Objective:To investigate the application effect of case-based collaborative learning (CBCL) based on data-information-knowledge-wisdom (DKIW) model in the training of the informatization teaching ability of clinical teachers.Methods:From March to August in 2022, 71 clinical teachers from four grade A tertiary hospitals in Tianjin, China, were selected as subjects and were randomly divided into control group with 35 patients and experimental group with 36 patients using a random number table. The teachers in the control group received blended teaching online and offline, and those in the experimental group received CBCL teaching based on DIKW model. The two groups were compared in terms of theoretical assessment score, informatization teaching demonstration score, and informatization teaching ability score before and after intervention. SPSS 27.0 was used for the t-test and the Mann-Whitney U rank sum test. Results:Compared with the control group after intervention, the experimental group had significantly higher scores of theoretical assessment (83.50±3.11) and informatization teaching demonstration (84.19±1.89) ( P<0.05). After intervention, the control group had significant increases in the total score of informatization teaching ability (74.34±4.08) and the scores of each dimension (15.40±1.19, 19.29±1.62, 28.54±1.67, and 11.11±1.79), and the experimental group also had significant increases in the total score of informatization teaching ability (83.64±5.25) and the scores of each dimension (16.53±1.21, 20.94±1.98, 33.03±2.10, and 13.14±1.48); the experimental group had significantly higher scores than the control group ( P<0.05). Conclusions:The CBCL teaching model based on DIKW model can help to improve the comprehensive informatization teaching ability of clinical teachers.

Bluetongue virus is an arbovirus that seriously harms ruminants such as sheep,this study aims to investigate the molecular mechanism of bluetongue virus infection and host cell interferon antiviral immune response.The study was conducted to characterize the mRNA expression of inter-feron pathway genes by real-time fluorescence quantitative PCR,as well as Western blot analysis of MDA5,TRAF3,RIG-Ⅰ,and TBK1 protein expression in BHK-21 cells induced by BTV with a multiplicity of infections(MOI)of 1 for 18,24,and 36 h.The results showed that the most pro-nounced changes in the expression of interferon signaling pathway genes were observed at 24 h of induction,the gene mRNA expression levels of the IFN-α,IFN-β,RIG-Ⅰ,TBK1,MDA5,VISA,and TRAF3 genes were upregulated.However,the mRNA expression levels of IKKε and TRAF6 genes were downregulated.At the protein level,MDA5 and TBK1 proteins were upregulated while RIG-1 and TRAF3 proteins were downregulated,which showed that BTV infection induces a typeⅠ interferon immune response in BHK-21 cells.This study lays the foundation for further exploring the antiviral immunity mechanism of IFN-Ⅰ signaling pathway regulatory genes in host cells infected with BTV infection.

Objective:To construct a prediction model of psychological distress risk in young and middle-aged patients with gynecologic malignancy based on random forest algorithm and validate its prediction effect, which provided a tool for healthcare professionals to detect patients′ psychological distress in early stage.Methods:This was a cross-sectional study, a total of 385 cases of young and middle-aged patients with gynecologic malignancies admitted to the gynecology and oncology departments of six tertiary hospitals in Tianjin from October 2021 to October 2022 were consecutively included, the study subjects were randomly divided into 270 cases in the training set and 115 cases in the testing set according to 7:3 by R-studio software. After grouping the training set patients according to the presence or absence of psychological distress (positive psychological distress 151 cases and negative psychological distress 119 cases), univariate analysis was performed on each influencing factor. A random forest model for the prediction of psychological distress in young and middle-aged gynecological malignancy patients using R-studio software on the training set, and the prediction effect was verified on the testing set.Results:The prediction accuracy was 94.78%, sensitivity was 96.88%, specificity was 92.16%, positive predictive value was 93.94%, negative predictive value was 95.92%, and AUC was 0.992 (95% CI 0.982-1.000). The top 5 significant predictor variables were ranked according to the average decrease in the Gini coefficient of each influencing factor in the random forest model: General Self-Efficacy Scale score, Herth Hope Index score, Perceived Social Support Scale score, Self-Rating Depression Scale score, Self-Rating Anxiety Scale score. Conclusions:In this study, the prediction model of psychological distress in young and middle-aged patients with gynecologic malignancy constructed by random forest algorithm has high predictive efficacy, which provides reference for healthcare professionals to identify patients′ psychological distress early and formulate interventions.

