Objective To develop and validate a scoring system to predict the possibility of laparoscopic cholecystectomy (LC) conversion to laparotomy based on preoperative clinical data, and to establish a grading management model of surgery. Methods A retrospective analysis was conducted on the clinical data of 9 414 patients who underwent LC at Renhe Hospital and Huashan Hospital from June 2013 to June 2018. The patients were divided into two groups: the LC group (9 246 patients who successfully underwent LC) and the conversion to laparotomy group (168 patients who required conversion to open surgery). The data of two groups were compared, and the risk factors affecting conversion to laparotomy were screened out by single factor analysis of Chi-square test. Then, the risk factors were analyzed by multiple Logistic regression, and the pre-coefficient of each variable of the risk factors was assigned according to the established conversion to laparotomy possibility function. After calculating the score of each case, the difference in the actual conversion rate of each group was compared. The area under receiver operating characteristic (ROC) curve was calculated to evaluate the performance of the scoring system. According to the scoring system, LC surgical grading management model was created and verified. Results The following factors were identified as significant risk factors for conversion to laparotomy (P < 0.001): body temperature ≥ 38.5℃, frequency of acute cholecystitis ≥3 times, maximum thickness of gallbladder wall ≥ 5 mm, gallbladder neck stone incarceration, diameter of common bile duct ≥8 mm, and surgical experience ≤50 cases were the risk factors for conversion to laparotomy (P < 0.001). A score >3 points was associated with a high risk of conversion to laparotomy. Conclusions The LC scoring system and surgical grading management are reliable and effective tools for predicting and reducing the conversion rate of LC to laparotomy.

Lentiviral vectors(LVs)are key gene delivery tools for integrating target genes into the host genome,but they may also pose risks of insertional mutagenesis.The vector copy number(VCN)in cells is critical for determining the safety of gene modification.However,the reliability and accuracy of its quantification process are influenced by multiple factors.Developing cell reference materials with specific vector copy numbers represents a viable approach to enhance the reliability and consistency of measurement results,enabling quality control of the quantification process and traceability of outcomes.However,the preparation of such reference materials faces challenges in cell sample design,preparation protocols,and advanced quantification techniques.In this study,T lymphocyte cell line Jurkat-based reference materials with LV gene copy numbers of 1 and 2 copy/cell were developed.A high-precision duplex digital polymerase chain reaction(dPCR)method was established to quantify the LV gene and endogenous genes simultaneously.Additionally,the results of dPCR were cross-validated through next-generation sequencing and flow cytometric analysis.Ultimately,confocal microscopy characterization results showed that the developed cell reference materials had intact morphology.The quantification result of VCN-1 was(1.07±0.11)copy/cell,and that of VCN-2 was(2.09±0.21)copy/cell.These cell reference materials demonstrated compliance with stability and homogeneity requirements,and could be applied for quality control throughout the VCN measurement workflow and metrological traceability,improving the accuracy,comparability,and validity of copy number measurements.

Self-limiting epilepsy syndrome（SeLES）can be classified into two types based on age of onset：one occurring in the neonatal to infant period and the other in the childhood period.These diseases can exhibit complete remission within a specific age range，or be completely controlled with anti-seizure drugs.Children with SeLES typically have normal cognition or only mild cognitive impairment.In recent years，advancements in genetic testing technology have led to a better understanding of the genetic etiologies of SeLES，offering more possibilities for precision treatment.This article aims to explore the role of genetic factors in SeLES，providing reference for the diagnosis，precise drug selection，and prognosis of this type of hereditary epilepsy syndrome，in order to provide theoretical support for the long-term management of patients，and improve their quality of life.

Psychotropic medication plays a crucial role in the field of mental illness,and the issues of drug efficacy and safety due to individual differences cannot be ignored.Genetic factors,especially the genetic poly-morphisms related to drug-metabolizing enzymes,drug action targets,and risk,have a significant impact on drug responses.Pharmacogenomics,by detecting genetic polymorphisms,can reveal a patient's inherited tend-encies towards drug efficacy,pharmacokinetic characteristics,and potential toxicity,thereby predicting the therapeutic effects and adverse reactions of drug treatment,and providing guidance for personalized therapy.Therefore,individualized medication based on pharmacogenomics helps to improve cure rates,reduce relapse rates,and decrease medical costs,which is of great significance to clinical medication in mental illness.

