Integrated analysis of the DNA methylome and RNA transcriptome during the development of skeletal muscle in Duroc pigs.

BACKGROUND: Skeletal muscle development plays a crucial role in yield and quality of pork; however, this process is influenced by various factors. In this study, we employed whole-genome bisulfite sequencing (WGBS) and transcriptome sequencing to comprehensively investigate the longissimus dorsi muscle (LDM), aiming to identify key genes that impact the growth and development of Duroc pigs with different average daily gains (ADGs). RESULTS: Eight pigs were selected and divided into two groups based on ADGs: H (774.89 g) group and L (658.77 g) group. Each pair of the H and L groups were half-siblings. The results of methylation sequencing revealed 2631 differentially methylated genes (DMGs) involved in metabolic processes, signalling, insulin secretion, and other biological activities. Furthermore, a joint analysis was conducted on these DMGs and the differentially expressed genes (DEGs) obtained from transcriptome sequencing of the same individual. This analysis identified 316 differentially methylated and differentially expressed genes (DMEGs), including 18 DMEGs in promoter regions and 294 DMEGs in gene body regions. Finally, LPAR1 and MEF2C were selected as candidate genes associated with muscle development. Bisulfite sequencing PCR (BSP) and quantitative real-time PCR (qRT-PCR) revealed that the promoter region of LPAR1 exhibited significantly lower methylation levels (P < 0.05) and greater expression levels (P < 0.05) in the H group than in the L group. Additionally, hypermethylation was observed in the gene body region of MEF2C, as was a low expression level, in the H group (P < 0.05). CONCLUSIONS: These results suggest that the differences in the ADGs of Duroc pigs fed the same diet may be influenced by the methylation levels and expression levels of genes related to skeletal muscle development.

Asymmetric Intramolecular Amination Catalyzed with Cp*Ir-SPDO via Nitrene Transfer for Synthesis of Spiro-Quaternary Indolinone.

An asymmetric intramolecular spiro-amination to high steric hindering α-C-H bond of 1,3-dicarbonyl via nitrene transfer using inactive aryl azides has been carried out by developing a novel Cp*Ir(III)-SPDO (spiro-pyrrolidine oxazoline) catalyst, thereby enabling the first successful construction of structurally rigid spiro-quaternary indolinone cores with moderate to high yields and excellent enantioselectivities. DFT computations support the presence of double bridging H-F bonds between [SbF6]- and both the ligand and substrate, which favors the plane-differentiation of the enol π-bond for nitrenoid attacking. These findings open up numerous opportunities for the development of new asymmetric nitrene transfer systems.

Metabolomics efficiently discriminates monozygotic twins in peripheral blood.

Monozygotic (MZ) twins cannot be distinguished using conventional forensic STR typing because they present identical STR genotypings. However, MZ twins do not always live in the same environment and often have different dietary and other lifestyle habits. Metabolic profiles are deyermined by individual characteristics and are also influenced by the environment in which they live. Therefore, they are potential markers capable of identifying MZ twins. Moreover, the production of proteins varies from organism to organism and is influenced by both the physiological state of the body and the external environment. Hence, we used metabolomics and proteomics to identify metabolites and proteins in peripheral blood to discriminate MZ twins. We identified 1749 known metabolites and 622 proteins in proteomic analysis. The metabolic profiles of four pairs of MZ twins revealed minor differences in intra-MZ twins and major differences in inter-MZ twins. Each pair of MZ twins exhibited distinct characteristics, and four metabolites-methyl picolinate, acesulfame, paraxanthine, and phenylbenzimidazole sulfonic acid-were observed in all four MZ twin pairs. These four differential exogenous metabolites conincidently show that the different external environments and life styles can be well distinguished by metabolites, considering that twins do not all have the same eating habits and living environments. Moreover, MZ twins showed different protein profiles in serum but not in whole blood. Thus, our results indicate that differential metabolites provide potential biomarkers for the personal identification of MZ twins in forensic medicine.

Acupuncture versus tricyclic antidepressants in the prophylactic treatment of tension-type headaches: an indirect treatment comparison meta-analysis.

