Taking Kunming Medical University as an example, we explore the mechanism for the separation and coordination of supervision, management, and evaluation, establish and implement a course quality rating system, and strengthen the course quality evaluation. The course quality rating system mainly consists of merit evaluation for courses of grades A and B and admittance evaluation for courses of grades C and D. Through the course quality rating, courses are diagnosed and compared, with the aim to improve course connotation construction (labeling, setting an example, promoting excellent courses, and removing inferior courses), achieve "good pay for good courses", encourage the faculty to strengthen curriculum quality, and measure ourselves with our own ruler. We discussed the problems about the difference in evaluation indicators, the professionality of evaluators, and the incentive effect of evaluation results, and also proposed strategies for improving course quality rating in medical colleges from the perspectives of deepening the content of evaluation indices, ensuring the effectiveness after evaluation, and ascertaining the main body of course construction in daily work.

BackgroundSuicide ideation in adolescent inpatients with depression is a multi-factorial problem， and perceived stress is considered to be closely related to suicide ideation， while its mediating role in suicide ideation among adolescent inpatients with depression remains unclear. ObjectiveTo explore the mediating effect of psychological capital on the relationship between perceived stress and suicide ideation among adolescent inpatients with depression， so as to provide references for preventing the onset of suicide ideation in adolescent inpatients with depression. MethodsA sample of 585 adolescent patients who were hospitalized in Beijing Huilongguan Hospital from June 2021 to March 2023 and fulfilling the International Classification of Diseases， 10th edition （ICD-10） diagnostic criteria for depression were enrolled. All patients were evaluated using self-designed questionnaire， Chinese Perceived Stress Scale （CPSS）， Positive Psychological Capital Questionnaire （PPQ） and Beck Scale for Suicide Ideation-Chinese Version （BSI-CV）. Pearson correlation was used to assess the correlation among the scores of the above scales. Bootstrap method was employed to verify the mediating effect of psychological capital on the relationship between perceived stress and suicide ideation. ResultsCPSS score in adolescent inpatients with depression was positively correlated with BSI-CV score （r=0.375， P<0.01）， and CPSS score and BSI-CV score were negatively correlated with PPQ score （r=-0.481， -0.436， P<0.01）. Psychological capital played a significant yet a partial role in mediating the link between perceived stress and suicide ideation， with an indirect mediating effect value of 0.160 （95% CI： 0.178~0.373）， accounting for 30.42% of the total effect. ConclusionThe perceived stress of adolescent inpatients with depression can affect the onset of suicide ideation both directly and indirectly through psychological capital.

Objective:To analyze the relationship between self-disclosure, self-efficacy and medical coping modes in adolescent depression, and explore the mediating effect of self-efficacy between self-disclosure and medical coping modes.Methods:Using the convenience sampling method, a total of 403 adolescents with depression in a tertiary psychiatric hospital in Beijing were recruited from March 2020 to March 2021. The data of general information questionnaire, distress disclosure index scale, medical coping modes questionnaire and general self-efficacy scale were collected.SPSS 26.0 software was used to analyze the correlation between self-disclosure, self-efficacy and medical coping modes of adolescent patients with depression, and Stata 13.1 software was used to analyze the mediating effect of self-efficacy between self-disclosure and medical coping modes.Results:The scores of dimension of the medical coping modes of adolescent depression patients were(16.90±3.84) for facing, (16.34±2.88) for yielding, (12.48±4.31) for avoiding, (30.47±9.91) for self-disclosure and (19.63±6.54) for self-efficacy, respectively. Self-disclosure and self-efficacy were positively correlated with facing of medical coping modes ( r=0.301, 0.327, both P<0.01), and negatively correlated with yielding of medical coping modes ( r=-0.465, -0.487, both P<0.01). Self-disclosure was negatively correlated with avoidance of medical coping modes ( r=-0.118, P=0.018). The direct effect of self-efficacy on medical coping modes was 0.103, and the total effect was 0.365, and the mediating effect accounted for 28.22%. Conclusion:Self-efficacy partially mediates between self-disclosure and medical coping modes in adolescents with depression.

