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Junqi Liao,1,&ast; Yuan Zhu,1,2,&ast; Aimei Zhang,1 Dan Wu,1 Xiaohui Yan,1 Qiuhua He,1 Fantao Song,1 Jingyi Chen,1 Yunze Li,1 Li Li,1 Zhaoyao Chen,1 Wenlei Li,1 Qin Yang,2 Zhuyuan Fang,3 Minghua Wu1 1Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, People’s Republic of China; 2Department of Medicine, Physiology and Biophysics, UC Irvine Diabetes Center, University of California Irvine (UCI), Irvine, CA, USA; 3Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Minghua Wu, Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, People’s Republic of China, Email yfy0069@njucm.edu.cn Zhuyuan Fang, Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, People’s Republic of China, Email fangzhuyuan@njucm.edu.cnBackground: The relationship between insulin resistance-related indices and the outcomes of acute ischemic stroke (AIS) is still unclear. This study aimed to explore the association between the Apo B/Apo A-1 ratio and the Prognostic Nutritional Index (PNI) with the 90-day outcomes of AIS.Methods: A total of 2011 AIS patients with a 3-month follow-up were enrolled in the present study from January 2017 to July 2021. Multivariate logistic regression modeling was performed to analyze the relationship between Apo B/Apo A-1 ratio, PNI, and AIS poor outcomes. The mediating effect between the three was analyzed using the Bootstrap method with PNI as the mediating variable.Results: Among the 2011 included AIS patients, 20.3% had a poor outcome. Patients were categorized according to quartiles of Apo B/Apo A-1 ratio and PNI. Multivariate logistic regression revealed that the fourth Apo B/Apo A-1 ratio quartile had poorer outcomes than the first quartile (OR 1.75,95%CL 1.21– 2.53, P=0.003), and the fourth PNI quartile exhibited a lower risk of poor outcomes than the first quartile (OR 0.40, 95%CL 0.27– 0.61, P< 0.001). PNI displayed a significant partially mediating effect (21.4%) between the Apo B/Apo A-1 ratio and poor AIS outcomes.Conclusion: The Apo B/Apo A-1 ratio is a risk factor for poor AIS outcomes, whereas PNI acts as a protective factor. The association between the ApoB/ApoA-1 ratio and poor AIS outcomes was partially mediated by PNI.Keywords: insulin resistance, Apo B/Apo A-1 ratio, prognostic nutritional index, acute ischemic stroke, outcomes

Introduction: Sessile plants engage in trade-offs between growth and defense capacity in response to fluctuating environmental cues. MYB is an important transcription factor that plays many important roles in controlling plant growth and defense. However, the mechanism behind how it keeps a balance between these two physiological processes is still largely unknown. Objectives: Our work focuses on the dissection of the molecular mechanism by which GhMYB33 regulates plant growth and defense. Methods: The CRISPR/Cas9 technique was used to generate mutants for deciphering GhMYB33 functions. Yeast two-hybrid, luciferase complementary imaging, and co-immunoprecipitation assays were used to prove that proteins interact with each other. We used the electrophoretic mobility shift assay, yeast one-hybrid, and luciferase activity assays to analyze GhMYB33 acting as a promoter. A β-glucuronidase fusion reporter and 5′ RNA ligase mediated amplification of cDNA ends analysis showed that ghr-miR319c directedly cleaved the GhMYB33 mRNA. Results: Overexpressing miR319c-resistant GhMYB33 (rGhMYB33) promoted plant growth, accompanied by a significant decline in resistance against Verticillium dahliae. Conversely, its knockout mutant, ghmyb33, demonstrated growth restriction and concomitant augmentation of V. dahliae resistance. GhMYB33 was found to couple with the DELLA protein GhGAI1 and bind to the specific cis-elements of GhSPL9 and GhDFR1 promoters, thereby modulating internode elongation and plant resistance in V. dahliae infection. The ghr-miR319c was discovered to target and suppress GhMYB33 expression. The overexpression of ghr-miR319c led to enhanced plant resistance and a simultaneous reduction in plant height. Conclusion: Our findings demonstrate that GhMYB33 encodes a hub protein and controls the expression of GhSPL9 and GhDFR1, implicating a pivotal role for the miR319c-MYB33 module to regulate the trade-offs between plant growth and defense.

Based on the whole desalination process, this paper reviewed the source and fate of risk factors in concentrated seawater including salinity, temperature, chemicals used for pretreatment, chemicals required in desalination process, by-products, corrosion products, and filter backwash. According to the hazard and toxicological thresholds combined with the no-effect concentration for marine species, the risk factors of brine discharge to seawater environment were further identified. The results showed that the risk factors contained ferric salt, aluminium salt, acrylamide, phosphates and total phosphorus, residual chlorine, total chlorine and disinfection by-products, isothiazolinone, sodium bisulfite, and heavy metals/metalloids such as copper, nickel, chromium, molybdenum, zinc, lead, titanium, cadmium, arsenic, selenium, mercury and barium. After the preliminary assessment, it was necessary to further monitor the risk factors in situ and know their actual concentration level in brine from seawater desalination, so as to provide a scientific basis for accurately assess the environmental influence of discharge brine in the seawater.

Ying Chen,1,2,&ast; Wen-Xia Li,1,2,&ast; Jia-Hua Wu,1,2 Geng-Hang Chen,2 Chun-Min Yang,1,2 Hai Lu,1,2 Xi Wang,3 Shu-Sen Wang,4 Heng Huang,5 Li Cai,6 Li Zhao,7 Rou-Jun Peng,8 Ying Lin,9 Jun Tang,3 Jian Zeng,10 Le-Hong Zhang,11 Yong-Li Ke,12 Xian-Ming Wang,13 Xin-Mei Liu,14 An-Qin Zhang,15 Fei Xu,4 Xi-Wen Bi,4 Jia-Jia Huang,4 Ji-Bin Li,16 Dan-Mei Pang,17 Cong Xue,4 Yan-Xia Shi,4 Zhen-Yu He,18 Huan-Xin Lin,18 Xin An,4 Wen Xia,4 Ye Cao,16 Ying Guo,16 Ruo-Xi Hong,4 Kui-Kui Jiang,4 Yong-Yi Zhong,4 Ge Zhang,19 Piyawan Tienchaiananda,20 Masahiro Oikawa,21 Zhong-Yu Yuan,4 Qian-Jun Chen22,23 1Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, People’s Republic of China; 2Department of Breast Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 3Department of Breast Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China; 4Department of Medical Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China; 5Department of Breast Oncology, Lianjiang People’s Hospital, Lianjiang, People’s Republic of China; 6Department of Medical Oncology, The Affiliated Tumour Hospital of Harbin Medical University, Harbin, People’s Republic of China; 7Department of Breast Oncology, Guangzhou First People Hospital, Guangzhou, People’s Republic of China; 8Department of Integrated Therapy in Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China; 9Department of Breast Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China; 10Department of Breast Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 11Department of Breast Oncology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China; 12Department of Breast Oncology, General Hospital of PLA Guangzhou Military Area, Guangzhou, People’s Republic of China; 13Department of Breast Oncology, Shenzhen Second People’s Hospital, Shenzhen, People’s Republic of China; 14Department of Breast Oncology, Haikou People’s Hospital, Haikou, People’s Republic of China; 15Department of Breast Oncology, Maternal and Child Health Care Hospital of Guangdong Province, Guangzhou, People’s Republic of China; 16Department of Good Clinical Practice, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China; 17Department of Medical Oncology, Foshan First People’s Hospital, Foshan, People’s Republic of China; 18Department of Radiotherapy, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China; 19Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases (TMBJ), School of Chinese Medicine, Hong Kong Baptist University, Hong Kong; 20Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Rangsit University, Rajavithi Hospital, Bangkok, Thailand; 21The Department of Breast Surgery, New-wa-kai Oikawa Hospital, Fukuoka, Japan; 22State Key Laboratory of Traditional Chinese Medicine Syndrome/Departments of Gynecologic Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China; 23State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qian-Jun Chen, 55N, Neihuanxi Road, Guangzhou, Guangdong, 510006, People’s Republic of China, Tel +86 1868883505, Email cqj55@163.com Zhong-Yu Yuan, 651 Dongfeng Road, Guangzhou, Guangdong, 510060, People’s Republic of China, Tel +86 13798027658, Email yuanzhy@sysucc.org.cnPurpose: Results from studies of extended capecitabine after the standard adjuvant chemotherapy in early stage triple-negative breast cancer (TNBC) were inconsistent, and only low-dose capecitabine from the SYSUCC-001 trial improved disease-free survival (DFS). Adjustment of the conventional adjuvant chemotherapy doses affect the prognosis and may affect the efficacy of subsequent treatments. This study investigated whether the survival benefit of the SYSUCC-001 trial was affected by dose adjustment of the standard adjuvant chemotherapy or not.Patients and Methods: We reviewed the adjuvant chemotherapy regimens before the extended capecitabine in the SYSUCC-001 trial. Patients were classified into “consistent” (standard acceptable dose) and “inconsistent” (doses lower than acceptable dose) dose based on the minimum acceptable dose range in the landmark clinical trials. Cox proportional hazards model was used to investigate the impact of dose on the survival outcomes.Results: All 434 patients in SYSUCC-001 trial were enrolled in this study. Most of patients administered the anthracycline-taxane regimen accounted for 88.94%. Among patients in the “inconsistent” dose, 60.8% and 47% received lower doses of anthracycline and taxane separately. In the observation group, the “inconsistent” dose of anthracycline and taxane did not affect DFS compared with the “consistent” dose. Moreover, in the capecitabine group, the “inconsistent” anthracycline dose did not affect DFS compared with the “consistent” dose. However, patients with “consistent” taxane doses benefited significantly from extended capecitabine (P=0.014). The sufficient dose of adjuvant taxane had a positive effect of extended capecitabine (hazard ratio [HR] 2.04; 95% confidence interval [CI] 1.02 to 4.06).Conclusion: This study found the dose reduction of adjuvant taxane might negatively impact the efficacy of capecitabine. Therefore, the reduction of anthracycline dose over paclitaxel should be given priority during conventional adjuvant chemotherapy, if patients need dose reduction and plan for extended capecitabine.Keywords: adjuvant chemotherapy, capecitabine, SYSUCC-001, triple-negative breast cancer, TNBC

