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ObjectiveThis study aims at establishing a teaching catalog and content for breast rare diseases and developing the syllabus for the breast rare disease using integrated multimodality of case-/problem-/resource-based learning (CBL+PBL+RBL).MethodsBy conducting bibliometrics co-occurrence analysis, we collected 6291 articles on breast rare disease published from January, 1975 to June, 2024. Additionally, we retrieved the Textbook on Rare Diseases, the Catalog of Chinese Rare Disease, and Second Batch of Rare Disease Catalog and then decided the teaching content.ResultsFrom 16, 387 keywords, 1000 (6.1%) keywords were identified through co-occurrence analysis, including 50(0.3%) candidate diseases. These were classified into three categories: rare primary breast diseases, rare genetic mutation-related diseases associated with breast cancer, and rare systemic multi-system diseases involving the breast. From the candidate list, 20(0.1%) rare primary breast diseases were further selected for their notable clinical teaching significance, and significant multi-systemic diseases affecting the breast, whether related to gene mutations or not. Teaching plans were drafted using a diversified parallel teaching approaches, taking into account the characteristics of different diseases and the focus of different teaching methods.ConclusionsThis study initiated the development of the teaching content for breast rare diseases and developed the teaching syllabus using the CBL+PBL+RBL integrated multi teaching model and targeting each rare breast disease for the critical point for teaching.

Phosphatase and tensin-homolog deleted on chromosome 10 (PTEN) is an important cancer suppressor gene. Its pathogenic mutation leads to PTEN hamartoma tumor syndrome (PHTS), a rare syndrome also known as Cowden syndrome, which is relevant to early-onset hereditary breast cancer (BC). In this paper, we report three patients with unilateral multicentric BC and synchronous and metachronous bilateral BC who harbored PTEN gene mutations, and summarize the clinical manifestations, pathological characteristics, diagnosis, treatment and follow-up outcomes to provide reference for management of PTEN gene mutation-related BC among the Cowden syndrome population.

Hormonal receptor positive human epidermal receptor 2 negative (HR+/HER2-) is the commonest molecular subtype of breast cancer (BC). Patients with HR+/HER2- BC may manifest clinically a late recurrence whose BC metastasizes 10-15 years post-operatively. We report one case who presented with pulmonary mass in upper lobe of lung and Horner syndrome 16 years after BC surgery. FDG PET/CT suggested pulmonary malignancy but could not differentiate between primary or metastatic cancer when invasive biopsy was quite risky. Novel 18F-FES PET/CT facilitated the non-invasive functional diagnosis of estrogen-receptor positive (ER+) pulmonary metastasis of BC, and the patient experienced partial response (PR) after CDK4/6 inhibitor and aromatase inhibitor as endocrine therapy. This article reviews the diagnosis and treatment process of this case, to provide guidance for non-invasive global evaluation of ER status among metastatic HR+/HER2- BC patients with 18F-FES PET/CT.

[Purpose/Significance] Interdisciplinary research has emerged as a key driver of knowledge innovation, its essence being integration of knowledge from different disciplines. A deep and nuanced understanding of the research content of interdisciplinary knowledge integration is essential to foster innovation beyond traditional academic boundaries. Most of the research reviews on interdisciplinary research summarize theories, concepts and indicators from the macro level, while the content of interdisciplinary knowledge integration at the micro level is scattered, and lacks systematicity and logic. Therefore, this study attempts to classify and summarize the research methods, research content and research ideas involved in order to provide reference for scholars and researchers engaged in interdisciplinary knowledge integration. [Method/Process] Based on Web of Science (WOS) and China National Knowledge Infrastructure (CNKI) database as the primary data sources, we reviewed the relevant literature on interdisciplinary knowledge integration. By clarifying the intrinsic meaning of interdisciplinary knowledge integration, we have systematically reviewed and summarized the existing research findings from three aspects. First, research on the degree of knowledge integration mainly involves measurement methods. Second, research on the content of knowledge integration is based on citations and keywords. Third, research on the process of knowledge integration involves its integration path and process, and the characteristics of the integration stage. On this basis, this paper also summarizes the limitations and challenges of existing research, and provides research perspectives for subsequent research on interdisciplinary knowledge integration. [Results/Conclusions] The existing results have extensively explored the definition, measurement method, content, and process of interdisciplinary knowledge integration, but there are problems such as limited applicability of knowledge integration measurement methods, insufficient semantic disclosure, and the lack of systematic research on the degree of knowledge integration. Future research in this area should pay attention to the following three aspects. First, the applicability of methods for measuring interdisciplinary knowledge integration should be improved in order to better adapt to the development of interdisciplinary knowledge integration. Second, there is also a need to strengthen the study of knowledge integration from the perspective of knowledge increment, examining how new knowledge is created and how it contributes to the advancement of the area. In addition, efforts should be made to explore new theories and methods, grasp the development law of interdisciplinary knowledge integration, and expand the application scope and application value of interdisciplinary knowledge integration.

