Evaluation of teaching-in-English reform in five-year clinical tropical medicine program–Case analysis of curriculum reform of clinical medicine in Hainan Medical University

Objective: To investigate the model, quality as well as effect of teaching-in-English in five-year clinical medicine program of Hainan Medical University.Methods: The questionnaire was carried out among clinical medicine undergraduates of2012–2015 grades in Hainan Medical University, to investigate studying time, studying habits and the impact of teaching in English. Additionally results of CET-4, CET-6 and overseas internship from undergraduates of 2012–2015 grade, as well as the result of phased medical licensing examination and post-graduate entrance examination from undergraduates of 2012 were accordingly collected from the Teaching Management Department.Results: For the Chinese students in international classes, the average time of self-study was 161.49 min, 58.3% had preview before classes, and 90.7% had habit of review after classes. Thus the first time pass rate, total pass rate, first time excellent rate and total excellent rate of CET-4 and CET-6 of international classes were significantly higher than those of regular classes. The result of post-graduate entrance examination in 2016 showed that the score, pass rate and acceptance rate of international classes of 2012 grade were significantly higher those of regular classes(P < 0.01).Conclusions: Teaching-in-English reform in Hainan Medical University has achieved initial success. Chinese students from international classes are superior to those from regular classes in many aspects. However, there are still many problems, and effective measures should be implemented to promote teaching quality continuously.

Influence of Temperature and Humidity on the Incidence of Pulmonary Tuberculosis in Hainan,China,2004-2018

According to the World Health Organization’s Global Tuberculosis Report 2023,there were 10.6 million cases of tuberculosis(TB)worldwide in 2022,an increase of 2.8%over 2021,and 1.3 million people had already died of the disease.The report also indicated that approximately 748,000 new cases occurred in China in 2022,accounting for 7.1%of the global total,with an incidence of 52/100,000.

Potential mosquito-associated melioidosis and analysis of sample processing results in Hainan, China, 2023

Burkholderia(B.)pseudomallei is a Gram-negative bacterium causing melioidosis,a tropical infection that is being recognized as a growing public health problem[1].Melioidosis,with mortality rates ranging from under 10%to 40%,is a significant concern in Southeast Asia,Australia,and beyond[2].The underdiagnosis,particularly in rural areas,emphasizes the need for improved awareness,surveillance,and management,potentially classifying melioidosis as a neglected tropical disease[3].

Application of fecal immunochemical test in colorectal cancer screening:A community-based,cross-sectional study in averagerisk individuals in Hainan

BACKGROUND The incidence of colorectal cancer(CRC)in China is steadily rising,with a high proportion of advanced-stage diagnoses.This highlights the significance of early detection and prevention measures to enhance survival rates.Fecal immunochemical testing(FIT)is a globally recommended CRC screening method;however,limited research has been conducted on its application in Hainan.AIM To assess the efficacy and adherence of FIT screening among average-risk individuals in Hainan,while also examining the risk factors associated with positive FIT results.METHODS This population-based cross-sectional study implemented FIT screening for CRC in 2000 asymptomatic participants aged 40-75 years from five cities and 21 community health centers in Hainan Province.The study was conducted from August 2022 to April 2023,employing a stratified sampling method to select participants.Individuals with positive FIT results subsequently underwent colonoscopy.Positive predictive values for confirmed CRC and advanced adenoma were calculated,and the relationship between relevant variables and positive FIT results was analyzed usingχ2 tests and multivariate logistic regression.RESULTS A total of 1788 participants completed the FIT screening,with a median age of 57 years(interquartile range:40-75).Among them,503(28.1%)were males,and 1285(71.9%)were females,resulting in an 89.4%compliance rate for FIT screening.The overall positivity rate of FIT was 4.4%[79 out of 1788;95%confidence interval(CI):3%-5%].The specific positivity rates for Haikou,Sanya,Orient City,Qionghai City,and Wuzhishan City were 9.6%(45 of 468;95%CI:8%-11%),1.3%(6 of 445;95%CI:0.1%-3.1%),2.7%(8 of 293;95%CI:1.2%-4.3%),3.3%(9 of 276;95%CI:1.0%-6.3%),and 4.2%(11 of 406;95%CI:1.2%-7.3%),respectively.Significant associations were found between age,dietary habits,and positive FIT results.Out of the 79 participants with positive FIT results,55 underwent colonoscopy,demonstrating an 82.2%compliance rate.Among them,10 had a clean gastrointestinal tract,43 had polyps or adenomas,and 2 were confirmed to have CRC,yielding a positive predictive value of 3.6%(95%CI:0.9%-4.2%).Among the 43 participants with polyps or adenomas,8 were diagnosed with advanced adenomas,resulting in an advanced adenoma rate of 14.5%(95%CI:10.1%-17.7%).CONCLUSION In the Hainan region,FIT screening for CRC among asymptomatic individuals at average risk is feasible and wellreceived.

