Objective To understand the genetic basis of the adaptation of Culex tritaeniorhynchus to different environmental ecology in Jining City, Shandong Province, so as to provide insights into understanding of the population structure or isolation pattern of Cx. tritaeniorhynchus in the city. Methods Seven sampling sites were selected from urban, suburban and rural areas of Jining City, Shandong Province from June to August 2023, and mosquitoes were collected using mosquito-trapping lamps. All collected adult mosquitoes were identified morphologically. Genomic DNA was extracted from a single female Cx. tritaeniorhynchus mosquito, and the mitochondrial cytochrome C oxidase I (COI) gene was amplified using a PCR assay, sequenced and subjected to molecular identification. The number of haplotypes, haplotype diversity (Hd), nucleotide diversity (Pi), and average number of nucleotide differences (K) of Cx. tritaeniorhynchus DNA sequences were estimated among different sampling sites using the software DnaSP 6, and a neutrality test was performed. The fixation index (F_ST), and gene flow (number of migrants, Nm) of Cx. tritaeniorhynchus populations were calculated using the software Arlequin 3.5.2, and subjected to analysis of molecular variance (AMOVA). In addition, a haplotype network diagrams and a phylogenetic tree of Cx. tritaeniorhynchus populations were created using the software PopART and MEGA 11, respectively. Results A total of 420 sequences were successfully amplified from the COI gene of Cx. tritaeniorhynchus samples collected from 7 sampling sites in Jining City, and a gene fragment sequence with a length of 603 bp was obtained, with 55 variable sites and 46 haplotypes and without insertion or deletion mutations. Of the 46 haplotypes, H01 was the dominant shared haplotype, and the haplotype frequency increased gradually from urban areas (34.00%) to rural areas (47.00%). The mean Hd, Pi and K values of Cx. tritaeniorhynchus COI genes were 0.814, 0.024 and 14.129, 0.489, 0.016 and 7.941 and 0.641, 0.016 and 10.393 in suburban, urban, and rural areas, respectively, with the highest population diversity of Cx. tritaeniorhynchus in suburban areas and the lowest in urban areas. Paired F_ST analysis among different types of sampling sites showed that the mean F_ST value was 0.029 between urban and suburban areas, indicating more frequent inter-population communication. AMOVA revealed that the percentage of intra-population variation (95.74%) was higher than that of inter-population variation (4.26%). Neutrality tests showed deviation from neutrality in Cx. tritaeniorhynchus populations collected from Nanyang Township (Tajima’s D = 2.793, Fu’s Fs = 6.429, both P values < 0.05). In addition, the mismatch distribution curves of Cx. tritaeniorhynchus COI gene appeared bimodal or multimodal patterns in Jining City, indicating a relatively stable overall population size. Conclusions The mitochondrial COI gene may be used as a molecular marker to investigate the population genetic diversity of Cx. tritaeniorhynchus. The population genetic diversity of Cx. tritaeniorhynchus is higher in the suburban areas of Jining City than in rural and urban areas, and there are frequent genetic exchanges between Cx. tritaeniorhynchus populations from urban and suburban areas.

Hepatocellular carcinoma is a kind of cancer with a strong invasion, a high incidence rate and mortality, and a poor prognosis. At the time of diagnosis, most patients are already in the advanced stages of a tumor and have lost the chance for radical surgical treatment. Advanced hepatocellular carcinoma treatment has a gradual transition from systemic chemotherapy to targeted therapy, immunotherapy, and combination therapy, especially immune checkpoint inhibitor-based immunotherapy combination therapy, such as combination with bevacizumab monoclonal antibodies and other drugs, or combination with TACE, HAIC, radiotherapy, ablation, and other treatment methods. Combination therapy has significant synergistic effects and thus has already become a future treatment trend for hepatocellular carcinoma. An immunotherapy-based combination therapy plan will run through the whole process of systemic therapy, which is expected to bring better survival benefits to patients with hepatocellular carcinoma. This article reviews the latest research progress in aspects of the first-line treatment of advanced hepatocellular carcinoma.