ObjectiveTo estimate postmortem interval （PMI） by analyzing the protein changes in skeletal muscle tissues with the protein chip technology combined with multivariate analysis methods.MethodsRats were sacrificed for cervical dislocation and placed at 16 ℃. Water-soluble proteins in skeletal muscles were extracted at 10 time points （0 d, 1 d, 2 d, 3 d, 4 d, 5 d, 6 d, 7 d, 8 d and 9 d） after death. Protein expression profile data with relative molecular mass of 14 000-230 000 were obtained. Principal component analysis （PCA） and orthogonal partial least squares （OPLS） were used for data analysis. Fisher discriminant model and back propagation （BP） neural network model were constructed to classify and preliminarily estimate the PMI. In addition, the protein expression profiles data of human skeletal muscles at different time points after death were collected, and the relationship between them and PMI was analyzed by heat map and cluster analysis.ResultsThe protein peak of rat skeletal muscle changed with PMI. The result of PCA combined with OPLS discriminant analysis showed statistical significance in groups with different time points （P

Glycine decarboxylase gene (GLDC) mutations cause nonketotic hyperglycinemia (NKH). Patients of NKH usually have heterogeneous phenotypes including respiratory failure, lethargy, myoclonic jerks, and hypotonia. The excessive glycine accumulation in brain is a crucial pathogenic mechanism.

Objective After micro-teaching, sandwich teaching method and case-based learning (CBL) method were successively applied to training eight-year clinical medical students and evaluating the effects of sandwich +CBL teaching in improving communication confidence. Methods All medical students who studied in the eight-year clinical medicine of Peking Union Medical College and entered the surgery internship were selected as the research objects. Anonymous written questionnaire survey was conducted before and after micro-teaching, and after sandwich +CBL teaching to evaluate the trainees' score of communication confidence in 4 preset scenarios, and their feedback on the teaching mode was collected. Results A total of 28 eight-year clinical medical interns were enrolled. After micro-teaching and sandwich +CBL teaching, thestudents' scores of communication confidence increased in the 4 preset scenarios, especially in the international conference scenario (P=0.009). After sandwich +CBL teaching, 26 students (92.8%) felt that the teaching method was helpful to improve their confidence. The optimal time ratio of the diversified teaching method to total teaching was 20% (chosen by 14 students), followed by 10% (chosen by 7 students) and 40% (chosen by 7 students). Conclusions Combination of sandwich +CBL teaching and micro-teaching sequentially would improve the confidence of eight-year medical undergraduates in expression and communication during clerkship and be of potential value in surgical teaching.

The main purposes of this one-year case study are to create learning environments for indigenous students through culture-based mathematics instructional modules, and what teachers' responds are in two tribes. The researcher leads sixteen in-service teachers and seven pre-service teachers to enter two indigenous tribes- "Cado" and "Jayama," and design culture-based math modules for indigenous students of tribal elementary schools. Through five stages of guidance, including "preparation and planning," "exploration and understanding," "reading and design," "comment and revision," and "practice and reflection," the participants work together to develop seven sets of culture-based math modules in total. Based on observation, interview, and analysis of related documents, it is shown that the implementation through culture-based mathematics instructional modules could motivate students' interest in learning math, and enhance their initiatives in the classroom. Hopefully, such cooperation between universities and local elementary schools will lead to improvement in the mathematics learning environments for the tribes.

This study aimed to examine the effects of remedial instruction on low-SES & low-math first graders' basic mathematics competence as well as their interest and confidence in mathematics learning. Fourteen participants of low-SES & low-math were selected from two classes totaling fifty-seven first graders at a public elementary school in central Taiwan. Results show that remedial instruction conducted during the study successfully improved the low-SES & low-math students' mathematics competence and enhanced their interest and confidence in mathematics. Remedial instruction in the form of story contexts conducted through small group collaboration with manipulatives appeared to improve low-SES & low-math students' mathematics learning. Implications related to remedial instruction for low-SES & low-math students are discussed.

