Objective To investigate the relationship between the ABCB1 rs1045642 polymorphism and clopidogrel resistance (CR) among Chinese Han patients with ischemic stroke.Methods In total,110 patients with acute ischemic stroke were included in the study.Venous blood samples (2 mL) were collected after oral administration of 75 mg/d clopidogrel;the platelet aggregation rate was measured before clopidogrel administration and after 7 days of clopidogrel administration.CR is defined as no more than 10％ change in the platelet aggregation rate over two times.Based on the results,patients were divided into the CR group and non-CR (NCR) group.Genomic DNA was extracted,the target gene was amplified by PCR,and the SNP was determined by RFLP.Results The TT genotype frequency of ABCB1 rs1045642 was significantly higher in the CR group than in the NCR group (P =0.003).T allele carriers in CR group show much more (57.1％ vs 34％,P =0.001) compared with those in the NCR group.Conclusion The ABCB1 rs1045642 polymorphism may be an independent risk factor and the T allele may be a gene indicating risk for CR among Chinese Han patients with ischemic stroke.

Purpose/Significance To investigate medical students'digital literacy level,and to propose cultivation strategies,so as to provide references for medical universities and colleges to carry out digital literacy education better.Method/Process Through a ques-tionnaire survey,the digital literacy level of 907 medical undergraduates is investigated from 3 dimensions:medical knowledge acquisition and analysis,online learning and security,communication and collaboration.Result/Conclusion The overall level of digital literacy of medical students is high,especially in the use of digital tools for communication and collaboration,but the ability in medical knowledge acquisition and analysis is relatively poor.The digital literacy level of medical students in different grades and majors is different.In order to further improve the digital literacy level of medical students,we should pay attention to creating a personalized digital literacy education mode,constructing a practical digital literacy evaluation system,highlighting the characteristics of digital literacy in the medical field,and strengthening practical education on digital security.

OBJECTIVETo investigate the surgical techniques and appropriate perioperative management for ensuring successful orthotopic liver transplantation (ROLT) in rats.

METHODSBased on the double-cuff technique of Kamada, we modified the surgical techniques of separation, perfusion and cold preservation of the donor liver, shearing and anastomosis of the suprahepatic vena cava with optimized postoperative infusion protocols and animal care.

RESULTSTwo hundred and seventy rats underwent ROLT and a learning curve of the success rate was built to reflect the improvement of techniques. The learning curve showed steep improvements over the exploration stage, breakthrough stage and maturation stage, and the success rates increased sharply over time (0%, 71.1%, and 94.5%, respectively) until finally reaching over 90%. The shearing and anastomosis of the suprahepatic vena cava remained the most critical and difficult techniques in ROLT modeling.

CONCLUSIONProficient microsurgical techniques and meticulous nursing can reduce postoperative complications, enhance operational success rate and extend the survival time after ROLT.

Anastomosis, Surgical ; Animals ; Disease Models, Animal ; Graft Survival ; Liver ; surgery ; Liver Transplantation ; methods ; mortality ; Perioperative Care ; Rats ; Rats, Sprague-Dawley

