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ObjectivePost-stroke cognitive impairment （PSCI） is a common syndrome associated with cerebral stroke，and there is a significant lack of objective cognitive assessment methods clinically for PSCI. This study aims to investigate the correlation between different electrode P300 latencies and cognitive functions in patients with PSCI，to provide experimental support for using P300 as an objective index in cognitive function assessment.MethodsThis study included 46 patients diagnosed with post-stroke cognitive impairment from May to August 2023 at the Rehabilitation Hospital affiliated with Fujian University of Traditional Chinese Medicine，along with 20 control subjects. The control group underwent the MoCA assessment. Participants in the PSCI group underwent neuropsychological tests：MoCA，Trail Making Test A （TMT-A），Trail Making Test B （TMT-B），Rivermead Behavioral Memory Test （RBMT-II），and Rey-Osterrieth Complex Figure Test （ROCFT）. All patients and control subjects completed the event-related potential P300 assessment.ResultsCompared with the control group，participants in the PSCI group had significantly longer P300 latencies at nine electrodes （Fz，Cz，Pz，F3，C3，P3，F4，C4，and P4） （P < 0. 001）. ROC analysis showed that the latencies of P300-Cz and P300-Pz were strongly correlated with predicting overall cognitive function in PSCI （AUC > 0. 7）. In the analysis of specific cognitive domains，we found that P300-Pz and P300-P4 latencies were highly correlated with visuospatial/executive functions，P300-Pz latency with orientation，P300-Fz latency with attention，and latencies at Cz，Pz，and P4 with memory function （P < 0. 01）.ConclusionThe prolongation of the P300 latency in PSCI patients is correlated with cognitive dysfunction. The P300 latencies at electrodes Fz，Cz，Pz，and P4 may serve as predictive indicators for overall cognitive function，visuospatial/executive abilities，orientation，attention，and memory. These results further expand the assessment tools for cognitive functions in patients with PSCI.

Glycogen, a polysaccharide composed of glucose molecules linked by α-1,4-glycosidic and α-1,6- glycosidic bonds, is one of the primary energy storage forms in human body. Glycogen is primarily stored in the liver (as liver glycogen) and skeletal muscles (as muscle glycogen), with smaller amounts present in tissues such as myocardium, kidneys, and brain. When the body requires energy, liver glycogen can be broken down into glucose, which is then utilized by various tissues and organs. During exercise, muscle glycogen is consumed by skeletal muscles to meet the energy demands of the muscles. Beyond its crucial roles in maintaining blood glucose levels and providing energy, recent research has revealed that glycogen metabolism also regulates biological processes such as cell differentiation, signal transduction, and redox reactions. This review focuses on the latest research advancements in the regulatory mechanisms of glycogen metabolism in metabolic diseases, tumors, and immune cell responses, highlighting new regulatory modes and mechanisms.

The majority of esophageal squamous dysplasia (ESD) patients progress slowly, while a subset of patients can undergo recurrence rapidly or progress to invasive cancer even after proper treatment. However, the molecular mechanisms underlying these clinical observations are still largely unknown.

Objective To establish age estimation models of northern Chinese Han adults using cranial suture images obtained by CT and multiplanar reformation （MPR）, and to explore the applicability of cranial suture closure rule in age estimation of northern Chinese Han population. Methods The head CT samples of 132 northern Chinese Han adults aged 29-80 years were retrospectively collected. Volume reconstruction （VR） and MPR were performed on the skull, and 160 cranial suture tomography images were generated for each sample. Then the MPR images of cranial sutures were scored according to the closure grading criteria, and the mean closure grades of sagittal suture, coronal sutures （both left and right） and lambdoid sutures （both left and right） were calculated respectively. Finally taking the above grades as independent variables, the linear regression model and four machine learning models for age estimation （gradient boosting regression, support vector regression, decision tree regression and Bayesian ridge regression） were established for northern Chinese Han adults age estimation. The accuracy of each model was evaluated. Results Each cranial suture closure grade was positively correlated with age and the correlation of sagittal suture was the highest. All four machine learning models had higher age estimation accuracy than linear regression model. The support vector regression model had the highest accuracy among the machine learning models with a mean absolute error of 9.542 years. Conclusion The combination of skull CT-MPR and machine learning model can be used for age estimation in northern Chinese Han adults, but it is still necessary to combine with other adult age estimation indicators in forensic practice.

Objective To analyze the effect of subanesthetic dose of esketamine on perioperative hemodynamics and adverse events in patients undergoing lumbar spine surgery under general anesthesia. Methods The clinical data of 70 patients who underwent general anesthesia lumbar spine surgery and treatment from June 2021 to June 2023 at Nanjing Jinling Hospital, Affiliated Hospital of Nanjing University Medical School, were retrospectively analyzed. According to the way of anesthesia induction, they were divided into the conventional group (conventional intravenous anesthesia induction, n=35) and the esketamine group (subanesthetic dose of esketamine+conventional intravenous anesthesia induction, n=35). Hemodynamic indices ［heart rate (HR), mean arterial pressure (MAP)］, and blood norepinephrine (NE) levels at each time point before induction of anesthesia (T0), in the immediate preoperative period (T1), at the end of the operation (T2), and at the time of postoperative awakening (T3), as well as the dosage of vasoactive medications (atropine and phenylephrine), and the incidence of adverse events (nausea and vomiting, postoperative agitation, respiratory depression, and bradycardia) were compared between the two groups. Results The HR levels of patients in the conventional group were significantly lower at T1 and T2 than that at T0, and significantly higher at point T3 than that at T1 and T2; at T2, the HR in the esketamine group was significantly higher than that in the conventional group (P＜0.05), and the difference in HR levels of patients in the esketamine group at each time point was not statistically significant (P＞0.05). The MAP levels of patients in the esketamine group at T1, T2 and T3 were significantly lower than those at T0, and the MAP levels of patients in the esketamine group were significantly higher than those in the conventional group at T1 and T2, and the MAP levels of patients in the conventional group first decreased and then increased over time, and the difference between the two groups was statistically significant (P＜0.05). The NE levels of patients in both groups showed a decreasing trend at all time points, in which the NE levels of patients in the esketamine group were significantly higher than those in the conventional group at T1, T2 and T3 (P＜0.05). The dosage of atropine and phenylephrine remedial drugs in patients in the esketamine group was significantly lower than that in the conventional group (P＜0.05). The incidence of bradycardia in the esketamine group was significantly lower than that in the conventional group (5.71% vs 22.86%, χ2=4.200， P=0.040). Conclusion The subanesthetic dose of esketamine can stabilize the hemodynamic changes during surgery in patients undergoing lumbar spine surgery under general anesthesia, with a good anesthetic effect, reduce the dosage of anesthetic remedial drugs, reduce the incidence of bradycardia, and with a high degree of safety.

