Objective To investigate whether clinical,endocrine,and sonographic characteristics of infertile women with polycystic ovary syndrome (PCOS) could predict the ovarian response to clomiphene citrate (CC) medication.Methods A prospective study was conducted,85 women with PCOS were given CC 50 mg per day for 5 days.In the case of an absent response,doses were increased to 100 daily in subsequent cycles.Clinical,endocrine,and sonographic characteristics were compared between responders and nonresponders.Results The cycle history (oligomenorrhea or amenorrhea) and antral follicle count (AFC) were significantly different in responders from those in nonresponders (P ＜ 0.05).There were no differences in age,serum testosterone,follicle stimulating hormone (FSH),luteotropic hormone (LH),body mass index (BMI),insulin resistant index (HOMA-IR),and glucose and insulin levels between the two groups (P ＞ 0.05).In addition,multivariate logistic regression analysis indicated that cycle history and AFC were the predictors of ovarian response to CC treatment.Conclusions The cycle history and AFC can be used as the simple and effective parameters to predict ovarian response to CC treatment in PCOS patients.

Objective Acute kidney injury (AKI) is common but usually under-diagnosed in hospitalized patients,of the impact of which on patients is still unclear.The paper was aimed to investigate the impact of delayed recognition of AKI on short-time prognosis of patients through a propensity score matched study.Methods From Oct 2013 to Sep 2014,1401 adult hospitalized patients with AKI in the First Affiliated Hospital of Nanjing Medical University were divided into delayed recognition group and timely-diagnosed group according to propensity score matching (1∶ 1) without replacement method.Primary endpoint was 30-day all-cause mortality,and secondary endpoints included recovery of kidney at discharge,length of hospitalization,length of intensive care unit stay and hospital costs.Results There were significant differences in age,department distribution,complications,stage of AKI,Charlson index,APACHE Ⅱ score,SOFA score between the two groups before matching.After matching,there were no significant difference in demographic data,department distribution,complications,stage of AKI,Charlson index,APACHE Ⅱ score,SOFA score between the two groups except in blood urea nitrogen (P=0.039) and use of diuretics (P=0.018).Delayed recognition of acute kidney injury was not associated with 30-day all-cause mortality in univariate (P=0.711) and multivariate Logistic regression analyses.The secondary endpoints did not differ in two groups.Conclusion Delayed acute kidney injury recognition did not associate with poor short-term outcomes in adult hospitalized patients.

Objective To observe the effects of autophagy on the expression of synaptic plasticity related protein, growth-associated pro-tein-43 (GAP-43) and microtubule associated protein-2 (MAP-2), in CA1 area of hippocampus of vascular dementia rats. Methods Nine-ty-six healthy male Sprague-Dawley rats were randomly divided into sham group, vascular dementia model group (VD group), autophagy in-hibitor 3-methyl adenine preconditioning group (3-MA group) and autophagy agonist rapamycin preconditioning group (Rap group). Each group was divided randomly into subgroups of one week, two weeks, four weeks and eight weeks after modeling, six rats in each group. The vascular dementia rat model was established with modified Pulsineli's four-vessel occlusion. The expression of GAP-43 and MAP-2 in CA1 area of hippocampus were detected with immunohistochemistry. Results Compared with the sham group, the expression of GAP-43 protein increased, and the expression of MAP-2 protein decreased at every time point in VD group (P<0.01). Compared with VD group, the expres-sion of both GAP-43 and MAP-2 increased in 3-MA group (P<0.05), and decreased in Rap group (P<0.05). Conclusion Autophagy may in-hibit the expression of synaptic plasticity related protein, GAP-43 and MAP-2, in CA1 area of hippocampus in vascular dementia rats, indi-cating inhibition of autophagy may promote synaptic remodeling.

Traditional Chinese medicine treatment is the key to restore the balance of Yin and Yang through gasification. So it is important to discuss the mode of gasificaiton of Qi and Chinese medicine and their relationship in the machanism of the Chinese medicine for diseases. Life is a mode of Qi and Qi movement and gasificaiton make people alive. The Chinese medicine works on the Qi gasification to balance the Yin and Yang to keep the peace inner and outsides.

Objective To analyze the experience of scientific research management in a Traditional Chinese medicine (TCM) hospitals.Methods We systematically summarized the experience of existing practices and established a TCM scientific research delicacy management model including project process management,funds management,personnel evaluation,institutional construction and output transfer.Results The scientific research management model was suitable for the hospital development,in accordance with daily medical and teaching practice.Conclusions Scientific research ability had gradually become an important indicator of TCM hospital evaluation.This management model could provide reference for related issues.