C60H92Br8N4O10Sn4, orthorhombic, Pccn (no. 56), a = 16.5363(14) Å, b = 20.3146(17) Å, c = 22.7452(19) Å, V = 7640.8(11) Å3, Z = 4, Rgt (F) = 0.0424, wRref (F 2) = 0.1254, T = 298 K.

ObjectiveTo analyze the epidemic characteristics of measles and rubella in Pudong New Area of Shanghai from 2013 to 2022， and to provide data support for the elimination of measles and rubella.MethodsEnzyme linked immunosorbent assay was used to detect IgM antibodies in serum samples. The sequence of 630 nucleotides at the C-terminal of N gene of measles virus was amplified by reverse transcription-polymerase chain reaction and the phylogenic tree was constructed.ResultsA total of 1 529 suspected cases of measles were detected from 2013 to 2022， among which the positive rate of measles IgM antibody was 33.55% （513/1 529）. The highest positive rate （20.73%） was from March to May ， and the positive rate of rubella IgM antibody was 6.80% （104/1 529）. The positive rate of both IgM was higher in males than that in females （P

Abstract [Objective] In unstable pollination environments, bisexual flowering plants often possess potential selfing ability. Given the mating cost of selfing, investigating selfing strategies in different environments are critical for the understanding of evolution of the mating systems. [Methods] To explore the selfing strategies of plants in the unstable pollination environments in early spring, we studied the flowering habits, pollinator groups, pollen dispersal dynamics, self-pollen transfer patterns, and mating systems in a natural population of Tulipa sinkiangensis, an early spring ephemeral plant. [Results] (1) T . sinkiangensis bloomed in early or mid April, with a single flowering period of 5-6 days. Flowers opened during the day and closed at night. Pollen dispersal started from the outer and appeared in a zippered order from bottom to top. (2) The pollinators were mainly bees and syrphids. Visiting frequencies were low, with great fluctuation among years, but the fruiting rates were generally higher in natural populations. (3) In the unstable pollination environment in early spring, the population was mainly outbred and partly self-inbred, forming a mixed mating system. The autonomous stamens movement during the closing of flowers in the evening promoted the autonomous self-pollination, and the massive deposition of self-pollen occurred on the 4th day after flowering, accounting for 50.22% of the total autonomous self-pollen deposition. It was a delayed self-pollination pattern, although promoting the occurrence of competing selfing. [Conclusion] Under limited pollination, the competing and delayed selfing promotes pollen deposition in T . sinkiangensis. This mating strategy that combined outcrossing, competing selfing, and delayed selfing flexibly responds to the unstable pollination environment in the early spring. It is an adaptation to the unstable pollination services under the low temperature condition in the early spring, and also a reproductive assurance strategy for the early spring ephemeral plants.

This paper addresses the challenge of managing state constraints in vehicle platoons, including maintaining safe distances and aligning velocities, which are key factors that contribute to performance degradation in platoon control. Traditional platoon control strategies, which rely on a constant time-headway policy, often lead to deteriorated performance and even instability, primarily during dynamic traffic conditions involving vehicle acceleration and deceleration. The underlying issue is the inadequacy of these methods to adapt to variable time-delays and to accurately modulate the spacing and speed among vehicles. To address these challenges, we propose a dynamic adjustment neural network (DANN) based cooperative control scheme. The proposed strategy employs neural networks to continuously learn and adjust to time varying conditions, thus enabling precise control of each vehicle’s state within the platoon. By integrating a DANN into the platoon control system, we ensure that both velocity and inter-vehicular spacing adapt in response to real-time traffic dynamics. The efficacy of our proposed control approach is validated using both Lyapunov stability theory and numeric simulation, which confirms substantial gains in stability and velocity tracking of the vehicle platoon.

ObjectiveTo analyze the epidemiological characteristics and etiology of clustered outbreaks of hand， foot， and mouth disease （HFMD） in Pudong New Area， Shanghai from 2017 to 2022， and to provide a scientific basis for the prevention and control of HFMD in the area.MethodsThe data related to HFMD clustered outbreaks from 2017 to 2022 were obtained from the Pudong New Area HFMD outbreak database. Descriptive analysis was conducted to explore the outbreak scope， seasonal characteristics， distribution of occurrence settings， and etiological composition.ResultsFrom 2017 to 2022， Pudong New Area reported a total of 2 547 HFMD clusters， involving 8 884 cases， with an average of 3.49 cases per event. The majority of events （78.52%） had between 2 and 4 cases. The peak reporting periods for clustered HFMD from 2017 to 2019 and in 2021 were during the summer （May‒July） and autumn （September‒November）. The seasonal pattern was less distinct in 2020 and 2022， likely due to the impact of the COVID-19 pandemic. The majority of clustered outbreaks occurred in childcare facilities （44.64%）， followed by households/neighborhood committees （44.21%）， with schools accounting for a smaller proportion （12.39%）. The etiology revealed the coexistence of multiple enterovirus genotypes， with a positive detection rate of 60.46%， and CoxA6 being the dominant strain.ConclusionHFMD clustered outbreaks in Pudong New Area show fluctuating trends， with significant yearly differences in the number of incidents. The predominant seasons for outbreaks are summer and autumn， with CoxA6 identified as the dominant strain. The implementation of prevention and control measures for COVID-19 significantly reduced the occurrence of HFMD outbreaks. Continuous monitoring and focus on large-scale clustered outbreaks in key institutions are essential for the future.

Species abundance distribution (SAD) combines species richness with species abundance in a community and is an important indicator of community structure. Although many studies have applied mathematical models to fit the SADs of plant communities, there are still few studies on the changes in the shape of SAD (i.e., the skewness of the SAD curves) along the environmental gradient. Especially for forest communities, it is still unclear whether the model fitting and shape change of SADs are consistent in different vegetation types. Here, 28 plots of 20 m × 20 m were set up in Hynobius amjiensis National Nature Reserve according to the main forest vegetation types. The species composition and abundance of each species were surveyed in each plot. The logseries model and the lognormal model were fitted to the SAD in each plot, and then the best-fit model was selected based on the corrected Akaike's Information Criteria (AICc). The α value in Gambin model and the η value in Weibull model were calculated to reflect the shape of SAD in each plot. The λ value in Weibull model was calculated to reflect the scale of SAD (i.e., the range observed in abundance). The relationship between altitude and the shape and scale of SAD was analyzed. The results were as follows: (1) The logseries model fitted SAD better than the lognormal model. (2) When all plots were included, there was no significant correlation between SAD shape (α and η) and altitude, but there was a significant positive correlation between the λ value and altitude. (3) There was a negative correlation between altitude and α and η values in the mixed evergreen and deciduous broad-leaved forests, and there was a significant positive correlation between the α value and altitude in the deciduous broad-leaved forests, while there was no significant correlations between both α value and η value and altitude. The results indicate that the model fitting and shape change of SADs along the environmental gradient are related to the vegetation types of the forest community. Therefore, it is necessary to consider the vegetation types when analyzing the relationship between SAD and impact factors in plant communities.

