Objectives:This study aims to establish a calcified aortic valve disease(CAVD)-related gene regulatory network,and clarify the impact of interactions between CAVD-related genes on CAVD.Methods:Differential expression gene method was used to screen candidate genes,and STRING software was used to construct protein-protein interaction networks for screened genes.The networks and genes with the highest scores were obtained.Monte Carlo method was used to rank the importance of genes in CAVD,and the top 1%genes were identified.Genes identified by these two methods are intersected to obtain the key genes.The correlation between the key genes and CAVD were confirmed by biological verification method.Then,key genes were used as query genes to establish CAVD gene regulatory module with a co-expression patterns-based gene regulatory network identifying method.Specifically,we first detected the underlying co-expression patterns of the seemingly uncorrelated genes,and then pieced the isolated gene pairs up into gene regulatory network with the help of the bridging genes.Finally,we verified the function of the established gene regulatory network through enrichment analysis and literature analysis.Results:We identified the CAVD gene regulatory network containing 211 genes from 18 084 candidate genes.Functional enrichment analysis indicate that the established gene regulatory network included genes with both known interactions and potential novel pathway interactions related to CAVD,serving as candidates for further experimental CAVD studies.Conclusions:Methodologically,the proposed method avoids the problem of complex computation,and relies only on available biological priors.It is also able to detect underlying co-expression patterns.The results will advance the understanding of the interactions of the CAVD-related genes and this method provides a novel way to identify underlying gene co-expression patterns in the setting of CAVD.

Objectives:Comparative analysis of the beagles acute-phase electrocardiographic,hemodynamic,left ventricular flow field status,and energy consumption characteristics of pacing at different sites of conduction system may help to elucidate the scientific mechanism of left bundle branch pacing(LBBP)as a option of physiological pacing therapy.Methods:Eight healthy adult beagles were used in this study.Initially,an active fixation lead was implanted in the right atrial appendage,followed by implantation of another active fixation lead at the right ventricular apex,distal His bundle,and left bundle septal branch,respectively.After connecting a dual-chamber pacemaker,electrocardiographic and acute phase hemodynamic parameters under sinus rhythm,right ventricular apex pacing(RVAP),distal His bundle pacing(DHBP),and LBBP states were collected and analyzed.Three complete cardiac cycles of standard apical three-chamber color Doppler dynamic images were acquired under vector flow mapping(VFM)mode.Offline analysis was performed on obtained parameters including isovolumic contraction period,rapid ejection period,isovolumic relaxation period,rapid filling period,atrial contraction period,and left ventricular intracavitary energy consumption.These parameters were compared under pacing at different sites and the linear correlations of major parameters were analyzed.Results:The QRS duration of baseline intrinsic sinus rhythm,RVAP,DHBP and LBBP were(45.0±4.0)ms,(98.4±6.2)ms,(50.0±4.5)ms and(62.0±4.7)ms,respectively.The LBBP-QRS duration was significantly wider than intrinsic sinus rhythm and DHBP,but significantly narrower than RVAP(all P<0.01).Compared with baseline AOO mode(the pacing rate was performed at 10 beats/min above the intrinsic heart rate),the change of acute phase maximum left ventricular pressure rise rate(LVdP/dtmax)in RVAP,DHBP and LBBP was([-7.89±5.67]% ),([0.74±2.05]% )and([-0.14±3.59]% ),respectively.There was no significant difference in LVdP/dtmax changes between DHBP and LBBP(P=0.667),but both pacing modalities were significantly better than RVAP(all P<0.01).The average energy consumption of the left ventricle under RVAP was significantly higher than that of intrinsic sinus rhythm,DHBP,and LBBP in isovolumic contraction period,rapid ejection period,isovolumic relaxation period,rapid filling period,and atrial contraction period(all P<0.01).However,there was no statistically significant difference in energy consumption among intrinsic sinus rhythm,DHBP,and LBBP during the above five phases(all P>0.05).DHBP and LBBP did not show a significant increase in the number of left ventricular vortices,vortex area,and circulation intensity compared to intrinsic sinus rhythm,and LBBP did not show a significant increase in vortex area and circulation intensity compared to DHBP.Conclusions:Although LBBP canines significantly prolonged the paced QRS duration,it showed no significant differences in acute phase left ventricular hemodynamics,left ventricular flow field status,and energy consumption compared to intrinsic sinus rhythm and DHBP.Performance of LBBP was superior to RVAP.This study may contribute to revealing the theoretical basis of LBBP as a feasible physiological pacing therapy.

