Objective To observe the pulmonary artery motion curve with anatomical M-mode echocardiography, and to investigate its influential factors. Methods The pulmonary artery motion curve was detected and pulsating amplitude of pulmonary artery wall (PAWPA) was measured with anatomical M-mode echocardiography in 160 patients with normal pulmonary artery pressure. Intraclass correlation coefficient (ICC) was used to assess inter-observer conisitency of PAWPA measurements between two investigators who were blinded to each other's findings, and intra-observer consistency of PAWPA with repeating the measurements on two occasions by the same investigator in 20 randomly selected cases. Stepwise multiple regression was used to analyze the following potential influential factors of PAWPA: age, gender, heart rate, blood pressure, atherosclerosis, right atrial diameter, and pulmonary insufficiency. Results There was good consistency between two independent observers' measurements and between two occasions in the same observer's measurements for PAWPA with ICC values of 0.91 (95% CI, 0.37-0.99) and 0.95 (95% CI, 0.60-0.99), respectively. PAWPA was negatively correlated with age (β=-0.47, P<0.001) and heart rate (β=-0.29, P<0.005). There was no correlation of PAWPA with gender, blood pressure, atherosclerosis, right atrial diameter, and pulmonary insufficiency. Conclusion Anatomical M-mode echocardiography can be used for measuring PAWPA with good consistency and reproducibility. In normal pulmonary artery pressure cases, PAWPA is affected by age and heart rate.

Objective To investigate the correlation of the serum prolactin level and the secret mode of Th1/Th2 eytokines with clinical activity in patients with systemic lupus erythematosus. Methods The serum level of The levels of PRL[ (21.58 ± 4.29 ) ng/ml vs ( 11.87 ± 2.57 ) ng/ml, P < 0.01 ), IL-4 [ ( 26.79 ± 5.08 ) ng/L vs (10.71 ± 1.35)ng/L,P <0.01 ] in SLE patients were significantly higher than the healthy controls,but IFN-γ [ (11.47±3.36)ng/L vs (18.36 ±2.61)ng/L,P <0.01 ], IFN-γ/IL-4(0.76γ±0.29 vs 2.30±0. 15,P <0.01) [ (38.52 ± 8.44) ng/L vs ( 14.15 ± 1.63 ) ng/L, P < 0.01 ] in the active SLE patients were significantly higher than that in the nonactive patients, whereas, the levels of IFN-γ [ (6.98 ± 2.72) ng/L vs ( 16.24 ± 2.57 ) ng/L, P < 0.01 ] and IFN-γ/IL-4 (0.35 ± 0.14 vs 1.24 ± 0.29, P < 0.01 ) were lower in the active group compared with the nonac-[ (45.12±10.44) ng/L vs ( 17.53 ± 5.42) ng/L, P < 0.01 ] declined while IFN-γ [ (6.31 ± 2.59) ng/L vs (16.89 ±4.43)ng/L,P<0.01 ] and IFN-γ/IL-4 (0.16 ±0. 11 vs 1.16 ±0. 27,P<0.01) increased when SLE patients in remission. Conclusions Hyperprolactinemia and imbalance of Th cytokines production which exhibited Th2 dominant are found in SLE patients. Prolactin and the degree of imbalance of Th cytokines production varies with the remission or exacerbation of the disease.