Objective To investigate the community structure of intestinal bacteria from patients with cirrhosis and its influencing factors. Methods From 2016 to 2017, 24 patients with liver cirrhosis ( the LC group) and 23 healthy family members of patients ( the HC group) were enrolled at the First Hospital of Lanzhou University. A comparative analysis of the community structure of intestinal bacteria was performed using 16S rRNA gene sequencing in LC and HC groups. Combined with LEfSe analysis and NMDS analysis, the differential markers were screened and the factors affecting the intestinal community structure of subjects were studied. Results The dominant six phylum of bacteria in intestines in LC and HC groups included Firmicutes, Bacteroides, Proteobacteria, Actinobacteria, Fusobacteria and Tenericumes. However, in the LC sample, Firmicutes was significantly reduced, while Bacteroides was significantly increased. The diversity of intestinal bacteria was significantly reduced, and the Firmicutes/Bacteroides ratio was significantly decreased, suggesting a variation of the community structure in intestinal bacteria of cirrhosis patients. The LEfSe result indicated that the abundance of Enterococcus, Lactobacillales, Bacilli, and Bacteroidetes showed a significant difference in the LC sample, which may be used as potential marked bacterial groups for cirrhosis. The NMDS analysis revealed a positive relationship between the concentration of Cd and Pb and the abundance of intestinal bacteria in the LC sample. Conclusion The community structure of intestinal bacteria from patients with cirrhosis has changed. Enterococcus, Lactobacillales, Bacilli, and Bacteroidetes are potential marked bacterial groups. The concentration of Cd and Pb in the intestinal tract of cirrhosis patients may interact with the abundance and structure of bacteria, and further affect the occurrence and development of cirrhosis.

OBJECTIVE： To compare the cost-effectiveness of long-effect and short-effect granulocyte stimulating factor in prevention and treatment of bone marrow suppression induced by chemotherapy for lung malignancies， and to provide reference for rational drug use in the clinic. METHODS： A retrospective analysis was conducted for 132 cases who used granulocyte stimulating factor to prevent and treat bone marrow suppression induced by chemotherapy for lung malignancies in the Affiliated Tumor Hospital of Zhengzhou University during Jan. 2017 to Jun. 2018. Among them， 60 cases were treated with Recombinant human granulocyte stimulating factor injection （short-effect， group A）， and 72 cases were treated with Polyethylene glycol recombinant human granulocyte stimulating factor injection （long-effect， group B）. Clinical efficacies， the occurrence of bone marrow suppression and ADR were compared between 2 groups. Cost was calculated， and cost-effectiveness analysis was conducted. Sensitivity analysis was conducted by down-regulating 20％ drug price. RESULTS： The total response rates of group A and B were 71.7％ and 75.0％， without statistical significance （P＞0.05）. There was no statistical significance in the incidence and duration of bone marrow suppression or the incidence of ADR （P＞0.05）. Average treatment costs of the two groups were （335.91±180.34） and （1 982.75±603.15） yuan； the cost of group A was significantly lower than that of group B （P＜0.05）. The cost-effectiveness ratio of them were 4.69 and 26.44， while group A as a reference， incremental cost-effectiveness ratio of group B was 494.55. The sensitivity analysis results were in agreement with the cost-effectiveness analysis. CONCLUSIONS： The effectiveness of Recombinant human granulocyte stimulating factor injection is similar to that of Polyethylene glycol recombinant human granulocyte stimulating factor injection for the prevention and treatment of bone marrow suppression induced by chemotherapy for lung malignancies. But the cost-effectiveness ratio of the former is lower than that of the latter.

Objective To investigate the epidemiologic and behavioral characteristics of HIV among community population in Liangshan prefecture.Methods We collected social demographic,behavioral and serological information by means of the monitoring questionnaire and serological tests.Data was analyzed by using the chi-square test and logistic regression.Results From April to June of 2010 to 2015,14 092 cases of community population were selected as the study objects,with 267 cases diagnosed as HIV positive patients.The HIV positive rates were 3.24％,3.07％,1.17％,1.38％,1.42％ and 1.25％,respectively.We observed that when community population having the following characteristics as:living in Butuo country (OR=3.83),being males (OR=1.77),being Yi nationality (OR=4.40) being widowed (OR=28.57),with history of drug abuse (OR=3.71) or injecting drug use (PWID) (OR=4.92),or history of needle sharing among PWID (OR=8.53),were under higher risks for HIV infection.With histories as:having had secondary or above levels of schooling (OR=0.59),having protected sex with regular parmers (OR =0.21) and with non-regular partners (OR =0.46),they seemed to be somehow protected for getting HIV infection.Conclusion The positive HIV rates of HIV among community population in Dechang,Ningnan and Butuo varied from 0.10％ to 8.77％while the HIV transmission among general population remained challenging.

Objective To investigate the potential relationship between neck circumference and obesity related indexes and metabolic disorders associated with insulin resistance.Methods A random cluster sampling method was used to identify study population among the 4 412 60 -70 years old permanent residents in Renqiu region.Face to face health questionnaire,physical examination,laboratory tests were used.According to the gender group,the correlation between neck circumference and obesity related indexes and metabolic disorders associated with insulin resistance were analyzed.Results Comparing neck circumference and waist circumference,waist height ratio, and body mass index(BMI) of man and woman respondents,the differences were statistically significant.Neck circum-ference and waist circumference,waist height ratio,and BMI had positive correlation(male:r =0.752,0.695 and 0.761.W:r =0.707,0.655,0.721,all P <0.01).Increased trends of neck circumference,waist circumference,waist height ratio and BMI coincided with increased trend of thypertension,diabetes,hyperlipidemia and hyperinsulinemia and hyperlipidemia,and no gender differences.With the increase of the neck circumference,the incidence of above mentioned diseases also increased accordingly.Conclusion Neck circumference was associated with obesity related indexes and metabolic disorders associated with insulin resistance.Neck circumference measurement can be used as an effective indicator of central obesity,and had great significance for early prediction and prevention of metabolic disorders associated with clinical insulin resistance.

