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Objective Although video feedback is incorporated into medical education research, its broad implementation in the practical teaching of procedural skills remains challenging. Thus, we aimed to investigate the practical effects of the mobile video feedback teaching method in clinical skills training for abscess incision and drainage. Methods A total of 72 second-year medical students majoring in a 5-year clinical medicine program were randomly allocated (1:1) to either the traditional teaching (TT) group or the mobile video feedback teaching (MVFT) group. All students received the same foundational theoretical knowledge, followed by distinct practical training sessions corresponding to their group allocation. The final procedural assessment on a simulation manikin was conducted by 2 examiners simultaneously, and each student's final score was calculated as the average of both examiners’ scores. Effects were further assessed using the Mini-Clinical Evaluation Exercise (Mini-CEX), in addition to evaluations of teaching performance and self-perception. Results Students in the MVFT group achieved a significantly higher average final score than those in the TT group (78.67 ± 6.72 vs 75.00 ± 7.95, P = .038). Additionally, 4 initially lower-performing students in the MVFT group scored significantly higher than 4 comparable students in the TT group (67.50 ± 1.29 vs 63.00 ± 3.16, P = .039). The MVFT group achieved significantly higher scores in clinical judgment, physical examination, organizational skills, and overall performance (P = .000, P = .000, P = .037, P = .040, respectively). Furthermore, students in the MVFT group reported significantly greater satisfaction across several domains, including their perception of the teaching methodology, comprehension of learning materials, and ability to perform self-directed learning with tools (P = .042, P = .032, P = .041, respectively). Conclusion This study demonstrates that the mobile video feedback method enhances comprehension and procedural proficiency in clinical skills, particularly for initially lower-performing students, supporting its integration into the curriculum to improve educational outcomes. The method's accessibility and low cost further facilitate its adoption as a scalable tool for self-directed learning and targeted remediation.

Pyruvate kinase M2 (PKM2) is a key glycolysis enzyme, and its effect on macrophages has not been entirely elucidated. Here, we identified that the PKM2 small-molecule agonist TEPP-46 mediated PKM2 activation by inducing the formation of PKM2 tetramer and promoted macrophage endotoxin tolerance. Lipopolysaccharide (LPS)-tolerant mice had higher expression of the PKM2 tetramer, which was associated with a reduced in vivo immune response to LPS. Pretreatment of macrophages with TEPP-46 resulted in tolerance to LPS stimulation, as demonstrated by a significant reduction in the production of TNF-α and IL-6. We found that TEPP-46 induced mitochondrial biogenesis in macrophages. Inhibition of mitochondrial biogenesis by mtTFA knockdown effectively inhibited TEPP-46-mediated macrophage tolerance to endotoxins. We discovered that TEPP-46 promoted the expression of PGC-1α and that PGC-1α was the key regulator of mitochondrial biogenesis in macrophages induced by TEPP-46. PGC-1α was negatively regulated by the PI3K/Akt signaling pathway. Knockdown of PKM2 or PGC-1α uniformly inhibited TEPP-46-mediated endotoxin tolerance by inhibiting mitochondrial biogenesis. In addition, TEPP-46 protected mice from lethal endotoxemia and sepsis. Collectively, these findings reveal novel mechanisms for the metabolic control of inflammation and for the induction of endotoxin tolerance by promoting mitochondrial biogenesis. Targeting PKM2 appears to be a new therapeutic option for the treatment of sepsis and other inflammatory diseases.

To investigate the effect and mechanism of macrophage membrane-coated nanoparticles (M-NPs) on hepatic ischemia-reperfusion injury (I/RI) caused by orthotopic liver transplantation. In addition, the advantages of TLR4 /M-NPs compared to M-NPs are discussed. We prepared biomimetic M-NPs and identified their characteristics. M-NPs were injected into an SD rat model of orthotopic liver transplantation, and the anti-inflammatory and anti-I/RI activities of M-NPs were studied in vivo and in vitro. In addition, we overexpressed macrophage membrane Toll-like receptor 4 (TLR4) in vitro and prepared TLR4+/M-NPs. Then, we assessed the characteristics and advantages of TLR4+/M-NPs. The M-NPs neutralized endotoxin, inhibited the overactivation of Kupffer cells (KCs) and suppressed the secretion of inflammatory factors by inhibiting the endotoxin-mediated TLR4/MyD88/IRAK1/NF-κB signaling pathway. In an orthotopic liver transplantation model in SD rats, M-NPs showed significant therapeutic efficacy by neutralizing endotoxin and suppressing the secretion of inflammatory factors. Moreover, overexpression of TLR4 on the macrophage membrane by using a TLR4 -plasmid in vitro effectively reduced the amount of M-NPs needed to neutralize an equivalent dose of endotoxin, reducing the potential risks of NP overuse. This study indicates that M-NPs can effectively alleviate I/RI induced by liver transplantation.

Postoperative nausea and vomiting (PONV) frequently occur in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) under general anesthesia. Glycopyrronium bromide, an anticholinergic medication, is believed to not only relieve gastrointestinal spasms but also effectively prevent PONV. To compare the incidence of nausea and vomiting and the effect of relieving spasm between patients administered glycopyrronium bromide and those given anisodamine hydrobromide following endoscopic retrograde cholangiopancreatography (ERCP). This is a monocentric prospective study. Patients eligible for ERCP were randomly assigned to two groups. One group received 0.2 mg glycopyrronium bromide (Group G) intravenously, while the other group received 10 mg anisodamine hydrobromide (Group A) intramuscularly for anesthesia induction. The study assessed duodenal motility during ERCP and the incidence of PONV within 24 hours. The study included 130 patients. Nausea and vomiting within 24 hours post-surgery occurred in nine patients (13.8%) in Group G and 19 patients (29.2%) in Group A, with statistical significance (relative risk (RR), 0.47; 95% confidence interval (CI) [0.02-0.29];  = 0.033). Vomiting specifically was observed in three patients (4.6%) in Group G and 12 patients (18.5%) in Group A, showing statistical significance (RR 0.25; 95% CI [0.03-0.25];  = 0.028). There was no significant difference in duodenal peristalsis between the groups (Group G: 10.9 ± 3.1 times/min; Group A: 11.6 ± 3.1 times/min;  = 0.174). For patients undergoing ERCP under general anesthesia, a subcutaneous injection of 0.2 mg glycopyrronium bromide significantly reduces PONV and provides similar anti-spasmodic effects to 10 mg intramuscular anisodamine hydrobromide.