Endovascular aneurysm repair (EVAR) is a key treatment for abdominal aortic aneurysms (AAA),but type Ⅱ endoleak (T2EL) is one of the most common postoperative complications. T2EL mainly arises from retrograde blood flow from collateral vessels such as the inferior mesenteric artery (IMA) and lumbar arteries (LA),which continue to perfuse the aneurysm sac. Although T2EL may lead to aneurysm sac enlargement or even rupture,its overall clinical impact is relatively minor,and most cases can be effectively managed through observation or minimally invasive interventions. Currently,the efficacy of prophylactic embolization of the IMA and LA in reducing the incidence of T2EL remains uncertain and may increase operative time,radiation exposure,and the risk of associated complications. More importantly,authoritative guidelines,both domestic and international,do not recommend routine prophylactic embolization of the IMA and LA during EVAR. Whether prophylactic embolization should be performed in high-risk patients for T2EL remains controversial,with most studies in this area being small-sample or single-center retrospective analyses,offering limited evidence quality. This article analyzes the harm of T2EL,the effectiveness of prophylactic embolization,and relevant guideline recommendations based on existing research,aiming to provide a reference for the individualized management of T2EL following EVAR.

Endovascular aneurysm repair (EVAR) is a key treatment for abdominal aortic aneurysms (AAA),but type Ⅱ endoleak (T2EL) is one of the most common postoperative complications. T2EL mainly arises from retrograde blood flow from collateral vessels such as the inferior mesenteric artery (IMA) and lumbar arteries (LA),which continue to perfuse the aneurysm sac. Although T2EL may lead to aneurysm sac enlargement or even rupture,its overall clinical impact is relatively minor,and most cases can be effectively managed through observation or minimally invasive interventions. Currently,the efficacy of prophylactic embolization of the IMA and LA in reducing the incidence of T2EL remains uncertain and may increase operative time,radiation exposure,and the risk of associated complications. More importantly,authoritative guidelines,both domestic and international,do not recommend routine prophylactic embolization of the IMA and LA during EVAR. Whether prophylactic embolization should be performed in high-risk patients for T2EL remains controversial,with most studies in this area being small-sample or single-center retrospective analyses,offering limited evidence quality. This article analyzes the harm of T2EL,the effectiveness of prophylactic embolization,and relevant guideline recommendations based on existing research,aiming to provide a reference for the individualized management of T2EL following EVAR.

Objective:To analyze molecular genetic characteristics of standard strains for functional antibody detection of pneumococcal polysaccharide vaccine, and provide the foundation for clinical research of pneumococcal polysaccharide vaccine. Methods:The 24 strains for functional antibody detection of pneumococcal polysaccharide vaccine were detected by PCR amplification and sequencing using standard strain 16S rRNA gene fragment, and the molecular typing of the related strains was performed by multi locus sequence analysis (MLST) and pulsed field gel electrophoresis (PFGE). Results:The result of 16S rRNA gene sequence alignment showed that the similarity between the gene sequences of the 24 strains and that of NCTC 7465 (LN831051) ranged from 98.35% to 99.86%, and the base difference was 2-23 bp. Multi locus sequence analysis showed that the ST types of 24 standard strains were different. PFGE analysis showed that 24 standard strains had good isolation effect from DNA fragments of 100 kb-1 000 kb, and each serotype had its own characteristic bands (12-15 fragments).Conclusions:This study analyzed the molecular genetic characteristics of the standard strains for the detection of pneumococcal functional antibodies for the first time, and may provide a reference for the quality control method of the standard strains for the subsequent detection of pneumococcal functional antibodies.

