Objective To explore the clinical characteristics of monochorionic or dichorionic twin pregnancy and the high-risk factors for selective intrauterine growth restriction.Methods 460 women with twin pregnancy were divided into a monochorionic group and a dichorion group.The related clinical features were compared between the two groups.Logistic regression was used to analyze the high-risk factors for selective intrauterine growth restriction.Results The maternal age,conception way,and mode of delivery differed significantly between the two groups (P ＜ 0.05).There were significant differences in the rates of selective intrauterine growth restriction and preterm premature rupture of membranes (P ＜ 0.05).The neonatal weight (large or small) and the rate of neonatal transfer differed significantly (P ＜ 0.05).Logistic regression showed that gestational age and birth weight were the risk factors.Conclusions The chorionic nature plays an important role in the process and outcomes of maternal pregnancy.Monochorionic pregnancy is a high risk factor for selective intrauterine growth restriction,meaning the major cause of selective intrauterine growth restriction may originate from the placenta,with should be a placenta-derived disease.

Objective To investigate the prevalence of dyslipidemia in migrants in Inner Mongolia Autonomous Region.Methods A stratified multi-stage cluster equal size sampling was performed among the migrants aged ≥ 18 years who were engaged in manufacturing,wholesale retail,accommodation and catering service,social service,construction and other and 1501 migrants from five area in Inner Mongolia Autonomous Region was investigated by means of questionnaires survey,physical measurements and laboratory detection.Results Complete data was obtained in 1 496 study subjects.The prevalence of dyslipidemia was 42.65％ (638/1496),the age-standardized prevalence was 42.05％;the prevalence of hypercholesterolemia,hypertriglyceridemia,combined hyperlipidemia and low high-density lipoprotein hyperlipidemia were 4.90％ (73/1491),14.76％ (220/1491),4.83％(72/1 496),25.27％ (378/1 496),respectively.Dyslipidemia characterized by high triglyceride (HTG)and low high-density lipoprotein cholesterol (LHDL-C) accounted for 81.97％ (523/638).The prevalence of dyslipidemia and HTG/LHDL-C dyslipidemia were similar,which increased significantly with age in both females and males,but was significantly higher in males.The prevalence among migrants with other occupations was highest.The prevalence of HTG/LHDL-C dyslipidemia didn't significantly increase with the duration of migration.However,the prevalence of high TG and dyslipidemia increased significantly with the duration of migration,the prevalence of high TG in age group ＜45 years showed the same characteristics.Conclusions The prevalence of dyslipidemia in migrants in Inner Mongolia was high,and the main form was HTG/LHDL-C dyslipidemia.The prevalence in males,the middle aged and aged as well as those with other occupations were high.Migrants with longer duration of migration had higher prevalence of dyslipidemia.

De novo variants (DNVs) are one of the most significant contributors to severe earlyonset genetic disorders such as autism spectrum disorder, intellectual disability, and other developmental and neuropsychiatric (DNP) disorders. Presently, a plethora of DNVs have been identified using next-generation sequencing, and many efforts have been made to understand their impact at the gene level. However, there has been little exploration of the effects at the isoform level. The brain contains a high level of alternative splicing and regulation, and exhibits a more divergent splicing program than other tissues. Therefore, it is crucial to explore variants at the transcriptional regulation level to better interpret the mechanisms underlying DNP disorders. To facilitate a better usage and improve the isoform-level interpretation of variants, we developed NeuroPsychiatric Mutation Knowledge Base (PsyMuKB). It contains a comprehensive, carefully curated list of DNVs with transcriptional and translational annotations to enable identification of isoformspecific mutations. PsyMuKB allows a flexible search of genes or variants and provides both table-based descriptions and associated visualizations, such as expression, transcript genomic structures, protein interactions, and the mutation sites mapped on the protein structures. It also provides an easy-to-use web interface, allowing users to rapidly visualize the locations and characteristics of mutations and the expression patterns of the impacted genes and isoforms. PsyMuKB thus constitutes a valuable resource for identifying tissue-specific DNVs for further functional studies of related disorders. PsyMuKB is freely accessible at http://psymukb.net.