Objective To develop and validate a nomogram prediction model for the early diagnosis of active pulmonary tuberculosis (ATB) based on LASSO regression. Methods A total of 403 patients with ATB admitted to the Third People's Hospital of Kunming between March 2021 and March 2023 were used as the experimental group, and 175 cases of healthy physical examiners during the same period were selected as the control group. General information and laboratory test results of patients were collected, variables were screened using LASSO regression based on R software, and multivariable logistic regression was performed. A nomogram model of ATB was established based on the results of multivariable analysis, and internal validation was performed using receiver operating curve (ROC) and calibration curves, while clinical utility analysis using clinical decision curves. Results A total of 19 potential risk factors were screened by LASSO regression, namely C-reactive protein (CRP), haptoglobin (HAP), immunoglobulin G (IgG), absolute number of CD4+ lymphocytes (CD4+), ratio of CD4+ lymphocytes to CD8+ lymphocytes (CD4+/CD8+), interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-17, lymphocyte percentage (LYM%), monocyte percentage (MON%), eosinophil percentage (EOS%), mean corpuscular hemoglobin concentration (MCHC), mean red blood cell volume (MCV), platelet count (PLT), red blood cell distribution width-standard deviation (RDW-SD), neutrophil to lymphocyte ratio (NLR) and platelet large cell ratio (PLCR). Multirariable analysis showed that CRP (OR=1.352, 95%CI: 1.134-1.612), IL-6 (OR=1.165, 95%CI: 1.032-1.315),IL-8 (OR=1.105, 95%CI: 1.019-1.198), IL-10 (OR=1.544, 95%CI: 1.066-2.235), EOS% (OR=1.386, 95%CI: 1.105-1.737), MCV (OR=1.154, 95%CI: 1.051-1.737), PLT (OR=1.025, 95%CI: 1.013-1.037), and MCHC (OR=0.899, 95%CI: 0.854-0.946) were the independent risk factors for ATB. According to the nomogram, the ROC was plotted and showed that AUC of ATB risk predicted by model was 0.982 (95%CI: 0.973-0.991), the calibration curve results showed that the predicting probability of ATB risk by the nomogram model was basically consistent with the actual probability, and the results of decision curve analysis showed that when the probability threshold of the nomogram model predicting the risk of ATB was more than 0.05, the net benefit value of the patients was greater than 0. Conclusion The risk of ATB increases with increasing levels of CRP, IL-6, IL-8, IL-10, EOS%, MCV, PLT and decreasing levels of MCHC. The nomogram prediction model based on the above factors can be used for the early diagnosis of ATB.

Objective To investigate the clinical characteristics of indolent B-cell non-Hodgkin lymphoma (iB-NHL) with monoclonal immunoglobulin (McIg). Methods The clinical and pathological data of 82 newly diagnosed iB-NHL patients in the Affiliated Hospital of Nantong University from November 2013 to October 2021 were retrospectively analyzed. According to the results of serum immunofixation electrophoresis (SIFE), they were divided into McIg positive group (30 cases) and negative group (52 cases). The clinical characteristics, laboratory examination results and overall survival (OS) were analyzed. Results iB-NHL with McIg were more common in males, with IgM-κ being the most common, and the clinical stage was mostly stage Ⅲ-Ⅳ, with marginal zone lymphoma (MZL) as the main stage. Compared with the negative group, patients in the positive group were more likely to have bone marrow infiltration, international prognostic index (IPI)≥3, decreased white blood cell count, anemia, hypoalbuminemia, elevated globulin and cystatin C (P＜0.05). Cox univariate analysis showed that IPI≥3 and McIg positivity were associated with worse OS in patients. Multivariate analysis showed that McIg positivity was an independent adverse prognostic factor for OS of patients (HR=0.074, 95%CI: 0.009-0.609, P=0.015). Follow-up ended on October 31, 2021. The median OS of the positive group was 52 months, but the median OS of the patients without McIg was not reached, and the difference of OS between two groups had statistical significance (P＜0.01). Conclusion Among the newly diagnosed patients with iB-NHL, the prognosis of patients with McIg is relatively poor, which needs to be paid more attention in clinical diagnosis and treatment.

Objective To explore the influence of reasonable examination contents and checkpoints on the training outcomes of continuing medical education. Methods From September 2020 to February 2021, we carried out online and offline continuing medical education training for clinicians in maternal and child health centers in 16 districts of Beijing. The effect was assessed after the training. The assessment contents were assigned following the characteristics of continuing medical education, and examination checkpoints were set up according to the teaching content and arrangement to evaluate the learning effect. Results A total of three sections of online training programs were completed with 10 courses in each section and one examination was conducted at the end of each section. A total of 48 examinations were completed in 16 district maternal and child health care hospitals. The offline training was undertaken by the maternal and child health care hospitals in 16 districts of Beijing. Four to six training courses were completed in each hospital and one offline training examination was completed at the end of the course. The average score of test after three times of online training in 16 district maternal and child health care hospitals was 88.56±4.76, 93.39±3.22 and 90.71±5.18, respectively. Offline test average score was 88.65±4.35. Most students chose ‘excellent’ and ‘good’ for offline training satisfaction. Conclusions Reasonable establishment of examination node and examination content in medical continuing education may have positive influence on training outcomes.

