Objective:To investigate the effect of BOPPPS teaching model combined with virtual simulation technologyin the teaching of Prevention and treatment of Major Infectious Diseases,in order to explore innovative teaching model and provide evidence for improving students'comprehensive ability to deal with major infectious disease events.Methods:Undergraduates from three classes of preventive medicine major in a medical university were selected as the research objects.One class was given the new teaching model,and the other two classes were given the traditional teaching model.The total scores,the theoretical score and the skill score were compared between the two groups.Results:A total of 141 students participated in the survey,49 students in the new teaching model group,and 92 students in the traditional teaching model group.The results showed that compared with the traditional model group,the total score,the theoretical score,the skill score of the new model group was significantly higher(P＜0.01).However,there was no significant difference between male and female students in each group(P＞0.05).Conclusions:Compared with the traditional teaching model,the students in the new teaching model has a good teaching effect,which can improve the students'theoretical knowledge level,cultivate the students'emergency response ability,and improve the students'comprehensive ability of discovery,analysis and solution.Boys and girls have the same acceptance of the two teaching models,and gender does not affect the teaching effect.

Objective To investigate the relationship between pentraxin 3(PTX3)and first-pass effect of mechanical thrombectomy in patients with large vessel occlusion acute ischemic stroke(AIS).Methods A total of 136 AIS patients with large vessel occlusion treated in Liaocheng People's Hospital from January to August 2023 were selected,and they were divided into first pass group(n=41)and non-first pass group(n=95)according to whether they achieved first-pass effect of mechanical thrombectomy.The clinical data of all patients were collected and the serum PTX3 levels were detected.All patients were followed up for 3 months,and the prognosis was evaluated according to the modified Rankin score.Multivariate Logistic regression was used to analyze the influencing factors of first-pass effect in AIS patients with large vessel occlusion.ROC analysis was used to analyze the predictive value of serum PTX3 for first-pass effect in AIS patients with large vessel occlusion.Results The rate of good prognosis in the first pass group was higher than that in the non-first pass group(56.10％vs 36.84％),and the difference was significant(x2=4.341,P=0.037).Compared with the non-first pass group,the age(59.38±5.12 years),the proportion of hypertension(43.90％),the National Institutes of Health Stroke Scale(NIHSS)score at admission(13.58±4.16 score)in the first pass group and serum PTX3 level(1.21±0.32 ng/L)in the first pass group were lower than those in the failed group(63.45±7.61 years,65.26％,15.75±5.13 score,1.71±0.41 ng/L),and the differences were significant(t/x2=3.129,5.395,2.389,6.944,all P＜0.05).Multivariate Logistic regression analysis showed that younger age[OR(95％CI):0.859(0.752～0.982)],no hypertension[OR(95％CI):0.672(0.480～0.942)],decreased NIHSS score at admission[OR(95％CI):0.867(0.781～0.962)]and decreased serum PTX3 levels[OR(95％CI):0.558(0.326～0.954)]were the influencing factors of the first-pass effect of mechanical thrombectomy in AIS patients with large vessel occlusion(Waldx2=4.997,5.238,7.280,4.543,all P＜0.05).After 3 months of follow-up,the serum PTX3 level of the good prognosis group was lower than that of the poor prognosis group(1.28±0.39 ng/L vs 1.65±0.43 ng/L),and the difference was significant(t=5.111,P＜0.001).ROC analysis showed that serum PTX3 had a high predictive value for first-pass effect and poor prognosis in AIS patients with large vessel occlusion,with the areas under the curve(95％CI)of 0.785(0.703～0.866)and 0.734(0.651～0.806),respectively,and their optimal cut-off values were 1.38 ng/L and 1.56 ng/L,respectively.Conclusion The first-pass effect of mechanical thrombectomy in AIS patients with large vessel occlusion is beneficial to the short-term prognosis.The expression of serum PTX3 is closely related to the first-pass effect in AIS patients with large vessel occlusion,and this index could have a high predictive value for whether the patients can achieve the first-pass effect.