Humoral immunity confers protection against COVID-19. The longevity of antibody responses after receiving an inactivated vaccine in individuals with previous SARS-CoV-2 infection is unclear. Plasma samples were collected from 58 individuals with previous SARS-CoV-2 infection and 25 healthy donors (HDs) who had been vaccinated with an inactivated vaccine. The neutralizing antibodies (NAbs) and S1 domain-specific antibodies against the SARS-CoV-2 wild-type and Omicron strains and nucleoside protein (NP)-specific antibodies were measured using a chemiluminescent immunoassay. Statistical analysis was performed using clinical variables and antibodies at different timepoints after SARS-CoV-2 vaccination. NAbs targeting the wild-type or Omicron strain were detected in individuals with previous SARS-CoV-2 infection at 12 months after infection (wild-type: 81%, geometric mean (GM): 20.3 AU/mL; Omicron: 44%, GM: 9.4 AU/mL), and vaccination provided further enhancement of these antibody levels (wild-type: 98%, GM: 53.3 AU/mL; Omicron: 75%, GM: 27.8 AU/mL, at 3 months after vaccination), which were significantly higher than those in HDs receiving a third dose of inactivated vaccine (wild-type: 85%, GM: 33.6 AU/mL; Omicron: 45%, GM: 11.5 AU/mL). The level of NAbs in individuals with previous infection plateaued 6 months after vaccination, but the NAb levels in HDs declined continuously. NAb levels in individuals with previous infection at 3 months post-vaccination were strongly correlated with those at 6 months post-vaccination, and weakly correlated with those before vaccination. NAb levels declined substantially in most individuals, and the rate of antibody decay was negatively correlated with the neutrophil-to-lymphocyte ratio in the blood at discharge. These results suggest that the inactivated vaccine induced robust and durable NAb responses in individuals with previous infection up to 9 months after vaccination.

Background: The traditional Chinese medicine prescription Ping-Wei-San decoction (PWS) has been used historically in East Asian countries. This study aimed to investigate the ingredients of the decoction and explore its potential role in the adjuvant treatment of pulmonary malignancies. Objectives: The primary objective was to analyze the ingredients of PWS and understand its potential in the treatment of pulmonary malignancy. Methods: Medical records of 143 394 patients using PWS over a decade were collected from the Affiliated Hospital of Qingdao University. UPLC-QE-Orbitrap-MS detected 13 chemical components, including 12 known components. Lung adenocarcinoma data were obtained from the TCGA-LUAD dataset, and differential genes were screened using R studio. The EVENN website and the STRING database were used to identify drug action and disease targets. Setting: The study was conducted at the Affiliated Hospital of Qingdao University. Participants: The study included 3147 patients with "pulmonary malignancies." Intervention: PWS was used as an adjuvant treatment. Results: Network analysis revealed 10 core targets (CCNA2, CHEK1, TOP2A, CDK1, CCNB1, CCNB2, AURKA, AURKB, KIF11, and MELK) for the treatment of lung adenocarcinoma and associated pathways. Conclusion: PWS may offer multifunctional efficacy in the treatment of pulmonary malignancies based on constituent analysis. Further research and clinical trials are needed to explore its potential. [ABSTRACT FROM AUTHOR]

Objective To investigate whether integration of micro-teaching into the surgical training may facilitate the learning outcome of eight-year program undergraduates of clinical medicine during their surgical clerkship. Methods Questionnaires were used before and after micro-teaching among the undergraduates to evaluate their confidence in expression and communication as well as attitudes towards micro-teaching. Results The self-rank confidence scores were significantly improved after micro-teaching in virtual situations including out-patient clinics (P＜0.05), lecture in surgical ward (P＜0.05) and presentation at international symposium (P＜0.01). Majority of medical students agreed that micro-teaching was beneficial (100%) whereas classical lecture-based learning (LBL) still indispensable (69.6%). Conclusions micro-teaching improves the confidence of eight-year program undergraduates in term of expression and communication during clerkship and has potential value in surgical teaching.

Objective To investigate the correlation between the polymorphism of 4 coagulation-related genes, rs1799963 （coagulation factor V gene Leiden）, rs6025 （prothrombin gene G20210A）, rs1042579 （thrombomodulin protein gene c.1418C>T） and rs1801131 （methylenetetrahydroflate reductase gene） and lower extremity deep venous thrombosis （LEDVT）. Methods The 4 genotypes mentioned above of 150 LEDVT patients and 153 healthy controls were detected by the kompetitive allele specific polymerase chain reaction （KASP）, then related blood biochemical indicators were collected, binary Logistic regression was established to screen the independent risk factors of LEDVT, and the correlation between polymorphism of 4 coagulation-related genes and LEDVT and its indicators under different genetic modes after adjusting confounding factors were analyzed. Results Five variables, D-dimer, fibrinogen degradation product, homocysteine, sex and age might be the risk factors of LEDVT. These variables were put into 4 genetic inheritance models, and adjusted in binary Logistic regression. The results suggested that the mutations of rs1042579 were correlated with LEDVT under dominant inheritance mode. Conclusion The gene polymorphism of rs1799963, rs6025 and rs1801131 has no significant correlation with the formation of LEDVT. The gene polymorphism of rs1042579 plays a role under dominant inheritance mode, and might be an independent risk factor for formation of LEDVT.