Structure-activity relationships of aniline-based squaraines for distinguishable staining and bright two-photon fluorescence bioimaging in plant cells.

An organelle-selective vision provides insights into the physiological response of plants and crops to environmental stresses in sustainable agriculture ecosystems. Biological applications often require two-photon excited fluorophores with low phototoxicity, high brightness, deep penetration, and tuneable cell entry. We obtained three aniline-based squaraines (SQs) tuned from hydrophobic to hydrophilic characteristics by modifying terminal pendant groups and substituents, and investigated their steady-state absorption and far-red-emitting fluorescence properties. The SQs exhibited two-photon absorption (2PA) ranging from 750 to 870 nm within the first biological spectral window; their structure-property relationships, corresponding to the 2PA cross sections (δ2PA), and structure differences were demonstrated. The maximum δ2PA value was ∼1220 GM at 800 nm for hydrophilic SQ3. Distinct biological staining efficiency and selective SQ bioimaging were evaluated utilizing the onion epidermal cell model. Contrary to the hydrophobic SQ1 results in the onion epidermal cell wall, amphiphilic SQ2 tagged the vacuole and nucleus and SQ3 tagged the vacuole. Distinguishable staining profiles in the roots and leaves were achieved. We believe that this study is the first to demonstrate distinct visualisation efficiency induced by the structure differences of two-photon excited SQs. Our results can help establish the versatile roles of novel near-infrared-emitting SQs in biological applications.

Fabrication of Large-Area Multi-Stimulus Responsive Thin Films via Interfacially Confined Irreversible Katritzky Reaction.

Fabrication of large-area thin films through irreversible reactions remains a formidable task. This study reports a breakthrough strategy for in situ synthesis of large-area, free-standing, robust and multi-stimulus responsive thin films through a catalyst-free and irreversible Katritzky reaction at a liquid-liquid interface. The as resulted films are featured with adjustable thickness of 1-3 µm and an area up to 50 cm2. The thin films exhibit fast photo-mechanical motions (a response time of ca 0.1 s), vapor-mechanical motions, as well as photo-chromic and solvato-chromic behaviors. It was revealed that the reason behind the observable motions is proton transfer from the imine groups to the carbonyl structures within the film induced by photo- and/or dimethyl sulfoxide-stimulus. In addition, the films can harvest anionic radicals and the radicals as captured can be efficiently degraded under UV light illumination. This study provides a new strategy for fabricating smart thin films via interfacially confined irreversible Katritzky reaction.

Analysis of Bacterial Culture of Fluid in the Surgical Area in Transanal Total Mesorectal Excision and Laparoscopic Total Mesorectal Excision.

Purpose: To investigate the clinical value of the bacterial culture of fluid in the surgical area in laparoscopic transanal total mesorectal excision (Lap-taTME) and laparoscopic total mesorectal excision (Lap-TME). Methods: Clinical data of 106 patients with rectal cancer who had undergone surgery were retrospectively collected, including 56 patients in the Lap-taTME group and 50 patients in the Lap-TME group. In the Lap-taTME group, the initial pelvic fluid, the rectal cavity fluid after purse-string suture, and the pelvic cavity fluid after anastomosis were collected and recorded as culture No. 1, No. 2, and No. 3, respectively. In the Lap-TME group, culture No. 1 and No. 3 were collected as done in the Lap-taTME group. The culture results and postoperative complications were statistically analyzed. Results: The positive rate of culture No. 1 was zero in both groups, and there were 6 cases (10.7%) with positive culture No. 2 in the Lap-taTME group. However, the number of patients with positive culture No. 3 (7, 12.5%) and cumulative positive culture cases (11, 19.6%) in the Lap-taTME group were significantly higher than those in the Lap-TME group (0) (all P < .05). Pelvic infection occurred in 4 (7.1%) of the 11 cases (19.6%) with positive culture in the Lap-taTME group, accounting for 36.4% (4/11). There were no significant intergroup differences in anastomotic leakage and pelvic infection (all P > .05). Conclusion: Positive bacterial culture of fluid during Lap-taTME indicates an increased risk of pelvic infection after operation. Lap-taTME is more prone to intraoperative contamination than Lap-TME but does not significantly increase the risk of postoperative pelvic infection.

Biodiversity mitigates drought effects in the decomposer system across biomes.

