Objective To explore the risk factors of stroke- associated pneumonia (SAP) in stroke patients. Methods A retrospective study was designed to analyze the clinical data of 159 patients with stroke. They were divided into SAP group (n=35) and non-SAP group (n=124). Their age, gender, hypertension, diabetes mellitus, gastric mucosal protective agents, dysphagia after stroke (DAS), stroke history, type of stroke, hypoproteinemia, disturbance of consciousness, nasal feeding and smoking were analyzed with univariate analysis and multivariate Logistic regression analysis. Results 22% of the 159 patients suffered from SAP. Univariate analysis showed, there was statistical difference in age (P<0.01), gastric mucosal protective agents (P<0.01), DAS (P<0.01), hypoalbuminemia (P<0.05), disturbance of consciousness (P<0.05), nasal feeding (P<0.001) and smoking (P<0.01) between two groups. Binary Logistic regression for the multivariate analysis indicated that age≥70 years old, DAS, nasal feeding and smoking were the risk factors related with SAP. After adjusting for all other variables, the odds of SAP were 5.119 times higher for patients requiring nasal feeding than those without nasal feeding. Conclusion There is a high morbidity for SAP, which is attributed to multiple factors. Age≥70, DAS, nasal feeding and smoking may be the most important risk factors related with SAP.

Abstract: Objective　To understand the general situation of death causes of permanent residents in Hainan Province from 2014 to 2020, analyze the causes of death, and provide scientific basis for the formulation of policies related to healthy Hainan. Methods The Hainan Provincial Population Death Information Registration and Management System was used to report data, and the death information of permanent residents in Hainan Province from 2014 to 2020 was obtained. Excel 2010 and SPSS 26.0 software were applied to perform statistical analysis related to the indicators including crude mortality rate, standardized mortality rate, ranking of causes of death, and composition ratio; the standardized mortality rate was calculated based on the data of the 2010 National Census Data. Results　From 2014 to 2020, the average annual resident population of Hainan Province was 9 175 300, and average annual resident population at each of the eight monitoringp oints is 297 100， anaverage of 83 878 cumulative deaths were reported, the annual total mortality rate was 504.09/100 000, the standard mortality rate was 618.69/100 000. The standardized mortality rates of male and female were 806.18/100 000 and 444.36/100 000 respectively (P<0.01). The mortality rate of all age groups showed that the crude mortality rate of 0~<1 years old group showed a decreasing trend with the passage of time, and the crude mortality rate was significantly higher than that of other age groups. From the age of 20, with the increase of age, the overall crude mortality rate of residents keeps increasing. The crude death rate increases rapidly after the age of 65, and peaks especially after the age of 85. The leading causes of death were circulatory diseases, tumors and respiratory diseases. From 2014 to 2020, the mortality rate of circulatory diseases and tumors, the two main causes of death, was more than 100/100 000. Conclusion　Chronic non-communicable diseases are still the first cause of death among permanent residents in Hainan Province. Targeted intervention and treatment of chronic non-communicable diseases is beneficial to reduce their mortality.

Objective: To understand the situation of school medical staff in Guangzhou after adopting multichannel medical model, and to provide reference for school medical team construction. Methods: A total of 1 099 primary and secondary schools in Guangzhou participated in this study through questionnaire survey regarding school medical personnel, basic situation of school medical personnel and work situation. Results: Among the 1 099 primary and secondary schools surveyed, 638(58.05%) of them consisted of 707 full-time school doctors, the eligible rate was 28.20%. The recruitment of school doctors was still based on independent recruitment(55.87%), and 44.13% of the purchase service modes (community deployment, hospital purchase services, and school clinic custody) were deployed. Most of school medical professionals majored in nursing(56.86%), followed by clinical medicine (26.03%) and preventive medicine (9.76%); In terms of professional titles, junior, intermediate and senior certificates accounted for 52.47%, 37.34%, and 1.27%, respectively; More than 68.74% of school doctors worked for less than 5 years; On average, 68.60% of training were provided every six months. About 33.95% of the school doctor were satisfied with salary, 20.79% were not satisfied. Compared with the year 2016, no significant changes were noticed in academic qualifications, professional titles, and working conditions of school medical team, however, increased proportion of staffs with nursing certificate instead of clinical medicine certificate increased, workload and satisfaction towards salary decreased(P<0.01). Conclusion After adopting the multi-channel deployment model, the construction of school health workforce in Guangzhou has made breakthrough progress. It is proposed to improve the guidelines for the standardization of school doctors, to strengthen the professional skills training of school doctors, and to better improve the overall level of school health work in the city.