Gingival recessions (GRs) result in root hypersensitivity, root surface caries, and esthetic problems. Various root coverage surgeries are being developed for periodontal plastic therapy. The tunnel technique (TUN) is one of the most widely applied surgeries due to its features of being minimally invasive, practical, excellent outcomes and long-term stability; however, there are still some limitations of this technique. The history and evolution from the envelope flap to TUN, including its efficiency when compared with coronally advanced flaps with a connective tissue graft (CTG), are reviewed in this paper. The limitations of TUN are discussed in consideration of our clinical experience; for example, there is high technique sensitivity when TUN is applied in GR>5 mm because of the great difficulty in covering the grafts. The advantages of surgical access, including vertical incisions in the vestibule, “W” type and pinhole access, are discussed for different situations. Mattress sutures and sling sutures in a single tooth or multiple teeth are applied in TUN. The different types of grafts, such as CTG, platelet-rich plasma, articular dermal matrix and xenogeneic collagen matrix, are described. Mechanical, chemical and biological conditioning of the root surface are recommended during surgery. Protecting the surgical area and taking antibiotics postoperatively are also very important. Finally, the modifications when TUN is applied with other kinds of techniques are discussed, including lateral closed TUN, laterally positioned flaps, double papilla flaps and frenuloplasty. Minimally invasive, esthetic, long-term stability and simplified techniques are the development trends of TUN in the future.

Objective To explore the effects of circular RNA circATP2B1 on proliferation and invasion of gastric cancer cells and its potential molecular mechanism. Methods From July 2018 to February 2021, 44 cases of gastric cancer tissue specimens and paracancerous tissue specimens were collected from the Department of Gastrointestinal Hepatobiliary Surgery of Quanzhou First Hospital Affiliated to Fujian Medical University. Four gastric cancer cell lines (SGC7901, HS-746T, MGC803, BGC823) and normal gastric mucosal epithelial cells (GES-1) were selected. The expression of circATP2B1 in gastric cancer tissues and cell lines was examined by RT-PCR. The gastric cancer cells with the lowest expression of circATP2B1 were divided into control group (transfected with negative control plasmid) and experimental group (transfected with circATP2B1 over expression plasmid). MTT and Transwell experiment were used to detect the proliferation activity and invasion ability of gastric cancer cells in each group. Bioinformatics and dual luciferase reporter gene experiments were used to analyze the possible molecular mechanism of circATP2B1, and RT-qPCR and Western blot were used to detect the expression of circATP2B1 downstream genes. Results The expression of circATP2B1 in gastric cancer tissue was significantly lower than that in adjacent tissues (0.92±0.08 vs. 3.62±0.23, P＜0.01). The expression of circATP2B1 in gastric cancer cell lines was significantly lower than that in GES-1 cells (P＜0.01)and HS-746T cells had the lowest expression level (P＜0.01). Compared with the control group, the proliferation activity of HS-746T cells in the experimental group was significantly reduced (P＜0.05), and the invasion ability was significantly reduced (P＜0.01). Bioinformatics and dual luciferase reporter gene experiments showed that circATP2B1 can target miR-452-5p (P＜0.01), and miR-452-5p can target protocadherin 9 (PCDH9) (P＜0.01). Compared with the control group, the expression of miR-452-5p in HS-746T cells in the experimental group decreased significantly (1.00±0.04 vs. 0.24±0.05, P＜0.01), and the expression of PCDH9 gene increased significantly(P＜0.01). Conclusions The circATP2B1 is low expressed in gastric cancer tissues and cell lines, and circATP2B1 positively regulates PCDH9 gene expression through binding miR-452-5p, thereby reducing the proliferation and invasion of gastric cancer cells HS-746T.

ObjectiveWe conducted a two-sample Mendelian randomization （MR） study to assess the causal relationship between circulating isoleucine， leucine and valine levels and the risk of peripheral atherosclerosis.MethodsBased on the large-scale genome-wide association study （GWAS） database， single nucleotide polymorphisms （SNPs） closely related to the circulating levels of isoleucine， leucine and valine were identified as instrumental variables （IVs）. Two-sample MR analysis applying the inverse variance weighted （IVW） method and the weighted median estimator （WME） method were performed to estimate the causal relationship between the risk of peripheral atherosclerosis and the exposure with more than three SNPs that were available as IVs. The pleiotropy was evaluated by using the MR-Egger regression and MR-PRESSO method， and the leave-one-out method was used in sensitivity analysis.ResultsFour， one and one SNPs were identified as IVs for circulating isoleucine， leucine and valine levels， respectively. For isoleucine， the IVW model demonstrated there was no evidence of heterogeneity among the IVs （P=0.715）， and there was a significant causal relationship between the increase of circulating isoleucine level and a higher risk of peripheral atherosclerosis risk. Per every 1 elevated standard deviation （SD） of circulating isoleucine level resulted in increasing 31% of peripheral atherosclerosis risk （OR=1.31， 95%CI： 1.07‒1.61）. Similarly， the OR（95%CI） was 1.33 （1.04‒1.71） in the WME model. The MR-Egger regression and MR-PRESSO analysis indicated no evidence of pleiotropy in IVs （all P>0.05）. The result of the leave-one-out sensitivity analysis was stable. The Wald ratio model displayed that the causal relationship between circulating leucine and valine levels and the risk of peripheral atherosclerosis was not statistically significant. The OR （95%CI） for leucine and valine was 1.13 （0.78‒1.63） and 1.11 （0.82‒1.50）， respectively.ConclusionThere is a significant causal relationship between the increase of circulating isoleucine level and a higher peripheral atherosclerosis risk. The causal relationships between circulating leucine and valine levels and the risk of peripheral atherosclerosis need to be further confirmed in future studies.

