Height， as one of the crucial indicators for assessing children’s growth and development， has consistently been a global focus. With economic development and improvements in social living standards， the clinical management needs for children with short stature have been increasingly growing. While growth hormone brings hope to children with short stature， it also triggers ethical challenges such as medical standardization， expansion of indications， equitable accessibility， and informed consent. To avoid the ethical issues related to the use of pediatric growth hormone， multidimensional and comprehensive clinical management should be implemented for children with short stature， including strictly adhering to medical standards and ethical guidelines， enhancing public awareness， and promoting the standardized development of recombinant human growth hormone （rhGH） therapy and ethics.

Hypoxic-ischemic (HI) brain damage poses a high risk of death or lifelong disability, yet effective treatments remain elusive. Here, we demonstrated that miR-100-5p levels in the lesioned cortex increased after HI insult in neonatal mice. Knockdown of miR-100-5p expression in the brain attenuated brain injury and promoted functional recovery, through inhibiting the cleaved-caspase-3 level, microglia activation, and the release of proinflammation cytokines following HI injury. Engineered extracellular vesicles (EVs) containing neuron-targeting rabies virus glycoprotein (RVG) and miR-100-5p antagonists (RVG-EVs-Antagomir) selectively targeted brain lesions and reduced miR-100-5p levels after intranasal delivery. Both pre- and post-HI administration showed therapeutic benefits. Mechanistically, we identified protein phosphatase 3 catalytic subunit alpha (Ppp3ca) as a novel candidate target gene of miR-100-5p, inhibiting c-Fos expression and neuronal apoptosis following HI insult. In conclusion, our non-invasive method using engineered EVs to deliver miR-100-5p antagomirs to the brain significantly improves functional recovery after HI injury by targeting Ppp3ca to suppress neuronal apoptosis.
Animals ; MicroRNAs/metabolism* ; Extracellular Vesicles/metabolism* ; Mice ; Recovery of Function/physiology* ; Hypoxia-Ischemia, Brain/therapy* ; Mice, Inbred C57BL ; Antagomirs/administration & dosage* ; Male ; Animals, Newborn ; Apoptosis/drug effects* ; Brain Injuries/metabolism* ; Glycoproteins ; Peptide Fragments ; Viral Proteins

Objective To analyze the efficacy of modified transvaginal rectal repair(MTVRR)in patients with moderate to severe rectocele(RC).Methods A retrospective analysis was conducted on the clinical data of 21 female patients with RC who underwent MTVRR.The Constipation Scoring System(CSS)scale was used to assess patients'constipation symptoms before surgery and at 3,6,12 and 24 months after surgery,and the efficiency of symptom improvement was recorded.The occurrence of postoperative complications in RC patients was observed.Results All 21 patients successfully un-derwent the surgery,with surgical duration ranging from 25 to 135 minutes,with average of(83.14±30.39)minutes,and hospital stay ranging from 10 to 21 days,with average of(14.10±2.34)days.Postoperatively,one patient was lost during follow-up among 21 patients.The CSS scores of the remai-ning 20 patients were lower than those before surgery,with a statistically significant difference(P＜0.05).The overall effective rates of constipation symptom improvement at 3,6 and 12 months postop-eratively were 100.00％,90.00％and 80.00％,respectively.Among 20 patients,15 patients com-pleted 24-month follow-up after surgery,and the CSS score after surgery was lower than that before sur-gery,the difference was statistically significant(P＜0.05).The CSS scores of the remaining 15 pa-tients were lower than those before surgery,with a statistically significant difference(P＜0.05).The overall effective rate of constipation symptom improvement at 24 months postoperatively was 80.00％among 15 patients.During postoperative follow-up,it revealed that no complications occurred in any patient.Conclusion MTVRR can improve constipation symptoms in patients with RC,demonstra-ting good therapeutic efficacy.

Objective To observe the value of Node-RADS based on dynamic contrast-enhanced MRI(DCE-MRI)for assessing axillary lymph node metastasis of breast cancer.Methods A total of 308 patients with breast cancer were retrospectively enrolled and divided into metastasis group(n=153)and non-metastasis group(n=155)based on the presence of axillary lymph node metastasis or not.Two radiologists independently scored the axillary lymph nodes shown on DCE-MRI according to Node-RADS criteria.Inter-observer scores was assessed using Kappa test.Taken pathological result as the gold standard,receiver operating characteristic curves were plotted,and the area under the curve(AUC)was calculated to evaluate the efficacy of Node-RADS scores for diagnosing axillary lymph node metastasis.Results Good inter-observer consistency of Node-RADS scores was observed.When Node-RADS score＞2,the highest AUC of 2 radiologists was 0.928 and 0.921,respectively,being not significantly different(P＞0.05).Conclusion Node-RADS based on DCE-MRI had good efficacy for evaluating axillary lymph node metastasis of breast cancer.Node-RADS score higher than 2 strongly indicated possibility of lymph node metastasis.