Objective To explore the problems in traditional Chinese medicine (TCM) scientific research project management and provide possible countermeasures.Methods Through cluster sampling,all the scientific research administrators and staff in a hospital were selected.A questionnaire about TCM hospital scientific research management was designed and used in our study.Results The majority of participants were basically satisfied with current scientific research management in TCM.Problems were analyzed including complex project application,singular evaluating standard,inflexible fund management,and backward professional concept.Conclusions The management of scientific research projects in TCM should combine professional characteristics,innovatively and comprehensively improve management concept,system,team and method.

Objective:To explore the countermeasures to strengthen hospital scientific research management and prevent research misconduct by studying the characteristics of research misconduct cases investigated by the NSFC in recent three years.Methods:Information of a total number of 67 research misconduct cases in 6 batches that publicly reported by the NSFC from 2019 to 2021 were collected, classified statistics were conducted on the situation of the supporting units involved, the specific issues of Misconduct and the disciplinary measures of the NSFC. According to the frequency proportion of misconduct problems, the tendency characteristics and reasons were analyzed and summarized, countermeasures and suggestions were put forward.Results:96.36% of the main responsibility entity of research misconduct was individuals, and 3.63% of the main responsibility of relying institution. There were 62 cases of research misconduct due to scientific papers and applications, accounted for 92.50%. Among the problematic papers involved, data fraud accounted for 48.20%, false signature or unauthorized signature accounted for 35.97%, plagiarism accounted for 32.37%, and unauthorized marking of other people′s fund number accounted for 27.33%. The NSFC revoked 55 fund projects involved and recovered funds, 67 people were disqualified from applying for projects with a maximum of 7 years and a minimum of 2 years, and 2 peer-review experts were punished.Conclusion:Hospital scientific research management should draw lessons from others, and put forward specific countermeasures from the aspects of strengthening scientific research integrity education, improving the construction of supervision mechanism, strictly implementing process management and perfecting scientific research credit evaluation system, in order to provide possible reference for preventing misconduct in hospital scientific research management practice.

Objective To explore the influencing factors of the collateral circulation formation in patients with acute cerebral infarction.Methods Three hundred and fifty-two patients with acute cerebral infarction were included in this study,the clinical date of their head and neck 256 slice spiral CT angiography (CTA)examination was analyzed.According to the formation of collateral circulation in the head and neck CTA imaging results,it is divided into the collateral circulation group and the non-collateral circulation group.The clinical data of the two groups were compared.The influencing factors of the formation of collateral circulation in patients with acute cerebral infarction were analyzed by single factor analysis and multivariate logistic regression analysis.Results (1)In 352 cases of acute cerebral infarction,197 cases(56.0%)had collaterals,155 cases (44.0%)had none collateral.(2)Single factor analysis showed that age(t=-2.860,P=0.004),hypertension combined with diabetes(χ2 = 10.709,P= 0.001),history of TIA(χ2 = 4.626,P= 0.034),low density lipoprotein(t=-2.176,P=0.030),high homocysteine(t=2.885,P=0.004),cerebral vascular stenosis(Z=-5.936,P=0.000),posterior circular lesions(χ2=8.548,P=0.004)were the influencing factors in the formation of collateral circulation.(3)Multivariate Logistic regression analysis showed that old age(OR=1.031;95%CI=1.008-1.054;P=0.007),hypertension combined with diabetes(OR= 2.009;95%CI=1.159-3.482;P=0.013),high homocysteine(OR=1.023;95%CI,1.005-1.041;P=0.014),circular lesions(OR=1.727;95%CI=1.063-2.804;P=0.027)were relatively independent risk factors in acute cerebral infarction patients with none circulation,the degree of cerebral vascular stenosis(OR=0.507;95%CI=0.389-0.661;P=0.000),low density lipoprotein(OR=0.723;95%CI=0.532-0.982;P=0.038)served as protective factor.Conclusion Old age,hypertension combined with diabetes,high homocysteine and posterior circulation lesions are risk factors for the formation of collateral circulation in patients with acute cerebral infarction,cerebral vascular stenosis degree and low density lipoprotein can promote the formation of collateral circulation.

