Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.

Objective:To investigate the clinical efficacy of autologous ear cartilage biomimetic nasal tip framework construction combined with dermal fat dorsal grafting in rhinoplasty.Methods:A retrospective analysis was conducted on clinical data of patients who underwent rhinoplasty at the Department of Plastic Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine from June 2021 to May 2023. Autologous ear cartilage with preserved perichondrium was harvested from patients, and fashioned into a nasal tip framework simulating the natural nasal tip structure. Dermal fat grafts were harvested from the lateral gluteal crease region where the dermis was thicker, and implanted into the nasal dorsum for augmentation rhinoplasty. Postoperative follow-up included observation of incision healing, nasal tip morphology, and complications. Pre- and postoperative photographs were taken to measure nasal length and nasal tip height. Ultrasound was used to measure subcutaneous fat thickness at the nasal root before and after surgery, and absorption rates were calculated. The absorption rate at 6, 12, and 24 months postoperatively = (1 -subcutaneous fat thickness at 6 or 12 or 24 months postoperatively/subcutaneous fat thickness at 1 month postoperatively) × 100%. Aesthetic satisfaction was evaluated based on surgeon assessment, patient self-evaluation, and third-party physician evaluation (satisfaction by all three parties was rated as markedly effective, by two parties as effective, by one party as fair, and by none as poor). The aesthetic satisfaction rate = (markedly effective + effective) cases/total cases × 100%. Comparisons of preoperative and postoperative nasal tip height and nasal length were performed using paired t-tests, with P<0.05 considered statistically significant. Comparisons of subcutaneous fat thickness at the nasal root at different time points and absorption rates at different postoperative time points were performed using repeated measures ANOVA, with post-hoc pairwise comparisons using Bonferroni correction. For subcutaneous fat thickness comparisons, P<0.007 was considered statistically significant; for absorption rate comparisons, P<0.017 was considered statistically significant. Results:A total of 38 patients were included, consisting of 5 males and 33 females, with a mean age of 29.42 years (range 20-38 years). All patients were followed up for 24 months postoperatively. All incisions healed well; nasal appearance was aesthetically pleasing; nasal dorsal height was satisfactory; nasal tip mobility was good; the framework was stable; and no complications occurred. At 24 months postoperatively, nasal tip height [(22.87±0.52) mm vs. (19.94±0.53) mm] and nasal length [(47.18±0.61) mm vs. (44.20±0.55) mm] were significantly increased compared to preoperative measurements (both P<0.01). Comparison of subcutaneous fat thickness at the nasal root between preoperative and postoperative time points (1, 6, 12, and 24 months) showed statistically significant differences ( P<0.007). Post-hoc comparisons revealed statistically significant differences between: postoperative 1 month and 6 months vs. preoperative; postoperative 12 months vs. postoperative 1 and 6 months; and postoperative 24 months vs. postoperative 1 and 6 months (all P<0.007). However, the comparison between postoperative 24 months and 12 months showed no statistically significant difference ( P>0.007). Comparison of absorption rates at postoperative time points (6, 12, and 24 months) showed statistically significant differences ( P<0.017). Comparisons between postoperative 12 months vs. 6 months, and postoperative 24 months vs. 6 months showed statistically significant differences (both P<0.017), while the comparison between postoperative 24 months and 12 months showed no statistically significant difference ( P>0.017). In the aesthetic satisfaction survey, 37 cases were markedly effective and 1 case was fair, achieving an aesthetic satisfaction rate of 97%. Conclusion:The use of autologous ear cartilage for constructing a biomimetic nasal tip framework combined with dermal fat dorsal grafting in rhinoplasty results in natural postoperative appearance and high patient satisfaction, demonstrating significant value for extensive clinical use.

