Objective To investigate the correlation between lipid accumulation index (LAP),visceral fat index (VFI) and insulin resistance (IR) in healthy check-up population.Methods A total of 9121 subjects who underwent physical examination in the Health Management Center of the First Affiliated Hospital of Ar-my Medical University from October 2016 to June 2023 were selected as the study subjects,including 5988 males and 3133 females.The age,waist circumference (WC),body mass index (BMI),LAP,VFI,blood lipid, blood glucose and homeostasis model assessment of insulin resistance (HOMA-IR) were compared between different genders.Obesity was assessed according to BMI.LAP,VFI and HOMA-IR were compared between obese (BMI≥28 kg/m2) and non-obese patients (BMI<28 kg/m2).Pearson correlation analysis was used to analyze the relationship between LAP,VFI and HOMA-IR in all healthy subjects.Multiple logistic regression analysis was used to analyze the independent influencing factors of HOMA-IR in all healthy subjects. Results The age and high-density lipoprotein cholesterol (HDL-C) of male healthy subjects were significant-ly lower than those of female,while WC,BMI,triglyceride (TG),total cholesterol (TC),low-density lipopro-tein cholesterol (LDL-C),LAP,VFI,fasting blood glucose (FBG),fasting insulin (FINS),glycosylated hemo-globin (HbA1c) and HOMA-IR were significantly higher than those of female (P<0.05).There were 1733 cases of obesity in all healthy subjects,accounting for 19％.The LAP,VFI and HOMA-IR of obese people were significantly higher than those of non-obese people (P<0.05).Pearson correlation analysis showed that HOMA-IR was positively correlated with WC,BMI,TG,TC,LDL-C,LAP and VFI,and negatively correlated with HDL-C (P<0.05).The correlation coefficient r value of LAP was the highest,reaching 0.367,followed by WC,BMI,TG and VFI.Multivariate logistic correlation analysis showed that BMI,LAP and VFI were in-dependent influencing factors of HOMA-IR in all healthy subjects (P<0.05).Conclusion Obesity should not be ignored in health check-up population.LAP and VFI are associated with IR,especially LAP,which can reliably evaluate body fat accumulation and blood glucose metabolism.

Objective To investigate the risk of diabetes mellitus in ABO blood type.Methods The da-ta of 1306397 healthy physical subjects in the Department of Health Management of the First Affiliated Hos-pital of Army Medical University from 2006 to 2018 were retrospectively analyzed,including gender,age, height,weight,blood glucose,blood lipid and ABO blood type.A total of 61296 subjects with both blood type and fasting blood glucose data were selected as the study population.Multivariable logistic regression was used to analyze the risk of diabetes in different ABO blood types.Results There were significant differences in gender,age and BMI distribution between the total population and the study population (P<0.05).The num-ber of patients with diabetes and prediabetes in the study population was 2649 (4.3％) and 3979 (6.5％),re-spectively.There were significant differences in the distribution of cholesterol,low-density lipoprotein choles-terol (LDL-C),diabetes and pre-diabetes among people with different blood types (P<0.05).Multivariate lo-gistic regression analysis showed that compared with type O blood,type A blood had an increased risk of dia-betes (OR=1.38,95％CI:1.02-1.86,P=0.04),while type B blood (OR=1.28,95％CI:0.93-1.77,P=0.13) and type AB blood (OR=1.33,95％CI:0.83-2.11,P=0.23) did not increase the risk of diabetes. Conclusion Early screening of type A blood population and preventive treatment and intervention can be used to reduce the incidence of diabetes.

