With reference to the Information and Documentation-Resource Description (GB/T 3792-2021) and Bibliographical Description for Ancient Chinese Books (GB/T 3792.7-2008) and other cataloging standards and rules, drawing on the practical experience of cataloging ancient TCM books, Bibliographical Cataloging for Ancient TCM Books was formulated. This standard specifies the entry items and their order of ancient TCM books, cataloging identifier, cataloging text, cataloging information source, and cataloging item details. The standard can provide standardized and unified guiding principles and methods for the work of ancient TCM books, and promote the sharing and utilization of ancient TCM books.

Surgical position is very important in upper urinary calculi surgery.The correct surgical position can provide a good surgical field of view,shorten the operation time,reduce the incidence of complications,and ensure the safety of patients'airway and comfort.Endoscopic surgery is the preferred treatment for kidney and ureteral stones.As the traditional position causes higher recurrence rate and more complications,more positions have been experimented.This article reviews the application and therapeutic effects of different surgical positions in percutaneous nephrolithotomy(PCNL),retrograde intrarenal flexible ureteroscopic lithotripsy(RIRS)as well as their combined use,and summarizes the advantages and disadvantages for clinical reference.

Objective::To evaluate the performance of optical genome mapping (OGM) in identifying an inversion located in the short arm of chromosome 8 (8p, 8p23.1), flanked by regions of complex segmental duplication (SD), using the GRCh38 and telomere-to-telomere (T2T) genome references.Methods::We investigated a couple suspected of carrying the 8p23.1 inversion due to a terminal deletion combined with an interstitial duplication of 8p found in their abortus. OGM was performed on both individuals. The data were mapped to the current GRCh38 and the updated T2T genome references, respectively.Results::The 8p23.1 inversion was observed in the female when mapping OGM data to the T2T assembly. In contrast, under the GRCh38 reference, the orientation between the suspected breakpoints within the SD regions could not be distinguished. Additional variants of uncertain significance were also identified in both individuals.Conclusion::Our findings highlight the superiority of the T2T reference in recognizing structural variations involving SD regions. The enhanced SV detection using the T2T reference may contribute to a better understanding of genome instability and human diseases.

Objective::To evaluate the performance of optical genome mapping (OGM) in identifying an inversion located in the short arm of chromosome 8 (8p, 8p23.1), flanked by regions of complex segmental duplication (SD), using the GRCh38 and telomere-to-telomere (T2T) genome references.Methods::We investigated a couple suspected of carrying the 8p23.1 inversion due to a terminal deletion combined with an interstitial duplication of 8p found in their abortus. OGM was performed on both individuals. The data were mapped to the current GRCh38 and the updated T2T genome references, respectively.Results::The 8p23.1 inversion was observed in the female when mapping OGM data to the T2T assembly. In contrast, under the GRCh38 reference, the orientation between the suspected breakpoints within the SD regions could not be distinguished. Additional variants of uncertain significance were also identified in both individuals.Conclusion::Our findings highlight the superiority of the T2T reference in recognizing structural variations involving SD regions. The enhanced SV detection using the T2T reference may contribute to a better understanding of genome instability and human diseases.

BACKGROUND: Rheumatoid arthritis (RA), a chronic systemic autoimmune disease, is characterized by synovitis and progressive damage to the bone and cartilage of the joints, leading to disability and reduced quality of life. This study was a randomized clinical trial comparing the outcomes between withdrawal and dose reduction of tofacitinib in patients with RA who achieved sustained disease control. METHODS: The study was designed as a multicenter, open-label, randomized controlled trial. Eligible patients who were taking tofacitinib (5 mg twice daily) and had achieved sustained RA remission or low disease activity (disease activity score in 28 joints [DAS28] ≤3.2) for at least 3 months were enrolled at six centers in Shanghai, China. Patients were randomly assigned (1:1:1) to one of three treatment groups: continuation of tofacitinib (5 mg twice daily); reduction in tofacitinib dose (5 mg daily); and withdrawal of tofacitinib. Efficacy and safety were assessed up to 6 months. RESULTS: Overall, 122 eligible patients were enrolled, with 41 in the continuation group, 42 in the dose-reduction group, and 39 in the withdrawal group. After 6 months, the percentage of patients with a DAS28-erythrocyte sedimentation rate (ESR) of <3.2 was significantly lower in the withdrawal group than that in the reduction and continuation groups (20.5%, 64.3%, and 95.1%, respectively; P  < 0.0001 for both comparisons). The average flare-free time was 5.8 months for the continuation group, 4.7 months for the dose reduction group, and 2.4 months for the withdrawal group. CONCLUSION: Withdrawal of tofacitinib in patients with RA with stable disease control resulted in a rapid and significant loss of efficacy, while standard or reduced doses of tofacitinib maintained a favorable state. TRIAL REGISTRATION Chictr.org, ChiCTR2000039799.
Humans ; Quality of Life ; China ; Arthritis, Rheumatoid/drug therapy* ; Piperidines/therapeutic use* ; Treatment Outcome ; Antirheumatic Agents/therapeutic use* ; Pyrroles/therapeutic use*