Objective To evaluate whether the timing of maternal hypoxia during pregnancy could myocardial remodeling in adult offspring.Methods Twenty-four pregnant rats were assigned to the maternal hypoxia group starting from the early period of pregnancy (G1,day 3 to 21 of pregnancy),the group starting from the middle period of pregnancy (G2,day 9 to 21 of pregnancy),the group starting from the late period of pregnancy (G3,day 15 to 21 of pregnancy),or the control group (G0).Six rats were included in each group.Rats in the maternal hypoxia groups (G1,G2 and G3) were subjected to hypoxia for 3 hours in a low pressure cabin with an oxygen concentration of (10± 1) ％.Systolic blood pressure,wet weight of the left ventricle normalized for body weight (left ventricular weight/body weight,LVW/BW),diameter of cardiomyocytes,and the expression levels of collagen Ⅰ and collagen Ⅲ were measured in adult male offspring at the age of 3 and 5 months.One-way ANOVA and SNK test were used for statistical analysis.Results Maternal hypoxia from day 3 to 21 of pregnancy induced higher systolic blood pressure in male offspring at the age of 3 months and 5 months [3 months:G1 (122.0± 11.7) mmHg,G0 (108.3±9.5) mmHg,F=2.97; 5 months:G1 (128.5±7.9) mmHg,G0 (114.6±-10.0) mmHg,F=3.17,both P＜0.05].Maternal hypoxia also led to a higher LVW/BW ratio (G1 1.99±0.03,G0 1.80±0.02,P＜0.05),and increased collagen Ⅰ and collagen Ⅲ expression (collagen Ⅰ /β-actin:G1 1.76±0.07,G0 0.48±0.04,P＜0.01; collagen Ⅲ /β-actin:G1 0.68±0.05,G0 0.34±0.03,P＜0.01) in adult male offspring at the age of 5 months.Maternal hypoxia from day 9 to 21 of pregnancy induced a higher LVW/BW ratio (3 months:G2 2.15 ± 0.05,G0 1.98 ± 0.02,P＜0.05; 5 months:G2 1.96±±0.05,G0 1.80±0.02,P＜0.05),and increased collagen Ⅰ and collagen Ⅲ expression (3 months:collagen Ⅰ /β-actin G2 0.98±±0.02,G0 0.87±0.02,P＜0.05; collagen Ⅲ /β-actin:G2 0.87±±0.01,G0 0.82±0.01,P＜0.05; 5 months; collagen Ⅰ /β-actin G2 1.61±0.05,G0 0.48±0.04,P＜0.01; collagen Ⅲ / β-actin:G2 0.61 ±0.04,G0 0.34±0.03,P＜0.01) in male offspring at the age of 3 months and 5 months,but did not affect systolic blood pressure.Maternal hypoxia from day 15 to 2l did not have any effect.The diameter of cardiomyocytes in male offspring was not significantly different between the groups.Conclusions Maternal hypoxia during different periods of pregnancy has different effects on cardiac structure in adult rat offspring.Maternal hypoxia started in early or mid-pregnancy leads to cardiac collagen deposition without an increase in myocyte size in adult offspring,which may be independent of the change in blood pressure.

Objective To study the dynamic changes of plasma C-reactive protein (CRP) and cortisol (COR) and their clinical value in prognosis of patients with sepsis. Methods Daily CRP and COR detection was conducted to record the dynamic changes of CRP and COR for cases of sepsis patients in ICU then the rela-tionship between dynamic changes of serum CRP and COR and prognosis were analyzed. Results Serum CRP and COR levels of dead patients were significantly higher than those of survival patients after treatment (P <0.05). According to the difference of the dynamic changes of CRP and COR, the data were divided into typeⅠ:sustained elevated type , typeⅡ: up-and-down type , type Ⅲ: fluctuated type and type Ⅳ: normal or mild ele-vation type. The mortality of CRP typeⅠ patients was significantly higher than that of type Ⅱ and type Ⅳ(P <0.001). The mortality of COR typeⅠ and COR Ⅲ patients was significantly higher than that in COR Ⅱand COR Ⅳ (P < 0.001). Further analysis showed that the mortality of group with significant elevation of CRP and COR were obviously higher than that of group with significant increase of CRP or COR and that of group with no significant elevation of CRP and COR (P < 0.001); the mortality of group with significant increase of CRP or COR was also significantly higher than that of group with no significant elevation of CRP and COR (P < 0.001). Conclusions The dynamic changes of COR and CRP in patients with sepsis present certain regularity and monitor-ing the dynamic changes of the two provides accurate assessment of the prognosis of sepsis.

The carotid initima-media thickness(CIMT)in 78 cases of type 2 diabetic patients was measured.The level of plasma endogenous secretion receptor for advanced glycation end-products(esRAGE)in patients with normal CIMT was higher than those with chickened CIMT[(0.257 3±0.165 6 vs 0.155 4±0.0701)μg/L,P<0.01].esRAGE was negatively associated with CIMT(r=-0.247,P<0.05).Logistic regression analysis showed that CIMT was negatively associated with esRAGE and hish density lipoprotein cholesterol,but was positively associated with age.