Objective To observe the value of Node-RADS based on dynamic contrast-enhanced MRI(DCE-MRI)for assessing axillary lymph node metastasis of breast cancer.Methods A total of 308 patients with breast cancer were retrospectively enrolled and divided into metastasis group(n=153)and non-metastasis group(n=155)based on the presence of axillary lymph node metastasis or not.Two radiologists independently scored the axillary lymph nodes shown on DCE-MRI according to Node-RADS criteria.Inter-observer scores was assessed using Kappa test.Taken pathological result as the gold standard,receiver operating characteristic curves were plotted,and the area under the curve(AUC)was calculated to evaluate the efficacy of Node-RADS scores for diagnosing axillary lymph node metastasis.Results Good inter-observer consistency of Node-RADS scores was observed.When Node-RADS score＞2,the highest AUC of 2 radiologists was 0.928 and 0.921,respectively,being not significantly different(P＞0.05).Conclusion Node-RADS based on DCE-MRI had good efficacy for evaluating axillary lymph node metastasis of breast cancer.Node-RADS score higher than 2 strongly indicated possibility of lymph node metastasis.

Objective:This study evaluates the performance of chemiluminescence assay, which is designed to detect Hepatitis D Virus (HDV) Immunoglobulin G (IgG) antibodies.Methods:A comparative analysis was conducted among chemiluminescence anti-HDV IgG reagent, the magnetic particle-based domestic reagent A and domestic reagent B, and the Robo Gene HDV RNA kit, using 1909 HBsAg-positive plasma samples. This comparison aimed to delineate clinical specificity and detection accuracy. The anti-HDV IgG reagent precision was assessed at three different concentration levels following the Clinical Laboratory Standards Institute EP5-A2 guidelines. The specificity of the assay was validated using 200 HAV IgM positive, 545 HBsAg-positive but anti-HDV IgG-negative, 350 anti HCV positive plasma samples and 200 healthy human blood samples. Additionally, a concordance study was conducted with 545 HBsAg-positive and 37 anti-HDV IgG-positive plasma samples, comparing the anti-HDV IgG reagent against reagent A.Results:1 909 HBsAg-positive plasma samples were tested using 3 anti HDV IgG reagent and 1 HDV RNA reagent, 19 samples were identified as anti-HDV IgG-positive. The anti-HDV IgG demonstrated superior accuracy and specificity. The assay exhibited excellent precision, with intra-assay coefficient of variation (CV) values ranging from 1.57% to 4.30%, and inter-assay CV values between 1.71% and 4.67% for detecting samples at high, medium, and low concentration levels. Concordance with Reagent A showed consistent results in both positive and negative detections.Conclusion:In this study, the anti-HDV IgG reagent (chemiluminescence method) displayed outstanding specificity in detecting clinical samples and exhibited a high conformity rate with commercialized reagents, making it potentially suitable for screening anti-HDV IgG in HBsAg-positive samples.

Objective:This study aims to evaluate the quality and explore the preliminary clinical applications of a domestically developed hepatitis D virus nucleic acid quantification reagent (abbreviated as"domestic HDV RNA reagent").Methods:The sensitivity and accuracy of the reagent were evaluated in accordance with the WHO HDV RNA international standard, employing the Bio-Rad CFX Opus 96 real-time fluorescence quantitative PCR analysis system. Serial dilutions of pseudo-viruses or cell culture-derived virus were used to determine the linear range of the domestic HDV RNA reagent. Specificity was assessed using positive samples of HAV, HBV, HCV infection, and HEV national reference materials. Precision was evaluated with samples at both high and low concentrations. In a comparative analysis, 30 HDV IgG positive samples were tested using both the domestic HDV RNA reagent and the RoboGene HDV RNA kit based on the ABI 7500 FAST DX system. The Pearson correlation coefficient (r) was used to examine the correlation between the two reagents.Results:The domestic HDV RNA reagent demonstrated a high sensitivity of up to 6 IU/ml, consistent with that of the comparator reagent. The calibration curve for WHO HDV RNA standards had a slope of -3.286, with an amplification efficiency of 101.6%. The linear detection range spanned from 10 to 10 8 IU/ml for eight HDV genotypes. The domestic HDV RNA reagent exhibited exceptional specificity, without cross-reactivity observed with HAV, HBV, HCV, or HEV. Accuracy assessments at five concentration levels met the required standards, with intra-assay precision coefficient of variation ( CV) ranging from 1.20% to 4.20%, and inter-assay precision CV from 1.20% to 7.90%. The detection results for HDV IgG positive samples were highly correlated with the comparator reagent ( r=0.984, P<0.001), achieving a diagnostic accuracy of 100% compared to sequencing results. Conclusion:In this study, the domestic HDV RNA reagent possesses excellent specificity, accuracy, precision, and a broad linear range, attaining a sensitivity level on par with international reagents of the same type.