Objective:To investigate the RHD genotypes of RhD-negative pregnant women and explore the optimum strategy for fetal RHD screening among this population in the region. Methods:This prospective study recruited 33 cases of RhD-negative singleton pregnancies at ≥12 weeks of gestation in Nanjing Drum Tower Hospital from March to November 2021. On the basis of RHD genotyping, quantitative real-time polymerase chain reaction (PCR) was used to amplify the exons 5 and 10 of RHD gene in the circulating cell-free DNA of RhD-negative pregnant women harboring whole RHD gene deletion and RHD-CE(2-9)- D. High-throughput sequencing was performed to detect chr1:25648453 locus from circulating cell-free DNA in plasma of RhD-negative pregnant women harboring RHD 1227A mutation to screen the fetal RhD blood group. Neonatal umbilical cord blood samples were collected for verifying fetal RHD genotyping. Descriptive statistical analysis was used. Results:Whole RHD gene deletion homozygous genotype ( n=20, 60.6%), RHD-CE(2-9) -D/whole RHD gene deletion heterozygous genotype ( n=5, 21.2%), RHD 1227A/whole RHD gene deletion heterozygous genotype ( n=7, 15.2%) and RHD 711delC/whole RHD gene deletion heterozygous genotype ( n=1) were identified in the 33 RhD-negative pregnant women. In the 25 cases with whole RHD gene deletion homozygous genotype or RHD-CE(2-9)- D/whole RHD gene deletion heterozygous genotype, 22 fetuses were RhD-positive and three were RhD-negative based on prenatal screening, which were confirmed by the neonatal serological test results after birth. In the seven cases carrying RHD 1227A/whole RHD gene deletion heterozygous genotype, all fetuses were RhD-positive, which were consistent with the results of serological detection after delivery. The case harboring RHD 711delC/whole RHD gene deletion heterozygous genotype did not receive fetal RHD screening. Conclusions:This study suggests that whole RHD gene deletion homozygous genotype is the most common allele in RhD-negative population in this area, followed by RHD 1227A/whole RHD gene deletion heterozygous genotype and RHD- CE(2-9)- D/whole RHD gene deletion heterozygous genotype. For women with whole RHD gene deletion homozygous genotype, RHD- CE(2-9)- D, or RHD 1227A mutation, fetal RHD screening with quantitative real-time PCR and high-throughput sequencing are important for the management of RhD-negative pregnant women.

【Objective:】 Using classic moral dilemma cases, this paper investigates the choice tendency of medical students when facing the moral dilemma, and analyzes their cognitive status and characteristics when facing the "moral dilemma", in order to provide effective enlightenment for optimizing the teaching cases of medical ethics. 【 Method:】 771 medical students in Shanghai Jiao Tong University School of Medicine were investigated by electronic questionnaire and SPSS 20.0 for statistical description and statistical analysis. 【Result:】 In the emergency room doctors and transition scenes, medical students tend to the principle of maximum happiness, and in the ring track scene and pedestrian overpass scene, they tend to the principle of deontology; In the loop track scene and pedestrian overpass scene, boys are more inclined to deontological principles than girls, and undergraduates are more inclined to deontological principles than postgraduates, and the difference is statistically significant (P<0.05). 【Conclusion:】 Although medical students have different moral tendencies in different scenes, they generally do not agree with the practice of sacrificing one person to save five people. Especially when more rigorous sacrifice conditions cause greater moral pressure, the vast majority of medical students will tend to the latter between utilitarianism and deontological principles.