Objective:To develop the Care Needs Scale for Young and Middle-aged Terminally Ill Patients and test its reliability and validity, so as to provide an effective tool for evaluating the care needs of young and middle-aged terminally ill patients for medical and nursing staff.Methods:This study is a cross-sectional study. Guided by the theory of supportive care needs, an initial scale was formed through literature review, qualitative interviews, Delphi expert consultation, and pre-survey. From July to September 2022, convenience sampling was used to select 570 young and middle-aged terminally ill patients hospitalized in the Oncology Department and Hospice Care Ward of six Class Ⅲ hospitals in Tianjin as the research subject, and a questionnaire survey was conducted on the patients. The items in the scale were selected using item analysis method. The structural validity of the scale was evaluated using exploratory factor analysis and confirmatory factor analysis. The content validity of the scale was evaluated using the scale-level content validity index and the item-level content validity index. The reliability of the scale was evaluated using internal consistency coefficient and half reliability coefficient. A total of 570 questionnaires were distributed, and 565 valid questionnaires were collected, with an effective response rate of 99.12% (565/570) .Results:A total of 18 experts completed two rounds of consultation, with an expert authority coefficient of 0.890, the Kendall's W values of 0.309 and 0.417, respectively ( P<0.05). The Care Needs Scale for Young and Middle-aged Terminally Ill Patients included 6 dimensions and a total of 39 items. Exploratory factor analysis extracted 6 common factors, with a cumulative variance contribution rate of 71.515%. Confirmatory factor analysis showed that the overall model fitted well. The content validity index at the scale level was 0.942, and the content validity index at the item level was 0.833 to 1.000. The total Cronbach's α coefficient of the scale was 0.975, and the half reliability coefficient was 0.911. Conclusions:The reliability and validity of the Care Needs Scale for Young and Middle-aged Terminally Ill Patients are good, and it can be used as an evaluation tool for the care needs of young and middle-aged terminally ill patients.

Objective:To investigate the correlation between activities of daily living and hemoglobin level in patients with acute ischemic stroke (AIS).Methods:A retrospective analysis was performed in 190 patients with acute ischemic stroke from August 2015 to April 2017. The hemoglobin (Hb) levels at admission were analyzed . According to the Barthel index (BI) score, the patients were divided into good improvement group ( n=119) and poor improvement group ( n=71). Spearman correlation analysis was used to study the relationship between hemoglobin level and short-term activities of daily living in patients with acute ischemic stroke. Results:(1)The short-term activities of daily living was improved in 119 patients. Among them, 62 (52.1%) were under 65 years old and 57 (47.9%) were over 65 years old, 9 (7.56%) male patients with hemoglobin <120 g/L and 39 (32.77%) male patients with hemoglobin > 150 g/L. There were 71 patients with poor short-term activities of daily living. Among them, 23(32.39%)were under 65 years old and 48(67.61%)were over 65 years old, 1(1.41%)male patients with hemoglobin <120 g/L and 12(16.9%) male patients with hemoglobin > 150 g/L. There were significant differences in age (χ 2= 6.985, P=0.008) and male hemoglobin level (χ 2= 8.069, P=0.005) between patients with good activities of daily living and patients with poor activities of daily living.(2)Regression analysis showed that age > 65 years ( β =1.386, OR=4.000, 95% CI=1.189-3.461, P=0.025) and abnormal hemoglobin levels in men (Hb<120 g/L or > 150 g/L) ( β =1.089, OR=2.972, 95% CI=1.383-6.388, P=0.005) were the influencing factors of poor short-term quality of life in patients with acute ischemic stroke.(3)Spearman correlation analysis showed that abnormal hemoglobin levels in men (Hb<120 g/L or>150 g/L) were positively correlated with poor short-term activities of daily living in patients with acute ischemic stroke( r=0.244, P=0.004). Conclusion:Abnormal hemoglobin level is associated with poor short-term activities of daily living improvement in patients with acute ischemic stroke.