Xue Zhang,1,&ast; Aili Zhang,2,&ast; Hao Guan,1 Li Zhou,1 Jiao Zhang,3 Wenjie Yin1 1Department of Pharmacy, Kunming Yan’an Hospital, Yan’an Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650051, People’s Republic of China; 2Department of Scientific Research, Kunming Yan’an Hospital, Yan’an Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650051, People’s Republic of China; 3Department of Basic Medicine, Zhaotong Health Vocational College, Zhaotong, Yunnan, 657000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wenjie Yin; Xue Zhang, Department of Pharmacy, Kunming Yan’an Hospital, Yan’an Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650051, People’s Republic of China, Email yinwenjie0606@163.com; zxyougubaihe@163.comObjective: Low back pain is one of the main causes of disability in the world. Although regenerative medicine may represent breakthroughs in the management of low back pain, its use remains controversial. Therefore, we conducted a meta-analysis to evaluate the clinical efficacy of platelet-rich plasma (PRP) injection therapy versus different control groups for chronic low back pain during 4 weeks, 3 months, and 6 months.Methods: Different electronic databases were searched for randomized controlled trials up to August 2023. Mean changes from baseline in pain and Oswestry Disability Index (ODI) scores at 4 weeks, 3 months, and 6 months and standard deviations of outcome were recorded.Results: Four articles with 154 cases were finally included in this meta-analysis. After 4 weeks, corticosteroid (CS) was the optimal treatment option for chronic low back pain in terms of improvement in pain and disability index (surface under the cumulative ranking curve [SUCRA]=71.3%, SUCRA=57.8%, respectively). After 3 months, radiofrequency (RF) emerged as the best therapy in pain (SUCRA=100%) and disability index (SUCRA=98.5%), followed by PRP (SUCRA=62.3%, SUCRA=64.3%, respectively), CS (SUCRA=24.6%, SUCRA=25.9%, respectively) and lidocaine (SUCRA=13.1%, SUCRA=11.3%, respectively). At 6 months, RF was most likely to be the best treatment in pain (SUCRA=94.9%) and disability index (SUCRA=77.3%), followed by PRP (SUCRA=71.2%, SUCRA=79.6%, respectively). However, compared with the last follow-up, there was a slight downward trend in improvement pain and disability index with RF, while PRP was still an upward trend.Conclusion: This study demonstrated better short-term improvement of chronic low back pain with CS after 4 weeks. PRP and RF improvement effects matched, but follow-up of at least 6 months showed that PRP seemed to be more advantageous in improvement in disability indices. Considering the limitations of this study, these conclusions still need to be verified by more comparative RCTs and a longer follow-up period.Keywords: platelet-rich plasma, chronic low back pain, meta-analysis, randomized controlled trial, clinical efficacy

ObjectiveTo identify the rate， population characteristics， and vaccination history of repeat infections among previously infected people in the current epidemic based on the rate of repeat infection and population characteristics of different mutant strains at different times in Pudong New Area of Shanghai， and to provide reference for the prevention and control strategies of novel coronavirus repeat infections.MethodsA total of 9 250 investigated subjects were randomly selected from the new cases of asymptomatic infection and confirmed cases reported by Pudong New Area from March to May 2022. The investigation mainly focused on demographic characteristics， nucleic acid or antigen test results， and symptoms after infection. The repeat infection rates among different populations were compared， and logistic regression was used to analyze the impact of gender， age， and vaccination status on repeat infections.ResultsThe survey sample of 9 250 people had a response rate of 81.85%. There were 4 043 males （53.40%） and 3 528 females （46.60%）， with a median age of 34 years old （P25， P75： 7， 61）. The overall vaccine uptake rate was 59.44% （4 500/7 571）. In December of 2022， there were 563 cases of repeat infection， with an infection rate of 7.44%. The lowest rate of repeat infection was seen in the 3‒ year-old group （2.86%） and the highest rate in the 30‒ year-old group （12.42%）， with significant differences between different age groups. The repeated infection rate for those who had completed their vaccinations was significantly lower （6.57%） compared to those who had not （7.11%）. The age groups of 3‒ years， 70‒79 years， as well as individuals who completed full vaccination and received booster shots were protective factors against repeat infections.ConclusionThe overall rate of reinfection among the infected in Shanghai during the spring of 2022 was low in the outbreak of the Omicron variant， and the rate of reinfection in the 3‒ year-old group was significantly lower than in other age groups. Completing the full course of vaccination significantly reduces the risk of reinfection. Although the reinfection rate is high in individuals who received booster shots， it remains a mitigating factor compared to those who do not receive the vaccine. It is recommended to continue monitoring reinfections in key populations and further strengthen immunization efforts.

Steroid-resistant nephrotic syndrome (SRNS) is the second cause of chronic kidney disease in children. The SRNS has high risk of rapid progression to end-stage renal disease. With the advancement of high-throughput sequencing technology, more than 70 monogenic mutation having the Mendelian inheritance patterns are identified to be associated with SRNS. Most of these genes are involved in podocyte function. Accurate diagnosis of monogenic mutation in SRNS patients helps with guiding clinical treatment protocols and genetic counseling, avoiding the excessive use of steroids/immunosuppressive therapy, and opening up possibilities for targeted therapies in SRNS patients. In this article, our research team summarizes and generalizes the molecular mechanisms, genetic testing, and specific treatment for the major types of monogenic mutations associated with SRNS.

Anbing Zhang,1,&ast; Jinguang Liang,2,&ast; Xiaoli Lao,1,3 Xiuqiong Xia,1 Jianping Liang1,3 1Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, Guangdong Province, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Zhongshan Huangpu People’s Hospital, Zhongshan, Guangdong Province, People’s Republic of China; 3Graduate School, Guangdong Medical University, Zhanjiang, Guangdong Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jianping Liang, Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, 2 Sunwen East Road, Zhongshan, 528400, People’s Republic of China, Tel +86-159-8910-7884, Fax +86-760-8988-0256, Email ljpzhongshan@163.comAbstract: We report a case of pneumonia caused by coinfection with Chlamydia psittaci and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron XBB.1 variant, confirmed using metagenomic next-generation sequencing (mNGS) and quantitative polymerase chain reaction (qPCR). C. psittaci and SARS-CoV-2 were detected in bronchoalveolar lavage fluid using mNGS. Additionally, mNGS detected C. psittaci in blood and nasopharyngeal specimens and was more sensitive than qPCR. The patient recovered after treatment with moxifloxacin. This report highlights the use of coinfections of C. psittaci and SARS-CoV-2, as mNGS has already been recognized to be a diagnostic tool for identifying coinfections.Keywords: coinfection, quantitative reverse-transcription polymerase chain reaction, bronchoalveolar lavage fluid, zoonoses

Anbing Zhang,1,&ast; Xiaoli Lao,1,2,&ast; Jinguang Liang,3 Xiuqiong Xia,1 Lei Ma,4 Jianping Liang1,2 1Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, People’s Republic of China; 2Guangdong Medical University, Zhanjiang, Guangdong, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, Zhongshan Huangpu People’s Hospital, Zhongshan, People’s Republic of China; 4Department of Respiratory and Critical Care Medicine, Fuyang Second People’s Hospital, Fuyang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jianping Liang, Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, No. 2, Sunwen East Road, Zhongshan, 528400, People’s Republic of China, Tel +86 15989107884, Fax +86 760-89880255, Email ljpzhongshan@163.comAbstract: This study presents a rare case of pneumonia caused by a co-infection of Chlamydia psittaci and Cryptococcus, confirmed by metagenomic next-generation sequencing (mNGS). The patient, who had underlying chronic hepatitis B, had adopted a stray pigeon before the onset of the disease. The primary symptoms were fever, and a productive cough. The patient recovered following treatment with moxifloxacin and itraconazole. C. psittaci and Cryptococcus infections may both have been transmitted from the stray pigeon. This report highlights the potential for infections caused by multiple zoonotic pathogens and the value of mNGS for making the diagnosis of these infections.Keywords: pneumonia, Chlamydia psittaci, Cryptococcus, co-infection, metagenomic next-generation sequencing

ObjectiveThis study aimed at conducting retrospective analysis of the clinical symptoms and genetic mutations in 20 children with Gitelman syndrome treated at the Affiliated Children′s Hospital of Nanjing Medical University from August 2015 to November 2022 and also explored the molecular mechanism of the pathogenic high-frequency mutation D486N in the Chinese population.MethodsWe collected the clinical manifestations, growth and development status, laboratory examination results, and SLC12A3 gene variations of the patients. We distinguished the wild-type and mutant SLC12A3 genes overexpressed in human embryonic kidney 293T cells (HEK293T). We used protein immunoblotting to detect the expression level of NCC, and used immunofluorescence techniques to examine the subcellular localization of NCC. In addition, we investigated the impact of the high-frequency SLC12A3 gene mutation D486N on NCC protein expression and localization.ResultsIn the 20 patients with Gitelman syndrome, all of them had hypokalemia. We indemnified twenty-six SLC12A3 gene mutations, 13 of which are missense mutation, 1 of which synonymous mutation, 1 nonsense mutation, 4 frameshift mutation, and 7 splicing site mutation. Among them, four mutations (p.T235K, c.1096-1G > A, p.A464A, and c.2660+1_2660+2insT) were novel mutations.ConclusionsWe found the preliminary evidence that the high-frequency mutation D486N in the Chinese population affected the expression of total and membrane-bound NCC protein and influenced the membrane localization of NCC protein. The findings of this study provides experimental evidence for genetic counseling, diagnosis, and treatment of Gitelman syndrome.

