生源多样化背景下医药卫生类高职分析化学教学改革实践

为提高医药卫生类高职院校专业人才培养质量,针对生源多样化情况下的分析化学课程进行教学改革探索。围绕教师教材教法,从优化理论教学资源、构建实践实训平台、课程思政元素应用、教师教学创新能力培养等方面开展建设,深度融合信息技术,助推高职学生自主、泛在、个性化学习,形成了培育学生成就教师的良性循环,改进了医药卫生类高职院校分析化学课程教学效果。为生源多样化背景下职业教育相关专业理论性较强的基础课程教学改革提供了参考。

An YIN (1959−2023)

Professor An Yin,a world-class geologist,was well known for his significant contribution to the understanding of tectonic evolution of the Earth,especially the Himalayas and Tibetan plateau(Yin A and Harrison,2000;Yin A,2006),and other planets and their satellites,such as Enceladus and Europa(Yin A et al.,2016;Leonard et al.,2018).He applied mechanical analysis to structural geology in order to understand the deformation process,not only on terrestrial planets(Yin A,2012),but also on icy Charon,the largest moon of Pluto(Chen HZ and Yin A,2022).He passed away unexpectedly in the afternoon of July 12,2023 while teaching a summer field camp at White Mountain,California,USA.

代谢综合征与胃癌发病风险及临床病理特征相关性的研究

目的:探讨代谢综合征(metabolic syndrome,MetS)与胃癌发病风险及其临床病理特征的相关性。方法:回顾性分析2011年2月至2013年6月天津医科大学肿瘤医院经病理确诊的808例胃癌患者的病例情况、术前检查及临床病理资料,同时选取1 146例随机对照者,分析其Mets与临床病理特征相关性。结果:与对照组相比,所有胃癌患者甘油三酯(triglyceride,TG)水平较高,高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)水平较低,高血压发病率较高。胃癌患者MetS阳性率显著高于对照组(19.1%vs. 9.6%)。MetS的发生与胃癌发病风险相关[总体:OR=2.535(1.805~3.562),女性:OR=1.514(1.197~2.390),男性:OR=2.683(1.798~4.004)]。MetS包含的各个代谢因素异常均能提高胃癌患者的发病风险,包括高身体质量指数(body mass index,BMI)及TG、低HDL-C、高血压和糖尿病。在男性胃癌患者中,高BMI、高血压和糖尿病是胃癌发病风险升高的重要因素;在女性胃癌患者中,低HDL-C、高血压和糖尿病与胃癌发病风险增加密切相关。MetS与低分化腺癌,较晚的T、N分期及TNM分期相关。结论:本研究胃癌患者MetS及其包含的各项代谢相关因素异常率均高于对照组,并且在低、未分化和进展期胃癌患者中MetS相关的代谢异常更为多见,提示代谢紊乱可能在胃癌发生发展中发挥一定作用。

Ultrasound features of extranodal extension in the metastatic cervical lymph nodes of papillary thyroid cancer:a case-control study

Objective：Extranodal extension in cervical lymph nodes is an important risk factor for the progression and prognosis of papillary thyroid cancer.The purpose of this study was to identify the common and characteristic preoperative ultrasonography features that are associated with the pathologic extranodal extension of metastatic papillary thyroid carcinoma.Methods：We retrospectively assessed and compared clinicopathologic and ultrasound features between 60 papillary thyroid cancer patients with extranodal extension and 120 control patients with papillary thyroid cancer without extranodal extension.Results：With respect to the pathological N stage and clinicopathologic features,N1b stage papillary thyroid carcinomas were more frequently found in patients who were extranodal extension-positive,in comparison with those who were extranodal extension-negative（78.3%vs.63.3%,P=0.043）.Extranodal extension was detected most frequently in level VI cervical lymph nodes（48.7%）.In our univariate analysis of patients with papillary thyroid carcinoma,cervical lymph nodes with extranodal extension showed higher incidences of node matting,microcalcification,cystic area,aspect ratio＆lt;2,and larger diameter than those without extranodal extension（all P〈0.05）.Our multivariate analysis demonstrated that node matting and cystic area were independent risk factors for the presence of extranodal extension[odds ratio（OR）：4.751,95%confidence interval（CI）：1.212~18.626,P=0.025;OR：2.707,95%CI：1.127~6.502,P=0.026].Conclusions：Common ultrasound features may indicate the presence of extranodal extension in patients with metastatic cervical lymph nodes of papillary thyroid carcinoma.