Objective:To analyze the risk factors of acute kidney injury (AKI) in hip fracture patients with serious underlying diseases and establish a prediction nomogram.Methods:Clinical information of hip fracture patients admitted to the intensive care unit (ICU) of Beth Israel Deaconess Medical Center (BIDMC) was analyzed using the Medical Information Mart for Intensive Care (MIMIC)-IV. Patient comorbidities, disease scores, vital signs and laboratory tests, surgical modalities, invasive procedures, and drug use were recorded. According to the diagnostic criteria of AKI in the Kidney Disease Improving Global Outcome (KDIGO) guideline, the enrolled patients were randomly divided into training set and validation set. Based on logistic regression analysis, least absolute shrinkage and selection operator (LASSO) logistic regression algorithm was used to analyze the risk factors of AKI after admission, and the corresponding prediction model was calculated.Results:A total of 474 patients were enrolled, including 331 in the training set and 143 in the validation set. According to the diagnostic criteria of AKI of KDIGO guidelines, the patients were divided into AKI group (159 cases) and non-AKI group (172 cases). Univariate analysis showed that age ( t=2.61, P=0.009), coronary heart disease (χ 2=2.08, P=0.038), heart failure (χ 2=2.60, P=0.009), hemoglobin ( t=1.89, P=0.059), platelets ( t=1.81, P=0.070), urea nitrogen ( t=2.83, P=0.005), blood creatinine ( t=3.65, P<0.001), blood sodium ( t=2.55, P=0.011), blood glucose ( t=2.52, P=0.012), anion gap ( t=3.44, P=0.001), diastolic blood pressure ( t=2.72, P=0.007), mean arterial pressure ( t=2.16, P=0.031), SOFA score ( t=3.69, P<0.001), simplified acute physiological function score II (SAPSII) score ( t=2.95, P=0.003), as well as furosemide (χ 2=2.03, P=0.042), vancomycin (χ 2=1.70, P=0.089), vasoactive medications (χ 2=3.74, P<0.001) and use of invasive mechanical ventilation (χ 2=4.81, P<0.001) were risk factors associated with the development of AKI in hip fracture patients. Multivariate logistic regression analysis showed that age ( OR=1.03, P<0.001), coronary heart disease ( OR=2.05, P=0.069), hemoglobin ( OR=0.88, P=0.050), blood creatinine ( OR=1.37, P=0.009), blood sodium ( OR=1.07, P=0.026), anion gap ( OR=1.09, P=0.028) and vasoactive medications ( OR=3.83, P=0.018) and the use of invasive mechanical ventilation ( OR=6.56, P<0.001) were independent predictors of the development of AKI in hip fracture patients with serious underlying diseases. The area under the curve of the nomogram prediction model constructed by the above 8 predictors was 0.789, and the calibration curve of the nomogram was close to the ideal diagonal. Decision curve analysis showed that the net benefit of the model was significant. Conclusion:The incidence of AKI is high in hip fracture patients with serious underlying diseases. Age, coronary heart disease, hemoglobin, serum creatinine, serum sodium, anion gap, vasoactive drugs, and invasive mechanical ventilation can predict the occurrence of AKI to a certain extent. Combined with the risk factors, the construction of the corresponding prediction model can predict and manage the diagnosis and treatment of AKI in patients with hip fracture complicated with severe underlying diseases.

Objective:To investigate the relationship between the expression level of thymocyte selection-associated high mobility group box protein ( TOX) gene and the radiosensitivity of lower-grade glioma (LGG) patients. Methods:Using bioinformatics research methods, 474 LGG patients from The Cancer Genome Atlas (TCGA) database were selected as the test set (TCGA-474 set), and two different genetic data sets ( n=412 and n=171) from the Chinese Glioma Genome Atlas (CGGA) database were selected as the validation set (CGGA-412 set and CGGA-171 set). Patients were stratified based on whether received radiotherapy, and divided into the high and low TOX expression group according to the expression level of TOX gene in LGG. Survival curves of all patients were plotted. The overall survival (OS) and progression-free survival (PFS) of patients in the high and low TOX expression groups were compared and analyzed using log-rank test. Results:Multivariate analysis of OS in the TCGA-474 set showed that high expression of TOX was a protective factor for OS ( HR=0.061, 95% CI: 0.005-0.791, P=0.044). After stratification analysis based on radiotherapy and adjustment for confounding factors, the HR (95% CI) of patients with high TOX expression in the TCGA-474, CGGA-412, and CGGA-171 sets were 0.405 (0.261-0.629), 0.581 (0.418-0.806), and 0.464 (0.269-0.800), respectively, with P values of <0.001, 0.001, and 0.008, respectively. Among patients receiving radiotherapy in the TCGA-474 set, the OS and PFS of patients with high TOX expression were significantly longer than those in the low TOX expression group, and the differences were statistically significant (both P<0.001). The OS benefit of patients with high expression of TOX was significantly prolonged in both the CGGA-412 and CGGA-171 sets compared to those with low TOX expression, and the differences were statistically significant (both P<0.001). Conclusion:The high expression of TOX may be related to the radiosensitivity of LGG, which may be a gene marker of the radiosensitivity of LGG.