BackgroundThe accuracy of transient thermal hydraulic parameter prediction of reactor cores under various working conditions directly affects reactor safety. Mass flow rate and temperature are important parameters of core thermal hydraulics, which are often modeled as time-series prediction problems.PurposeThis study aims to solve the accuracy problem of continuous prediction of core thermal hydraulic parameters under instantaneous conditions and to test the feasibility of a gated cycle unit based on the attention mechanism in core parameter prediction.MethodsThe 1/2 full core model of China Experimental Fast Reactor (CEFR) core was taken as the research object. The subchannel SUBCHANFLOW program was employed to generate the time series of transient core thermal hydraulic parameters. The gated recurrent unit (GRU) model based on soft attention was used to predict the mass flow and temperature time series of the core.ResultsThe results show that, compared with the adaptive radial basis function (RBF) neural network, the GRU network model with soft attention offers better prediction results. The average relative error of temperature is

Objective To summarize the clinical features of unilateral Wallenberg syndrome. Methods and Results The clinical data of 28 patients with unilateral Wallenberg syndrome admitted to Shengli Oilfield Central Hospital and Weifang People′s Hospital from March 2005 to November 2021 were retrospectively analyzed. Clinical manifestations were pain and temperature disturbance in 26 cases (92.86%), ataxia in 24 cases (85.71%), numbness in 21 cases (75%), dizziness in 20 cases (71.43%); MRI showed dorsolateral medulla oblongata infarction lesion in all patients, 9 cases (32.14%) with lesions located in the rostral medulla oblongata, 7 cases (25%) in the central region and 12 cases (42.86%) in the caudal region; CTA showed there were responsible arteries in 27 cases (96.43%), including vertebral artery stenosis (15 cases, 53.57%), posterior inferior cerebellar artery occlusion (10 cases, 35.71%), bilateral vertebral artery occlusion and unilateral vertebral artery dissection (one case each, 3.57%). Eleven cases (39.29%) were treated with intravenous thrombolysis, including 3 cases with bridging vertebral artery stent implantation and 17 cases (60.71%) with conservative treatment. 19 cases (67.86%) had a good prognosis, while 9 cases (32.14%) had a poor prognosis. There are 5 cases (17.86%) complicated with respiratory failure, one case with good prognosis after symptomatic treatment, one case of ventilator assisted ventilation, one case was severely disabled, and 2 cases were dead. Conclusions Unilateral Wallenberg syndrome has multiple clinical manifestations, imaging examination has great significance for clear diagnosis, some patients may develop respiratory failure and their respiratory function should be closely monitored.

The final step in the production of the human Sd(a) antigen is catalyzed by beta-1,4-N-acetyl-galactosamine transferase 2 (B4GALNT2). This is done by adding a N-acetylgalactosamine residue via a beta-1,4 linkage to a subterminal galactose residue that has been substituted with an alpha-2,3-linked sialic acid. The final stage of the production of the Cad antigen is also catalyzed by B4GALNT2. Knocking out pig B4GALNT2 gene decreased human serum antibodies binding to pig cells, which greatly reduces the immunological rejection in clinical xenotransplantation trials. Interestingly, gene region LOC110255214 (hereafter named B4GALNT2-like) showed high similarity with the B4GALNT2 gene in the pig genome in our previous work, but whether B4GALNT2-like shares similar biological properties like B4GALNT2 remains to be elucidated, whether B4GALNT2-like is a potential immune gene in xenotransplantation remains to be determined.

Background The global population disease burden report shows that atrial fibrillation (AF) and chronic kidney disease (CKD) have emerged as the fast-growing causes of death in the last 20 years. The concept of cardiorenal syndrome suggests that AF may increase the risk of new-onset CKD, however, there are few studies related to the increased risk of new-onset CKD with AF at home and abroad, and the interaction with age remains unclear atpresent. Objective To investigate whether AF increases the risk of new-onset CKD in northern Chinese population. Methods The population who attended a comprehensive health check-up for the employees of Kailuan Group in Hebei Province from 2006 to 2010 were selected as study subjects. The general information and laboratory test results of the study subjects were collected, and the study subjects were followed up with the final follow-up date of 2020-12-31 and the end point of new-onset CKD. The included patients were divided into AF group (n=368) and non-AF group (n=110 487) according to the presence or absence of AF. The cumulative incidence of new-onset CKD in patients was calculated using the lifetable method. The Kaplan-Meier method was used to plot the survival curves of the cumulative incidence of new-onset CKD in the AF group and the non-AF group. The Log-rank test was used to compare the differences in the cumulative incidence of CKD between the two groups. The multivariate Cox proportional hazard regression model was used to explore the effect of AF on the risk of new-onset CKD. Results AF group was higher than non-AF group in age, male proportion, systolic blood pressure level, diastolic blood pressure level, body mass index, the proportions of education level, participation in physical exercise, hypertension, diabetes, taking hypotensive drugs and hypoglycemic drugs, and high-sensitivity C-reactive protein level (P65 years (P

Anqing Zhang,1 Liqin Zhang,2 Xia Xie,1 Dan Liu2 1Gynaecology Department, Sunshine Union Hospital, Weifang, People’s Republic of China; 2Gynaecology Department, Affiliated Hospital of Weifang Medical University, Weifang, People’s Republic of ChinaCorrespondence: Dan Liu, Gynaecology Department, Affiliated Hospital of Weifang Medical University, Yuhe Road 2428&num;, Weifang, 261041, People’s Republic of China, Email kaiyan0417@126.comBackground: Endometrial cancer (EC) is one of the most prevalent gynecologic cancers, which poses a serious threat to women’s health worldwide. Olaparib, the first FDA-approved PARP inhibitor for the treatment of BRCA-mutated breast, ovarian and pancreatic cancers, triggers apoptosis of cancer cells through synthetic lethality by inhibiting PARP1/2 enzymatic activity and BRCA1/2-dependent homologous recombination (HR) repair deficiency. However, the synergistic lethal effects between Olaparib and inhibitors of other DNA damage response proteins, such as ATM, PTEN and RAD51, are still unknown.Aim: Exploring the synergistic lethal effect between Olaparib and KU-55933 on EC.Methods: The GEPIA database was used to test EC patient survival rate. CCK8 was used for cell viability assays. Western blot was used for examining gene levels. The wound healing assay was used to detect cell migration ability. Flow cytometry was used for detecting the apoptosis rate. All experimental conditions were repeated independently in triplicate and analyzed in three separate experiments.Results: In this study, we discovered that the frequency of ATM alterations in endometrial cancer reaches nearly 20% and that there is a positive correlation between ATM alterations and prognosis. Furthermore, we discovered that endometrial cells with low expression levels of ATM are sensitive to Olaparib. Treatment with KU-55933, a specific inhibitor of ATM, significantly enhanced the sensitivity of endometrial cancer cells to Olaparib, as evidenced by colony formation, cell migration and apoptosis assay. Further analysis revealed that KU-55933 potentiates Olaparib-induced cell apoptosis by inhibiting ATM phosphorylation.Conclusion: Our study demonstrates that inhibiting ATM could enhance the sensitivity of endometrial cancer to Olaparib, thereby providing a potential alternative treatment for the clinical treatment of endometrial cancer.Keywords: endometrial cancer, ATM inhibitor, PARP inhibitor, homologous recombination, synthetic lethality