Mathematical modeling for selecting center locations for medical and health supplies reserve in Hainan Province

Objective:To explore how to choose the center locations to build the medical and health supplies reserve among many island towns.Methods:The center locations were selected from 18 towns Hainan Province,it's maximum service range(distance)was required to reach the minimum,or to minimize.Results:Three scenarios were considered,the center locations included only one town,two towns,three towns.By the use of graph theory and MATLAB programming,a mathematical model was established to obtain the shortest distance and the shortest path between arbitrary two towns.Conclusions:We find out the center sites under certain conditions,and determine the specific service ranges of the center sites.

Comparative analysis of the gut microbiota of wild adult rats from nine district areas in Hainan,China

BACKGROUND Wild rats have the potential to hold zoonotic infectious agents that can spread to humans and cause disease.AIM To better understand the composition of gut bacterial communities in rats is essential for preventing and treating such diseases.As a tropical island located in the south of China,Hainan province has abundant rat species.Here,we examined the gut bacterial composition in wild adult rats from Hainan province.METHODS Fresh fecal samples were collected from 162 wild adult rats,including three species(Rattus norvegicus,Leopoldamys edwardsi,and Rattus losea),from nine regions of Hainan province between 2017-2018.RESULTS We analyzed the composition of gut microbiota using the 16S rRNA gene amplicon sequencing.We identified 4903 bacterial operational taxonomic units(30 phyla,175 families,and 498 genera),which vary between samples of different rat species in various habitats at various times of the year.In general,Firmicutes were the most abundant phyla,followed by Bacteroidetes(15.55%),Proteobacteria(6.13%),and Actinobacteria(4.02%).The genus Lactobacillus(20.08%),unidentified_Clostridiales(5.16%),Romboutsia(4.33%),unidentified_Ruminococcaceae(3.83%),Bacteroides(3.66%),Helicobacter(2.40%)and Streptococcus(2.37%)were dominant.CONCLUSION The composition and abundance of the gut microbial communities varied between rat species and locations.This work provides fundamental information to identify microbial communities useful for disease control in Hainan province.

One Health practice in Hainan,China

The devastating COVID-19 pandemic over the past three years has made One Health a trending philosophy not only as a regional and national initiative but also as transboundary efforts calling for multilateral cooperations.Mwatondo et al.presented One Health Networks in a recent article published in The Lancet,calling for further promotion of the One Health approach[1].Likewise,recent studies in developing countries described the rapid adoption of One Health concepts globally and the major advances in practice of One Health in the past two decades[2-4].In this perspective,we highlight a pilot One Health program China spearheaded by the World Bank and the provincial government of Hainan.This pilot program aims to boost our awareness of preventing and combating emerging infectious diseases using the One Health approach[5].

HIV-1 Subtype Diversity and Factors Affecting Drug Resistance among Patients with Virologic Failure in Antiretroviral Therapy in Hainan Province,China,2014–2020

