Objective To explore the influencing factors for usage of the official App of a hospital, based on Unified Theory of Acceptance and Use of Technology (UTAUT).Methods 616 outpatients were randomly sampled from outpatient clinics of three tertiary hospitals in Hangzhou for questionnaire survey, to learn the usage and intention for hospital′s official App.Results It was found that women (0.134), high performance expectancy (0.321), facilitating conditions (0.256), high effort expectancy (0.224), and desirable social influence (0.100) all contributed positive influence (P<0.05) to usage of such App.Conclusions It is recommended to enhance service functions of such App and simplify its usage, in addition to better promotion and online security measures.

Objective To construct a prostate cancer specific oncolytic adenovirus armed with a fusion protein gene , PSA-IZ-CD40L, and to evaluate its oncolytic efficiency and immune activation ability in vitro.Methods Prostate Specific Antigen (PSA) gene, CD40L-N and CD40L-C genes were obtained from cDNA of LNCaP cells and Jurkat cells using poly-merase chain reaction (PCR) or nested-PCR, respectively.PSA,Linker,CD40L-N and CD40L-C were linked sequentially to generate fusion protein gene PSA-IZ-CD40L (PL) by overlapping PCR.Then, prostate specific oncolytic adenovirus PL-carrying gene, Ad-PL-PPT-E1A,was constructed using the oncolytic adenovirus system , which was based on Adeasy sys-tem.PC3M cells were infected by Ad-PL-PPT-E1A at serial multiplicity of infection (MOI), and the apoptosis was detec-ted by flow cytometry at several time points post-infection.For immune activation detection , PC3M cells were infected with Ad-PL-PPT-E1A at a MOI of 50, and the cell lysate was collected at 48 h post-infection.Peripheral blood mononuclear cells derived (PBMCs) from healthy donors were stimulated by the lysate from PC 3M cells or Ad-PL-PPT-E1A infected PC3M cells before proliferation was assayed using cell counting kit-8 (CCK8).Results Fusion protein gene, PSA-IZ-CD40L, was successfully constructed and cloned into the prostate cancer specific adenovirus to generate Ad -PL-PPT-PL. The expression of E1A and PL protein could be detected by reverse transcription PCR and Western-blotting.Cytopathic effect was observed in PC3M cells infected with Ad-PL-PPT-E1A.Furthermore, the apoptosis rate reached 70.67% ± 2.98%at 48 h post-infection with 200 MOI Ad-PL-PPT-E1A.Compared with the lysate of PC3M cells, that from Ad-PL-PPT-E1A infected cells could promote the proliferation of PBMCs .Conclusion We have constructed a prostate cancer spe-cific oncolytic adenovirus armed can fusion protein gene PL , Ad-PL-PPT-E1A, which could kill PC3M cells effectively and enhance the proliferation of PBMCs in vitro.

Objective To find the correlation between real best corrected visual acuity (BCVA) and test-ing results of microperimetry and visual evoked potential (VEP) and to explore a newmethod in record-ing BCVAin macular disease. Methods Sixty-two patients with macular disease (macular disease group, 62 eyes) and eighteen healthy volunteers (control group, 36 eyes) had BCVA, microperimetry and VEP recorded. Results (1) By microperimetry, the values of retinal mean sensitivity and fixation percentage in macular disease group were lower than that in control group. The bicurve ellipse area in macular dis-ease group was higher than that in control group. By V EP, P100 amplitude under 0.5 cpd and 2 cpd in macular disease group were significantly higher than that in control group and the latency was prolonged (P<0.05). (2) In macular disease group, BCVAhad significant positive correlation with retinal mean sen-sitivity, bicurve ellipse area, macular central 2°and 4°fixation percentage, respectively (P<0.05). There was a significant correlation between retinal mean sensitivity and P100 amplitude (P<0.05). (3) multiple linear regression equation was y=0.053 x1+0.008 x3+3.897 (y was BCVA, while x1 was retinal mean sensi-tivity and x3 was P100 amplitude under 2 cpd). Conclusion C ombined use of microperimetry and VEP is useful in the assessment of BCVAin macular disease.

