The contents recorded in the rotation registration manual is not only the quantitative indicators for evaluating the quality of residency training, but also the important basis for training assessment and issuance of training certificates. In order to solve the problems of data authenticity, information delay, and repeated entry in the rotation registration manual for residency training, Shanghai East Hospital, Tongji University, launched a project to dock the electronic rotation registration manual with the hospital information system. Through the establishment of the project team, the development of working mechanisms, and the implementation of the project, data analysis was used for process reformation and system optimization, so as to continuously improve management efficiency and medical safety while solving problems and form a set of implementation system with reference significance in practice.

Objective To investigate the diagnostic value of three-dimensional power Doppler ultrasound(3D-PDUS)in fetal growth restriction(FGR).Methods A total of 120 pregnant women in the third trimester who were given birth in Wenzhou People's Hospital from September 2021 to December 2023 were selected as study objects,50 pregnant women with FGR confirmed by clinical and ultrasound were included in case group,and 70 pregnant women with normal fetal development were included in control group.The renal volume and renal blood flow parameters of the fetuses in two groups were compared.The pregnancy outcomes and perinatal conditions of two groups were compared.Receiver operating characteristic(ROC)curve was plotted to calculate the area under the curve(AUC),and the diagnostic efficacy of various blood flow parameters for FGR was evaluated.Results The renal volume/gestational week,renal vascularization index,vascularization flow index and renal artery peak systolic velocity of the fetuses in case group were significantly lower than those in control group,while renal artery peak systolic velocity/end diastolic velocity,pulsation index and resistance index were significantly higher than those in control group(P＜0.05).There was no significant difference in renal flow index between two groups(P＞0.05).ROC curve results showed that the diagnostic efficacy of renal volume/gestational week and renal artery peak systolic velocity were higher,while the diagnostic efficacy of combined application was the highest,with an AUC of 0.89.The rate of low birth weight infants in case group was significantly higher than that in control group,and neonatal Apgar score was significantly lower than that in control group(P＜0.01).Conclusion 3D-PDUS quantitative analysis parameters evaluated renal volume and blood perfusion could predict FGR,which is conducive to early diagnosis of FGR and guide clinical intervention,and effectively reduce adverse pregnancy outcomes.

Objective To explore the clinical characteristics of drug-induced liver injury(DILI),and provide reference for early clinical recognition,diagnosis and treatment of DILI.Methods Clinical datas of 65 patients with DILI hospitalized in the First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2019 to December 2023 were retrospectively analyzed,and their general conditions,using drugs,distribution type of liver injury,traditional Chinese medicine treatment and outcome were statistically analyzed.Results A total of 65 patients were included,including 27 males and 38 females,with an average age of(46.40±19.19)years old.The majority of patients were 41 to 60 years old.Chinese herbal medicine and Chinese patent medicine accounted for the highest proportion of drugs inducing DILI(30.8％).Hepatocyte injury was the most common type of DILI,with 39 cases.The main clinical manifestations of DILI patients were fatigue,abdominal discomfort,aversion to oil,yellow eyes,yellow urine and so on.In the treatment of traditional Chinese medicine,liquorice root was the most frequently used,with a frequency of 60.7％.After active treatment,59 patients were cured and discharged from hospital.Conclusion Hepatocyte injury is the main type of DILI.Clinical monitoring of hepatotoxicity of traditional Chinese herbal medicine and Chinese patent medicine should be strengthened to reduce the damage to liver caused by adverse drug reactions.

Conventional administration methods have problems including low bioavailability, complex operation process, and discomfort of patients with fear of needles. Transdermal delivery can avoid these problems, whereas most drugs are difficult to directly penetrate the skin cuticle and reach the diseased site. Microneedling is an emerging method of local drug delivery, enabling the drug penetration through the stratum corneum of the skin in a minimally invasive manner and delivering the drug directly to the diseased site, thereby improving the treatment effect. Stimuli-responsive microneedles have attracted much attention because of the spatiotemporal controllability, high drug delivery efficiency, and mild potential side effects. This review introduced the commonly used materials and various types of stimuli-responsive microneedles and the drug release mechanisms. In addition, this paper expounded the biomedical applications of stimuli-responsive microneedles as drug delivery systems in response to different stimuli and discusses the challenges and potential solutions for stimuli-responsive microneedles.
Needles ; Drug Delivery Systems/instrumentation* ; Microinjections/instrumentation* ; Humans ; Administration, Cutaneous