Objective:To investigate the risk of new-onset stroke caused by cerebral microbleed (CMB) and asymptomatic lacunar infarction (ALI) and their risk factors.Methods:A prospective observational study over a 18 month period was conducted on 397 non stroke patients who visited the Affiliated Hospital of Xuzhou Medical University from March 2020 to June 2022. By the presence of CMB and ALI about magnetic resonance imaging, they were divided into th control group (without CMB and ALI, 117 cases, 29.5%), ALI group (101 cases, 25.4%), CMB group (89 cases, 22.4%) and CMB-ALI group (90 cases, 22.7%).They were followed up for 18 months, the risk factors for CMB, ALI, and the risk of new stroke were analyzed.Results:The systolic blood pressure and uric acid in the CMB group were higher than those in the control group: (155.2 ± 24.2) mmHg(1 mmHg = 0.133 kPa) vs. (138.2 ± 19.0) mmHg, (387.0 ± 28.3) μmol/L vs. (354.0 ± 21.5) μmol/L, there were statistical differences ( P<0.05). After followed up for 18 months, the incidence rate of cerebral infarction, cerebral hemorrhage and TIA in the CMB group and CMB-ALI group were higher than those in the control group: 13.5%(12/89), 13.3%(12/90) vs.5.1%(6/117); 9.0%(8/89), 10.0%(9/90) vs. 2.6%(3/117); 5.6%(5/89), 6.7%(6/90) vs. 0.8%(1/117), there were statistical differences ( P<0.05). Conclusions:CMB is prone to abnormal systolic blood pressure and uric acid. CMB, CMB-ALI are prone to new onset ischemic stroke, cerebral hemorrhage and TIA.

Objective:To evaluate the safety and effectiveness of single posterior osteotomy in the correction of rigid cervical spine deformities (CSD) and to explore the indications and key surgical techniques involved.Methods:A retrospective analysis was conducted on the clinical data of 9 patients with rigid CSD who underwent single posterior osteotomy correction between June 2012 and June 2023 in the Department of Spine Surgery at the First Affiliated Hospital of Xinjiang Medical University. The cohort comprised 4 males and 5 females, with a mean age of 19.8±27.2 years (range, 7-48 years). Among these, 5 cases were congenital CSD, 3 were post-tuberculosis deformities, and 1 was iatrogenic. Various coronal and sagittal alignment parameters were measured, including C 1, 2 angle, cervical lordosis (CL), structural scoliosis angle (SSA), structural kyphosis angle (SKA), head tilt (HT), C 2-C 7 sagittal vertical axis (CSVA), sagittal vertical axis (SVA), coronal balance distance (CBD), T 1 slope (T 1S), and the difference between T 1 tilt and cervical lordosis (T 1S-CL). Clinical outcomes were assessed using the neck disability index (NDI), visual analogue scale (VAS), and Scoliosis Research Society-22 questionnaire (SRS-22). Results:The average operation time was 273.9±76.1 min, with an average blood loss of 472.2±128.8 ml. All 9 patients were followed up for an average of 45.2±41.8 months (range, 12-116 months). A total of 7 patients underwent single-segment osteotomies (C 3, C 6 and C 7: 1 case each; C 5: 4 cases), and 2 patients underwent double-segment osteotomies (C 2 and C 7, C 3 and C 4). Four cases involved pedicle subtraction osteotomy (PSO), while 7 cases required vertebral column resection. The upper instrumented vertebra (UIV) was located at the occiput in 1 case and in the cervical spine in 8 cases. The lower instrumented vertebra (LIV) was located in the upper thoracic spine in 6 cases and in the cervical spine in 3 cases, with 2 of the latter cases having both UIV and LIV in the cervical spine. The average number of fused segments was 7.6±4.4 segments (range, 2-12 segments). All patients achieved successful bone fusion within an average of 8.8±3.2 months (range, 6-12 months). Preoperatively, the mean values for CL, SSA, SKA, HT, and CBD were 19.8° (17.2°, 30.5°), 27.4°(23.3°, 30.4°), 28.4°(25.6°, 30.1°), 9.0°(6.2°, 12.3°), and 18.5(12.3, 23.6) mm, respectively. Postoperative improvements were noted with values of -11.1°(-8.8°, -14.4°), 1.3°(0.8°, 1.6°), -11.1°(-8.6°, -14.5°), 1.6°(0.5°, 2.2°), and 9.4 (4.8-13.5) mm, respectively. At the final follow-up, these parameters were maintained, with values of -11.0°(-8.8°, -14.3°), 1.2°(0.8°, 1.5°), -11.0° (-8.6°, -14.3°), 1.5°(0.5°, 2.2°), and 9.4(4.8, 13.4) mm, respectively. Statistically significant improvements were observed between preoperative and postoperative measurements ( P<0.05), except for C 1, 2 angle, CSVA, SVA, T 1S, and T 1S-CL ( P>0.05). NDI and SRS-22 scores showed significant improvements postoperatively ( P<0.05), while VAS scores did not show a significant change ( P>0.05). Postoperative complications included transient nerve injury in two patients, one case of right central retinal artery occlusion, and one case of vertebral artery injury. Conclusion:This study confirms the safety and efficacy of single posterior osteotomy for treating rigid CSD of various etiologies. Standard PSO or modified techniques are effective for correcting cervical kyphosis, while hemivertebra resection and concave-side distraction are recommended for congenital scoliosis or kyphoscoliosis.