Objective To investigate changes of muscle activation in the lower limbs during landing impact as running fatigue pro-gresses. Methods From November to December,2022,eleven male runners were recruited from Wuhan Sports University.They performed a steady-state run at 75%of their maximum heart rate and continued until Borg rating score≥17 or 90%of their maximum heart rate.Muscle activity data were collected using a Delsys wireless surface electromy-ography system,continuously recording the EMG of the quadriceps(vastus medialis,rectus femoris,vastus later-alis),hamstrings(biceps femoris,semitendinosus),gluteus maximus,lateral head of the gastrocnemius and tibia-lis anterior.The pre-activation,post-activation and co-activation characteristics of these lower limb muscles were analyzed. Results With fatigue accumulation during running,significant differences were observed in the pre-activation level of the tibialis anterior among different fatigue points(F=2.955,P=0.048),with the 100%fatigue point showing significantly higher pre-activation levels than the start(P=0.010);as well as post-activation levels of quadriceps(F=6.609,P=0.001),with higher levels at the 100%point compared to the start(P=0.011),33%(P=0.009)and 67%(P=0.043)fatigue points;co-activation ratios of ankle joint during the pre-activation phase(F=3.287,P=0.034),with a significantly higher co-activation ratio at the 100%fatigue point compared to the start(P=0.023). Conclusion As running fatigue accumulates,the central nervous system adjusts the activation levels of various lower limb muscles to modify impact posture,reducing the risk of injury from accumulated lower limb loads.

As numerous connections between oncogenic signalling pathways and metabolic activities emerge, the importance of metabolic reprogramming in cancer is being increasingly recognized. During tumorigenesis, breast cancer cells undergo metabolic reprogramming, which generally includes enhanced glycolysis, tricarboxylic acid cycle activity, glutaminolysis and fatty acid biosynthesis. The extension and functional importance of these metabolic alterations may diverge according to breast cancer subtypes.Besides, aberrant metabolism of breast cancer cells remodels tumor microenvironment, promoting cancer vascularization and inhibiting anti-tumor immunity, and thus accelerates tumor progression.This review addresses current knowledge on the metabolic reprogramming and breast cancer microenvironment, which provides some reference for the development of metabolic target drugs for each breast cancer subtype.

Objective To analyze the hemodynamic changes of cerebral arteries in patients with chronic extracranial internal carotid artery occlusion (EICAO).Methods Ninety-six patients with chronic unilateral EICAO who were admitted to Kailuan General Hospital from September 2012 to December 2015 were selected as the case group (EICAO group),and 30 volunteers were selected as the control group.Color transcranial Doppler ultrasonography was used to detect the anterior communicating artery (ACOA) of the grade Ⅰ collateral circulation,the posterior communicating artery (PCOA),the ocular artery of the grade Ⅱ collateral circulation,and the pial collateral branch.Circulation rate and cerebral hemodynamic parameters:(Mean blood flow velocity (Vm) and pulsatility index).Results In the left and right EICAO groups,the opening rates of collateral circulation at grade Ⅰ were 86.96％ (40/46),96.00％ (48/50) and 78.26％ (36/46) and 88.00％ (44/50) respectively.There were significant differences in the opening rates of collateral circulation at grade Ⅰ between the two groups (x2 =4.114,P =0.043).There was no significant difference in the opening rates of collateral circulation at grade Ⅱ between the two groups (x2 =3.544,P =0.060).The left and right sides of EICAO group were compared with the same side of control group.The Vm of the common carotid artery (left side of the EICAO group (24.08 ± 9.25) cm/s),left side of the control group (32.52±3.28) cm/s,P＜0.01);right side of the EICAO group (22.20±5.51) cm/s),right side of the control group(31.58±3.35) cm/s,P＜0.01)) and the end-carotid artery end stage (TICA) The pulsation index (left side of left EICAO group (0.78 ±0.17),left side of control group (0.92±0.08),P ＜0.01);right side of right EICAO group (0.75 ± 0.19),right side of control group (0.91 ± 0.10),P ＜0.01),Vm of middle cerebral artery (MCA) (left side of left EICAO group(40.29 ±20.61) cm/s,left side of control group(55.72 ±5.60) cm/s,right side of EICAO;The right side of group (37.10±19.70) cm/s),the right side of control group (53.70±6.28) cm/s,P＜0.01),the pulsation index of MCA (left side of left EICAO group(0.74±0.19),left side of control group(0.87±0.10),P＜0.01;right side of right EICAO group (0.69±0.23),right side of control group:(0.90 ± 0.08),P ＜ 0.01).There were significant differences.NIHSS score of neurological impairment:normal 17.39％ (8/46),mild 39.13％ (18/46),moderate 30.44％ (14/46),moderate severe 13.04％ (6/46) in left EICAO group,and normal 18.00％ (9/50),mild 54.00％ (27/50),moderate 24.00％ (12/50),moderate severe 4.00％ (2/50) in right EICAO group.There was no significant difference between the two groups (P =0.178).Conclusion The ipsilateral common carotid artery and its distal middle cerebral artery in patients with chronic unilateral internal carotid artery occlusionshow hypoperfusion of hemodynamics,accompanied by neurological impairment.