Objective:To investigate the impact of teacher-student language interaction behavior in the teaching quality of health management courses in lecture competitions by using the Flanders interaction analysis method.Methods:The Flanders interaction analysis model was used to collect and analyze the data on teacher-student interaction behavior of three teachers during the lecture competitions of health management courses, and the three teachers were analyzed in terms of behavior in classroom interaction, student reactions, and features of interaction mode.Results:During the lecture competition, it was found that region E in the FIAS matrix was positive and qualified, and the frequency ratio of positive and qualified to defective grids was much greater than 1 for the three teachers. The teaching methods of all three teachers could alleviate the tense atmosphere in the classroom, enhance interaction between teachers and students, and improve the learning effectiveness of students. The speech behaviors of Teacher C and Teacher S were 91.87% and 81.48%, respectively, which were higher than the norm, while the speech behaviors of Teacher Y was 52.63%, which was lower than the norm. The integrated teaching method was better than the teaching methods of case-based learning and problem-based learning and could better help students master health knowledge and skills, cultivate a healthy lifestyle, promote physical and mental health, and improve health literacy.Conclusions:By using the Flanders interaction analysis method, teachers can observe and analyze interactions with students, evaluate teaching effectiveness, and provide targeted feedback and improvement suggestions to improve teaching quality and the learning outcomes of students. At the same time, teachers and students can also understand their strengths and weaknesses through observation and analysis of interaction methods and make corresponding improvements to teaching methods and contents, so as to encourage students to actively participate in classroom interaction and improve learning effectiveness and student satisfaction.

Objective:To explore the influence of points system management on the career development of medical staff in health management discipline.Methods:Using a cross-sectional study design, medical staff in the health management discipline of tertiary hospitals in China were selected as the research objects from February 1 to March 1, 2024 through questionnaire star convenience sampling and snowball sampling, and their general information, performance appraisal satisfaction, professional identity, burnout, professional benefit, professional career management and other information were collected, and the correlation and influencing factors among them were explored. A total of 423 questionnaires were distributed, and 402 (95.0%) valid questionnaires were collected.Results:A total of 207 (51.5%) medical staff had job burnout, and 257 (63.9%) of them had medium or below level of professional identity. There were positive correlations among performance appraisal satisfaction, professional identity, career benefit and professional career management. There was a negative correlation between burnout and performance appraisal satisfaction ( r=-0.439), professional identity ( r=-0.356), career benefit ( r=-0.584), and professional career management ( r=-0.185) (all P<0.05). Higher age, working time, monthly income level, title level, position level, understanding of performance appraisal system, satisfaction with feedback results and application satisfaction were the protective factors of burnout, and under the points-based system, the scores of performance appraisal satisfaction, professional identity, career benefit, and professional career management were higher, and the differences were statistically significant (all P<0.05). A total of 310 medical staff (77.1%) believed that performance appraisal had a motivating effect on them. Conclusion:The performance appraisal of the point system has a good motivating effect on the medical staff of the health management discipline, and is closely related to professional identity, burnout, professional benefit, and professional career planning.

Objective    To evaluate the safety and efficacy of mitral valve surgery and cryoablation in elderly patients with mitral valve disease and persistent or long-term persistent atrial fibrillation. Methods    From May 2014 to July 2018, 144 patients with mitral valve diseases combined with persistent or long-term persistent atrial fibrillation in the Department of Cardiothoracic Surgery, General Hospital of Northern Theater Command were selected. Among them, there were 69 patients in a non-elderly group (<60 years) including 18 males and 51 females aged 52.07±5.56 years, and 75 patients in an elderly group (≥60 years) including 32 males and 43 females aged 65.23±4.29 years. A propensity-score matching (PSM) study was conducted to eliminate confounding factors. Both groups underwent mitral valve surgery and cryoablation at the same time. A 2-year follow-up was conducted after discharge from the hospital, and the perioperative and postoperative efficacy indexes were compared between the two groups. Results    After PSM analysis, there were 56 patients in each group. The sinus rhythm conversion rate of the two groups at each follow-up time point was above 85%, and the cardiac function was graded asⅠorⅡ, which was significantly improved compared with that before the surgery, but there was no statistical difference between the two groups (P>0.05). Among the perioperative indicators of the two groups, the elderly group had more coronary artery bypass graft surgeries and longer postoperative ICU stay time compared with the non-elderly group (P<0.05), and the differences in other indicators were not statistically different (P>0.05). Conclusion    The mitral valve surgery and cryoablation in elderly patients with mitral valve diseases combined with persistent or long-term persistent atrial fibrillation are safe, and the short-term outcome is satisfactory.