乳腺癌高危人群预防措施的研究进展

乳腺癌已成为最常见的恶性肿瘤之一,严重威胁着女性的生命健康。针对乳腺癌高危人群,加强科普、筛查以及合理有效的预防措施,是乳腺癌防控的重要手段。目前,倡导良好的生活方式、合理预防性使用药物及手术切除是主要预防措施。虽预防性使用药物和手术切除效果较好,但因药物的不良反应、术后外观改变以及心理等负面因素的存在,不易被乳腺癌高危人群所接受。制定合理的预防措施已成为对乳腺癌高危人群预防的突破点,既可降低该人群乳腺癌的发病风险,又可减少不必要的医疗消耗,使患者受益,节约社会资源。本文将就乳腺癌高危人群预防措施的研究进展进行综述。

晚期雌激素受体阳性乳腺癌的治疗进展

针对晚期雌激素受体阳性乳腺癌虽然主要使用内分泌、靶向等治疗方法,但内分泌治疗的耐药问题在临床上较常见。随着对CDK4/6、PI3K-Akt1-m TOR通路等治疗靶点和耐药机制的研究,晚期雌激素受体阳性乳腺癌的靶向治疗已成为研究热点,利用基因靶向治疗等也可能成为新的突破点,同时在如何针对不同患者选择最佳治疗方案、最佳治疗时间等问题上仍存在挑战。本文将就晚期雌激素受体阳性乳腺癌的治疗进展进行综述。

基于体波有限频层析成像的青藏高原南部和中部下方印度大陆岩石层俯冲和撕裂的三维图像

使用TIBET-31N无源地震台阵以及以前临时地震台阵记录到的远震体波数据进行了有限频层析成像反演,对青藏高原南部及中部的三维速度结构成像。在喜马拉雅和拉萨地块下方存在向北倾角40°的高速体。我们把这些高速异常区域解释为俯冲的印度大陆岩石层(ICL)。印度大陆岩石层似乎在青藏高原中部比东部向北延伸更多——沿85°E在31°N到达350km深处,而沿91°E则是在30°N到达350km深度。P波和S波低速异常区在当惹雍错裂谷、亚东—谷露裂谷和错那裂谷下方从下地壳延伸至≥180km深度,这表明青藏高原南部的裂谷可能包含了整个岩石层的变形。当惹雍错裂谷下方的异常区向下延伸到约180km,而亚东—谷露裂谷西部和错那裂谷东部的异常延伸到了超过300km的深度。亚东—谷露裂谷西部的低速区上地幔延伸至最北,并且似乎与青藏高原中部下方广阔的上地幔低速区相连。于是,北向俯冲的印度板块沿着南北走向的裂缝撕裂。这些裂缝允许或者导致的软流层上涌同青藏高原北部上地幔相类似。

A novel method for identifying SARS-CoV-2 infection mutants via an epitope-specific CD8^(+)T cell test

