 1.169-2.996, P = 0.009), and PD-L1-positive expression ( HR = 2.187, 95% CI 1.373-3.484, P = 0.001) were independent adverse influencing factors for the overall survival of rectal cancer patients. Conclusion:PD-L1 is highly expressed in rectal cancer tissues, and the positive expression of PD-L1 is associated with poor overall survival of patients.

【Objective】 To investigate the clinical efficacy and safety of centrifugal plasma separation combined with plasma adsorption in the treatment of hypertriglyceridemia. 【Methods】 The data of 42 patients with hypertriglyceridemia from February 2019 to October 2020 were retrospectively collected and analyzed. The patients were treated with plasma component exchange by centrifugal plasma separation combined with plasma adsorption (PA) lipid-lowering therapy. The plasma was separated by an automatic blood cell separator, and was then adsorbed by membrane plasma component absorber. Conditions for plasma component exchange were sodium citrate as anticoagulant, the whole blood flow rate at (30~80) mL/min, the plasma circulation volume 2 500 mL, the treatment time 2 h, and the discarded plasma 200 mL. The treatment was performed once every two weeks, twice in total, and the efficacy was evaluated 6 weeks later. The changes of serum total protein (TP), blood lipid indexes and hemorheology indexes before and after treatment were observed, and the adverse reactions during treatment were recorded. 【Results】 The effective rate of 42 patients after treatment was 95.24%. The values of TP, TC, TG and LDL-C decreased significantly (82.53±6.37 vs 74.26±5.91, 7.46±1.83 vs 3.88±1.06, 5.91±2.16 vs 2.20±1.13, 4.23±1.02 vs 3.17±0.85) while HDL-C increased significantly(0.92±0.15 vs 1.23±0.26) after the treatment (P<0.05). After the treatment, the levels of whole blood high-cut viscosity, whole blood low-cut viscosity, plasma viscosity, hematocrit and fibrinogen decreased significantly (7.53±1.21 vs 5.16±0.88, 18.27±3.15 vs 12.04±2.32, 2.46±0.37 vs 1.68±0.29, 52.24±5.31 vs 32.53±4.42, 4.28±0.76 vs 3.14±0.45)(P<0.05). The incidence of adverse reactions was 14.3%, and no serious adverse reactions were observed. 【Conclusion】 The centrifugal plasma separation combined with plasma adsorption in the treatment of hypertriglyceridemia is safe and effective.

Objective:To analyze the associations between prenatal and 1-year-old exposure to antibiotics and allergic symptoms in children aged 6-11 months and 18-23 months.Methods:In this study, a prospective birth cohort study was adopted. A total of 2 122 pregnant women were enrolled in Maternal and Child Health Care Center of Ma′anshan from June 2015 to June 2016, and they were followed up from the beginning of pregnancy to children′s 24 months of age. Excluding 564 pairs of mothers and children who were lost to follow-up or with incomplete information on the use of antibiotics and children′s allergic symptoms, a total of 1 558 pairs of mothers and children were included in the analysis of this study. The parents and children′s general demographic information, early-life antibiotic exposure and other data were collected, the information about allergic symptoms in children aged 6-11 months and 18-23 months were investigated by reference to the "International Study of Asthma and Allergies in Childhood (ISAAC)". The univariate and multivariate binary unconditional logistic regression model was used to was used to estimate associations between the effects of early-life antibiotic exposure on allergic symptoms in 2-year-old children.Results:The antibiotic usage rate of pregnant women during pregnancy was 3.4% (53), and the antibiotic usage rates of children between 0 to 2 months, 3 to 5 months, and 6 to 11 months were separately 15.2%(237), 15.5%(242) and 17.3%(269). The total prevalence of allergic diseases in children aged 6 to 11 months was 24.1% (375 children), and the total prevalence of allergic diseases in children aged 18 to 23 months was 22.0% (342 children). After adjust parental (maternal) education level, family monthly income per capita, parental (maternal) allergy history, parental (maternal) age at pregnancy, mother′s Body Mass Index (BMI) before pregnancy, exposure to second-hand smoke during pregnancy, delivery method, child gender, birth weight, preterm birth, the use of antibiotics when children were 3-5 months old ( RR=1.61,95% CI:1.19-2.17) and 6-11 months old ( RR=1.43,95% CI:1.06-1.93) were the risk factors for allergic symptoms at 6-11 months of age; and the use of antibiotics when children were 0-2 months old (RR=1.41, 95% CI: 1.03-1.95), 3-5 months old ( RR=1.54, 95% CI: 1.12-2.11) and 6-11 months old ( RR=1.58, 95% CI: 1.17-2.14) were the risk factors for allergic symptoms at 18-23 months of age. Conclusion:Children′s exposure to antibiotics within 1 year of age was a risk factor for allergic symptoms in children aged 6-11 months and 18-23 months, children should avoid unnecessary antibiotic use in infancy.