Qichao Hu,1,2,&ast; Jinhao Zeng,3,4,&ast; Xiaomei Zhang,5 Tingting He,6 Aozhe Zhang,6 Jianyu Li,6 Shizhang Wei,2,7 Manyi Jing,2 Haotian Li,2 Xin Wang,2 Lei Chang,2 Xiao Ma,1,2 Yanling Zhao2 1State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, People’s Republic of China; 2Department of Pharmacy, Chinese PLA General Hospital, Beijing, People’s Republic of China; 3TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 4Department of Gastroenterology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, People’s Republic of China; 5Institute of Medicinal Chemistry of Chinese Medicine, Chongqing Academy of Chinese Materia Medica, Chongqing, People’s Republic of China; 6Division of Integrative Medicine, The Fifth Medical Center, General Hospital of PLA, Beijing, People’s Republic of China; 7Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Health Science Center, Peking University, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiao Ma; Yanling Zhao, Email tobymaxiao@163.com; zhaoyl2855@126.comObjective: Chronic non-atrophic gastritis (CNAG) is a common clinical gastrointestinal disease with a long and recurrent course. In China, Wuzhuyu decoction (WZYD) has been used for centuries to treat gastrointestinal disorders. To unravel the efficacy and mechanism of WZYD for CNAG, a clinical study was conducted. And metabolomics was used to explore the mechanism of WZYD for CNAG patients.Methods: Twenty patients in total were recruited in this study (Nos. ChiCTR2200062296) and the protocol was approved by the Ethics Committee (Approval number: KY-2022-2-6-1) and complied with the Declaration of Helsinki. The formula granule of WZYD were assessed by UHPLC-QQQ-TOF to discern the main potential active compounds. The endoscopy evaluation and histopathological changes were detected as effective indicators. Serum samples from patients were used for metabolomics. Inflammatory factors in patients’ serum were determined by ELISA. Metabolomics revealed a series of differential metabolites and signaling pathways.Results: WZYD was capable to prevent CNAG by ameliorating score of endoscopy evaluation including erosion, hemorrhage, as well as chronic inflammation and active chronic inflammation score after treatment were decreased. The results indicated that 10 core metabolic components were associated with the treatment of WZYD. Moreover, these metabolic components proved that pyrimidine metabolism and thiamine metabolism were critically responsible for CNAG. In addition, WZYD treatment effectively reduced serum levels of TNF-α, IL-10, and COX-2.Conclusion: Altogether, WZYD can effectively alleviate CNAG by inhibiting inflammation and regulating related metabolic processes, which might be the molecular mechanism of WZYD treatment of CNAG. More studies are warranted to be conducted in this area.Trial Registration: ChiCTR, ChiCTR2200062296. Registered 1 August 2022, https://www.chictr.org.cn/com/25/showprojen.aspx?proj=174027.Keywords: Wuzhuyu decoction, chronic non-atrophic gastritis, metabolomics, natural product

ObjectiveTo explore the effects and satisfaction of reference-induced blended teaching method in medical statistics teaching for undergraduate students in clinical medicine.MethodA total of 83 clinical medical undergraduate students from the class of 2018 at the Tongji University School of Medicine were enrolled into the study. The effect evaluation of blended teaching based on reference-induced self education （RISE） in the course of medical statistics was conducted. A self-designed questionnaire was used to assess student satisfaction.ResultsCompared with the traditional teaching method group， students’ distinguished achievement rate and pass rate in total score from RISE blended teaching group were 53.7% and 96.3%， respectively， and 83.3% students were satisfied with the overall effect. The RISE blended teaching method had higher satisfaction in stimulating learning interest （90.7% satisfaction rate， P=0.034） and cultivating scientific research ability （96.3% satisfaction rate， P=0.048）.ConclusionThe RISE blended teaching method， which integrates literature guidance with online and offline approaches， organically combines statistical knowledge with clinical research problems. It yields positive results in medical statistics education， stimulating learning interest， and fostering innovative scientific research abilities.

The study of everyday life has gained attention across various disciplines in the context of modernity. This study utilizes Lefebvre's rhythmanalysis to explore the everyday experiences of residents in the Xiguan Community, a historically significant residential area in western Guangzhou undergoing urbanization and tourism development. Adopting an emic perspective, this study employed auto-ethnography to depict the daily rhythms and spatially embodied experiences of the author, a native resident of the Xiguan Community. By incorporating reflective and self-narrative elements and comparing them across generations, this approach provides first-hand knowledge and self-awareness. This research offers an insider's comprehensive understanding of the effects of urbanization and tourism on residents' everyday lives. Informed by Lefebvre's rhythmanalysis, this analysis incorporates spatial and temporal dimensions, with a specific emphasis on residents' experiences of spatial embodiment and their engagement with everyday rhythms. The study reveals two key findings: First, urbanization and the commodification of landscapes have created a constructed "the present" in traditional communities, displacing the meaningful "existence" of everyday life. Certain spaces within these communities have detached from residents' everyday lives, serving urban and tourism purposes, and leading to partial alienation in spatial and temporal dimensions. These spaces represent the simulacra and fragments of residents' everyday lives, lacking subjectivity, temporality, and wholeness. Over time, the "existence" that embodies the meaning of residents' everyday lives has been squeezed out by structural forces such as urban renewal and community tourism. For tourists, these landscapes may serve only as replicas of attractions, devoid of the essence of residents' everyday lives. For the residents, these community spaces have become manifestations of instrumental rationality and commodification. Second, this study highlights that traditional community residents' bodies are disciplined and governed by the instrumental rationality of urban production and the invisible rhythms of the tourism industry. In large cities, the significance of individual bodies in traditional urban communities is often overlooked, as bodies become tools for creating value through work. Individuals adjust their everyday rhythms based on urban settings' production rationality and efficiency priorities. This undermines the bodily rhythms that align with natural cycles and prompts residents to distance themselves from traditional communities. While the older generation in the Xiguan Community experiences overlapping leisure time and shares community spaces, fostering solid social relationships, the younger generation faces longer working hours, extended commuting distances, and more individualized leisure time. As a result, there is a lack of synchronization in leisure rhythms among neighbors. The embodied rhythms of traditional community residents have shifted from a state of harmony with natural rhythms and community spaces to being governed by the instrumental rationality of urban production and invisible rhythms of the tourism industry. This study provides an emic and longitudinal perspective to the investigation of spatial experiences and embodied rhythms in urban and tourism development. The use of auto-ethnography amplifies residents' voices and calls for greater consideration of local daily life. These findings emphasize the importance of incorporating residents' everyday experiences into the planning and development of sustainable communities and tourism.

Anqi Zhang,1 Lei Gao2 1Oncology Department, Huabei Petroleum Administration Bureau General Hospital, Renqiu, Hebei, People’s Republic of China; 2Medical Imaging Department, Huabei Petroleum Administration Bureau General Hospital, Renqiu, Hebei, People’s Republic of ChinaCorrespondence: Lei Gao, Medical Imaging Department, Huabei Petroleum Administration Bureau General Hospital, Renqiu, Hebei Province, 062550, People’s Republic of China, Tel +86 152 9739 4123, Fax +86-0317-2723381&num;, Email laughing_gao1107@163.comAbstract: Radiotherapy is a pivotal method for treating malignant tumors, and enhancing the therapeutic gain ratio of radiotherapy through physical techniques is the direction of modern precision radiotherapy. Due to the inherent physical properties of high-energy radiation, enhancing the therapeutic gain ratio of radiotherapy through radiophysical techniques inevitably encounters challenges. The combination of hyperthermia and radiotherapy can enhance the radiosensitivity of tumor cells, reduce their radioresistance, and holds significant clinical utility in radiotherapy. Multifunctional nanomaterials with excellent biocompatibility and safety have garnered widespread attention in tumor hyperthermia research, demonstrating promising potential. Utilizing nanotechnology as a sensitizing carrier in conjunction with radiotherapy, and high atomic number nanomaterials can also serve independently as radiosensitizing carriers. This synergy between tumor hyperthermia and radiotherapy may overcome many challenges currently limiting tumor radiotherapy, offering new opportunities for its further advancement. In recent years, the continuous progress in the synthesis and design of novel nanomaterials will propel the future development of medical imaging and cancer treatment. This article summarizes the radiosensitizing mechanisms and effects based on gold nanotechnology and provides an overview of the advancements of other nanoparticles (such as bismuth-based nanomaterials, magnetic nanomaterials, selenium nanomaterials, etc.) in the process of radiation therapy.Keywords: nanotechnology, gold nanoparticles, tumor radiotherapy, hyperthermia, radiosensitization

The intestinal microbial metabolite trimethylamine oxide (TMAO) affects the formation and development of atherosclerosis (AS). The design and development of an effective targeted drug to reduce serum TMAO levels may provide new avenues for inhibiting AS morbidity. Target genes that may elevate TMAO levels in patients with AS were explored using bioinformatics, virtual screening, and molecular dynamics (MD). We expected these genes to indicate potential TMAO inhibitors. Of these genes, hFMO3 was responsible for increasing TMAO levels. Four small-molecule compounds (SMC-1, SMC-2, SMC-3, and SMC-4) with the lowest binding energy and CGenFF penalty < 10 were connected to the main binding pocket of hFMO3 by hydrogen and/or cation–pi interactions. A 100 ns MD simulation showed that the four systems quickly reached equilibrium. The root mean square deviation of all four small-molecule compounds was less than 0.35 nm, that of the four ligand complexes was less than 0.40 nm, and the average deviations of each amino acid residue from the reference position over time did not differ. Molecular mechanics Poisson–Boltzmann surface area analyses showed that SMC-2, SMC-3, and SMC-4 bound very well to hFMO3, and the energy contribution of the key residues LEU40 and GLU32 was more remarkable in SMC-2, SMC-3, and SMC-4. These four small-molecule compounds may be useful as targeted drugs to reduce serum TMAO levels, inhibiting atherosclerosis formation.

