Objective To observe the correlations of pontine biological indicators on fetal brain median sagittal MRI with gestational week.Methods Data of head MRI of 226 normal fetuses without obvious abnormalities of central nervous system(normal group)and 17 fetuses with abnormalities(abnormal group)at gestational age of 23 to 38 weeks were retrospectively analyzed.Pontine biological indicators based on median sagittal MRI were obtained,including pons anteroposterior diameter(PAD),total pons area(TPA),pontine basal anteroposterior length(AP),pontine basal cranio-caudal length(CC),basis pontis area(BPA)and pontine angle of midbrain(MAP).According to the gestational week,the fetuses of normal group were divided into 8 subgroups.The distributing ranges of pontine biological indicators at different gestational weeks were analyzed,and the correlations of pontine biological indicators with gestational week in normal group were explored,and the developmental status of fetal pons in abnormal group were assessed.Results In normal group,PAD,TPA,AP,CC and BPA all showed linear positive correlation(r=0.887,0.914,0.787,0.866,0.865,all P＜0.001),while MAP was not significantly correlated with gestational week(P＞0.05).Among 17 fetuses in abnormal group,abnormal PAD or TPA was found each in 8 fetuses,abnormal AP was observed in 14,abnormal CC was noticed in 3 and abnormal BPA was found in 11 fetuses.Conclusion Fetal pontine biological indicators such as PAD,TPA,AP,CC and BPA on median sagittal MRI were positively correlated with gestational week,hence being able to be used for evaluating fetal pontine development.

Objective:To investigate the effects of wza gene deletion in Klebsiella pneumoniae on capsule formation ability and bacteriophage sensitivity. Methods:The wza deletion mutant strain was constructed through a temperature-sensitive plasmid-mediated homologous recombination. The growth curves of W14 and Δ wza were detected by measuring the optical density OD 600. In order to analyze the effect of gene wza on bacterial capsule formation, wild-type strain W14 and Δ wza mutant strain were detected by transmission electron microscope, and their capsule contents were measured by quantifying the uronic acid contents. The plaque assay was used to detect bacterial sensitivity to bacteriophage in wild-type strain W14 and Δ wza mutant strain. The t test was used to compare whether there were differences in the contents of uronic acid in the capsules of wild-type strain W14 and Δ wza mutant strain. Results:The PCR results revealed that the Δ wza mutant strain was successfully constructed. Compared with wild-type strain W14, the growth curves of Δ wza on the solid plates demonstrated a slightly slower growth. However, no difference in growth was observed among wild-type strain W14 and Δ wza mutant strains in LB broth. The transmission electron microscope results showed that wza gene deletion resulted in the loss of capsule in bacteria. The uronic acid content assay suggested that the capsule content was significantly decreased in Δ wza mutant strain (45.963±2.795) μg/ml compared with wild-type strain W14 (138.800±5.201) μg/ml. There was a statistical difference between the two groups ( t=27.233, P<0.001). The plaque assay indicated that bacteria lost its sensitivity to bacteriophage when gene wza was deleted. Conclusion:Deletion of the wza gene impairs bacterial capsule formation ability and can affect bacterial sensitivity to bacteriophage phiW14.

Objective:To express and purify the phage depolymerase from hypervirulent Klebsiella pneumoniae (hv Kp) serotype K1 and validate its function. Methods:Phage that infected serotype K1-type hv Kp was isolated from hospital sewage. The biology and morphology of the phage were determined by plaque assay and transmission electron microscopy. The whole genome of the phage was sequenced by the Illumina HiSeq 2500 platform. The presence of depolymerase was determined by observing the plaque halo. Bioinformatic analysis and prokaryotic protein expression system were further used to predict and identify phage depolymerase. The depolymerase gene fragment was obtained by PCR and cloned into the pET28a expression vector, and the expression and purification of the depolymerase were completed in strain BL21. The depolymerase activities on the capsular polysaccharide of serotype K1-type hv Kp clinical isolates were detected by plaque assay and low-speed centrifugation assay. Results:A lytic phage (phiA2) that infected serotype K1-type hv Kp clinical isolate was isolated from hospital sewage. It was typical of the Caudovirales order and Autographiviridae family, and its whole genome was 43 526 bp in length and contained 51 coding domain sequences. The phage phiA2-derived depolymerase phiA2-dep was predicted, expressed and purified. The plaque assay and low-speed centrifugation assay indicated that the depolymerase phiA2-dep had good lytic activity on the capsular polysaccharide of serotype K1-type hv Kp clinical isolates. Conclusion:Depolymerase phiA2-dep can specifically degrade the capsular polysaccharide of serotype K1-type hv Kp, which has potential application value in treating bacterial infection.