Objective:To investigate the correlation between serum 25-hydroxyvitamin D (serum 25(OH)D) and Meige syndrome.Methods:A retrospective analysis was performed on 47 patients with Meige syndrome (Meige syndrome group) treated in Yuquan Hospital of Tsinghua University admitted from August 2012 to July 2018 in our hospital.In the same period, 69 healthy people of the same age group were selected as the healthy control group.The difference of serum 25(OH)D concentration among different subtypes of Meige syndrome (type I, II, III) was compared.Logistic regression analysis was used to analyze the correlation between serum 25(OH)D level and Meige syndrome.Results:The serum 25(OH)D concentration in patients with Meige syndrome was (12.68±6.77) μg/L, which was significantly lower than that in the healthy control group ((17.93±6.93) μg/L). The difference was statistically significant ( t=4.044, P<0.001). The serum 25(OH)D concentrations of subtypes I, II and III in patients with Meige syndrome were (14.7±8.14), (11.4±5.02), (8.38±4.99) μg/L, respectively. There was no significant difference among the three types ( F=1.892, P=0.231). Logistic regression results showed that serum 25(OH)D levels were correlated with Meige syndrome ( OR=0.938, 95% CI: 0.885-0.995, P=0.034). Conclusion:The serum 25(OH)D expression level in patients with Meige syndrome is low, suggesting that vitamin D deficiency may be involved in the pathogenesis of Meige syndrome.

Objective To explore the effects of husband and wife joint education model on marriage adjustment and birth and quality of life in female patients with infertility. Methods Totally 360 sterile females who received In Vitro Fertilization-Embryo Transfer (IVF-ET) in the Fertility Dpartment of a Class Ⅲ Grade A hospital in Wenzhou were selected using convenient sampling from June to August 2018. The study subjects were randomly divided into intervention (n=180) and control (n=180) groups. The conventional nursing method was used in the control group, and the husband and wife joint education model was applied in the intervention group after the conventional nursing. On the basis of transplantation, the dyadic adjustment scale and birth and quality of life scale were used before the patients were discharged to compare the result of marriage adjustment and birth and quality of life in the two groups. Results The martial adjustment score and birth and quality of life score in the intervention group scored (114.56±20.64) and (68.05±15.18) respectively, both higher than those of the control group, and there was statistically significant difference between the two groups (P＜0.05). Conclusions Husband and wife joint education model can not only promote the intimate relationship between patients and their spouse, but also improve their quality of life, which is worth applying in the clinical care of patients with infertility.

OBJECTIVETo investigate the effect of high-intensity focused ultrasound (HIFU) on tumor metastasis in mouse model bearing melanoma xenograft.

METHODSMice bearing murine melanoma B16-F10 cell xenograft were randomized for sham-HIFU or HIFU exposure when the tumors grew to a maximum diameter of 7-10 mm, and the tumor size was measured every 3 days. The cumulative survival rate of the mice and tumor metastasis rate were calculated, and the circulating melanoma cells were detected using qRT-PCR. At 14 days after HIFU treatment, B16-F10 cells were retransplanted via the tail vein and the pulmonary metastatic nodules were counted.