Objective To compare the curative effect of open and minimally invasive treatment of acute closed achilles tendon rupture with 5 years followed-up study.Methods From September,2010 to January,2012,28 patients with acute closed Achilles tendon rupture in our hospital were followed up for 5 years.There were 21 males and 7 females.Minimally invasive percutaneous suture in 11 cases;open suture in the treatment of 17 cases.The patients were followed up at 6 months,1 year,2 years,3 years,4 years,and 5 years after AOFAS and ATRS score.Results The follow-up time ranged from 60 to 72 months.All incisions healed by first intention and no incision related complications occurred.2 groups of patients with ATRS score at 6 months after operation:the open group was 81.23±3.99,minimally invasive percutaneous group of 88.27±4.27,the difference between the two groups was statistically significantly.After 1 year,there was no significant difference in the scores between the two groups.Two groups of patients with AOFAS score at 6 months after operation:the open group was 69.00±6.23,minimally invasive percutaneous group of 79.27±4.83,the difference between the two groups was statistically significantly.At one year after operation,the open group was 85.53±3.38,and the minimally invasive group was more than 89.90±3.38.The difference between the two groups was statistically significantly.After 2 years,there was no significant difference in the scores between the two groups.Conclusion There is no significant difference between the 2 years after surgery in the treatment of acute closed Achilles tendon rupture or open surger.

Hemophilia is a recessive inherited disorder linked to the X chromosome. On July 28, 2020, a case of hemophilia A with severe left kidney hydronephroses and acute left kidney hemorrhage was admitted to the Affiliated Hospital of Qinghai University. The patient had a family history of hemophilia A and activated partial thromboplastin before surgery. The APTT was 95.0s (reference value 22.7-31.8s), factor Ⅷ activity (FⅧ∶C) was 3.2% (reference value 70%-150%), and B-ultrasonic examination revealed severe hydronephroses in the left kidney, and the nephrogram indicated that the left kidney was absent of perfusion. On the 9th day of admission, the pain in the left lower back was aggravated than before. The CT scan of the whole abdomen revealed irregular patches with slightly higher density in the left kidney. Considering bleeding, through multidisciplinary consultation and perioperative infusion of human coagulation factor Ⅷ, the patient was underwent retroperitoneal laparoscopic left nephrectomy. There was no bleeding during and after operation. After 20 months of follow-up, the renal function and coagulation function were normal, and there were no symptoms of hematuria and low back pain.

Objective:To observe Leber's hereditary optic neuropathy (LHON) microperimetry features, discuss its significance in diagnosis and treatment of LHON assessment.Methods:A retrospective clinical study. A total of 13 LHON patients (25 eyes) diagnosed in Department of Ophthalmology of the First Affiliated Hospital of Army Medical University from May 2015 to May 2020 (disease group) were included in the study, including 9 males (18 eyes) and 4 females (7 eyes), and beginning with the age of 15.0 (10.0, 57.0). Ten healthy volunteers (19 eyes) were selected as the normal group, including 7 males (13 eyes) and 3 females (6 eyes), aged 22.0 (6.0, 46.0) years at the first diagnosis. According to the course is divided into: asymptomatic group (carriers), subacute (<6 months), the dynamic group (6-12 months), chronic group (>12 months). There were 7, 6, 5 and 7 eyes, respectively. All eyes underwent best corrected visual acuity (BCVA) and microperimetry. BCVA test was performed using the international standard visual acuity chart, which was statistically converted to the logarithm of the minimum Angle of resolution (logMAR) visual acuity. MP-3 microperimetry was used to perform microperimetry, and the mean sensitivity (MS) values of five regions were recorded: center, superior, temporal, inferior, and nasal. Mann-Whitney U test was used for comparison between two groups, and Kruskal-Wallis H test was used for comparison between multiple groups. Results:Compared with the normal group, MS in the center, superior, temporal, inferior and nasal of the diseased group decreased, and the differences were statistically significant ( Z=-5.629, -4.906, -5.630, -5.631, -5.227; P<0.05). There were significant differences in different regions of MS between different course groups ( H=12.296, 11.583, 10.110, 12.994, 8.663; P<0.05). There were significant differences in logMAR BCVA and central MS between asymptomatic group and subacute group ( P=0.040, 0.007). There were significant differences in temporal, inferior and superior MS between subacute group and dynamic group ( P=0.026, 0.017, 0.018). Dynamic and chronic group, MS above the difference was statistically significant ( P=0.031). Idebenone treatment significantly improved visual field defects in 4 of 23 eyes. Conclusions:In the early stage of LHON, the central visual field defect gradually progresses to the temporal, inferior and superior areas, and the temporal and inferior areas are more severe. Visual field defects reached a stable level at 6-12 months. MP-3 can assist in early diagnosis of LHON, and provide reliable basis for efficacy evaluation.

