Objective:To evaluate the role of myosin heavy chain 9(MYH9) in gut-vascular barrier damage in septic mice.Methods:Eighty SPF C57BL/6J male mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups( n=20 each) by the random number table method: sham operation group(Sham group), sham operation + MYH9 inhibitor blebbistatin group(Sham+ Ble group), cecal ligation and perforation(CLP) group, and CLP+ blebbistatin group(CLP+ Ble group). A mouse sepsis model was established using CLP in anesthetized animals. Blebbistatin solution 5 mg/kg was intraperitoneally injected at 1 h before CLP in Sham+ Ble and CLP+ Ble groups, while the equal volume of phosphate buffer was given instead in Sham and CLP groups. Fourteen mice were randomly selected from each group to observe the survival at 24 h after CLP. Blood samples were taken by apical puncture at 24 h after surgery in the remaining 6 mice in each group for determination of the plasma concentrations of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β) and interleukin-6(IL-6)(using enzyme-linked immunosorbent assay), expression of plasma membrane vesicle-associated protein(PLVAP) in intestinal microvascular endothelial cells(using immunofluorescence), and expression of MYH9, PLVAP, vascular endothelial calreticulin(VE-cadherin) and β-catenin protein and mRNA(by Western bot or fluorescent quantitative real-time polymerase chain reaction) and for examination of the pathological changes of intestinal tissues. Intestinal damage was assessed and scored according to Chiu. Results:Compared with Sham group, the expression of MYH9 protein and mRNA was significantly down-regulated in Sham+ Ble group, and the survival rate was significantly decreased at 24 h after surgery, Chiu′s scores in intestinal tissues were increased, the plasma concentrations of TNF-α, IL-1β and IL-6 were increased, the expression of PLVAP in intestinal microvascular endothelial cells was up-regulated, the expression of MYH9 and PLVAP protein and mRNA in intestinal tissues was up-regulated, and the expression of VE-cadherin and β-catenin protein and mRNA was down-regulated in CLP group( P<0.05). Compared with CLP group, the survival rate was significantly increased at 24 h after surgery, Chiu′s scores in intestinal tissues were decreased, the plasma concentrations of TNF-α, IL-1β and IL-6 were decreased, the expression of PLVAP in intestinal microvascular endothelial cells was down-regulated, the expression of MYH9 and PLVAP protein and mRNA in intestinal tissues was down-regulated, and the expression of VE-cadherin and β-catenin protein and mRNA was up-regulated in CLP+ Ble group( P<0.05). Conclusions:MYH9 is involved in gut-vascular barrier damage in septic mice.

Objective:To examine the validity and reliability of the Chinese version of the Transgender Atti-tudes and Beliefs Scale(TABS)in the general adult population.Methods:A total of 1 656 residents aged≥18 years were recruited by convenient sampling method,and were equally divided into sample 1 and sample 2 accord-ing to age group.The total sample was used for item analysis and internal consistency reliability test.Sample 1 was used for exploratory factor analysis,Sample 2 was used for confirmatory factor analysis,and 60 residents were se-lected for retesting at a 2-week interval.Results:The TABS Chinese version included a total of 26 items,with the content validity index(I-CVI)of each item ranging from 0.83 to 1.00,and the content validity index(S-CVI)of the scale being 0.98.Exploratory factor analysis extracted 3 common factors,namely interpersonal comfort,gender beliefs,and human value,with a cumulative total variance of 57.13％.Confirmatory factor analysis showed that the scale fit was acceptable(x2/df=2.95,RMSEA=0.05,GFI=0.92,AGFI=0.90).The Cronbach α coefficients of the total score of the scale and the scores of the 3 factors were 0.95,0.95,0.88 and 0.86.The retest reliabilities were 0.88,0.78,0.65 and 0.91.Conclusion:The Chinese version of the Transgender Attitudes and Beliefs Scale(TABS)has good validity and reliability in assessing general adults'attitudes toward the transgender community.