Objective:To explore the impact of home enteral nutrition (HEN) on the treatment strategy of patients with high position intestinal fistula.Methods:The clinical and follow-up data of 36 patients with high position intestinal fistula requiring HEN treated in Beijing Tsinghua Changgung Hospital from Jan 2021 to Sep 2023 was retrospectively analyzed.Results:Among the 36 cases, 2 had indwelling nasogastric tubes, 12 had indwelling nasojejunal nutritional tubes, and 22 had percutaneous jejunostomy. The incidence of HEN-related complications in patients was 13.9%, and there were no serious catheter complications.During HEN, high position intestinal fistula healed in 19 cases (52.8%), returned to the hospital for the next stage of intestinal fistula treatment in 11 cases (30.6%), needed to return to the hospital for nutritional support in 1 case (2.8%), and intestinal fistula aggravated to terminate HEN in 2 cases (5.6%).Conclusion:Under the management of professional team, HEN via nasogastric/jejunal nutritional tube or percutaneous jejunostomy is safe and feasible in patients with high intestinal fistula.

Objective:To observe the changes of somatosensory evoked potential (SEP) in the upper limbs of patients with acute middle cerebral artery (MCA) cerebral infarction, and to explore its relationship with neurological impairment.Methods:From January 2015 to December 2016, 62 patients with 38 cases of male and 24 women of cerebral infarction who were treated in the department of neurology, Kailuan General Hospital were selected for a retrospectively prospective cohort study, including 38 males and 24 females.aged (66.7 ± 10.9) years old and ranging from 33.0 to 85.0 years old.According to the side of cerebral infarction, 37 cases were divided into left MCA group and 25 cases into right MCA group.During the 48 hours of admission, the electromyography evoked potential meter was used to detect the upper limb SEP, and the peak latency, amplitude and electrical activity waveform of the cerebral cortex potentials N20, P25 and N35 were recorded.Results:The results of SEP in the contralateral limbs of the left and right MCA cerebral infarction group were as follows: 1 case (2.70%) and 5 cases (20.00%) of normal median nerve; 36 cases (97.30%) and 20 cases (80.00%) of abnormality.The ratio of median nerve abnormalities in the group was statistically significant (χ 2=12.577, P<0.001). The ulnar nerve was normal in 3 cases (8.11%), 4 cases (16.00%); 34 cases (91.89%) and 21 cases (84.00%) were abnormal.There was no statistically significant difference between the two groups (χ 2=2.320, P=0.128). The peak latency and/or amplitude of each peak decreased in 34 groups (60.71%) and 33 cases (60.00%) of the ulnar nerve; the waveform of electrical activity disappeared, 22 cases (39.29%) of median nerve and 22 cases of ulnar nerve (40.00%). The peak latency and/or amplitude decreased, the electrical activity waveform disappeared, and the median nerve and ulnar nerve were compared, and the difference was not statistically significant (χ 2=0.021, P=0.885). The National Institue of Health Storke Scale(NIHSS) scores of left and right MCA cerebral infarction group were 34 (91.89%) and 19 (76.00%) respectively.Among them, the disappearance of electrical activity waveform were 18 cases (52.94%) and 4 cases (21.05%)of median nerve; 18 cases (52.94%) and 4 cases (21.05%) of ulnar nerve.The SEP electrical activity waveform disappeared in patients with moderate or higher neurological impairment, and the median nerve and ulnar nerve were statistically significant (χ 2=20.613, 20.613, all P<0.001). Conclusion:The median nerve and ulnar nerve SEP of the contralateral upper limb, which is dominated by the acute middle cerebral artery cerebral infarction, were abnormally changed.The main manifestations were that the latency of each peak of N20, P25 and N35 was prolonged and/or the amplitude was significantly decreased, and the waveform of SEP electrical activity disappeared.In addition, the disappearance of SEP wave activities only occurred in moderate and above neurological damage