Objective:To investigate the clinical results of anteriorly displaced orbicularis oculi flap and autologous granular fat injections via sub-brow incision for correction of different degrees of sunken upper eyelid.Methods:From September 2021 to September 2022, a total of 80 patients with upper eyelid skin laxity and sunken upper eyelid were recruited prospectively from the Department of Plastic Surgery, Jiangsu Province Hospital of Chinese Medicine. There were 18 males and 62 females, aged 28 to 60 years, with a mean age of (42.7±9.2) years. According to Park's method, 59 patients with grade Ⅰ and grade Ⅱ sunken upper eyelid were treated with eyebrow lifting and orbicularis oculi flap correction, and 21 patients with grade Ⅲ upper eyelid sunken were treated with eyebrow lifting combined with autologous particles fat filling. The patients were followed up for 6 months. The depth of sunken upper eyelid was measured before and after operation. The incidence of adverse reactions and patient satisfaction were recorded.Results:The mean depth of depression measured preoperatively was (6.01±2.25) mm in the grades Ⅰ and Ⅱ sunken upper eyelid, which was improved to (2.00±1.06) mm at the 6-month postoperative follow-up ( P=0.001), and the mean depth of depression was (13.15±1.75) mm in the group of grade Ⅲ, which was improved to (4.15±1.49) mm at the 6-month postoperative follow-up ( P=0.001). After 6-month follow-up, the incidence of complications was 6.3% (5/80) and the satisfaction rate was 90.0% (72/80). Conclusions:Different correction methods should be chosen according to the degree of sunken upper eyelid. Grades Ⅰand Ⅱ sunken upper eyelid are corrected with orbicularis muscle flap through sub-eyebrow incision, and grade Ⅲ is corrected with autologous fat injection. Both the clinical effect and patient satisfaction rate are higher.

Objective:To evaluate the clinical efficacy and safety of fractional CO 2 laser combined with topical application of radix scutellariae ointment in the treatment of hyperplastic scar. Methods:This randomized controlled trial prospectively enrolled 90 patients with hyperplastic scar treated with fractional CO 2 laser at the Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Chinese Medicine) from January 2020 to December 2021. Participants were randomly divided into a trial group and a control group using a random number table. The trial group ( n=45, 22 males, 23 females, aged 18-54 years) received topical radix scutellariae ointment post-laser treatment, while the control group ( n=45, 23 males, 22 females, aged 19-55 years) received recombinant bovine basic fibroblast growth factor gel. Both groups underwent treatment every 3 months, with scar assessments conducted at 1-month post-treatment. Outcomes included Vancouver scar scale (VSS) scores, scar cosmesis assessment and rating (SCAR) scores, adverse reaction rates, and patients' satisfaction. Results:After the first, second, and third treatments, the trial group showed significantly lower VSS and SCAR scores compared to the control group (all P<0.05). Patients' satisfaction in the trial group was 91.1% (41/45), significantly higher than 77.8% (35/45) in the control group ( P=0.036). The adverse reaction rate in the trial group was 15.6% (7/45), and 28.9% (13/45) in the control group, there was no statistical difference ( P=0.813). Conclusion:Fractional CO 2 laser combined with topical radix scutellariae ointment demonstrate superior clinical efficacy, higher patient satisfaction, and lower adverse reaction rates in the treatment of hyperplastic scar.

Surface enhanced Raman scattering(SERS)is an important technique for detecting pesticide residues.However,many pesticides have small Raman scattering cross sections and low affinity for gold/silver enhancement substrates,resulting in low sensitivity for direct SERS detection.Indirect methods typically require complex surface modifications and have poor universality.Here,a dual functional composite Au@MnO2 combined with acetylcholinesterase(AChE)was proposed for SERS biosensing of pesticides.The Au@MnO2 with oxidase-like activity could oxidize 3,3′,5,5′-tetramethylbenzidine(TMB)into oxTMB with a large Raman scattering cross section,producing strong SERS signal using Au@MnO2 itself as enhancement substrate.In the presence of AChE,acetylthiocholine(ATCh)was catalytically hydrolyzed to produce thiocholine(TCh),and its reducibility could induce the decomposition of MnO2.Consequently,oxidase-like activity of Au@MnO2 was declined,less oxTMB was produced,and gold nanoparticles(AuNPs)detached from the MnO2 layer,resulting in a weakened SERS response.Organophosphorus pesticides(OPs),as inhibitors of AChE,prevented the production of TCh,thereby blocking the decomposition of MnO2 and leading to the recovery of Raman signals.Under optimized conditions,the Raman signal switching strategy was successfully used for detection of three OPs,i.e.,fenthion,chlorpyrifos,and methyl parathion,with detection limits of 4×10-11 mol/L,2×10-9 mol/L,and 3×10-9 mol/L,respectively.In actual spinach sample testing,the spiked recoveries of the three OPs ranged from 86.5%to 110.6%.This study provided a new strategy for detecting pesticide residues using SERS.