Teaching evaluation is an important part of the whole teaching process. In view of the shortcomings of the traditional final assessment, formative assessment has received wide attention from the education community with its characteristics of diverse assessing subjects, diverse assessment contents and diverse assessment tools. This paper introduces formative assessment into flipped classroom, and tries to construct formative assessment index system, which may provide the theoretical basis for the implementation of formative assessment in flipped classroom.

RAS, a member of the small GTPase family, functions as a binary switch by shifting between inactive GDP-loaded and active GTP-loaded state. RAS gain-of-function mutations are one of the leading causes in human oncogenesis, accounting for ∼19% of the global cancer burden. As a well-recognized target in malignancy, RAS has been intensively studied in the past decades. Despite the sustained efforts, many failures occurred in the earlier exploration and resulted in an 'undruggable' feature of RAS proteins. Phosphorylation at several residues has been recently determined as regulators for wild-type and mutated RAS proteins. Therefore, the development of RAS inhibitors directly targeting the RAS mutants or towards upstream regulatory kinases supplies a novel direction for tackling the anti-RAS difficulties. A better understanding of RAS phosphorylation can contribute to future therapeutic strategies. In this review, we comprehensively summarized the current advances in RAS phosphorylation and provided mechanistic insights into the signaling transduction of associated pathways. Importantly, the preclinical and clinical success in developing anti-RAS drugs targeting the upstream kinases and potential directions of harnessing allostery to target RAS phosphorylation sites were also discussed.

[Abstract] Objective: Toevaluatetheexpressionof6-phosphofructo-2-kinase/fructose-2, 6-biphosphatase 3(PFKFB3) in malignant glioma tissues and the effects of inhibitor of PFKFB3(PFK15) on the proliferation, migration, invasion, clone formation and tumorigenesis of H4 cells. Methods: Malignant brain glioma tissues and corresponding paratumor tissues from 31 patients, who were hospitalized in Department of Neurosurgery,Ankang Hospital of Traditional Chinese Medicine during February 1, 2015 to January 31, 2016 for operative treatment, were collected for this study. Immunohistochemistry and western blotting assays were applied to detect the expression of PFKFB3 in collected tissues. PFKFB3 in H4 cells were blocked by PFK15 (1.25, 2.5, 5.0 μmol/L). The effect of PFK15 on proliferation, migration, clone formation and tumorigenesis of H4 cells were determined by MTT assay, EdU incorporation assay, wound healing assay, Transwell assay, colone formation assay and in vivo xenograft bearing nude mice model respectively. Results: Positive expression rate of PFKFB3 was significantly higher in malignant glioma tissues compared with normal adjacent tissues[(80.60±8.98)% vs (41.57±10.16)%, P<0.05]. The results of MTT assay and EdU incorporation assay indicated that PEK15 significantly inhibited the proliferation of H4 cells in a concentration dependent manner. The migration, invasion and clone formation activity of H4 cells were significantly reduced by treatment with PFK15 (all P<0.05). In tumor bearing nude mice, the tumor volume of mice treated with PFK15 was significantly smaller than that of mice from control group ([254.15±154.25] vs [801.52±224.25] mm3, P<0.05). Conclusion: PFKFB3 was highly expressed in malignant glioma tissues. Blocking of PFKFB3 by PFK15 significantly reduced the malignant biological behaviors and tumorigenesis of H4 cells in vitro and in vivo, which may serve as a promising target for the treatment of malignant gliomas.