Objective: The serotype screening of Shigella flexneri from 1934 to 1965 preserved by the National Center for Medical Culture Collections was carried out, and the molecular characteristics of the serotype conversion strains were studied. Methods: Serotyping of Shigella flexneri in this study was conducted by slide agglutination and multiplex PCR, respectively. The gtrⅡ gene sequence alignment and pulsed field gel electrophoresis typing were performed on the serotype conversion strains. Results: Among the 255 strains of Shigella flexneri preserved in CMCC (B) from 1934 to 1965, 79 were carrying gtrⅡ gene, of which 19 strains and 1 strain were agglutinated with the Y serotype and X serotype, respectively, and furthermore, the multiplex PCR assays results showed serotypes 2a and 2b, respectively, and the strains were considered to have serotype conversion. The 20 strains carrying the gtrⅡ gene showed multiple nucleotide mutations. Besides 3 strains of 3 amino acid mutations, the amino acid sequences of the other 17 strains showed a stop codon in advance, resulting in functional inactivation of gtrⅡ. PFGE analysis revealed that the similarity between the serotype Y strain carrying the gtrⅡ gene and the serotype 2a strain was 75.8%-100%, and the similarity between the serotype X strain carrying the gtrⅡ gene and the serotype 2b strain was 81.6%-100%. Conclusion Mutations in the gtrⅡ gene are more complicated in serotype-transforming Shigella flexneri serotype Y or X strains. Molecular typing suggests that the serotype-transforming Shigella flexneri serotype Y or X strains may be derived from the Shigella flexneri serotype 2a or 2b, and advance the serotype conversion to 1949.

Sex differences are widely observed under various circumstances ranging from physiological processes to therapeutic responses, and a myriad of sex-biased genes have been identified. In recent years, transcriptomic datasets of microRNAs (miRNAs), an important class of non-coding RNAs, become increasingly accessible. However, comprehensive analysis of sex difference in miRNA expression has not been performed. Here, we identified the differentially-expressed miRNAs between males and females by examining the transcriptomic datasets available in public databases and conducted a systemic analysis of their biological characteristics. Consequently, we identified 73 female-biased miRNAs (FmiRs) and 163 male-biased miRNAs (MmiRs) across four tissues including brain, colorectal mucosa, peripheral blood, and cord blood. Our results suggest that compared to FmiRs, MmiRs tend to be clustered in the human genome and exhibit higher evolutionary rate, higher expression tissue specificity, and lower disease spectrum width. In addition, functional enrichment analysis of miRNAs show that FmiR genes are significantly associated with metabolism process and cell cycle process, whereas MmiR genes tend to be enriched for functions like histone modification and circadian rhythm. In all, the identification and analysis of sex-biased miRNAs together could provide new insights into the biological differences between females and males and facilitate the exploration of sex-biased disease susceptibility and therapy.
Biological Evolution ; Female ; Genome, Human ; Humans ; Male ; MicroRNAs ; blood ; genetics ; Organ Specificity ; Sex Characteristics ; Transcriptome

Objective To identify and rename one strain stored in National Center for Medicine Culture Collections ( CMCC) and used for tracheitis vaccine production. Methods The test strain CMCC (B)29108 and the type strain DSM30007T were cultured on NA medium. Characteristics in morphology, physiology, biochemistry and fatty acid profile were compared between the two strains. Phylogenetic analysis was based on 16S rRNA and rpoB gene sequences, together with the DNA-DNA hybridization assay. Results A Comparative analysis of a partial sequence of the 16S rRNA gene sequence revealed that the CMCC( B) 29108 strain was closed to the Acinetobacter species and showed the highest similarity with the type strain Acinetobacter baumannii DSM30007T. Moreover, the CMCC(B)29108 strain was highly similar to type strain DSM30007T in morphology, physiology, biochemistry and fatty acid profile. On the phylogenetic tree based on 16S rRNA and rpoB gene of all Acinetobacter members, the CMCC(B)29108 strain steadily clustered into one independent branch only with the DSM30007 T strain with a DNA-DNA hybridization value of 100%. Conclusion The CMCC(B)29108 strain that is one of the strains used for the production of tracheitis vac-cine should be assigned to the species of Acinetobacter baumannii based on its phenotypic, phylogenetic and chemotaxonomic characteristics.