Objective:To investigate the application valve of bFGF to improve the viability of subdermal vascular network flap.Methods:Four white healthy pigs were used,each pig had 6 SVNF on back,16cm?4cm,totally 24 flaps were divided randomly into 2 groups:The bFGF groups and the control groups.On postoperative day 6,we observed the appearance of the flaps.The survival area of each flap was measured and the flap was harvested for histological analysis and the density of angiogenesis was also examined.Results:On postoperative day 6,the survival rates of the bFGF group and the control group were (81.2?1.7)% and (66.2?1.8)% respectively,the angiogenesis density of the middle and the distal segment in the bFGF group was (16.7?6.0)/mm2,(29.7?5.5)/mm2,(14.9?6.0)/mm2 respectively,while (16.6?4.0)/mm2,(21.4?5.2)/mm2,(3.5?5.1)/mm2 respectively in the control group.The bFGF group was superior to the control group in the appearance and histological analysis of the flaps.Conclusion:The results suggest that the injection of bFGF locally can promote the survival rate by accelerating the blood circulation of the SVNF’ bottom and edge,shorten the division time of SVNF and broaden the ratio of length and width.

Objective:To investigate the synchronized feature patterns of local field potentials in the hippocampus (HPC) and prefrontal cortex (PFC) during working memory based on time-varying spectral coherence so as to support the study of information processing mechanisms in working memory.Methods:The local field potentials (LFPs) signals of the ventral hippocampus (vHPC) and medial prefrontal cortex (mPFC) were collected from six SD rats during the performance of a spatial working memory task in the Y-maze, and the time-frequency distributions of vHPC and mPFC LFPs were calculated by applying the short-time Fourier transform (STFT) to determine the characteristic frequency bands of the working memory and then to investigate the synchronized patterns of vHPC and mPFC LFPs based on the coherent of the time-varying frequency spectrum. Finally, support vector machines were applied to explore the feasibility of applying spectral coherence values to predict working memory.Results:When rats performed working memory tasks correctly, the energy of the theta band (4 - 12 Hz) of the HPC and PFC increased (all P < 0.01), and the spectral coherence value of the theta band of the HPC-PFC increased ( P < 0.05). Support vector machine training and prediction using the average peak spectral coherence and the difference between the peak and the onset when correctly and incorrectly executing the working memory as features resulted in 89% accuracy, 90% precision, 88% recall, and 88% F1 scores, all of which were statistically significant differences compared to the results of the randomly disrupted labeled data rearranging (all P < 0.05). Conclusions:Synchronized synergy in the HPC-PFC theta band is one of the potential mechanisms for correctly performing information processing in working memory.

Objective:To evaluate the effect of closed-loop therapy system in adult non-mechanical ventilation patients in order to provide evidence-based basis for promoting the safety of oxygen therapy.Methods:Randomized controlled trials of closed-oxygen therapy system on the percentage within SpO 2 target, the incidence of hypoxaemia or hyperoxia, oxygen consumption, the mean oxygen therapy days, as well as the length of hospital stay in adult non-mechanical ventilation patients were searched in PubMed, Web of Science, Embase, Cochrane, CNKI, Wanfang, VIP from inception to June 30, 2022. Data extraction, and literature quality evaluation were performed by two researchers independently, RevMan 5.3 was used for meta-analysis. Results:A total of 5 articles including 502 patients were included. The results showed that the closed oxygen therapy system could significantly improve the percentage of time within SpO 2 target of patients ( SMD=1.56, 95% CI 1.22-1.90, Z=9.04, P<0.001) and reduce the percentage of time with hypoxaemia ( SMD=-0.35, 95% CI-0.50--0.19, Z=4.37, P<0.001) or hyperoxia ( SMD=-0.91, 95% CI-1.07--0.75, Z=11.04, P<0.001) of patients. Moreover, the mean oxygen flow rate of closed oxygen therapy ( SMD=-0.64, 95% CI-1.25--0.03, Z=2.07, P<0.05), the mean oxygen therapy days ( SMD=-0.55, 95%, CI-1.06--0.03, Z=2.08, P<0.05), as well as the length of hospital stay ( SMD=-1.68, 95% CI-2.22--1.14, Z=6.11, P<0.001) were lower than those of patients with manual adjustment systems. Conclusion:The closed oxygen therapy system can promote the safety of oxygen use, but it needs clinical application to further explore.