Objective To evaluate the quality of animal studies into acupuncture for glaucoma using SYRCLE's risk of bias tool,ARRIVE 2.0 guidelines,and the GSPC checklist.Methods Databases from CNKI,VIP,Wanfang,Sinomed,PubMed,Web of Science,Embase and Cochrane Library were searched to find animal research articles on acupuncture for glaucoma.Risk of bias was assessed for the included studies using the SYRCLE's tool,and reporting quality was evaluated using the ARRIVE 2.0 guidelines and GSPC checklist.Statistical analysis was performed by Excel and SPSS software.Results Thirty articles met the inclusion/exclusion criteria and were included in the final analysis.Six of the 10 items of the SYRCLE's tool had a low-risk rate of＜50％,and the non-low-risk items focused on selectivity bias,implementation bias and measurement bias.Twelve of the 22 essential sub-items of the ARRIVE 2.0 guidelines had a low-risk rate of＜50％;9 of the 16 recommended sub-items had a low-risk rate of＜50％;and 12 of the 19 subentries of the GSPC list had a low-risk rate of＜50％.Randomization,blinding,ethical statements,housing and husbandry,animal care and monitoring,and protocol registration were the non-low-risk items in the ARRIVE 2.0 guidelines and GSPC list.Conclusions The quality of the methodology and experimental reporting of animal studies into acupuncture for glaucoma are generally low,and the description of several items is not yet complete,which affects the readers'judgment on whether the result of animal studies can be translated to clinical studies.It is advisable to further promote the use of SYRCLE's tool and reporting guidelines for animal experiments to enhance the design,performance,and reporting of animal experiments;ensure the reproducibility of experiments and result;and provide reliable evidence for the translation of result to the clinic.

To investigate the genomic features and perform cluster analysis of Carbapenem-resistant Klebsiella pneumoniae (CRKP) to provide an experimental basis for guiding the prevention and treatment of CRKP infections.A retrospective case-cohort study was conducted on 19 non-redundant CRKP strains isolated from the Tenth Affiliated Hospital of Southern Medical University between January and June 2023. Whole genome sequencing (WGS) and multilocus sequence typing (MLST) were performed to compare genomic features and analyze the resistance genes and homology of the strains.The results showed that the 19 CRKP strains were isolated from 8 different clinical departments, mainly from respiratory specimens. The whole genome sequencing revealed that the genomic lengths of CRKP ranged from 4.90 to 5.85 Mbp, with contigs N50 values>20 kb for each genome. The median overall GC content was 57.0% (50.4%-57.1%). Comparative genomic analysis identified three regions with high genomic variability. WGS detected 32 resistance genes across 11 categories. All 19 strains carried carbapenem resistance genes ( blaKPC-2 and blaOXA-48), blaTEM-1B extended-spectrum β-lactamase resistance genes, qnrS1 quinolone resistance gene, and fosA fosfomycin resistance gene, with each strain carrying only one carbapenemase gene. The detection rate of blaKPC-2 was 94.7% (18/19). MLST identified three sequence types: ST11, ST437 and ST147, with ST11 being predominant (89.5%, 17/19). Clustering analysis based on acquired resistance genes revealed three clonal transmission patterns among strains 72 and 90, and strains 88, 84, 66 and 79.In conclusion, CRKP strains carry multiple resistance genes, and clustering analysis indicating that nosocomial clonal transmission is closely related to acquired resistance genes. The ST11- blaKPC-2 type strain is the predominant clone. Strengthened surveillance and effective control strategies are necessary to reduce nosocomial transmission of CRKP.