OBJECTIVE:Postoperative delirium (POD) is a common and severe complication following heart valve replacement (HVR) with cardiopulmonary bypass (CPB), associated with poor outcomes. Accurate early prediction is crucial for targeted prevention. This study aimed to develop and externally validate machine learning (ML) models for predicting POD in this high-risk population. METHODS:We conducted a retrospective cohort study involving 1076 adult patients who underwent HVR with CPB between January 2018 and December 2022. POD was assessed using the CAM-ICU. Perioperative factors were analyzed to develop a traditional logistic regression-based nomogram and four ML models. The best-performing model was then tested on an independent external validation cohort of 281 patients. RESULTS:The incidence of POD was 25.1% (270/1076) and was associated with significantly increased mortality (11.9% vs. 0.2%, P < 0.001) and prolonged hospitalization. In the internal test set, the Random Forest (RF) model demonstrated the highest predictive performance with an AUROC of 0.854 (95% CI, 0.764-0.945), outperforming the traditional nomogram (AUROC: 0.754). The RF model maintained robust performance in the external validation cohort, achieving an AUROC of 0.793. Model interpretation using SHAP analysis identified postoperative awakening time (PAT), postoperative mechanical ventilation time (PMVT), and postoperative reintubation (POR) as the most influential predictors. CONCLUSIONS:Machine learning models, particularly Random Forest, provide a robust and generalizable tool for the early prediction of POD after HVR. These models outperform traditional statistical approaches and offer interpretable insights, highlighting PAT as a critical, modifiable target for perioperative management to mitigate POD risk.

Abstract Inflammatory bowel disease (IBD), including ulcerative colitis (UC), is a prevalent global chronic gastrointestinal disorder with rising incidence, burdening healthcare and patients; current treatments are often ineffective. Thus, there is an urgent need to find efficient therapeutic approaches or drugs. Tea polyphenols(TP), natural compounds derived from China's millennia-old tea culture, have demonstrated potent anti-inflammatory and antioxidant properties. Network pharmacology analysis revealed that tea polyphenols exert therapeutic effects on ulcerative colitis (UC) by modulating inflammation and reactive oxygen species (ROS) -mediated signaling pathways. However, their clinical application is severely limited by suboptimal targeting efficacy, low bioavailability and adverse effects. To address these challenges, we developed oral tea polyphenol nanoparticles (TP-NPs) to enhance therapeutic delivery efficiency. Thermodynamic analysis and release kinetics showed that TP-NPs significantly improve the stability and sustained-release properties of tea polyphenols, maintaining prolonged therapeutic concentrations. Both in vitro and in vivo studies demonstrated that TP-NPs exhibit strong resistance to gastric acid and preferentially accumulate at sites of intestinal inflammation. In a murine model of UC, TP-NPs effectively reduced colonic ROS levels, thereby mitigating oxidative stress-induced damage. These findings highlight the dual anti-inflammatory and antioxidant properties of TP-NPs, underscoring their potential as an innovative therapeutic strategy for UC.

BACKGROUND:Postoperative complications following hepatectomy are often complex and involve multiple systems. This study aims to employ the Comprehensive Complication Index (CCI) to thoroughly assess postoperative complications, identify patients at high risk for severe complications, and inform preoperative management and preventive strategies. METHODS:In this retrospective study, we evaluated all adverse events within 30 days post-hepatectomy. Each complication was individually assessed, and CCI scores were calculated based on the Clavien-Dindo Classification (CDC) system. Short-term outcomes were analyzed for all patients to identify predictors of severe complications. RESULTS:A total of 1350 cases were analyzed, with 21 types of complications recorded, resulting in an overall complication rate of 46.61 %. Patients in the high CCI score group experienced significantly longer postoperative and total hospital stays. Independent risk factors identified included prolonged postoperative hospital stay, increased total intraoperative output, elevated postoperative blood creatinine levels, and preoperative pulmonary comorbidities. Conversely, a higher postoperative neutrophil ratio and red blood cell count were protective factors. Two surgical teams were associated with worse postoperative CCI outcomes. The nomogram model developed in this study demonstrated strong predictive performance, with an area under the ROC curve of 0.844 (95 % CI: 0.814-0.874), a sensitivity of 86.9 %, and a specificity of 65.4 %. The model estimated a 9.36 % risk of severe complications in patients with a total score of 36. CONCLUSIONS:The predictive model developed in this study effectively identifies high-risk patients for severe complications after hepatectomy. This tool can guide perioperative preventive measures and early interventions to improve patient outcomes.