BACKGROUND: Acupuncture showed better improvement than sham acupuncture in reducing attack frequency of tension-type headache (TTH), but its effectiveness relative to first-line drugs for TTH is unknown, which impedes the recommendation of acupuncture for patients who are intolerant to drugs for TTH. We aimed to estimate the relative effectiveness between acupuncture and tricyclic antidepressants (TCAs) through indirect treatment comparison (ITC) meta-analysis. METHODS: We searched Ovid Medline, Embase, and Cochrane Library from database inception until April 13, 2023. Randomized controlled trials of TCAs or acupuncture in the prevention of TTH in adults were included. The primary outcome was headache frequency. The secondary outcomes were headache intensity, responder rate, and adverse event rate. Bayesian random-effect models were used to perform ITC meta-analysis, and confidence of evidence was evaluated by using the GRADE approach. RESULTS: A total of 34 trials involving 4426 participants were included. Acupuncture had similar effect with TCAs in decreasing TTH frequency (amitriptyline: mean difference [MD] -1.29, 95% CI -5.28 to 3.02; amitriptylinoxide: MD -0.05, 95% CI -6.86 to 7.06) and reducing TTH intensity (amitriptyline: MD 2.35, 95% CI -1.20 to 5.78; clomipramine: MD 1.83, 95% CI -4.23 to 8.20). Amitriptyline had a higher rate of adverse events than acupuncture (OR 4.73, 95% CI 1.42 to 14.23). CONCLUSION: Acupuncture had similar effect as TCAs in reducing headache frequency of TTH, and acupuncture had a lower adverse events rate than amitriptyline, as shown by very low certainty of evidence.

Green space exposure and Chinese residents' physical activity participation: empirical evidence from a health geography perspective.

Background: With continuous efforts made to promote the strategic goals of carbon neutrality and carbon peak, it is crucial to meet the growing and diversified needs of the public for fitness by practicing the concept of green development and promote the combination of national fitness and ecological civilization. Methods: To achieve this purpose, an OLS regression model was applied to estimate the role of green space exposure in Chinese residents' participation in physical activity and its underlying mechanisms, using the microdata from the China General Social Survey (CGSS) data and the Provincial Vegetation Cover Index (NDVI) matched macrostatistical data. Results: The empirical results show that green space exposure significantly increases the probability of residents' physical activity participation, and creating a green environment is conducive to creating a favorable physical activity environment for residents. Also, the core conclusions still hold after the year-by-year regression test is passed and the endogeneity problem is addressed. As revealed by mechanistic studies, green space exposure has indirect effects on the physical activity participation of residents through the independent mediating roles of reducing carbon emissions and promoting social interaction. According to heterogeneity results, males, those in marriage, and urban dweller groups are more inclined to perform physical activity in green spaces. Conclusion: The results show that the exposure of green space can help increase the probability of residents' participation in physical exercise, and can that it achieved through two channels: reducing carbon emissions and enhancing social interaction. It is necessary to further strengthen the protection of the ecological lifestyle, give full play to the advantages of greenness and low-carbon, and create favorable conditions for the green development of a new model of national fitness.

Diagnostic efficacy of combining diffusion-weighted magnetic resonance imaging with serum Mucin 1, Mucin 13, and Mucin 16 in distinguishing borderline from malignant epithelial ovarian tumors.