Objective:The aim of this study was to investigate the role of cyclic adenosine monophosphate (cAMP) signaling on the differentiation of stem cells from the apical papilla (SCAPs).Methods:SCAPs were cultured by enzyme digestion method.After adding activator (Forskolin) and inhibitor (H-89) into the culture of SCAPs in mineralization-inducing medium,calcium deposition was measured by alizarin red staining.QPCR was performed to measure the mRNA expression of mineralization-related genes.Results:When the cAMP signaling was activated,calcium deposition and the mRNA expression of ALP,OCN,OSX and RUNX2 increased sharply.After inhibiting the signaling,calcium deposition and the mRNA expression of ALP,OCN,OSX and RUNX2 decreased.Conclusion:The cAMP signaling may promote the odontogenic and osteogenic differentiation of SCAPs.

Objective To investigate the correlation between invasion ability and cytoskeleton remodeling of hepatocarcinoma cell by atomic force microscopy (AFM) and to explore mechanical properties during genesis,development and invasion of hepatocellular carcinoma (HCC).Methods Four HCC cell lines (MHCC-97H,MHCC-97L,SMMC-7721 ,Huh-7 )with different invasive ability were studied.Mechanical parameter (Young′s modulus)was measured by AFM.The pattern of cytoskeleton remodeling of HCC cell lines with different invasive ability was detected by immunofluorescent staining. The difference of cell invasive ability was tested by cell scratch experiment in other to verify mechanical data.Kruskal-Wallis H test was used to compare the differences between groups.Results The results of AFM indicated that Young′s modulus of cytoplasma area and nucleus area decreased gradually as cell invasion ability increased (χ2 =472.78,622.43,both P <0.01).According to invasive ability from low to high,Young′s modulus of cell cytoplasm area of Huh-7,SMMC-7721 ,MHCC-97L and MHCC-97H were 1 602.43 (845 .48,3 317.25)Pa,1 055 .28 (367.48,2 280.77)Pa,1 026.78 (369.20,2 019.96)Pa and 503.12 (366.11 ,700.31)Pa,respectively.Young′s modulus of cell nucleus area of Huh-7,SMMC-7721 ,MHCC-97L and MHCC-97H were 2 823.98 (1 262.78,4 440.07 )Pa,1 313.43 (590.71 , 2 678.62)Pa,1 285 .17 (583.29,1 961 .19)Pa and 655 .57 (441 .29,943.39)Pa,respectively.The results of immunofluorescent staining showed that the stronger the cell invasive ability,the worse cytoskeletal integrity and more irregular cell microfilament distribution. In cell scratch assay, the migration rate of MHCC-97H was 46.67% in 24 h and 86.47% in 48 h,that of MHCC-97L was 45 .70%in 24 h and 82.86% in 48 h,that of SMMC-7721 was 39.41 % in 24 h and 79.85 % in 48 h and that of Huh-7 was 34.60% in 24 h and 72.09% in 48 h,which showed that the cell migration orderly in creased as the cell invasion ability increased.Conclusions It seemed that HCC with higher invasive ability had lower Young′s modulus,softer cell,stronger deformability,worse cytoskeleton integrity and more irregular cell structure,and vice versa.

Objective To investigate the efficacy of nicergoline combined with hyperbaric oxygen treatment on vascular cognitive impairment.Methods 120 patients with vascular cognitive impairment were randomly divided into 3 treatment groups:nicergoline,hyperbaric oxygen,and both treatment (n=40,each) for 8 weeks.Mini mental state examination (MMSE),Wechsler memory scale (WMS) and activities of daily living scale (ADL) were used as assessing items.The efficacy of treatment in each group was evaluated.Results There were no significant differences in clinical data among the three groups(x2=0.324,t=0.265 and 0.861,P=0.764,0.784 and 0.386).After 8 weeks of intervention,scores of MMSE,WMS and ADL were significantly improved in the combined treatment groups compared with pre-treatment (all P＜0.01),and the improvements were observed in nicergoline group (all P＜0.05),while only MMSE and ADL were improved in hyperbaric oxygen group (both P＜0.05).There were significant differences in scores of MMSE,WMS and ADL between combination therapy group and nicergoline group,hyperbaric oxygen group after treatment (all P＜0.05).But only MMSE had significant difference between niccrgoline group and hyperbaric oxygen group after treatment.No significant side effects were observed in the three groups.Conclusions Combination treatment of nicergline and hyperbaric oxygen has better efficacy on vascular cognitive impairment.It can markedly improve the activities of daily living and cognitive function without significant side effects,which is worthy of application in clinical medicine.