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Background: The application of artificial intelligence (AI) in the delivery of health care is a promising area, and guidelines, consensus statements, and standards on AI regarding various topics have been developed., Objective: We performed this study to assess the quality of guidelines, consensus statements, and standards in the field of AI for medicine and to provide a foundation for recommendations about the future development of AI guidelines., Methods: We searched 7 electronic databases from database establishment to April 6, 2022, and screened articles involving AI guidelines, consensus statements, and standards for eligibility. The AGREE II (Appraisal of Guidelines for Research & Evaluation II) and RIGHT (Reporting Items for Practice Guidelines in Healthcare) tools were used to assess the methodological and reporting quality of the included articles., Results: This systematic review included 19 guideline articles, 14 consensus statement articles, and 3 standard articles published between 2019 and 2022. Their content involved disease screening, diagnosis, and treatment; AI intervention trial reporting; AI imaging development and collaboration; AI data application; and AI ethics governance and applications. Our quality assessment revealed that the average overall AGREE II score was 4.0 (range 2.2-5.5; 7-point Likert scale) and the mean overall reporting rate of the RIGHT tool was 49.4% (range 25.7%-77.1%)., Conclusions: The results indicated important differences in the quality of different AI guidelines, consensus statements, and standards. We made recommendations for improving their methodological and reporting quality., Trial Registration: PROSPERO International Prospective Register of Systematic Reviews (CRD42022321360); https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=321360., (©Ying Wang, Nian Li, Lingmin Chen, Miaomiao Wu, Sha Meng, Zelei Dai, Yonggang Zhang, Mike Clarke. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 22.11.2023.)

Rationale: Many factors can contribute to the development of macular injury, which results in vision loss as a result of a disease. Heredity, age, underlying eye illness, internal eye surgery, or eye trauma can all cause it. A safer alternative to current therapies for macular degeneration is urgently needed since they all induce ocular irritation and postoperative recurrence as well as a host of other adverse effects., Patient Concerns: A 12-year-old girl was the patient. A laser pen burnt her right eye. There was a spot and a shadow in the middle of her right eye's visual field., Diagnoses: Macular degeneration., Interventions: Given the patient's age, we opted out of medicine and instead used acupuncture as a symptomatic treatment., Outcomes: Two months after therapy concluded, optical coherence tomography result report indicate that the macula region of the right eye is better than it was previously. The corrected visual acuity of the right eye recovered from 0.25 to 1.0, and the clinical accompanying symptoms of the right eye disappeared., Lessons: No additional medication or surgical procedure was employed in this instance. We treated the macular damage with acupuncture, which relieved the patient's clinical symptoms and had no adverse effects. This demonstrates that acupuncture may be beneficial in treating ophthalmopathy in this direction., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objective: The Chinese healthcare industry has immense potential for innovation and requires competent publication professionals for global reach. Changes in regulatory landscape of China necessitates pharmaceutical industries to collaborate with medical professionals who are capable of keeping up with both changes in regulations and innovative medicine., Methods: We initiated an online questionnaire-based survey via WeChat from August 3 to August 14, 2019 which focused on experience level, challenges, career development, and training requirements of survey participants., Results: A total of 53 medical publication professionals participated in this survey. Contrary to global trends, 77% of participants had <5 years of professional experience in publication, although only 36% of participants had <5 years of experience in healthcare industry. In all, 63% of respondents spent <50% of their time in publication-related activities, contributing to <10 manuscripts per year. Their expertise in manuscripts spanned clinical studies (68%), post-marketing studies (62%), and reviews (38%). Poor research design and data quality, limited medical writing skill, and inefficient communication with authors were major challenges for developing high-quality publications. Awareness of good publication practices guidelines was high (49%) and 15% of respondents were Certified Medical Publication Professionals. Strategic publication planning (72%), industry trends (66%), and best practices (55%) were some of training requirements identified to increase competencies among respondents., Conclusions: Although the Chinese medical publication professional industry is at a nascent stage, an attempt is being made to provide opportunities for its publication professionals to develop their competencies to match global standards.

Objective·To investigate the effect of neferine (Nef) on renal tissues of diabetic nephropathy (DN) rats and its related mechanism.Methods·DN model rats were constructed by feeding high-fat diet combined with intraperitoneal injection of streptozotocin, and the successfully constructed rats were randomly divided into DN group, Nef (low, medium and high) dose groups and Nef high-dose+pathway antagonist (AMD3100) group, with 10 rats in each group. At the same time, 10 common rats were selected as the normal group. The levels of fasting blood glucose (FBG), 24 h urinary protein, serum glycosylated hemoglobin (HbA1c), serum creatinine (Scr), blood urea nitrogen (BUN) and renal index of rats in the six groups were measured. Hematoxylin-eosin (H-E) and Masson staining were used to observe the pathological changes of renal tissues. The content of malondialdehyde (MDA) in renal tissues was determined by thiobarbituric acid (TBA) method, and the activities of superoxide dismutase (SOD) and catalase (CAT) in renal tissues were determined by water soluble tetrazolium (WST-1) method and ammonium molybdate method, respectively. The mRNA and protein expressions of stromal cell-derived factor-1 (SDF-1) and CXC chemokine receptor 4 (CXCR4) in renal tissues were detected by quantitative real-time PCR (qPCR) and Western blotting, respectively. Rat renal tubular epithelium cells NRK-52E were induced by high glucose (30 mmol/L glucose) to establish DN cell model. The cells were divided into control group, high glucose (HG) group, HG+Nef (low, medium and high) dose (i.e.HG+Nef-L, M and H) group, and HG+Nef-H +AMD3100 group. SOD and CAT activities were detected by WST-1 method and ammonium molybdate method, respectively. MDA content was detected by TBA method. The mRNA and protein expressions of SDF-1 and CXCR4 were detected by qPCR and Western blotting, respectively. CCK-8 method and flow cytometry were used to detect cell viability and apoptosis rate, respecti-vely.Results·Compared with the DN group, the levels of FBG, 24 h urinary protein, HbA1c, Scr, BUN, renal index and MDA content in Nef (low, medium and high) dose groups and Nef high-dose+AMD3100 group were decreased, the mRNA and protein expressions of SDF-1 and CXCR4 were increased, and the activities of SOD and CAT were increased (all P