italic>Artemisia argyi (A. argyi) is a Chinese herbal medicine in China. The main active components are volatile oils, flavonoids, and other compounds, which have various pharmacological activities. Methoxylated flavonoids are the main active ingredients in A. argyi. Flavonoid O-methyltransferase (FOMT) is a key enzyme in the O-methylation of flavonoids. In order to further understand the function and characteristics of FOMT proteins, this paper carried out the whole genome mining and identification of FOMT genes in A. argyi and performed phylogenetic, chromosomal localization, gene sequence characterization, subcellular localization prediction, protein structure, gene structure analysis, and expression pattern analysis. The results showed that a total of 83 FOMT genes were identified in the genome of A. argyi. The phylogenetic tree shows that FOMT genes are divided into two subgroups, CCoAOMT (caffeoyl CoA O-methyltransferase) subfamily (32 genes) and COMT (caffeic acid O-methyltransferase) subfamily (51 genes). Gene sequence analysis showed that the number of amino acids encoded by FOMT was 70-734 aa, the molecular weight was 25 296.55-34 241.3 Da, and the isoelectric point was 4.51-9.99. Compared with 32 members of the CCoAOMT subfamily, nearly 1/3 of the 51 members of the COMT subfamily were hydrophobic proteins and 2/3 were hydrophilic proteins. Subcellular localization prediction showed that more than 80% of CCoAOMT subfamily members were located in the cytoplasm, and 96% of COMT subfamily members were located in the chloroplast. COMT subfamily members have more motifs than CCoAOMT subfamily members. The N-terminal motifs of COMT subfamily proteins are relatively variable, while the C-terminal motifs are relatively conserved. Expression pattern analysis showed that CCoAOMT subfamily members were mainly expressed in roots, while COMT members were mainly expressed in leaves. Some FOMTs showed the tissue expression specificity by real-time quantitative PCR analysis, especially in leaves. In this study, we identified and analyzed the FOMT gene family in A. argyi, and provided a theoretical basis for further research on the function of FOMTs and the biosynthesis of methylated flavonoids in A. argyi.

OBJECTIVETo study the effects of hermap gene on kinases in erythroid signal transduction pathway and investigate the mechanism of hermap on erythroid differentiation.

METHODSThe K562 cells expressing hermap and hermap-siRNA respectively were established for up- and down-regulating the expression of hermap gene. These K562 cells were then induced by Ara-C to erythroid differentiation and analyzed at 0, 24, 48, 72 and 96 h, respectively, for cell morphology and biphenylamine staining positive cells, determination of CD235a, CD36, kinases p-STAT5, p-Akt, p-MAPK and p-c-JUN by FCM; and quantification of hermap gene and γ (Aγ,Gγ) globin gene by FQ-PCR.

RESULTSWith up-regulating hermap gene and inducing by Ara-C, K562 cells were changing to low ratio of nucleus to cytoplasm, cytoplasm colour from basophilic to pinkish or amethyst tinge, increase of number of biphenylamine positive cells and expression of CD235a, CD36, γ (Aγ,Gγ) globin gene, hermap gene and p-STAT5 from 0 to 96 h. At 0, 24, 48, 72 and 96 h of culture, the positive rates of p-STAT5 cells were detected of 0.46%, 4.54%, 20.01%, 23.65% and 33.08%, respectively. This results demonstrated that there was a positive correlation between expression of p-STAT5 and hermap gene expression (P < 0.05).

CONCLUSIONhermap gene can stimulate erythroid differentiation of Ara-C induced K562 cells mainly through JAK/STAT5 signal transduction pathway.

Cell Differentiation ; Erythrocyte Membrane ; Erythrocytes ; cytology ; Erythropoiesis ; Gene Expression ; Humans ; K562 Cells ; Receptors, Erythropoietin ; genetics ; STAT5 Transcription Factor ; metabolism ; Signal Transduction

Monitoring the long-term radiotherapy-associated molecular changes in low-grade gliomas (LGGs) facilitates the understanding of LGG response to radiotherapy. In this study, we used immunohistochemistry to analyze the expression of Ki-67, tumor protein P53 (TP53), P21, and P27 in 8 paired WHO grade II astrocytoma samples. The interval between radiotherapy (RT) and the second surgery was more than 3 months in all cases. The average Ki-67 labeling index (LI) was 5.3% in pre-RT samples and 11.54% in post-RT samples. Ki-67 LI was higher in the primary tumors that underwent malignant transformation observed at the second surgery after radiation. Post-RT Ki-67 LI decreased in 2 cases with an interval of less than 12 months between RT and the second surgery. TP53 expression was found in 3 out of 4 pre-RT samples with malignant transformation and in 1 out of 4 pre-RT samples without malignant transformation. Post-RT TP53 increased in 2 cases in which increased expression of P21 or P27 was also observed. Our study suggests that radiotherapy can inhibit WHO grade II astrocytoma proliferation as reflected by Ki-67 LI, but the effect attenuates with time. In addition, there is a tendency of malignant transformation for WHO grade II astrocytomas with a high Ki-67 level or TP53 expression in initial samples.
Adult ; Astrocytoma ; metabolism ; pathology ; radiotherapy ; surgery ; Brain Neoplasms ; metabolism ; pathology ; radiotherapy ; surgery ; Cell Proliferation ; radiation effects ; Cell Transformation, Neoplastic ; radiation effects ; Cyclin-Dependent Kinase Inhibitor p21 ; metabolism ; Cyclin-Dependent Kinase Inhibitor p27 ; metabolism ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Male ; Middle Aged ; Neoplasm Grading ; Tumor Suppressor Protein p53 ; metabolism