AIMS: To enhance ovarian tumor diagnosis beyond conventional methods, this study explored combining diffusion-weighted magnetic resonance imaging (DWI-MRI) and serum biomarkers (Mucin 1 [MUC1], MUC13, and MUC16) for distinguishing borderline from malignant epithelial ovarian tumors. METHODS: A total of 126 patients, including 71 diagnosed with borderline (BEOTs) and 55 with malignant epithelial ovarian tumors (MEOTs), underwent preoperative DWI-MRI. Region of interest (ROI) was manually drawn along the solid component's boundary of the largest tumor, focusing on areas with potentially the lowest apparent diffusion coefficient (ADC). For entirely cystic tumors, a free-form ROI enclosed the maximum number of septa while targeting the lowest ADC. Serum biomarkers were determined using enzyme-linked immunosorbent assay. RESULTS: Basic morphological traits proved inadequate for malignancy diagnosis, warranting this investigation. BEOTs had an ADC mean of (1.670 ± 0.250) × 103 mm2 /s, while MEOTs had a lower ADC mean of (1.332 ± 0.481) × 103 mm2 /s, with a sensitivity of 63.6% and specificity of 90.1%. Median MUC1 (167.0 U/mL vs. 87.3 U/mL), MUC13 (12.44 ng/mL vs. 7.77 ng/mL), and MUC16 (180.6 U/mL vs. 36.1 U/mL) levels were higher in MEOTs patients. The biomarker performance was: MUC1, sensitivity 50.9%, specificity 100%; MUC13, sensitivity 56.4%, specificity 78.9%; MUC16, sensitivity 83.64%, specificity 100%. Combining serum biomarkers and ADC mean resulted in a sensitivity of 96.4% and specificity of 100%. CONCLUSION: The integration of DWI-MRI with serum biomarkers (MUC1, MUC13, and MUC16) achieves exceptional diagnostic accuracy, offering a powerful tool for the precise differentiation between borderline and malignant epithelial ovarian tumors.

Rosmarinic acid activates the Ras/Raf/MEK/ERK signaling pathway to regulate CD8+ T cells and autophagy to clear Chlamydia trachomatis in reproductive tract-infected mice.

Chlamydia trachomatis (CT) is the leading cause of bacterial sexually transmitted diseases worldwide, which can cause diseases such as pelvic inflammatory disease, and cervical and fallopian tube inflammation, and poses a threat to human health. Rosmarinic acid (RosA) is an active ingredient of natural products with anti-inflammatory and immunomodulatory effects. This study aimed to investigate the role of RosA in inhibiting autophagy-regulated immune cells-CD8+ T cells via the Ras/Raf/MEK/ERK signaling pathway in a CT-infected mouse model. Mice were inoculated with CT infection solution vaginally, and the mechanistic basis of RosA treatment was established using H&E staining, flow cytometry, immunofluorescence, transmission electron microscopy, and western blot. The key factors involved in RosA treatment were further validated using the MEK inhibitor cobimetinib. Experimental results showed that both RosA and the reference drug azithromycin could attenuate the pathological damage to the endometrium caused by CT infection; flow cytometry showed that peripheral blood CD8+ T cells increased after CT infection and decreased after treatment with RosA and the positive drug azithromycin (positive control); immunofluorescence showed that endometrial CD8 and LC3 increased after CT infection and decreased after RosA and positive drug treatment; the results of transmission electron microscopy showed that RosA and the positive drug azithromycin inhibited the accumulation of autophagosomes; western bolt experiments confirmed the activation of autophagy proteins LC3Ⅱ/Ⅰ, ATG5, Beclin-1, and p62 after CT infection, as well as the inhibition of Ras/Raf/MEK/ERK signaling. RosA and azithromycin inhibition of autophagy proteins activates Ras/Raf/MEK/ERK signaling. In addition, the MEK inhibitor cobimetinib attenuated RosA's protective effect on endometrium by further activating CD8+ T cells on a CT-induced basis, while transmission electron microscopy, immunofluorescence, and western blots showed that cobimetinib blocked ERK signals activation and further induced phagocytosis on a CT-induced basis. These data indicated that RosA can activate the Ras/Raf/MEK/ERK signaling pathway to inhibit autophagy, and RosA could also regulate the activation of immune cells-CD8+T cells to protect the reproductive tract of CT-infected mice.

Association of histone modification with the development of schizophrenia.

Schizophrenia, influenced by genetic and environmental factors, may involve epigenetic alterations, notably histone modifications, in its pathogenesis. This review summarizes various histone modifications including acetylation, methylation, phosphorylation, ubiquitination, serotonylation, lactylation, palmitoylation, and dopaminylation, and their implications in schizophrenia. Current research predominantly focuses on histone acetylation and methylation, though other modifications also play significant roles. These modifications are crucial in regulating transcription through chromatin remodeling, which is vital for understanding schizophrenia's development. For instance, histone acetylation enhances transcriptional efficiency by loosening chromatin, while increased histone methyltransferase activity on H3K9 and altered histone phosphorylation, which reduces DNA affinity and destabilizes chromatin structure, are significant markers of schizophrenia.