Objective:To investigate the effect of FOXQ1 expression on chemoresistance in colorectal cancer and analyze its regulatory role in SIRT1 expression and p53 deacetylation under DNA damage response(DDR)condi-tions.Methods:qRT-PCR was used to detect FOXQ1 mRNA expression levels in SW620 cells and SW620 cells stimulated with cisplatin(CDDP).Lentiviral vectors were constructed for FOXQ1 overexpression and RNA interference.The cells were divided into three groups:FOXQ1 overexpression group(oe-FOXQ1),FOXQ1 RNA interference group(sh-FOXQ1),and a control group transfected with an empty vector(NC).The half-maximal inhibitory concentration(IC50)of CDDP in each group was determined using the CCK-8 assay.Apoptosis level and cell viability were assessed using the Annexin V-APC/7-ADD apoptosis detection kit and Calcein/PI staining.Western blot analysis was performed to evaluate the effect of FOXQ1 on SIRT1 expression and acetylated p53 levels.The SIRT1 pathway inhibitor(S)-Selisi-stat was introduced to observe changes in p53 acetylation levels.Results:Compared to normal colon tissues,FOXQ1 expression was significantly upregulated in SW620 cells(P＜0.05),and low-dose CDDP stimulation further en-hanced its expression(P＜0.05).After 24 hours of CDDP treatment,the IC50 values for the oe-FOXQ1,sh-FOXQ1,and NC groups were 58.3 μmol/L,36.4 μmol/L,and 43.7 μmol/L,respectively,with statistically significant differences among the groups(P＜0.05).Compared to the NC group,the oe-FOXQ1 group showed a decrease in late apoptotic cell count(P＜0.05),while the sh-FOXQ1 group exhibited an increase(P＜0.05).Cytotoxic fluorescence staining re-vealed that the proportion of cell death was lower in the oe-FOXQ1 group and higher in the sh-FOXQ1 group com-pared to the NC group(P＜0.05).Protein expression analysis showed that FOXQ1 and SIRT1 levels were higher in the oe-FOXQ1 group and lower in the sh-FOXQ1 group compared to the NC group(P＜0.05).FOXQ1 overexpression pro-moted p53 deacetylation,while the addition of the SIRT1 pathway inhibitor(S)-Selisistat restored p53 acetylation levels(P＜0.05).Conclusion:FOXQ1 promotes p53 deacetylation by upregulating SIRT1 expression,thereby inhibiting DDR-induced apoptosis.

Objective To analyze the dual-channel with single channel recorded somatosensory evoked potentials(SSEPs)monitoring in the thoracic vertebral disease that underwent surgical fixation surgery waveform differentiation and evaluate the value of dual-channel SSEPs applied in thoracic surgery diseases.Methods The study included 135 patients who underwent surgery for thoracic vertebra disease in Xi'an Honghui hospital from November 2019 to November 2023.Of them,66 underwent conventional single-channel SSEPs monitoring and 69 underwent dual-channel SSEPs monitoring.By observing the waveform differentiation of single-channel SSEPs and dual-channel SSEPs,Chi-square test and Fisher exact test were used to analyze the influences of age and etiological classification on the waveform differentiation and monitoring success rate of SSEPs.The success rate of intraoperative monitoring and the incidence of postoperative adverse events in alarm cases were compared between the two groups.Results Univariate analysis showed that age group and etiological classification of thoracic vertebral diseases affected the success rate of intraoperative SSEPs monitoring.Among the etiological classification,the SSEPs waveform differentiation in fracture group was the least ideal.Intraoperative monitoring results showed that the success rate of single-channel SSEPs monitoring was 80.30％,while the success rate of dual-channel SSEPS monitoring was 98.55％(P＜0.05).In the intraoperative alarm cases,the incidence of postoperative adverse events monitored by single-channel SSEPs was 66.67％;the incidence of adverse events after dual-channel SSEPs monitoring was 33.33％.Conclusion The age of patients and etiological type of thoracic spine diseases affect the success rate of intraoperative SSEPs monitoring.Dual-channel SSEPs monitoring can effectively and accurately evaluate the function of patients with posterior spinal cord conduction pathway.Using dual-channel SSEPs monitoring can significantly improve the success rate of monitoring and reduce the occurrence of postoperative adverse events in patients with thoracic vertebra disease.