Objective To compare the tumor sizes of primary lesions in pancreatic cancer based on CT scan and postoperative pathological analysis and measure the extent of filtration under a microscope,and to determine the CTV in radiotherapy target delineation.Methods A total of 19 patients with pancreatic cancer who were admitted to PLA General Hospital and Air Force General Hospital,PLA from 2013 to 2014 were analyzed.In 15 patients,the maximum diameters of tumor cross-section were measured based on the images of preoperative multi-slice spiral CT and postoperative gross samples,respectively.In 19 patients,the extent of tumor infiltration was measured on pathological sections under a microscope and the actual extent of infiltration was calculated.The paired t-test was applied to analyze the differences in the results of different measurement methods.Results In the 15 patients,the maximum tumor diameters measured with gross samples and CT scan were 33.6 mm and 30.1 mm,respectively (P=0.000),and the median and mean of the differences were 3.1 mm (1.2-8.0 mm) and 3.6±2.0 mm,respectively (95％ CI 1.2-6.0).In the 19 patients,the maximum actual infiltration distance and the maximum distance measured were 3.50 mm and 3.19 mm,respectively (P=0.000),and the median and mean of the differences were 0.31 mm (0.15-0.50 mm) and 0.30±0.09 mm,respectively.The maximum distance between the margin of primary lesions and the infiltrating lesions was 5.21 mm,with a median of 3.34 mm (2.19-5.21 mm) and a mean of 3.50± 0.88 mm (95％ CI 2.19-5.06).Conclusions Contrast-enhanced CT scan underestimates the actual size of primary lesions in pancreatic cancer,and an extension of 5 mm outside gross tumor volume (GTV) as CTV may not be sufficient.It is recommended to extend another 1-3 mm outside GTV as CTV.

Objective To comparatively analyze the advantages and disadvantages between a double immune-diffusion assay and a rate nephelometer analysis for the detection of antigen activity of pneu -mococcal capsular polysaccharides .Methods The antigen activity of pneumococcal capsular polysaccharides of serotypes 1,6B,9V,10A,14 and 19A from four manufacturers and ATCC were analyzed by a double im-mune-diffusion assay and a rate nephelometer analysis , respectively .The effects of antiserum samples and gain values on the rate response value were evaluated .Results The sample 4 of type 9V showed no antigeni-city with a rate response value similar to that of negative control as indicated by both tests .However ,the pre-cipitation lines and the rate response values presented by other polysaccharide samples differed in a wide range.Results of the rate nephelometer analysis were not affected by the anti -serum samples from different sources and the gain values .Conclusion The rate nephelometer analysis could quantitatively analyze the antigen activity of pneumococcal capsular polysaccharides .

Objective To investigate the employment status of higher vocational medical col-lege graduates in Hainan province, analyze the existing employment problems, and put forward some effective suggestions. Methods A questionnaire was applied to survey the employment problems of 1 048 medical graduate in 11 medical related field of Grade 2012. A total of 989 valid questionnaires were collected. The questionnaires covered six aspects including graduates' basic information, their employment intention, access to employment information channel, service and satisfaction about school employment agencies, and employment psychology etc. SPSS 13.0 was used to analyze the statistical numbers in each option and the percentage was calculated. Results Only 22.9%(227/989) of the graduates were willing to accept the provincial employment, 49.1%(486/989) of the graduates obtained employment information channels through the school employment sector; 10.6%(105/989) of gradu-ates expressed dissatisfaction with employment services; graduates' entrepreneurial intention reached 26.9%(267/989); only 19.8% of graduates signed employment agreement, and 25.1%(248/989) of gradu-ates face the employment with anxiety and confusion. Conclusion The higher vocational medi-cal graduates in Hainan provinces need to change their employment concept and school employment guidance needs strengthening to link up the employer position requirements and expectations of grad-uates employment. Besides, the school enrollment professional settings and employment market demand also need to be linked up, to guarantee the system interface between career guidance, internship and training base.

Objective To assess the CSCD-covered 7 journals of pediactrics.Methods The average number of refe rences,cited half life, H index, citation half life, self citation, IF, immediate index, self-cited rate of each paper pub-lished in 2013 in 7 journals of pediactric, covered in China Science and Technology Journal Citation Index Database, were divided into positive correlation group and negative correlation group.Their Spider Web maps were plotted.The papers published in the 7 journals of pediactrics were assessed.Results The top 3 journals, assessed according to the average number of references, IF, and immediate index, were Chinese Journal of Pediatrics,Chinese Journal of Prac-tical Pediatrics, and Chinese Journal of Evidence-based Pediatrics while the top 3 journals, assessed according to their citation half life , self citation, cited half life, and self cited rate, were Chinese Journal of Evidence-based Pe-diatrics,Chinese Journal of Pediatrics, and Journal of Clinical Pediatrics.Conclusion The academic level of the 7 journals of pediatrics is rather high.Chinese Journal of Evidence-based Pediatrics and Chinese Journal of Pediatrics have the highest assessment score.There is a large room for the other 4 journals to improve their academic level.