Multiple facets of global change affect the earth system interactively, with complex consequences for ecosystem functioning and stability. Simultaneous climate and biodiversity change are of particular concern, because biodiversity may contribute to ecosystem resistance and resilience and may mitigate climate change impacts. Yet, the extent and generality of how climate and biodiversity change interact remain insufficiently understood, especially for the decomposition of organic matter, a major determinant of the biosphere-atmosphere carbon feedbacks. With an inter-biome field experiment using large rainfall exclusion facilities, we tested how drought, a common prediction of climate change models for many parts of the world, and biodiversity in the decomposer system drive decomposition in forest ecosystems interactively. Decomposing leaf litter lost less carbon (C) and especially nitrogen (N) in five different forest biomes following partial rainfall exclusion compared to conditions without rainfall exclusion. An increasing complexity of the decomposer community alleviated drought effects, with full compensation when large-bodied invertebrates were present. Leaf litter mixing increased diversity effects, with increasing litter species richness, which contributed to counteracting drought effects on C and N loss, although to a much smaller degree than decomposer community complexity. Our results show at a relevant spatial scale covering distinct climate zones that both, the diversity of decomposer communities and plant litter in forest floors have a strong potential to mitigate drought effects on C and N dynamics during decomposition. Preserving biodiversity at multiple trophic levels contributes to ecosystem resistance and appears critical to maintain ecosystem processes under ongoing climate change.

Seeded growth of single-crystal black phosphorus nanoribbons.

Two-dimensional materials have emerged as an important research frontier for overcoming the challenges in nanoelectronics and for exploring new physics. Among them, black phosphorus, with a combination of a tunable bandgap and high mobility, is one of the most promising systems. In particular, black phosphorus nanoribbons show excellent electrostatic gate control, which can mitigate short-channel effects in nanoscale transistors. Controlled synthesis of black phosphorus nanoribbons, however, has remained an outstanding problem. Here we report large-area growth of black phosphorus nanoribbons directly on insulating substrates. We seed the chemical vapour transport growth with black phosphorus nanoparticles and obtain uniform, single-crystal nanoribbons oriented exclusively along the [100] crystal direction. With comprehensive structural calculations, we discover that self-passivation at the zigzag edges holds the key to the preferential one-dimensional growth. Field-effect transistors based on individual nanoribbons exhibit on/off ratios up to ~104, confirming the good semiconducting behaviour of the nanoribbons. These results demonstrate the potential of black phosphorus nanoribbons for nanoelectronic devices and also provide a platform for investigating the exotic physics in black phosphorus.

Ti-B-O System for Catalyzing Boron Nitride Nanotube Growth.

Chemical vapor deposition (CVD) stands out as the most promising method for cost-effective production of high-quality boron nitride nanotubes (BNNTs). Catalysts play a crucial role in BNNT synthesis. This work delves into the impact of oxygen (O) on Ti-based catalysts during the CVD growth of BNNTs. In contrast to the B/TiB2 nanoparticles (NPs) and B/TiN NPs systems, the oxygen-containing precursor B/TiO2 NPs remarkably catalyzes the growth of high-quality and high-purity BNNTs across a wider range of synthesis parameters. Subsequent analyses reveal that TiBO3 acts as an active catalyst, facilitating BNNT growth in Ti-based catalyst systems. Moreover, the nanocomposite film synthesized from BNNTs and PVDF-HFP exhibits excellent mechanical properties and heat dissipation capabilities. Utilizing the nanocomposite film as a thermal interface material effectively enhances the heat dissipation for a 5 W light-emitting diode (LED) chip. Consequently, our research confirms the effectiveness of the Ti-B-O system in catalyzing BNNT growth.

Role of Edge Reconstruction in the Synthesis of Few-Layer Black Phosphorene.

Recent advancements in preparing few-layer black phosphorene (BP) are hindered by edge reconstruction challenges. Our previous studies have revealed the factors contributing to the difficulty of growing few-layer BP. In this study, we have successfully identified three reconstructed edges in bi- and multilayer BP through a combination of the crystal structure analysis by particle swarm optimization (CALYPSO) global structure search and density functional theory (DFT). Notably, the reconstruction between adjacent layers proves more beneficial than self-passivation or maintaining pristine edges. Among the reconstructed edges, the reconstructed ZZ edge is the most stable, regardless of the number of layers. Calculated electronic band structures reveal a significant transition in the electronic properties of black phosphorus nanoribbons (BPNRs), changing from metallic to semiconducting. This insight not only enhances the understanding of the fundamental properties of BP but also provides valuable theoretical guidance for the experimental growth of BPNRs or black phosphorus nanowires (BPNWs).