OBJECTIVE T o establish the automatic diagnosis system for varicella pneumonia based on multi-slice spiral computed tomography(MSCT)and verify its application value.METHODS The clinical data were collected from 295 patients with varicella who were treated in the hospital from Jan.2016 to Mar.2023 and assigned as the training set,the pulmonary imaging findings were acquired from the MSCT chest scanning.The automatic diagno-sis system for varicella pneumonia was established based on MSCT with the use of convolutional neural network technology.Totally 279 patients with varicella who were treated during the same period were chosen as the valida-tion set,the result of comprehensive diagnosis was set as gold standard,and the efficiency of the above system in diagnosis of varicella pneumonia was observed.RESULTS Totally 279 patients with varicella were included in the validation group,243 of whom had varicella pneumonia,and 36 had simple varicella infection.The sensitivity of the automatic diagnosis system established based on MSCT was 97.53％in diagnosis of the varicella pneumonia of the validation group,with the specificity 91.67％,the accuracy 96.77％,respectively higher than 93.83％,83.33％and 92.47％of MSCT,and it was highly consistent with the gold standard(Kappa=0.919,P＜0.001);there was consistency between MSCT and the gold standards(Kappa=0.675,P＜0.001).CONCLUSION The au-tomatic diagnosis system for varicella pneumonia established based MSCT can raise the sensitivity,specificity and accuracy in diagnosis of varicella pneumonia and have the advantages of automation and convenience,and serve as a new tool for clinical diagnosis of varicella pneumonia.

Objective To evaluate the effects of bladder neck preservation on postoperative stress urinary inconti-nence and retrograde ejaculation in patients undergoing transurethral thulium laser enucleation of the prostate(ThuLEP).Methods The clinical data of 203 patients who underwent ThuLEP in our hospital from September 2021 to December 2023 were retrospectively analyzed.According to the operation method,the patients were divided into bladder neck preservation group(n=95)and non-bladder neck preservation group(n=108).The occurrence of postoperative stress urinary inconti-nence and retrograde ejaculation of the two groups were compared.Results The differences between the patients of two groups in operative time(110[80,130]min vs 110[90,140]min),hospital stay(8[8,8]d vs 8[8,8]d),in-dwelling catheter time(7[7,7]h vs 7[7,7]h),and hemoglobin decline(9[6,14]g/L vs 8[4,13]g/L)were not statistically significant(P＞0.05).There were no statistically significant differences between the two groups at 3 months postoperatively in maximum flow rate(20[18,21]mL/s vs 19[18,20]mL/s),scores of International Prostate Symp-tom Scale(5[4,6]vs 5[4,5]),post-void residual urine volume(0[0,8]mL vs 0[0,7.5]mL)and quality of life(2[1,3]vs 2[1,3])(P＞0.05).The differences in the rates of postoperative stress urinary incontinence(2.1％vs 9.3％)and retrograde ejaculation(49.4％vs 74.5％)between the two groups were statistically significant(P＜0.05).Conclusion Bladder neck preservation during ThuLEP reduces the incidence of postoperative stress urinary incontinence and retrograde ejaculation.