AIM To evaluate the chemical constituent consistency in formula granules and traditional decoctions of Gouteng Jiangya Formula.METHODS HPLC characteristic chromatograms were established,the analysis was performed on a 30 ℃ thermostatic YMC-Triart C18 column(4.6 mm× 250 mm,5 μm),with the mobile phase comprising of acetonitrile-0.2％phosphoric acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 240 nm.Puerarin was used as an internal standard to calculate the relative correction factors of 3'-methoxy puerarin,puerarin apioside,magnolflorine,paeoniflora,daidzin,baicalin,palmatine,berberine,wogonoside and benzoylpaeoniflorin,after which the content detemination was made by quantitative analysis of multi-components by single-marker(QAMS).RESULTS The characteristic chromatograms of 9 batches of formula granules and 15 bacthes of traditional decoctions demonstrated the similarities of more than 0.90 at the detection wavelengths of 192,210,240,260,280,300,320,360 nm,along with similar total peak areas.Eleven constituents showed good linear relationships within their own ranges(r＞0.999 0),whose average recoveries were 97.27％-101.64％with the RSDs of 0.36％-1.11％,the result obtained by QAMS and external standard method demonstrated no significant differences(P＞0.05).The contents of various constituents in the formula granules approximated those in the traditional decoctions.CONCLUSION The consistent kinds and contents of various constituents are obversable in formula granules and traditional decoctions of Gouteng Jiangya Formula,which can provide a reference for the reasonable clinical application of this formula.

Objective:To investigate the clinical and genetic characteristics of patients with amyotrophic lateral sclerosis (ALS) caused by FUS gene mutations. Methods:A retrospective analysis was conducted on 7 families diagnosed with FUS gene related ALS in the Department of Neurology of Henan Provincial People′s Hospital from January 2018 to June 2024. Clinical data and neuroelectrophysiological results of the probands and family members were collected. Next generation sequencing or whole exome sequencing was conducted on the probands. The detected variants of the FUS gene were confirmed by Sanger sequencing. Results:Among the 7 probands, 4 were with familial ALS and 3 with sporadic ALS, including 6 males and 1 female. The average age of onset was 24.6 years (ranging from 21 to 30 years). The onset site included bulbar muscles in 1 case, proximal upper limbs in 3 cases, proximal lower limbs in 2 cases, and both upper and lower limbs in 1 case. Four patients presented both upper and lower motor neurons involvement on examination, and 3 had only lower motor neuron syndrome. Muscle atrophy and fasciculation were observed in 6 patients respectively, and dyspnea in 3 patients. Bilateral muscle strength was asymmetric in 5 patients. Proximal muscle weakness was predominant in 6 of the 7 patients with upper limb weakness, and 3 of the 5 patients with lower limb weakness. Electromyography showed neurogenic damage in all 7 cases. Five heterozygous variants of the FUS gene were detected in 7 patients, including 2 patients with c.1574C>T(p.P525L), 2 with c.1552A>G(p.R518G), 1 with c.1561C>T(p.R521C), 1 with c.1441delC(p.R481Efs *48), and 1 with both c.1574C>T(p.P525L) and c.430_447del(p.G144_Y149del) variants. The variant c.1441delC(p.R481Efs *48) had not been previously reported. During follow-up, 6 patients died of respiratory failure 6-18 months after onset, with an average of 11.8 months. Conclusions:Patients with FUS gene related ALS have an early age of onset, rapid progression, short survival period, asymmetric limb weakness, and more severe involvement of proximal limbs. The c.1574C>T(p.P525L) is a hotspot mutation, and the novel variant c.1441delC(p.R481Efs *48) enriches the mutation spectrum of the FUS gene.

Objective:To investigate the clinical and genetic characteristics of spinal muscular atrophy (SMA) patients with SMN1 gene compound heterozygous mutations. Methods:Three SMA-Ⅲ pedigrees treated in Henan Provincial People′s Hospital from October 2019 to July 2020 were selected. The clinical data of 3 SMA-Ⅲ probands were retrospectively analyzed. Multiplex ligation-dependent probe amplification (MLPA) technology was used to detect the copy number of the SMN gene in the probands and their parents. Polymerase chain reaction amplification combined with microfluidic capillary electrophoresis were used to detect point mutations in the SMN1 gene of the probands. Sanger sequencing was used to validate candidate variant sites. Results:The 3 probands are all male, aged 19, 17 and 12 years, respectively. The main clinical manifestations were symmetrical muscle weakness mainly in the proximal lower limbs, mild to moderate elevation of serum creatine kinase, and neurogenic injury as determined by electromyography or muscle pathology. The genetic testing results showed that all 3 probands had heterozygous deletion in exon 7 of the SMN1 gene, and carried heterozygous variations c.275G>A (p.Trp92 *), c.689C>T (p.Ser230Leu), and c.708dupT (p.Pro237Serfs *19), respectively. The exon deletion and point mutation were inherited separately from their parents. c. 275G>A (p.Trp92 *) and c.708dupT (p.Pro237Serfs *19) variations had not been reported before. Conclusions:The clinical manifestations of SMA-Ⅲ patients are symmetrical muscle weakness, mainly in the proximal extremities of both lower limbs, and electromyography or muscle biopsy suggesting neurogenic lesions. The compound heterozygous variation of point mutation and heterozygous deletion in the SMN1 gene can lead to SMA-Ⅲ. Suspected SMA patients with SMN1 gene heterozygous deletion should take point mutation testing.