Objective:To investigate the correlation between the prognosis of late-onset depression(LOD)in the elderly and lncRNA expression levels and coping styles.Methods:Differential expression of lncRNAs in peripheral blood of LOD 92 patients was detected by a real-time quantitative PCR(qPCR)detection system, and the Hamilton Depression Scale(HAMD)and the Trait Coping Style Questionnaire(TCSQ)were used for psychological assessment.Results:Compared with the control group, the expression levels of TCONS_00019174(7.55 vs.4.36), ENST00000566208(6.48 vs.3.26), ENST00000517573(8.33 vs.5.32)and NONHSAT142707(6.78 vs.3.26)in elderly patients of the LOD group were significantly down-regulated( Z=5.09, 5.87, 4.35, 6.44, P<0.05); Compared with the low-expression subgroup, scores of anxiety/somatization[(3.83±1.40) vs.(6.39±2.35)], diurnal variation[(0.22±0.42) vs.(0.83±0.94)], retardation[(5.74±0.96) vs.(6.48±1.28)], hopelessness[(2.78±0.67) vs.(4.52±1.56)]and HAMD[(20.39±1.75) vs.(26.83±4.88)]in the high-expression subgroup were significantly lower( t=-4.50, -2.84, -2.22, -4.90, -5.96, P<0.05). The ΔCT value of TCONS_00019174 was negatively correlated with the reduction rates of anxiety/somatization, diurnal variation, retardation, sleep disturbance, hopelessness and HAMD( r=-0.40-0.66, P<0.05). The ΔCT value of ENST00000566208 was negatively correlated with the reduction rates of anxiety/somatization, sleep disturbance, hopelessness and HAMD( r=-0.47-0.62, P<0.01). The ΔCT values of ENST00000517573, NONHSAT034045 and NONHSAT142707 were negatively correlated with the reduction rates of retardation, sleep disturbance, hopelessness and HAMD( r=-0.39-0.76, P<0.05). The positive coping style was positively correlated with the reduction rates of HAMD, anxiety/somatization, retardation, sleep disturbance and hopelessness( r=0.38-0.55), while the negative coping style was negatively correlated with the reduction rates of HAMD, anxiety/somatization, sleep disturbance and hopelessness( r=-0.39-0.67, P<0.05). When TCONS_00019174, ENST00000566208, NONHSAT034045, NONHSAT142707, positive coping and negative coping were taken into the regression equation as variables for HAMD reduction, it was found that they were able to explain 32.4% of the variance for the reduction rate of the total HAMD score( t=-8.713, -3.584, -3.864, -2.257, 5.675, -2.357, P<0.05). Conclusions:TCONS_00019174, ENST00000566208, NONHSAT034045, NONHSAT142707, positive coping style and negative coping style are predictors of the prognosis of LOD in the elderly.

