Objective To compare and analyze the application value of domestic Octoparms and imported Celect inferior vena cava filter(IVCF)in the interventional treatment of venous thromboembolism(VTE).Methods Forty patients with VTE were randomly divided into Octoparms group(experimental group)and Celect group(control group)according to the double-blinded method of the central random system.All the patients underwent filter placement,catheter-directed thrombolysis and filter retrieval.The primary end point was the success of filter placement and retrieval,and the secondary end point included indwelling complications such as the occurrence of pulmonary embolism(PE)and filter tilt and migration.Results Forty patients were enrolled in this study,22 patients and 18 patients were divided into the experimental group and the control group,respectively.Among them,11 cases were identified with right lower extremity deep vein thrombosis,29 cases with left lower extremity deep vein thrombosis,17 cases with PE,and 6 cases with inferior vena cava thrombosis.The success rate of IVCF placement was 100%in all participants.Immediately after filter place-ment,the angle of filter tilt was(3.8±2.3)° in the experimental group and(4.9±2.8)° in the control group(t=1.44,P=0.16).Filter retrieval was successful in 21 cases(21/22,95.5%)of the experimental group and 17 cases(17/18,95.5%)of the control group.There was no significant difference between the two groups(t=0.14,P=0.89).The mean indwelling time of filter was(8.0±2.1)days in the experimental group and(9.7±3.1)days in the control group(t=0.73,P=0.47).The angle of filter tilt was(5.3±3.4)° in the experimental group and(5.7±7.7)° in the control group(t=0.19,P=0.85).There was no significant difference for filter placement and retrieval between the two groups(t=0.48 and 2.00,P=0.06 and 0.64,respectively).There were no complications of filter migration,strut penetration or new PE in both groups.Conclusion The application value of domestic Octoparms and impor-ted Celect IVCF is similar in interventional treatment of VTE.

Objective To observe the value of B1 corrected T1 mapping for distinguishing pathological types and differentiation degrees of lung cancers.Methods A total of 74 lesions in 65 patients with lung cancers were prospectively enrolled,including 49 poorly differentiated lesions and 25 moderately or well differentiated ones,i.e.42 adenocarcinomas,14 squamous cell carcinomas and 18 small cell lung cancers(all poorly differentiated).B1 corrected T1 mapping was performed,ROI(ROI1 and ROI2)were delineated using 2 methods,and T1 values of different pathological types and differentiation degrees lung cancers were compared.The receiver operating characteristic(ROC)curves were drawn,and the areas under the curve(AUC)were calculated.Results Significant differences of T1 values were found among different pathological types of lung cancer(all P＜0.05),as well as between small cell lung cancer and the rest 2 types of lung cancer(both P＜0.05).There were significant differences of T1 values between poorly differentiated and moderately well differentiated lung cancer(squamous cell carcinoma+adenocarcinoma)(both P＜0.05).Taken ROI1 T1 value=1 524.21 ms as the cut-off value,the AUC of T1 value for distinguishing poorly differentiated and moderately well differentiated lung cancer(squamous cell carcinoma+adenocarcinoma)was 0.698,with sensitivity of 64.50％and specificity of 76.00％.Taken ROI2 T1 value=1 630.68 ms as the cut-off value,the AUC of T1 value was 0.676,with sensitivity of 54.80％and specificity of 80.00％.Conclusion B1 corrected T1 mapping was helpful for distinguishing pathological types and differentiation degrees of lung cancers.

Objectives:To analyze the functional movement characteristics after brace treatment for patients with adolescent idiopathic scoliosis(AIS),and to develop and validate a nomogram model to predict the risk of poor outcome.Methods:AIS patients who were treated with braces at our institution from March 2020 to March 2022 were collected as a training set,and were tested for functional movement before treatment,at initial follow-up and after treatment.The same criteria were used to collect AIS patients who underwent brace treatment in our hospital from April 2022 to August 2022 as the validation set.On the basis of whether the degree of scoliosis progression was＞5° after 1 year of treatment,the patients in the training set were divided into stable(≤5°)and progressive(＞5°)groups.Comparison of data was made between groups.Spearman corre-lation analysis was used to analyze the correlation between variables.Logistic regression model was used to screen the risk factors for poor outcomes.R software was applied to develop a nomogram prediction model.Area under curve(AUC)of receiver operating characteristic(ROC)curve and calibration curve were applied to evaluate the discrimination and accuracy of the model.Internal validation was performed with the model predicted risk values before and after training set Bootstrap self-sampling as the test variables and the actual prognosis of patients as the state variable;External validation of the model was performed after randomization of the validation set Bootstrap self-sampling.Results:A total of 102 patients with AIS were included in the training set.There were 73 cases in the stable group and 29 cases in the progressive group(range of degrees of progression:8° to 27°).The median follow-up time was 15.4 months.Both thoracic and lumbar Cobb angles decreased significantly after treatment(P＜0.05).Rotational stability and push-ups were higher at initial follow-up than before treatment,and scores on bow-step squat,hurdle striding,rotational stability,and push-ups improved after treatment(P＜0.05).There was no significant correlation between functional movement characteristics and Cobb angle(P＞0.05).Pre-treatment Cobb angle≥35°,Risser's sign≥3°,apex rotation≥degree Ⅲ,and spinal length gain≥20mm/year were independent risk factors for scoliosis progression.Lumbar spine bone density≥0.8g/cm2 and spinal flexibility≥50%were protective factors.The total value of the risk of scoliosis progression after brace treatment predicted by the nomogram model was 0.93.The AUCs before and after training set self-sampling were 0.928(95%CI:0.858-0.998)and 0.926(95%CI:0.854-0.997),respectively.The validation set included 37 patients.The external validation AUC for validation set was 0.891(95%CI:0.857-0.998).The calibration curves all showed good degree of fitting.Conclusions:Patients with AIS have poor movement patterns due to spinal restrictions.Brace treatment improves trunk stability and rotational stability,which has good corrective effects on the movement pattern.AIS patients with Cobb angle≥35°,Risser's sign≥3°,apex rotation≥degree Ⅲ,spinal length gain≥20mm/year,lumbar spine bone mineral density＜0.8g/cm2,and spinal flexibility＜50%before treatment who underwent bracing are prone to scoliosis progression.Timely warning shall be made based on the nomogram model and postural correction needs to be supplemented at appropriate time to improve the prognosis of AIS brace treatment.