BackgroundAt present, only the rare earth industry has established discharge limits for waste water generated from associated radioactive mines. Liquid effluent from associated radioactive mines industries other than rare earths should satisfy with the requirements of Integrated Wastewater Discharge Standard (IWDS). However, discharge limits of IWDS are disputable to be implemented, hence not suitable for the development and utilization of associated radioactive mines.PurposeThis study aims to consider the need of establishing designated standards of discharge limits on liquid effluent from related radioactive mines wastewater.MethodsFirstly, investigation was conducted on the types and concentration of radionuclides of wastewater from associated radioactive mine, as well as the level of radioactive wastewater treatment technology. Results on the discharge limits for natural radioactive isotopes both in China and abroad were examined and compared. Then, the types of radionuclides and discharge limits to be controlled in the development and utilization of liquid effluent from associated radioactive mines were studied in a scientific manner. Finally, the method of establishing discharge limits for liquid effluents from associated radioactive mines by referring to the uranium mining and metallurgical industries was proposed.Results & ConclusionsThe specific standard on discharge limits for wastewater treatment from associated radioactive mines has a significant impact on regulating the discharge of effluent in China and reducing the radiation environmental impact of associated radioactive mines. It is reasonable to refer to the standard limits of uranium mining and metallurgy. Liquid effluent from associated radioactive mines industries other than rare earths should satisfy with the requirements of IWDS.

Objective To explore the regulatory role and molecular mechanism of sodium butyrate (NaB) in lipopolysaccharide (LPS) induced inflammatory phenotype in BV2 microglia cells and the molecular mechanism. Methods BV2 cells were treated with different concentrations of NaB alone or combined with LPS.CCK8 assay was used to detect the change of cell viability and to screen the optimal concentration of the drug.Then the BV2 cells were divided into control, LPS group, low-and high-dose NaB groups (0.125 and 0.25 mmol/L).An inflammatory model of BV2 cells were established by pretreatment with NaB for 17 h followed by LPS treatment for 24 h.Griess assay was used to measure the NO content in the supernatant, and ELISA was employed to determine the contents of IL-1β, TNF-α and IL-10 in culture medium.The mRNA levels of iNOS and CD206 were detected by RT-qPCR.Immunofluorescence staining was used to observe the expression of iNOS and CD206.The protein levels of TLR4, NF-κB p65m, IKB-α and p-IKB-α were detected by Western blotting.Cytoplasmic and nuclear proteins were isolated to detect the nuclear translocation of NF-κB p65. Results Griess assay showed that the secretion of NO in the high-and low-dose NaB groups were lower than that in the LPS group (P < 0.05).ELISA results indicated that the high-and low-dose NaB groups had lower secretion levels of IL-1β and TNF-α, but high secretion level of IL-10 than the LPS model group (all P < 0.05).RT-qPCR revealed that high-and low-dose NaB treatment significantly decreased the mRNA expression of iNOS (M1 phenotypic marker) and promoted that of CD206(M2 phenotypic marker)(both P < 0.05).Immunofluorescence staining presented similar results as RT-qPCR (P < 0.05).Western blot results displayed that high-and low-dose NaB resulted in significantly inhibited protein expression of TLR4, NF-κB p65 and p-IKB-α as well as nuclear translocation of NF-κB p65 when compared with the LPS group (P < 0.05). Conclusion NaB significantly reduces LPS-induced neuroinflammatory responses in BV2 cells, which might be associated with its inhibition of TLR4/NF-κB signaling pathway and promotion of BV2 cells shifting from M1 to M2 phenotype.

Corona virus disease 2019 (COVID-19) is prone to induce multiple organ damage. The kidney is one of the target organs of SARS-CoV-2, which is susceptible to inducing acute kidney injury (AKI). Huanglian Jiedu Decoction (HLJDD) is one of the recommended prescriptions for COVID-19 with severe complications. We used network pharmacology and molecular docking to explore the therapeutic and protective effects of HLJDD on COVID-19-associated AKI. Potential targets related to “HLJDD,” “COVID-19,” and “Acute Kidney Injury/Acute Renal Failure” were identified from several databases. A protein–protein interaction (PPI) network was constructed and screened the core targets according to the degree value. The target genes were then enriched using gene ontology and Kyoto Encyclopedia of Genes and Genomes. The bioactive components were docked with the core targets. A total of 65 active compounds, 85 common targets for diseases and drugs were obtained; PPI network analysis showed that the core protein mainly involved JUN, RELA, and AKT1; functional analysis showed that these target genes were mainly involved in lipid and atherosclerosis signaling pathway and IL-17 signal pathway. The results of molecular docking showed that JUN, RELA, and AKT1 had good binding activity with the effective chemical components of HLJDD. In conclusion, HLJDD can be used as a potential therapeutic drug for COVID-19-associated AKI.

C17H13NO8S, monoclinic, P21/c (no. 14), a = 17.7630(4) Å, b = 7.04725(16) Å, c = 13.7187(3) Å, β = 102.748(2)°, V = 1674.97(7) Å3, Z = 4, Rgt (F) = 0.0557, wRref (F 2) = 0.1652, T = 273 K.

C14H10Cl2N2, monoclinic, P21/n (no. 14), a = 9.4145(9) Å, b = 14.8530(15) Å, c = 10.0405(11) Å, β = 116.714(5)°, V = 1254.1(2) Å3, Z = 4, Rgt(F) = 0.0653, wRref(F2) = 0.1901, T = 293 K.

In this paper, we first studied the basic content of deep learning in college sports and explored the principles of physical education evaluation in colleges and universities in the context of deep learning. Then, the framework of the physical education evaluation index system is constructed, the indexes are screened and optimized by combining the Delphi method, and the weights of the indexes are calculated by using the fuzzy comprehensive evaluation method. Then, based on the expectation and satisfaction data of students in the sample colleges and universities, the gap is analyzed according to the perception-expectation matrix, and the SERVQUAL model is used to analyze each issue of the quality of physical education in colleges and universities one by one. The maximum value of the expectation of the quality of physical education in colleges and universities is 6.558 points, the minimum value is 6.348 points, the maximum value of the mean value of perception is 6.349 points, the minimum value is 5.797 points, and the scores are above 5 points, which makes the quality of education in colleges and universities better. This study further enriches the theory of quality evaluation of education in sports colleges and establishes the evaluation model and method with specific specifications.

Abstract

This paper firstly proposes a digital resource system of university libraries oriented to knowledge service for digital library resource evaluation research, which mainly consists of a knowledge service diamond system and digital resource diamond system, and studies the evaluation elements and evaluation process of this system, then constructs the evaluation system of library digital resources from quantitative evaluation and qualitative evaluation, etc., and through multi-level topologizable theory, the evaluation indexes and The evaluation indexes and the correlation function are calculated by multi-level topology theory, to derive the weight coefficients and comprehensive superiority of the evaluation indexes, and an example analysis of the digital library based on multi-level topology optimization decision making is conducted. The results show that the users’ comprehensive evaluation of digital library decision-making is excellent, S2, S5 is good, S3 is medium, and S4 is average, where S5 has a higher comprehensive correlation degree in the good level than the correlation degree of S2, indicating that this study improves the quality of digital library decision making in universities and then better serves the users.

This paper utilizes VR technology to construct a virtual sports training situation and proposes a sports training feedback teaching mode based on VR technology. Aiming at the VR high-resolution scene generation technology, it analyzes the image super-resolution recovery algorithm based on multi-frames, introduces the regularization solution method, and, on this basis, proposes a generalized entropy variational image super-resolution recovery algorithm to realize better VR panoramic visual teaching. Taking Taekwondo movement training in K-school as the research content, we compared the learning attitude change, the influence of special physical quality, and the technical mastery ability of Taekwondo movement between the experimental group and the control group. The evaluation results found that the technical score of movement completion ability after the experiment was 94.98±2.36 in the experimental group and 85.79±5.32 in the control group. The quality of physical education teaching can be improved by using VR technology in teaching mode.

An event-triggered adaptive control algorithm is proposed for cooperative tracking control of high-order nonlinear multi-agent systems (MASs) with prescribed performance and full-state constraints. The algorithm combines dynamic surface technology and the backstepping recursive design method, with radial basis function neural networks (RBFNNs) used to approximate the unknown nonlinearity. The barrier Lyapunov function and finite-time stability theory are employed to prove that all agent states are semi-globally uniform and ultimately bounded, with the tracking error converging to a bounded neighborhood of zero in a finite time. Numerical simulations are provided to demonstrate the effectiveness of the proposed control scheme.

