Purpose/Significance To explore the ways for hospital libraries to provide subject services based on mapping knowledge do-mains.Method/Process The paper summarizes subject services implemented by hospital libraries based on mapping knowledge domains from aspects of reference consulting service,information attainment education service,discipline resource construction service,scientific re-search support service,management and decision-making support service.It elaborates on concrete practice of the library of The Fourth Hospital of Hebei Medical University based on mapping knowledge domains,including improvement of professional attainment of discipline librarians,information attainment education of readers,and scientific research support service.Result/Conclusion Hospital librarians should improve their ability to interpret the mapping knowledge domains,and comprehensively use the visual analysis function of database documents and artificial intelligence scientific research assistance tools to ensure high-quality development of subject services.

AIM:To investigate the impact of celastrol intervention on excitatory amino acid transporter 2(EAAT2)and its neuroprotective role in subarachnoid hemorrhage(SAH).METHODS:Western blot analysis was uti-lized to assess the EAAT2 expression level within 72 h after SAH,while glutamate concentration in cortical brain tissues was measured.Computational simulation was employed to explore the binding of celastrol with EAAT2.Seventy SD rats were randomly assigned to sham,model,model+GT949(an EAAT2 agonist),model+dihydrokainic acid(DHK;an EAAT2 inhibitor),and model+celastrol groups.Glutamate concentration in cortical brain tissues was quantified,and brain edema was assessed by dry-wet weight method.Western blot analysis was conducted to evaluate the expression of EAAT2,aquaporin 4 and apoptosis-related proteins(Bax,Bcl-2,caspase-3 and caspase-9),and TUNEL staining was employed to assess the apoptotic cell count in each group.RESULTS:(1)EAAT2 level decreased while glutamate con-centration increased.(2)Celastrol was found to directly bind to EAAT2,enhancing EAAT2 expression and reducing glu-tamate concentration after SAH.(3)Celastrol demonstrated the ability to inhibit brain edema after SAH.(4)Celastrol was effective in reducing neuronal apoptosis after SAH.CONCLUSION:Celastrol has the potential to up-regulate EAAT2 expression,lower glutamate level,mitigate brain edema,and decrease neuronal apoptosis after SAH.

Objective:To investigate the association of serum fibroblast growth factor 23(FGF23) level with insulin resistance(IR) and sex hormone levels in patients with polycystic ovary syndrome(PCOS).Methods:A retrospective study was performed in eighty-seven patients with PCOS, fifty-seven patients with simple IR, and sixty-one healthy women who were admitted to Affiliated Hospital of Zunyi Medical University during October 2021 and November 2022. According to the homeostasis model assessment-IR index, all subjects were divided into normal control group( n=61), IR group( n=57), PCOS without IR group(PCOS group, n=15), and PCOS+ IR group( n=72). The levels of serum FGF23, adiponectin, and sex hormones in all groups were compared, and their correlations with glucose and lipid metabolism indicators were analyzed. Results:The FGF23 level was significantly elevated in the IR group, while markedly reduced in the PCOS group and PCOS+ IR group, with the PCOS group showing a significantly lower concentration. The adiponectin levels were significantly decreased in the IR group, PCOS group, and PCOS+ IR group(all P<0.05). The correlation analysis showed that FGF23 level was positively correlated with adiponectin and sex hormone binding globulin, and negatively correlated with luteinizing hormone, luteinizing hormone/follicle stimulating hormone, and free testosterone index(all P<0.05). Logistic regression results indicated that both FGF23 and adiponectin could be used as good indicators for the diagnosis of PCOS and PCOS with IR(all P<0.05). Conclusion:FGF23 is closely related to IR and androgen as well, and under certain conditions, it can reflect the severity of IR and hyperandrogenemia in PCOS patients. The cutoff value of FGF23 obtained in this study can provide a good reference for the diagnosis of PCOS diseases.