Background and Aims: Hepatectomy is currently the most effective way to treat liver diseases, and its safety has observably improved. However, the incidence of postoperative complications (POCs) remains high. Therefore, exploring the related influencing factors helps identify high-risk groups early and improve patient prognosis. Methods: Clinical data were retrospectively collected from a real-world setting. Patients were divided into two groups based on the incidence of postoperative pulmonary complications (PPCs). Univariate analysis, LASSO regression, and logistic regression were applied to analyse the correlation between PPCs and perioperative indicators. A nomogram prediction model was constructed, whose discrimination, accuracy, and clinical effectiveness were evaluated. Results: The incidence of PPCs was 36.33% among the 1244 patients in this study. The total length of hospital stay and perioperative mortality in the PPCs group were markedly higher (P < 0.001) than in the non-PPCs group. Logistic regression showed that surgical method [odds ratio (OR) =2.469 (95% CI: 1.665, 3.748); P < 0.001], duration of surgery [OR = 1.003 (95% CI: 1.002, 1.005); P < 0.001], postoperative patient destination [OR = 1.453 (95% CI: 1.115, 1.893); P = 0.006], and postoperative international normalised ratio (INR) [OR = 2.245 (95% CI: 1.287, 4.120); P = 0.007] were independent risk factors of PPCs; the number of clamping [OR = 0.988 (95% CI: 0.980, 0.995); P = 0.001] was an independent protective factor of PPCs. The area under the receiver operating characteristic (ROC) curve was 0.675 (95% CI: 0.638, 0.703), the consistency index of the calibration curve was 0.675 (95% CI: 0.641, 0.703), and the Hosmer-Lemeshow goodness-of-fit test yielded P = 0.327. Conclusions: In this study, the incidence of PPCs after hepatectomy was the highest. Our nomogram model can predict the probability of PPCs after hepatectomy.

To meet the demands of regional mapping with synthetic aperture radar (SAR) satellites, this study proposes a multistrip stitching imaging mission planning (MSIMP) method that considers energy consumption. Accounting for both regional coverage rate and satellite energy consumption, an MSIMP model was constructed. The model maximizes the region coverage benefit (RCB), minimizes the total imaging time (TIT) as the optimization objectives, and sets the indices of orbit selection, side-swing angle coefficients, and determination coefficients of the start time and end times of each orbit as the decision variables to realize the overall optimal scheduling of available orbital resources (ORs), side-swing angles, and imaging time of satellites. To address the problem of the large-scale and diverse types of decision variables in the MSIMP model, an improved particle swarm optimization (PSO) algorithm with a hybrid local search and differential evolution (LSDE) strategy (LSDE-PSO) that implements differential operations and local searches on two types of particles at various stages of the evolution process to enhance the model's solution efficiency was proposed. The proposed method was validated using three simulation scenarios with different regional sizes. The experimental results showed that the proposed method demonstrated consistent adaptability to different-scale tasks, achieving the synchronized optimization of coverage revenue and on-orbit energy consumption. Compared with existing algorithms, the proposed LSDE-PSO algorithm can obtain the optimal imaging scheme with a higher RCB with lower TIT at almost the same computational cost, which provides significant technical support for mission planning for regional SAR satellite imaging in practical applications.