Objective To investigate the value of blood oxygenation level dependent(BOLD)fMRI in assessing the functional changes of the lumbar dorsal extensor muscles before and after exercise in healthy young people.Methods The changes of the R2*value of lumbar dorsal extensor group in 30 healthy young volunteers(15 males and 15 females)before and after exercise was prospectively studied.BOLD-fMRI scans were performed on healthy young volunteers before and after exercise, the exercise mode was to perform the upper body flexion and extension movement with a simple Rome stool.The scanned images were processed and analyzed, the cross-sectional area and R2* value of the lumbar dorsal extensor muscles (including the multifidus,the longissimus and the iliocostalis)were measured at the upper margin of the L3 and L4 vertebral body before and after exercise.The paired t test was used to compare CSA and R2*values of muscles before and after loading. The CSA and R2* value of different muscles in different sides were compared by independent sample t test. Pearson correlation analysis was used to analyze the relevance between CSA and R2* in muscle before and after exercise. Results After exercise, the R2* values of multifidus,longissimus and iliocostalis at the upper margin of the L4 vertebral body were[(39.2±8.6),(38.9± 7.7),(41.6±7.8)]Hz,significantly lower than before exercise[(46.1±6.9),(45.3±6.2),(46.0±6.7)]Hz(P<0.01);the changes of R2*values of the muscles between the left and right sides before and after the movements were not statistically significant(P>0.05).The R2*values of longissimus and iliocostalis at the upper margin of the L3 vertebral body were[(44.2±9.1),(46.6±9.3)]Hz,significantly lower than before exercise[(48.6±7.2),(49.7± 6.8)]Hz (P<0.01), but the R2* values of multifidus after loading was (43.9 ± 9.0)Hz, there was no statistical difference compared with before exercise (46.8 ± 6.6)Hz (P>0.05);there was a significant difference in the changes of R2*value before and after the movement between the left and right side of iliocostalis(P<0.05).A significant negative correlation between CSA and R2*value was found in the iliocostalis on the right side at the upper margin of L3 vertebral body and in the multifidus on the left side at the upper margin of L4 vertebral body,and the correlation coefficients were (-0.697,-0.616).Conclusion BOLD-fMRI can be a new way to assess the functional changes of the lumbar dorsal extensor group before and after exercise.

Objective To explore the value of T2-mapping imaging in assessment of lumbar dorsal extensors group (multifidus,longissimus and iliocostalis) function before and after exercises in healthy volunteers.Methods Totally 50 healthy young volunteers underwent T2-mapping imaging before and after exercises.T2 value and cross-section area (CSA) of multifidus,longissimus and iliocostalis were measured at the level of L3 and 14 superior border.Differences of CSA and T2 value were compared between left and right side muscles before and after exercises.The correlation between CSA difference and T2 difference before and after exercises was analyzed.Results At the level of L3 and L4 superior border,CSA and T2 value of bilateral multifidus,longissimus and iliocostalis increased after exercises (all P＜0.05).At the level of L3 superior border,CSA after exercises and CSA difference of left multifidus were higher than those of right side (all P＜0.05).Before exercises,there were statistical differences of T2 values on left and right side of longissimus and iliocostalis at the level of L3 superior border and the longissimus at the level of L4 superior border (all P＜0.05).Positive correlations were found between CSA difference and T2 difference on bilateral iliocostalis at the level of L3 and L4 superior border,as well as on bilateral multifidus at the level of L4 superior border (all P ＜0.05).Conclusion T2-mapping imaging can be used to assess the activity state of lumbar dorsal extensors group before and after exercises.

Objective To investigate the surgical techniques and appropriate perioperative management for ensuring successful orthotopic liver transplantation (ROLT) in rats. Methods Based on the double-cuff technique of Kamada, we modified the surgical techniques of separation, perfusion and cold preservation of the donor liver, shearing and anastomosis of the suprahepatic vena cava with optimized postoperative infusion protocols and animal care. Results Two hundred and senventy rats underwent ROLT and a learning curve of the success rate was built to reflect the impovment of techniques. The learning curve showed steep improvemts over the exploration stage, breakthrough stage and maturation stage, and the success rates incresed sharply over time (0%, 71.1%, and 94.5%, respectively) until finnally reaching over 90%. The shearing and anastomosis of the suprahepatic vena cava remained the most critical and difficult techniques in ROLT modeling. Conclusion Proficient microsurgical techniques and meticulous nursing can reduce postoperative complications, enhance operational success rate and extend the survival time after ROLT.

Objective To investigate the surgical techniques and appropriate perioperative management for ensuring successful orthotopic liver transplantation (ROLT) in rats. Methods Based on the double-cuff technique of Kamada, we modified the surgical techniques of separation, perfusion and cold preservation of the donor liver, shearing and anastomosis of the suprahepatic vena cava with optimized postoperative infusion protocols and animal care. Results Two hundred and senventy rats underwent ROLT and a learning curve of the success rate was built to reflect the impovment of techniques. The learning curve showed steep improvemts over the exploration stage, breakthrough stage and maturation stage, and the success rates incresed sharply over time (0%, 71.1%, and 94.5%, respectively) until finnally reaching over 90%. The shearing and anastomosis of the suprahepatic vena cava remained the most critical and difficult techniques in ROLT modeling. Conclusion Proficient microsurgical techniques and meticulous nursing can reduce postoperative complications, enhance operational success rate and extend the survival time after ROLT.