Objective:To explore the risk factors of all-cause death in hypertensive patients in the community.Methods:A cohort of 4 049 hypertensive patients who participated in annual health checkups at Xinzhuang Community Health Service Centre of Shanghai Minhang district from January to December 2012 were enrolled in the study. All-cause death was the endpoint event of this study, and patients were divided into a fatal group and a survival group. The collection date for the endpoint event was December 2022. A multivariate Cox regression model was used to analyse the independent risk factors of all-cause mortality among hypertensive patients in the community.Results:Among 4 049 patients aged (67.9±7.1) years, 1 856 (45.8%) were males. There were 610 cases in the fatal group and 3 439 cases in the survival group. Multivariate Cox proportional regression showed that male gender ( HR=1.446, 95% CI: 1.200-1.742, P<0.001), older age ( HR=1.130, 95% CI: 1.118-1.143, P<0.001), higher waist-to-height ratio ( HR=8.117, 95% CI: 2.235-29.481, P=0.001), positive urinary protein ( HR=2.974, 95% CI: 2.202-4.016, P<0.001), high fasting blood glucose ( HR=1.070, 95% CI: 1.012-1.131, P=0.017), and history of stroke ( HR=1.819, 95% CI: 1.414-2.340, P<0.001) were independent risk factors for all-cause mortality in hypertensive patients, while exercise≥1/week ( HR=0.816, 95% CI: 0.668-0.996, P=0.046) and taking lipid-lowering medications ( HR=0.459, 95% CI: 0.223-0.947, P=0.035) were protective factors for all-cause mortality. Conclusion:For hypertensive patients, male gender, older age, higher waist-to-height ratio, positive urinary protein, high fasting blood glucose, and history of stroke are risk factors for all-cause mortality, while exercise≥1/week and taking lipid-lowering medications are protective factors.

Objective:To analyze the association between sleep status and ambulatory blood pressure monitoring indicators in community-dwelling hypertensive patients.Methods:It was a cross sentional study. Hypertensive patients who underwent 24-hour ambulatory blood pressure monitoring from May 2021 to April 2023 in Shanghai Xinzhuang Town were enrolled. The demographic information and sleep status of patients were obtained from the questionnaire. A TM-2430 blood pressure monitor was used to measure 24-hour ambulatory blood pressure, and the relevant indicators, including blood pressure level and blood pressure coefficient of variation were documented. The association between sleep status and blood pressure indicators was analyzed with multivariate linear regression model.Results:A total 1 135 patients aged (65.07±12.61) years were enrolled, and 473 (41.67%) of whom were males. The sleep time was<7 hours in 76 cases, 7- 8 hours in 219 cases and >8 hours in 840 cases; the bedtime was earlier than 22∶00 in 415 cases, between 22∶00 and 23∶00 in 474 cases and later than 23∶00 in 246 cases; the wake-up time was before 6∶00 in 230 cases, between 6∶00 and 7∶00 in 521 cases and after 7∶00 in 384 cases. Multivariate linear regression analysis showed that after controlling for gender and age, the sleep time was negatively associated with diurnal, noctumal and 24-hour diastolic blood pressure levels (all P<0.05), and positively associated with diurnal and noctumal systolic blood pressure coefficient of variation, noctumal diastolic blood pressure coefficient of variation, and 24-hour systolic blood pressure coefficient of variation (all P<0.05).The bedtime was positively associated with diurnal, noctumal and 24-hour diastolic blood pressure (all P<0.05), diastolic blood pressure (all P<0.05); and negatively associated with diurnal systolic blood pressure coefficient of variation, diurnal diastolic blood pressure coefficient of variation, noctumal systolic blood pressure coefficient of variation, 24-hour systolic blood pressure coefficient of variation, and 24-hour diastolic blood pressure coefficient of variation (all P<0.05). The wake-up time was positively associated with diurnal systolic blood pressure, diurnal, noctumal and 24-hour diastolic blood pressure (all P<0.05), and positively associated with diurmal systolic blood pressure and diastolic blood pressure (both P<0.05). Conclusion:Sleep status is closely associated with ambulatory blood pressure monitoring indicators in community-dwelling hypertensive patients.