Suebsarn Ruksakulpiwat,1 Chitchanok Benjasirisan,1 Kedong Ding,2 Lalipat Phianhasin,1 Sutthinee Thorngthip,3 Anuoluwapo D Ajibade,4 Jai Thampakkul,5 Amy Y Zhang,6 Joachim G Voss6 1Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand; 2Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA; 3Department of Nursing Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 4College of Art and Science, Department of Anthropology, Case Western Reserve University, Cleveland, OH, USA; 5Case School of Engineering, Case Western Reserve University, Cleveland, OH, USA; 6Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USACorrespondence: Suebsarn Ruksakulpiwat, Email Suebsarn25@gmail.comIntroduction: Ischemic strokes and their recurrence create an immense disease burden globally. Therefore, preventing recurrent strokes by promoting medication adherence is crucial to reduce morbidity and mortality. In addition, understanding the barriers to medication adherence related to the social determinants of health (SDoH) could promote equity among persons with ischemic stroke.Objective: To explore the barriers to medication adherence among patients with ischemic stroke through the SDoH.Methods: This systematic review included studies published between January 2018 and December 2022 identified through PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text. The descriptions of the studies were systematically summarized and discussed based on the SDoH from the US Healthy People 2030 initiative.Results: Eight studies met the inclusion criteria and were included in this review. The most common barrier to adherence was inappropriate medication beliefs, medication side effects, and patient-physician relationship, which relate to the dimensions of healthcare access and quality. Health literacy and health perception, dependent on education access and quality, frequently influenced adherence. Other social determinants, such as financial strain and social and community context, were found to alter adherence behaviors. No study addressed the neighborhood and built environment domain. We found that cognitive impairment is another factor that impacts adherence outcomes among stroke patients.Conclusion: Multifaceted approaches are needed to address the SDoH to improve medication adherence among patients with ischemic stroke. This review emphasized strategies, including patient education, provider-patient communication, social support, health literacy, technology, and policy advocacy to enhance adherence.Keywords: ischemic stroke, medication adherence, social determinants of health, systematic review

With businesses increasingly prioritizing data-driven decision making, the demand for business analysts is high and expected to grow. In response, many universities and institutions have developed courses and programs related to business analytics to prepare more graduates for careers in this field. Business analytics programs and educators consistently strive to achieve a high level of student learning success, ensuring competence in working in the business analytics field after graduation. In this study, we aim to examine key factors influencing student learning in business analytics, focusing on performance expectancy and satisfaction. We examined specific factors, including personal interest, career relevance expectancy, learning effort, and perceived course structure effectiveness, from perspectives related to both students and instructors. A research model was developed and empirically tested. The results showed that all factors significantly influenced both perceived academic performance and learning satisfaction. Additionally, personal interest and career relevance expectancy could significantly impact learning effort.

During attempts to prevent and control the COVID-19 pandemic in China, higher education programs shifted their traditional educational models to online models. This paper aimed to explore how Chinese universities organized online teaching and learning during the pandemic. It investigated the factors affecting the implementation of online teaching and provided policy recommendations for improving the quality of education in the post-pandemic period. The primary data for this study came from in-depth interviews with nine students and five teaching and administrative staff at eight major universities in mainland China. Literature was obtained in both English and Chinese from January 2020 to September 2021. Peer-reviewed journals, policy reports, and university documents regarding online education in Chinese universities were reviewed, and their challenges and countermeasures were investigated. The paper found that the implementation of online education was affected by various sources, including technologies, teachers' teaching skills, network information literacy, and students' learning motivations and self-directed learning skills. Based on the insiders' views, the paper suggested that to promote the quality of online education in the post-COVID-19 pandemic, higher education institutes and programs could develop their infrastructure construction, improve teachers' quality of teaching, and focus on students' learning motivations.

The past 50 years have witnessed a massive expansion in the demand and application of pesticides. However, pesticides are difficult to be completely degraded without intervention hence the pesticide residue could pose a persistent threat to non-target organisms in many aspects. To aim at the problem of the abuse of pesticide products and excessive pesticide residues in the environment, chemical and biological degradation methods are widely developed but are scaled and insufficient to solve such a pollution. In recent years, bio-degradative tools instructed by synthetic biological principles have been further studied and have paved a way for pesticide degradation. Combining the customized design strategy and standardized assembly mode, the engineering bacteria for multi-dimensional degradation has become an effective tool for pesticide residue degradation. This review introduces the mechanisms and hazards of different pesticides, summarizes the methods applied in the degradation of pesticide residues, and discusses the advantages, applications, and prospects of synthetic biology in degrading pesticide residues.

Yun Wang,1 Zhongfeng Huang,2 Huijuan Chen,3 Ye Yuan,2 Edward B McNeil,4 Xiaolong Lu,5 Aihua Zhang1 1Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, Guizhou, People’s Republic of China; 2Department of Tuberculosis, Guiyang Public Health Clinical Center, Guiyang, Guizhou, People’s Republic of China; 3Department of Tuberculosis Prevention and Control, Guizhou Center for Disease Prevention and Control, Guiyang, Guizhou, People’s Republic of China; 4Department of Infectious Diseases, School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, People’s Republic of China; 5School of Medicine and Health Management, Guizhou Medical University, Guiyang, Guizhou, People’s Republic of ChinaCorrespondence: Aihua Zhang, Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, Guizhou, People’s Republic of China, Tel +86 851 88416187, Fax +86 851 88416187, Email 97349238@qq.comPurpose: We aimed to assess the household financial burden due to multidrug-resistant tuberculosis (MDR-TB) treatment and its predictors, examine its association with patient mobility, and test their impact on patient loss to follow-up (LTFU).Methods: A cross-sectional study combining follow-up data collection was conducted at the largest designated MDR-TB hospital in Guizhou. Data were collected from medical records and questionnaires. Household financial burden was measured by the incidence of 2 indicators: catastrophic total costs (CTC) and catastrophic health expenditure (CHE). Mobility was classified as mover or non-mover after the patient’s address was verified twice. A multivariate logistic regression model was used to identify associations between variables. Model I and Model II were separated by CHE and CTC.Results: Out of 180 households, the incidence of CHE and CTC was 51.7% and 80.6%, respectively. Families with low income and patients who were primary income earners were significantly associated with catastrophic costs. 42.8% of patients were movers. Patients from households with CHE (ORadj=2.2, 95% CI: 1.1– 4.1) or with CTC (ORadj=2.6, 95% CI: 1.1– 6.3) were more likely to move. Finding a job against financial difficulty (58.4%) was the top reason for movers. 20.0% of patients experienced LTFU. Patients from households with catastrophic payments (CHE: ORadj=4.1, 95% CI 1.6– 10.5 in Model I; CTC: ORadj=4.8, 95% CI 1.0– 22.9 in Model II), patients who were movers (ORadj=6.1, 95% CI 2.5– 14.8 in Model I; ORadj=7.4, 95% CI 3.0– 18.7 in Model II) and primary income earners (ORadj=2.5, 95% CI: 1.0– 5.9 in Model I; ORadj=2.7, 95% CI 1.1– 6.6 in Model II) had an increased risk of LTFU.Conclusion: There is a significant association between household financial burden due to MDR-TB treatment and patient mobility in Guizhou. They impact patients’ treatment adherence and cause LTFU. Being a primary breadwinner increases the risk for catastrophic household payments and LTFU.Keywords: household catastrophic costs, migration, loss to follow-up, Guizhou, MDR-TB

To produce the porous coating on the inner wall of the pipe is an effective way to enhance heat transfer performance and improve heat exchange efficiency. The electric explosion spraying method was employed to produce the porous coating on the inner wall of the pipe. The surface morphology, roughness and pore distribution of the coating under different initial voltages were studied. The mechanism for the formation of the coating was investigated by the deposition energy and explosive products explained. The results indicate that the initial voltage of the electric explosion spraying influences the microstructure of coating. The optimal porous coating can be obtained when the initial voltage of the electric explosion spraying is 14.0 kV. The optimal porous coating is formed by the accumulation of the small particles. Moreover, the optimal porous coating is obtained, the surface area is 4.47 times that of the uncoated pipe and the porosity of the ideal coating is 57.8%. The uniform round porous coating is formed, when the initial voltage of the electric explosion spraying is 15.2 kV. The porosity of those coating is 40.3%. The formation of the coating depends on the energy deposited on the copper wire during the explosion. The energy deposited on the copper wire acts as the thermodynamic condition for the sprayed particles, determines the energy and particle size of the sprayed particles and the states of the sprayed particles collide with the surface of the base tube or the particles accumulate or form a molten pool. Finally, it influences the microscopic morphology of the coating.