RESULTSThe median survival time of the mice was 19.00 days (95% CI 17.14-20.86 days) in the sham group and 26.00 days (95%CI 24.76-27.25 days) in HIFU group. The cumulative survival rate in the HIFU group was significantly higher than that in sham-HIFU group (P<0.01), and the tumor size was significantly smaller in HIFU group at 20, 23, and 26 days after HIFU treatment (P<0.05). Compared with the sham-HIFU group, HIFU group had significantly lower levels of MAGE-A3, MART1 and PAX3 at 7 days after HIFU (P<0.05) with still lower MAGE-A3 level at 14 days (P<0.05). HIFU group showed a significantly smaller number of pulmonary metastatic nodules following tumor cell retransplantation than in sham-HIFU group (P<0.01) with a metastasis inhibition rate of 42.4%.

CONCLUSIONHIFU treatment can inhibit tumor metastasis in melanoma-bearing mice possibly by reducing tumor cell detachment from the primary tumor site and suppressing colonization of the circulating melanoma cells.

Objective To investigate the effect of high-intensity focused ultrasound (HIFU) on tumor metastasis in mouse model bearing melanoma xenograft. Methods Mice bearing murine melanoma B16-F10 cell xenograft were randomized for sham-HIFU or HIFU exposure when the tumors grew to a maximum diameter of 7-10 mm, and the tumor size was measured every 3 days. The cumulative survival rate of the mice and tumor metastasis rate were calculated, and the circulating melanoma cells were detected using qRT-PCR. At 14 days after HIFU treatment, B16-F10 cells were retransplanted via the tail vein and the pulmonary metastatic nodules were counted. Results The median survival time of the mice was 19.00 days (95 % CI 17.14-20.86 days) in the sham group and 26.00 days (95%CI 24.76-27.25 days) in HIFU group. The cumulative survival rate in the HIFU group was significantly higher than that in sham-HIFU group (P<0.01), and the tumor size was significantly smaller in HIFU group at 20, 23, and 26 days after HIFU treatment (P<0.05). Compared with the sham-HIFU group, HIFU group had significantly lower levels of MAGE-A3, MART1 and PAX3 at 7 days after HIFU (P<0.05) with still lower MAGE-A3 level at 14 days (P<0.05). HIFU group showed a significantly smaller number of pulmonary metastatic nodules following tumor cell retransplantation than in sham-HIFU group (P<0.01) with a metastasis inhibition rate of 42.4%. Conclusion HIFU treatment can inhibit tumor metastasis in melanoma-bearing mice possibly by reducing tumor cell detachment from the primary tumor site and suppressing colonization of the circulating melanoma cells.

Objective To investigate the effect of high-intensity focused ultrasound (HIFU) on tumor metastasis in mouse model bearing melanoma xenograft. Methods Mice bearing murine melanoma B16-F10 cell xenograft were randomized for sham-HIFU or HIFU exposure when the tumors grew to a maximum diameter of 7-10 mm, and the tumor size was measured every 3 days. The cumulative survival rate of the mice and tumor metastasis rate were calculated, and the circulating melanoma cells were detected using qRT-PCR. At 14 days after HIFU treatment, B16-F10 cells were retransplanted via the tail vein and the pulmonary metastatic nodules were counted. Results The median survival time of the mice was 19.00 days (95 % CI 17.14-20.86 days) in the sham group and 26.00 days (95%CI 24.76-27.25 days) in HIFU group. The cumulative survival rate in the HIFU group was significantly higher than that in sham-HIFU group (P<0.01), and the tumor size was significantly smaller in HIFU group at 20, 23, and 26 days after HIFU treatment (P<0.05). Compared with the sham-HIFU group, HIFU group had significantly lower levels of MAGE-A3, MART1 and PAX3 at 7 days after HIFU (P<0.05) with still lower MAGE-A3 level at 14 days (P<0.05). HIFU group showed a significantly smaller number of pulmonary metastatic nodules following tumor cell retransplantation than in sham-HIFU group (P<0.01) with a metastasis inhibition rate of 42.4%. Conclusion HIFU treatment can inhibit tumor metastasis in melanoma-bearing mice possibly by reducing tumor cell detachment from the primary tumor site and suppressing colonization of the circulating melanoma cells.