BACKGROUND:For patients with degenerative mitral annulus dilatation complicated by atrial fibrilation, atrial fibrilation is needed to be treated concomitant with artificial valve ring implantation. Although Cox maze III procedure is the gold standard for treatment of atrial fibrilation, its safety has been questioned. OBJECTIVE:To evaluate the safety of artificial valve rings implantation and Cox Maze III procedure for treatment of degenerative mitral annulus dilatation complicated by atrial fibrilation. METHODS: A total of 43 patients with degenerative mitral annulus dilatation and atrial fibrilation were enroled and were randomly divided into test group (n=21) and control group (n=22). Patients in the test group were treated with mitral valvuloplasty and Cox Maze III procedure. Patients in the control group were only treated with mitral valvuloplasty. RESULTS AND CONCLUSION: (1) Intraoperative safety indexes: the durations of cardiopulmonary bypass and aortic clamping. and the incidence of hemoglobinuria in the test group were higher than those in the control group (P < 0.001). There was no significant difference in the urine output between these two groups. (2) Postoperative safety indexes: the incidence of atrial dysrhythmia (i.e., any atrial dysrhythmia other than atrial fibrilation), proportion of patients requiring a temporary pacemaker and hospital stays in the test group were higher than those in the control group (P < 0.05). There were no significant differences in the secondary-thoracotomy bleeding rate and incidence of stroke between these two groups. (3) Postoperative outcomes: the rates of cardioversion to achieve sinus rhythm at the day of surgery and at discharge in the test group were significantly higher than those in the control group (P < 0.001). At discharge, patients in both groups were al at NYHA functional class Ior II. Echocardiography showed trace to mild mitral regurgitation and complete closure of the tricuspid valve. There were no significant differences in the left atrial diameter, left ventricular diameter, left ventricular volume, and ejection fraction between these two groups. However, the proportions of mitral and tricuspid valve peak A-waves were significantly higher than those in the control group (P < 0.001). These results show that artificial valve ring implantation and Cox Maze III procedure is a safe and effective method for treating degenerative mitral annulus dilatation complicated by atrial fibrilation during operation.

BACKGROUND:Incidence of degenerative mitral regurgitation show a gradual increase tendency,but there is no report on degenerative mitral regurgitation due to pure mitral valve ring expansion in China.OBJECTIVE:To summarze the early and midterm outcomes of pure mitral valve annuloplasty in the treatment of degenerative mitral regurgitation due to pure mitral valve ring expansion. METHODS :Forty-eight patients with degenerative mitrlal regurgitation due to pure mitral valve ring expansion underwent pure mitral valve annuloplasty, including 23 cases treated with Carpentier-Edwards Physio ring and 23 with SJMTM rigid saddle ring.Affter discharge,echocardiography was used to evaluate heart function and mitral regurgitation degree during the follow-up.The outcomes were compared between the two groups. RWSULTS AND CONCLUSION:There was no early death after operation and all cases were cured and discharged.All patients were followed up for 3 months to 4years,and the cardiac function and mitral valve regurgitation were significantly improved (no mitral regurgitation in 36 cases,trivial regurgitation in 10 cases and mild mitral regurgitation in 2cases).According to NYHA grading,there were 32 cases of level 1 and 16 ceses of level Ⅱ. The echocardiography showed that postoperative left atrium diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, pulmonary artery systolic pressure and the ratio of regurgitation beam area to left atrial area were significantly lower than those before operation (P < 0.01). The left ventricular ejection fraction increased greatly (P < 0.01). There was no ring rupture, ring avulsion and hemolysis. Postoperative transvalvular pressure was less than 3 mm Hg. However, there were no significant differences in the above-mentioned parameters between the Carpentier-Edwards Physio ring and SJMTM rigid saddle ring groups. The results suggest that the pure mitral valve annuloplasty is excelent in the treatment of degenerative mitral regurgitation due to pure mitral valve ring expansion, through the right surgical techniques and the right choice of artificial valve ring.