Fully Reversible and Super-Fast Photo-Induced Morphological Transformation of Nanofilms for High-Performance UV Detection and Light-Driven Actuators.

Flexible and highly ultraviolet (UV) sensitive materials garner considerable attention in wearable devices, adaptive sensors, and light-driven actuators. Herein, a type of nanofilms with unprecedented fully reversible UV responsiveness are successfully constructed. Building upon this discovery, a new system for ultra-fast, sensitive, and reliable UV detection is developed. The system operates by monitoring the displacement of photoinduced macroscopic motions of the nanofilms based composite membranes. The system exhibits exceptional responsiveness to UV light at 375 nm, achieving remarkable response and recovery times of < 0.3 s. Furthermore, it boasts a wide detection range from 2.85 µW cm-2 to 8.30 mW cm-2, along with robust durability. Qualitative UV sensing is accomplished by observing the shape changes of the composite membranes. Moreover, the composite membrane can serve as sunlight-responsive actuators for artificial flowers and smart switches in practical scenarios. The photo-induced motion is ascribed to the cis-trans isomerization of the acylhydrazone bonds, and the rapid and fully reversible shape transformation is supposed to be a synergistic result of the instability of the cis-isomers acylhydrazone bonds and the rebounding property of the networked nanofilms. These findings present a novel strategy for both quantitative and qualitative UV detection.

A LlWRKY33-LlHSFA4-LlCAT2 module confers resistance to Botrytis cinerea in lily.

Gray mold caused by Botrytis cinerea is one of the major threats in lily production. However, limited information is available about the underlying defense mechanism against B. cinerea in lily. Here, we characterized a nuclear-localized class A heat stress transcription factor (HSF)-LlHSFA4 from lily (Lilium longiflorum), which positively regulated the response to B. cinerea infection. LlHSFA4 transcript and its promoter activity were increased by B. cinerea infection in lily, indicating its involvement in the response to B. cinerea. Virus-induced gene silencing (VIGS) of LlHSFA4 impaired the resistance of lily to B. cinerea. Consistent with its role in lily, overexpression of LlHSFA4 in Arabidopsis (Arabidopsis thaliana) enhanced the resistance of transgenic Arabidopsis to B. cinerea infection. Further analysis showed that LlWRKY33 directly activated LlHSFA4 expression. We also found that both LlHSFA4 and LlWRKY33 positively regulated plant response to B. cinerea through reducing cell death and H2O2 accumulation and activating the expression of the reactive oxygen species (ROS) scavenging enzyme gene LlCAT2 (Catalase 2) by binding its prompter, which might contribute to reducing H2O2 accumulation in the infected area. Taken together, our data suggested that there may be a LlWRKY33-LlHSFA4-LlCAT2 regulatory module which confers B. cinerea resistance via reducing cell death and the ROS accumulation.

Recent Advances in Construction Strategies for Fluorescence Sensing Films.

A year ago, film-based fluorescent sensors (FFSs) were recognized in the "IUPAC Top Ten Emerging Technologies in Chemistry 2022" due to their extensive application in detecting hidden explosives, illicit drugs, and volatile organic compounds. These sensors offer high sensitivity, specificity, immunity to light scattering, and noninvasiveness. The core of FFSs is the construction of high-performance fluorescent sensing films, which are dependent on the processes of "energy transfer" and "mass transfer" in the active layer and involve complex interactions between sensing molecules and analytes. This Perspective focuses on the latest strategies in constructing these films, emphasizing the design of sensing molecules with various innovative features and structures that enhance the mass transfer efficiency. Additionally, it discusses the ongoing challenges and potential advancements in the field of FFSs.

Lily LlHSFC2 coordinates with HSFAs to balance heat stress response and improve thermotolerance.