Since the outbreak of the coronavirus disease 2019(COVID-19)epidemic in 2019,the public health system has faced enormous challenges.Tracking the individuals who test positive for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is a key step for interrupting chains of transmission of SARS-CoV-2 and reducing COVID-19-associated mortality.With the increasing of asymptomatic infections,it is difficult to track asymptomatic infections through epidemiological surveys and virus whole-genome sequencing.However,due to the cross-reactivity of neutralizing antibodies produced by multiple virus subtypes,neutralizing antibody detection cannot be used to determine whether an individual has a history of infection with a specific subtype of SARS-CoV-2.We recruited 4 human leukocyte antigen A2(HLA-A2)infections,15 individuals who received three doses of inactivated vaccines,and 30 breakthrough infections after vaccination and discussed a case-tracking approach to detect epitope-specific CD8^(+)T cells in the peripheral blood of close contacts,including accurate HLA typing based on ribonucleic acid(RNA)-sequencing and flow cytometry data and the comparison and characterization of SARS-CoV-2 HLA-A2 and HLA-A24 epitope-specific CD8^(+)T cells.From individuals who received three doses of inactivated vaccine,we observed that the CD8^(+)T cell specificity for ancestral epitopes was significantly higher than for mutated epitopes,and the fold change of CD8^(+)T cells corresponding to mutated epitopes relative to ancestral epitopes was less than 1.The enzyme-linked immunospot(ELISpot)results further validate this result.This study forms a“method for understanding the infection history of SARS-CoV-2 subtypes based on the proportion of epitope-specific CD8^(+)T cells in the peripheral blood of subjects”,covering up to 46%of the population,including HLA-A2+and HLA-A24+donors,providing a novel method for SARS-CoV-2 infected case tracing.

Effectiveness of COVID-19 Vaccination Against SARS-CoV-2 Omicron Variant Infection and Symptoms—China,December 2022–February 2023

Summary What is already known about this topic?A considerable percentage of the population has received both primary and booster vaccinations,which could potentially provide protection against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron infections and related symptoms.What is added by this report?The self-reported infection rate,as determined from an online survey,reached its peak(15.5%)between December 19 and 21,2022,with an estimated 82.4%of individuals in China being infected as of February 7,2023.During the epidemic,the effectiveness of booster vaccinations against SARS-CoV-2 Omicron infection was found to be 49.0%within three months of vaccination and 37.9%between 3 and 6 months following vaccination.Furthermore,the vaccine effectiveness of the booster vaccination in relation to symptom prevention varied from 48.7%to 83.2%within three months and from 25.9%to 69.0%between 3 and 6 months post-booster vaccination.

Uplifting mechanism of the Tibetan Plateau inferred from the characteristics of crustal structures

The Tibetan Plateau has been known for its highest elevation and thickest crust on earth,and become a key region for comprehending the rheology and tectonic evolution of continental plates and associated dynamic processes.Over the past years,numerous geophysical studies have been conducted to explore the deep structure of the Tibetan Plateau,resulting in significant advancements in understanding the formation and growth of the Plateau.This paper aims to provide a comprehensive summary and discussion of the geophysical observations and underlying mechanisms of the plateau uplift.First,major relevant tectonic models are reviewed,and the corresponding features of crustal structures and related deformation are presented.Then,recent observations,including the identification of a high-velocity layer in the lower crust of the Lhasa block,the spatial distribution of crustal channel flow,and the decoupling of shallow and deep crustal deformation,are synthesized to gain insights into the crustal structures,and multidisciplinary data are integrated to discuss the potential mechanisms of the plateau uplift.Lastly,some pertinent suggestions are put forward for future research on the Tibetan Plateau.

大陆俯冲板片的持续断离正在终结喜马拉雅造山作用

俯冲的大陆岩石圈在大陆碰撞后仍然对地表板块施加拖拽作用,使造山作用得以维持.但是大陆碰撞作用最终为何减弱乃至停止,目前存在多种解释.本文利用覆盖青藏高原的流动地震观测数据,进行地震层析成像研究,在地慢过渡带中识别出多个高地震波速度异常,认为它们是俯冲印度大陆岩石圈断离形成的碎片.俯冲板片会不断沿大陆岩石圈内部的先存薄弱带断离,该过程将持续减小俯冲岩石圈的板片拖曳力,进而导致中新世印度-欧亚板块汇聚速率降低.据此推断,俯冲大陆板片持续断离将导致印欧大陆碰撞和喜马拉雅造山作用最终结束.

