The rich club, as a community of highly interconnected nodes, serves as the topological center of the network. However, the similarities and differences in how the rich club supports functional integration and segregation in the brain across different species remain unknown. In this study, we first detected and validated the rich club in the structural networks of mouse, monkey, and human brains using neuronal tracing or diffusion magnetic resonance imaging data. Further, we assessed the role of rich clubs in functional integration, segregation, and balance using quantitative metrics. Our results indicate that the presence of a rich club facilitates whole-brain functional integration in all three species, with the functional networks of higher species exhibiting greater integration. These findings are expected to help to understand the relationship between brain structure and function from the perspective of brain evolution.
Animals ; Humans ; Brain/diagnostic imaging* ; Mice ; Male ; Nerve Net/diagnostic imaging* ; Macaca ; Female ; Neural Pathways/diagnostic imaging* ; Magnetic Resonance Imaging ; Biological Evolution ; Adult ; Diffusion Magnetic Resonance Imaging ; Brain Mapping ; Species Specificity ; Mice, Inbred C57BL

Objective:To investigate the differences in estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki-67 expressions between metastatic sites and primary sites in metastatic triple-negative breast cancer (TNBC) patients and to analyze their effects on the prognosis of patients.Methods:A retrospective cohort study was conducted. The clinicopathological data of 108 patients diagnosed with metastatic TNBC in Lianyungang Hospital Affiliated to Xuzhou Medical University from September 2018 to September 2023 were collected. Local metastatic sites included ipsilateral axillary lymph nodes and chest wall, while distant metastatic sites encompassed contralateral axillary lymph nodes and chest wall, bilateral supraclavicular lymph nodes, cervical lymph nodes, bone and viscera. The metastatic sites were identified as metastatic TNBC by using immunohistochemistry (IHC) and/or fluorescence in situ hybridization. The heterogeneity in ER, PR, HER2, and Ki-67 expression between primary sites and metastatic sites in all patients and those with local and distant metastases was analyzed, and the heterogeneity was defined as the inconsistency in the expression of markers including loss and gain expressions between primary sites and metastatic sites. The Kaplan-Meier method was used to analyze disease-free survival (DFS), and log-rank test was used for comparison among groups.Results:All patients were female, with an average age of (55±10) years; 51 cases had local metastases, and 57 cases had distant metastases. In metastatic sites, no ER and PR positivity were observed; in primary sites, 28.7% (31/108) of patients were ER positive and 21.3% (23/108) of patients were PR positive, and there were statistically significant differences in the proportion of patients with ER or PR positive between primary sites and metastatic sites (all P < 0.001). There were no statistically significant differences in the proportions of patients with different expression status including HER2 [positive: 0 (0/108) vs. 4.6%(5/108), low expression: 50.0% (54/108) vs. 45.4% (49/108), negative: 50.0% (54/108) vs. 50.0% (54/108)], Ki-67 [high expression: 86.1% (93/108) vs. 91.7% (99/108)] between metastatic sites and primary sites (all P > 0.05). The proportions of patients with inconsistent ER and PR expression between metastatic sites and primary sites were 28.7% (31/108) and 21.3% (23/108), respectively, all due to the expression loss in metastatic sites; the proportions of patients with inconsistent HER2 and Ki-67 expression between metastatic sites and primary sites were 42.6% (46/108) and 11.1% (12/108), respectively, with HER2 and Ki-67 expression loss of metastatic sites accounting for 22.2% (24/108) and 8.3% (9/108), respectively and expression gain accounting for 20.4% (22/108) and 2.8% (3/108), respectively. The proportions of patients with inconsistent ER [45.6% (26/57) vs. 9.8% (5/51)], PR [36.8% (21/57) vs. 3.9% (2/51)] and Ki-67 [17.5% (10/57) vs. 3.9% (2/51)] expression in distant metastatic sites and primary sites were higher than those with local metastatic sites and primary sites, and the differences were statistically significant (all P < 0.05). The proportions of patients with inconsistent HER2 between distant metastatic sites and primary sites and those with inconsistent HER2 between local metastatic sites and primary sites were 47.4% (27/57), 37.3% (19/51), respectively, and the difference was not statistically significant ( P = 0.300). Patients with inconsistent ER and Ki-67 expressions had better DFS than those with consistent expressions, with median DFS time of 30 months (95% CI: 22-40 months) vs. 22 months (95% CI: 22-24 months) for ER and 28 months (95% CI: 20-61 months) vs. 22 months (95% CI: 22-24 months) for Ki-67, and the differences were statistically significant (all P < 0.05). There were no significant differences in DFS between metastatic sites and primary sites with consistent expressions of PR and HER2 or not (all P > 0.05). Conclusions:There are differences in ER and PR expressions between primary sites and metastatic sites of metastatic TNBC patients, while the expressions of HER2 and Ki-67 seem to be no differences. The inconsistency of ER, PR and Ki-67 expressions with primary sites in distant metastatic sites are more common compared with in local metastatic sites. The differences in hormone receptor expression between primary sites and metastatic sites may impact patients' DFS.