Background Cognitive impairment can lead to a decline in cognitive function, depression, and loneliness, as well as decreased self-efficacy and quality of life in older adults. Objective To investigate the effects of non-pharmacological integrated interventions on cognitive function, depression, loneliness, self-efficacy, and quality of life in older adults with mild cognitive impairment. Methods Based on risk factors for cognitive impairment, a non-pharmacological integrated intervention program was developed in five dimensions of cognitive training, physical exercise, emotional management, social connection, and healthy lifestyle habits. Using a single-subject A-B-A experimental design, a 3-month intervention, which was conducted once a week for 60 minutes, was performed in three elderly individuals with mild cognitive impairment from June to December 2021. The Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale-15 (GDS-15), 12-item Short Form Health Survey (SF-12), General Self-Efficacy Scale (GSES), and De Jong Gierveld Loneliness Scale (DJGLS) were administered to the 3 older adults at baseline, 3 months of the intervention, and 3 months after the intervention, to assess the scores of each scale from the 5 dimensions of cognitive function, self-efficacy, quality of life, depression, and loneliness, the changes in the scores were analyzed. A semi-structured interview was conducted 3 months after the intervention to evaluate the intervention effects in terms of cognitive function, quality of life, depression, self-efficacy, and loneliness dimensions. Results The 3 older adults included in the study were 74, 70, 73 years old, all married, living with their spouses and grandchildren. The three older adults had MoCA scores of 21, 22, and 24 at baseline, 28, 26, and 27 at 3 months of intervention, and 25, 19, and 23 at 3 months after intervention; GSES scores were 25, 30, and 27 at baseline, 29, 29, and 30 at 3 months of intervention, and 28, 31, and 28 at 3 months after intervention. SF-12 scores were 69, 32, and 51 at baseline, 81, 81, and 83 at 3 months of intervention, and 78, 38, and 59 at 3 months after intervention. The GDS-15 scale scores were 4, 8, and 2 at baseline, 2, 6, and 1 at 3 months of intervention, and 1, 8, and 4 at 3 months after intervention. The DJGLS scores were 8, 7, and 8 at baseline, 5, 5, and 4 at 3 months of intervention, and 5, 5, and 7 at 3 months after intervention. Semi-structured interview data indicated improvement in all five dimensions of cognitive function, quality of life, depression, loneliness, and self-efficacy of the subjects. Conclusion For older adults with mild cognitive impairment, it is of great significance to perform a non-pharmacological integrated intervention in terms of cognitive training, physical exercise, emotional management, social connection, and healthy lifestyle habits. The MoCA, SF-12, GDS-15, and DJGLS scores of older adults with mild cognitive impairment improved at 3 months of intervention, while the GSES scores improved at 3 months after intervention. GSES scores were not as effective after the intervention. All dimension scores showed a decreasing trend at 3 months after the intervention.

ObjectiveTo explore the variation rules and health risks of trihalomethane in regional drinking water， and to provide evidence for the innovative water processing technology and the optimization of drinking water quality.MethodsBased on regional drinking water sanitation monitoring， non-parametric rank sum test was used to analyze the effects of residual trihalomethane production in different periods and with disinfection methods. The United States environmental protection agency （USEPA） classic "four-step" health risk assessment model was used to evaluate the carcinogenic risk and non-carcinogenic risk of trihalomethane through drinking water exposure.ResultsThe yield of trichloromethane in wet season was 6.3 μg·L-1， which was higher than that in dry season. Compared with chlorination pretreatment， ozone pretreatment reduced the content of bromomethane dichloromethane. Compared to liquid chlorine disinfection， sodium hypochlorite treatment incresed the levels of trichloromethane and bromomethane chloride. Although the total carcinogenic and non-carcinogenic risks of trihalomethane in drinking water in the region were at safe levels， they were above the acceptable limits occasionally. The highest carcinogenic risk of trihalomethane were dichlorobromomethane and chlorodibromomethane，and the highest non-carcinogenic risk was trichloromethane. The health risk of children was 1.2 times higher than that for adults.ConclusionThe production of residual trihalomethane in drinking water in this area is relatively low， which is less harmful to the health of adults and children. Monitoring， including other disinfection byproducts， should continue and appropriate disinfection techniques for drinking water should be explored.