Rapid detection of human cytomegalovirus by multienzyme isothermal rapid amplification and lateral flow dipsticks.

Introduction: Human cytomegalovirus (HCMV) is the most common viral infection seen in newborns. The major route of transmission for acquired human cytomegalovirus infection is breast milk from mothers who are HCMV seropositive to the infants. Thus, a rapid, economical, and simple method to perform HCMV test in breast milk is crucial and necessary for preventing acquired HCMV infection, especially in underdeveloped regions with limited laboratory resources. Methods: In this study, an effective technique for the detection of HCMV was constructed by combining multienzyme isothermal rapid amplification (MIRA) and lateral flow chromatography strip (LFD). Primers for the conserved HCMV sequence UL83 were utilized for MIRA-LFD testing. Results: Our results showed that the entire MIRA reaction could be completed in 12 minutes at 37°C, and LFD outcomes could be observed visibly after 10 minutes. The detection sensitivity of this method reached 50 copy/µl. Samples of breast milk were examined to compare MIRA-LFD and conventional qPCR. The accuracy of MIRA-LFD was 100%. Discussion: The straightforward, rapid, economic features of the test can provide the significant advantages for the prevention of breast milk-acquired cytomegalovirus infection, particularly in resource-limited locations with high seroprevalence of cytomegalovirus.

Disease-Related Factors Associated with Acupuncture Response in Patients with Chronic Tension-Type Headache: A Secondary Analysis of A Randomized Controlled Trial.

OBJECTIVE: To explore the demographic and disease-related factors associated with acupuncture response in patients with chronic tension-type headache (CTTH). METHODS: Using data from a randomized clinical trial (218 cases) consisting of 4 weeks of baseline assessment, 8 weeks of treatment, and 24 weeks of follow-up, participants were regrouped into responders (at least a 50% reduction in monthly headache days at week 16 compared with baseline) and non-responders. Twenty-three demographic and disease-related factors associated with acupuncture response in 183 participants were analyzed by multivariable logistic regression. RESULTS: One hundred and nineteen (65.0%) participants were classified as responders. Four factors were significantly independently associated with acupuncture response, including treatment assignment, headache intensity at baseline, and 2 domains [general health (GH) and social functioning (SF)] from the 36-Item Short Form Health Survey quality of life questionnaire. Treatment assignment was associated with non-response: participants receiving true acupuncture were 3-time more likely to achieve a CTTH response than those receiving superficial acupuncture [odds ratio (OR) 0.322, 95% confidence interval (CI) 0.162 to 0.625, P=0.001]. Compared with patients with mild-intensity headache, patients with moderate-intensity headache were twice as likely to respond to acupuncture (OR 2.001, 95% CI 1.020 to 4.011, P=0.046). The likelihood of non-response increased by 4.5% with each unit increase in the GH grade (OR 0.955, 95% CI 0.917 to 0.993, P=0.024) while decreased by 3.8% with each unit increase in the SF grade (OR 1.038, 95% CI 1.009 to 1.069, P=0.011). CONCLUSIONS: Greater headache intensity, lower GH score, and higher SF score were associated with better acupuncture responses in CTTH patients. These 3 factors require independent validation as predictors of acupuncture effectiveness in CTTH.

Research progress of D-dimer and kidney diseases / 中华肾脏病杂志

D-dimer is a fibrin degradation product. The increased D-dimer indicates hypercoagulability and secondary hyperfibrinolysis, which can be used as a biomarker for activation of coagulation and fibrinolysis system. D-dimer is routinely used in the diagnosis of thrombotic diseases. D-dimer level is affected by age, pregnancy, blood glucose, infection, liver failure, cancer and stroke. The increased D-dimer is closely related to kidney diseases. The paper reviews the formation mechanism and influencing factors of D-dimer, the relationship between D-dimer and kidney diseases, and the prognostic value of D-dimer in kidney diseases, to provide references for clinical diagnosis and treatment.