Trends of Mortality in End-Stage Liver Disease—China,2008–2020

Introduction:Liver cancer and cirrhosis represent the most prevalent forms of end-stage liver diseases(ESLDs).Notably,in China,deaths attributed to ESLDs contribute significantly to the global mortality rate of these disorders.Enhanced comprehension of the mortality profile associated with ESLDs in China could provide crucial insights into intervention prioritization,which could in turn help reduce the overall global burden of these diseases.Methods:Data were obtained from China’s Disease Surveillance Points system.The presentation includes both crude and age-standardized mortality rates,stratified by sex,residential location,and region.Using Joinpoint Regression,trends in annual mortality rates were estimated from the period of 2008 to 2020 and expressed as the average annual percentage change(AAPC).Results:In 2020,the gross mortality rate of ESLD stood at 30.08 cases per 100,000 individuals.A higher age-standardized ESLD mortality rate was observed in males and rural populations in comparison to their female and urban counterparts,respectively.Noticeably,the highest mortality rates associated with liver cancer and cirrhosis were reported in South and Southwest China,respectively.A positive correlation was noticed between age-specific ESLD mortality rates and advancing age.Interestingly,an annual decrease in the ESLD mortality rate was observed from 2008 to 2020.In urban contexts,the AAPC of cirrhosis was noted to be higher than that of liver cancer.Conclusions:The mortality rate associated with ESLDs in China decreased between 2008 and 2020.Nevertheless,the death burden attributable to ESLD continues to be alarmingly high.Future initiatives should prioritize the reduction of ESLD mortality in particular populations:males,elderly individuals,and those residing in rural regions of South and Southwest China.The emphasis of future interventions should beplaced on antiviral therapy for adults diagnosed with viral hepatitis,and on the prevention of hepatitis B virus(HBV)infection across all demographics.

Construction and experimental verification research of a magnetic detection system for submarine pipelines based on a two-part towed platform

With the acceleration of the investigation and development of marine resources,the detection and location of submarine pipelines have become a necessary part of modern marine engineering.Submarine pipelines are a typical weak magnetic anomaly target,and their magnetic anomaly detection can only be realized within a certain distance.At present,a towfish or an autonomous underwater vehicle(AUV)is mainly used as the platform to equip magnetometers close to the submarine pipelines for magnetic anomaly detection.However,the mother ship directly affects the towfish,thus causing control interference.The AUV cannot detect in real time,which affects the magnetic anomaly detection and creates problems regarding detection efficiency.Meanwhile,a two-part towed platform has convenient control,thus reducing the interference of the towed mother ship and real-time detection.If the platform can maintain constant altitude sailing through the controller,the data accuracy in the actual magnetic anomaly detection can be guaranteed.On the basis of a two-part towed platform,a magnetic detection system with constant altitude sailing ability for submarine pipelines was constructed in this study.In addition,experimental verification was conducted.The experimental verification research shows that the constant altitude sailing experiment of the two-part towed platform verifies that the platform has good constant altitude sailing ability in both a hydrostatic environment and the actual marine environment.Meanwhile,the offshore magnetic anomaly detection experiment of submarine pipelines verifies the stable measurement function of the magnetic field and the function of the system to detect magnetic anomaly of submarine pipelines.

Cyclical one-way continental rupture-drift in the Tethyan evolution: Subduction-driven plate tectonics