Objective·To explore the relationship between sleep quality and carotid atherosclerosis in the population with low or moderate risk of cardiovascular and cerebrovascular diseases.Methods·Based on the population-based cohort study of chronic diseases in Xinjiang, the researchers selected residents aged 35－75 from two fixed communities in Urumqi and Korla, in Northern and Southern Xinjiang, respectively, using a two-stage random cluster sampling method from July 2019 to September 2021. In the population without a history of coronary heart disease and cerebrovascular events, the prediction model for atherosclerotic cardiovascular disease (ASCVD) risk in China (China-PAR) was used to evaluate the risk of cardiovascular and cerebrovascular diseases. Low and moderate risk population of cardiovascular and cerebrovascular diseases were included. Participants completed physical examinations, questionnaires [including the Risk Factors Assessment Scale of Cardiovascular and Cerebrovascular Diseases in Xinjiang, Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire (IPAQ), and Food Frequency Questionnaire], cardiovascular and metabolic biochemical examinations, and carotid color doppler. Carotid intima-media thickness (CIMT) and plaque formation were used to determine the carotid atherosclerosis of the study subjects. Multivariate Logistic regression model and restricted cubic spline (RCS) were used to analyze the relationship between sleep quality and carotid intima-media thickening/plaque formation in the population with low and moderate risk of cardiovascular and cerebrovascular diseases.Results·A total of 1 528 subjects were included in the study, the mean age was (49.4±8.2) years, and 685 (44.8%) were male. In the included population, there were 581 (38.0%) subjects with carotid intima-media thickening and 305 (20.0%) subjects with carotid plaque formation. Among them, intima-media thickening and plaque formation both occurred in 154 (10.1%) people. Therefore, the prevalence of carotid atherosclerosis was 47.9% (732 subjects). Compared with the group without carotid artery thickening, the group with carotid intima-media thickening/plaque formation had higher levels of general cardiovascular and cerebrovascular risk factors, including age, male ratio, blood lipid levels and obesity, and higher PSQI sleep score [(7.06±2.13) vs (7.43±2.51), P=0.001]. The proportion of patients with poor sleep quality was higher (6.5% vs 12.1%, P=0.001). Multivariate Logistic regression analysis showed that poor sleep quality was an independent risk factor for carotid atherosclerosis [adjusted OR (aOR)=1.22, 95%CI 1.004－1.492, P=0.040]. RCS analysis suggested that PSQI and the risk of carotid atherosclerosis showed a positive linear correlation, that is, the worse quality of sleep, the higher risk of carotid atherosclerosis.Conclusion·Although the traditional metabolic risk factors are at a low risk level, the prevalence of carotid atherosclerosis is high and poor sleep quality is an independent risk factor for carotid atherosclerosis in the low and moderate risk population of cardiovascular and cerebrovascular diseases.

Objective·To construct an mRNA vaccine encoding hemagglutinin (HA) of influenza A H1N1 virus, and explore the protective effects of different booster vaccination strategies.Methods·Firefly luciferase (Fluc) was used as the reporter gene to construct Fluc mRNA vaccine enveloped in lipid nanoparticles (LNP). The in vivo expression of Fluc mRNA-LNP after intramuscular injection was determined by live imaging assay in mice. Furthermore, M15-HA mRNA-LNP derived from H1N1 subtype (A/Michigan/45/2015) was constructed. Mice were immunized with 20, 10, 5, or 1 µg doses of M15-HA mRNA-LNP twice (with an interval of 3 weeks) through intramuscular injection. Serum antibody titers were measured by enzyme-linked immunosorbent assay (ELISA) at 2 weeks and 4 weeks after the second immunization, and functional antibody levels were detected by hemagglutination inhibition test. The third booster vaccination was performed 40 d after the second immunization in 1 µg dose group with 1 µg M15-HA mRNA-LNP or 10 µg HA subunit vaccine. The levels of specific antibody and functional antibody were detected by ELISA and hemagglutination inhibition test, respectively 2 weeks and 4 weeks later.Results·Live imaging assay showed that luciferase activity could be detected in mice 1 d after injection of Fluc mRNA-LNP. At 2 weeks and 4 weeks after the second immunization of M15-HA mRNA-LNP, HA-specific antibodies were significantly higher than those before the immunization in all vaccination groups at different doses (P=0.000). The hemagglutination inhibition test showed that the levels of functional antibodies in the 20 μg dose and 10 μg dose groups were significantly higher than those in the PBS control group (P

The study aimed to investigate comorbidities, major adverse respiratory events, and mortality in patients with idiopathic pulmonary fibrosis (IPF). We established an IPF cohort and a comparative cohort matched for sex, age, and the date of IPF diagnosis. We recorded the most frequent comorbidities, the proportions, and time durations to the episode of major adverse respiratory events and death. Both cohorts were followed up to the end of 2016. We included 921 patients in the IPF cohort and 3,677 individuals in the comparative cohort. Comorbidities associated with IPF included pulmonary hypertension, chronic obstructive pulmonary disease, heart failure, asthma, and gastroesophageal reflux disease. The IPF cohort was more likely to have pneumonia (47.6 vs 12.0%), acute respiratory failure (17.8 vs 4.30%), chronic respiratory failure (4.23 vs 0.63%), and death (36.3 vs 15.0%) than the comparative cohort. The time durations to the first episode of pneumonia, acute respiratory failure, chronic respiratory failure, and death were 2.09 ± 2.98, 3.12 ± 3.62, 3.20 ± 4.03, and 3.27 ± 3.03 years in the IPF cohort. In conclusion, patients with IPF had significant comorbidities, particularly pulmonary and cardiovascular comorbidities. The duration from diagnosis to the major adverse respiratory events or death was short.