Objective:To evaluate the role of myosin heavy chain 9(MYH9) in gut-vascular barrier damage in septic mice.Methods:Eighty SPF C57BL/6J male mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups( n=20 each) by the random number table method: sham operation group(Sham group), sham operation + MYH9 inhibitor blebbistatin group(Sham+ Ble group), cecal ligation and perforation(CLP) group, and CLP+ blebbistatin group(CLP+ Ble group). A mouse sepsis model was established using CLP in anesthetized animals. Blebbistatin solution 5 mg/kg was intraperitoneally injected at 1 h before CLP in Sham+ Ble and CLP+ Ble groups, while the equal volume of phosphate buffer was given instead in Sham and CLP groups. Fourteen mice were randomly selected from each group to observe the survival at 24 h after CLP. Blood samples were taken by apical puncture at 24 h after surgery in the remaining 6 mice in each group for determination of the plasma concentrations of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β) and interleukin-6(IL-6)(using enzyme-linked immunosorbent assay), expression of plasma membrane vesicle-associated protein(PLVAP) in intestinal microvascular endothelial cells(using immunofluorescence), and expression of MYH9, PLVAP, vascular endothelial calreticulin(VE-cadherin) and β-catenin protein and mRNA(by Western bot or fluorescent quantitative real-time polymerase chain reaction) and for examination of the pathological changes of intestinal tissues. Intestinal damage was assessed and scored according to Chiu. Results:Compared with Sham group, the expression of MYH9 protein and mRNA was significantly down-regulated in Sham+ Ble group, and the survival rate was significantly decreased at 24 h after surgery, Chiu′s scores in intestinal tissues were increased, the plasma concentrations of TNF-α, IL-1β and IL-6 were increased, the expression of PLVAP in intestinal microvascular endothelial cells was up-regulated, the expression of MYH9 and PLVAP protein and mRNA in intestinal tissues was up-regulated, and the expression of VE-cadherin and β-catenin protein and mRNA was down-regulated in CLP group( P<0.05). Compared with CLP group, the survival rate was significantly increased at 24 h after surgery, Chiu′s scores in intestinal tissues were decreased, the plasma concentrations of TNF-α, IL-1β and IL-6 were decreased, the expression of PLVAP in intestinal microvascular endothelial cells was down-regulated, the expression of MYH9 and PLVAP protein and mRNA in intestinal tissues was down-regulated, and the expression of VE-cadherin and β-catenin protein and mRNA was up-regulated in CLP+ Ble group( P<0.05). Conclusions:MYH9 is involved in gut-vascular barrier damage in septic mice.

Objective:To examine the validity and reliability of the Chinese version of the Transgender Atti-tudes and Beliefs Scale(TABS)in the general adult population.Methods:A total of 1 656 residents aged≥18 years were recruited by convenient sampling method,and were equally divided into sample 1 and sample 2 accord-ing to age group.The total sample was used for item analysis and internal consistency reliability test.Sample 1 was used for exploratory factor analysis,Sample 2 was used for confirmatory factor analysis,and 60 residents were se-lected for retesting at a 2-week interval.Results:The TABS Chinese version included a total of 26 items,with the content validity index(I-CVI)of each item ranging from 0.83 to 1.00,and the content validity index(S-CVI)of the scale being 0.98.Exploratory factor analysis extracted 3 common factors,namely interpersonal comfort,gender beliefs,and human value,with a cumulative total variance of 57.13％.Confirmatory factor analysis showed that the scale fit was acceptable(x2/df=2.95,RMSEA=0.05,GFI=0.92,AGFI=0.90).The Cronbach α coefficients of the total score of the scale and the scores of the 3 factors were 0.95,0.95,0.88 and 0.86.The retest reliabilities were 0.88,0.78,0.65 and 0.91.Conclusion:The Chinese version of the Transgender Attitudes and Beliefs Scale(TABS)has good validity and reliability in assessing general adults'attitudes toward the transgender community.