Objective: To construct a scientific and perfect evaluation index system of infectious disease prevention and control ability in colleges and universities, so as to provide reference tools for colleges and universities to effectively respond to infectious disease. Methods: The initial framework of the evaluation index system of infectious disease prevention and control ability in colleges and universities was constructed by using literature analysis method. Experts familiar with infectious disease prevention and control or school health work were selected to conduct two rounds( n =16，18) of Delphi expert consultation for determining the evaluation index system. Analytical hierarchy process was used to calculate the index weights and combined weights. About 198 prevention and control personnel were conveniently selected from 3 universities in Inner Mongolia Autonomous Region to comprehensively evaluate the evaluation indicators by using fuzzy comprehensive evaluation method. Results: After two rounds of Delphi consultation questionnaire, the effective recovery rates were 80.0% and 90.0%, the expert authority levels were 0.89 and 0.86, the expert harmony coefficients for Kendall W were 0.166 and 0.310, and the variation coefficient of each index was <0.25. Finally, the evaluation index system of infectious disease prevention and control ability of colleges and universities included 4 first level indicators, 14 second level indicators and 75 third level indicators. The weights of prevention and monitoring and early warning, organizational system guarantee, emergency management, rehabilitation and summary were 0.176, 0.476, 0.268 and 0.080, respectively. The top 3 weights of the secondary indexes were 0.623 for infectious disease surveillance and early warning, 0.595 for loss assessment and 0.370 for emergency response. The score of fuzzy comprehensive evaluation of the index system of infectious disease prevention and control ability in colleges and universities was 79.148, suggesting a high level. Conclusion The established evaluation index system of infectious disease prevention and control ability in colleges and universities is scientific and reasonable, which is conducive to provide tool reference for the evaluation of infectious disease prevention and control ability in colleges and universities.

Aim To explore the mechanism of the syn-ergistic effect of the ferroptosis inducer erastin com-bined with shikonin in promoting ferroptosis in human hypertrophic scar fibroblasts(HSFBs).Methods Hypertrophic scar tissues provided by the General Hos-pital of Ningxia Medical University were collected,and HSFBs were extracted.HSFBs were identified by HE staining and immunofluorescence.The inhibitory rates of Era and SHK on HSFBs at different concentrations were detected by CCK-8 assay,and the IC50 value was calculated.CompuSyn software was used to calculate the co-use index(CI).Control group,Erastin(Era)group,shikonin(SHK)group and Era+SHK group were set up,and the number and morphological chan-ges of cells were observed after 24 hours of interven-tion.The ability of cell migration and invasion was de-tected by scratch test and Transwell test.The changes of malondialdehyde(MDA),total iron ion and reactive oxygen species(ROS)were detected by corresponding biochemical kits.The expressions of collagen I,α-SMA and GOT1,SLC7A11,GPX4 and FTH1 were detected by Western blot.Results The IC50 value of Era and SHK of primary HSFBs was 2.22 μmol·L-1 and 3.94μmol·L-1 respectively,which was used as the single drug concentration for subsequent experiments.The CompuSyn software was employed to calculate the CI value when the two drugs were used in combination,and the concentrations corresponding to CI=0.39597(Era:1.2 μmol·L-1+SHK:1.5 μmol·L-1)were selected as subsequent combination concentrations(Because when CI was equal to 0.395 97,the concen-tration of each drug was lower than the concentration of single drug,and the inhibition rate of combined drug was greater than 50％).Compared with the monother-apy group,the number of HSFBs in the SHK+Era group was significantly reduced,cell membrane showed breakage and vesiculation,cell wrinkling became smal-ler,and cytoplasm was concentrated.The migration and invasion ability of HSFBs in the SHK+Era group were obviously weakened(P＜0.05),and the expres-sion of fibrosis-related proteins collagen Ⅰ and α-SMA was reduced(P＜0.05);the contents of MDA,total i-ron ions,and ROS in HSFBs of the SHK+Era group increased(P＜0.05),and the protein expression lev-els of SLC7A11,GOT1,GPX4,and FTH1 further de-creased(P＜0.05).Conclusions Erastin in combi-nation with shikonin can synergistically inhibit the pro-liferation,migration and fibrosis levels of HSFBs.The mechanism may be that erastin enhances the inhibition of shikotin on GOT1,increases the levels of cellular i-ron ions,ROS,and lipid peroxides,thereby promoting ferroptosis in HSFBs.