ObjectiveTo examine the prevalence and influencing factors of smoking in urban and rural residents in Shaoxing City for providing evidences to effective tobacco control.MethodsWith stratified multistage random sampling， we conducted a face-to-face survey among 4 063 residents aged 15‒69 years in the city. A face-to-face questionnaire survey was used to collect information on smoking among urban and rural residents.ResultsAmong the 4 063 valid respondents， the rate of current smoking was 22.69%， the current smoking rate of rural residents was 24.85% and the rate of urban residents was 20.48%. The results of unconditional multivariate logistic regression analysis revealed that the following were the protective factors of smoking among urban and rural residents： having health literacy， suffering the chronic disease， being female， with poor self-evaluated health status， being a personnel of organizations/institutions， students， farmers， workers and other staffs of enterprises （P

ObjectiveTo observe the effect of hot and cold Chinese medicine whirlpool bath combined with motor control training on patients with shoulder-hand syndrome (SHS) after stroke.MethodsA total of 40 patients with SHS after stroke in the Xuzhou Rehabilitation Hospital and Xuzhou Central Hospital from January to December 2020 were randomly divided into control group and observation group according to random number table method, with 20 cases in each group. Both groups received routine rehabilitation training such as physical agent modalities and occupational therapy. The control group received motor control training on the basis of routine rehabilitation training, 40 minutes a time, once a day, five times a week, lasting for four weeks; the observation group received hot and cold Chinese medicine whirlpool bath on the basis of control group, 40 minutes a time, once a day, five times a week, lasting for four weeks. Before and after four weeks of treatment, visual analogue scale (VAS) was used to evaluate the severity of shoulder pain; overflow method was used to evaluate the degree of hand swelling; Fugl-Meyer assessment upper extremity (FMA-UE) was used to evaluate motor function of the affected limb; modified Barthel index (MBI) was used to evaluate the activities of daily living; motor activity log-amount of use (MAL-AOU) and motor activity log-quality of movement (MAL-QOM) were recorded by the motor activity record sheet.ResultsCompared with those before treatment, VAS score and hand swelling value of both groups decreased significantly after treatment, while FMA-UE, MBI, MAL-AOU and MAL-QOM scores increased significantly after treatment, and the differences were statistically significant (PP

Objective Construction of mouse liver senescence model induced rapidly in vitro by 3D organoid culture. Methods Mouse hepatocytes were collected by two-step perfusion method and cultured in 3D. Organoids were preliminarily identified by morphology, qPCR and immunofluorescence. The function of hepatocyte organoid was evaluated by their uptake of LDL. The hepatocyte organoids were treated with oleic acid, and their clonal growth, senescence related secretory phenotype, LDL uptake and ROS level of liver cells were detected. The hepatocytes were further treated with N-acetylcysteine (NAC) to detect the above phenotypic and functional changes. Results A large number of active primary mouse hepatocytes were obtained by two-step perfusion method. The hepatocyte organoid with self-reproduction ability was collected by 3D culture in the matrix gel. The expression of liver marker genes in hepatocyte organoid and primary hepatocytes was shown by qPCR detection. The immunofluorescence results showed that it highly expressed ALB protein. Moreover, hepatocyte organoid had normal uptake function of LDL. After treatment with oleic acid, the growth of hepatocyte organoid was slowed down, the expression of senescence related secretory phenotype genes was up-regulated(P＜0.001), the uptake of LDL was reduced(P＜0.001), and ROS was significantly increased(P＜0.001). The above phenotypes were alleviated by NAC treatment(P＜0.01 or P＜0.001). Conclusions Oleic acid treatment can successfully construct the aging model of mouse liver in vitro. Adding NAC can clear ROS and alleviate the occurrence of aging.

Neuroendocrine neoplasms (NENs) are a group of malignancies arising from neuroendocrine cells and peptidergic neurons. The high heterogeneity of NENs leads to challenges and complexities in its diagnosis and treatment. Experts from relevant disciplines were convened by the Society of Neuroendocrine neoplasm of China Anti-Cancer Association to develop this first edition of the Chinese Guideline for diagnosis and treatment of NENs (2022) based on existing evidence combined with domestic and international guidelines and consensus. In this article, we summarize the important contents of this guideline and make further discussion on some controversial issues, with the aim to provide treatment reference in clinical practice.

Objective To investigate the clinical manifestations, diagnostics, and treatment of chylothorax following neck dissection for oral cancer. Methods The clinical data of 3 patients with chylothorax after neck dissection for oral cancer from January 2020 to May 2021 in the Stomatological Center of Xiangya Hospital, Central South University, were retrospectively analyzed in detail, and the relevant literature was reviewed. The risk factors, clinical manifestations, diagnostics, treatment, and prognosis of chylothorax were summarized. Results The 3 patients were all male patients with oral cancer aged 42-63 years. Their clinical manifestations were progressive dyspnea 2-5 days after cervical lymphadenectomy. Chest X-ray, B-ultrasound, and/or CT showed unilateral or bilateral pleural effusion, and the diagnosis was confirmed after a positive chylous test of pleural puncture fluid. There was 1 case with left chylothorax (1 case after left neck dissection) and 2 cases with bilateral chylothorax (1 case after left neck dissection, 1 case after bilateral neck dissection). Severe neck chylous leakage occurred in 2 patients; local compression did not work, and the thoracic ducts were ligated. All patients were treated with nutritional support, assisted mechanical ventilation, tube thoracostomy drainage, and other conservative treatments. The chylothorax volume of each patient was gradually reduced, and the chest drainage tube was removed 7 to 15 days later. All patients recovered successfully. The literature review results showed that when patients with oral cancer after neck dissection experienced progressive dyspnea, related auxiliary examination methods such as chest X-ray, B-ultrasound, CT, and chyle tests should be used by clinicians. When a patient is diagnosed with chylothorax, they should be treated with nutritional support, mechanical ventilation, somatostatin, thoracic puncture drainage, other conservative treatments, and even thoracotomy and ligation of the thoracic duct surgery when necessary. Conclusion Chylothorax is a relatively rare complication after neck dissection for oral cancer. It mainly occurs bilaterally or only in the ipsilateral pleural cavity on the surgical side of neck dissection. Left neck dissection is a risk factor. The clinical manifestations are mostly progressive dyspnea after neck dissection. Detailed physical examination, chest X-ray, B ultrasound, and/or CT could detect pleural effusion, and chylothorax could be diagnosed when milky white or pale yellow chylous liquid is aspirated and the chylous test is positive. Most patients can be cured with tube thoracostomy drainage, respiratory support, and other conservative treatments.