Objective This study aimed to determine the HIV-1 subtype distribution and HIV drug resistance(HIVDR)in patients with ART failure from 2014 to 2020 in Hainan,China.Methods A 7-year cross-sectional study was conducted among HIV/AIDS patients with ART failure in Hainan.We used online subtyping tools and the maximum likelihood phylogenetic tree to confirm the HIV subtypes with pol sequences.Drug resistance mutations(DRMs)were analyzed using the Stanford University HIV Drug Resistance Database.Results A total of 307 HIV-infected patients with ART failure were included,and 241 available pol sequences were obtained.Among 241 patients,CRF01_AE accounted for 68.88%,followed by CRF07_BC(17.00%)and eight other subtypes(14.12%).The overall prevalence of HIVDR was 61.41%,and the HIVDR against non-nucleoside reverse transcriptase inhibitors(NNRTIs),nucleotide reverse transcriptase inhibitors(NRTIs),and protease inhibitors(PIs)were 59.75%,45.64%,and 2.49%,respectively.Unemployed patients,hypoimmunity or opportunistic infections in individuals,and samples from 2017 to 2020 increased the odd ratios of HIVDR.Also,HIVDR was less likely to affect female patients.The common DRMs to NNRTIs were K103N(21.99%)and Y181C(20.33%),and M184V(28.21%)and K65R(19.09%)were the main DRMs against NRTIs.Conclusion The present study highlights the HIV-1 subtype diversity in Hainan and the importance of HIVDR surveillance over a long period.

Data analysis guidelines for single‑cell RNA‑seq in biomedical studies and clinical applications

The application of single-cell RNA sequencing(scRNA-seq)in biomedical research has advanced our understanding of the pathogenesis of disease and provided valuable insights into new diagnostic and therapeutic strategies.With the expansion of capacity for high-throughput scRNA-seq,including clinical samples,the analysis of these huge volumes of data has become a daunting prospect for researchers entering this field.Here,we review the workflow for typical scRNA-seq data analysis,covering raw data processing and quality control,basic data analysis applicable for almost all scRNA-seq data sets,and advanced data analysis that should be tailored to specific scientific questions.While summarizing the current methods for each analysis step,we also provide an online repository of software and wrapped-up scripts to support the implementation.Recommendations and caveats are pointed out for some specific analysis tasks and approaches.We hope this resource will be helpful to researchers engaging with scRNA-seq,in particular for emerging clinical applications.

Differential expression analysis of coronary heart disease related genes in Hainan residents

Objective:To explore the correlation between coronary heart disease related genes and coronary heart disease in hospitalized patients in Hainan,and to provide theoretical basis for enriching the screening methods of high-risk groups of coronary heart disease in Hainan,and optimizing the prevention and treatment strategies.Methods:We select hospitalized patients born in Hainan and aged>30 years old from the Second Affiliated Hospital of Hainan Medical Unversity between January 1,2020 and June 30,2022,and divided the patients into the coronary heart disease group and the non-coronary heart disease group.PCR real-time fluorescence was used to measure gene expression,and Spearman correlation analysis was used to explore the correlation between gene expression and coronary heart disease.Results:A total of 55 whole blood samples were collected from non-coronary heart disease patients(including 26 women and 29 men),with a median age of 57 years,and 170 whole blood samples from coronary heart disease patients(including 44 women and 126 men),with a median age of 63.17.Apolipoprotein B gene(ApoB)was highly expressed in patients with coronary heart disease(P<0.001);AGT gene(P=0.0158),ApoE gene(P=0.0126),FGB gene(P=0.005),GNB gene(P=0.0151),MTFHR gene(P=0.0119),SEL gene(P=0.005),TNF gene(P=0.0298)were significantly overexpressed in the non-coronary heart disease group.The expression of NOS3 gene(P=0.3047),IL6 gene(P=0.7239),ACE gene(P=0.7852)was not different between the two groups.Coronary heart disease was negatively correlated with AGT gene(r=-0.163,P=0.011,P<0.05),positively correlated with APOB gene(r=0.75,P=0,P<0.01),negatively correlated with FGB gene(r=-0.163,P=0.011,P<0.05),negatively correlated with GNB gene(r=-0.165,P=0.011,P<0.05),negatively correlated withSEL gene(r=-0.171,P=0.007,P<0.01),negatively correlated with MHTHR gene(r=-0.210,P=0.001,P<0.01)and negatively correlated with TNF gene(r=-0.131,P=0.04,P<0.05),but coronary heart disease was not correlated with APOE,NOS3,ACE,IL6 and other genes(P>0.05).The ApoB gene of coronary heart disease was negatively correlated with triglyceride(r=-0.461,P=0),positively correlated with age(r=0.173,P=0.009),positively correlated with total cholesterol(r=0.499,P=0),negatively correlated with high-density lipoprotein(r=-0.181,P=0.007),and negatively correlated with low-density lipoprotein(r=-0.143,P=0.031).Conclusion:(1)The detection of apolipoprotein B gene expression may be used as an indicator for screening coronary heart disease in the coronary population in Hainan.It may increase the risk of coronary heart disease by affecting the level of total cholesterol.A larger sample of research is still needed.(2)AGT,ApoE,FGB,GNB,MTFHR,SELE,TNF and other genes may be the protective genes of non-coronary heart disease population in Hainan,and the high expression of these genes may reduce the occurrence of coronary heart disease,which still needs further study.