Objective:To investigate the differences in polyunsaturated fatty acid metabolites in seminal plasma between normal group and low sperm motility group, and their relationship with sperm motility.Methods:Totally 581 human seminal plasmas collected from Guizhou Province were divided into normal group and low sperm motility group according to the motility rate. The metabolite products of 24 kinds of polyunsaturated fatty acids were detected by liquid phase tandem mass spectrometry/mass spectrometry (LC-MS/MS). Through the in vitro culture experiment of sperm, the culture supernatant was collected during the culture of the upstream screening sperm for 24 h, and the polyunsaturated fatty acid products with different differences detected in the different groups of seminal plasma were also verified by LC-MS/MS method. Results:Among the polyunsaturated fatty acid metabolites detected in seminal plasma, the concentrations of 9-hydroxyoctadecadienoic acid (9-HODE) and 13-hydroxyoctadecadienoic acid (13-HODE) in the seminal plasma of the low sperm motility group were significantly different from those in the normal seminal plasma group ( P=0.001, P=0.033). In vitro culture experiments showed that the concentration of 9-HODE and 13-HODE in the culture medium increased significantly with the prolongation of culture time and the decrease of sperm motility rate ( P=0.003, P=0.035). Statistical analysis showed that the concentrations of 9-HODE and 13-HODE were significantly negatively correlated with sperm motility （ r=-0.91， P=0.045； r=-0.95， P=0.026）. Considering the sperm density factor in the analysis of polyunsaturated fatty acid metabolites and sperm motility in the seminal plasma of the population, the results showed that 9-HODE and 13-HODE were significantly higher in the low sperm motility group than in the normal group ( P<0.000 1). And there was a negative correlation ( r=-0.38) with the sperm motility rate ( P<0.000 1). Conclusion:9-HODE and 13-HODE are released into the culture medium and seminal plasma by sperm cell metabolism, which is a potential indicator of the degree of sperm membrane damage, which may be helpful in judging and detecting the asthenospermia.

Objective:To investigate the differences in polyunsaturated fatty acid metabolites in seminal plasma between normal group and low sperm motility group, and their relationship with sperm motility.Methods:Totally 581 human seminal plasmas collected from Guizhou Province were divided into normal group and low sperm motility group according to the motility rate. The metabolite products of 24 kinds of polyunsaturated fatty acids were detected by liquid phase tandem mass spectrometry/mass spectrometry (LC-MS/MS). Through the in vitro culture experiment of sperm, the culture supernatant was collected during the culture of the upstream screening sperm for 24 h, and the polyunsaturated fatty acid products with different differences detected in the different groups of seminal plasma were also verified by LC-MS/MS method. Results:Among the polyunsaturated fatty acid metabolites detected in seminal plasma, the concentrations of 9-hydroxyoctadecadienoic acid (9-HODE) and 13-hydroxyoctadecadienoic acid (13-HODE) in the seminal plasma of the low sperm motility group were significantly different from those in the normal seminal plasma group ( P=0.001, P=0.033). In vitro culture experiments showed that the concentration of 9-HODE and 13-HODE in the culture medium increased significantly with the prolongation of culture time and the decrease of sperm motility rate ( P=0.003, P=0.035). Statistical analysis showed that the concentrations of 9-HODE and 13-HODE were significantly negatively correlated with sperm motility （ r=-0.91， P=0.045； r=-0.95， P=0.026）. Considering the sperm density factor in the analysis of polyunsaturated fatty acid metabolites and sperm motility in the seminal plasma of the population, the results showed that 9-HODE and 13-HODE were significantly higher in the low sperm motility group than in the normal group ( P<0.000 1). And there was a negative correlation ( r=-0.38) with the sperm motility rate ( P<0.000 1). Conclusion:9-HODE and 13-HODE are released into the culture medium and seminal plasma by sperm cell metabolism, which is a potential indicator of the degree of sperm membrane damage, which may be helpful in judging and detecting the asthenospermia.