Objective:To evaluate the short-term outcomes of aortic root repair using a pericardial autograft for acute type A aortic dissection.Methods:Between January 2020 and August 2021, 12 patients underwent aortic root repair using a pericardial autograft for type A aortic dissection. There were 8 males and 4 females, aged from 32.0 to 71.0 years, with a mean of (49.1±13.0) years, weight from 40.0 to 100.0 with a mean of (78.6±20.5) kg. Short-term outcomes were assessed by cardiopulmonary bypass time, cross-clamp time, circulatory arrest time, mechanical ventilation time, ICU time, postoperative stay time. The diameter of Valsalva sinus and aortic regurgitation were assessed before, after operation and during follow-up.Results:There were no postoperative and follow-up death. Cardiopulmonary bypass time was(256.4±60.6)min, ranging from 182.0 to 243.0 minutes; cross-clamp time was(195.0±52.5)minutes, ranging from 127.0 to 284.0 minutes; circulatory arrest time was(19.9±3.6)min, ranging from 15.0 to 25.0 min; mechanical ventilation time was (69.1±72.1)hours, ranging from 6.4 to 250.3 h; ICU time was (143.6±81.7) h, ranging from 56.9 to 288.0 h; postoperative stay time was (12.8±4.1) days, ranging from 8.0 to 20.0 days. One patient had transient paralysis (8.3%), and one patient needed hemofiltration due to acute kidney failure (8.3%), they all completely recovered before discharge. Follow-up time ranged from 10.0 to 21.0 months, with a median of 13 months. Heart function (NYHA) was I to II degrees. The mean diameter of aortic root was (36.7±5.8)mm(27.0-45.0 mm) preoperatively, (35.8±5.1)mm (25.0-44.8 mm) before discharge, and (35.7±5.9)mm (25.1-44.8 mm) during follow-up, respectively. There was no significant difference between them ( P>0.05). The preoperative aortic regurgitation was as follow: severe aortic regurgitation 2, moderate 1, mild to moderate 3, mild 1, trivial 1, none 4; postoperative aortic regurgitation: mild 2, trivial 2, none 8; follow-up aortic regurgitation: mild 3, trivial 1, none 8. Conclusion:Aortic root repair with a pericardial autograft is a safe and effective technique to treat acute type A dissection involving the sinus. Using this technique, residual dissection tissues could be significantly reduced, which subsequently decreases the risk of proximal bleeding, maintains the function of sinus, and increases long-term durability. Short-term results are satisfactory, and the long-term results need further follow-up.