Heat stress transcription factors (HSFs) are core regulators of plant heat stress response. Much research has focused on class A and B HSFs, leaving those of class C relatively understudied. Here, we reported a lily (Lilium longiflorum) heat-inducible HSFC2 homology involved in thermotolerance. LlHSFC2 was located in the nucleus and cytoplasm and exhibited a repression ability by binding heat stress element. Overexpression of LlHSFC2 in Arabidopsis, tobacco (Nicotiana benthamiana), and lily, all increased the thermotolerance. Conversely, silencing of LlHSFC2 in lily reduced its thermotolerance. LlHSFC2 could interact with itself, or interact with LlHSFA1, LlHSFA2, LlHSFA3A, and LlHSFA3B of lily, AtHSFA1e and AtHSFA2 of Arabidopsis, and NbHSFA2 of tobacco. LlHSFC2 interacted with HSFAs to accelerate their transactivation ability and act as a transcriptional coactivator. Notably, compared with the separate LlHSFA3A overexpression, co-overexpression of LlHSFC2/LlHSFA3A further enhanced thermotolerance of transgenic plants. In addition, after suffering HS, the homologous interaction of LlHSFC2 was repressed, but its heterologous interaction with the heat-inducible HSFAs was promoted, enabling it to exert its co-activation effect for thermotolerance establishment and maintenance. Taken together, we identified that LlHSFC2 plays an active role in the general balance and maintenance of heat stress response by cooperating with HSFAs, and provided an important candidate for the enhanced thermotolerance breeding of crops and horticulture plants.

A multi-wavelength cross-reactive fluorescent sensor ensemble for fingerprinting flavonoids in serum and urine.

Flavonoids are a kind of natural polyphenols which are closely related to human health, and the identification of flavonoids with similar structures is an important but difficult issue. We herein easily constructed a powerful fluorescent sensor ensemble by using surfactant cetyltrimethylammoniumbromide (CTAB) encapsulating two commercially available fluorescent probes (F1 and F2) with multi-wavelength emission. Fluorescence measurements illustrate the present sensor ensemble exhibits turn-off responses to flavones and flavonols but ratiometric responses to isoflavones, owing to different FRET processes. The heat map and linear discriminant analysis (LDA) results show that this single sensor can effectively distinguish 6 flavonoids belong to three subgroups by collecting the fluorescence variation at four typical wavelengths. Moreover, it can be applied to identify different flavonoids even in biofluids like serum and urine, providing potential practical application.

Application of Failure Mode and Effects Analysis to Improve the Quality of the Front Page of Electronic Medical Records in China: Cross-Sectional Data Mapping Analysis.

BACKGROUND: The completeness and accuracy of the front pages of electronic medical records (EMRs) are crucial for evaluating hospital performance and for health insurance payments to inpatients. However, the quality of the first page of EMRs in China's medical system is not satisfactory, which can be partly attributed to deficiencies in the EMR system. Failure mode and effects analysis (FMEA) is a proactive risk management tool that can be used to investigate the potential failure modes in an EMR system and analyze the possible consequences. OBJECTIVE: The purpose of this study was to preemptively identify the potential failures of the EMR system in China and their causes and effects in order to prevent such failures from recurring. Further, we aimed to implement corresponding improvements to minimize system failure modes. METHODS: From January 1, 2020, to May 31, 2022, 10 experts, including clinicians, engineers, administrators, and medical record coders, in Zhejiang People's Hospital conducted FMEA to improve the quality of the front page of the EMR. The completeness and accuracy of the front page and the risk priority numbers were compared before and after the implementation of specific improvement measures. RESULTS: We identified 2 main processes and 6 subprocesses for improving the EMR system. We found that there were 13 potential failure modes, including data messaging errors, data completion errors, incomplete quality control, and coding errors. A questionnaire survey administered to random physicians and coders showed 7 major causes for these failure modes. Therefore, we established quality control rules for medical records and embedded them in the system. We also integrated the medical insurance system and the front page of the EMR on the same interface and established a set of intelligent front pages in the EMR management system. Further, we revamped the quality management systems such as communicating with physicians regularly and conducting special training seminars. The overall accuracy and integrity rate of the front page (P<.001) of the EMR increased significantly after implementation of the improvement measures, while the risk priority number decreased. CONCLUSIONS: In this study, we were able to identify the potential failure modes in the front page of the EMR system by using the FMEA method and implement corresponding improvement measures in order to minimize recurring errors in the health care services in China.

Ultrabright Acrylic Polymers with Tunable Fluorescence Enabled by Imprisoning Single TICT Probe.