Objective:To explore the implementation status and influencing factors of enhanced recovery after surgery (ERAS) in perioperative management of patients undergoing total hip arthroplasty.Methods:This study was a cross-sectional study. From May to December 2022, purposive sampling was used to select 186 orthopedic nurses from 9 ERAS pilot hospitals in Beijing as the research subject. A self-designed questionnaire was used to investigate the implementation status of ERAS. Pearson correlation was used to analyze the correlation between Nurse ERAS Implementation Status Questionnaire scores and ERAS Behavioral Intention Questionnaire scores. Multiple linear regression was used to analyze the influencing factors of ERAS in perioperative nursing of patients undergoing total hip arthroplasty.Results:A total of 186 questionnaires were distributed and 186 valid questionnaires were collected, with an effective response rate of 100.00% (186/186). The total score of the Nurse ERAS Implementation Status Questionnaire was (116.49±20.71), and the standardized scores for each dimension from high to low were follow-up management (80.22±20.44), intraoperative period (78.98±15.17), preoperative period (74.72±14.09), and postoperative period (69.77±15.94). The total score of the ERAS Behavioral Intention Questionnaire was (77.39±15.08), and the standardized scores of each dimension from high to low were subjective norm (79.93±19.01), behavioral intention (77.69±19.61), behavioral attitude (74.19±15.77), and perceived behavioral control (64.41±14.69). The nurse's professional title, familiarity with ERAS, ERAS training, and subjective norm were the influencing factors of the specific implementation status score of ERAS ( P<0.05), explaining 40.9% of the total variance. Conclusions:Nurses should strengthen training on ERAS, increase their familiarity with knowledge, and adopt various incentive measures to further enhance the implementation of ERAS programs in clinical practice.

Objective:To identify the predictive validity of C-reactive protein to albumin ratio (CAR) in the early diagnosis of Kawasaki disease shock syndrome (KDSS).Methods:This was a retrospective case-control study.Children with KDSS hospitalized in the Children′s Hospital, Capital Institute of Pediatrics, from January 2019 to December 2022, were selected as the case group, and children with Kawasaki disease (KD) hospitalized in the same period were selected as the control group.After a 1︰4 propensity score matching (PSM) of age and gender, the demographic characteristics, laboratory and imaging examinations, and other clinical data of all the patients were analyzed and compared between the two groups.Multivariate Logistic regression was used to analyze the possible risk factors of KDSS.The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of risk factors for KDSS.Results:There were 45 KDSS children and 269 KD children included in the study.The KDSS patients were older than the KD patients at the onset [43(19, 51) months vs.24(14, 44) months, Z=2.791, P<0.05].After age- and gender-based PSM, there were 45 children in the KDSS group and 180 children in the KD group.The children with KDSS had a shorter duration of fever [6(4, 6) days vs.6(5, 7) days] and a higher risk of coronary artery lesions [42.22%(19/45) vs.25.56%(46/180)] compared to those with KD ( Z=2.184, χ2=4.868, all P<0.05).Multivariate Logistic regression analysis showed that CAR, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, D-dimer, platelet count, serum sodium and estimated glomerular filtration rate were the independent risk factors for KDSS.The area under the ROC curve for identifying KDSS based on CAR was 0.850.When the cutoff value of CAR was 2.73, the sensitivity and specificity were 77.80% and 81.67%, respectively.After subgroup analysis, each one-unit increment in CAR was associated with a 239.6% increased risk of KDSS in children ≥ 3 years old ( OR=3.396, 95% CI: 2.105-5.479, P<0.05). Conclusions:As one of the independent risk factors for KDSS, CAR has high predictive value for early diagnosis of KDSS.In KD patients ≥ 3 years old, the risk of developing KDSS increases significantly with increased CAR.