Phosphodiesterase 4D interacting protein (PDE4DIP) interacts with cAMP-specific phosphodiesterase 4D and its abnormal expression promotes the development of hematological malignancies, breast cancer, and pineal cell carcinoma. However, there is currently no systematic pan-cancer analysis of the association between PDE4DIP and various cancers. Thus, this study aimed to elucidate the potential functions of PDE4DIP in various cancers. Based on the multiple public databases and online websites, we conducted comprehensive analyses for PDE4DIP in various cancers, including differential expression, prognosis, genetic variation, DNA methylation, and immunity. We thoroughly analyzed the specific role of PDE4DIP in acute myeloid leukemia (LAML). The results indicated that there were differences in PDE4DIP expression in cancers, and in kidney chromophobe, LAML, pheochromocytoma and paraganglioma, thymoma, and uveal melanoma, PDE4DIP had potential prognostic value. PDE4DIP expression was also correlated with genetic variation, DNA methylation, immune cell infiltration, and immune-related genes in cancers. Functional enrichment analysis showed that PDE4DIP was mainly related to immune-related pathways in cancers, and in LAML, PDE4DIP was mainly related to immunoglobulin complexes, T-cell receptor complexes, and immune response regulatory signaling pathways. Our study systematically revealed for the first time the potential prognostic and immunotherapeutic value of PDE4DIP in various cancers, including LAML.

Objective To evaluate the effect of ultrasonography visualization teaching in the integration course of diagnostics and ultrasonic medicine for eight-year clinical medicine program students and to provide reference for further optimization of the teaching program. Methods The study conducted a questionnaire survey with electronic questionnaire in the eight-year clinical medicine program students from Peking Union Medical College who participated in ultrasonography visualization teaching of neck and abdomen. We adopted self-control study(data from the questionnaires completed by the same student before and after the course) to compare the accuracy of each knowledge point before and after teaching to evaluate the teaching effect, and collected course satisfaction ratings and feedback from the students. Results A total of 124 eight-year medical students participated in the survey, with 107 cases eight-year clinical medicine program students in grade 2017, and 17 cases '4+4' pilot class students in grade 2019 from Peking Union Medical College. Altogether 116 valid questionnaires (the response rate was 93.5%, 116/124) were collected for neck ultrasound courses and 101 valid questionnaires (the response rate was 94.4%, 101/107) for abdominal ultrasound courses. After the teaching of neck ultrasound course, the correctness of 68.8%(11/16) and 66.7%(10/15) of the knowledge points was significantly improved for the grade of 2017 and 2019 medicine students, respectively (all P < 0.05); after the teaching of abdominal ultrasound course, the correctness of 80%(4/5) of the knowledge points was significantly improved for both the grade of 2017 and 2019 medicine students (all P < 0.05). Course satisfaction surveys showed that 99.1%(115/116)of the students were very satisfied or satisfied with the cervical ultrasound course, and 0.9%(1/116) were somewhat satisfied. As for the abdominal ultrasound course, 99.0% (100/101) of the students were very satisfied or satisfied and 1.0%(1/101) were somewhat satisfied. Twenty one medical students gave feedback on the evaluation of the course, believing that ultrasound visualization teaching improved learning initiative (52%, 11/21) and learning efficiency (43%, 9/21) and stimulated learning interest (5%, 1/21); 27 medical students made suggestions on the teaching mode, among which 'increasing teaching hours' accounted for the highest proportion (56%, 15/27), followed by 'recommending reference books' (26%, 7/27). Conclusion The ultrasonography visualization teaching improves the learning initiative and efficiency of eight-year clinical medicine program undergraduates, stimulates the learning interest, and promotes their mastery of relevant knowledge.

ObjectiveTo investigate the condom use of men who have sex with men （MSM） in Shanghai， the information motivation behavioral skills model （IMB） theory was used to introduce psychosocial factors and study the relevant factors of consistent condom use （CCU） in this population.MethodsA cross-sectional study of 547 MSM in four districts of Shanghai was conducted by snowball sampling. The structural equation model based on psychosocial optimization was constructed and validated using the data collected by structured questionnaires.ResultsAmong the 547 respondents， the proportion of CCU in the past six months was 45.5%. Comparing the fitness of the initial model with that of the adjusted model， we found that the fitness of the adjusted model was good.ConclusionThe proportion of CCU among MSM in Shanghai is relatively low； In addition， information and motivation do not directly affect the CCU of this population； Only behavioral skills have a direct effect on CCU. Finally， social psychological measures should be emphasized for this population， and comprehensive and multi-level strategies should be formulated to control the spread of HIV in this population.