We researched the mechanism of African swine fever virus (ASFV) protein E248R in regulating the cGAS-STING pathway. First, we verified via the dual-luciferase reporter assay system that E248R protein inhibited the secretion of IFN-β induced by cGAS-STING or HT-DNA in a dose-dependent manner. The relative quantitative PCR analysis indicated that the overexpression of E248R inhibited HT-DNA-induced transcription of IFN-b1, RANTES, IL-6, and TNF-α in PK-15 cells. Next, we found that E248R interacted with STING by co-immunoprecipitation assay and laser confocal microscopy. Finally, we demonstrated that E248R inhibited the expression of STING protein by using Western blotting. We demonstrated for the first time that the E248R protein of ASFV suppressed the host innate immune response via inhibiting STING expression. The results are pivotal in extending the understanding of the ASFV immune escape and can guide the design of vaccines against ASFV.
African Swine Fever Virus/genetics* ; Animals ; DNA ; Immunity, Innate ; Nucleotidyltransferases/metabolism* ; Signal Transduction ; Swine

Objective: To explore the application effect of fine needle aspiration cytology and sentinel lymph nodes stain assisted by contrast-enhanced ultrasound in early breast cancer. Methods: A patient with early breast cancer enrolled in Beijing Friendship Hospital, Capital Medical University received fine needle aspiration cytology assisted by contrast-enhanced ultrasonography and the sentinel lymph nodes were stained with blue dye before a standard sentinel lymph nodes biopsy traced with indocyanine green. The axillary status accessed by these two methods were compared. Results: Three sentinel lymph nodes were found and aspirated assisted by contrast-enhanced ultrasonography. Seven sentinel lymph nodes were obtained in sentinel lymph nodes biopsy surgery. All of these sentinel lymph nodes were negative. The stained sentinel lymph nodes could be recognized and dissected in open lymph nodes biopsy surgery. Conclusions Fine needle aspiration cytology assisted by contrast-enhanced ultrasonography could be a substitute for open sentinel lymph nodes biopsy. More related researches should be carry out to further compare these two methods.

Objective:To understand the duration of survival and related influencing factors of HIV/AIDS patients in Liuzhou city.Methods:Both life table method and Kaplan-Meier method were used to calculate the average survival time of HIV/AIDS patients aged ≥15 years reported in Liuzhou city from 2008 to 2018. Factors related to the duration of HIV/AIDS patients were analyzed by univariate and multivariate Cox regression models.Results:A total of 14 856 patients with HIV/AIDS were involved in this study and with the average duration of survival time as 98.74 (95 %CI: 97.73-99.75) months. The cumulative survival rates of 1, 3, 5 and 10 years were 77.0%, 72.0%, 68.0%, 61.0% respectively. Results from the multivariate Cox proportional risk regression analysis showed that factors as sex, level of education, age when HIV infection was confirmed, occupation, route of transmission, source of samples, results of the first CD 4 test and antiviral treatment were all related to the duration of survival to the HIV/AIDS patients. Conclusions:Strategies involving early detection of HIV infection, improvement of the CD 4 initial detection rate and early antiviral treatment will help to significantly reduce the risk of death in HIV/AIDS population. Focus should be on male, middle-aged and elderly (over 41 years old), junior high school education or below farmers and migrant worker populations.

[Objective] To investigate associations between the functional polymorphisms of signal transducer and activator of transcription 4 (STAT4) gene and unexplained recurrent spontaneous abortion (URSA) and between STAT4 protein expression and the genotypes of rs 10181656 locus.[Methods] PCR-restriction fragment length polymorphism was used to genotype rs 1 0181656 locus polymorphism in 332 URSA cases and 260 normal controls,in 86 URSA cases and 77 normal controls of which immunohistochemical technique was used to detect STAT4 protein expression.[Results] The frequencies of rs10181656 C/G were 36.45 ％,46.54％ in genotype C/C,46.99％,45.38％ in genotype C/G and 16.57％,8.08％ in genotype G/G between URSA patients and normal controls.They reached statistical difference (P ＜ 0.05).The carriers of rs 10181656 G allele increased the risk of URSA (OR =1.50,P ＜ 0.05).STAT4 protein expression in decidual tissues:①There was statistical difference in the STAT4 protein expression in decidual tissues between cases and controls (P ＜ 0.05).In URSA patients there was statistical difference in the STAT4 protein expression among genotype CC,CG and GG of rs10181656 locus (P ＜ 0.05).So was in normal controls (P ＜ 0.05).In genotype CC there was no difference in the STAT4 protein expression between cases and controls (P ＞ 0.05).Neither was In genotype CG and GG respectively (P all ＞ 0.05).[Conclusion] Functional polymorphisms of the rs10181656 locus could probably associate with the susceptibility of URSA via STAT4 protein expression increased by genotype G/G in maternal decidual tissue.