Purpose:Doxorubicin (DOX), an anthracycline antibiotic, has limited clinical use due to its pronounced cardiotoxicity. Irisin, a myokine known for its metabolic regulation, has shown therapeutic effects on cardiovascular disease. This study investigates the potential cardioprotective function of irisin in reducing the cardiac injury induced by DOX. Methods:In vitro, H9c2 cells were pretreated with irisin (20 nM) for 24 hours before exposure to DOX (1 μM). In vivo, C57BL/6 mice were administered DOX (5 mg/kg/week, i.p.) for 4 weeks, reaching a cumulative dose of 20 mg/kg. Irisin (1 mg/kg/ 3 days, i.p.) was administered to the mice both 7 days prior to and during DOX injection.Cardiac function was evaluated by echocardiography, and cardiac histology was assessed using HE, WGA, and Masson staining. Myocardial injury markers were quantified using ELISA, and apoptosis was analyzed via TUNEL staining. Oxidative stress was determined by measuring antioxidase activity, MDA and GSH levels, and DHE staining, while mitochondrial superoxide production was assessed using MitoSOX Red. Mitochondrial morphology and function evaluated using transmission electron microscopy and Seahorse analysis, respectively Inflammatory cytokines were quantified in serum and cell supernatants. The role of the PERK-eIF2α-ATF4 pathway mediated by irisin was investigated by Western blot. Using adeno-associated virus serotype-9 carrying mouse FNDC5 shRNA (AAV9-shFNDC5) further validated the protective role of irisin in DOX-induced myocardial injury. Results:Irisin reduced DOX-induced cardiac dysfunction and fibrosis. Moreover, irisin mitigated oxidative stress and inflammation through inhibiting the PERK-eIF2α-ATF4 pathway activated by DOX, thus preserving mitochondrial function. While cardiac FNDC5 knockdown exacerbated DOX-induced heart injury and PERK-eIF2α-ATF4 activation, which was partially reversed by irisin. Conclusion:Irisin mitigates oxidative stress and inflammation by modulating the PERK-eIF2α-ATF4 pathway, highlighting its potential as a prospective approach for combating DOX-induced cardiotoxicity.

ABSTRACT Aim New‐onset diabetes mellitus is a frequent and severe complication arising after liver transplantation (LT). We aimed to identify the risk factors for new‐onset diabetes mellitus after liver transplantation (NODALT) and to develop a risk prediction score system for relevant risks. Methods We collected and analyzed data from all recipients who underwent liver transplantation at the First Affiliated Hospital of Xi'an Jiaotong University. The OR derived from a multiple logistic regression predicting the presence of NODALT was used to calculate the risk prediction score. The performance of the risk prediction score was externally validated in patients who were from the CLTR (China Liver Transplant Registry) database. Results A total of 468 patients met the outlined criteria and finished the follow‐up. Overall, NODALT was diagnosed in 115 (24.6%) patients. Age, preoperative impaired fasting glucose (IFG), postoperative fasting plasma glucose (FPG), and the length of hospital stay were significantly associated with the presence of NODALT. The risk prediction score includes age, preoperative IFG, postoperative FPG, and the length of hospital stay. The risk prediction score of the area under the receiver operating curve was 0.785 (95% CI: 0.724–0.846) in the experimental population and 0.782 (95% CI: 0.708–0.856) in the validation population. Conclusions Age at the time of transplantation, preoperative IFG, postoperative FPG, and length of hospital stay were independent predictive factors of NODALT. The use of a simple risk prediction score can identify the patients who have the highest risk of NODALT and interventions may start early.

Molecular beacons (MBs) based on hairpin-shaped oligonucleotides are captivating owing to their capability to enable effective real-time detection of cytosolic mRNA in living cells. However, DNase in the nucleus and lysosome could induce the degradation of oligonucleotides in MBs, leading to the generation of false-positive signals. Herein, a graphene oxide (GO) nanosheet was applied as a nanocarrier for MBs to greatly enhance the anti-interference of the easily designed nanoprobe. Advantageously, the absorption capacity of GO for MBs increased with the decrease in pH values, providing the MB-GO nanoprobe with the ability to detect the expression of cytosolic Ki-67 mRNA without interference from DNase Ⅱ in lysosomes. Moreover, the size of GO nanosheets was considerably higher than that of the nuclear pore complex (NPC), which prevented nanoprobes from transition through the NPCs, thereby avoiding the generation of false-positive signals in the nucleus. Altogether, the present work affords a convenient approach for the successful detection of Ki-67 mRNA expression in the cytosol without interference from DNase Ⅰ/Ⅱ in the nucleus/lysosome, which may be potentially further applied for the detection of other cytosolic RNAs.