A retrospective analysis was made on the clinical data and gene mutation characteristics of 2 children admitted to the Children′s Hospital of Zhejiang University School of Medicine for epilepsy without periventricular nodules caused by the ARF1 gene mutation from August 2023 to February 2024, and relevant literature was reviewed.Both patients presented with seizures and psychomotor retardation, and 1 of them was diagnosed with West syndrome.Whole exome sequencing confirmed that the 2 patients carried a missense mutation in the ARF1 gene (c.55C>A, p.R19S).Brain magnetic resonance imaging (MRI) of 2 patients revealed no obvious abnormalities.A summary analysis of 5 cases of ARF1 gene mutations reported in three foreign literatures showed that patients with ARF1 gene mutations usually presented with seizures, developmental delay, hypotonia, mental retardation, and motor stereotypies.MRI showed periventricular nodular heterotopia, corpus callosum dysplasia, subcortical white matter abnormalities, and delayed myelination.This study found for the first time that ARF1-related disorders can occur without significant brain structural malformations, indicating that there are inconsistencies in neuroimaging findings, adding valuable phenotypic information to this gene.The differences in imaging findings may be the result of genetic background or variation in ARF1-interacting proteins, or may be caused by altered regulatory mechanisms of protein activity.

Objective:To explore the clinical effectiveness of hemostatic bandage on wound safety and comfort after transradial coronary angiography and/or interventional therapy.Methods:This was a experimental study. A total of 400 consecutive patients who underwent transradial coronary angiography and/or interventional therapy in the Department of Cardiology, Peking University Third Hospital from July to October 2022 were enrolled and randomly divided into the hemostatic bandage group and the hemostatic balloon compressor group by the envelope method with 200 cases in each group. The hemostatic bandage group and the hemostatic balloon compressor group were treated with hemostatic bandage and hemostatic balloon compressor as transradial artery hemostatic device, respectively, to observe and compare postoperative hemostatic effect, hemostat use time, complication rate, postoperative pain, the degree of numbness in the finger on the operated side and wristband comfort between the two groups.Results:The hemostatic success rate was 98.5% (197/200) and 99.0% (198/200) in the hemostatic bandage and the hemostatic balloon compressor group, respectively, with no statistical difference ( χ2=0.20, P>0.05). The hemostat use time in the hemostatic bandage group and the hemostatic balloon compressor group was (6.23 ± 0.47) h and (17.01 ± 7.74) h, respectively, and the difference was statistically significant ( t=-19.66, P<0.01). The incidence of complications in the hemostatic bandage group and the hemostatic balloon compressor group was 13.5%(27/200) and 29.5%(59/200), respectively, and the difference was statistically significant ( χ2=8.01, P<0.05). Among the complications, swelling occurred in 21 individuals of the hemostatic bandage group and 54 individuals of the hemostatic balloon compressor group with statistically significant differences ( U=16 689.50, P<0.01). Besides, the hemostatic bandage group was significantly better than the hemostatic balloon compressor group with statistically significant differences in wound pain at immediate postoperative ( U=13 669.50, P<0.01), in finger numbness at immediate postoperative and 1-hour postoperative (immediate postoperative: U=17 838.00, P<0.05; 1-hour postoperative: U=13 342.50, P<0.01), in comfort at immediate postoperative, 4-hours, 8-hours and 12-hour postoperative(immediate postoperative: U=9 966.50, P<0.01; 4-hour postoperative: U=12 851, P<0.01; 8-hour postoperative: U=14 900, P<0.01; 12-hour postoperative: U=15 920, P<0.01). Conclusions:The hemostatic bandage shows better hemostatic effect, shorter compression time, lower complication rate, less wound pain, less numbness of the finger on the operation side, and higher comfort of the wrist band compared to hemostatic balloon compressor after transradial coronary angiography and/or interventional therapy, which is worthy of clinical promotion.

Objective:To explore the evaluation of nursing undergraduates on the effect of ideological and political teaching in nursing research courses.Methods:Using the purposive sampling method, a total of 19 undergraduate students from School of Nursing at Peking University who participated in nursing research ideological and political education courses were selected for face-to-face semi-structured interviews from March to June 2022. The interview data was analyzed using the Colaizzi phenomenological data analysis method.Results:A total of 19 students were interviewed, and the interviewees stated that through the study of nursing research ideological and political teaching courses, they had mastered scientific research methods, cultivated scientific thinking, strengthened innovation consciousness, expanded international vision and enhanced professional identity.Conclusions:This study is a beneficial attempt at ideological and political education in nursing research courses, providing a basis for the design, implementation and evaluation of ideological and political teaching of similar courses in the future.