Numerous continents have rifted and drifted away from Gondwana to repeatedly open ocean basins over the past-500 millionyears.These Gondwana-derived continents drifted towards and collided with components of the Eurasian continent to successively close the preexisting oceans between the two.Plate tectonics satisfactorily describes the continental drift from Gondwana to Eurasia but does not define the geodynamic mechanism of continuously rifting to collisions of continents in the Tethy an Realm.After reappraisal of geological records of the rift,collision and subduction initiation from the surface and various geophysical observations from depth,we propose that Eurasia-directed subducting oceanic slabs would have driven Tethyan system in the Phanerozoic.The Eurasia-directed subduction would have dragged the passive Gondwana margin to rift and drift northwards,giving birth to new oceans since the Paleozoic.The closure of preexisting oceans between the Gondwana-derived continents and Eurasia led to continental collisions,which would have induced the initiation of oceanic subduction in the Tethyan Realm.Multiple episodic switches between collision-subduction-rift repeatedly led to the separation of continental fragments from Gondwana and dragged them to drift towards Eurasia.The final disappearance of Neo-Tethy s would have induced collision of the Gondwana-derived continents with the Eurasian continent,giving rise to the Cenozoic Alpine-Zagros-Himalayan collisional system.Therefore,the Eurasia-directed oceanic subduction would have acted as a’one-way train’that successively transferred the ruptured Gondwana continental fragments in the south,into the terminal in the north.In this regard,the engine of this"Tethyan one-way train"is the negative buoyancy of subducting oceanic slabs.

Subduction tectonics vs.plume tectonics——Discussion on driving forces for plate motion

Plate tectonics describes the horizontal motions of lithospheric plates,the Earths outer shell,and interactions among them across the Earths surface.Since the establishment of the theory of plate tectonics about half a century ago,considerable debates have remained regarding the driving forces for plate motion.The early"Bottom up"view,i.e.,the convecting mantledriven mechanism,states that mantle plumes originating from the core-mantle boundary act at the base of plates,accelerating continental breakup and driving plate motion.Toward the present,however,the"Top down"idea is more widely accepted,according to which the negative buoyancy of oceanic plates is the dominant driving force for plate motion,and the subducting slabs control surface tectonics and mantle convection.In this regard,plate tectonics is also known as subduction tectonics."Top down"tectonics has received wide supports from numerous geological and geophysical observations.On the other hand,recent studies indicate that the acceleration/deceleration of individual plates over the million-year timescale may reflect the effects of mantle plumes.It is also suggested that surface uplift and subsidence within stable cratonic areas are correlated with plumerelated magmatic activities over the hundred-million-year timescale.On the global scale,the cyclical supercontinent assembly and breakup seem to be coupled with superplume activities during the past two billion years.These correlations over various spatial and temporal scales indicate the close relationship and intensive interactions between plate tectonics and plume tectonics throughout the history of the Earth and the considerable influence of plumes on plate motion.Indeed,we can acquire a comprehensive understanding of the driving forces for plate motion and operation mechanism of the Earth's dynamic system only through joint analyses and integrated studies on plate tectonics and plume tectonics.

Association Between COVID-19 Vaccination Coverage and Case Fatality Ratio:a Comparative Study—Hong Kong SAR,China and Singapore,December 2021–March 2022

Summary What is already known about this topic?Hong Kong Special Administrative Region(SAR),China and Singapore are both facing considerable Omicron variant epidemic.However,the overwhelmed medical system and high case fatality ratio(CFR)just occurred in Hong Kong SAR,China but not in Singapore.What is added by this report?The low vaccination coverage in Hong Kong SAR,China,especially among the older adults,is shown to be a primary reason of its recent high CFR.What are the implications for public health practice?Facing the potential epidemic risk,non-vaccinated,non-fully-vaccinated,and non-booster-vaccinated people in China,especially the elderly,should get any type of accessible vaccine,which could save lives when the infection unfortunately befalls.

Intra-host Ebola viral adaption during human infection

The onsite next generation sequencing(NGS)of Ebola virus(EBOV)genomes during the 2013–2016 Ebola epidemic in Western Africa provides an opportunity to trace the origin,transmission,and evolution of this virus.Herein,we have diagnosed a cohort of EBOV patients in Sierra Leone in 2015,during the late phase of the outbreak.The surviving EBOV patients had a recovery process characterized by decreasing viremia,fever,and biochemical parameters.EBOV genomes sequenced through the longitudinal blood samples of these patients showed dynamic intra-host substitutions of the virus during acute infection,including the previously described short stretches of 13 serial TNC mutations.Remarkably,within individual patients,samples collected during the early phase of infection possessed Ts at these nucleotide sites,whereas they were replaced by Cs in samples collected in the later phase,suggesting that these short stretches of TNC mutations could emerge independently.In addition,up to a total of 35 nucleotide sites spanning the EBOV genome were mutated coincidently.Our study showed the dynamic intra-host adaptation of EBOV during patient recovery and gave more insight into the complex EBOV-host interactions.