Objective To discuss the clinical features of Traumatic Spinopelvic Dissociation(TSD) and to evaluate the clinical results treated by lumbopelvic fixation by retrospective case study.Methods From July 2008 to December 2012,twelve patients of Traumatic Spinopelvic Dissociations were surgically treated at our department in Tianjin Hospital.There were 8 males and 4 females with a mean age of 34.6±9.2 years(range,18-50 years).The causes of injuries were fall or jump from height (11 patients) and traffic injury (1 patient).All the fractures were closed injuries and associated injuries in different degrees were noted in all the patients.The sacral fractures were classified according to fracture shape,with 4 cases of U shape,6 cases of H shape and 2 cases of Y shape.The transverse part of the sacral fractures were classified by Roy-Camille classification,and there were 6 cases of type Ⅱ and 6 cases of type Ⅲ.All the 12 patients were surgically treated by lumbopelvic fixation of a posterior approach,and 6 patients with significant neurological impairments were performed with sacral decompression via the same approach.The clinical results were evaluated by Majeed functional evaluation and the neurological impairments were evaluated by Gibbons score.Results All the patients were followed up on an average of 15.5±6.3 months (range,12-36 months).The diagnosis of the TSD were missed or delayed in 9 of the 12 patients.There were different neurological impairments in all the 12 patients.All the fractures healed in a mean time of 4.8±2.8 months(range,4-8 months).Clinical outcome was rated excellent in 4 patients,good in 4 patients,fair in 2 patients,and poor in 2 patients,according to the Majeed functional evaluation,and the excellent and good rate was 66.7％ (8/12).The neurological injuries were recovered completely or partially in sensation and motion in 11 of all 12 patients (91.7％).For the neural decompression patients,the neurological injuries were recovered completely or partially in sensation and motion in 5 of all 6 patients (83.3％).At last follow up,the average Gibbons score improved from 3.25 preoperatively to 1.67 postoperatively,with significant difference.Conclusion TSD is a rare high-energy injury pattern.It has a high rate of associated injuries and neurological impairments.The correct diagnosis of the injury pattern is easy to be missed or delayed.Surgical procedure of lumbopelvic fixation via post approach should be considered as the method of choice.Early neural decompression for the patients with obvious indications could be helpful in overall neurological and functional recoveries.

Objective To observe the impact of the diverse caloric energy intake on the outcomes and occurrence rate of complications in septic patients.Methods A prospective single-blind randomized controlled trial was conducted.158 cases of septic patients in intensive care unit (ICU) were enrolled and randomly assigned to three groups according to their different target value of nutrition:group A [measurements of resting energy expenditure (MREE)＜90％],B (MREE 90％-110％) and C (MREE ＞ 110％).The caloric intake,mechanical ventilation duration (MVD),nosocomial infection rate,28-day and 60-day mortality were analyzed.Results Daily energy intake in 7 days after ICU admission was as follows:the difference in target value of nutrition(kJ/d:7 075.0 ± 1 046.5,5 667.8 ± 1 908.8,4 428.8 ± 1 377.8),calory intake (kJ/d:4 671.6 ± 1 205.6,5 655.3 ± 1 373.0,6 053.0 ± 1 557.2),enteral nutrition value (kJ/d:2 051.1 ± 1 046.5,3 980.9 ± 1 586.5,5 337.1 ±2 921.8) and average intake rate [(66.0 ± 15.8)％,(100.0 ± 5.7)％,(134.0 ± 19.7)％],and they were statistically significant difference among A,B,C groups (all P＜0.05).The parenteral nutrition in group C were much higher than that in group A and group B (kJ/d:2 055.3 ± 273.4vs.427.0 ± 273.4,473.0 ± 332.0,both P＜0.05).The calories provided by glucose and diprivan were similar among three groups.The MVD and ICU stay were shorter in group B than that in groups A and C [MVD (days):8.4 ± 6.3 vs.11.0 ± 8.2,17.8 ± 13.0,P＞ 0.05 and P＜ 0.05 ; ICU stay (days):11.0 ± 6.4 vs.14.9 ± 9.6,17.8 ± 13.0,respectively,P＞0.05 and P＜0.05].The total hospital stay (days:32.0 ± 22.5,26.8 ± 7.0,30.4 ± 21.4) and nosocomial infection rate [91.1％ (51/56),84.0％ (42/50),90.4％ (47/52)] were similar among A,B,C groups (all P＞0.05).There was no difference in survival rate at 28 days among three groups as shown by the Kaplan-Meier survival curve (F=3.145,P=0.076).The survival rate at 60 days showed a tendency of lowering in groups A and C,especially in group C (F=9.284,P=0.010).Conclusion Both higher and lower caloric energy intake may be associated with an adverse impact,but appropriate caloric intake would improve the outcome and reduce the complication rate in septic patients.