ObjectiveTo analyze the chemical structure of the interfering substance that affects the result of methamphetamine analysis in wastewater.MethodsA combination of GC-MS and liquid chromatography-quadrupole time-of-flight mass spectrometry （LC-QTOF-MS） was used to analyze the mass spectrum characteristics of the interfering substance that affects the result of methamphetamine analysis and to infer its possible structure. Liquid chromatography-triple quadrupole-mass spectrometry （LC-TQ-MS） was used to confirm the control material.ResultsUsing LC-QTOF-MS in positive electrospray ionization （ESI+） mode, the mass-to-charge ratio （m/z） of quasi-molecular ion in the MS1 mass spectrometry of interfering substance was identical to that of methamphetamine, indicating that the interfering substance was probably an isomer of methamphetamine. The MS2 mass spectra obtained at three collision energies of 15 V, 30 V and 45 V were highly similar to methamphetamine, suggesting that the interfering substance contained methylamino and benzyl groups. Further analysis using GC-MS in electron impact （EI） ionization mode showed that the base peak in the mass spectrum of the interfering substance was at m/z 44. The interfering substance was confirmed to be N-methyl-2-phenylpropan-1-amine by compared with the standard reference.ConclusionThe chemical structure of N-methyl-2-phenylpropan-1-amine is highly similar to methamphetamine, which is easy to cause interference for the detection of trace amounts of methamphetamine in wastewater using LC-TQ-MS. Therefore, in the actual analysis, the chromatographic retention time can be used to distinguish between N-methyl-2-phenylpropan-1-amine and methamphetamine.

Objective To investigate the clinical efficacy of combined gonadotropin-releasing hormone agonist(GnRH-a) therapy in patients with ovarian endometrioma after conservative surgery. Methods Using a retrospective cohort study analysis, 206 patients who underwent conservative surgery for ovarian endometriosis cysts at the Department of Gynecology, Affiliated Hospital of Nanjing University of Chinese Medicine from December 2014 to December 2018 were selected and divided into 138 cases in the observation group(postoperative combined GnRH-a use for 6 months) and 68 cases in the control group(postoperative with no drug). Recurrence between two groups and the scores of dysmenorrhea, pain during in tercouse（PDI）, and chronic pelvic pain were compared between two groups at different times in 2 years after surgery. Results In the 2 years follow-up, the observation group was superior with statistical significance in the comparison of chronic pelvic pain and dysmenorrhea scores between the two groups and time points(P＜0.05). There was no significant difference in intergroup effect and time effect of sexual intercourse pain (P>0.05). The recurrence rate of patients in the observation group was lower than that of the control group in the first year after surgery(3.62% vs 11.77%, P＜0.05), while no significant difference in recurrence rate of two groups was found in the second year after surgery (P>0.05), but the 2-year cumulative recurrence rate in the observation group was lower than that in the control group (13.24% vs 25.00%, PConclusion GnRH-a can be a choice for postoperative pain management and recurrence prevention in endometriosis.

Objective To explore the teaching effect of the teaching mode changed from traditional teaching to online teaching after the outbreak of coronavirus disease 2019 (COVID-19) pandemic. Methods Relying on the Beijing Women's Health Care Technology Improvement Project, the online and offline continuing medical education was carried out, to train the obstetrician and gynecologist working in 16 maternal and child health care hospitals in 16 administrative regions of Beijing, which was planned from September 2020 to December 2025. This study retrospectively collected the assessment results of the two teaching modes from March 2021 to December 2021 (the first year of the teaching plan), and compared the teaching effects. Results Online teaching completed three sessions of 30 live online conference courses, with about 25 000 participants, including 4757 obstetricians and gynecologists from 16 maternal and child health care hospitals in Beijing. A total of 82 on-site teaching courses were held for offline teaching, and 1771 gynecologists and obstetricians from 16 maternity and child care hospitals in Beijing participated in the study. The scores of online teaching and offline teaching were 90.88±4.88 and 88.65±4.35, respectively. Conclusions Online teaching maybe has similar teaching effects as offline teaching. Compared with offline teaching, online teaching has more advantages, such as convenience, efficiency and economy, which is worthy of promotion and application in the context of the COVID-19 pandemic.

Objective To analyze the clinical, imaging and pathological features of patients with epithelial-myoepithelial carcinoma(EMC). Methods The data of a patient with primary EMC of the thymus in Peking Union Medical College Hospital was retrospectively analyzed, and the relevant literature was reviewed. Results The patient was a middle-aged male diagnosed with primary EMC of the thymus, and he was the first case currently reported at home and abroad. Even though the patient received comprehensive treatments including surgery, chemotherapy, radiotherapy and molecular targeted therapy, he still experienced disease progression, with a survival time of 22 months after surgery. Conclusions Primary EMC of the thymus is extremely rare and has atypical clinical manifestations. The diagnosis mainly depends on histopathological examination. Surgery is currently the major treatment and multidisciplinary treatment is very important to prolong the survival time of EMC patients.

Neuroendocrine neoplasm (NEN) is a group of heterogeneous malignancies arising from neuroendocrine cells and peptidergic neurons. According to its cell differentiation, NEN can be divided into two distinct groups as well-differentiated neuroendocrine tumor (NET) and poorly-differentiated neuroendocrine carcinoma (NEC). For advanced NEN, medication is the preferred treatment. In this article, we reviewed current clinical trials in medical treatment for NEN and aimed to provide treatment reference in clinical practice.