Objective:To analyze the clinical characteristics and predictive factors of SSc associated heart disease.Methods:The clinical data of patients with SSc from January 2016 to December 2021 in Ningbo Medical Center Lihuili Hospital were collected. Aight healthy controls come from the medicial examination center. They were divided into a positive group and a negative group based on whether heart involvement was present or not. The clinical manifestations of the two groups were compared by t test, Wilcoxon signed rank test and χ2 test and Logistic regression or ROC curve was used to analyze the prognostic risk of SSc associated heart disease. Then the transcriptome sequencing was used to analyze the differential gene expression. Results:①A total of 75 SSc patients were treated in our hospital, of which 6 patients with overlap syndrome and 1 patient with congenital heart disease were excluded. The clinical data of 68 patients were analyzed including 16 patients in the positive group and 52 patients in the negative group. Among the 16 patients with cardiac involvement, 12 patients (75.0%) had abnormal electrocardiogram, 9 patients (56.2%) with heart valve disease, 8 patients (50.0%) with abnormal cardiac structure and 8 patients (50.0%) with pericardial effusion. The biomarkers were elevated in 10 cases (83.3%). ②Univariate analysis showed that the positive group had a longer course of disease [120(11.2, 132) months vs 48(24, 90)months, Z=-2.08, P=0.037], and the rate of pulmonary arterial hypertension (50.0% vs 11.5%, χ2=11.07, P<0.001) and renal insufficiency(50.0% vs 3.8%, χ2=20.78, P<0.001) in the positive group were significantly higher than those in the negative group. Further Logistic regression analysis revealed that long course of disease [ OR (95% CI) =1.011 (1.001, 1.021), P=0.031], pulmonary arterial hypertension [ OR (95% CI) =5.431, 95% CI (1.065, 27.710), P=0.042] and renal insufficiency [ OR (95% CI) =30.444 (4.139, 223.938), P<0.001] were risk factors for SSc associated heart disease. ③Nail-fold videocapillaroscopy (NVC) was checked in 63 patients. The difference of abnormal NVC changes between the two groups was statistically significant (93.3% vs 58.3%, χ2=5.87, P=0.013). The total number of capillaries in the positive group was significantly less than that in the negative group [3.5(2, 4.8) vs 6 (5, 7), Z=-2.97, P=0.003]. Further ROC curve analysis showed that the total number of capillaries less than 4.5 predicted the occurrence of cardiac involvement (sensitivity was 80.0%, specificity was 83.8%), and the area under the ROC curve (95% CI) was 0.805 (0.061, 1.000, P=0.003).④The transcriptome of a total of 11 SSc patients (including 6 in the positive group and 5 in the negative group) and 8 healthy controls were analyzed to obtain the synchronously down regulated gene TNFRSF13B. The differences between the three groups were statistically significant ( χ2=11.88, P=0.003), especially in the positive group and the healthy controls( χ2=11.19, P=0.004). Conclusion:SSc patients with long course of disease accompanied by PAH and renal insufficiency are prone to have heart involvement. Early capillary endoscopy is also helpful to predict the risk of heart involvement. Moreover, TNFRSF13B genetic testing is helpful but further study is needed.

Objective:To establish neurodevelopmental mice model of schizophrenia(SZ) with prepulse inhibition(PPI) deficits and investigate the effectiveness of olanzapine on PPI disruption.Methods:On the 9th day of pregnancy of SPF grade C57BL/6 mice, female mice were injected with polyinosinic acid poly (I∶C) (6 mg/kg) through tail vein for immune stimulation. The stress model was constructed by chronic unpredictable mild stress 30-40 d after birth (PND30-40). The offspring mice were divided into pregnancy immune stimulation + adolescent stress group (P + S + group), pregnancy immune stimulation group (P + S- group), adolescent stress group (P-S+ group) and non stimulation group (P-S-group), with 18 mice in each group. The mice in P+ S+ group were divided into OLZ intervention group (OLZ group) and non-OLZ intervention group (non-OLZ group), with 9 mice in each group. The PPI function of mice was detected by acoustic startle reflex test after modeling and OLZ intervention. Adopt StatView Version 5.0 software for data analysis, and multi factors analysis of variance was used to test the main effect, interactive effect and simple effect of each factor.Results:The main effects of maternal Poly(I: C) immune activation and pubertal chronic unpredictable stress were significant( F(1, 330)=47.72, P<0.01), and there was a significant interaction between the two factors( F(1, 330)=14.80, P<0.01), simple effect analysis showed that average percent prepulse inhibition (PPI%) in P+ S+ group((15.42±6.13)%) was significantly decreased compared with groups of P+ S-((27.33±4.58)%), P-S+ ((31.17±3.97)%) and P-S-((47.14±12.28)%)(all P<0.01). There was significant gender difference in Prepulse inhibition(PPI)score( F(1, 396)=61.94, P<0.01), in male and female mice, average startle reactivity of Pulse under Prepulse+ Pulse influence of distinct intensities was significantly different( F(1, 198)=18.68, 18.44, P<0.01), and the maternal Poly(I∶C) immune activation had a significant main effect( F(1, 198)=32.18, 12.58, P<0.01) and interaction with pubertal chronic unpredictable stress( F(1, 198)=34.54, 11.39, P<0.01), simple effect analysis suggested that the average startle reactivity of Prepulse+ Pulse in P+ S+ group(0.47±0.12) was significantly higher than other three groups(P+ S-: 0.36±0.11, P-S+ : (0.25±0.22), P-S-: (0.31±0.19)) in male mice( P<0.01) and in P-S+ group was significantly higher than the other three groups in female mice ( P<0.01). OLZ treatment could efficiently reverse the deficits on PPI by increasing PPI%( F(1, 165)=18.24, P<0.01), OLZ could reduce PPI score in male "dual-hit" model mice( F(1, 102)=21.81, P<0.01)and raise it in female( F(1, 102)=4.88, P<0.05). Conclusion:OLZ can reverse PPI deficits in schizophrenic neurodevelopmental model mice, and in the evaluation of PPI function in the model mice through PPI of acoustic startle reflex, PPI% has better stability and reactivity to OLZ intervention.

