Forsythia suspensa is a traditional Chinese medicine and a commonly used landscaping plant. Its dried fruit is used in medicine for its functions of clearing heat, removing toxins, reducing swelling, dissipating masses, and dispersing wind and heat. It possesses extremely high medicinal and economic value. However, the genetic differentiation and diversity of its wild populations remain unclear. In this study, chloroplast genome sequences were obtained from 15 wild individuals of F. suspensa using high-throughput sequencing technology. The sequence characteristics and intraspecific variations were analyzed. The results were as follows:(1) The full length of the F. suspensa chloroplast genome ranged from 156 184 to 156 479 bp, comprising a large single-copy region, a small single-copy region, and two inverted repeat regions. The chloroplast genome encoded a total of 132 genes, including 87 protein-coding genes, 37 tRNA genes, and 8 rRNA genes.(2) A total of 166-174 SSR loci, 792 SNV loci, and 63 InDel loci were identified in the F. suspensa chloroplast genome, indicating considerable genetic variation among individuals.(3) Population structure analysis revealed that F. suspensa could be divided into five or six groups. Both the population structure analysis and phylogenetic reconstruction results indicated significant genetic variation within the wild populations of F. suspensa, with no obvious correlation between intraspecific genetic differentiation and geographical distribution. This study provides new insights into the genetic diversity and differentiation within F. suspensa species and offers additional references for the conservation of species diversity and the utilization of germplasm resources in wild F. suspensa.
Genome, Chloroplast ; Forsythia/classification* ; Phylogeny ; Genetic Variation ; Chloroplasts/genetics* ; Microsatellite Repeats

Objective To investigate and analyze the distribution of serum cytokeratin 19 fragment antigen 21-1(CYFRA21-1)and squamous cell carcinoma-associated antigen(SCCA)levels in healthy pregnant women during pregnancy and to assess their diagnostic value for cervical cancer in pregnancy.Methods A total of 441 healthy pregnant women and 69 patients with cervical cancer in pregnancy who attended the Obstetrics and Gynecology Hospital of Fudan University from Jan 2021 to May 2024 were selected,and 165 healthy women in the Physical Examination Center of the Obstetrics and Gynecology Hospital of Fudan University were included in the same period as the control group.The healthy pregnant women were divided into 143 in early pregnancy(T1 group),147 in middle pregnancy(T2)and 151 in late pregnancy(T3).Serum CYFRA21-1 and SCCA values were detected and analyzed in all groups.One-way ANOVA,independent samples t-test,Mann-Whitney U-test,Kruskal-Wallis H-test,logistic analysis,and ROC curves were used for comparative analysis.Results The CYFRA21-1 and SCCA values were 1.66(1.19-2.17)ng/mL and 0.8(0.6-1.0)ng/mL in the control group,3.07(2.11-4.14)ng/mL and 0.9(0.7-1.3)ng/mL in the healthy pregnant women group,and were 4.33(2.99-7.60)ng/mL and 1.8(0.9-8.5)ng/mL in the patients with cervical cancer in pregnancy group,respectively.There was a statistically significant difference in the two serum values between every two groups(P<0.05).CYFRA21-1 levels were 3.13(2.46-4.05)ng/mL,1.89(1.50-2.53)ng/mL and 4.19(3.48-5.43)ng/mL in the T1,T2,and T3 groups,respectively;and SCCA levels were 0.9(0.7-1.1)ng/mL,0.7(0.6-1.0)ng/mL and 1.2(0.8-1.7)ng/mL,respectively.The results of T1 and T3 groups were higher than those of the control group(P<0.05);however,there was no statistically significant difference between the results of the T2 group and those of the control group(P>0.05).The areas under the ROC curves for the diagnosis of cervical cancer in pregnancy for CYFRA21-1,SCCA,human epididymis protein 4(HE4),anti-carcinoembryonic antigen(CEA)and joint indicators were 0.684,0.724,0.612,0.791 and 0.913,with sensitivities of 36%,48%,38%,57%and 73%,specificities of 96%,97%,89%,86%and 99%,respectively.The cut-off values of each indicator were 6.05 ng/mL,2.60 ng/mL,51.45 pg/mL and 1.75 ng/mL,respectively.Conclusion Serum CYFRA21-1 and SCCA levels were higher in pregnant women during early and late pregnancy compared with non-pregnant individuals,while they were not statistically different from non-pregnant women during mid-trimester.CYFRA21-1 and SCCA have diagnostic value for patients with cervical cancer during pregnancy.