Objective To investigate the effect of tension on donor site recovery of modified forearm flaps (closed forearm donor site skin flaps). Methods From October 2018 to April 2021, 12 patients with oral cancer underwent forearm flap repair at Xuzhou Central Hospital. Handgrip strength and wrist motion were recorded before surgery. During the surgical incision at the donor site of the forearm, the triangular full-thickness skin of the donor site was used to close part of the surgical incision, and the other part of the surgical incision was directly closed and sutured. Tension was measured with a tension meter during the surgical incision at the donor site. Patients were followed up after surgery to observe whether there were postoperative complications such as necrosis and poor healing of donor site wounds, as well as forearm grip strength, wrist range of motion and appearance satisfaction. Results Among the 12 patients, there was only one elderly patient with postoperative necrosis near the wrist in the donor site skin, and the average tension of the patient was 0.65 kg; the lesion healed after dressing changes. All of the other patients recovered well without postoperative complications. The mean tension of 12 patients was (0.51 ± 0.05) kg. The preoperative and postoperative grip strength of 12 patients was (23.7 ± 10.3) kg and (22.3 ± 10.7) kg, respectively, and the difference was not statistically significant (t=5.872, P

Objective To explore whether RhoA plays a role in the migration and invasion of the salivary adenoid cystic carcinoma cell lines SACC-LM and SACC-83. Methods Total RNA and total protein were extracted from 20 salivary adenoid cystic carcinoma (SACC) and normal adjacent tissues frozen in liquid nitrogen to detect RhoA expression. RhoA-siRNA was constructed to transfect two cell lines (SACC-LM and SACC-83) for cytological experiments. The research included an experimental group (RhoA-siRNA transfection), negative control group (siRNA-NC transfection) and blank group by transient transfection with liposomes. Expression of RhoA mRNA and protein as well as the protein expression of biomarkers of epithelial-mesenchymal transition (EMT) were analyzed, including E-cadherin, N-cadherin, and Vimentin. Furthermore, the changes in invasion and migration of cells in each group were analyzed by comparing the number of transmembrane cells in the Transwell assay and the results of the scratch test. Results Compared with normal adjacent tissues, RhoA protein and mRNA levels increased in SACC tissues. Compared with the control group, the relative expression levels of RhoA mRNA and protein decreased (P < 0.01), the relative expression levels of E-cadherin protein increased, and the relative expression levels of N-cadherin and vimentin protein increased in the experimental group (P < 0.01). Additionally, the trial results revealed that RhoA knockdown restrained cell migration and invasion (P < 0.01). Conclusion RhoA expression increased in SACC tissue. Silencing RhoA in vitro could effectively restrain cell migration and invasion in SACC-LM and SACC-83 cells through the regulation of EMT signaling pathways.

The endocrown, a modified overlay or crown, is considered to have the advantages of adhesive retention and mechanical retention. Marginal adaptation and mechanical strength are common criteria for evaluating endocrowns. This review studied these aspects of endocrowns to guide further clinical application. Results from previous academic studies indicate that endocrowns made of different materials, such as glass-based ceramics, zirconia-based ceramics and resin-based ceramics, exhibit clinically acceptable marginal adaptation. Zirconia is a common dental material, but when used in endocrowns, it tends to present a risk of irreparable tooth root fractures. Compared with products manufactured with zirconia, endocrowns manufactured with resin-based ceramics and glass-based ceramics, such as lithium disilicate ceramics, do not tend to cause irreparable results, such as tooth root fracture, but their mechanical strengths are not as good as those of zirconia. At the same time, the tooth prepration design such as the types of endocrowns, the pulp chamber extension depth and angles, the endocrown thickness can influence the mechanical strength of endocrowns as well. Compared with traditional zirconia, self-glazed zirconia, a new type of material used to restore defective teeth, has the similar elasticity modulus（210 GPa）and better aesthetic advantages, and is suitable for short crown patients with insufficient occlusal space. Further study is warranted to improve the performance of endocrowns made from ceramic materials to prevent root fracture.

With the increase of the workload and complexity in the ultrasound department, scheduling is becoming more and more important. In order to improve the efficiency of scheduling, satisfaction of employees, and overall service satisfaction of the department, we developed the software system of integrated intelligent scheduling. Scientific, digital and intelligent scheduling can effectively optimize and integrate the human resources of the department, reduce the cost of staff management, enhance the management of operation, and improve medical practice, teaching, research and management.

Immune adjustment has become a sepsis occurring in the development of an important mechanism that cannot be ignored. This article from the perspective of immune infiltration of pediatric sepsis screening markers, and promote the understanding of disease mechanisms. Bioinformatics integrated six data sets of pediatric sepsis by using the surrogate variable analysis package and then analyzed differentially expressed genes (DEGs), immune infiltration and weighted gene co-expression network analysis of characteristics (WGCNA) of immune infiltration between pediatric sepsis and the control. Common genes of WGCNA and DEGs were used to functional annotation, pathway enrichment analysis and protein-protein interaction network. Support vector machine (SVM), least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were used to confirm the key genes for the diagnosis of pediatric sepsis. Receiver operating characteristic (ROC) curve, C index, principal component analysis (PCA) and GiViTi calibration band were used to evaluate the diagnostic performance of key genes. Decision curve analysis (DCA) was used to evaluate the clinical application value of key genes. Lastly, the correlation between key genes and immune cells was analyze. NK cells Resting and NK cell activated in pediatric sepsis during immune infiltration were significantly lower than those in the control group, while M1 Macrophages were higher than those in the control group. ROC, C-index, PCA, GiViTi calibration band and DCA indicated that MCEMP1, CD177, MMP8 and OLFM4 had high diagnostic performance for pediatric sepsis. There is a negative correlation between 4 key genes and NK cells resting, NK cells activated. Except for MCEMP1 , the other 3 genes were positively correlated with M1 Macrophages. This study revealed differences in immune responses in pediatric sepsis and identified four key genes as potential biomarkers. Pediatric sepsis in pathology maybe understood better by learning about how it develops.

