Objective To investigate the effects of isoflurane and sevoflurane at the equivalent depth of subanesthesia on neuronal proliferation and phosphorylation of extraceullar signal-regulated kinase 1/2 (ERK1/2)protein in the hippocampi of neonatal rats.Methods Seventy-two neonatal rats at postnatal day 7 were involved in this study and they were assigned randomly into isoflurane group (Iso group),sevoflurane group (Sev group) and control group (Con group).The rats in I group,S group or C group were separately exposed to 0.75％ isoflurane or 1.2％ sevoflurane (equivalent to 0.3 MAC for neonatal rats) or air for 6 h.Some rats in each group were injected intraperitoneally BrdU 100 mg/kg immediately (D0) (n =6) or 3 days after exposure (D3) (n =6),and their brains were perfusion and embedded by paraffin 24 h after BrdU injection.BrdU positive expressions in the in dentate gyrus (DG) area of hippocampus were detected by IHC staining.Besides,the fresh hippocampi of some rats each group were dissected at the end of anesthesia,caspase-3 and phospho-ERK1/2,ERK1/2 proteins expression were detected by Western blot (n =6).The other rats in each group were used to measure changes of pH and blood glucose (n =6).One way ANOVA test was used for data analysis among groups.Results BrdU-positive cells had no significant difference among group IsoD0 ((1332.43 ± 192.70)/mm2),group SevD0 ((1207.33 ±139.50)/mm2),and group ConDO ((1362.40 ± 227.90)/mm2) at D0,while which had significantly decreased by 32.6％ (P＜ 0.05) in group IsoD3 ((604.56 ± 65.77)/mm2) when compared with those in group ConD3 ((896.90 ± 78.77)/mm2) at D3.There was no significant difference between groups of SevD3 ((808.73 ± 41.27)/mm2) and ConD3.The expression of caspase-3 protein was increased by 195％ (P＜ 0.01) in Iso group while which only increased by 74％ (P ＜ 0.05) in Sev group when compared with Con group.The expression of P44 and P42 of phospho-ERK1/2 protein in the hippocami decreased by 53％ (P ＜ 0.01) and 47％ (P ＜ 0.01))seperately in Iso group when compared with Con group,while there were no significant differences between Sev group and Con group.Conclusion 0.3 MAC isoflurane,not sevoflurane inhibits neuronal proliferation in DG of hippocampi in the neonatal rats.Inhibiting ERK1/2 phosphorylation may involve in the mechanisms of that isoflurane inhibits neuronal proliferation.

In recent years,radiomics has been developed rapidly in the field of clinical medicine,and the artificial intelligence(AI)technology has been utilized to assist diagnosis.This paper introduced the background of radiomics,analyzed the basic research process of radiomics,and looked forward to its application in the identification of bone and joint injuries in the field of forensic medicine.Reviewing the three aspects is expected to provide a theoretical foundation of radiomics,which will be helpful to develop its application in forensic medicine.

OBJECTIVE: To find out the clinical characteristics of Meniere's disease in flight aircrew and discuss relevant principles of clinical aviation medicine, in order to summarize experience in medical evaluation of aircrew. METHOD: Collect the data of 35 cases that were diagnosed with Meniere's disease from 1966 to 2011 in our hospital and analyze the clinical characteristics, diagnosis and flight conclusion of them. RESULT: Among the 35 cases, 34 patients complained of vertigo. 27 patients complained of tinnitus and 21 patients complained of hearing loss. (1) 18 cases manifested typical symptoms of Meniere's disease (paroxysmal vertigo, fluctuating neurosensory hearing loss, tinnitus and ear fullness); (2) 7 patients showed the symptoms of vertigo and tinnitus, not complaining of significant hearing loss (after inspection. 4 of them proved the low-frequency hearing loss); (3) 7 patients only manifested as vertigo; (4) 2 patients manifested as tinnitus and hearing loss. 1 patients manifested only hearing loss. On the basis of the diagnostic criteria of Meniere's disease formulated hy Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery. 22 patients were diagnosed with definite Meniere's disease, 2 patients were diagnosed with probable Meniere's disease, 11 patients were diagnosed with possible Meniere's disease. For patients with definite Meniere's disease and probable Meniere's disease, the phases of the disease were: 11 cases of phase I, 7 case of phase II and 6 case of phase III. The flight conclusion of all the 35 patients was permanent grounding. The time from the attack of the disease to receiving the conclusion of permanent grounding fluctuated from three months to 11 years. CONCLUSION The diagnosis of Meniere's disease of flight aircrew must he cautious. For patients with atypical symptoms of Meniere's disease, the diagnosis should be made in the case of completely ruling out other possible diseases. Once be diagnosed, a patient should normally be flight unqualified. The flying waiver would he recommended only under exceptional circumstances. The criterion of waiver condition need to be further explored in the future.
Adult ; Aerospace Medicine ; methods ; Humans ; Male ; Meniere Disease ; diagnosis ; Middle Aged