Correlation between long-term use of aspirin and Helicobacter pylori infection in elderly people and its effectiveness on Helicobacter pylori eradication / 中华老年医学杂志

Objective:To investigate the correlation between long-term use of low-dose aspirin and Helicobacter pylori(HP)infection in elderly people and its effectiveness on HP eradication and recurrence.Methods:A retrospective analysis was conducted on 2 834 elderly people aged 60 and above who underwent the C 13-or C 14-urea breath test(UBT)for the first time in the Physical Examination Center of the First Hospital of Lanzhou University between March 2010 and December 2019.According to the results of UBT, people were divided into an HP infection group with 1 510 patients and a non-HP infection group with 1 324 patients.Univariate and multivariate Logistic regression analysis were used to investigate the relationship between aspirin use and HP infection.Additionally, in a prospective case-control analysis, 544 elderly hypertensive patients diagnosed with HP infection between March 2015 and December 2020 were selected and divided into an aspirin group(402 cases)and an observation group(142 cases), based on whether aspirin was used.The aspirin group was further divided into a 1 to <2 years group(134 cases), a ≥2 to <5 years group(142 cases)and a ≥5 years group(126 cases)based on the duration of aspirin treatment.The rates of HP eradication, safety and one-year post-treatment HP recurrence with bismuth-containing quadruple therapy were compared. Results:The overall HP infection rate was 53.28%(1 510/2 834).Univariate analysis showed that the infection rate in women was higher than in men[56.86%(584/1 027) vs.51.25%(926/1 807), χ2=8.307, P=0.004].The infection rate in aspirin users was higher than in non-aspirin users[57.29%(920/1 606) vs.48.05%(590/1 228), χ2=23.866, P<0.001], with no significant difference between aspirin use for 1-<2 years, ≥2-<5 years and ≥5 years[60.22%(162/269) vs.56.4%(273/484) vs.56.86%(485/853), χ2=1.166, P=0.558].Fasting blood glucose levels in the HP infection group were higher than in the non-HP infection group[(5.92±1.78)mmol/L vs.(5.77±1.40)mmol/L, t=2.317, P=0.021].Multivariate Logistic regression analysis showed the risk of HP infection in women was higher than in men( OR=1.254, 95% CI: 1.075-1.464, P=0.004).Long-term aspirin use increased the risk of HP infection( OR=1.450, 95% CI: 1.249-1.684, P<0.001).Among the 544 cases selected for eradication therapy, 522 completed the treatment protocol, with 479 achieving successful eradication.The overall eradication rate was 91.76%(479/522)according to per-protocol(PP)analysis and 88.05%(479/544)according to intention-to-treat(ITT).After 1 year, 472 cases underwent reexamination, with an overall recurrence rate of 3.6%(17/472).There was no statistical significance in the eradication rate and recurrence rate among the groups with different durations of aspirin treatment and the observation group. Conclusions:Long-term use of low-dose aspirin increases the risk of HP infection in the elderly, but does not affect the eradication rate and one-year recurrence rate of bismuth-containing quadruple therapy.Therefore, periodic screening and eradication of HP should be performed.

Correlation between PM 2.5 in Taiyuan city and the number of elderly patients with chronic kidney disease admitted to hospital from 2019 to 2021 / 中华肾脏病杂志

Objective:To investigate the correlation between atmospheric particulate matter 2.5 (PM 2.5) concentration and the number of chronic kidney disease (CKD) hospital admissions in the elderly in Taiyuan city. Methods:The atmospheric PM 2.5 concentration in Taiyuan city during 2019—2021 was used as the environmental exposure data, and the number of CKD admission of the elderly patients (> 60 years old) in Taiyuan city at the same time was used as the disease progression index. The distributed lag nonlinear model was used to analyze overall and lag effects of PM 2.5 average daily concentration on the elderly patients admitted to CKD. Results:A total of 6 037 cases elderly patients with CKD admitted to hospital were included, with a male-to-female ratio of 1.36∶1. The average daily concentration of PM 2.5 was 52.80 μg/m 3, which did not exceed China's air quality standard (75 μg/m3); But in autumn and winter, the average daily concentration of PM 2.5 significantly exceeded the normal reference value, with the highest value reaching 302 μg/m 3. The relationship between the average daily concentration of PM 2.5 and the number of elderly patients admitted to CKD was nonlinear and there was a lag effect. The relative risk ( RR) value reached the maximum when PM 2.5 average daily concentration was 87 μg/m 3 with lag time of 11 days [1.074(95% CI 1.018-1.321)]. The subgroup analysis results showed that the risk of admission of elderly female CKD patients was higher than that of male patients with lag time of 10 days, and the RR was 1.073(95% CI 1.001-1.151). Elderly CKD patients with hypertension (PM 2.5 87 μg/m 3) and diabetes (PM 2.5 88 μg/m 3) had a higher risk of admission when exposed to PM 2.5, with maximum RR values of 1.067(95% CI 1.002-1.136) and 1.162(95% CI 1.021-1.320), respectively. Conclusions:High atmospheric PM 2.5 concentration in Taiyuan city can increase the risk of admission in elderly patients with CKD, especially in women and patients with hypertension or diabetes.