Objective To observe the effect of microRNA-613 (miR-613) on the biological behavior of human renal cell carcinoma cells and explore its molecular mechanism.Methods The synthesized miR-613 mimics and miR-NC were respectively transferred into 786-0 cells by Lipofectamine 3000 and divided into experimental group and control group.Real time quantitative polymerase chain reaction (qPCR) was used to detect the expression of miR-613 in cells of two groups to verify the transfection success.The proliferation of 786-0 cells was detected by methyl thiazolyl tetrazolium (MTT) assay and the migration of 786-0 cells was detected by Transwell migration assay.Bioinformatics predicts the target gene of miR-613.Dual luciferase reporter assay validates the targeted relationship between miR-613 and target genes,and their binding sites.qPCR and Western blot were used to detect the expression of target genes.Results qPCR test results showed that the expression of miR-613 in the experimental group (16.22 ± 1.08) was significantly higher than that in the control group (1.06 ± 0.20),with statistically significant difference (P ＜ 0.01).The results of MTT showed that the cells in the experimental group showed a decrease in absorbance value at the d-th point after transfection (P ＜ 0.05).Transwell cell migration test results showed that the cells in the control group and experimental group migrated from the upper chamber of Transwell to the lower chamber of the cells were respectively (95.55 ± 17.88) and (199.10 ± 22.74),with statistically significant difference (P ＜ 0.05).Bioinformatics predicts that the target gene of miR-613 is Cortactin (CTTN).Dual luciferase reporter assay confirmed that miR-613 can target CTTN gene (P ＜ 0.05).miR-613 can significantly inhibit the CTTN gene expression in renal cell carcinoma cells (P ＜ 0.01).Conclusions Upregulation of miR-613 expression can inhibit the proliferation and migration of renal cell carcinoma cells,and its possible molecular mechanism is that miR-613 inhibits the expression of CTTN gene.

Objective To investigate the predictive value of nutritional and fluid status measured by bioelectrical impedance methods for the prognosis of acute kidney injury (AKI) patients undergoing continuous renal replacement therapy (CRRT). Methods Patients with severe AKI received CRRT in the First Affiliated Hospital of Nanjing Medical University from September 2016 to September 2018 were enrolled, and divided into death group and survival group according to 28-day survival. Cox regression was used to analyze the association between 28-day survival and lean tissue index (LTI), fat tissue index (FTI), the ratio of extracellular water (ECW) and body cell mass (BCM) (ECW/BCM), and overhydration (OH), respectively. Results A total of 156 patients were included, including 101 males and 55 females. The age was (62.7 ± 15.4) years, with sequential organ failure assessment (SOFA) score of 9.9±3.9. The 28-day mortality rate was 46.2％. The pre-CRRT OH values in the 28-day survival group and death group were 2.95(1.80, 5.50) L and 4.20(2.95, 5.70) L(P=0.016), and ECW/BCM values were 1.00(0.76, 1.18) and 1.07(0.88, 1.25) (P=0.033), respectively. Univariate Cox regression analysis showed that pre-CRRT high OH values (HR=1.08, 95％CI 1.00-1.17, P=0.040) and high ECW/BCM values (HR=3.02, 95％CI 1.46-6.22, P=0.003) were associated with 28-day death. The changes of OH values (HR=0.83, 95％CI 0.72-0.95, P=0.008) and ECW/BCM values (HR=6.79, 95％CI 1.72-26.82, P=0.006) between pre - CRRT and the 7th day after CRRT initiation were significantly associated with 28-day mortality in patients who survived 7 days after CRRT initiation. After adjusting for age, gender, and SOFA scores, multivariate Cox regression analysis showed that the high OH value (HR=1.16, 95％CI 1.06-1.27, P=0.002) and the high ECW/BCM value (HR=2.80, 95％CI 1.30-6.06, P=0.003) before CRRT, the change of OH value (HR=0.82, 95％CI 0.72-0.95, P=0.008) and ECW/BCM value (HR=2.79, 95％CI 1.30-5.98, P=0.009) between the 7th day after CRRT initiation and pre-CRRT, were independently associated with 28-day death, while LTI (HR=0.93, 95％CI 0.86-1.02, P=0.113) and FTI (HR=0.98, 95％ CI 0.92-1.04, P=0.475) before CRRT were uncorrelated with 28-day death. Conclusions In bioelectrical impedance analysis, the high OH value and high ECW/BCM value before CRRT are associated with 28-day mortality in patients with AKI, while the nutritional indicators LTI and FTI before CRRT are not significantly related. The correction of fluid overload by CRRT within 7 days may reduce the risk of 28-day mortality.