Cytokine storm and ROS overproduction in the lung always lead to acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in a very short time. Effectively controlling cytokine storm release syndrome (CRS) and scavenging ROS are key to the prevention and treatment of ALI/ARDS. In this work, the naringin nanoparticles (Nar-NPs) were prepared by the emulsification and evaporation method; then, the mesenchymal stem cell membranes (CMs) were extracted and coated onto the surface of the Nar-NPs through the hand extrusion method to obtain the biomimetic CM@Nar-NPs. In vitro, the CM@Nar-NPs showed good dispersity, excellent biocompatibility, and biosafety. At the cellular level, the CM@Nar-NPs had excellent abilities to target inflamed macrophages and the capacity to scavenge ROS. In vivo imaging demonstrated that the CM@Nar-NPs could target and accumulate in the inflammatory lungs. In an ALI mouse model, intratracheal (i.t.) instillation of the CM@Nar-NPs significantly decreased the ROS level, inhibited the proinflammatory cytokines, and remarkably promoted the survival rate. Additionally, the CM@Nar-NPs increased the expression of M2 marker (CD206), and decreased the expression of M1 marker (F4/80) in septic mice, suggesting that the Nar-modulated macrophages polarized towards the M2 subtype. Collectively, this work proves that a mesenchymal stem cell membrane-based biomimetic nanoparticle delivery system could efficiently target lung inflammation via i.t. administration; the released payload inhibited the production of inflammatory cytokines and ROS, and the Nar-modulated macrophages polarized towards the M2 phenotype which might contribute to their anti-inflammation effects. This nano-system provides an excellent pneumonia-treated platform with satisfactory biosafety and has great potential to effectively deliver herbal medicine.

Postoperative pain management is challenging for hip arthroscopy, and the effectiveness and specific protocols of femoral nerve block (FNB) in hip surgeries remain insufficient. Therefore, we designed this study to investigate the analgesic efficacy and optimal drug concentrations of FNB after hip arthroscopy. A total of 148 patients undergoing hip arthroscopy were included and randomly divided into three groups: 0.3

An oral colon-targeted drug delivery system holds great potential in preventing systemic toxicity and preserving the therapeutic benefits of ulcerative colitis (UC) treatment. In this study, we developed a negatively charged PLGA-PEG nanoparticle system for encapsulating naringin (Nar). Additionally, chitosan and mannose were coated on the surface of these nanoparticles to enhance their mucosal adsorption and macrophage targeting abilities. The resulting nanoparticles, termed MC@Nar-NPs, exhibited excellent resistance against decomposition in the strong acidic gastrointestinal environment and specifically accumulated at inflammatory sites. Upon payload release, MC@Nar-NPs demonstrated remarkable efficacy in alleviating colon inflammation as evidenced by reduced levels of pro-inflammatory cytokines in both blood and colon tissues, as well as the scavenging of reactive oxygen species (ROS) in the colon. This oral nanoparticle delivery system represents a novel approach to treating UC by utilizing Chinese herbal ingredient-based oral delivery and provides a theoretical foundation for local and precise intervention in specific UC treatment.

A highly sensitive nanoprobe HAPPF@FeSe2NPs was developed for real-time detection of hyaluronidase (HAase) as tumor marker. Hyaluronic acid (HA) was first functionalized with adipic acid dihydrazide (ADH) via amide formation. Carboxyl-terminated polylactide (PLA) was then grafted to HA-ADH using EDC/NHS as coupling agents, yielding an HA-ADH-PLA (HAP) graft copolymer. Iron selenide nanoparticles (FeSe2NPs) were surface coated with HAP by ultrasonic assisted self-assembly. Finally, the resulted HAP@FeSe2NPs were surface-modified with fluorescein isothiocyanate (FITC) and polyethyleneimine (PEI) to obtain HAPPF@FeSe2NPs fluorescent nanoprobe. Analyses by FTIR, XRD, XPS, EDX, TEM, DLS, 1H NMR and TGA confirmed the successful synthesis of the nanoprobe, and fluorescence spectroscopy proved its good detection performance. Moreover, cell imaging results demonstrated the ability of the nanoprobe to target tumor cells. MTT assay and hemolysis tests confirmed its good cyto- and hemo-compatibility. Therefore, it is concluded that HAPPF@FeSe2NPs nanoprobe could be used in targeted tumor cell imaging for early diagnosis of cancers.

