With the rapid development of sequencing technologies, the detection of alternative polyadenylation (APA) in mammals has become more precise. APA precisely regulates gene expression by altering the length and position of the poly(A) tail, and is involved in various biological processes such as disease occurrence and embryonic development. The research on APA in mammals mainly focuses on the following aspects:(1) identifying APA based on transcriptome data and elucidating their characteristics; (2) investigating the relationship between APA and gene expression regulation to reveal its important role in life regulation;(3) exploring the intrinsic connections between APA and disease occurrence, embryonic development, differentiation, and other life processes to provide new perspectives and methods for disease diagnosis and treatment, as well as uncovering embryonic development regulatory mechanisms. In this review, the classification, mechanisms and functions of APA were elaborated in detail and the methods for APA identifying and APA data resources based on various transcriptome data were systematically summarized. Moreover, we epitomized and provided an outlook on research on APA, emphasizing the role of sequencing technologies in driving studies on APA in mammals. In the future, with the further development of sequencing technology, the regulatory mechanisms of APA in mammals will become clearer.

OBJECTIVE: To investigate the clinical efficacy and advantages of robot-assisted total knee arthroplasty (TKA) in patients with varus knee osteoarthritis. METHODS: Between October 2022 and June 2023, a total of 59 patients with severe knee osteoarthritis resulting in varus were treated with total knee arthroplasty, aged from 59 to 81 years with an average (70.90±4.63) years, including 19 mals and 40 females. The patients were divided into two groups based on the surgical method used:28 patients in the robot group and 31 patients in the traditional group. The robot group consisted of 8 males and 20 femalse patients, with an average age of (70.54±4.80) years and an average disease duration of (14.89±8.72) months. The traditional group consisted of 11 males and 20 females patients, with an average age of (71.39±4.5) years and an average disease duration of (12.32±6.73) months. The operative duration, amount of bleeding during the operation, postoperative activity time after the operation, hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and complications were compared between the two groups before and after the operation. Lateral tibia component (LTC), frontal tibia component (FTC), frontal femoral component (FFC) and lateral femoral component (LFC) were measured 6 months after operation Additionally, the degree of knee joint motility, American Knee Society score (KSS), and visual analogue scale(VAS) were compared before and after the operation. RESULTS: All patients had gradeⅠwound healing without any complications, and all patients were followed up for 6 to 8 months, with an average of (6.5±1.5) months. There were no significant differences preoperative imaging evaluation indexes (including HKA, LDFA, and MPTA), preoperative knee mobility, preoperative VAS, and preoperative KSS between the two groups (P>0.05). Comparing the operation time (109.11±7.16) min vs. (83.90±7.85) min, length of the incision (16.60±2.33) cm vs. (14.47±1.41) cm, intraoperative bleeding (106.93±6.15) ml vs. (147.97±7.62) ml, postoperative activity time (17.86±1.84) h vs. (21.77±2.68) h, between the two groups showed statistically significant differences (P<0.05). There were significant differences in FFC (88.96±0.84)° vs. (87.93±1.09)° and LFC (88.57±1.10)° vs. (87.16±1.2)° between the two groups at 6 months after operation (P<0.05). The robotic group 1, 3, 6 months after KSS (75.96±3.96), (81.53±3.78), (84.50±3.29) scores, VAS (3.68±0.67), (2.43±0.79), (0.54±0.64), knee joint mobility (113.32±4.72) °, (123.93±3.99) °, (135.36±2.34) °;Traditional group KSS (73.77±4.18), (76.48±3.60), (80.19±3.28) scores, VAS (4.16±1.04), (3.03±0.75), (1.42±0.76) scores, knee joint mobility (109.19±6.95) °, (119.94±6.08) °, (134.48±2.14) °. Compared to before surgery, both groups showed significant improvement in KSS, VAS and knee mobility during the three follow-up visits (P<0.001). Additionally, postoperative HKA (180.39±1.95)° vs. (178.52±2.23)°, LDFA (89.67±0.63) ° vs. (89.63±0.63)°, and MPTA (89.44±0.55)° vs. (89.29±0.60)° were significantly improved in both groups compared to before surgery (P<0.001). The robotic group had higher KSS than the traditional group at 1, 3, and 6 months after surgery (P<0.05). The robotic group also had lower VAS than the traditional group at 1, 3, and 6 months after surgery (P<0.05). Furthermore, knee mobility was higher in the robotic group than those in the traditional group at 1 and 6 months after surgery (P<0.05), but there was no significant difference between the two groups at 6 months after surgery. CONCLUSION Robot-assisted total knee arthroplasty is a safe and effective method for total knee replacement. The use of robotics can improve the limb axis and prosthesis alignment for patients with preoperative varus deformity, resulting in better clinical and imaging outcomes compared to the conventional group.
Humans ; Female ; Male ; Arthroplasty, Replacement, Knee/methods* ; Aged ; Middle Aged ; Osteoarthritis, Knee/physiopathology* ; Aged, 80 and over ; Robotic Surgical Procedures/methods*