Summary: Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a severe dose-limiting side effect of chemotherapy and remains a huge clinical challenge. Here, we explore the role of microcirculation hypoxia induced by neutrophil extracellular traps (NETs) in the development of CIPN and look for potential treatment. Methods: The expression of NETs in plasma and dorsal root ganglion (DRG) are examined by ELISA, IHC, IF and Western blotting. IVIS Spectrum imaging and Laser Doppler Flow Metry are applied to explore the microcirculation hypoxia induced by NETs in the development of CIPN. Stroke Homing peptide (SHp)-guided deoxyribonuclease 1 (DNase1) is used to degrade NETs. Findings: The level of NETs in patients received chemotherapy increases significantly. And NETs accumulate in the DRG and limbs in CIPN mice. It leads to disturbed microcirculation and ischemic status in limbs and sciatic nerves treated with oxaliplatin (L-OHP). Furthermore, targeting NETs with DNase1 significantly reduces the chemotherapy-induced mechanical hyperalgesia. The pharmacological or genetic inhibition on myeloperoxidase (MPO) or peptidyl arginine deiminase-4 (PAD4) dramatically improves microcirculation disturbance caused by L-OHP and prevents the development of CIPN in mice. Interpretation: In addition to uncovering the role of NETs as a key element in the development of CIPN, our finding provides a potential therapeutic strategy that targeted degradation of NETs by SHp-guided DNase1 could be an effective treatment for CIPN. Funding: This study was funded by the National Natural Science Foundation of China 81870870, 81971047, 81773798, 82271252; Natural Science Foundation of Jiangsu Province BK20191253; Major Project of “Science and Technology Innovation Fund” of Nanjing Medical University 2017NJMUCX004; Key R&D Program (Social Development) Project of Jiangsu Province BE2019732; Nanjing Special Fund for Health Science and Technology Development YKK19170.

ObjectiveTo analyze the epidemic characteristics of road traffic injuries in Haishu District of Ningbo City and to provide evidence for effective prevention strategies.MethodsBased on the "Ningbo Inpatient Injury Monitoring Report Card"， we analyzed the epidemiological characteristics and the influencing factors of hospitalization expenses using the road traffic injuries cases collected from 2015-2019 of Haishu District were analyzed.ResultsThe ratio of male to female was 1.46∶1 among the 8 543 cases. Most cases were between 25 to 64 years old. There were 83.09% cases had junior high school education or below. The top three occupations in the cases were preschoolers， transportation workers， and retired people. Road traffic injuries occurred more frequently in spring for preschoolers and in summer vacation for school-age children. Motor vehicle accidents caused more serious injuries than non-motor vehicle accidents （χ2=59.069， P

To understand the clinical characteristics of omicron in COVID-19 Rehabilitation Clinic after the current shift of dynamic zeroing policy, we consecutively collected the patients’ data who visited in COVID-19 Rehabilitation Clinic of a Grade-A tertiary hospital in Hangzhou, Zhejiang Province, from January 3 to January 10, 2023, analyzed related data and then compared the pneumonia between elderly and non-elderly groups. The results showed that 95.68% of the patients in COVID-19 Rehabilitation Clinic had symptoms, 70.10% had a dry cough, 12.36% had abnormal complete blood count or C-reactive protein, 19.35% had electrolyte disorder, and 2% had abnormal troponin or creatine kinase-MB. 40.45% of patients had abnormal lung CT findings, among them 86.49% of elderly patients had abnormal lung CT findings, and the utilization rate of glucocorticoids in COVID-19 Rehabilitation Clinic was only 5.98%, although people are all susceptible to getting the COVID-19 infection, the elderly are more prone to getting pneumonia, and the glucocorticoids utilization rate is relatively insufficient. It is needed to be stressed that Chinese medical staff should pay more attention to the elderly patients who are vulnerable to getting pneumonia during this period.

Objective To investigate MBNL3 expression and its effect on malignant biology behavior of pancreatic cancer cells. Methods Fifty paraffin samples of pancreas cancer excised during surgery in Peking Union Medical College Hospital from 2017 to 2020 were collected. Immunohistochemistry was conducted to explore expression of MBNL3. Pancreatic cancer cells were treated with MBNL3 knocked down or over-expressed by transfection. The proliferation and invasion or migration in different pancreas cells were examined respectively by real time cellular analysis and Transwell assay. The colony formation in different pancreas cells were examined by plate colony forming test. The MBNL3 expression in cell lines was analyzed by Western blot. Results Overall staining score of MBNL3 in pancreatic cancer tissues was 5.0±2.7, significantly higher than that of adjacent tissues(2.1±0.6)(P＜0.05). Cell proliferation experiment showed that 72 h after transfection, MBNL3 knockdown groups grew slower than control group in pancreatic cancer cells, whereas MBNL3 over-expressed groups grew faster than control group. Transwell assay showed that 10 h after transfection, invasion and migration of MBNL3 knockdown groups were weaker than control groups in pancreatic cancer cells (P＜0.05),meanwhile MBNL3 over-expressed groups were stronger than control groups in pancreaticcancer cells (P＜0.05). Colony forming experiments showed that colony formation number of MBNL3 knockdown groups were less than control groups in pancreatic cancer cells (P＜0.05), and the same of MBNL3 over-expressed groups were more than control group in pancreatic cancer cells(P＜0.05). Conclusions MBNL3 is highly expressed in pancreatic cancer tissue, which might take part in regulating the proliferation, invasion and migration of pancreatic cancer cells.

Abstract Background AdipoR2, which belongs to the seven-transmembrane-domain receptor family, has been shown to play an important role in the development of human tumours, but the underlying mechanisms are poorly understood. In this study, we found that AdipoR2 expression correlates with glioma grade. In addition, we also investigated the mechanisms behind the antiproliferative effects of AdipoR2 in U251 cells (a human glioma cell line) using colony formation and WST-8 growth assays. Methods The U251 cell line was cultured in vitro. Western blotting was used to detect the expression of relevant proteins. Quantitative RT-PCR was used to detect AdipoR1 and AdipoR2 expression. Flow cytometry was used to detect cell cycle assay results. The gene expression profiles of glioma samples from the CGGA database were analysed by MATLAB and GSEA software. Results The AMPK/mTOR pathway plays a central role in the regulation of cell proliferation, differentiation and migration and may promote tumorigenesis. Therefore, we can control cancer progression by modulating the AMPK/mTOR pathway. However, there is no information on the relationship between AdipoR and AMPK/mTOR in central nervous system tumours such as GBM. In this study. We found 648 upregulated genes and 436 downregulated genes correlated with AdipoR2 expression in 158 glioma samples. GSEA suggested that AdipoR2 is a cell cycle-associated gene. The results of the flow cytometry analysis indicated that AdipoR2 induced G0/G1 cell cycle arrest in U251 cells. Furthermore, we identified the AMPK/mTOR signalling axis to be involved in AdipoR2-induced cell cycle arrest. Conclusions Our results suggest that AdipoR2 may represent a novel endogenous negative regulator of GBM cell proliferation. These findings also suggest that AdipoR2 may be a promising therapeutic target in GBM patients.