Carbon quantum dots (CQDs) have aroused much attentions for their excellent ROS regulating properties. However, there is still few reports systematically discuss the dual properties of CQDs for ROS-generating and ROS-scavenging. This review attempts to systematically summarize the mechanism and structure-activity relationship of CQDs on ROS-regulation, and comprehensively summarize their biomedical applications. Generally, ROS generation could be attributed to the coexistence of the excitonic and charge-carrier aspects, while scavenging of free radicals can be attributed to electron transfer or hydrogen donation ability of the sp2 carbon core, functional surface groups and other introduced reaction sites. The intrinsic ROS generating and/or scavenging properties could be tuned through doping with nonmetal/metal elements, combining with metal nanoparticles, combining with semiconductors, etc. Especially, it is interesting to note that doping with non-metal elements (such as N, P, S, Cl) or combining with gold nanoparticle could both enhance ROS generating and scavenging ability of CQDs. Thus, CQDs with appropriate design could be used as ROS-generator or -scavenger depending on ambient conditions (the presence or absence of light source) for anti-tumor, anti-bacterial, wound healing, etc.

Tenascin C (TNC), a glycoprotein that is abundant in the tumor extracellular matrix (ECM), is strongly overexpressed in tumor tissues but virtually undetectable in most normal tissues. Many TNC antibodies, peptides, aptamers, and nanobodies have been investigated as delivery vectors, including 20A1, α-A2, α-A3, α-IIIB, α-D, BC-2, BC-4 BC-8, 81C6, ch81C6, F16, FHK, Ft, Ft-NP, G11, G11-iRGD, GBI-10, 19H12, J1/TN1, J1/TN2, J1/TN3, J1/TN4, J1/TN5, NJT3, NJT4, NJT6, P12, PL1, PL3, R6N, SMART, ST2146, ST2485, TN11, TN12, TNFnA1A2-Fc, TNfnA1D-Fc, TNfnBD-Fc, TNFnCD-Fc, TNfnD6-Fc, TNfn78-Fc, TTA1, TTA1.1, and TTA1.2. In particular, BC-2, BC-4, 81C6, ch81C6, F16, FHK, G11, PL1, PL3, R6N, ST2146, TN11, and TN12 have been tested in human tissues. G11-iRGD and simultaneous multiple aptamers and arginine-glycine-aspartic acid (RGD) targeting (SMART) may be assessed in clinical trials because G11, iRGD and AS1411 (SMART components) are already in clinical trials. Many TNC-conjugate agents, including antibody-drug conjugates (ADCs), antibody fragment-drug conjugates (FDCs), immune-stimulating antibody conjugates (ISACs), and radionuclide-drug conjugates (RDCs), have been investigated in preclinical and clinical trials. RDCs investigated in clinical trials include 111In-DTPA-BC-2, 131I-BC-2, 131I-BC-4, 90Y-BC4, 131I81C6, 131I-ch81C6, 211At-ch81C6, F16124I, 131I-tenatumomab, ST2146biot, FDC 131I-F16S1PF(ab')2, and ISAC F16IL2. ADCs (including FHK-SSL-Nav, FHK-NB-DOX, Ft-NP-PTX, and F16*-MMAE) and ISACs (IL12-R6N and 125I-G11-IL2) may enter clinical trials because they contain components of marketed treatments or agents that were investigated in previous clinical studies. This comprehensive review presents historical perspectives on clinical advances in TNC-conjugate agents to provide timely information to facilitate tumor-targeting drug development using TNC.

The encapsulation and release of hydrophobic drugs from polymersomes are of great importance in drug delivery. A significant challenge is to enhance the encapsulation capacity of finding better drug-polymer compatibility. Herrin, poly(trimethylene carbonate)-b-poly(ethylene glycol) (PTMC-PEG) diblock copolymers were successfully synthesized by ring opening polymerization of trimethylene carbonate using monomethoxy poly(ethylene glycol) (mPEG) as macro-initiator and stannous octoate as catalyst. The resulting diblock copolymer were characterized by H-1 NMR, FTIR, GPC, and DSC techniques. Blank and paclitaxel (PTX) loaded micelles was prepared by co-solvent evaporation method and characterized by transmission electron microscope (TEM) and dynamic light scattering (DLS). The influence of hydrophilic/hydrophobic segment length to drug loading and release was explored. All micelles have the sustained hydrophobic drug release properties of the micelles. Moreover, the cytotoxicity of micelles was evaluated by MTT and live-dead cell staining assay using L929 cell lines, showing the good biocompatibility. Therefore, PTMC-PEG micelles could be a suitable material for the loading and releasing of hydrophobic drugs.