Bright and colorful fluorescent polymers are ideal materials for a variety of applications. Although polymers could be made fluorescent by physical doping or chemical binding of fluorescent units, it is a great challenge to get colorful and highly emissive polymers with a single fluorophore. Here the development of a general and facile method to synthesize ultrabright and colorful polymers using a single twisted intramolecular charge transfer (TICT) probe is reported. By incorporating polymerizable, highly fluorescent, and environmental sensitive TICT probe, a series of colorful acrylic polymers (emission from 481 to 543 nm) with almost 100% fluorescence quantum yields are prepared. Like the solvatochromic effect, functional groups within side chains of acrylic polymers (including alkyl chain, tetrahydrofurfuryl group, and hydroxyl group) provide varied environmental polarity for the incorporated fluorophore, resulting in a series of colorful polymeric materials. Benefiting from the excellent photophysical properties, the polymers show great potential in encryption, cultural relics protection, white light-emitting diode bulb making, and fingerprint identification.

Comparative Observation of Distinct Dynamic Stokes Shifts in Diaryl BODIPY Triads with Broadband Two-Photon Absorption.

Time-resolved evolution of excited states in the twist-conjugated chromophores is of great fundamental interest for photoluminescent applications. The four diaryl BODIPY triads modified with diverse end-cappers at 2,6-positions were investigated properly, and considerable two-photon absorption capabilities in the first biological spectral window were obtained. Fast relaxations from the initially twisted conformation to the planarized conformation in the excited state were resolved spectrally and kinetically, accompanied by the discernible phenomenon of the fluorescence dynamic Stokes shift (DSS). Along with increasing electron donating capabilities and solvent polarities, the characteristics of structural rearrangement and intramolecular charge transfer have been estimated by enhanced DSS behaviors. Especially, the blue-shifted DSS was rationalized as the sequence conversion between the planarized state and the twisted charge transfer state. A molecular-level picture for relaxation pathways in different polarities was depicted and supported by the theoretical simulations. Significant and fast structural motions in this work contribute to the excited-state dynamics and rational development of versatile BODIPY chromophores.

Global genomic diversity and conservation of SARS-CoV-2 since the COVID-19 outbreak.

IMPORTANCE: Our results indicate that most severe acute respiratory syndrome coronavirus 2 genomes sampled from patients had a mutation rate ≤1.07 ‰ and genome-tail proteins (including S protein) were the main sources of genetic polymorphism. The analysis of the virus-host interaction network of genome-tail proteins showed that they shared some antiviral signaling pathways, especially the intracellular protein transport pathway.

Low LdMYB12 expression contributes to petal spot deficiency in Lilium davidii var. unicolor.

Petal spots are widespread in plants, they are important for attracting pollinators and as economic traits in crop breeding. However, the genetic and developmental control of petal spots has seldom been investigated. To further clarify the development of petal spots formation, we performed comparative transcriptome analysis of Lilium davidii var. unicolor and Lilium davidii petals at the full-bloom stage. In comparison with the parental species L. davidii, petals of the lily variety L. davidii var. unicolor do not have the distinct anthocyanin spots. We show that among 7846 differentially expressed genes detected, LdMYB12 was identified as a candidate gene contributing to spot formation in lily petals. The expression level of LdMYB12 in the petals of L. davidii was higher than that in L. davidii var. unicolor petals. Moreover, overexpression of LdMYB12 led to the appearance of spots on the petals of L. davidii var. unicolor, accompanied by increased expression of anthocyanin synthesis-related genes. Taken together, these results indicate that abnormal expression of LdMYB12 contributes to petal spot deficiency in L. davidii var. unicolor.

Application of exponential smoothing method and SARIMA model in predicting the number of admissions in a third-class hospital in Zhejiang Province.

OBJECTIVE: To establish the exponential smoothing prediction model and SARIMA model to predict the number of inpatients in a third-class hospital in Zhejiang Province, and evaluate the prediction effect of the two models, and select the best number prediction model. METHODS: The data of hospital admissions from January 2019 to September 2022 were selected to establish the exponential smoothing prediction model and the SARIMA model respectively. Then compare the fitting parameters of different models: R2_adjusted, R2, Root Mean Square Error (RMSE)、Mean Absolute Percentage Error (MAPE)、Mean Absolute Error(MAE) and standardized BIC to select the best model. Finally, the established model was used to predict the number of hospital admissions from October to December 2022, and the prediction effect of the average relative error judgment model was compared. RESULTS: The best fitting exponential smoothing prediction model was Winters Addition model, whose R2_adjusted was 0.533, R2 was 0.817, MAPE was 6.133, MAE was 447.341. The best SARIMA model is SARIMA(2,2,2)(0,1,1)12 model, whose R2_adjusted is 0.449, R2 is 0.199, MAPE is 8.240, MAE is 718.965. The Winters addition model and SARIMA(2,2,2)(0,1,1)12 model were used to predict the number of hospital admissions in October-December 2022, respectively. The results showed that the average relative error was 0.038 and 0.015, respectively. The SARIMA(2,2,2)(0,1,1)12 model had a good prediction effect. CONCLUSION: Both models can better fit the number of admissions, and SARIMA model has better prediction effect.