OBJECTIVE: To evaluate the efficacy and safety of Shexiang Tongxin Dropping Pill (STDP) in treating stable angina patients with phlegm-heat and blood-stasis syndrome by exercise duration and metabolic equivalents. METHODS: This multicenter, randomized, double-blind, placebo-controlled clinical trial enrolled stable angina patients with phlegm-heat and blood-stasis syndrome from 22 hospitals. They were randomized 1:1 to STDP (35 mg/pill, 6 pills per day) or placebo for 56 days. The primary outcome was the exercise duration and metabolic equivalents (METs) assessed by the standard Bruce exercise treadmill test after 56 days of treatment. The secondary outcomes included the total angina symptom score, Chinese medicine (CM) symptom scores, Seattle Angina Questionnaire (SAQ) scores, changes in ST-T on electrocardiogram and adverse events (AEs). RESULTS: This trial enrolled 309 patients, including 155 and 154 in the STDP and placebo groups, respectively. STDP significantly prolonged exercise duration with an increase of 51.0 s, compared to a decrease of 12.0 s with placebo (change rate: -11.1% vs. 3.2%, P<0.01). The increase in METs was significantly greater in the STDP group than in the placebo group (change: -0.4 vs. 0.0, change rate: -5.0% vs. 0.0%, P<0.01). The improvement of total angina symptom scores (25.0% vs. 0.0%), CM symptom scores (38.7% vs. 11.8%), reduction of nitroglycerin consumption (100.0% vs. 11.3%), and all domains of SAQ, were significantly greater with STDP than placebo (all P<0.01). The changes in Q-T intervals at 28 and 56 days from baseline were similar between the two groups (both P>0.05). Twenty-five participants (16.3%) with STDP and 16 (10.5%) with placebo experienced AEs (P=0.131), with no serious AEs observed. CONCLUSION STDP could improve exercise tolerance in patients with stable angina and phlegm-heat and blood stasis syndrome, with a favorable safety profile. (Registration No. ChiCTR-IPR-15006020).
Humans ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Male ; Female ; Middle Aged ; Angina, Stable/physiopathology* ; Aged ; Syndrome ; Treatment Outcome ; Placebos ; Tablets

Objective To develop a prefilled portable intelligent intravenous transfusion pump to facilitate fast and convenient fluid pumping during emergency treatment and casualty transport.Methods The prefilled portable intelligent venous transfusion pump was composed of a driver module,a pump module,a human-machine interface,a prefilled sterile infusion bag and a pump catheter.The driver module adopted integrated design and applied a high-voltage DC-AC converter to driving the piezoelectric pump used as the power source of the pump module;the human-machine interface consisted of several keys for on/off,rate adjustment,switching and confirmation;the prefilled sterile infusion bag was made of medical-grade polypropylene,and the pump catheter was made of medical silicone rubber.Results The transfusion pump developed could be worn on the casualty limb and did not require height difference for intravenous infusion,which enhanced intravenous drug delivery in portability,reliability and intelligence.Conclusion The transfusion pump developed gains advantages in low size,weight and easy operation,and thus is worthy promoting for venous transfusion in battlefield conditions and field emergency environments.[Chinese Medical Equipment Journal,2024,45(5):111-114]

Objective To investigate the clinical efficacy and safety of single-port thoracoscopic surgery for elderly patients with non-small cell lung cancer(NSCLC).Methods The clinical data of 93 patients with NSCLC who underwent thoracoscopic lobectomy or segmentectomy was collected,the patients were divided into uniportal operation group(40 cases,received single-port thoracoscopic surgery)and single-operation port operation group(53 cases,received single-operation port thoracoscopic surgery)according to the operation methods.The operation time,the amount of blood loss,the number of lymph node dissection,chest drainage volume 3 days after surgery,duration of indwelling drainage tube,postoperative hospital stay,visual analogue scale(VAS)score of postoperative pain,and incidence of postoperative complications of patients between the two groups were compared.The cumulative survival rate between the two groups was compared.Results The operation were successfully completed in both groups.There was no statistically significant difference in terms of operation time,the amount of blood loss,the number of lymph node dissection,chest drainage volume 3 days after surgery,duration of indwelling drainage tube,or postoperative hospital stay of patients between the two groups(P>0.05).There was significant difference in VAS score of postoperative pain of patients between the two groups(P<0.05).There was no early death within 1 months after surgery in both groups.There was no significant difference in the incidence of complications between the two groups(P>0.05).After 4 to 30 months of follow-up,there was no significant difference in the cumulative survival rate between the two groups(P>0.05).Conclusion Single-port thoracoscopic lobectomy or segmentectomy for elderly patients with NSCLC has high safety and feasibility,with less trauma,faster recovery and less postoperative pain.

