The online and offline hybrid teaching model of evidence-based medicine (EBM) is currently in the stage of development. Previous teaching focused on the teaching process in the classroom, and did not organically combine all the course contents before, during, and after class. The BOPPPS model can be used to establish coherence and integrity in the EBM teaching process. Considering the discipline characteristics and teaching objectives of EBM, this study initially explored and designed a BOPPPS-based online and offline hybrid teaching model. Taking the "diagnostic evidence" module as an example, the teaching implementation details were introduced. A pre-designed questionnaire was used to conduct baseline survey and follow-up survey on students before and after class to evaluate the teaching model and effect. The surveys showed that half of the students (77/154) preferred the new online and offline hybrid teaching model of EBM. The students found that all aspects of BOPPPS teaching were generally acceptable and satisfactory. Compared with before teaching, the students' proficiency in EBM was significantly improved after the teaching ( P<0.001), particularly in their ability to retrieve literature and evaluate the quality of evidence, which is of great significance for expanding their knowledge and clinical thinking.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

In order to characterize the chloroplast genome and phylogenetic relationships of Isopyrum anemonoides, we performed Illumina Hiseq high-throughput sequencing to sequence the complete chloroplast genome of this plant and constructed a whole-genome map based on contig assembly and annotation. The chloroplast genome of I. anemonoides is 161 034 bp in length and has a typical tetrad structure, comprising 85 protein-coding genes, 37 tRNA genes, and 8 rRNA genes. The genome also contains a total of 44 dispersed repeat sequences and 47 simple sequence repeats. Among the genome's 53 678 codons, the largest proportion are leucine-encoding codons (5 251), whereas the smallest proportion encode tryptophan (712). Colinear analysis revealed an absence of inversions and rearrangements between I. anemonoides and related species at the chloroplast genome level. Whereas phylogenetic analysis indicated that I. anemonoides did not cluster in a clade with I. manshuricum, it did show a very close phylogenetic relationship with Paraquilegia microphylla. The findings of this study provide basic data that will contribute to further species identification and phylogenetic study of the genus Isopyrum.
Codon ; Genome, Chloroplast/genetics* ; Microsatellite Repeats ; Phylogeny ; Ranunculaceae/genetics*

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective:To explore the effect of health education based on the Internet in patients with rheumatoid arthritis (RA) .Methods:From January 2019 to January 2020, convenience sampling was used to select 296 patients with RA in Xinxiang Municipal Central Hospital. According to the random number table method, the patients were divided into the control group and the observation group, each with 148 cases. The control group conducted routine health education, and the observation group implemented health education based on the Internet. The treatment compliance, Chronic Disease Self-Management Behavior Scale, the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) , and Disease Activity Score 28 (DAS28) scores were compared between the two groups after intervention.Results:The treatment compliance of the observation group was 46.62% (69/148) , which was higher than 12.84% (19/148) of the control group, and the difference was statistically significant ( P<0.05) . After the intervention, the self-management score and scores of all dimensions of the observation group were higher than those of the control group, and the SF-36 score was higher than that of the control group, and the DAS 28 score was lower than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Health education based on the Internet can improve the treatment compliance, self-management ability and quality of life of RA patients, and reduce the disease activity.

Objective The aim of this study was to investigate the response in health-related epidemiological investigation among Chinese population aged 15 and over.We analyzed the specific causes of non-response,and explored the effective ways to improve the response rate,so as to provide reference for future epidemiological studies of this kind.Methods Two modes of studies regarding the prevalence of important cardiovascular diseases were used in Chongqing,during the 12th Five-Year Plan period in oder to find out the cause related to non-response.Intervention programs were carried out to evaluate the effects.Results When using the concentrated mode (CM),the completion rate to the questionnaires was only 20.00％ in the pre-investigation,with the response rate as 13.48％.In the deconcentrated mode (DM),the completion rate was 31.16％,with the response rate as 25.19％.After a series of incentives provided to both the respondents and the project-related core staff in the two modes,response rates of the two modes increased to the expected 60％.Conclusions CM appeared having advantages on quality control,but was more time consuming,with higher cost,and without effective follow-up measures to improve the response rate.However,DM had the advantages on controlling the cost and could increase the response rate through making advanced appointment with the households but quality control remained difficult.Two key points should be strengthened to improve the response rates,which including:Precisely finding out the research objects and providing incentives to the respondents to attract their interests of participating in the investigation.