Objective:To explore personality change and its association with lncRNA expression of peripheral blood mononuclear cells in patients with epilepsy.Methods:Fifty-eight epilepsy patients recruited by the convenient sampling were assessed utilizing personality diagnostic questionnaire(PDQ) for personality change screening.The expression levels of lncRNA in peripheral blood of study group and the controls were investigated by qRT-PCR.Descriptive statistical analysis, correlation analysis, regression analysis and ROC analysis were employed for data processing.Results:There were 9 of schizoid (S≥4), 11 of schizotypal(S≥5), 17 of paranoid (S≥4) and 15 of compulsive (S≥4) personality change in epilepsy patients, and 52 patients had different types personality changes(89.66%).Schizoid, schizotypal, paranoid and compulsive personality changes were negatively correlated with expression levels of NONHSAG012869(PR3), NONHSAT006265(PR4), ENST00000581634(PR6) and ENST00000524610(PR8) ( r=-0.46--0.71, P<0.05 or 0.01).PR1, PR3, and PR8 had significant predictive effects on schizoid personality change ( P<0.01), PR4, PR8 had a significant predictive effect on schizotypal personality change ( P<0.01), PR3, PR4 and PR6 had significant predictive effects on paranoid personality change( P<0.05), and PR4, PR5, PR8 had significant predictive effects on compulsive personality change ( P<0.05).The effects of lncRNAs on the personality change variance accounted for 0.36, 0.30, 0.40, 0.20 respectively.ROC curve analysis of the diagnostic value of lncRNA expression level on personality change in the epilepsy group showed that NONHSAG012869 (PR3), NONHSAT006265(PR4), ENST00000581634(PR6) and ENST00000524610(PR8) had certain diagnostic value for personality change.The area under curve(AUC)=0.650-0.682, P<0.05, 95% CI: 0.546-0.784. Conclusion:Schizoid, schizotypal, paranoid, and compulsive personality change are common in epileptic patients, and the expression level of peripheral blood lncRNA has a certain diagnostic value for personality change.

Objective:To explore the effects of expression level of long noncoding RNA (lncRNA) in peripheral blood mononuclear cells (PBMCs), chronic stress in childhood on cognitive function for providing scientific basis of prevention, intervention and rehabilitation of cognitive impairment in schizophrenia patients.Methods:Quantitative real-time PCR (qPCR) was used to screen lncRNA expression in peripheral blood mononuclear cells (PBMCs) of 100 schizophrenic patients who was recruited by convenient sampling, and all the patients were assessed by Montreal cognitive assessment-Beijing version (MoCA) and childhood chronic stress questionnaire (CCSQ). Mann-Whitney test, t-test, correlation analysis and regression analysis were employed for data processing. Results:The ΔCt values of NONHSAT089447(5.07), NONHSAT041499(8.56) were higher ( Z=-2.38, -2.07, P<0.05) and scores of all three CCSQ dimensions were lower in higher MoCA goup than those in lower MOCA group (peer bullying: 42.36±11.13 vs 50.84±9.09, abuse and neglect: 55.08±14.22 vs 69.56±13.45, adverse life events: 47.64±12.21 vs 55.80±13.92, t=-2.20--3.70, P<0.05 or 0.01). The ΔCt value of NONHSAT089447, NONHSAT041499 positively correlated with scores of visuospatial-executive, language, abstraction and delayed recall ( r=0.43-0.75, P<0.01). All three CCSQ dimensions negatively correlated with scores of visuospatial-executive, attention, language, abstract thinking and delayed recall ( r=-0.40--0.62, P<0.05 or 0.01). Multiple regression analysis showed that the ΔCt valueof NONHSAT089447, abuse and neglect in childhood significantly predicted the total score of MOCA, which could explained 31.9% of variation ( t=4.31, 5.89, P=0.007, 0.001). The ΔCt value of NONHSAT089447, NONHSAT041499 negatively correlated with peer bullying, abuse and neglect in childhood ( r=-0.39--0.53, all P<0.01). Conclusion:There are correlation in NONHSAT089447, NONHSAT041499 and chronic stress in childhood in patients with schizophrenia, which can jointly predict their cognitive function.