Xiongjie Jia,&ast; Tao Zhang,&ast; Junjie Sun, Hengxue Lin, Tianliang Bai, Yating Qiao, Yaxin Li, Gang Li, Guicun Li, Xinyu Peng, Aimin Zhang Department of Gastrointestinal Surgery, Affiliated Hospital of Hebei University, Baoding, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Aimin Zhang; Xinyu Peng, Department of Gastrointestinal Surgery, Affiliated Hospital of Hebei University, No. 212 Yu-Hua East Road, Baoding City, Hebei Province, People’s Republic of China, Tel +863125983782, Email hdfyzam@126.com; pengxinyu_2012@163.comObjective: Thymidine Phosphorylase (TYMP) gene was of potential significance in the process of colorectal cancer (CRC) development and played an important role in capecitabine metabolism. This study was to identify the association between TYMP polymorphism and prognosis of postoperative patients with CRC who received capecitabine-based adjuvant chemotherapy.Methods: A total of 218 patients with CRC who were treated with surgical resection and capecitabine-based adjuvant chemotherapy were included in this study retrospectively. Peripheral blood and peripheral blood mononuclear cell (PBMC) specimen of the patients were collected for the genotyping of TYMP polymorphism and TYMP mRNA expression, respectively. Univariate analysis of genotypes and prognosis was carried out by Kaplan–Meier survival analysis, Cox regression analysis was adopted in multivariate analysis. The mRNA expression of TYMP according to genotype status was analyzed using non-parameter test.Results: Prevalence of rs11479 in TYMP among the 218 patients exhibited that minor allele frequency of rs11479 was 0.20 (GG 141 cases, GA 68 cases and AA 9 cases), which was in accordance with Hardy-Weinberg equilibrium (P=0.825). Association analysis suggested that the median disease-free survival (DFS) of patients with GG genotype and GA/AA genotype was 3.1 and 6.1 years, respectively (P=0.004). Furthermore, the median overall survival of patients with GG genotype and GA/AA genotype was 5.0 and 7.0 years, respectively (P=0.033). Multivariate Cox regression analysis exhibited that rs11479 polymorphism was an independent factor for DFS (HR = 1.64, P=0.009). Additionally, of the 65 PBMC specimens, mRNA expression results indicated that patients with GA/AA genotypes conferred significantly higher mRNA expression of TYMP than that of patients with GG genotype (P< 0.001).Conclusion: Polymorphism rs11479 in TYMP gene might predict the prognosis of patients with CRC who received capecitabine-based adjuvant chemotherapy through mediation of the mRNA expression of TYMP. The conclusion of this study should be validated in prospective clinical trials subsequently.Keywords: colorectal cancer, adjuvant chemotherapy, capecitabine, prognosis, polymorphism

Ai-Hua Zhang,1 Guang-Xia Dai,2 Qi-Dong Zhang,1 Hong-Dong Huang,1 Wen-Hu Liu1 1Nephrology Department, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, People’s Republic of China; 2Endocrinology Department, Beijing Nanyuan Hospital, Beijing, People’s Republic of ChinaCorrespondence: Hong-Dong Huang; Wen-Hu Liu, Nephrology Department, Capital Medical University Affiliated Beijing Friendship Hospital, No. 95 Yong An Road, Xi Cheng District, Beijing, 100050, People’s Republic of China, Tel +86-10 63138579, Fax +86-10 63139144, Email huangHD201902@163.com; l13901163354@163.comBackground: Primary membranous nephropathy (PMN) is a common cause of nephrotic syndrome in adults. Forty percent of the patients continue to progress and eventually develop into chronic renal failure. Although phospholipase A2 receptor (PLA2R) is the major antigen of PMN, the clinical features do not often parallel with the antibody titers. Therefore, it is significant to find relative credible markers to predict the treatment response.Methods: One hundred and eighteen PMN patients were recruited. The response to treatment was defined as ALB≥ 30g/L at 6 months and complete remission (CR) or not at the end of the follow-up. Renal outcome endpoint was defined as 50% or more Cr increase at the end.Results: The patients with poor treatment effects had numerically higher platelet-lymphocytes ratio (PLR). For patients with CR or not, the difference was near to statistic significant (P=0.095). When analyzing CR or not, the fitting of the binary logistic regression model including both PLA2R Ab titer and PLR (Hosmer–Lemeshow test: χ2=8.328, P = 0.402; OR (PLA2R Ab titer) = 1.002 (95% CI 1.000– 1.004, P = 0.042); OR (PLR) = 1.006 (95% CI 0.999– 1.013, P = 0.098)) was markedly better than that with only PLA2R Ab titer (Hosmer–Lemeshow test: χ2=13.885, P = 0.016). The patients with renal function deterioration showed significantly higher monocyte-lymphocyte ratio (MLR) (0.26 (0.22– 0.31) vs 0.18 (0.13– 0.22), P = 0.012).Conclusion: PMN patients with poor treatment response tended to have higher PLR at the time of renal biopsy, and a higher MLR was associated with poor renal outcomes. Our findings suggested that PLR and MLR might be used to predict treatment efficacy and prognosis for PMN patients, respectively.Keywords: membranous nephropathy, peripheral blood cell ratios, platelet-lymphocytes ratio, monocyte–lymphocyte ratio, treatment response, outcome

To evaluate the mind mapping-based health education in perioperative nursing of glioma patients undergoing awake surgery. Methods Totally 60 glioma patients undergoing awake surgery were randomly divided into the intervention group and control group, with 30 cases in each group. The control group received routine perioperative nursing and health education, and the intervention group was given mapping-based health education in addition to routine nursing. The patient satisfaction, readiness for hospital discharge and anxiety state were measured and compared between two groups. Results Score of Hamilton Anxiety Scale(HAMA) in the intervention group was lower than that in the control group (P＜0. 05). Score of Readiness for Hospital Discharge Scale(RHDS) in the intervention group was higher than that in the control group (P＜0. 05). The score of patient satisfaction assessment in the intervention group was higher than that in the control group (P＜0. 05). Conclusion The mind mapping-based health education is potentially effective to improve the patient satisfaction and preparedness for discharge, and relieve the anxiety of glioma patients undergoing awake surgery. (目的 探讨基于思维导图的宣教模式在脑胶质瘤患者唤醒手术围手术期中的应用效果。方法 选取首都医科大学附属北京天坛医院2021年3月—12月收治的拟行术中唤醒的脑胶质瘤患者作为研究对象, 随机分为对照组(n=30)和干预组(n=30)。对照组接受常规围手术期护理和健康教育, 干预组在对照组的基础上接受思维导图的健康宣教模式。对比两组患者满意度、出院准备度和焦虑情绪。结果 干预组患者HAMA量表评分低于对照组, 差异有统计学意义(P＜0. 05); 干预组RHDS量表总分高于对照组, 差异有统计学意义(P＜0. 05); 干预组满意度评分高于对照组, 差异有统计学意义(P＜0. 05)。结论 基于思维导图的健康宣教模式能有效提高脑胶质瘤患者满意度和出院准备度, 缓解患者焦虑情绪。)

Helicobacter pylori(HP) associated chronic atrophic gastritis (CAG) is known to be a precancerous lesion of gastric cancer, and can act on gastric carcinogenesis through a variety of factors, but the specific mechanism of action is not yet clear. In this paper, we review the research progress of the mechanism of HP associated CAG in the development of gastric cancer to provide reference for clinical medical staff.

In order to convey bionic image semantics of the intelligent projection TV efficiently and accurately, and improve the matching of users' perceptual cognitive needs with the bionic image of intelligent projection TV. An image coupling bionic design method was proposed. Firstly, the intelligent projection TV target image was obtained by KJ, Semantic difference method (SD) and K-means clustering method. Secondly, the primary, secondary and general target images were distinguished by anallytic hierarchy process(AHP), and the bionic prototype was selected according to the coupling of the primary target images. Thirdly, by means of morphological analysis and AHP, the decline structure of multi-feature coupled images was established and the judgment matrix was constructed. The contribution of coupled image of biological features was obtained. The main features were integrated into the intelligent projection TV styling to form a visual scheme. Finally, the reliability of image coupling styling method was verified by Delphi and fuzzy comprehensive evaluation method. The research process provides a reference for related product innovation design.

Guanming Li,1 Airun Zhang,1 Silan Yang,2 Niyang Lin,2 Xiaoyi Fang1 1Department of Neonatology, Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, People’s Republic of China; 2Department of Neonatology, First Affiliated Hospital, Shantou University Medical College, Shantou, People’s Republic of ChinaCorrespondence: Xiaoyi Fang, Department of Neonatology, Seventh Affiliated Hospital, Sun Yat-sen University, No. 628, Zhenyuan Road, Guangming District, Shenzhen, Guangdong, 518107, People’s Republic of China, Tel +86-18923451061, Email fangxy29@mail.sysu.edu.cnAbstract: Aplasia cutis congenita (ACC) is a rare disease with an unclear pathogenic mechanism. ACC has been suggested to result from the disrupted development or degeneration of skin in the uterus. This study describes two cases that may have underlying pathogenic cause that have not been previously reported. Two neonates who were admitted to the neonatal intensive care unit due to “skin lesions on the limbs” without other deformities or complications were diagnosed with type VII ACC by dermatologist. The mothers showed positivity for hepatitis B virus (HBV) surface antigen and elevated level of HBV DNA copies, which may be related to ACC. But this association could be a coincidence. Both neonates were treated with antibacterial dressings and achieved satisfactory healing.Keywords: aplasia cutis congenita, case report, hepatitis B virus, newborn, skin defect