Objective:This paper aims to analyze the current status,characteristics,and problems of the policy text of China's chronic disease from the perspective of full-cycle,and provide a reference for subsequent policy optimization.Methods:The author selected 104 policy documents on chronic disease published at the national level from 2009 to 2023,used content analysis method,constructed a two-dimensional analysis framework of"policy tools-full-cycle management",and carried out one-dimensional quantitative analysis and two-dimensional cross-analysis.Results:The application of policy tools is obviously unbalanced,with supply-type policy tools accounting for as much as 63.23％,and demand-type policy tools used the least,only 10.51％.In the dimension of full-cycle management,the proportions of prevention,prevention and treatment,treatment,treatment and rehabilitation,health care,and full-cycle stages are 21.01％,24.58％,28.89％,7.32％,4.69％and 13.51％respectively.It is noteworthy that the proportions of the treatment and rehabilitation,and health care stages are relatively low.All stages of chronic disease health management interact frequently with supply-type policies,and the treatment and rehabilitation,health care and full-cycle stages cross less with demand-type policy tools.Conclusion:It is necessary to adjust the proportion of policy tools,strengthen their internal coordination,improve the top-level design of treatment and rehabilitation and health care,enhance the synergistic interaction between various types of policy tools and full-cycle management,and improve the overall effectiveness of policies.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To analyze the clinical data of patients undergoing emergency operation for small intestinal perforation secondary to small intestinal metastasis of lung cancer and explore the clinical characteristics,treatment strategies,and preventive measures.Methods The clinical data of 11 patients who underwent emergency operation for small intestinal perforation secondary to small intestinal metastasis of lung cancer at the Department of Emergency Surgery,Zhongshan Hospital,Fudan University from Jan 2018 to Jun 2023 were selected for retrospective analysis.Analysis factors included age,gender,clinical manifestations,comorbidities,past history,preoperative imaging results,preoperative blood test results,treatment,surgical methods,metastasis sites,perforation sites,pathological types,hospitalization time,and prognostic outcomes.Results All of the 11 patients went to the emergency room with abdominal pain,and their duration of abdominal pain ranged from 8 to 96 hours.There were white blood cells≥9.5×109/L in 10 patients,neutrophil percentages≥90%in 8 patients,procalcitonin(PCT)≥0.05 ng/mL in 10 patients,and C-reactive protein(CRP)≥5 mg/L in 11 patients.Among the 11 patients,7 cases had jejunal perforation and 4 cases had ileal perforation;10 patients underwent partial small bowel resection and enter-enterostomy,and 1 patient underwent small bowel perforation repairment and jejunostomy;10 patients were receiving anti-tumor drug treatment before operation,of which 7 patients received targeted therapy alone,2 patients received chemotherapy alone,and 1 patient received both targeted therapy and chemotherapy.Postoperative hospitalization time ranged from 4 to 71 days,of which 3 patients died and 8 patients were discharged successfully.Conclusion Jejunum is the main perforation site of small intestinal perforation secondary to small intestinal metastasis of lung cancer.Patients with advanced lung cancer should have regular comprehensive examinations to detect distant metastases early.Early detection enables timely intervention,which can help prevent serious complications.

Objective To explore the effects of different acupoints,different target organs,and different interventions on acupoint efficacy based on ACU&MOX-DATA platform;To illustrate and visualize whether the above factors have the characteristics of"specific effect"or"common effect"of acupoint efficacy.Methods The multi-source heterogeneous data were integrated from the original omics data and public omics data.After standardization,differential gene analysis,disease pathology network analysis,and enrichment analysis were performed using Batch Search and Stimulation Mode modules in ACU&MOX-DATA platform under the conditions of different acupoints,different target organs,and different interventions.Results Under the same disease state and the same intervention,there were differences in effects among different acupoints;under the same disease state,the same acupoint and intervention,the responses produced by different target organs were not completely consistent;under the same disease state and acupoint,there were differences in effects among different intervention measures.Conclusion Based on the analysis of ACU&MOX-DATA platform,it is preliminary clear that acupoints,target organs,and interventions are the key factors affecting acupoint efficacy.Meanwhile,the above results have indicated that there are specific or common regulatory characteristics of acupoint efficacy.Applying ACU&MOX-DATA platform to analyze and visualize the critical scientific problems in the field of acupuncture and moxibustion can provide references for deepening acupoint cognition,guiding clinical acupoint selection,and improving clinical efficacy.

AIM To evaluate the quality of Beidougen Formula Granules.METHODS Fifteen batches of standard decoctions and three batches of formula granules were prepared,after which paste rate and contents,transfer rates of magnoflorine,daurisoline,dauricine were determined.HPLC specific chromatograms were established,and cluster analysis was adopted in chemical pattern recognition.RESULTS For three batches of formula granules,the paste rates were 15.1%-16.6%,the contents of magnoflorine,daurisoline,dauricine were 18.93-19.39,9.42-9.60,6.79-6.85 mg/g with the transfer rates of 34.42%-35.25%,43.81%-44.65%,27.27%-27.51%from decoction pieces to formula granules,respectively,and there were seven characteristic peaks in the specific chromatograms with the similarities of more than 0.95,which demonstrated good consistence with those of standard decoctions and accorded with related limit requirements.Fifteen batches of standard decoctions were clustered into two types,and the medicinal materials produced from Jilin,Hebei,Shangdong could be used for the preparation of formula granules.CONCLUSION This reasonable and reliable method can provide references for the quality control and clinical application of Beidougen Formula Granules.