Objective:To systematically review and evaluate the predictive efficacy of various derived indicators of sequential organ failure assessment (SOFA) in mortality rate of sepsis patients.Methods:Literature on sepsis and SOFA scores were searched in PubMed, Embase and Cochrane Library. The retrieval time will be set to the time of database-building to February, 2023. The main outcome measures included 28-day mortality, 30-day mortality, in-hospital mortality, intensive care unit (ICU) mortality and long-term mortality. Literature screening, data extraction and quality evaluation were carried out independently by 2 researchers. Data were analyzed by Revman 5.3.5, Meta-disc and Stata software. Deek funnel plots were used to assess publication bias in the included studies.Results:A total of 40 articles including 51 trials were included. Of these, 32 were in English and 8 in Chinese, 17 were in prospective trials and 34 were in retrospective trials, 38 were in initial SOFA-related trials and 9 were in the change of SOFA score (ΔSOFA)-related studies, a total of 59?962 patients were enrolled. ① The area under the receiver operator characteristic curve (AUC) of initial SOFA and ΔSOFA for predicting outcome in sepsis was 0.773 and 0.787 ( Z = 0.115, P > 0.05), respectively. There was no significant difference between the two indexes in predicting the outcome of patients with sepsis. ② In subgroup analysis, due to limitations in the number of literature articles, the 28-day mortality rate and 30-day mortality rate were merged for discussion. The predictive power of ΔSOFA for 28-day or 30-day mortality was significantly higher than that of initial SOFA (AUC was 0.854, 0.787, Z = 2.603, P ≤ 0.01). ③ There were few studies onΔSOFA in predicting in-hospital mortality, ICU mortality and long-term mortality of sepsis patients. The AUC of the initial SOFA for predicting the study endpoints described above was: ICU mortality (0.814) > 28-day or 30-day mortality (0.787) > in-hospital mortality (0.697) > long-term mortality (0.646). ④ Initial SOFA and ΔSOFA in patients with sepsis of non-Han original had good predictive performance and there was no significant difference between them (AUC was 0.766, 0.811, respectively). However, the pooled sensitivity of ΔSOFA was higher (92%). ⑤ In prospective studies, initial SOFA was better at predicting outcomes in patients with sepsis (AUC was 0.804, pooled sensitivity 64%). The sensitivity of ΔSOFA indicators in predicting the outcome of sepsis patients was significantly higher than the initial SOFA (78% vs. 64%). The funnel plot showed that there was no significant publication bias in the included literature. Conclusion:ΔSOFA has a relatively high diagnostic efficacy in predicting short-term (28-day or 30-day) mortality in patients with sepsis.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Intravascular large B-cell lymphoma(IVLBCL)is an aggressive extranodal large B-cell lymphoma,cocurrence in the same organ with other malignancies is very rare,especially in the lung.Here,we report a rare case of lung adenocarcinoma with IVLBCL.The patient was admitted to the hospital due to diarrhea associated with fever and cough.A computed tomography(CT)scan of the chest showed an irregular patchy high-density shadow in the upper lobe of the right lung with ground-glass opacity at the margin.After admission,the patient was given anti-infection treatment,but still had inter-mittent low fever(up to 37.5 oC).The pathological diagnosis of percutaneous lung biopsy(PLB)was lepidic-predominant ad-enocarcinoma with local infiltration,which was proved to be invasive nonmucinous adenocarcinoma of the lung with IVLBCL after surgery.This paper analyzed the clinicopathological characteristics and reviewed the relevant literature to improve the knowledge of clinicians and pathologists and avoid missed diagnosis or misdiagnosis.