Recommendations and Future Direction for Population-Based Prevention and Control of Behavioral Risk Factors for NCDs

Based on the major findings of our studies,we found that in the past two or three decades,China’s noncommunicable diseases(NCDs)prevention and control policies experienced rapid development.The service mode of NCDs management was transformed,the service capabilities at primary medical facilities were comprehensively improved,and the health literacy and action capability of residents were improved.Remarkable achievements have been made in the prevention and control of NCDs,and a lot of experience has been accumulated.However,unhealthy lifestyles among Chinese residents are still common,and the control of NCDs and related behavioral risk factors faces great challenges.Therefore,in order to implement the Healthy China strategy,early prevention and strengthening of the health management of NCDs in high-risk groups are essential.

When and How to Adjust Non-Pharmacological Interventions Concurrent with Booster Vaccinations Against COVID-19—Guangdong,China,2022

Introduction:With the large-scale roll-out of the coronavirus disease 2019(COVID-19)booster vaccination effort(a vaccine dose given 6 months after completing primary vaccination)in China,we explore when and how China could lift non-pharmacological interventions(NPIs)against COVID-19 in 2022.Methods:Using a modified susceptible-infectiousrecovered(SIR)mathematical model,we projected the COVID-19 epidemic situation and required medical resources in Guangdong Province,China.Results:If the number of people entering from overseas recovers to 20%of the number in 2019,the epidemic in 2022 could be controlled at a low level by a containment(215 local cases)or suppression strategy(1,397 local cases).A mitigation strategy would lead to 21,722 local cases.A coexistence strategy would lead to a large epidemic with 6,850,083 local cases that would overwhelm Guangdong’s medical system.With 50%or 100%recovery of the 2019 level of travelers from overseas,the epidemic could also be controlled with containment or suppression,but enormous resources,including more hotel rooms for border quarantine,will be required.However,coexistence would lead to an uncontrollable epidemic with 12,922,032 local cases.Discussion:With booster vaccinations,the number of travelers from overseas could increase slightly in 2022,but a suppression strategy would need to be maintained to ensure a controllable epidemic.

Long-Term Trend Analysis of Major Human Helminth Infections — Guangdong Province, China, 1988–2021

Introduction:Although helminth infections threaten millions of people worldwide,the spatiotemporal characteristics remain unclear across China.This study systematically describes the spatiotemporal changes of major human helminth infections and their epidemiological characteristics from 1988 to 2021 in Guangdong Province,China.Methods:The survey data in Guangdong Province were primarily obtained from 3 national surveys implemented during 1988–1992,2001–2004,and 2014–2016,respectively,and from the China Information System for Disease Control and Prevention during 2019–2021.A modified Kato-Katz technique was used to detect parasite eggs in collected fecal samples.Results:The overall standardized infection rates(SIRs)of any soil-transmitted helminths(STH)and Clonorchis sinensis decreased from 65.27%during 1988–1992 to 4.23%during 2019–2021.In particular,the SIRs of STH had even more of a decrease,from 64.41%during 1988–1992 to 0.31%during 2019–2021.The SIRs of Clonorchis sinensis in the 4 surveys were 2.40%,12.17%,5.20%,and 3.93%,respectively.This study observed different permutations of gender,age,occupation,and education level on the SIRs of helminths.Conclusions:The infection rate of STH has substantially decreased.However,the infection rate of Clonorchis sinensis has had fewer changes,and it has become the dominant helminth.