Objective To evaluate the anti-infective effect of polysaccharide isolated from fungus PH1008 in vaginal Candida albicans infection model of mouse,and to provide a new and potential pathway to the development of anti-candida drugs. Methods Determination of gene expression level of transcriptome in mice vagina after yeast infection mouse model was treated by exopolysaccharide of fungus PH1008. Results The expression of hepatocyte growth factor and complement 1 receptor was increased, and the up-regulation was related to varied signal transduction pathways. Conclusions The anti-infection effect of Candida albicans can be induced by vaginal mucosal immunization with exopolysaccharide of fungus PH1008, and the relevant mechanism needs further research.

Recent studies have revealed that microRNAs regulate radiosensitivity of non-small cell lung cancer (NSCLC). The aim of this study was to investigate whether miR-101-3p is correlated with radiosensitivity of NSCLC. According to our results, miR-101-3p was downregulated in NSCLC tissues and cell lines. Moreover, miR-101-3p was decreased in A549 cells’ response to irradiation in a dose-dependent manner. Upregulation of miR-101-3p decreased survival fraction and colony formation rate and increased irradiation-induced apoptosis in irradiation-resistant cells, while miR-101-3p depletion had the opposite effects in irradiation-sensitive cells. Furthermore, mechanistic target of rapamycin (mTOR) is a target gene of miR-101-3p. The expressions of mTOR, p-mTOR, and p-S6 were curbed by overexpression of miR-101-3p in A549R cells, which was enhanced by repression of miR-101-3p in A549 cells. Intriguingly, elevation in mTOR abated miR-101-3p upregulation-induced increase in irradiation sensitivity in irradiation-resistant cell line. In contrast, rapamycin undermined miR-101-3p inhibitor-mediated reduction of irradiation sensitivity in irradiation-sensitive cell line. Besides, miR-101-3p overexpression enhanced the efficacy of radiation in an NSCLC xenograft mouse model. In conclusion, miR-101-3p sensitized A549 cells to irradiation via inhibition of mTOR-signaling pathway.

Sirtuin 6 (SIRT6) plays a critical role in the progression and development of gastrointestinal cancers. However, the association between SIRT6 expression and clinicopathological parameters and prognosis in gastrointestinal cancer patients remains inconclusive. Consequently, we conducted this meta-analysis to evaluate the importance of SIRT6 expression in various types of gastrointestinal cancers. PubMed, EMBASE, and Web of Science databases were systematically searched to screen the relevant literature. The reported or estimated hazard ratio (HR) and odds ratio (OR) and their corresponding 95% confidence interval (CI) were pooled to assess the strength of the association. Nine studies involving 867 patients were included in the meta-analysis. Overall analysis showed that high SIRT6 expression was related to better overall survival in gastrointestinal cancers (HR = 0.62, 95% CI = 0.47–0.82). High SIRT6 expression was also related to a favorable tumor node metastasis (TNM) stage (OR = 0.44, 95% CI = 0.28–0.70) among gastrointestinal cancer patients. Our meta-analysis revealed that high SIRT6 expression might be a potential biomarker predicting better prognosis in gastrointestinal cancers, which may offer options for gastrointestinal cancer treatment.

Objective To evaluate the discrimination efficiency of the SeqType􀳏 P52 Human Ancestry Identification SNP Detection Kit based on a high-throughput sequencing platform in five Chinese ethnic groups. Methods Using the SeqType􀳏 P52 Human Ancestry Identification SNP Detection Kit based on a high-throughput sequencing platform, a total of 350 samples from Han, Tibetan, Mongolian, Uygur, and Yi populations in China were detected and population cluster analysis was performed. Results The effective sequencing depth of a single site in a single sample was ≥720×, and the average report rate was 96%. The mean values of allele frequency differences between the Tibetan, Mongolian, Uygur, Yi and Han population were 0.20, 0.05, 0.24 and 0.11, respectively. Using Structure 2.3.4 software under K=5 mode, independent ancestral component in Han, Tibetan and Uygur could be detected, which was consistent with the result observed from the principal component analysis （PCA）. For the Yi population, two thirds of them had relatively independent ancestral component close to the Tibetan population and one third were similar to the Uygur population. The Mongolian population had similar ancestral origin component with Han population. Conclusion The composite detection system with 52 screened ancestry-informative SNP sites has been established in this study, which can effectively analyze the composition and individual genetic components of populations from Han, Tibetan and Uygur. The ability to discriminate among Han, Mongolian and Yi needs to be further improved. The SeqType􀳏 P52 Human Ancestry Identification SNP Detection Kit can be used to infer the origin of an individual’s ancestors in some forensic DNA cases.

This study aims to investigate the potential effects of regional hyperthermia combined with chemotherapy (RHCT) as a treatment strategy for advanced gastric cancer (AGC).