Research update on the clinical application of the quantity and quality of high-density lipoprotein in atherosclerosis / 中华检验医学杂志

Recent research evidence challenges the hypothesis that high density lipoprotein (HDL) has a protective effect on atherosclerosis. Due to the heterogeneity of HDL particle composition and the diversity of HDL functions, the evaluation of HDL particle composition and the detection of HDL function might overcome the deficiency from the measurement of single high-density lipoprotein cholesterol (HDL-C) level. This review briefly introduced the detection method and clinical application for the "quantity" of HDL, and focused on the current status of clinical application and the future development trend of related detection method for the structure and function of HDL. It is postulated that the evaluation of the "quality" of HDL may become the routine method of HDL detection in the future.

Study on relationship between Helicobacter pylori infection and blood glucose / 中华老年医学杂志

Objective:To examine the relationship between fasting blood glucose(FBG)levels and H. pylori infection, as well as their impact on eradication and recurrence rates.Methods:A total of 1 584 patients with type 2 diabetes, ranging in age from 44 to 91 years old(mean age of 66.6±7.6 years), were included in this study conducted at the Physical Examination Center of the First Hospital of Lanzhou University between March 2010 and December 2019.Of the total participants, 1 063(67.1%)were male and 521(32.9%)were female.Logistic regression analysis was performed to investigate the impact of age, gender, fasting blood glucose, and H. pylori infection on the patients.In the study, 263 patients in the euglycemic control group(HbA1c<7%), 271 patients in the poor glycemic control group(HbA1c≥7%), and 269 patients in the control group underwent H. pylori eradication using bismuth-containing quadruple therapy, and the eradication efficacy, adverse reactions, and recurrence rates were compared after 1 year.Results:In patients with type 2 diabetes, the infection rate of H. pylori was found to be 48.2%.Further regression analysis revealed that poor glycemic control increased the risk of H. pylori infection( OR=1.611, 95% CI: 1.269~2.045, P<0.01). However, the constituent ratio and infection rate of different hypoglycemic drug groups did not show any significant statistical difference.The eradication rate of H. pylori was 90.9%, and there was no significant difference in the eradication rate among different blood glucose groups and control groups.However, after 1 year, the recurrence rate was 3.8%, with a higher rate observed in the poor glycemic control group compared to the euglycemic control group and the control group( P<0.05). There was a statistically significant difference in constipation as the main side effect of eradication therapy between the diabetic group and the control group[25.1%(134/253) vs.16.4%(44/269), P<0.01]. Conclusions:Diabetic patients with fasting hyperglycemia or poor glycemic control are at an increased risk of H. pylori infection.Additionally, these patients have a higher risk of recurrence after eradication.Therefore, it is important for clinicians to closely monitor and manage glycemic control in diabetic patients to reduce the risk of H. pylori infection and improve treatment outcomes.