Objective:To investigate the incidence of thyroid dysfunction in patients with chronic kidney disease and analyze the influencing factors.Methods:One hundred and ninety-eight patients with chronic kidney disease who were treated in Chronic Disease Management Department of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from Apr. 2021 to Apr. 2022 were selected, including 71 patients with abnormal thyroid function and 127 patients with normal thyroid function. The differences in TT3, FT3, TT4, FT4, and TSH between patients with abnormal thyroid function and those with normal thyroid function were analyzed. At the same time, the abnormal thyroid function of patients with different clinical characteristics and the influencing factors were analyzed. The intergroup differences were analyzed using t-test or χ2-test, and the influencing factors were analyzed using logistic regression analysis. Results:In one hundred and ninety-eight patients with chronic kidney disease, thyroid function abnormality occurred in 71 patients (35.86%), including two or more abnormal thyroid function indicators in 35 patients (49.30%). The total triiodothyronine (TT3), free triiodothyronine (FT3), total thyroxine (TT4) and free thyroxine (FT4) in patients with abnormal thyroid function were (1.02 ± 0.29) nmol/mL, (3.03 ± 0.88) pmol/L, (77.93 ± 20.02) nmol/mL and (11.02 ± 1.95) pmol/L respectively, which was significantly lower in patients with normal thyroid function (1.32±0.25) nmol/mL, (4.20±0.92) pmol/L, (93.30±19.28) nmol/mL and (13.54±1.82) pmol/ ( P<0.05), while thyroid stimulating hormone (TSH) was (3.14 ± 0.96) mIU/L, which was significantly higher than that in patients with normal thyroid function (1.84±0.89) mIU/L ( P<0.05). The incidence of thyroid dysfunction in female patients was 50.59% (43/85), It was significantly higher than 24.78% (28/113) of male patients (P <0.05) ; The incidence of thyroid dysfunction in patients aged 60 years was 49.55% (55/111), It was significantly higher than 18.39% (16/87) of the patients aged <60 years ( P<0.05) ; The incidence of thyroid dysfunction in patients with 1-year duration of disease was 71.43% (30/42), It was significantly higher than 25.28% (41/156) of patients with a course of disease <1 year ( P<0.05) ; The incidence of thyroid dysfunction in patients with clinical stage G 4 to 5 was 50.62% (41/81), It was significantly higher than 25.64% (30/117) of patients in G1~3 stages ( P<0.05) ; The incidence of thyroid dysfunction in patients with diabetes was 74.36% (29/39), This was significantly higher than 26.42% (42/159) in patients without diabetes mellitus ( P<0.05). Logistic regression analysis showed that gender, age, course of disease and clinical stage were the influencing factors of thyroid dysfunction in patients with chronic kidney disease ( P<0.05) . Conclusion:A high proportion of patients with chronic kidney disease have abnormal thyroid function, which is affected by the patient's sex, age, course of disease and clinical stage,clinical attention should be paid to targeted intervention to prevent the incidence of thyroid dysfunction in chronic kidney disease population.

Objective To understand the feelings and experiences of nurses in family medical team in the process of implementing contracted services,in order to provide a reference for effectively exerting the function of nursing in contracted services,and promoting and optimizing the contracted services in China.Methods Using phenomenological research methods,14 team nurses from 3 community health service centers in Beijing were interviewed with semi-structured interviews.The content analysis method was used to analyze the data.Results 3 themes were extracted in the nurses'experiences and feelings during the implementation of the contracted services,personal growth and benefit,and the need to optimize the work.3 sub-themes were extracted in work experiences and feelings,namely sense of optimization of nursing philosophy,sense of changing focus of nursing,improvement of nurse and patient bond.4 sub-themes were extracted in personal growth and benefits,namely increasing job responsibility and accomplishment,forming a sense of teamwork,greater understanding and respecting for patients.5 sub-themes were extracted in the optimization of contracted service needs,namely clarifying the position of team nurses,improving the bidirectional referrals,improving the contracted team management and assessment mechanisms,strengthening the support of the policy on home care,and providing opportunities for continuing education and training.Conclusion In practicing contracted services,team nurses have gained recognition of their profession and continuous self-growth.The government should continue to improve the support of contracting-related policies to meet the needs of team nurses'career development,optimize contracted services,and attract more nurses into the practice of contracted services.

The monitoring unit used in the nuclear magnetic resonance system,as an important unit of the system,faces a high thermal risk during its entire life cycle.This paper ensures the high efficiency and reliability of the thermal design of the product module from the two dimensions of structural design and device derating design.In order to reduce the risk of thermal design of electronic modules and comprehensively verify the effectiveness of thermal design of electronic modules,the design verification is carried out by combining simulation and experiment.In the simulation process,by establishing a thermal simulation model at the circuit board level,the crustal temperature of the core device is numerically calculated,and the index is compared with the thermal design index value and the test value,on the one hand,to verify the correctness of the simulation model.On the other hand,the validity of thermal design is verified.In the testing process,a thermal test platform for product modules is built,and the thermal characteristics test values of the core components of the module under extreme electrical conditions are obtained,and the corresponding conversion methods are used to predict the thermal performance and thermal design margin of the product at different altitudes.The results show that the electronic module can meet the thermal design requirements in terms of structural design and derating design of core components,and can ensure that the product module can work safely and reliably during the entire life cycle of the NMR system.