Objective:To systematically evaluate the prevalence of malnutrition in elderly patients with diabetes.Methods:A total of eight databases, namely PubMed, Embase, Web of Science, The Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), and VIP Database, were systematically searched for cross-sectional studies on malnutrition in elderly diabetic patients published from the inception of the databases to September 13, 2023. Two researchers independently conducted literature screening, data extraction, and quality assessment. Data analysis was performed using Stata 16.0 software.Results:A total of 22 studies were included, involving 6 349 elderly diabetic patients. Results of the meta-analysis showed that the overall prevalence of malnutrition in elderly patients with diabetes was 32.3% (95% CI: 0.21 to 0.43), and the prevalence of at-risk of malnutrition was 49.0% (95% CI: 0.31 to 0.67). Subgroup analysis showed that the prevalence of malnutrition in elderly diabetic patients with chronic complications (56.8%) was significantly higher than those without chronic complications (21.9%). Inpatients also showed a higher prevalence compared with outpatients and community (44.4%, 29.0%, and 18.5%, respectively). The prevalence of malnutrition as per mini-nutritional assessment scale was higher than that as per mini-nutritional assessment short-form scale (35.8% vs. 23.3%, P<0.05). There was no significant difference in the prevalence of malnutrition in elderly diabetic patients of different genders ( P>0.05). Conclusions:The prevalence of malnutrition and at-risk of malnutrition in elderly diabetic patients is high. In clinical practice, we should not only strengthen the early diagnosis of malnutrition in patients, but also emphasize the screening of malnutrition risk, implement timely corresponding interventions, and promote patient education on nutrition and health, to improve the prognosis and quality of life in elderly diabetes patients.

3' Untranslated Regions ; Animals ; Biomarkers ; metabolism ; Cell Proliferation ; Cell Survival ; Embryonic Stem Cells ; cytology ; metabolism ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; Mice ; Swine ; Transcription Factors ; genetics ; metabolism

Objective:To retrospectively analyze the setup errors of thermoplastic head and shoulder molds alone or combined with vacuum pad in hypofractionated stereotactic radiotherapy (HFSRT) for non-small cell lung cancer (NSCLC) with brain metastases.Methods:Fifty-four NSCLC patients with brain metastases who received HFSRT from 2017 to 2019 were enrolled in this study. Twenty-four patients were fixed with thermoplastic head and shoulder molds (group A), and 30 patients were fixed with thermoplastic head and shoulder molds plus vacuum pad (group B). The interfraction and intrafraction setup errors were acquired from cone-beam CT online image registration before and after the HFSRT. Optical surface system was applied in monitoring the intrafraction setup errors. The setup errors in each direction between two groups were analyzed by independent samples t-test. Results:For the interfraction setup errors of the whole group, the proportion of the horizontal setup errors of ≥3mm was 7.0% to 15.4% and 7.0% to 12.6% for the rotation setup errors of ≥2°. In group A, the anteroposterior setup error was (1.035±1.180)mm, significantly less than (1.512±0.955)mm in group B ( P=0.009). In group A, the sagittal rotation setup error was 0.665°±0.582°, significantly less than 0.921°±0.682° in group B ( P=0.021). For the intrafraction setup errors of the whole group, the proportion of horizontal setup errors of ≥1mm was 0% to 0.7%, whereas no rotation setup error of ≥1° were observed. In group B, bilateral, anteroposterior and sagittal rotation setup errors were (0.047±0.212)mm, (0.023±0.152)mm and 0.091°±0.090°, significantly less compared with (0.246±0.474)mm, (0.140±0.350)mm and 0.181°±0.210° in group A ( P=0.004, P=0.020, P=0.001), respectively. Optical surface monitoring data were consistent with the obtained results. Conclusions:Thermoplastic head and shoulder molds (with or without vacuum pad) combined with online image registration and six-dimensional robotic couch correction can be applied in HFSRT for brain metastases from NSCLC. The intrafraction setup errors in group B are smaller than those in group A. Optical surface system has certain value in monitoring the intrafractional movement.