Construction and evaluation of clinical-thinking patterned curriculum for parallel graduate students with "running through clinical diagnosis and treatment process" / 中华医学教育探索杂志

Objective:To explore the construction and implementation effect of clinical-thinking patterned curriculum for parallel graduate students with "running through clinical diagnosis and treatment process."Methods:In this study, 94 Batch 2016-2017 graduate students with clinical medical professional degree in Shanxi Provincial People's Hospital were selected as the research subjects. Among them, 48 Batch 2017 parallel graduate students were selected as the experimental group. The curriculum of clinical-thinking patterned training of "running through the clinical diagnosis and treatment process" was used. In addition to participating in the degree courses and residency courses, a series of training to improve the clinical-thinking ability were introduced. And 46 Batch 2016 parallel graduate students were divided in the control group, using a traditional curriculum and only participating in degree courses and residency courses. The differences among mini-clinical evaluation exercise (Mini-CEX) scores, direct observation of procedural skills (DOPS) scores, objective structured clinical examination (OSCE) scores and students' satisfaction were compared by t test, chi-square test and repeated measures analysis of variance. Results:The Mini-CEX scores showed the average scores of other aspects except humanistic care were higher than those of the control group, and the score of communication skills was significantly higher than that of the control group [(6.55±0.98) vs. (5.77 ±1.12)], with significant differences ( t=3.62, P<0.001). In the DOPS scores, except for the skills of communication with patients, ability to consider patient's feelings and practice of occupational literacy, the average scores of other aspects of the experimental group were higher than those of the control group, and the real operation-ability score of clinical skills was significantly higher than that of the control group [(6.38 ± 1.38) vs. (5.53±1.23)], with a significant difference ( t=3.12, P=0.002). In terms of the outpatient receiving station, the emergency treatment station, the clinical thinking station①, the clinical thinking station②, the specialist skill station, the auxiliary examination station and the case writing station, their OSCE scores at different stages in the experimental group were higher than those in the control group, and in terms of clinical thinking station①, the score of the experimental group was significantly higher than that of the control group, with a significant difference ( F=6.51, P=0.012). The satisfaction rate of the experimental group in terms of curriculum was higher than that in the control group except for the future career development, and in improving logical-thinking ability, the score of the experimental group was significantly higher than that of the control group, with a significant difference ( χ2=19.18, P<0.001). Conclusion:The curriculum of clinical-thinking ability with "running through the clinical diagnosis and treatment process" can enhance the clinical practical ability of parallel graduate students, making them meet the residential academic standards as soon as possible and effectively promoting the training quality of the students.

Application evaluation of evidence-based medicine concept-based problem-based learning teaching mode in the clinical practice teaching of an orthopedic department / 中华医学教育探索杂志

Objective:To investigate the effect of application of problem-based learning (PBL) combined with evidence-based medicine (EBM) in clinical practice teaching of an orthopedic department.Methods:A total of 48 interns who entered Department of Orthopedics, The Second Hospital of Anhui Medical University, Hefei, China from June 2017 to June 2018 were randomly divided into experimental group (the PBL combined with EBM concept teaching group, n = 24) and control group (the traditional teaching group, n = 24). In the experimental group, teachers selected typical cases, designed questions with certain flexibility and complexity, and organized the students to consult the literature, discuss in groups, and report and summarize around the practical problems. In the control group, traditional indoctrination teaching was adopted according to the clinical experience of the teachers. The teaching effect was assessed by a questionnaire survey, a theoretical examination, and a clinical skill examination. The results were analyzed by t-test and Chi-square test using SPSS 16.0 software. Results:The questionnaire survey showed that compared with the control group, the experimental group gave a significantly better evaluation of the teaching methods they received in terms of improving their theoretical knowledge comprehension ability, comprehensive analysis ability, team collaboration awareness, document retrieval and language expression ability, stimulating their learning motivation, and enhancing their scientific thinking and innovation ability ( P < 0.05). Furthermore, compared with the control group, the experimental group had significantly higher mean scores for both the theoretical test (92.42±2.55 vs. 86.17±3.36, P < 0.05) and the clinical skill test (85.79±3.15 vs. 78.88±3.41, P < 0.05). Conclusion:The application of PBL teaching in orthopedic practice, with the concept of EBM throughout the teaching process, has obtained a good effect. It can improve the clinical teaching quality in orthopedics, improve the comprehensive quality of clinical medical students, inspire their active learning enthusiasm, and cultivate their creative thinking, problem construction, comprehensive analysis, literature retrieval, and communication ability.