Objective:To compare results of four glycosylated hemoglobin A1c (HbA1c) detection methods and to evaluate the uncertainty of HbA1C results in clinical laboratory, and to provide method for clinical laboratory on the evaluation of uncertainty.Methods:According to the four uncertainty evaluation methods, which were recommended by "CNAS-TRL-001, the evaluation and expression of measurement uncertainty in medical laboratory", the relative and absolute uncertainty of low, medium and high HbA1c in 33 clinical laboratories measured in 2019 and 35 clinical laboratories measured in 2020 was evaluated by more than 6 months of internal quality control (IQC) data, trueness verification and external quality assessment (EQA) data. The four uncertainty evaluation methods were: IQC data and trueness verification data (method 1), only trueness verification data (method 2), IQC and EQA data (method 3) and only EQA data (method 4). The related statistical methods used in this analysis were Friedman and Wilcoxon signed rank test.Results:For method 1, the median range of relative and absolute uncertainty of low, medium and high HbA1c detection in 2019 and 2020 ranged from 4.21% to 9.24% and from 0.27% to 0.64%, respectively. Compared to method 1, the relative and absolute uncertainties obtained by method 2 were smaller, and the differences were statistically significant ( P<0.016 7, P<0.05). Compared to method 1, the relative uncertainties obtained by method 3 and method 4 were smaller, except for the high concentration of HbA1c level in 2020. Among the 6 pairs of comparisons (low, medium and high HbA1c in 2019 and 2020), there were 3 pairs (high HbA1c in 2019, low and medium HbA1c in 2020) and 2 pairs (low and high HbA1c in 2020) of differences with statistical significance (all P<0.016 7). Conclusion:The uncertainty evaluation of HbA1c detection in clinical laboratory should be evaluated based on IQC and trueness verification data.

Objective:To investigate the epidemiological data of maternal sepsis in intensive care unit (ICU), analyze the common causes, outcomes of maternal sepsis, and the risk factors of multi-drug resistant (MDR) bacteria.Methods:A retrospective cohort study. Maternal sepsis cases admitted to ICUs of Peking University Third Hospital, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, and Beijing Friendship Hospital Affiliated to Capital Medical University from January 2008 to September 2022 were enrolled. The following data were recorded: demographic characteristics, sequential organ failure assessment (SOFA) during infection, infection time, infection sites, invasive intervention measures before infection, microbial culture results, blood routine test during infection, body temperature, and clinical outcomes caused by infection. According to the time of sepsis occurrence, the patients were divided into pre-ICU sepsis group and ICU sepsis group, and the causes of sepsis in the two groups were analyzed. According to whether MDR occurred, the patients were divided into MDR group and non-MDR group, and clinical outcomes were analyzed. Multivariate Logistic regression was used to analyze the risk factors of MDR bacteria infection in obstetrics with sepsis.Results:160 patients were enrolled, among which 104 cases of sepsis happened before ICU and 56 cases of sepsis happened during ICU, 53 cases were with MDR bacteria and 107 cases were without MDR bacteria. The median age of the patients was 30.5 (28.0, 34.0) years old, the median temperature was 38.8 (38.2, 39.5) ℃, and the median white blood cell count (WBC) was 17.2 (13.2, 21.3)×10 9/L, the median SOFA score was 5.0 (3.0, 8.0), and 130 cases (81.2%) were referred from other hospitals. The main infection sites were uterine cavity in 64 cases (40.0%), lung in 48 cases (30.0%), abdominal and pelvic cavity in 30 cases (18.8%), urinary system in 27 cases (16.9%). Sepsis led to hysterectomy in 6 cases (3.8%), stillbirth in 8 cases (5.0%), and neonatal death in 2 cases (1.3%). The main surgical intervention measures were cesarean section (44 cases, accounting for 27.5%), followed by exploratory laparotomy (19 cases, 11.9%). The median length of ICU stay was 5.0 (3.0, 10.0) days, and the median hospital length was 14.0 (10.0, 20.8) days. Intrauterine infection was the primary cause of sepsis happened during ICU, accounting for 50.0% (28/56), of which postpartum hemorrhage accounted for 85.7% (24/28). The proportion of diabetes [28.3% (15/53) vs. 14.0% (15/107)], intrauterine operation [41.5% (22/53) vs. 23.4% (25/107)], intrauterine infection [50.9% (27/53) vs. 34.6% (37/107)] and bacteremia [18.9% (10/53) vs. 2.8% (3/107)] in the MDR group were significantly higher than those in the non-MDR group (all P < 0.05). Multivariate Logistic regression analysis showed that diabetes [odds ratio ( OR) = 2.348, 95% confidence interval (95% CI) was 1.006-5.480, P = 0.048] and intrauterine operation ( OR = 2.541, 95% CI was 1.137-5.678, P = 0.023) were independent risk factors for MDR bacterial infection in obstetrics with sepsis. Conclusions:Intrauterine infection is the common cause of maternal sepsis in ICU, and postpartum hemorrhage is the common cause of secondary intrauterine infection in ICU. MDR bacteria can lead to serious clinical outcomes. Diabetes and intrauterine operation are independent risk factors for MDR bacteria' infection.