Objective To explore the distribution and types of platelet antibodies in children with positive platelet anti-body in initial screening.Methods Blood samples of 80 pediatric patients who applied for platelet transfusion in our hospi-tal from September 2021 to May 2022 and tested positive for platelet antibodies were identified using the PAKPLUS kit for antibody identification,and the distribution of HLA and HPA antibodies were analyzed.Results Among the 80 reactive samples in initial screening,9 were negative,71 were positive.Among the 71 positive cases,1 was HLA-Ⅰantibody positive(1.41％,1/71),21 were HPA antibody positive(29.58％,21/71),and 49 were both HLA-Ⅰantibody and HPA antibody positive(69.01％,49/71).Among the70 HPA positive cases,23.95％(17/71)had a single HPA antibody,with18.31％(13/71)of anti GP Ⅱb/Ⅲa,2.82％(2/71)of anti GP Ⅰa/Ⅱa,2.82％(2/71)of anti GP Ⅳ and 0％(0/71)of anti GP Ⅰb/Ⅸ,while74.65％(53/71)presented multiple HPA antibodies.No statistically significant difference was found in antibody distribution among age,gender,transfusion history and disease types.Conclusion HLA-Ⅰ antibody combined with HPA antibody are the main types of platelet antibodies among children with positive platelet antibodies.Anti-GPⅡb/Ⅲa accounted for the largest proportion of HPA antibodies.Antibody distribution is not releted to age,gender,history of blood transfusion and disease types.

Purpose/Significance To construct a named entity corpus of traditional Chinese medicine(TCM)ancient records,and to improve the recognition accuracy and applicability of the general domain named entity recognition(NER)model in the field of TCM ancient records.Method/Process Annotation standards for entities in TCM ancient records are formulated,and 2 384 Xin'an medical records are annotated.A RoBERTa-BiLSTM-CRF model is developed,and word vectors with semantic features are generated using the RoBERTa pre-trained language model.The BiLSTM-CRF model is used to learn the global semantic features of sequences and decode and output the optimal label sequence.Dictionary and rule features are incorporated to enhance the model's capability to recognize entity boundaries and categories.Result/Conclusion The model shows a good recognition effect on the named entity corpus of Xin'an medical cases.Integration of domain terminology dictionaries and rule-based features improves the overall Fl score to 72.8％.

Objective:To explore the feasibility of using ultrasonic convex array probe compressing abdominal wall to increase success rate of external cephalic version (ECV) without anesthesia in full-term and near-term pregnancy.Methods:Totally 190 singleton and non‐cephalic presentation pregnant women in 36-39 +4 weeks of gestation performed ECV from April 2019 to August 2023 in the First Affiliated Hospital of Nanjing Medical University were analyzed. According to whether use the ultrasound probe compressing fetal breech or not, the pregnant women were divided into two groups: 81 cases in the probe-compressing group (including primipara 61 cases and multipara 20 cases) and 109 cases in the non-probe-compressing group(including primipara 72 cases and multipara 37 cases). Clinical data, ECV related factors and complications were analyzed and compared between the two groups. Results:(1) The overall success rate of ECV was 64.2% (122/190). There was no significant difference in the success rate of ECV between probe-compressing group and non-probe-compressing group [69.1% (56/81) vs 60.6% (66/109), χ2=1.490, P=0.222]. The total vaginal delivery rate after successful ECV was 81.1% (99/122), while 71.1% (54/76) in primipara and 97.8% (45/46) in multipara, respectively. (2) Compare to the non-probe-compressing group, the success rate of ECV in primipara was significantly higher in the probe-compressing group [45.8% (33/72) vs 70.5% (43/61)], but the gestational age was shorter and the height was higher in the probe-compressing group (all P<0.05). The success rate of ECV of multipara in the probe-compressing group (65.0%, 13/20) was lower than that in the non-probe-compressing group (89.2%, 33/37), but there was no significant difference between the two groups ( P>0.05). (3) Multivariate logistic regression analysis showed that abdominal wall compressed by ultrasound probe ( OR=2.601, 95% CI: 1.113-6.075; P=0.027) and amniotic fluid index (AFI; OR=1.010, 95% CI: 1.001-1.020; P=0.028) were positive factors for the successful rate of ECV in primipara pregnant women. (4) The main complication of ECV was transient fetal heart rate reduction (8.9%,17/190), the incidence in the probe-compressing group was significantly higher than that in the non-probe-compressing group [14.8% (12/81) vs 4.6% (5/109); χ2=5.967, P=0.015]. No statistical differences were found in rates of complications between the ECV successful and unsuccessful pregnant women, and between probe-compressing and non-probe-compressing groups (all P>0.05). No adverse maternal and neonatal outcomes related to ECV were observed. Conclusions:The ultrasonic convex array probe compressing could significantly improve the success rate of ECV in primipara without increasing the incidence of adverse maternal and fetal outcomes. The success rate of ECV in primipara is influenced by AFI and operation mode.