Objective To investigate the clinical significance and serum changes of asprosin(ASP)levels in patients with essential hypertension and early renal damage.Methods According to urinary albumin/creatinine ratio(UACR),160 patients with essential hypertension were divided into the simple hypertension group(78 cases)and the early renal damage group(82 cases).Another 60 healthy subjects were selected as the control group.The differences of serum ASP,interleukin-6(IL-6)and UACR levels were compared between groups.The correlation between ASP and blood pressure,IL-6 and UACR was analyzed.Logistic regression analysis was used to analyze the factors influencing early renal damage in essential hypertension.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of each index for early renal injury.Results The serum levels of ASP,IL-6 and UACR were higher in the early renal damage group than those in the control group and the simple hypertension group(all P＜0.05).The serum levels of ASP and IL-6 showed an increasing trend with the increase of blood pressure.ASP was positively correlated with systolic blood pressure(SBP),diastolic blood pressure(DBP)and IL-6 levels in patients with essential hypertension(all P＜0.05).Serum ASP was positively correlated with SBP,UACR and IL-6 levels in essential hypertension patients(P＜0.05),and serum ASP was positively correlated with UACR and IL-6 levels in the early renal damage group(P＜0.05).Logistic regression analysis showed that higher levels of SBP,ASP and IL-6 were independent risk factors for early renal damage.ROC curve showed that ASP had the largest area under the curve(AUC)of 0.972(95%CI:0.950-0.993).The AUC of combined detection of ASP+IL-6+SBP was 0.986(95%CI:0.972-0.999).Conclusion The increased serum ASP level in patients with early renal damage in essential hypertension is a good predictor of early renal damage.The combined detection of ASP+IL-6+SBP is better than single detection.

Innovation is the driving force behind leading the development of medicine and continuously meeting the health needs of the people.Strengthening and innovating the Party building work in public hospitals is an inevitable requirement for enhancing the comprehensive leadership of the Party,an urgent need for improving the modern hospital management system,and a mission to fulfill the purpose of serving the people.Facing the 14th Five Year Plan and beyond,public hospitals adhere to the guidance of Party building,serve the Healthy China strategy,and provide sustained impetus for the high-quality development of public hospitals.Tongjiang County People's Hospital,based on its own characteristics and needs,has strengthened and inno-vated the hospital's Party building work in a targeted manner,actively consolidated the achievements of Party building work lead-ing the development of the hospital business work,and established a set of county-level hospital Party building work model,provi-ding useful references for promoting the high-quality development of public hospitals.

Objective:To investigate the effects of wza gene deletion in Klebsiella pneumoniae on capsule formation ability and bacteriophage sensitivity. Methods:The wza deletion mutant strain was constructed through a temperature-sensitive plasmid-mediated homologous recombination. The growth curves of W14 and Δ wza were detected by measuring the optical density OD 600. In order to analyze the effect of gene wza on bacterial capsule formation, wild-type strain W14 and Δ wza mutant strain were detected by transmission electron microscope, and their capsule contents were measured by quantifying the uronic acid contents. The plaque assay was used to detect bacterial sensitivity to bacteriophage in wild-type strain W14 and Δ wza mutant strain. The t test was used to compare whether there were differences in the contents of uronic acid in the capsules of wild-type strain W14 and Δ wza mutant strain. Results:The PCR results revealed that the Δ wza mutant strain was successfully constructed. Compared with wild-type strain W14, the growth curves of Δ wza on the solid plates demonstrated a slightly slower growth. However, no difference in growth was observed among wild-type strain W14 and Δ wza mutant strains in LB broth. The transmission electron microscope results showed that wza gene deletion resulted in the loss of capsule in bacteria. The uronic acid content assay suggested that the capsule content was significantly decreased in Δ wza mutant strain (45.963±2.795) μg/ml compared with wild-type strain W14 (138.800±5.201) μg/ml. There was a statistical difference between the two groups ( t=27.233, P<0.001). The plaque assay indicated that bacteria lost its sensitivity to bacteriophage when gene wza was deleted. Conclusion:Deletion of the wza gene impairs bacterial capsule formation ability and can affect bacterial sensitivity to bacteriophage phiW14.

Objective:To express and purify the phage depolymerase from hypervirulent Klebsiella pneumoniae (hv Kp) serotype K1 and validate its function. Methods:Phage that infected serotype K1-type hv Kp was isolated from hospital sewage. The biology and morphology of the phage were determined by plaque assay and transmission electron microscopy. The whole genome of the phage was sequenced by the Illumina HiSeq 2500 platform. The presence of depolymerase was determined by observing the plaque halo. Bioinformatic analysis and prokaryotic protein expression system were further used to predict and identify phage depolymerase. The depolymerase gene fragment was obtained by PCR and cloned into the pET28a expression vector, and the expression and purification of the depolymerase were completed in strain BL21. The depolymerase activities on the capsular polysaccharide of serotype K1-type hv Kp clinical isolates were detected by plaque assay and low-speed centrifugation assay. Results:A lytic phage (phiA2) that infected serotype K1-type hv Kp clinical isolate was isolated from hospital sewage. It was typical of the Caudovirales order and Autographiviridae family, and its whole genome was 43 526 bp in length and contained 51 coding domain sequences. The phage phiA2-derived depolymerase phiA2-dep was predicted, expressed and purified. The plaque assay and low-speed centrifugation assay indicated that the depolymerase phiA2-dep had good lytic activity on the capsular polysaccharide of serotype K1-type hv Kp clinical isolates. Conclusion:Depolymerase phiA2-dep can specifically degrade the capsular polysaccharide of serotype K1-type hv Kp, which has potential application value in treating bacterial infection.