ObjectiveTo clarify the anti-inflammatory and lung-protective effects of Yantiao prescription on lipopolysaccharide （LPS）-induced acute lung injury （ALI）， and to explore the impact of Yantiao prescription on the metabolic pathways of arachidonic acid （AA） in vivo. MethodsThirty male C57BL/6J mice were randomly divided into the following groups based on body weight： normal group， model group， dexamethasone group （2 mg·kg^-1）， low-dose Yantiao prescription group （18 g·kg^-1）， and high-dose Yantiao prescription group （36 g·kg^-1）， with 6 mice in each group. The ALI mouse model was established by intraperitoneal injection of LPS. The treatment groups received oral gavage once a day for 7 consecutive days， and serum and lung tissue were collected at the end of the experiment. The content of pro-inflammatory cytokines tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） in serum was detected by enzyme-linked immunosorbent assay （ELISA）. Hematoxylin-eosin （HE） staining was used to assess lung tissue pathology. The wet/dry weight ratio （W/D） and myeloperoxidase （MPO） activity in lung tissue were measured. The content of AA metabolites in serum and lung tissue was measured by liquid chromatography triple quadrupole-mass spectrometry （LC-MS/MS）. ResultsCompared with the conditions in the normal group， the content of serum pro-inflammatory cytokines TNF-α， IL-1β， and IL-6 in the model group was significantly increased （P<0.01）. The alveolar structure in mice was severely damaged， with markedly thickened alveolar walls and extensive inflammatory cell infiltration. The W/D ratio and MPO activity in lung tissue were significantly increased （P<0.01）. The content of AA metabolites， including prostaglandin D₂ （PGD₂）， prostaglandin E₂ （PGE₂）， 11（S）-hydroxy-eicosatetraenoic acid ［11（S）-HETE］， and 5-hydroxy-eicosatetraenoic acid （5-HETE） in serum and lung tissue was significantly increased （P<0.05）， while the content of 11，12-epoxyeicosatrienoic acid （11，12-EET） and 14，15-epoxyeicosatrienoic acid （14，15-EET） in serum was significantly decreased （P<0.01）. Compared with the results in the model group， the content of serum pro-inflammatory cytokines TNF-α， IL-1β， and IL-6 in the dexamethasone group， low-dose Yantiao prescription group， and high-dose Yantiao prescription group was significantly reduced （P<0.05）. Mild thickening of alveolar walls， scattered inflammatory cell infiltration， and relatively intact tissue structure with improved alveolar architecture were observed. The W/D ratio and MPO activity in lung tissue were significantly reduced （P<0.01）. The content of AA metabolites PGD₂， PGE₂， 11（S）-HETE， and 5-HETE in serum from the dexamethasone group was significantly decreased （P<0.05）， while the content of 14，15-EET in serum significantly increased （P<0.01）， and the content of 5-HETE in lung tissue significantly decreased （P<0.01）. In the low-dose and high-dose Yantiao prescription groups， the content of AA metabolites PGD₂， PGE₂， 11（S）-HETE， and 5-HETE in serum and lung tissue was significantly decreased （P<0.05）， while the content of 11，12-EET in both serum and lung tissue was significantly increased （P<0.05）. ConclusionYantiao prescription has significant protective effects against LPS-induced ALI， which are related to its regulation of AA metabolic pathways in vivo.

【Objective】 To summarize a rapid and effective method to eliminate autoantibodies interference with blood group identification and evaluate its treatment effect. 【Methods】 Blood samples with suspicious results in initial blood group identification were collected, and those caused by autoantibodies were chosen, and their red blood cells were washed, dispersed or treated with sulfhydryl reagent. After allogeneic or autologous absorption of plasma, blood groups of those patients were re-detected to evaluate the effectiveness of the above method. 【Results】 Among 39 patients presenting suspicious ABO blood group, 9 were interfered by autoantibodies. After appropriate treatment, the ABO/RhD blood group of those patients could be identified. 【Conclusion】 Autoantibodies could interfere the identification of ABO/RhD blood group, and the efficiency and accuracy of blood group identification could be improved by analyzing the test results and selecting appropriate treatment methods.