Abstract： Objective　Aedes albopictus is the main indigenous vector of dengue fever in China. Understanding the spatial genetic structure of Aedes albopictus populations, migration, and gene flow is crucial for the effective prevention and control of vector-borne diseases. Methods　From June to September 2023, mosquitoes were collected and morphologically identified from eight different geographic locations across tropical, subtropical, and temperate zones of China. Genomic DNA was extracted from individual female mosquitoes, and the mitochondrial cytochrome C oxidase I gene was amplified and sequenced. Population genetic diversity and associated population characteristics were assessed using software such as BioEdit, DnaSP version 6, Arlequin 3.5, and Mega 11. Results　A total of 233 samples from eight Aedes albopictus populations across the three climatic zones were successfully sequenced, yielding a gene fragment sequence of 632 bp with 19 variable sites and no insertion or deletion mutations. A total of 21 haplotypes were detected, with H4 being the dominant shared haplotype among the three climate types. Haplotype diversity (Hd) ranged from 0.191 (Beijing population) to 0.887 (Xishuangbanna population), and nucleotide diversity (Pi) ranged from 0.000 51 (Beijing population) to 0.002 98 (Xishuangbanna population), suggesting high haplotype diversity and low nucleotide diversity in Aedes albopictus. The genetic differentiation indices ranged from 0.026 to 0.641, with higher genetic differentiation between temperate and tropical/subtropical regions. The analysis of molecular variation supported that genetic differentiation mainly came from within populations (60.45%). Conclusions　The ecological and climatic environment in the tropics results in higher genetic diversity of Aedes albopictus. Human activities have exacerbated the risk of dengue transmission across different climatic zones.

Abstract: Objective　To explore the genetic diversity of Aedes albopictus populations in plain, hilly, and mountainous areas of Hainan Province, and to analyze the genetic structure of Aedes albopictus populations in different terrain regions of Hainan Province. Methods Aedes albopictus were collected from the plain areas of Sanya and Haikou City, the hills of Danzhou and Tunchang City, and the mountainous areas of Baisha City in Hainan Province. DNA was extracted from a single mosquito and stored in a -80 ℃ refrigerator for use. Mitochondrial cytochrome C oxidase subunit Ⅰ (mtDNA-COⅠ) was amplified by PCR and sequenced. The results were compared on the National Center for Biotechnology Information (NCBI) website, sequence peaks were observed using BioEdit 7.0, genetic diversity parameters were calculated using DnaSP v6, haplotype networks were constructed using PopART 1.7, and analysis of molecular variance (AMOVA) values were calculated using Arlequin to analyze differences between populations. Results A total of 414 mtDNA-COⅠ sequences were obtained from Aedes albopictus populations in 5 regions, with lengths of 663 bp. All sequences had five mutation sites, with a G+C content of 32.86% and an A+T content of 67.14%, consistent with mitochondrial DNA characteristics. Compared with other populations, the nucleotide diversity of the Danzhou and Tunchang populations in the plain and hilly areas was higher. The average nucleotide differences were higher in the Sanya, Tunchang, and Danzhou populations. Haploid analysis revealed 6 haplotypes, with H02 being the dominant haplotype. The Sanya and Tunchang populations had the highest number of haplotypes, while the Haikou and Sanya populations had exclusive haplotypes. Only the plains populations had unique haplotypes, while the hill and mountainous populations had relatively fewer haplotypes. The neutral results and mismatch distribution map indicated that the population of Aedes albopictus has recently expanded in all regions. The AMOVA value showed that the intra-population differences were greater than the inter-population differences. Conclusions　The mtDNA-COⅠ gene can serve as a molecular marker for studying the genetic diversity of Aedes albopictus populations. The Sanya population in the plain region shows higher genetic diversity, and the two populations in the hilly region also have higher genetic diversity. However, the number of haplotypes is only higher in the Sanya population in the plains and the Danzhou population in the hills.