Objective:To construct a novel cuproptosis-related gene signature (CRGS) for prediction of prognosis, immunotherapy response and drug sensitivity in patients with hepatocellular carcinoma (HCC).Methods:Data materials for this study were obtained from the international cancer genome consortium (ICGC), the cancer genome atlas (TCGA) database and Migort210 database, and protein expression profiles were obtained from the human protein atlas image classification database. Based on the TCGA cohort, the least absolute shrinkage and selection operator algorithm was applied to construct the CRGS and calculate the risk score for each HCC patient. HCC patients were grouped according to the median risk score: HCC patients in the TCGA cohort were divided into a high-risk group TCGA and a low-risk group TCGA with 184 cases in each group; HCC patients in the ICGC cohort were divided into a high-risk group ICGC and a low-risk group ICGC with 116 cases in each group. Patients in the Migort210 cohort were divided into a responder group ( n=68) and a non-responder group ( n=230) based on their response to immunotherapy. We assessed the value of CRGS in predicting the prognosis of HCC patients in the TCGA cohort and validated whether CRGS could be used to predict the prognosis of HCC patients in the ICGC dataset. To explore the role of CRGS in predicting immunotherapy response and drug sensitivity in HCC patients based on data from the TCGA cohort, and to apply the Migort210 immunotherapy cohort to validate the clinical value of CRGS in predicting immunotherapy in malignant tumors. Results:CRGS consists of four copper death-related genes: GLS, CDKN2A, LIPT1, and DLAT. Patients in the high-risk group TCGA had lower overall survival (OS), disease-specifical survival, and progression-free interval than those in the low-risk group TCGA (all P<0.01). OS of patients in the high-risk group ICGC was lower than that in the low-risk group ICGC ( P=0.022). Multivariate Cox regression analysis showed that CRGS was an independent risk factor for poor prognosis in HCC patients (TCGA: HR=2.991, 95% CI: 1.781-5.049, P<0.001; ICGC: HR=4.621, 95% CI: 1.685-12.674, P=0.033). Risk scores were positively correlated with the expression levels of CTLA4, PDCD1, CD80 and HLLA2 (all P<0.001). Patients in the high-risk group TCGA had lower tumor immune dysfunction and rejection scores than those in the low-risk group TCGA [-0.04(-0.07, -0.02) vs. -0.02(-0.04, 0) points], and the difference was statistically significant ( P<0.001). Patients in the responder group had a higher risk score than the non-responder group [1.70 (1.56, 1.90) vs. 1.63 (1.52, 1.80)], with a statistically significant difference ( P<0.05). The half-inhibitory concentrations (IC 50) for sunitinib, rapamycin and etanercept were higher in the high-risk group TCGA than that in the low-risk group TCGA, while the IC 50 for erlotinib was lower than that in the low-risk group TCGA, and the differences were all statistically significant (all P<0.001). Conclusion:The CRGS might be served as a potential biomarker to predict the prognoses, immunotherapy response, and drug sensitivity of patients with HCC.