Objective To explore a kind of visual evoked potential test equipment and method that is more suitable for the application of forensic clinical visual acuity evaluation. Methods Thirty-four volunteers （68 eyes） were selected, including 15 males and 19 females, aged between 20 and 40 years. Test lenses were placed before the tested eyes of volunteers to induce refractive myopia with insert method, and the diopter lenses were adjusted so that the visual acuity level of one eye of volunteers was above 0.8, and the visual acuity of the other eye was at moderate damage level （

Objective To investigate the effects of salidroside(Sal) on proliferation, apoptosis and epithelial-mesenchymal transition(EMT) of osteosarcoma cell lines(HOS and U2OS). Methods Osteosarcoma HOS and U2OS cells were incubated with different concentrations of Sal for 24 h. Cell activity and apoptosis were detected by MTT assay and flow-cytometry, respectively. Western blot was used to detect the expression of Bcl-2/Bak and EMT-related molecules E-cadherin, N-cadherin, Slug and Snial. Subsequently, the effects of Sal on cell invasion and migration were detected by Transwell assay and cell scratch assay. Finally, the level of EMT-related molecules E-cadherin, N-cadherin, Slug and Snial was detected by Western blot after treatment with PI3K/Akt inhibitor. Results Different concentrations of Sal significantly inhibited cell activity of HOS and U2OS cells, increased the cellular apoptosis rate and expression of Bak, while reduced the expression of Bcl-2 in cells. The invasion rate and migration of HOS and U2OS cells were significantly reduced after incubation with Sal at 150 μmol/L.The expression of E-cadherin was up-regulated, while N-cadherin, Slug and Snial expression were down-regulated in HOS and U2OS cells after incubation with Sal at 150 μmol/L.After incubation with PI3K/Akt inhibitor, the expression of E-cadherin was further increased as compared with the cells treated with Sal alone, while the expression of N-cadherin, Slug and Snial was significantly decreased(P＜0.05). Conclusions Sal may inhibit the proliferation, invasion, migration of osteosarcoma cell lines,promote their apoptosis and decreases the EMT through inhiting PI3K/Akt signaling pathway of osteosarcoma cell lines.

Objective To investigate the effects of dehydrocostuslactone treatment on the proliferation and apoptosis of human HepG2 cells and potential mechanisms. Methods HepG2 cells were divided into 6 groups incubated with different concentration of Dehydrocostuslactone. The cell proliferation was evaluated by MTT assays, and Hoechst 33258 fluorescence staining was conducted to observe apoptosis of cells subsequently.The expression of p-IκBα, IκBα, nuclear p65 and total p65 proteins in HepG2 cells were measured using Western blot. Results Compared with the control group, dehydrocostuslacton,in a dose dependent manner, significantly inhibited the proliferation of HepG2 cells with impressive profile of apoptosis (P＜0.05 or P＜0.01). Dehydrocostuslactone, at concentrations of 10, 20 and 30 μmol/L, resulted in a significantly decrease of p-IκBα and nuclear p65 expression (P＜0.05 or P＜0.01) and an increased IκBα expression (P＜0.05 or P＜0.01), whereas no marked effect on total p65 expression was observed. Conclusions Dehydrocostuslactone inhibits proliferation and promotes apoptosis of HepG2 cells, the mechanism may be explained by the down-regulation of NF-κB pathway in HepG2 cell.

Methyl-CpG-binding protein 2 (MeCP2) encoded by the MECP2 gene is a transcriptional regulator whose mutations cause Rett syndrome (RTT). Mecp2-deficient mice show fear regulation impairment; however, the cellular and molecular mechanisms underlying this abnormal behavior are largely uncharacterized. Here, we showed that Mecp2 gene deficiency in cholinergic interneurons of the nucleus accumbens (NAc) dramatically impaired fear learning. We further found that spontaneous activity of cholinergic interneurons in Mecp2-deficient mice decreased, mediated by enhanced inhibitory transmission via α2-containing GABAA receptors. With MeCP2 restoration, opto- and chemo-genetic activation, and RNA interference in ChAT-expressing interneurons of the NAc, impaired fear retrieval was rescued. Taken together, these results reveal a previously unknown role of MeCP2 in NAc cholinergic interneurons in fear regulation, suggesting that modulation of neurons in the NAc may ameliorate fear-related disorders.

Binocular vision refers to a progress of analysing and integrating the binocular visual signals into a whole and three-dimensional sensory perception by higher nerve centre. In this process, the interac- tion between the two eyes results in the changes of output signal, which is called binocular interaction. Through a series of subjective and objective experiments, it can be concluded that binocular interaction can be divided into three types： facilitation, summation and suppression, and the forms of binocular interaction in different visual states are different. In general, the visual signal is processed by binocular interaction, so that there are some differences between binocular vision and monocular vision. The extent of the difference can be affected by the damage of monocular vision and then affects the binocular vision. Thus, it is necessary for forensic scientists to further study the effects of the monocular visual impairment on visual function. Based on relevant data, this paper reviews the mechanism of the monocular visual impairment in binocular vision, the research methods and the application prospect in forensic science.

Objective To compare the differences between Hertel exophthalmometry and CT on exophthalmos measurement, and explore its practical application value in forensic medicine. Methods Fifty-six normal individuals without eye injuries or diseases were selected as the control group. The absolute values of exophthalmos were measured in the standardized CT image workstation. The difference of binocular exophthalmos was compared in normal group. Forty-seven cases with unilateral orbital fracture were divided into injured eye group and normal eye group according to the presence of binocular orbital fractures. The differences of the absolute values of eophthalmos from the same eye and the relative values of eophthalmos between two eyes for same person measured by Hertel exophthalmometry and CT were analyzed. Results There was no statistical difference of exophthalmos between the normal eyes measured by CT method. In the normal eye group, the absolute value of exophthalmos measured by CT method was （16.66±5.41） mm, which was （16.16±4.45） mm when measured by the Hertel exophthalmometry method. There was no statistical difference between two groups （P>0.05）. In the injured eye group, there was statistical difference between the absolute values of exophthalmos measured by two measurement methods （P0.05）. Conclusion CT method has a good consistency with Hertel exophthalmometry, which can be applied into the practice of medicolegal expertise.