Studies on Extraction and Activity of Peptides from Haemadipsa hainana

[Objectives]Peptides was extracted from Haemadipsa hainana and its activity was studied.[Methods]Electric stimulation,water extraction and ultrasonic extraction were used to extract the peptides from H.hainana.Then the protein content and molecular weight distribution of H.hainana peptides were detected by the BCA method and SDS-PAGE method,respectively.The antithrombin activity and analgesic activity of the three peptide extracts of H.hainana were detected by Markwardt thrombin titration method and mouse hot plate experiment,respectively.[Results]There extraction methods of electric stimulation,water extraction and ultrasonic extraction were used to extract the peptide extract of H.hainana,and the yields were as follows:water extraction>electrical stimulation>ultrasonic extraction.The three peptide extracts from H.hainana had antithrombin activity,and the antithrombin activity was as follows:water extraction>ultrasonic extraction>electrical stimulation.Through the hot plate experiment in mice,it was verified that the three peptide extracts of H.hainana had analgesic activity,and the analgesic activity was water extraction>electric stimulation>ultrasonic extraction.The analgesic activity of high-dose(100 mg/kg)group of H.hainana obtained by water extraction was slightly weaker than that of tramadol.[Conclusions]This study confirmed that the peptide extract of H.hainana had certain antithrombin and analgesic activity,laying a foundation for the subsequent development and application of H.hainana.

Integration of Theory and Practice in Medical Morphology Curriculum in Postgraduate Training:A Flipped Classroom and Case-based Learning Exercise

Objective:The integration of training in theory and practice across the medical education spectrum is being encouraged to increase student understanding and skills in the sciences.This study aimed to determine the deciding factors that drive students'perceived advantages in class to improve precision education and the teaching model.Methods:A mixed strategy of an existing flipped classroom(FC)and a case-based learning(CBL)model was conducted in a medical morphology curriculum for 575 postgraduate students.The subjective learning evaluation of the individuals(learning time,engagement,study interest and concentration,and professional integration)was collected and analyzed after FC-CBL model learning.Results:The results from the general evaluation showed promising results of the medical morphology in the FC-CBL model.Students felt more engaged by instructors in person and benefited in terms of time-saving,flexible arrangements,and professional improvement.Our study contributed to the FC-CBL model in Research Design in postgraduate training in 4 categories:1)advancing a guideline of precision teaching according to individual characteristics;2)revealing whether a learning background is needed for a Research Design course to guide setting up a preliminary course;3)understanding the perceived advantages and their interfaces;and 4)barriers and/or improvement to implement the FC-CBL model in the Research Design class,such as a richer description of e-learning and hands-on practice.Conclusion:Undertaking a FC-CBL combined model could be a useful addition to pedagogy for medical morphology learning in postgraduate training.

Innovative Practice of Medical Chinese Teaching Based on Constructivism Theory

Based on constructivism theory and task-driven teaching methods,medical Chinese teaching gradually transitions from the current teaching mode to a“student-centered”teaching mode.The ideological elements are integrated into the medical Chinese teaching curriculum,guiding students in acquiring medical Chinese language skills while instilling a spirit of humanistic care and professional ethics inherent in the medical profession.