Objective:To compare the clinical characteristics and analyze the prognostic factors between human immunodeficiency virus (HIV)-infected patients and non-HIV-infected immunocompromised patients with pneumocystis pneumonia (PCP) complicated with acute respiratory failure (ARF) in intensive care unit (ICU).Methods:The clinical data of patients with PCP complicated with ARF admitted in ICU of The First Affiliated Hospital of Zhengzhou University and The Sixth People′s Hospital of Zhengzhou City between May 2018 and October 2020 were retrospectively reviewed. All subjects were divided into HIV-infected group and non-HIV-infected immunocompromised group. General characteristics and underlying diseases of patients in the two groups were analyzed. Laboratory parameters, treatment and outcomes between two groups were compared. Independent sample t test, Mann-Whitney U test and chi-square test were used for statistical analysis, and univariate and multivariate logistic regression models were used to identify the risk factors for the clinical outcome. Results:A total of 129 PCP complicated with ARF patients were enrolled, including 75 HIV-infected patients and 54 non-HIV-infected immunocompromised patients. Only 10.7%(8/75) patients of HIV-infected group received anti-retroviral therapy (ART), but none of the patients in either groups had previously received trimethoprim-sulfamethoxazole (TMP-SMX) for PCP prophylaxis. Acute physiology and chronic health evaluation (APACHE) Ⅱ score of HIV-infected group was 18.7±6.0, which was higher than that in non-HIV-infected immunocompromised group (13.1±4.4) when admitted in ICU ( t=-5.45, P<0.001). Hypoproteinemia was common in both groups. Ninety-six percent (72/75) of HIV-infected patients had CD4 + T lymphocyte counts lower than 200/μL and 84.0%(63/75) of patients had CD4 + T lymphocyte counts even lower than 50/μL, while 5.74%(31/54) of patients in non-HIV-infected immunocompromised group had CD4 + T lymphocyte counts lower than 200/μL. The CD4 + /CD8 + T lymphocyte counts ratio was 0.05(0.02, 0.12) in HIV-infected group, which was lower than that in non-HIV-infected immunocompromised group (0.96(0.64, 1.44)), and the difference was statistically significant ( Z=-9.16, P<0.001). The length of ICU stay and hospital stay of non-HIV-infected immunocompromised patients were 10.0(7.0, 14.0) days and 18.0(11.8, 32.5) days, respectively, which were both longer than those in HIV-infected patients (7.0(4.0, 9.0) days and 13.0(7.0, 23.0) days, respectively), and the differences were both statistically significant ( Z=-3.58 and -2.73, respectively, both P<0.050). The hospital mortality of HIV-infected patients was 57.3%(43/75), which was significantly higher than that in non-HIV-infected immunocompromised patients (38.9%, 21/54) ( χ2=4.27, P=0.039). Multivariable logistic regression identified that lactic dehydrogenase (LDH), C-reactive protein (CRP) and APACHE Ⅱ score were the risk factors for the clinical outcome of HIV-infected patients (odds ratio ( OR)= 1.006, 1.015 and 1.736, respectively, all P<0.050). The partial pressure of oxygen in arterial blood/fractional concentration of inspiratory oxygen (PaO 2/FiO 2), LDH and CD4 + T lymphocyte counts were the risk factors for the clinical outcome of non-HIV infected immunocompromised patients ( OR=0.970, 1.008 and 0.989, respectively, all P<0.050). Conclusions:PCP patients with ARF are critically ill with high mortality rate. LDH, CRP and APACHEⅡscore are predictors for prognosis of HIV-infected patients with PCP, while PaO 2/FiO 2, LDH and CD4 + T lymphocyte counts are predictors for prognosis of non-HIV infected immunocompromised patients with PCP.