Objective:To summarize the best evidence of intracranial hypertension nursing for adult patients with severe brain injury, and to provide reference for clinical nursing practice.Methods:According to the evidence-based methodology, a systematic search of Chinese and English literature on intracranial hypertension nursing of adult patients with severe brain injury was conducted in domestic and foreign databases such as CNKI, Wanfang, PubMed, Cochrane Library and Cinahl Plus and so on, as well as related guide websites and professional association websites from the establishment of database to August 2022. Two researchers independently evaluated literature quality and screened evidence, and then the project team summarized and concluded the evidence.Results:A total of 6 009 articles were obtained through preliminary search, and 33 articles were included after screening, including 13 guidelines, 1 systematic review, 17 expert consensus, 1 evidence summary, and 1 meta-analysis. In total, 33 pieces of best evidence were obtained from 8 dimensions, including intracranial pressure related threshold, assessment and monitoring, respiratory care, circulation care, analgesic and sedative care, temperature care, nutrition care and cerebrospinal fluid care.Conclusions:This study summarizes the evidence-based basis of intracranial hypertension nursing in adult patients with severe brain injury, which provides a basis for the standardized construction of clinical nursing strategies and empirical research.

Objective:To promote the development of basic research, clarify the development trend of frontier biotechnology, and strengthen scientific research management in project management, resource integration, risk supervision and other aspects.Methods:Through literature study and expert discussion, this paper analyzed the hot spots of frontier biotechnology research, and put forward suggestions for optimizing strategic tasks and innovation management from the perspective of innovation management.Results:The research of frontier biotechnology in our country showed a rapid development trend, but also faced with challenges such as insufficient technological innovation ability and relatively lagging management level. It is imperative to explore and establish a new scientific research management model and optimize the operation mechanism.Conclusions:The major research achievements of frontier biotechnology are emerging constantly, showing a trend of multi-disciplinary and multi-field integration. China should actively explore innovative management models, optimize and improve strategic tasks, improve the efficiency of scientific research management, and do a good job in supporting the realization of high-level scientific and technological self-reliance.

Objective　To understand the infection status and typing of Wolbachia in Culex pipiens pallens population in coastal areas of Shandong Province, and to provide new research directions and theoretical basis for the prevention and control of mosquito-borne diseases. Methods　From June 2022 to August 2023, mosquito samples were collected from 8 sites in four coastal cities of Yantai, Qingdao, Rizhao, and Dongying in Shandong Province by light lure method. The collected samples were identified as Culex pipiens pallens by combining morphological and molecular methods. Then, using the PCR detection method established by the Wolbachia surface protein (wsp) gene sequence, the Wolbachia infection rate of Culex pipiens pallens collected in the field from 8 sites along the coast of Shandong Province was detected. In addition, the representative strain of Wolbachia was downloaded from the GenBank database, and the obtained gene sequences were subjected to phylogenetic analysis using Mega5.2 software for typing. Results　Wolbachia infection was found in all four coastal areas of Shandong Province, with an average infection rate of 80.8% (261/323). Among them, Yanti had the highest infection rate of 100% (46/46), while Wulian County, Rizhao City had the lowest infection rate of 60.6% (20/33). A total of 12 wsp haplotypes were identified, with 92.5% infection rates for Hap1, 70.0% for Hap2, and lower rates for Hap3 to Hap12. From the perspective of haplotype sources, Hap1 was detected in all 8 sampling sites, while other haplotypes were only detected in some geographical populations of sampling sites. Among them, Dongying District, Dongying City had the highest haplotype diversity, with six haplotypes detected. Phylogenetic tree analysis concluded that the Wolbachia strains found in all eight sampling points belonged to group B. Conclusions　Infection of Wolbachia group B is common in Culex pipiens pallens in coastal areas of Shandong Province. Still, there are certain differences in the haplotypes of Wolbachia infections in different regions. This provides a valuable theoretical basis for targeted prevention and control of specific mosquito-borne diseases in the region．

A 54-year-old asymptomatic man underwent a video-assisted thoracoscopic left pneumonectomy for squamous-cell carcinoma. During the surgery, a complete left pericardial defect was unexpectedly discovered, but no special intervention was made. The preoperative chest CT was reciewed, which showed the heart extended unusually to the left, but the left pericardial defect was not evident. The operation time was 204 min and the patient was discharged from hospital upon recovery 9 days after the surgery. The pathological result indicated moderately differentiated squamous-cell carcinoma (T2N1M0, stage ⅡB), and metastasis was found in the parabronchial lymph nodes (3/5). The patient did not receive chemotherapy after the surgery, and there was no signs of recurrence 6 months after the surgery. Complete pericardial defects usually do not endanger the lives of patients, and if the patient is asymptomatic, pneumonectomy is feasible.