Copper Metabolism and Cuproptosis:Molecular Mechanisms and Therapeutic Perspectives in Neurodegenerative Diseases

Copper is an essential trace element,and plays a vital role in numerous physiological processes within the human body.During normal metabolism,the human body maintains copper homeostasis.Copper deficiency or excess can adversely affect cellular function.Therefore,copper homeostasis is stringently regulated.Recent studies suggest that copper can trigger a specific form of cell death,namely,cuproptosis,which is triggered by excessive levels of intracellular copper.Cuproptosis induces the aggregation of mitochondrial lipoylated proteins,and the loss of iron-sulfur cluster proteins.In neurodegenerative diseases,the pathogenesis and progression of neurological disorders are linked to copper homeostasis.This review summarizes the advances in copper homeostasis and cuproptosis in the nervous system and neurodegenerative diseases.This offers research perspectives that provide new insights into the targeted treatment of neurodegenerative diseases based on cuproptosis.

An Intelligent Sensor Data Preprocessing Method for OCT Fundus Image Watermarking Using an RCNN

Watermarks can provide reliable and secure copyright protection for optical coherence tomography(OCT)fundus images.The effective image segmentation is helpful for promoting OCT image watermarking.However,OCT images have a large amount of low-quality data,which seriously affects the performance of segmentationmethods.Therefore,this paper proposes an effective segmentation method for OCT fundus image watermarking using a rough convolutional neural network(RCNN).First,the rough-set-based feature discretization module is designed to preprocess the input data.Second,a dual attention mechanism for feature channels and spatial regions in the CNN is added to enable the model to adaptively select important information for fusion.Finally,the refinement module for enhancing the extraction power of multi-scale information is added to improve the edge accuracy in segmentation.RCNN is compared with CE-Net and MultiResUNet on 83 gold standard 3D retinal OCT data samples.The average dice similarly coefficient(DSC)obtained by RCNN is 6%higher than that of CE-Net.The average 95 percent Hausdorff distance(95HD)and average symmetric surface distance(ASD)obtained by RCNN are 32.4%and 33.3%lower than those of MultiResUNet,respectively.We also evaluate the effect of feature discretization,as well as analyze the initial learning rate of RCNN and conduct ablation experiments with the four different models.The experimental results indicate that our method can improve the segmentation accuracy of OCT fundus images,providing strong support for its application in medical image watermarking.

Prognostic significance of grade of malignancy based on histopathological differentiation and Ki-67 in pancreatic ductal adenocarcinoma

Objective:Tumor cell malignancy is indicated by histopathological differentiation and cell proliferation.Ki-67,an indicator of cellular proliferation,has been used for tumor grading and classification in breast cancer and neuroendocrine tumors.However,its prognostic significance in pancreatic ductal adenocarcinoma(PDAC)remains uncertain.Methods:Patients who underwent radical pancreatectomy for PDAC were retrospectively enrolled,and relevant prognostic factors were examined.Grade of malignancy(GOM),a novel index based on histopathological differentiation and Ki-67,is proposed,and its clinical significance was evaluated.Results:The optimal threshold for Ki-67 was determined to be 30%.Patients with a Ki-67 expression level>30%rather than≤30%had significantly shorter 5-year overall survival(OS)and recurrence-free survival(RFS).In multivariate analysis,both histopathological differentiation and Ki-67 were identified as independent prognostic factors for OS and RFS.The GOM was used to independently stratify OS and RFS into 3 tiers,regardless of TNM stage and other established prognostic factors.The tumor-nodemetastasis-GOM stage was used to stratify survival into 5 distinct tiers,and surpassed the predictive performance of TNM stage for OS and RFS.Conclusions:Ki-67 is a valuable prognostic indicator for PDAC.Inclusion of the GOM in the TNM staging system may potentially enhance prognostic accuracy for PDAC.

Mitochondrial targeting sequence of magnetoreceptor MagR:More than just targeting