Objective To investigate the expression of hypoxia inducible factor 1α (HIF-1α) and glucose transporter 1 (GLUT1) in lung adenocarcinoma and its correlation with tumor metastasis. Methods SP immunohistochemistry was used to detect GLUT1 and HIF-1α protein expression in 125 lung adenocarcinoma, including 41 cases without metastasis, 38 cases with lymphatic metastasis and 46 cases with brain metastasis. The correlation of GLUT1 and HIF-1α in lung adenocarcinoma metastasis was analyzed by using x 2 test and Pearson correlation analysis. Results Most lung adenocarcinoma were histologically heterogeneous, which contained more than one adenocarcinoma type. 73.2 % (30/41) cases were acinar predominant adenocarcinoma in lung adenocarcinoma without metastasis; 53.6 % (15/38) cases were acinar predominant adenocarcinoma and 26.3 % (10/38) cases were solid predominant adenocarcinoma in lung adenocarcinoma with lymphatic metastasis; 47.8 % (22/46) cases were papillary predominant adenocarcinoma and 34.8 % (16/46) cases were solid predominant adenocarcinoma in lung adenocarcinoma with brain metastases. The expression level of GLUT1 and HIF-1α in lung adenocarcinoma with lymphatic metastasis group was higher than that of the group without tumor metastasis (P< 0.05); the expression of GLUT1 and HIF-1α were positively correlated (r=0.407, P=0.000). Conclusions Papillary adenocarcinoma is the most histological type in lung adenocarcinoma with brain metastasis, suggesting that papillary adenocarcinoma is more prone to brain metastasis. The expression of GLUT1 and HIF-1α play an important role in lymph node metastasis and brain metastasis of lung adenocarcinoma.

Objective To investigate the current situation of community health service requirements and health-seeking behaviors of the elderly in Yuzhong District of Chongqing City and analyse its mainly influencing factors,in order to provide references for further promoting hierarchical medical pattern.Methods A total of 410 elderly persons aged 60 year old or older treated in four community health service centers in Yuzhong district of Chongqing city in June 2015 were recruited by using multi-stage random sampling technique.The basic information about demography,cognitions and requirements of community health service,cost of health service and health-seeking behaviors were surveyed via questionnaire,and were analysed.Results A total of 402 effective questionnaires were returned,and the effective response rate was 98.05％.There were 76.37％ of elderly persons firstly selected community health service centers for disease treatment.The main factors affected health-seeking behaviors of the elderly were suffering from the coronary heart disease,the waiting time in community health service centers,the medical costs per month,facilities and environment of the community health service centers and whether to pay for health insurance.Conclusion Community health centers should make full use of their own advantages and convenience.It is necessary to provide characteristic services for the corresponding elderly patients,and increase the public health input.All of these are intended to raise the synthesized level of diagnosis and treatment in community health service centers,and change health-seeking behaviors of elderly patients fundamentally.

Objective:To reveal the action mechanism and efficacy of electroacupuncture (EA) plus external application of Wei Ling Xian (Radix Clematidis) extract in treating knee osteoarthritis (KOA), for providing theoretical evidence and novel plan for the treatment of KOA.Methods:Totally 284 inpatients were divided into an EA group and an observation group by the random number table, 142 cases in each group. The EA group was intervened by EA, ultrashort waves, and oral administration of Glucosamine Hydrochloride capsules; while the observation group was by external application of Wei Ling Xian (Radix Clematidis) extract at topical area in addition to the treatment given to the EA group. The intervention lasted 14 d in both groups. X-ray examination of knee joint was ordered before and after treatment, as well as the detection of positive expression of matrix metalloproteinase-1 (MMP-1) in cartilage of knee joint, hyaluronic acid (HA) and interleukin-1β (IL-1β) in the inflammatory effusion; the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and visual analogue scale (VAS) were adopted to evaluate the clinical efficacy.Results:In the observation group, the X-ray examination result of knee joint was significantly improved, the positive expressions of MMP-1 and IL-1β content were significantly decreased, the level of HA was increased, WOMAC and VAS scores dropped, and the total effective rate was 91.5%, which were significantly different from those in the EA group (P<0.05).Conclusion:EA plus external application of Wei Ling Xian (Radix Clematidis) extract can produce a more significant efficacy in treating KOA compared to ordinary EA treatment.

Objective To comprehensively evaluate the effectiveness of health education interventions on endemic fluorosis for Chinese students and housewives,and to provide a basis for prevention and control of the disease.Methods A computerized literature search was carried out in CBM(Chinese Biomedical Database),CNKI (Chinese National Knowledge Infrastructure),Wan-fang,VIP,Pub-Med,Web of Knowledge and EBSCO to collect articles published at home and abroad between 1994-2012 concerning the effectiveness of health education interventions on endemic fluorosis for Chinese students and housewives.The study was a self-controlled intervention study.The quality of literature was evaluated using the standards of Cochrane and EPOC.Meta-analysis was performed to assess the knowledge about fluorosis prevention using Rev-Man 5.0.Homogeneous data(P ＞ 0.05) was analyzed using a fixed effects model,and heterogeneous data (P≤ 0.05) was analyzed using a random effects model.Results A total of 146 Chinese research papers and 192 English research papers were retrieved.By screening,35 Chinese research papers meet the standards.After reading the full text,6 papers were selected.English literature was not found.According to EPOC criteria all the six literatures included were grade B.Because heterogeneity of the literatures was higher,knowledge point was stratify analyzed according to the study subjects.The intervention effect of students was higher than that of the housewives.After the intervention,the fluorosis disease prevention knowledge awareness of schoolchildren and housewives were increased by 28％ and 26％.Conclusions Health education has a good effect in improving the knowledge of fluorosis for Chinese students and housewives.