Neurogenesis decline in hippocampal dentate gyrus (DG) participates in stress-induced depressive-like behaviors, but the underlying mechanism remains poorly understood. Here, we observed low-expression of NOD-like receptor family pyrin domain containing 6 (NLRP6) in hippocampus of stress-stimulated mice, being consistent with high corticosterone level. NLRP6 was found to be abundantly expressed in neural stem cells (NSCs) of DG. Both Nlrp6 knockout (Nlrp6^-/-) and NSC-conditional Nlrp6 knockout (Nlrp6CKO) mice were susceptible to stress, being more likely to develop depressive-like behaviors. Interestingly, NLRP6 was required for NSC proliferation in sustaining hippocampal neurogenesis and reinforcing stress resilience during growing up. Nlrp6 deficiency promoted esophageal cancer-related gene 4 (ECRG4) expression and caused mitochondrial dysfunction. Corticosterone as a stress factor significantly down-regulated NLRP6 expression, damaged mitochondrial function and suppressed cell proliferation in NSCs, which were blocked by Nlrp6 overexpression. ECRG4 knockdown reversed corticosterone-induced NSC mitochondrial function and cell proliferation disorders. Pioglitazone, a well-known clinical drug, up-regulated NLRP6 expression to inhibit ECRG4 expression in its protection against corticosterone-induced NSC mitochondrial dysfunction and proliferation restriction. In conclusion, this study demonstrates that NLRP6 is essential to maintain mitochondrial homeostasis and proliferation in NSCs, and identifies NLRP6 as a promising therapeutic target for hippocampal neurogenesis decline linked to depression.

The superior mesenteric artery (SMA) is one of the visceral branches of the abdominal aorta. It has multiple branches to supply blood and nutrition to the intestinal segment, and these form an anastomosis with each other. SMA injuries are usually classified as major visceral artery injuries, and have an incidence of <1%. The clinical manifestations of patients with SMA injuries include intra-abdominal bleeding and peritoneal irritation. The compromised blood supply can lead to intestinal ischemia and perforation. These injuries are often not diagnosed in time and have significant mortality rates of 25%‍-‍68% due to the lack of specific features (Maithel et al., 2020). Not only that, but patients with less severe trauma or no visible damage on initial examination may still have clinically significant intra-abdominal injuries (Nishijima et al., 2012). Emergency departments often encounter multiple cases that require urgent diagnosis and treatment (Li et al., 2021; Zhang et al., 2021; Zhou et al., 2021), and therefore, it is imperative to diagnose and manage these rare injuries expeditiously.
Humans ; Mesenteric Artery, Superior/surgery* ; Abdominal Injuries/diagnosis* ; Intestines

Objective:To establish a risk prediction model for hospital acute heart failure in elderly patients with chronic heart failure (CHF) .Methods:From January 2018 to December 2020, 619 elderly CHF patients admitted to the Cardiovascular Department of Peking University Third Hospital were selected as the research object by convenience sampling. The patients were divided into the occurrence group ( n=55) and the non-occurrence group ( n=564) according to whether the patients had acute heart failure in hospital. Binomial Logistic regression was used to explore the independent risk factors of acute heart failure in elderly CHF patients. The nomogram model was constructed by R software, and its prediction effect was verified. Results:Binomial Logistic regression showed that high heart rate at admission [ OR=1.021, 95% CI (1.003, 1.039) ], history of cerebrovascular disease [ OR=2.253, 95% CI (1.197, 4.240) ], constipation [ OR=10.382, 95% CI (1.376, 78.308) ], arrhythmia [ OR=2.051, 95% CI (1.079, 3.898) , taking aspirin [ OR=2.741, 95% CI (1.447, 5.193) ], intravenous diuretics [ OR=6.326, 95% CI (2.629, 15.220) ]and high level of N-terminal forebrain natriuretic peptide [ OR=3.511, 95% CI (1.890, 6.521) ]were independent risk factors for hospital onset of acute heart failure in elderly patients with CHF, and the use of vasodilator was a protective factor. The nomogram model was validated. The area under the receiver operating characteristic curve ( AUC) of the subject was 0.808 [95% CI (0.753, 0.864) ], the AUC of internal validation was 0.821 [95% CI (0.764, 0.871) ], and the calibration curve was a straight line with a slope close to 1. Conclusions:There are many risk factors of hospital acute heart failure in elderly CHF patients. The prediction model based on risk factors has good discrimination and calibration, and can predict the risk of acute heart failure in elderly CHF patients in hospital.