Objective To investigate the possible mechanism of circ RNA in the pathogenesis of epilepsy.Methods In this study,circRNA expression profiles in peripheral venous blood of epileptic patients and healthy controls were studied by using circRNA gene chip technology,and differentially expressed circrnas were screened.Bioinfor-matics databases such as circPrimer,circMir and TargetScan were used to analyze its possible role in epilepsy and adenovirus vector was constructed.Thirty male adult C57BL/6 mice were randomly divided into control group,empty vector group and circ_0017178 overexpressed group(10 mice/group).Normal saline,empty plasmid ade-novirus vector and circ_0017178 overexpressed adenovirus vector were injected into the hippocampus of the three groups respectively.The change of animal behavior of mice in each group was observed after the establishment of pentetrazole epilepsy model,and the apoptosis of hippocampal tissue cells of mice in each group was analyzed by Tunel staining.Results The results of gene microarray showed that circ_0069272,circ_0033065,circ_0017178,circ_0073442,circ_0033063 and circ_0049415 in epilepsy group were up-regulated significantly compared with the control group.And circ_0083773,circ_0088262,circ_0016396 decreased significantly.Circ_0017178 might be the most associated with epilepsy.Through bioanalysis,circ_0017178 might regulate 39 epilepsy genes by combi-ning 20 miRNA and possess potential m6A,IRES and ORF1 binding sites.In the experiment of pentatetrazole epi-leptic mice,compared with the empty carrier group and the control group,the latency period of epilepsy in the circ_0017178 overexpression group was shortened(P＜0.05),the seizure time was prolonged(P＜0.05),and the seizure frequency increased(P＜0.05).There was no statistical significance between the empty carrier group and the control group(P＞0.05).In animal experiments,compared with the empty vector group and the control group,the apoptosis degree of hippocampal tissue of epileptic mice in the circ_0017178 overexpression group sig-nificantly increased(P＜0.05),but there was no statistical significance between the empty vector group and the control group(P＞0.05).Conclusion Circ_0017178 significantly increases in the expression profile of peripher-al blood mononuclear cells in patients with epilepsy,which may act as a"molecular sponge"of miRNA in epilepsy and has the potential of m6A methylation and protein translation.Circ_0017178 may increase the susceptibility and severity of epilepsy by promoting apoptosis in penetetrazole epileptic mice.

Objective:To evaluate the short-term outcomes of cuff wrapping technique using remnant aortic wall in modified Bentall procedure.Methods:Between January 2018 and December 2018, 23 patients underwent modified Bentall procedure with the remnant aortic wall as a cuff to cover the sewing area of composite valved graft and the aortic annulus for proximal hemostasis. After the sewing ring of the composite valved graft was sutured to the aortic annulus by continuous suture, the remnant aortic wall was sutured to the graft just distal to the sewing ring by continuous suture. There were 21 males and 2 females, aged from 22 to 72 with a mean of(50.96±13.23)years. Short-term outcomes were assessed by cardiopulmonary bypass time, clamp aorta time, mechanical ventilation time, ICU time, postoperative stay time, effusion drainage till the first postoperative day, Left ventricular end diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF), and follow-up results.Results:There were no postoperative and follow-up death. Cardiopulmonary bypass time was(157.74±39.85)min, ranged from 114 to 275 min; clamp aorta time(122.61±30.25)min, ranged from 84 to 212 min; mechanical ventilation time(11.65±3.08)h, ranged from 7.87 to 20.33 h; ICU time(81.43±45.88) h, ranged from 15.18 to 184.77 h; postoperative stay time(8.73±2.80)days, ranged from 6 to 15 days. Effusion drainage was(336.82±117.65)ml, ranged from 200 to 670 ml till the first postoperative day. Follow-up was performed from 19 to 30 months, with a mean of(23.17±3.17)months. There were significant differences between preoperative LVEDD and postoperative LVEDD before discharge[(49.78±6.21)mm vs.(58.78±10.54)mm, P<0.05]; There were a little decrease of follow-up LVEDD compared with postoperative LVEDD, but no significant difference between them[(48.87±4.63)mm vs.(49.78±6.21)mm, P>0.05] . There were a little decrease of postoperative LVEF compared with preoperative LVEF, but no significant difference between them(0.57±0.07 vs. 0.59±0.05, P>0.05). There were significant differences between follow-up LVEF and preoperative LVEF(0.62±0.04 vs. 0.57±0.07, P<0.05), postoperative LVEF before discharge( P<0.05). Conclusion:Cuff wrapping technique using remnant aortic wall in modified Bentall procedure has got good short-term results. This modification may be a simple, effective way in controlling proximal bleeding.