Objective:To investigate and summarize pediatric patients with severe Mycoplasma pneumoniae pneumonia (MPP) presenting with varied clinical and chest imaging features in order to guide the individualized treatment. Methods:This was a retrospective cohort study. Medical records of clinical, imaging and laboratory data of 505 patients with MPP who were admitted to the Department Ⅱ of Respirology Center, Beijing Children′s Hospital, Capital Medical University from January 2016 to October 2023 and met the enrollment criteria were included. They were divided into severe group and non-severe group according to whether lower airway obliterans was developed. The clinical and chest imaging features of the two groups were analyzed. Those severe cases with single lobe ≥2/3 consolidation (lobar consolidation) were further divided into subtype lung-necrosis and subtype non-lung-necrosis based on whether lung necrosis was developed. Comparison on the clinical manifestations, bronchoscopic findings, whole blood C-reactive protein (CRP) and other inflammatory indicators between the two subtypes was performed. Comparisons between two groups were achieved using independent-sample t-test, nonparametric test or chi-square test. Univariate receiver operating characteristic (ROC) curve analyses were performed on the indicators such as CRP of the two subtypes. Results:Of the 505 cases, 254 were male and 251 were female. The age of the onset was (8.2±2.9) years. There were 233 severe cases, among whom 206 were with lobar consolidation and 27 with diffuse bronchiolitis. The other 272 belonged to non-severe cases, with patchy, cloudy infiltrations or single lobe <2/3 uneven consolidation or localized bronchiolitis. Of the 206 cases (88.4%) severe cases with lobar consolidation, 88 harbored subtype lung-necrosis and 118 harbored subtype non-lung-necrosis. All 206 cases (100.0%) presented with persistent high fever, among whom 203 cases (98.5%) presented with inflammatory secretion obstruction and plastic bronchitis under bronchoscopy. Of those 88 cases with subtype lung-necrosis, there were 42 cases (47.7%) with dyspnea and 39 cases (44.3%) with moderate to massive amount of pleural effusion. There were 35 cases (39.8%) diagnosed with lung embolism during the disease course, of which other 34 cases (38.6%) were highly suspected. Extensive airway mucosal necrosis was observed in 46 cases (52.3%), and the level of their whole blood CRP was significantly higher than that of subtype non-lung-necrosis (131.5 (91.0, 180.0) vs. 25.5 (12.0, 43.1) mg/L, U=334.00, P<0.001). They were regarded as subtype "lung consolidation-atelectasis-necrosis". Of those 118 cases with subtype non-lung-necrosis, 27 cases (22.9%) presented with dyspnea and none were with moderate to massive amount of pleural effusion. Sixty-five cases (55.1%) presented with plastic bronchitis and localized airway mucosal necrosis was observed in 32 cases (27.1%). They were deemed as subtype "lung consolidation-atelectasis". ROC curve analyses revealed that whole blood CRP of 67.5 mg/L on the 6-10 th day of disease course exhibited a sensitivity of 0.96, a specificity of 0.89, and an area under the curve of 0.97 for distinguishing between these two subtypes among those with lobar consolidation. Conclusions:Pediatric patients with severe MPP present with lobar consolidation or diffuse bronchiolitis on chest imaging. Those with lobar consolidation harbor 2 subtypes as "lung consolidation-atelectasis-necrosis" and "lung consolidation-atelectasis". Whole blood CRP of 67.5 mg/L can be applied as an early discriminating indicator to discriminate between these two subtypes.

