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.

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.

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 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 explore the feasibility of quantitative evaluation of extracellular volume (ECV) fraction in acute ST-segment elevation myocardial infarction (STEMI) by dual-layer spectral detector CT.Methods:The clinical and imaging data of 20 patients with STEMI who underwent cardiac contrast-enhanced CT and MRI from January to October 2019 in Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine were retrospectively analyzed.The dual spectral detector was used in the enhanced CT scan of the coronary artery with retrospectively gate and the late iodine enhancement with prospective gate. Conventional image and holographic spectral image were obtained by iterative and spectral reconstruction. The short axis image of the heart matched with MR image was obtained by multiplanar reconstruction. Based on the data of spectral based image, the IDD map was reconstructed for the calculation of myocardial CT-ECV during the late iodine enhancement. ECV of infarcted myocardium, salvageable myocardium and remote myocardium based on CT and MRI were calculated respectively. Bland-Altman consistency test and intra group correlation coefficient analysis (ICC) were used to compare the consistency of two measurements and different methods. The correlation between CT-ECV and MRI-ECV was compared by Spearman method.Results:The CT-ECV values of infarcted, salvageable, and remote myocardium were 51.21 (49.27, 53)%, 38.64 (36.17, 40)%, and 51.21 (49.27, 53)%, respectively. The difference was statistically significant ( H= 43.17, P<0.01). The CT-ECV value of infarcted myocardium was significantly higher than that of salvageable myocardium and remote myocardium ( Z=-24.60, 35.40, P<0.01), but there was no significant difference between salvageable myocardium and remote myocardium ( Z= 10.80, P=0.15). The T 1 values of infarcted myocardium, salvageable myocardium and remote myocardium were (1 554.85±70.94), (1 443.85±67.28) and (1 307.05±91.73) ms respectively, the difference was statistically significant ( F=51.35, P<0.01). The T 1 value of infarcted myocardium was higher than that of salvageable myocardium and remote myocardium ( t=-5.07, 9.55, P<0.01), and salvageable myocardium was significantly higher than that of remote myocardium ( t=5.38, P<0.01). The MRI-ECV values of infarcted myocardium, salvageable myocardium and remote myocardium were 55.00 (49.27, 57.75)%, 33.50 (29.00, 35.00)%,and 27.00 (26.00, 29.00)%, respectively. The difference was statistically significant ( Z= 47.12, P<0.01). MRI-ECV of infarcted myocardium was significantly higher than that of salvageable myocardium and remote myocardium ( Z=37.45, -20.30, P< 0.01), and salvageable myocardium was significantly higher than that of remote myocardium ( Z = 17.15, P<0.05). The difference between CT-ECV and MRI-ECV measured by two physicians was good. The bias of Bland-Altman analysis was -0.1% (95% CI:-5.5%-5.2%), 0.8% (95% CI:-9.8%-8.2%), and the ICC values were 0.92 and 0.94, respectively. The bias of Bland-Altman analysis in CT-ECV and MRI-ECV consistency test was 4.00% (95% CI:-9.0%-16.9%) and ICC value was 0.88, which had a good correlation ( r=0.75, P=0.001). Conclusions:The iodine density based ECV fromdual-layer spectral detector CT can be used to quantitatively evaluate the changes of extracellular space after acute STEMI, which is helpful to quantitatively evaluate the histological changes after myocardial ischemia.