Objective To investigate the effects of comprehensive nutrition management on glycolipid metabolism and pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 121 pregnant women with GDM at 24-28 weeks gestation who were registered in the obstetrics department of 6 sub-central hospi-tals in China from May 2021 to July 2021 were included in this study and were randomly divided into intervention group(n=74)and control group(n=47).The intervention group received intensive comprehensive nutrition man-agement,including at least 6 outpatient interventions,individualized nutrition management and a half-day standard-ized outpatient education on gestational diabetes mellitus,continuous dynamic blood glucose monitoring and micro-blood glucose monitoring,and routine check of glycated albumin and urine every 4 weeks.Body weight,body com-position and diet and exercise implementation procedures and fetal development as well as complications were recor-ded.The control group received conventional nutritional guidance.The two groups were compared for difference in blood glucose related indicators at 37 weeks of gestation,weight gain before delivery,some lipid metabolism indica-tors,pregnancy outcomes,and oral glucose tolerance test(OGTT)at 42 days postpartum.Results Compared with the control group,the level of prenatal fasting blood glucose(P=0.006),intravenous plasma glucose(P=0.009)and blood ketone(P = 0.044)in the intervention group was significantly reduced.There was no significant difference in weight gain and weight attainment rate between the two groups.The 2-hour postpartum OGTTs of preg-nant women in the intervention group(P=0.006)were significantly lower than those in the control group,and the incidence of preeclampsia and postpartum blood loss were lower than those in the control group but no statistical difference was found.For newborns,the incidence of macrosomia(P=0.042)and planation(P=0.048)in the in-tervention group was slightly lower than that in the control group,and the results were statistically different.Other adverse pregnancy outcomes were not statistically different between the two groups.Conclusions Intensive compre-hensive nutrition management has a positive impact on the control of the blood glucose in pregnant women and im-proves the maternal and neonatal outcomes of women with GDM.

OBJECTIVE To optimize the ultrasound-assisted extraction-deep eutectic solvents technology of total flavonoids from Hypericum japonicum， evaluate its hypoglycemic activity in vitro， and analyze its chemical compositions preliminarily. METHODS The most suitable deep eutectic solvent for total flavonoids from H. japonicum was screened using the composition of hydrogen bond acceptor and donor， molar ratio， water content as factors， and the total flavonoid yield as the response value. Using liquid-solid ratio， ultrasonic power， ultrasonic temperature and ultrasonic time as factors， the yield of total flavonoids as response value， the extraction technology of total flavonoids from H. japonicum was optimized by single-factor experiments combined with Box-Behnken response surface method， and the optimum extraction technology was validated. Taking acarbose as the positive control， the inhibitory activities of total flavonoids from H. japonicum on α-amylase and α-glucosidase in vitro were determined. The chemical constituents of total flavonoids from H. japonicum were analyzed by UPLC combined with comparing the reference substances. RESULTS The most suitable deep eutectic solvent was choline chloride-oxalic acid （the molar ratio of 1∶1， the water content of 30%）. The optimum extraction technology was as follows： the ratio of liquid-solid was 52∶1 （mL/g）， the ultrasonic temperature was 54 ℃ ， the ultrasonic power was 240 W， and the ultrasonic time was 42 min； the total extraction yield of total flavonoids from H. japonicum in 3 validation tests was （73.26±2.48） mg/g， the relative error of which with the theoretical value （73.48 mg/g） was －0.30%. The total flavonoids from H. japonicum could inhibit α-amylase and α-glucosidase with IC50 values of 0.73 and 0.44 mg/mL， respectively， which were higher than those of acarbose （0.23 and 0.15 mg/mL）. UPLC analysis showed that the total flavonoids from H. japonicum contained isoquercetin， quercitrin， quercetin-7-O-α-L-rhamnoside and quercetin. CONCLUSIONS The optimized extraction technology of total flavonoids from H. japonicum is stable and feasible， and the extract has certain hypoglycemic activity in vitro and contains isoquercetin， quercitrin and quercetin-7-O-α-L-rhamnoside， etc.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Central medial thalamic nucleus (CM) is a nucleus located in the medullary plate of the midline thalamus. It belongs to the midline nucleus group of the thalamus and serves as a non-specific projection system. CM has extensive anatomical connections with other brain areas and acts as a relay and integration center for brain functions. Recent research has demonstrated that CM is involved in various behaviors such as general anesthesia and arousal, pain, itch, emotions, and cognition. This paper reviews the anatomical structure, morphology, fiber connection, electrophysiological characteristics, and other related functions of CM to provide references for future research.