Objective:To identify the types of fear of progression in patients after percutaneous coronary intervention (PCI) based on latent profile analysis, and to explore the influencing factors of different types.Methods:Cross-sectional survey method was used to select the patients with coronary heart disease and underwent PCI in Anhui Public Health Clinical Center from April to December 2023 as the research object. The general information questionnaire, Fear of Progression Questionnaire-Short Form, Ruminative Response Scale and Brief Illness Perception Questionnaire were used to investigate them. Mplus8.3 software was used to construct the latent profile model.Results:A total of 240 patients with complete data were enrolled, including 176 males and 64 females, aged 28-84 (62.94 ± 11.20) years. The results of latent profile analysis showed that the fear of progression of patients after PCI could be divided into three latent categories: There were 59 cases (24.6%) in the low fear group, 111 cases (46.3%) in the medium fear group, and 70 cases (29.1%) in the high fear-worried family group. The results of multiple logistic regression analysis showed that compared with the low fear group, the probability of having primary school education or below was higher in the medium fear group ( OR=4.054, 95% CI 1.370-11.996) and the high fear-worry family group ( OR=5.996, 95% CI 1.562-23.014), secondary school was more likely in the moderate fear group ( OR=3.096, 95% CI 1.104-8.682, all P<0.05);Living in rural areas were more likely to be in the moderate fear group ( OR=2.587, 95% CI 1.187-5.637) and the high few-worry family group ( OR=6.958, 95% CI 2.567-18.856, all P<0.05); The probability of the first interventional therapy was higher in the moderate fear group ( OR=2.496, 95% CI 1.107-5.630) and the high fear-worry family group ( OR=4.924, 95% CI=1.809-13.402, all P<0.05). In addition, compared with the low fear group, patients with higher rumination were more likely to belong to the high few-worry family working group ( OR=1.130, 95% CI 1.055-1.210, P<0.05);Moderate fear group ( OR=1.181, 95% CI 1.046-1.334) and high fear family working group ( OR=1.349, 95% CI 1.164-1.562, all P<0.05) had a higher level of illness perception. Conclusions:There is significant heterogeneity in the fear of progression among patients after PCI. Medical staff can implement precise intervention according to the potential category characteristics of patients′ fear of progression, so as to reduce the level of fear of disease progression.

Objective To explore the effect of stereotactic hematoma puncture aspiration (SHPS) combined with edaravone in the treatment of patients with cerebral hemorrhage in the Neurosurgery Intensive Care Unit (NICU). Methods A total of 98 patients with cerebral hemorrhage in NICU were divided into experimental group and control group by drawing lots, with 49 cases in each group. The control group was treated with SHPS and conventional therapy, while the experimental group was treated with edaravone on the basis of the control group. The clinical efficacy, the quality of life[the National Institute of Health Stroke Scale (NIHSS) score, the Ability of Daily Living (ADL) score and the China Stroke Scale (CSS) score], glucose and lipid metabolism indicators[jugular venous oxygen saturation (SjvO₂), arteriovenous lactate (A-VLac) and arteriovenous glucose (A-VGlu)], inflammatory factors[interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)]levels as well as incidence of complications were compared between the two groups. Results The total effective rate of the experimental group was 91.84%, which was significantly higher than 77.55% of the control group (P < 0.05). After treatment, the NIHSS score and CSS score of the experimental group were significantly lower than those of the control group, while the ADL score was significantly higher than that of the control group (P < 0.05). After treatment, the SjvO₂ level in the experimental group was significantly higher than that in the control group, while the levels of A-VGlu and A-VLac were significantly lower than those in the control group (P < 0.05). After treatment, the IL-8, IL-6 and TNF-α levels in the experimental group were significantly lower than those in the control group (P < 0.05). The incidence of complications in the experimental group was 12.24%, which was significantly lower than 30.61% in the control group (P < 0.05). Conclusion The combination of SHPS and edaravone can reinforce the clinical efficacy of patients with cerebral hemorrhage in NICU, improve neurological function, and reduce the incidence of postoperative complications.

Objective To analyze the influencing factors of oral frailty in elderly patients with type 2 diabetes and construct a nomogram prediction model. Methods A total of 370 elderly patients with type 2 diabetes were selected as the research subjects, including 284 patients in the modeling group and 86 patients in the validation group. The Oral Frailty Index-8 (OF-8) Scale was used for oral frailty screening, and a score of ≥4 was considered positive for oral frailty. General information of the two groups was collected through a self-made questionnaire. Multivariate Logistic regression analysis was used to analyze the influencing factors of oral frailty in patients with type 2 diabetes, and nomogram model was constructed. The goodness-of-fit and predictive performance of the model were verified using the Hosmer-Lemeshow goodness-of-fit test and the receiver operating characteristic curve (ROC). Results The incidence of oral frailty among elderly patients with type 2 diabetes was 45.4% (129/284). Age, body mass index (BMI), appendicular skeletal muscle mass index (ASMI), smoking, monthly income and subjective chewing difficulty were identified as influencing factors for oral frailty in elderly diabetic patients (P < 0.05). The areas under the ROC for internal and external validation were 0.887 (95%CI, 0.847 to 0.925) and 0.839 (95%CI, 0.755 to 0.923), respectively. The Hosmer-Lemeshow test showed that χ²=4.852, P=0.773, indicating good goodness-of-fit for the nomogram model. Conclusion Age, ASMI, BMI, smoking, monthly income and subjective chewing difficulty are influencing factors for oral frailty in elderly diabetic patients. The nomogram prediction model constructed based on these influencing factors demonstrates good performance.