Iron-sulfur clusters(ISC)are essential cofactors for proteins involved in various biological processes,such as electron transport,biosynthetic reactions,DNA repair,and gene expression regulation.ISC assembly protein IscA1(or MagR)is found within the mitochondria of most eukaryotes.Magnetoreceptor(MagR)is a highly conserved A-type iron and iron-sulfur cluster-binding protein,characterized by two distinct types of iron-sulfur clusters,[2Fe-2S]and[3Fe-4S],each conferring unique magnetic properties.MagR forms a rod-like polymer structure in complex with photoreceptive cryptochrome(Cry)and serves as a putative magnetoreceptor for retrieving geomagnetic information in animal navigation.Although the N-terminal sequences of MagR vary among species,their specific function remains unknown.In the present study,we found that the N-terminal sequences of pigeon MagR,previously thought to serve as a mitochondrial targeting signal(MTS),were not cleaved following mitochondrial entry but instead modulated the efficiency with which iron-sulfur clusters and irons are bound.Moreover,the N-terminal region of MagR was required for the formation of a stable MagR/Cry complex.Thus,the N-terminal sequences in pigeon MagR fulfil more important functional roles than just mitochondrial targeting.These results further extend our understanding of the function of MagR and provide new insights into the origin of magnetoreception from an evolutionary perspective.

Short-term effects of low-level PM_(2.5),PM_(10),O_(3),and tropical meteorological conditions on emergency department visits for respiratory diseases in Haikou,China

Objective:To assess the correlation between atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City.Methods:Daily data on atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City from 2018 to 2021 were collected.The Spearman rank correlation test was used to analyze the correlation,and a distributed lag non-linear model was employed to analyze the health effects and lag impacts of environmental factors.Subgroup analyses were conducted based on sex and age.Results:According to the criteria of International Classification of Diseases(ICD-10:J00-J99),a total of 221913 cases were included,accounting for 21.3%of the total emergency department visits in Haikou City.For every 1℃increase in temperature,the risk of emergency department visits increased by 1.029%(95%CI 1.016%-1.042%).Relative humidity greater than 80%reduced the risk of visits,while higher atmospheric pressure(>1010 hpa)also decreased the likelihood of daily emergency department visits.Higher concentrations of PM_(2.5)(30-50μg/m^(3)),PM10(>60μg/m^(3)),and O_(3)(75-125μg/m^(3))were associated with increased visits.Higher temperatures(>25℃)have a greater impact on females and children aged 0-14 years,while males are more sensitive to low atmospheric pressure.Individuals aged 65 and above exhibited increased sensitivity to O_(3)concentration,and the effects of PM2.5,PM10,and O_(3)are more pronounced in individuals over 14 years old.Conclusions:Short-term exposure to high temperatures,particulate matter pollutants(PM_(2.5)and PM_(10)),and ozone(O_(3))is associated with increased emergency department visits for respiratory diseases.

Diagnostic value associated with the combination of saliva pepsin and microorganisms in functional heartburn and gastroesophageal reflux disease

Heartburn is a common symptom shared by both gastroesophageal reflux disease(GERD)and functional heartburn(FHB),which can make it challenging to differentiate between the two conditions.However,examining oral manifestations of GERD can be a cost-effective and readily available method to aid in this differentiation process.It may serve as a valuable tool in distinguishing GERD from FHB.

Thrombopoietin ameliorates doxorubicin-induced toxicities in H9c2 myocardiocytes by inhibiting oxidative stress through the SIRT1/p38 MAPK signaling pathway

Objective:To explore whether thrombopoietin can exert a protective effect against doxorubicin-induced cardiotoxicity by modulating the sirtuin 1(SIRT1)signaling pathway.Methods:H9c2 cell viability was determined by CCK-8 and cardiomyocyte apoptosis was detected by TUNEL assay.The protein expressions of SIRT1 and p38 MAPK were measured by Western blot.RT-qPCR was also used to determine SIRT1 mRNA expression.In addition,intracellular reactive oxygen species levels and antioxidant enzyme activities were evaluated.Results:Thrombopoietin treatment reversed doxorubicin-induced decline in H9c2 cell viability.It also increased SIRT1 and decreased p-p38 MAPK protein expressions.In addition,thrombopoietin significantly attenuated doxorubicin-induced apoptosis and oxidative stress,and enhanced antioxidant enzyme activities.However,silencing SIRT1 abrogated the protective effects of thrombopoietin,as evidenced by reduced cell viability and increased oxidative stress and reactive oxygen species levels.Conclusions:Thrombopoietin alleviates doxorubicin-induced cardiomyocyte injury by reducing oxidative stress and apoptosis via the SIRT1/p38 MAPK pathway.However,its protective effects need to be further verified in animal tests.