Cell immobilization is an alternative to microencapsulation for the maintenance of cells in a liquid medium. However, artificial immobilization carriers are expensive and pose a high safety risk. Okara, a food-grade byproduct from soymilk production, is rich in prebiotics. Lactobacilli could provide health enhancing effects to the host. This study aimed to evaluate the potential of okara as a natural immobilizer for L. plantarum 70810 cells. The study also aimed to evaluate the effects of okara-immobilized L. plantarum 70810 cells (IL) on soymilk fermentation, glucosidic isoflavone bioconversion, and cell resistance to simulated gastric and intestinal stresses. Scanning electron microscopy (SEM) was used to show cells adherence to the surface of okara. Lactic acid, acetic acid and isoflavone analyses in unfermented and fermented soymilk were performed by HPLC with UV detection. Viability and growth kinetics of immobilized and free L. plantarum 70810 cells (FL) were followed during soymilk fermentation. Moreover, changes in pH, titrable acidity and viscosity were measured by conventional methods. For in vitro testing of simulated gastrointestinal resistance, fermented soymilk was inoculated with FL or IL and an aliquot incubated into acidic MRS broth which was conveniently prepared to simulate gastric, pancreatic juices and bile salts. Survival to simulated gastric and intestinal stresses was evaluated by plate count of colony forming units on MRS agar. SEM revealed that the lactobacilli cells attached and bound to the surface of okara. Compared with FL, IL exhibited a significantly higher specific growth rate, shorter lag phase of growth, higher productions of lactic and acetic acids, a faster decrease in pH and increase in titrable acidity, and a higher soymilk viscosity. Similarly, IL in soymilk showed higher productions of daizein and genistein compared with the control. Compared with FL, IL showed reinforced resistance to simulatedgastric and intestinal stresses in vitro that included low pH, low pH plus pepsin, pancreatin, and bile salt. Our results indicate that okara is a new potential immobilization carrier to enhance the growth and glucosidic isoflavone bioconversion activities of L. plantarum in soymilk and improve cell survivability following simulated gastric and intestinal conditions.

It is unclear whether an "obesity paradox" exists in the respiratory system, especially in acute respiratory distress syndrome (ARDS) and acute lung injury (ALI). Previous studies have postulated a causal relation between obesity and ARDS/ALI but have lacked power to form a definitive conclusion.To investigate the relationships between obesity, ARDS/ALIrisk, and mortality.A systematic search current to April 2016 was performed in Pubmed, EMBASE, Medline, Cochrane databases to find relevant studies. All studies that estimate the effect of obesity in the morbidity and mortality of ARDS/ALI were included.A total of 24 studies including 9,187,248 subjects were analyzed. The combined results from 16 studies that examined the effect of obesity in morbidity of ARDS/ALI showed an89% increase in odds ratio(pooled odds ratios (OR) 1.89, 95% confidence intervals (CI) 1.45 to 2.47). In subgroup analysis, compared to normal weight, obesity was associated with an increased risk of ARDS/ALI (OR1.57, 95% CI 1.30-1.90 for obese (BMI30-39.9kg/m2); OR1.75, 95% CI 1.42-2.15 for obese(BMI≥30kg/m2); OR1.67, 95% CI 1.04-2.68 for morbid obese(BMI≥40kg/m2)). The combined results from 9 studies that examined the effect of obesity in mortality of ARDS/ALI had a pooled odds ratio(pooled OR 0.63, 95% CI 0.41 to 0.98). Inversely, obesity was significantly associated with reduced risk of ARDS/ALI mortality(OR0.88, 95% CI 0.78-1.00 for overweight(BMI≤18.5m2); OR0.74, 95% CI 0.64-0.84 for obese (BMI30-39.9kg/m2);OR0.84, 95% CI 0.75-0.94 for 60days mortality; OR0.38, 95% CI 0.22-0.66 for 90days mortality).Our data identify obesity as an important risk factor for the development of ARDS/ALI; however, ARDS/ALI outcomes are improved in this population when compared to individuals with a normal body mass index. This meta-analysis results supported ''obesity paradox" in ARDS/ALI.

Abstract Background Embryonic stem cells (ESCs) are pluripotent stem cells and can form tumors containing cells from all three germ layers. Similarities between pluripotent stem cells and malignant tumor cells have been identified. The purpose of this study was to obtain ESCs-converted tumor cell lines and to investigate the mechanism of malignancy in pluripotent stem cells. Methods Mouse ESCs were subcutaneously injected into nude mice to obtain tumors from which a tumor-like cell line (ECCs1) was established by culturing the cells in chemical-defined N2B27 medium supplied with two small molecular inhibitors CHIR99021 and PD0325901 (2i). The ECCs1 were then subcutaneously injected into nude mice again to obtain tumors from which another tumor-like cells line (ECCs2) was established in the same 2i medium. The malignant degree of ESCs, ECCs1 and ECCs2 was compared and the underlying mechanism involved in the malignancy development of ESCs was examined. Results The three ESCs, ECCs1 and ECCs2 cell lines were cultured in the same 2i condition and showed some likeness such as Oct4-expression and long-term expansion ability. However, the morphology and the tumor-formation ability of the cell lines were different. We identified that ECCs1 and ECCs2 gradually acquired malignancy. Moreover, Wnt signaling-related genes such as CD133 and β-catenin expression were up-regulated and Frizzled related protein (FRP) was down-regulated during the tumor development of ESCs. Conclusions The two tumor-like cell lines ECCs1 and ECCs2 stand for early malignant development stage of ESCs and the ECCs2 was more malignant than the ECCs1. Moreover, we identified that Wnt/β-catenin signaling played an important role in the malignancy process of ESCs.