Objective To investigate the role of RNA-binding motif protein X-linked(RBMX)in regulating the proliferation,migration,invasion and glycolysis in human bladder cancer cells.Methods A lentivirus vectors system and RNA interference technique were used to construct bladder cancer 1376 and UC-3 cell models with RBMX overexpression and knockdown,respectively,and successful cell modeling was verified using RT-qPCR and Western blotting.Proliferation and colony forming ability of the cells were evaluated using EdU assay and colony-forming assay,and cell migration and invasion abilities were determined using Transwell experiment.The expressions of glycolysis-related proteins M1 pyruvate kinase(PKM1)and M2 pyruvate kinase(PKM2)were detected using Western blotting.The effects of RBMX overexpression and knockdown on glycolysis in the bladder cancer cells were assessed using glucose and lactic acid detection kits.Results RT-qPCR and Western blotting confirmed successful construction of 1376 and UC-3 cell models with RBMX overexpression and knockdown.RBMX overexpression significantly inhibited the proliferation,clone formation,migration and invasion of bladder cancer cells,while RBMX knockdown produced the opposite effects.Western blotting results showed that RBMX overexpression increased the expression of PKM1 and decreased the expression of PKM2,while RBMX knockdown produced the opposite effects.Glucose consumption and lactate production levels were significantly lowered in the cells with RBMX overexpression(P<0.05)but increased significantly following RBMX knockdown(P<0.05).Conclusion RBMX overexpression inhibits bladder cancer progression and lowers glycolysis level in bladder cancer cells by downregulating PKM2 expression,suggesting the potential of RBMX as a molecular target for diagnosis and treatment of bladder cancer.

Objective To investigate the role of RNA-binding motif protein X-linked(RBMX)in regulating the proliferation,migration,invasion and glycolysis in human bladder cancer cells.Methods A lentivirus vectors system and RNA interference technique were used to construct bladder cancer 1376 and UC-3 cell models with RBMX overexpression and knockdown,respectively,and successful cell modeling was verified using RT-qPCR and Western blotting.Proliferation and colony forming ability of the cells were evaluated using EdU assay and colony-forming assay,and cell migration and invasion abilities were determined using Transwell experiment.The expressions of glycolysis-related proteins M1 pyruvate kinase(PKM1)and M2 pyruvate kinase(PKM2)were detected using Western blotting.The effects of RBMX overexpression and knockdown on glycolysis in the bladder cancer cells were assessed using glucose and lactic acid detection kits.Results RT-qPCR and Western blotting confirmed successful construction of 1376 and UC-3 cell models with RBMX overexpression and knockdown.RBMX overexpression significantly inhibited the proliferation,clone formation,migration and invasion of bladder cancer cells,while RBMX knockdown produced the opposite effects.Western blotting results showed that RBMX overexpression increased the expression of PKM1 and decreased the expression of PKM2,while RBMX knockdown produced the opposite effects.Glucose consumption and lactate production levels were significantly lowered in the cells with RBMX overexpression(P<0.05)but increased significantly following RBMX knockdown(P<0.05).Conclusion RBMX overexpression inhibits bladder cancer progression and lowers glycolysis level in bladder cancer cells by downregulating PKM2 expression,suggesting the potential of RBMX as a molecular target for diagnosis and treatment of bladder cancer.