Objective:To analyse the settings of sub-campus of public hospitals directly under the National Health Commission, so as to provide research reference and suggestions for further promoting the scientific and standardized construction of sub-campuses of public hospitals.Methods:Data before August 30, 2022 were collected from the official websites of the hospitals in question including their introduction, overview, navigation, news and other categories of information.Relevant literatures on multi-campus published by hospitals under the direct management of the National Health Commission were obtained from the China National Knowledge Network, which was identified by searching the keywords " sub or multi-campus hospital" with " author affiliation", using such search conditions as " MeSH major topic" or " title/keywords/abstract" of the studied hospitals in advanced search builder. Descriptive analysis and frequency analysis were conducted on the numbers, the construction reasons, geographical location, operation scale, characteristics and positioning of the sub-campuses in the studied hospitals.Results:Of the 44 such hospitals, 30 had a total of 50 sub-campuses in operation. Generally there were two modes of construction. 35 were newly constructed and 15 formed by mergers; 37 sub-campuses were built and put into operation since 2010. Sub-campuses were usually located in the same area of the main campus, with 11 in the same area of the same city and areas, 35 in different areas of the same city, and 4 in different cities; the average geographical distance between the sub-campus and the main hospital campus was 31.18 kilometers; 27 sub-campuses had beds ≤ 500, 12 sub-campuses had beds between 501-1 000, 11 had beds>1 000; 14 specialized sub-campuses and 31 out of the 35 comprehensive sub-campuses clearly indicating their characteristics of specialized departments, and 1 other (research institute areas with research beds).Conclusions:Future proofing is characteristic of these public hospitals in terms of their sub-campus construction, regional setting, planning and positioning, and functional layout. However, both government regulatory departments and public hospitals should comprehensively consider and make prudent decisions on the planning, investment, demonstration, layout, and other aspects of the construction of sub-campuses of hospitals.

Objective To prepare and optimize the formulation of Albumin nanoparticles loading PROTAC molecule and observe the inhibition effect of nanoparticles on the proliferation and NAD⁺ metabolism of glioma cells. Methods Albumin nanoparticles loading NPT-B2 were prepared and characterized with a thermal driving method, and the prescription was optimized. An HPLC method was established to determine the content of NPT-B2. The proliferation inhibition of NPT-B2 and B2-BSA-NPs on U251 cells were investigated by the CCK8 method, and the degradation effects of NPT-B2 and B2-BSA-NPs on NAMPT in glioma cells were investigated by western blotting. Results The HPLC method was stable, with good linearity, precision, and recovery rate. The nanoparticles had a particle size of about 55.48 nm, a potential of about −12.9 mV, an encapsulation rate of about 94.74%, and a drug loading amount of about 8.61%. The IC₅₀ of NPT-B2 on glioma cells was 61.16 nmol/L, which had a degradation effect on NAMPT. The IC₅₀ of B2-BSA-NPs on glioma was 41.21 nmol/L, which had a very significant degradation effect on NAMPT. Conclusion Albumin nanoparticles loading PROTAC molecules were constructed. The prescription was optimized to improve the drug encapsulation rate, and the low water solubility of PROTAC molecule was improved, which had a significant inhibitory effect on the proliferation and NAD⁺ energy metabolism of glioma cells.

Infectious bone defect is bone defect with infection or as a result of treatment of bone infection. It requires surgical intervention, and the treatment processes are complex and long, which include bone infection control,bone defect repair and even complex soft tissue reconstructions in some cases. Failure to achieve the goals in any step may lead to the failure of the overall treatment. Therefore, infectious bone defect has been a worldwide challenge in the field of orthopedics. Conventionally, sequestrectomy, bone grafting, bone transport, and systemic/local antibiotic treatment are standard therapies. Radical debridement remains one of the cornerstones for the management of bone infection. However, the scale of debridement and the timing and method of bone defect reconstruction remain controversial. With the clinical application of induced membrane technique, effective infection control and rapid bone reconstruction have been achieved in the management of infectious bone defect. The induced membrane technique has attracted more interests and attention, but the lack of understanding the basic principles of infection control and technical details may hamper the clinical outcomes of induced membrane technique and complications can possibly occur. Therefore, the Chinese Orthopedic Association organized domestic orthopedic experts to formulate An evidence-based clinical guideline for the treatment of infectious bone defect with induced membrane technique ( version 2023) according to the evidence-based method and put forward recommendations on infectious bone defect from the aspects of precise diagnosis, preoperative evaluation, operation procedure, postoperative management and rehabilitation, so as to provide useful references for the treatment of infectious bone defect with induced membrane technique.