Abstract Previous studies have shown that the neuregulin 1 (NRG1)-ErbB4 signaling pathway may regulate the excitability of fast-spiking neurons in the frontal cortex and participate in primary epilepsy pathogenesis. However, the exact roles and mechanism for NRG1/ErbB4 in human symptomatic epilepsy are still unclear. Using fresh human symptomatic epilepsy tissues, we found that the protein levels of NRG1 and ErbB4 were significantly increased in the temporal cortex. In addition, NRG1-ErbB4 signaling suppressed phosphorylation of GluN2B at position 1472 by Src kinase, and decreased levels of phosphorylation level of GluN2B and Src were detected in human symptomatic epilepsy tissues. Our study revealed a critical role of the NRG1-ErbB4 signaling pathway in symptomatic epilepsy, which is different from that in primary epilepsy, and we propose that the NRG1-ErbB4 signaling may act as a homeostasis modulator that protects the brain from aggravation of epileptiform activity.

Objective To study the characteristic of contrast visual evoked potentials （CVEP） in patients with ocular trauma. Methods Sixty patients defined as ocular trauma by forensic clinical examination in our center were selected, and split into 0.2-0.3 （Group A）, 0.3-0.5 （Group B） and ≥0.5 （Group C） according to the best corrected visual acuity. The variation characteristics of wave amplitude and latency of CVEP under 100%, 25% and 10% contrast were observed and analyzed statistically. Results （1） Under the same contrast, the wave amplitude of P100 decreased with the decrease of stimulus perspective. （2） Under the same stimulus perspective, the wave amplitude of P100 decreased with the decrease of contrast （P

Background Alfalfa (Medicago sativa) is an important forage material widely used for animal feed production. Ensiling is an effective method for preserving alfalfa, but it has shown some limitations in the production of high-quality alfalfa silage due to its low water soluble carbohydrates (WSC) content and high buffering capacity. Lactic acid bacteria (LAB) and cellulase are often used as silage additives to promote the ensiling process and enhance fermentation quality. Methods Experiments were conducted to investigate the effects of ferulic acid esterase (FAE)-producing Lactobacillus fermentum 17SD-2 (LF) and cellulase (CE) on the fermentation quality and microbial community of alfalfa silage. After 60 days of ensiling, analysis of fermentation quality and bacterial diversity in alfalfa silages were conducted using high-performance liquid chromatography and high-throughput sequencing methods. Results Alfalfa was ensiled with additives (LF, CE, and LF+CE) or without additives for 60 days. All additives increased lactic acid and decreased pH values and ammonia-N contents compared to control. Among all treatments, the combined addition of LF and CE showed lowest pH (4.66) and ammonia-N (NH3-N, 0.57% DM) content, highest contents of lactic acid (LA, 10.51% DM), dry matter (DM, 22.54%) and crude protein (CP, 24.60% DM). Combined addition of LF and CE performed better in reducing neutral detergent fiber (NDF, 29.76% DM) and acid detergent fiber (ADF, 22.86% DM) contents than the addition of LF (33.71, 27.39% DM) or CE (32.07, 25.45% DM) alone. Moreover, the microbial analysis indicated that LF+CE treatments increased the abundance of desirable Lactobacillus and inhibited the growth of detrimental Enterobacter and Clostridia in alfalfa silage. Discussion Combined addition of FAE-producing LF and CE is more effective than treatments of LF or CE alone in improving fermentation quality and nutrition values of alfalfa silage. This is likely due to a synergistic effect of CE and FAE produced by LF on plant cell wall degradation, indicating that these additives promote each other to improve fiber degradation and silage fermentation. In conclusion, combined addition of FAE-producing LF and CE could be a feasible way to improve alfalfa silage quality.

The mandibular canine usually has a single root with a single canal. It is rarely to see a mandibular ca⁃ nine with two roots and two toot canals. A case of a patient who has a right mandibular canine with two roots and two root canals was reported. Cone beam computed tomography (CBCT) comprehensively demonstrated the root canal system and especially provided the information of canal varieties and complex canal before operation. CBCT can improve the discovery rate of canal varieties, guide root canal treatment and prevent missed roots in tooth extraction.

To investigate potential mechanisms involving abnormal iron metabolism and related inflammation in Parkinson disease (PD) patients with probable rapid eye movement sleep behavior disorder (PRBD).Total 210 PD patients and 31 controls were consecutively recruited. PD patients were evaluated by RBD Screening Questionnaire (RBDSQ) and classified into PRBD and probable no RBD (NPRBD) groups. Demographics information were recorded and clinical symptoms were evaluated by series of rating scales. Levels of iron and related proteins and inflammatory factors in cerebrospinal fluid (CSF) and serum were detected. Comparisons among control, NPRBD and PRBD groups and correlation analyses between RBDSQ score and levels of above factors were performed.(1) The frequency of PRBD in PD patients is 31.90%. (2) PRBD group has longer disease duration, more advanced disease stage, severer motor symptoms and more non-motor symptoms than NPRBD group. (3) In CSF, levels of iron, transferrin, NO and IL-1β in PRBD group are prominently increased. RBDSQ score is positively correlated with the levels of iron, transferrin, NO and IL-1β in PD group. Iron level is positively correlated with the levels of NO and IL-1β in PD group. (4) In serum, transferrin level is prominently decreased in PRBD group. PGE2 level in PRBD group is drastically enhanced. RBDSQ score exhibits a positive correlation with PGE2 level in PD group.PRBD is common in PD patients. PRBD group has severer motor symptoms and more non-motor symptoms. Excessive iron in brain resulted from abnormal iron metabolism in central and peripheral systems is correlated with PRBD through neuroinflammation.