Objective To evaluate the effectiveness of a 1470 nm semiconductor laser therapeutic instrument(referred to as a curestar therapeutic instrument)for prostatectomy in Beagle dogs.Methods Twenty-eight adult male Beagle dogs were randomly divided into three groups:sham(n=3),experimental(n=15),and control(n=10).The experimental group was further divided into three subgroups:120 W/50 W,150 W/50 W,and 160 W/50 W for vaporization cutting/coagulation hemostasis.The control group was divided into two subgroups:120 W/50 W and 150 W/50 W with five in each subgroup.Experimental and control groups underwent canine prostatectomy through the entrance of the bladder neck under electrocision.The operational suitability and effectiveness of the product during surgery were assessed.After the operation,the general condition of the dogs was observed,and blood biochemical and hematological indicators were measured before,immediately after,and at 3,7,and 28 days after the operation.At 1 h and 4 weeks after surgery,B-ultrasound and electric resection were performed under anesthesia to observe the conditions of the urethra and prostate,and prostatic tissue was subjected to HE staining for pathological observations.The thickness of the coagulation layer at 1 h after the operation and repair of the urothelial epithelium at 4 weeks were analyzed.Results During the operation,experimental and control groups had good operability and showed good vaporization cutting and coagulation hemostasis performance.After the operation,no significant effects were observed on the general condition,and blood biochemical and hematological indicators of the dogs.Ultrasound showed that the urethral expansion was visible immediately after the operation,and the echo of the urethral epithelium was slightly enhanced.At 4 weeks,the prostate tissue had a slightly low echo with uniformly distributed small point-like echoes inside,and the capsule had a linearly high echo,consistent with the sham group.The weight of the vaporized prostate tissue in experimental and control groups was 0.91～1.33 g with a resection rate of 17.11％～20.27％.As the power of vaporization cutting increased,the laser emission time gradually decreased,while the vaporization cutting speed and efficiency both increased.However,no significant difference was found between experimental and control groups(P＞0.05).Under the electrocision microscope,a burn-like change was observed in the surgical wounds of the prostate urethra in experimental and control groups at 1 h after surgery,and the boundary between the wound and normal urothelium was visible.At 4 weeks,the urothelium of the prostate had been repaired and flattened,and the boundary with the surrounding normal urothelium was blurred.Similarly,pathological observations showed that experimental and control groups had significant damage to the prostate urethral orifice at 1 h after surgery with a small amount of carbonization and coagulative necrosis on the surface of the wound,a small amount of inflammatory cell infiltration,and a coagulation layer thickness of approximately 0.4 mm.At 4 weeks,the prostate urethral morphology of the sham group was normal,whereas experimental and control groups showed new epithelial growth covering the wound with a uniform thickness and no coagulative necrosis tissue attached to the wound.A mild inflammatory reaction was still present in the surrounding area,fibroblast proliferation was obvious,and stromal and epithelial cell proliferation was visible in the surrounding prostate,some of which showed squamous metaplasia.The prostate capsule was intact and the morphology of the surrounding nerves and blood vessels was normal.Conclusions The curestar therapy instrument is effective for prostatectomy in Beagle dogs with good vaporization cutting and coagulation hemostasis performance.No significant difference was found in postoperative physiological indicators compared with the sham group.

Objective:To evaluate the risk factors for the formation of parastomal Hernias(PSH)using meta-analysis,and to provide a theoretical basis for the prevention and treatment of PSH.Methods:Case control or Cohort study of PSH risk factors were collected by searching PubMed,CNKI,Wanfang data and other databases.Extract relevant data and perform meta-analysis using RevMan 5.3.Results:The results included a total of 16 studies,with a total sample size of 2411 cases,including 670 in the PSH group and 1741 in the non PSH group.The results showed that advanced age,female gender,BMI≥25,hypertension,COPD/chronic cough,diabetes,and postoperative Hypoproteinemia could increase the risk of PSH(P＜0.05);Smoking,previous ab-dominal surgery history,preoperative radiotherapy/chemotherapy etc.,were not significantly asso-ciated with the occurrence of PSH(P＞0.05).Conclusion:The current evidence shows that ad-vanced age,female gender,BMI≥25,hypertension,COPD/chronic cough,diabetes,postoperative Hypoproteinemia are risk factors for PSH,and extraperitoneal stoma can reduce the occurrence of PSH.