Abstract Background Ischemic postconditioning (IPost) has aroused much attention since 2003 when it was firstly reported. The role of microRNAs (miRNAs or miRs) in IPost has rarely been reported. The present study was undertaken to investigate whether miRNAs were involved in the protective effect of IPost against myocardial ischemia-reperfusion (IR) injury and the probable mechanisms involved. Methods Thirty SD rats weighing 250-300 g were equally randomized to three groups: Control group, where the rats were treated with thoracotomy only; IR group, where the rats were treated with ischemia for 60 min and reperfusion for 180 min; and IPost group, where the rats were treated with 3 cycles of transient IR just before reperfusion. The extent of myocardial infarction, LDH and CK activities were measured immediately after treatment. Myocardial apoptosis was detected by TUNEL assay. The myocardial tissue was collected after IR or IPost stimulation to evaluate the miRNAs expression level by miRNA-microarray and quantitative real-time RT-PCR. Real-time PCR was conducted to identify changes in mRNA expression of apoptosis-related genes such as Bcl-2, Bax and Caspase-9 (CASP9), and Western blot was used to compare the protein expression level of CASP9 in the three groups. The miRNA mimics and anti-miRNA oligonucleotides (AMO) were transferred into the cultured neonatal cardiomyocytes and myocardium before they were treated with IR. The effect of miRNAs on apoptosis was determined by flow cytometry and TUNEL assay. CASP9, as one of the candidate target of miR-133a, was compared during IR after the miR-133a mimic or AMO-133a was transferred into the myocardium. Results IPost reduced the IR-induced infarct size of the left ventricle, and decreased CK and LDH levels. TUNEL assay showed that myocardial apoptosis was attenuated by IPost compared with IR. MiRNA-microarray and RT-PCR showed that myocardial-specific miR-1 and miR-133a were down-regulated by IR, and up-regulated by IPost compared with IR. Furthermore, IPost up-regulated the mRNA expression of Bcl-2, down-regulated that of Bax and CASP9. Western blot showed that IPost also down-regulated the CASP9 protein expression compared with IR. The results of flow cytometry and TUNEL assay showed that up-regulation of miR-1 and miR-133a decreased apoptosis of cardiomyocytes. MiR-133a mimic down-regulated CASP9 protein expression and attenuated IR-induced apoptosis. Conclusion MiRNAs are associated with the protective effect of IPost against myocardial IR injury. IPost can up-regulate miR-1 and miR-133a, and decrease apoptosis of cardiomyocyte. Myocardial-specific miR-1 and miR-133a may play an important role in IPost protection by regulating apoptosis-related genes. MiR-133a may attenuate apoptosis of myocardiocytes by targeting CASP9.

Abstract Background Zbtb7A is a proto-oncogenic transcriptional regulator that plays an important role in adipogenesis, osteogenesis and oncogenesis, but little is known about the regulation of Zbtb7A gene expression which is of importance in the function uncovering of this gene. Finding Here, a 5'-flanking region of the human Zbtb7A gene was cloned and characterized. It was found that the GC box within Zbtb7A promoter is necessary for the promoter activity. Furthermore, we identified that Sp1 acts as an activator in the regulation of Zbtb7A promoter activity and the physical interaction between Sp1 and GC box is responsible for the activation of Zbtb7A gene promoter. Conclusion Our results confirmed that Sp1 upregulates Zbtb7A gene expression via direct binding to GC box within the promoter.

ObjectiveTo understand the usage of antibiotics in outpatients in a county of Zhejiang Province from 2015 to 2020， so as to provide a basis for further standardizing the clinical application of antibiotics in this region.MethodsOutpatient records and prescription records of 146 public medical institutions from 2015 to 2020 were extracted from the electronic medical record data sharing platform system of medical institutions in a county of Zhejiang Province. The utilization rates and the number of types of antibiotics used in outpatient patients were described. According to the drug anatomy， therapeutic and chemical classification system （ATC）， clinical application classification and dosage form， the use status of different types of antibiotics was observed. The annual percentage change （APC） was used to analyze the time trend of antibiotic use. Among the antibiotic prescriptions in each year， the proportions of prescriptions aimed for different use reasons and patients were compared to analyze the changes in the structures of antibiotic prescriptions.ResultsDuring 2015‒2020， a total of 2 861 438 prescriptions were issued in 146 primary public medical institutions in this county， including 314 642 prescriptions for antibiotics， and the overall utilization rate of antibiotics was 11%. The utilization rate of antibiotics showed a decreased trend across the years （from 14.23% in 2015 to 7.59% in 2020， APC=-11.51%， 95%CI=-0.01%‒-21.7%， t=-12.05， P

Abstract Water pollution containing dyes become increasingly serious environmental problem with the acceleration of urbanization and industrialization process. Renewable adsorbents for cationic dye wastewater treatment are becoming an obstacle because of the difficulty of desorbing the dye from the adsorbent surface after adsorption. To overcome this dilemma, herein, we report a hydrothermal method to fabricate sulfonic acid modified yeast carbon microspheres (SA/YCM). Different characterization techniques like scanning electron microscopy, FTIR spectroscopy, and X-ray diffraction have been used to test the SA/YCM. Decorated with sulfonic acid group, the modified yeast carbon microspheres possess excellent ability of adsorbing positively charged materials. The removal rate of Methyl blue (MB) by renewable adsorbent SA/YCM can reach 85.3% when the concentration is 500 mg/L. The SA/YCM regenerated by HCl showed excellent regeneration adsorption capacity (78.1%) after five cycles of adsorption–desorption regeneration experiment. Adsorption isotherm and kinetic behaviors of SA/YCM for methylene blue dyes removal were studied and fitted to different existing models. Owing to the numerous sulfonic acid groups on the surface, the SA/YCM showed prominent reusability after regeneration under acidic conditions, which could withstand repeated adsorption–desorption cycles as well as multiple practical applications.