Flexible Strain-Sensitive Sensors Assembled from Mussel-inspired Hydrogel with Tunable Mechanical Properties and Wide Temperature Tolerance in Multiple Application Scenarios.

Conductive hydrogels, exhibiting wide applications in electronic skins and soft wearable sensors, often require maturely regulating of the hydrogel mechanical properties to meet specific demands and work for a long-term or under extreme environment. However, in situ regulation of the mechanical properties of hydrogels is still a challenge, and regular conductive hydrogels will inevitably freeze at subzero temperature and easily dehydrate, which leads to a short service life. Herein, a novel adhesive hydrogel (PAA-Dopa-Zr4+) capable of strain sensing is proposed with antifreezing, nondrying, strong surface adhesion, and tunable mechanical properties. 3,4-Dihydroxyphenyl-l-alanine (l-Dopa)-grafted poly(acrylic acid) (PAA) and Zr4+ ion are introduced into the hydrogel, which broadly alters the mechanical properties via tuning the in situ aggregation state of polymer chains by ions based on the complexation effect. The catechol groups of l-Dopa and viscous glucose endow the hydrogel with high adhesiveness for skin and device interface (including humid and dry environments) and exhibit an outstanding temperature tolerance under extreme wide temperature spectrum (-35 to 65 °C) or long-lasting moisture retention (60 days). Furthermore, this PAA-Dopa-Zr4+ can be assembled as a flexible strain-sensitive sensor to detect human motions based on specific mechanical properties requirements. This work, enabling superior adhesive and temperature tolerance performance and broad mechanical tenability, presents a new paradigm for numerous applications to wearable sensing and personalized healthcare monitoring.

Application of problem based learning (PBL) and case based learning (CBL) in the teaching of international classification of diseases encoding.

To study the application of PBL combined with CBL teaching mode in the teaching of international classification of diseases (ICD) encoding, so as to improve students' grasp of ICD encoding knowledge. From March 2020 to June 2020, 50 students majoring in health information management who were interns in a Grade A general hospital were selected as the research participants and randomly divided into experimental group and control group, 25 in each group. The experimental group and the control group adopted the PBL combined CBL teaching mode and the traditional teaching mode respectively to carry out the classification and coding teaching. The academic achievement of the two groups of students was evaluated by means of achievement assessment and questionnaire survey based on information processing theory. The scores of theoretical knowledge in the experimental group and the control group were 79.78 ± 8.55 and 70.92 ± 10.81, respectively, and the scores of skill operation in the two groups were 79.76 ± 8.28 and 70.00 ± 10.41, respectively. The test scores of the experimental group were higher than those of the control group, and the difference was statistically significant (P < 0.05). The scores of knowledge acquisition ability of experimental group and control group were 16.72 ± 1.79 and 16.60 ± 2.36, the scores of knowledge sharing ability were 24.20 ± 2.61 and 21.00 ± 2.65, the scores of knowledge storage ability were 20.80 ± 2.47 and 17.24 ± 4.90, respectively. The scores of knowledge application ability were 14.00 ± 1.80 and 11.00 ± 2.69, the scores of knowledge innovation ability were 20.16 ± 2.34 and 18.08 ± 3.70, and the total scores were 95.88 ± 6.08 and 83.92 ± 11.30, respectively. The scores of all questionnaires in the experimental group were higher than those in the control group. The scores of knowledge sharing ability, knowledge storage ability, knowledge application ability, knowledge innovation ability and total score between the two groups were higher than those of the control group, and the differences were statistically significant (P < 0.05). PBL combined with CBL teaching model has good academic achievement in ICD encoding teaching, which can significantly improve academic performance and learning ability, and is worthy of promotion.