Dissolvable hydrogels have shown great potentials in removing the exudes and alleviating pain during wound dressing replacement. Herein, a series of carbon dots (CDs) composing high complexation ability with Cu2+ were prepared for capturing Cu2+ from Cu2+-alginate hydrogels. CDs were prepared using biocompatible lysine as the main starting material, while ethylenediamine was chosen as the other starting material for its extremely high complexation ability with Cu2+. The complexation ability increased with the increasing amount of ethylenedi-amine, while the cell viability decreased. When the mass ratio of ethylenediamine to lysine in CDs was above 1/ 4, six-coordinate copper centers could be formed. CD1/4 at the concentration of 90 mg/mL could dissolve Cu2+- alginate hydrogels within 16 min, which was about twice faster than lysine. In vivo results showed the replaced hydrogels could ameliorate hypoxic conditions, alleviate local inflammatory reactions and promote the healing speed of burn wounds. Thus, the above results suggested the competitive complexation of CDs with Cu2+ could effectively dissolve Cu2+-alginate hydrogels, which have much potential in realizing facile wound dressing replacement.

Complete postoperative analgesia is very important for puerperae after cesarean section. The objective of this study was to explore the optimal postoperative analgesia after cesarean section. A total of 180 full-term puerperae who underwent cesarean section in Hanzhong People's Hospital from March 2019 to March 2020 were enrolled and were randomly divided into three groups. Group A was given 0.9

Introduction Pain is a common postoperative complication. The ideal postoperative analgesia is awake, safe, mobile, and without side effects. The objective of this study is to provide new ideas for postoperative analgesia by observing the safety and analgesic effect of different analgesic methods in patients undergoing laparotomy after surgery. Methods Patients, who underwent laparotomy between September 2019 and December 2020, were randomly divided into three groups: group S received sufentanil, group N received nalbuphine, group T + N received postoperative bilateral transversus abdominis plane block (TAPB) and nalbuphine. The primary outcomes included visual analog scale (VAS) score and the use of postoperative analgesic pump. Secondary outcomes included quality of life recovery (QoR-15) scale score and incidence of postoperative adverse reactions. Results Compared with group S and N, there were significant differences in the resting VAS score within 48 h after surgery, dynamic VAS score within 12 h after surgery, the first compression time, and cumulative use of patient-controlled intravenous analgesia (PCIA) drugs at 24 h in group T + N (P < 0.05). The QoR-15 score within 48 h after surgery in group T + N was significantly higher than group N (P < 0.05). The first exhaust time and the incidence of nausea and vomiting in group T + N were significantly lower than those in group N (P < 0.05). Conclusions Sufentanil PCIA and nalbuphine PCIA have equivalent analgesic effects, while TAPB combined with nalbuphine PCIA can ensure a good analgesic effect, thereby reducing the incidence of adverse reactions.

Liver transplantation (LT) is an effective way to cure end-stage liver diseases (ESLDs), which have generally been regarded as examples of acquired bleeding disorders. However, postoperative thrombosis after LT is recognised and remains a life-threatening complication. This study aimed to show that blood loss during LT is a predictor of postoperative thrombosis and to establish a predictive model. We analysed the medical records of all patients who underwent LT at the First Affiliated Hospital of Xi'an Jiaotong University from January 2017 to April 2019 to identify the risk factors for post-transplant thrombosis. The predictive nomogram was established based on independent predictors identified by logistic regression analysis. Blood loss during LT of ≥31.25 mL/kg can predict postoperative thrombosis, and the nomogram achieved an accurate prediction.

目的 探讨微助教(micro-teachermate)辅助基于问题的(problem-based learning,PBL)翻转课堂(flipped classroom)在医学本科麻醉教学中的应用效果.方法 本研究选取西安交通大学临床医学本科五年制2015级两个班作为研究对象,其中一班为实验组(n=53),另一班为对照组(n=56).实验组采用微助教辅助PBL联合翻转课堂教学模式,对照组采用传统PBL联合翻转课堂模式.期末对两组进行理论考试和教学满意度、学习意愿和专业意愿进行调查分析.结果 实验组理论成绩显著高于对照组(P<0.05),实验组教学满意度和学习意愿显著高于对照组(P<0.05),两组专业意愿差异无统计学意义(P>0.05).结论 微助教辅助PBL翻转课堂可显著提高医学本科的麻醉教学效果.