BACKGROUND: B-cell maturation antigen (BCMA)-directed chimeric antigen receptor T (CAR-T) therapy yield remarkable responses in patients with relapsed/refractory multiple myeloma (R/RMM). Circulating tumor DNA (ctDNA) reportedly exhibits distinct advantages in addressing the challenges posed by tumor heterogeneity in the distribution and genetic variations in R/RMM. METHODS: Herein, the ctDNA of 108 peripheral blood plasma samples from patients with R/RMM was thoroughly investigated before administration of anti-BCMA CAR-T therapy to establish its predictive potential. Flow cytometry is used primarily to detect subgroups of T cells or CAR-T cells. RESULTS: In this study, several tumor and T cell effector-mediated factors were considered to be related to treatment failure by an integrat analysis, including higher percentages of multiple myeloma (MM) cells in the bone marrow (P = 0.013), lower percentages of CAR-T cells in the peripheral blood at peak (P = 0.037), and higher percentages of CD8+ T cells (P = 0.034). Furthermore, there is a substantial correlation between high ctDNA level (>143 ng/mL) and shorter progression-free survival (PFS) (P = 0.007). Multivariate Cox regression analysis showed that high levels of ctDNA (>143 ng/mL), MM-driven high-risk mutations (including IGLL5 [P = 0.004], IRF4 [P = 0.024], and CREBBP [P = 0.041]), number of multisite mutations, and resistance-related mutation (ERBB4, P = 0.040) were independent risk factors for PFS. CONCLUSION: Finally, a ctDNA-based risk model was built based on the above independent risk factors, which serves as an adjunct non-invasive measure of substantial tumor burden and a prognostic genetic feature that can assist in predicting the response to anti-BCMA CAR-T therapy. REGISTERATION Chinese Clinical Trial Registry (ChiCTR2100046474) and National Clinical Trial (NCT04670055, NCT05430945).

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.

Objective:To analyze the changes in serum IL-1β, IFN-γ and IL-4 levels in children with sepsis and analyze their values in the differential diagnosis of Gram-positive (G + )/Gram-negative (G -) bacterial infection. Methods:Clinical data of 195 children with sepsis admitted to Xuzhou Central Hospital from February 2020 to February 2023 were retrospectively analyzed. They were all confirmed to have G + /G - bacterial infection based on pathogen culturing and identification and enrolled as disease group. Another 180 healthy children taking physical examination in the same hospital during the same period were recruited as control group. The distribution of G + /G - bacterial infection in the disease group was analyzed after pathogen culturing. ELISA was used to detect serum IL-1β, IFN-γ and IL-4 levels in both groups. Differences in the levels of serum IL-1β, IFN-γ and IL-4 were compared between the disease group and the control group as well as between the patients with G + /G - bacterial infection. Receiver operating characteristic (ROC) curve was drawn to evaluate the values of serum IL-1β, IFN-γ and IL-4 levels used alone or in combination in the differential diagnosis of G + /G - bacterial infection. Results:A total of 211 strains were isolated from 195 blood culture samples in the disease group, including 181 strains (85.78%) of G + bacteria and 30 strains (14.22%) of G - bacteria. Coagulase-negative Staphylococcus and Salmonella were the predominant bacteria causing G + /G - bacterial infection, respectively. The levels of serum IL-1β and IFN-γ in the disease group were higher than those in the control group ( P<0.05), while the levels of serum IL-4 were similar in the two groups ( P>0.05). The levels of serum IL-1β, IFN-γ and IL-4 in the patients with G - bacterial infection were higher than those in the patients with G + bacterial infection ( P<0.05). The sensitivity and the area under the ROC curve of serum IL-1β, IFN-γ and IL-4 levels used in combination in the differential diagnosis of G + /G - bacterial infection were respectively 91.62% and 0.960, which were higher than those of each parameter used alone ( P<0.01, P<0.05). However, there was no significant difference in the specificity ( P>0.05). Conclusions:The levels of serum IL-1β and IFN-γ increased in children with sepsis, while the serum IL-4 level was basically normal in them. Children with G - bacterial infection tended to have higher serum IL-1β, IFN-γ and IL-4 levels. The combination use of all three parameters showed higher value in the differential diagnosis of G + /G - bacterial infection.