Liver cancer is one of the most common neoplastic diseases with high mortality in China. Currently, antimicrotubule drugs such as paclitaxel (PTX) and vincristine (VCR), are used as the common agents in the clinical chemotherapy for liver cancer. However, the responses of patients to these drugs vary markedly. Successful identification of intracellular factors influencing liver cancer's sensitivity to antimicrotubule drugs would be of great clinical importance. In this study, by engineering human hepatoma cell HepG2 to overexpress synuclein-gamma (SNCG), we investigated if SNCG is a molecular factor associated with the sensitivity to antimicrotubule drug treatment. Real-time RT-PCR and Western blotting assays showed SNCG was successfully overexpressed in HepG2/ SNCG cells compared with HepG2/Neo cells. The overexpressed SNCG altered the proliferation activity in HepG2 cells, which was 66% higher than that of HepG2/Neo cells through MTT method. The overexpressed SNCG also reduced sensitivity of HepG2 cells to antimicrotubule drugs: after PTX or VCR treatment, the proportion of HepG2/SNCG cells in G2/M arrest was significantly lower than that in HepG2/Neo cells. Correspondingly, HepG2/SNCG cells showed significantly lower mitotic index than HepG2/Neo cells. Meanwhile, HepG2/SNCG cells showed higher resistance to PTX and VCR than HepG2/Neo cells, with resistance index 21 and 15 respectively. Our studies suggested that the overexpression of SNCG could confer resistance to antimicrotubule drugs in hepatoma cells; and it indicated that SNCG may be as a potential response marker for antimicrotubule drugs in liver cancer chemotherapy.
Antineoplastic Agents, Phytogenic ; pharmacology ; Cell Cycle ; Cell Proliferation ; Drug Resistance, Neoplasm ; Gene Expression Regulation, Neoplastic ; Genetic Vectors ; Hep G2 Cells ; drug effects ; metabolism ; Humans ; Microtubules ; drug effects ; Mitosis ; drug effects ; Mitotic Index ; Paclitaxel ; pharmacology ; Plasmids ; RNA, Messenger ; metabolism ; Transfection ; Vincristine ; pharmacology ; gamma-Synuclein ; biosynthesis ; genetics ; physiology

Objective To construct and identify an organoid model of human placental site trophoblastic tumor(PSTT).Methods The tumor cells were obtained by digesting and separating the PSTT tissues and then embedded in Matrigel.The organoids were cultured in the specific organoid medium.The histological morphology of the organoid model was observed by HE staining and the expression levels of the PSTT specific markers[human placental prolactin(HPL),human leukocyte antigen-G(HLA-G)and placental alkaline phosphatase(PLAP)]were detected by immunohistochemistry and immunofluorescence,so as to evaluate the consistency between the organoid model and the PSTT tissue.Meanwhile,the morphology and forming efficiency of the constructed model were observed under a microscope after primary culture,passage generation and cryopreservation to evaluate its potential application as an organoid model in basic and clinical translational research of PSTT.Results The constructed organoid model could proliferate stably,growing from small microspheres into compact solid spheres or spheres with follicle-like structures,and could passage after fully grown in 7-10 days.The cell state remained stable after passage,frozen storage and recovery.HE staining showed that the morphology of the cells in the organoids was similar to that of the primary PSTT tumor cells,and immunofluorescence staining showed that the organoids highly expressed HLA-G and lowly expressed β-HCG,indicating that the constructed organoid model mainly contained intermediate trophoblast.Conclusion The adult-derived PSTT organoid(ADPO)models were successfully established.

Aim To evaluate the effectiveness and safety of remimazolam tosylate for administering general anesthesia in morbidly obese patients.Methods This clinical trial was conducted at a single center from De-cember 2021 to October 2023.It assessed 108 morbid-ly obese patients(body mass index,BMI≥40)who underwent laparoscopic sleeve gastrectomy.Patients were randomly assigned to either the remimazaolam group(Group R)or the propofol group(Group P)for general anesthesia induction and maintenance.The primary outcome was to compare the incidence of ad-verse events and postoperative recovery characteristics between the two groups.Results During induction pe-riod,the incidence of adverse events was higher in group P,including hypotension(P＜0.01),hypox-emia(P＜0.05),bradycardia(P＜0.01),and in-creased vasopressor requirement(P＜0.05).The time to loss of consciousness and BIS falling to 60 was shor-ter in group P than in group R(P＜0.01).There were no statistically significant differences between the two groups in terms of postoperative quality of recovery(QoR-40 score),24-hour postoperative pain visual an-alogue scale(VAS)scores and morphine consump-tion.In conclusion,remimazolam tosylate,utilized for anesthesia induction in morbidly obese patients,signif-icantly reduced hypotension and hypoxemia compared to propofol,while it could also maintain similar postop-erative recovery quality.Conclusions Remimazolam is effective in reducing the incidence of hypotension and hypoxaemia during the induction period of general anaesthesia in morbidly obese patients and it is compa-rable to propofol in terms of quality of postoperative re-covery.

Cardiomyopathy, Hypertrophic ; Heart Aneurysm ; Humans