Objective To study the infection of multidrug-resistant organism(MDRO)in elderly pa-tients with catheter-associated urinary tract infection(CAUTI)and analyze the infection factors.Methods The medi-cal records of 175 elderly patients with CAUTI admitted to Jiangsu Province Hospital from January 2021 to July 2022 were selected,the distribution of MDRO infection in elderly patients with CAUTI was analyzed,and the influencing factors of MDRO infection were analyzed.The predictive value of independent risk factors for rele-vant nosocomial infections was analyzed by receiver operating characteristics(ROC)curves.Results Among the 175 elderly patients with CAUTI,87 cases(49.71％)developed MDRO infection and were included in the MDRO infection group),and 88 cases(50.29％)had no MDRO infection and were included in the non-MDRO infection group.A total of 432 MDRO pathogens were detected in the MDRO infection group,inclu-ding 415 strains of Gram-negative bacteria,accounting for 96.06％,186 strains of carbapenem-resistant Acine-tobacter baumannii(43.06％),147 strains of carbapenem-resistant Klebsiella pneumoniae(34.03％),79 strains of carbapenem-resistant Pseudomonas aeruginosa(18.29％)and 3 strains of carbapenem-resistant Escherichia coli(0.69％).There were 17 strains of Gram-positive bacteria(3.94％),all of which were methi-cillin-resistant Staphylococcus aureus.Multivariate analysis showed that the use of carbapenems,tigecycline,polymyxin,and days of central venous intubation were considered as independent risk factors.The area under the curve of MDRO infection was 0.883.Conclusion For elderly patients with CAUTI,it is necessary to take strict antimicrobial management measures,master the indications of antimicrobial application,shorten the hos-pitalization time of patients and reduce the incidence of MDRO infection.

Objective To compare the efficiency of nomogram and different machine learning algo-rithms for constructing the dental caries predictive models for middle-aged and elderly people.Methods The multi-stage stratified random sampling method was used to select 510 middle-aged and elderly people from Nanning City,Guigang City and Chongzuo City as the research subjects for conducting the questionnaire sur-vey and oral cavity examination.The univariate analysis and Lasso regression were used to screen the related variables,and the multivariate logistic regression analysis was used to determine the final independent influen-cing factors.Based on the salient features,the nomogram predictive model was established,and the seven ma-chine learning algorithms,including linear discriminant analysis (LDA),partial least squares (PLS),range Doppler algorithm (RDA),generalized linear models (GLM),random forest (RF),support vector machine (SVM) kernel function (SVM-Radial),and SVM linear kernel function (SVM-Linear),were used to construct the seven kinds of dental caries risk predictive models.The area under the receiver operating characteristic (ROC) curve (AUC) was adopted to evaluate the predictive performance of various models and the predictive performance of models constructed using different variable screening methods.Results The detection rate of dental caries in middle-aged and elderly people was 71.18％.After feature screening,the five predictive factors were ultimately retained,which were the age (OR=0.945,95％CI:0.917-0.973),brushing frequency (OR=0.688,95％CI:0.475-0.997),whether having teeth cleaning in the past one year (OR=0.303,95％CI:0.103-0.890),number of remaining teeth (OR=1.062,95％CI:1.038-1.087) and oral health assess-ment tool (OHAT) score (OR=1.363,95％CI:1.234-1.505).The results of comparison of various models showed that the predictive model constructed by the RF algorithm performed the best,the median of AUC was 0.747,followed by the nomogram,and the median of AUC was 0.733.The median of AUCs in the predic-tion model constructed by single factor+Lasso+multivariate logistic (Lasso+logistic) screening independent variables were higher than those constructed by RF algorithm screening independent variables.ConclusionBased on Lasso+logistic screening variables,RF provide more reliable predictive efficiency in predicting dental caries in middle-aged and elderly people than nomogram and the other machine learning algorithms.

It remains unclear whether heart transplantation is still feasible on patients who develop neurological complications before surgery and underwent successful neurological treatment.This article reported the diagnosis and treatment process of a heart failure patient complicating with acute ischemic stroke,who underwent successful heart transplantation after thrombectomy for acute ischemic stroke,aiming to provide clinical evidence and decision-making plan on diagnosis and treatment options for this group of patients with severe neurological complications.