Objective:To analyze the clinical manifestations and muscular magnetic resonance imaging (MRI) features of 12 families with facioscapulohumeral muscular dystrophy (FSHD).Methods:Retrospective analysis was conducted on 12 FSHD families diagnosed by genetic testing at the Department of Neurology of Henan Provincial People′s Hospital from January 2017 to June 2021. Clinical data and lower limb muscle MRI results of the probands and related members of the families were collected, and the degree of muscle fatty degeneration shown in the MRI was scored using the modified Mercuri score.Results:There were 21 patients in 12 families, with the age of onset ranged from 10 to 47 years (mean 19.5 years). The course of disease ranged from 1 to 47 years (mean 23.1 years). The onset sites included unilateral upper extremity in 8 cases, bilateral proximal upper extremities in 9 cases, bilateral proximal lower extremities in 2 cases, unilateral proximal lower extremity in 1 case, and simultaneous onset in all 4 limbs in 1 case. Sixteen patients had limb weakness and bilateral asymmetry, and 11/16 cases were more severe on the right side than the left side. Winged scapular and facial muscle weakness were observed in all patients. The creatine kinase range was 85-1 038 U/L (461 U/L on average) in 12/21 cases. There were 10/21 cases of myogenic lesion in electromyography. Myodystroph-like pathological changes were found in 11/21 cases. The fragment length of the 4q35 subtelomere polymorphism EcoRI/p13E-11 was less than 38 kb in 20/21 cases; 1 case was confirmed based on clinical symptoms and family history. Fat infiltration occurred in at least one muscle of lower limbs in 9/10 cases, in thigh muscle in 9/10 cases and in calf muscle in 6/10 cases. The average score of fat infiltration in thigh muscle group was higher than that in calf muscle group. The muscles with higher fat infiltration scores were the vastus intermedius, the long head of the biceps femoris, the vastus medialis, the vastus lateralis, the semitendinosus, the semimembranosus, the vastus lateralis in the thigh (with score ≥2.15), the tibialis anterior, and the medial head of the gastrocnemius in the calf (with score ≥1.11). Fat infiltration in the medial and posterior thigh muscles was more common than in the anterior thigh muscles. There was asymmetry of bilateral muscle fat in 9/10 cases. There were edematous changes in thigh muscles in 1 case and in calf muscles in 3 cases.Conclusions:The age of onset of FSHD patients is mostly ≤30 years. Bilateral asymmetric involvement is the characteristic manifestation of FSHD. The FSHD patients ' muscles most affected by the disease in the thigh are the quadriceps femoris, the long head of the biceps femoris, the vastus medialis, the vastus lateralis, the semitendinosus, the semimembranosus, and the vastus intermedius. In the calf, the muscles most affected are the anterior tibial muscle and the medial head of the gastrocnemius. The MRI pattern of muscle involvement of patients with FSHD is bilateral asymmetrical lesions, with the right side having more severe lesions. The fatization of thigh muscles is more significant than that of calf muscles, and the asymmetry of fatization between bilateral muscles is also present.

Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021.Methods A total of 9 261 strains of B.cepacia were collected from 52 hospitals between January 1,2015 and December 31,2021.Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol.The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute(CLSI)guidelines(2023 edition).Results A total of 9 261 strains of B.cepacia were isolated from all age groups,especially elderly patients.The proportion was 11.1％(1 032 strains)in children,significantly lower than the proportion in adults.About half(46.5％,4 310/9 261)of the strains were isolated from patients at least 60 years old and 42.3％(3 919/9 261)of the strains were isolated from young adults.Most isolates(71.1％)were isolated from sputum and respiratory secretions,followed by urine(10.7％)and blood samples(8.1％).B.cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document(33rd edition,2023).B.cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin.However,the resistance rates to ceftazidime,trimethoprim-sulfamethoxazole,and minocycline remained below 8.1％.The percentage of B.cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups(from 12.4％in the patients＜18 years old to 20.6％in the patients aged 60 years or older).Conclusions B.cepacia is one of the clinically important non-fermenting gram-negative bacteria.Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.