Based on the competition reaction of target protein, aptamer probe, padlock probe and complementary sequence, a highly sensitive fluorescent aptasensor was developed in this study in combination with rolling circle amplification. In the absence of target protein, the ligation-rolling circle amplification reaction was repressed because the complementary sequence hybridized with aptamer probe to form double-stranded duplex. While in the presence of target protein, the target molecules bound specifically with aptamer probe, inducing displacement of the complementary sequence and hybridization with padlock probe. The padlock probe was circularized with the assistance of E. coli DNA ligase, and the rolling circle amplification process could be accomplished by Phi 29 DNA polymerase. The amplification product contained thousands of repeated sequences which could hybridize with the loop of molecular beacon ( the detection probes) , resulting in a significant fluorescence signal. The effects of length of complementary DNA ( CDNA ) sequence and concentration of padlock probe were investigated. Under the optimized experimental conditions, the model target protein thrombin could be highly sensitively detected by the proposed aptasensing system in a linear range of 0 . 067-32 . 4 nmol/L with a detection limit of 0 . 03 nmol/L ( approximately 90 amol target molecules). Moreover, the presented sensing method was universal for other target analysis by skillfully design of the sequence of aptamer probe and related oligonucleotides.

Objective To evaluate the efficacy difference of different embolization agents in transcatheter embolization for treating massive hemoptysis caused by systemic pulmonary circulation shunt(SPS). Methods The clinical and imaging data in 98 patients with hemoptysis complicating SPS,including bronchodilator in 72 cases,pulmonary tuberculosis in 18 cases and lung carcinoma in 8 cases. All cases were treated with bronchial arterial embolization (BAE). According to different used embolization agents, the cases were divided into the gelfoam group and polyvinyl alcohol(PVA)grains embolization group. All cases were followed up at postoperative 1 d,1,3,6 months as well as 1,2 years. The data were analyzed by using Ridit test. Results Ninety-eight cases of massive hemoptysis were confirmed by DSA,among them,84 cases were complicating pulmonary artery fistula, 18 cases were pulmonary venous fistula and 2 cases were mixed fistula; 32 cases were simple BPS, 62 cases were pulmonary circulation fistula existed in the bronchial arteries and non-bronchial artery and 4 cases were simple non-BPS. The two groups had no complications such as embolism,paraplegia,esophagus-trachea fistula and skin ischemic necrosis. The follow up on postoperative 1 d, at postoperative 1, 3,6 months and at postoperative 1,2 years indicated that among 48 cases in the gelfoam group, 20 cases were cured, 18 cases were significantly effective,6 cases were effective and 4 cases were ineffective,the effective rate was 91.7 % ;among 50 cases in the PVA grain embolization group, 38 cases were cured, 8 cases were significantly effective,4 cases were effective and O case was ineffective, the effective rate was 100%. Moreove no severe complications such as ectopic embolism, paraplegia, esophagus-trachea fistula and skin ischemic necrosis occurred. The difference between the two groups had statistical significance by Ridit analysis. Conclusion Transcatheter embolization for treating massive hemoptysis caused by SPS is safe and reliable,has small trauma, using PVA grains embolization can reduce the long term recurrence rate of hemoptysis.

Objective:To investigate the factors contributing to frailty in very elderly patients with multimorbidity.Methods:This cross-sectional study enrolled 119 very elderly patients with multimorbidity who were hospitalized in the Department of Geriatrics of Huadong Hospital Affiliated to Fudan University from August 2022 to March 2023.The study aimed to understand the basic status of multimorbidity by collecting general information, the number and types of diseases, and frailty status.The subjects were divided into frail and non-frail groups through comprehensive geriatric assessment.Various factors including gender, age, Tinetti balance gait score, risk of sarcopenia, dementia, depression, risk of deep vein thrombosis, dysphagia, comorbidity index, medication count, Basic Activities of Daily Living(BADL)score, Instrumental Activities of Daily Living(IADL)score, Nutritional Risk Screening 2002(NRS-2002)score, Norton pressure injury risk assessment score, and Social Support Rating Scale(SSRS)score were compared.The correlation between each factor and the occurrence of frailty was analyzed using univariate analysis and multivariate Logistic regression analysis.Results:A total of 119 elderly inpatients with multimorbidity, with an average age of 90.8±5.9 years old, were included in the study.The incidence of frailty was 68.9%(82 cases).Univariate analysis revealed significant statistical differences between the frail group and the non-frail group in various factors including age( t=-3.131, P=0.002), Tinetti score( Z=-5.544, P<0.001), risk of sarcopenia( χ2=39.205, P<0.001), dysphagia( χ2=5.937, P=0.015), Charlson comorbidity index( Z=-2.565, P=0.010), medication count( Z=-3.325, P<0.001), BADL( Z=-5.871, P<0.001), IADL( Z=-5.062, P<0.001), Norton score( Z=-5.922, P<0.001), and SSRS social support( Z=-2.637, P=0.008).Multivariate logistic regression analysis showed that the Tinetti score( OR=0.843, 95% CI: 0.737-0.966, P=0.014), decreased muscle strength( OR=11.226, 95% CI: 2.157-58.432, P=0.004), sarcopenia( OR=18.084, 95% CI: 2.041-106.211, P=0.009), Norton score( OR=0.462, 95% CI: 0.254-0.838, P=0.011), and medication count( OR=1.153, 95% CI: 1.000-1.329, P=0.049)were independently associated with frailty. Conclusions:In very elderly patients with multimorbidities, the occurrence of frailty is notably increased.Frailty is linked to multiple risks including falls, muscle weakness/sarcopenia, pressure ulcer risk, and polypharmacy, and these risks are independent of other factors.