To explore the evaluation method of evidence body for acupuncture and moxibustion clinical practice guidelines (CPGs), and to provide methodological support for the development of acupuncture and moxibustion CPGs and to promote the establishment and application of acupuncture and moxibustion standard. Based on the academic characteristics of TCM acupuncture, the stratified evidence evaluation method was proposed. Firstly, evidences were collected from the ancient literature, modern literature and clinical experience, and were scientifically distinguished and evaluated. Secondly, all the evidences were integrated as body of evidence by analytic hierarchy process (AHP). Lastly, based on the general index (GI), the clinical recommendations for acupuncture were proposed. Based on the stratified evidence evaluation method, acupuncture and moxibustion CPGs were developed in a more scientific and objectiveway with the comprehensive and sufficient evidences.
Acupuncture Therapy ; Moxibustion

[Abstract] [Objective] To analyze the production of platelet antibodies in children with congenital heart disease, identify the types of antibodies, and explore their effects on platelet count, coagulation function and platelet function. [Methods] A retrospective analysis was conducted on 3 504 congenital heart disease patients without a history of blood transfusion who were treated at Beijing Children's Hospital between January 2019 and June 2024 to study the positive rate of platelet antibodies. Platelet antibody types were detected using the solid-phase agglutination method, and the platelet count and coagulation function of the children were analyzed. The impact of platelet antibodies on platelet function was evaluated using a coagulation and platelet function analyzer. [Results] The positive rate of platelet antibody in children with congenital heart disease with no history of blood transfusion was 9.7% (341/3 504), higher than the overall positive rate of 6.6% (2 657/40 311) in the general pediatric population. The platelet antibodies in congenital heart disease cases with positive platelet antibodies were mainly autoantibodies. There was no significant difference in platelet count between antibody-positive children and antibody-negative children. However, the prothrombin time (s) of antibody-positive children was significantly longer than that of antibody-negative children[(12.19±1.07) vs (11.32±0.77)]. Platelets sensitized by antibodies showed a significant reduction in function compared to non-sensitized platelets. [Conclusion] Children with congenital heart disease have a high rate of positivity for autoantibodies, which are associated with abnormalities in coagulation function and can lead to reduced platelet function.

The neuropeptide Y receptors system is a receptor-ligand system composed of neuropeptide Y and its receptors, which is represented by two subtypes, including Y1 receptor (Y1R) and Y2 receptor (Y2R). The system is widely involved in pain modulation in mammals. These receptors are G protein-coupled receptors, participating in neuronal membrane signaling. Neuropeptide Y receptors distribute in the pain-related regions of the central nervous system, play a variety of roles in maintains neuronal activity of pain transmission, relate to the specificity of distribution. At the spinal level, Y1R plays an analgesic role, whereas Y2R is usually related to pain-promoting. The system can also take part in cerebral pain modulation at different nuclei.

Helicobacter pylori (H. pylori), creating a global infection rate over 50%, presents great challenges in clinical therapies due to its complex pathological microenvironment in vivo. To improve the eradication efficacy, herein we fabricated a pharmaceutical vesicle RHL/Cl-Ch-cal where cholesterol-PEG, calcitriol and first-line antibiotic clarithromycin were co-loaded in the rhamnolipid-composed outer lipid layer. RHL/Cl-Ch-cal could quickly penetrate through gastric mucus layer to reach H. pylori infection sites, and then effectively destroyed the architecture of H. pylori biofilms, killed dispersed H. pylori and inhibited the re-adhesion of residual bacteria (called biofilms eradication tetralogy). Moreover, RHL/Cl-Ch-cal activated the host immune response to H. pylori by replenishing cholesterol to repair lipid raft on the cell membrane of host epithelial cells. Finally, RHL/Cl-Ch-cal killed the intracellular H. pylori through recovering the lysosomal acidification and assisting degradation. In experiments, RHL/Cl-Ch-cal demonstrated prominent anti-H. pylori efficacy in the classical H. pylori-infected mice model. Therefore, the study provides a "comprehensive attack" strategy for anti-H. pylori therapies including biofilms eradication tetralogy, immune activation and intracellular bacteria killing.