Objectives:Comparative analysis of the beagles acute-phase electrocardiographic,hemodynamic,left ventricular flow field status,and energy consumption characteristics of pacing at different sites of conduction system may help to elucidate the scientific mechanism of left bundle branch pacing(LBBP)as a option of physiological pacing therapy.Methods:Eight healthy adult beagles were used in this study.Initially,an active fixation lead was implanted in the right atrial appendage,followed by implantation of another active fixation lead at the right ventricular apex,distal His bundle,and left bundle septal branch,respectively.After connecting a dual-chamber pacemaker,electrocardiographic and acute phase hemodynamic parameters under sinus rhythm,right ventricular apex pacing(RVAP),distal His bundle pacing(DHBP),and LBBP states were collected and analyzed.Three complete cardiac cycles of standard apical three-chamber color Doppler dynamic images were acquired under vector flow mapping(VFM)mode.Offline analysis was performed on obtained parameters including isovolumic contraction period,rapid ejection period,isovolumic relaxation period,rapid filling period,atrial contraction period,and left ventricular intracavitary energy consumption.These parameters were compared under pacing at different sites and the linear correlations of major parameters were analyzed.Results:The QRS duration of baseline intrinsic sinus rhythm,RVAP,DHBP and LBBP were(45.0±4.0)ms,(98.4±6.2)ms,(50.0±4.5)ms and(62.0±4.7)ms,respectively.The LBBP-QRS duration was significantly wider than intrinsic sinus rhythm and DHBP,but significantly narrower than RVAP(all P<0.01).Compared with baseline AOO mode(the pacing rate was performed at 10 beats/min above the intrinsic heart rate),the change of acute phase maximum left ventricular pressure rise rate(LVdP/dtmax)in RVAP,DHBP and LBBP was([-7.89±5.67]% ),([0.74±2.05]% )and([-0.14±3.59]% ),respectively.There was no significant difference in LVdP/dtmax changes between DHBP and LBBP(P=0.667),but both pacing modalities were significantly better than RVAP(all P<0.01).The average energy consumption of the left ventricle under RVAP was significantly higher than that of intrinsic sinus rhythm,DHBP,and LBBP in isovolumic contraction period,rapid ejection period,isovolumic relaxation period,rapid filling period,and atrial contraction period(all P<0.01).However,there was no statistically significant difference in energy consumption among intrinsic sinus rhythm,DHBP,and LBBP during the above five phases(all P>0.05).DHBP and LBBP did not show a significant increase in the number of left ventricular vortices,vortex area,and circulation intensity compared to intrinsic sinus rhythm,and LBBP did not show a significant increase in vortex area and circulation intensity compared to DHBP.Conclusions:Although LBBP canines significantly prolonged the paced QRS duration,it showed no significant differences in acute phase left ventricular hemodynamics,left ventricular flow field status,and energy consumption compared to intrinsic sinus rhythm and DHBP.Performance of LBBP was superior to RVAP.This study may contribute to revealing the theoretical basis of LBBP as a feasible physiological pacing therapy.

Objective:To identify the risk factors for postoperative cognitive dysfunction (POCD) in elderly patients undergoing hip fracture surgery.Methods:In this case-control study, 6 differentially expressed genes were screened through gene expression database analysis and protein-protein interaction network analysis: cytochrome c oxidase subunit 7C (COX7C), ubiquinol-cytochrome c reductase complex III subunit VII (UQCRQ), cytochrome c oxidase subunit 7A2 (COX7A2), translocase of outer mitochondrial membrane 7, ubiquinone oxidoreductase subunit S5, and ribosomal protein L31. Elderly patients who underwent hip fracture surgery at Anhui No. 2 Provincial People′s Hospital from April 2022 to April 2024 were recruited. Based on the results of the Mini-Mental State Examination, the patients were divided into POCD group ( n=51) and non-POCD (NPOCD) group ( n=53). The expression of differentially expressed genes in the peripheral blood was detected using the fluorescent quantitative real-time polymerase chain reaction. The 6 differentially expressed genes were subjected to a difference test, and genes with P<0.05 were included in the binary logistic regression analysis to screen for risk factors for POCD. Results:The expression of COX7C, UQCRQ and COX7A2 was significantly down-regulated in POCD group compared with non-POCD group ( P<0.05). The results of logistic regression showed that the low-expression COX7C ( OR=1.926, 95% confidence interval [ CI] 1.604-5.264, P=0.022), UQCRQ ( OR=3.023, 95% CI 1.966-7.156, P=0.001), and COX7A2 ( OR=1.744, 95% CI 1.479-6.127, P=0.013) in peripheral blood were independent risk factors for the occurrence of POCD in elderly patients. Conclusions:Low-expression COX7C, UQCRQ and COX7A2 are risk factors for POCD in elderly patients undergoing hip fracture surgery.

Objective:To identify the risk factors for postoperative cognitive dysfunction (POCD) in elderly patients undergoing hip fracture surgery.Methods:In this case-control study, 6 differentially expressed genes were screened through gene expression database analysis and protein-protein interaction network analysis: cytochrome c oxidase subunit 7C (COX7C), ubiquinol-cytochrome c reductase complex III subunit VII (UQCRQ), cytochrome c oxidase subunit 7A2 (COX7A2), translocase of outer mitochondrial membrane 7, ubiquinone oxidoreductase subunit S5, and ribosomal protein L31. Elderly patients who underwent hip fracture surgery at Anhui No. 2 Provincial People′s Hospital from April 2022 to April 2024 were recruited. Based on the results of the Mini-Mental State Examination, the patients were divided into POCD group ( n=51) and non-POCD (NPOCD) group ( n=53). The expression of differentially expressed genes in the peripheral blood was detected using the fluorescent quantitative real-time polymerase chain reaction. The 6 differentially expressed genes were subjected to a difference test, and genes with P<0.05 were included in the binary logistic regression analysis to screen for risk factors for POCD. Results:The expression of COX7C, UQCRQ and COX7A2 was significantly down-regulated in POCD group compared with non-POCD group ( P<0.05). The results of logistic regression showed that the low-expression COX7C ( OR=1.926, 95% confidence interval [ CI] 1.604-5.264, P=0.022), UQCRQ ( OR=3.023, 95% CI 1.966-7.156, P=0.001), and COX7A2 ( OR=1.744, 95% CI 1.479-6.127, P=0.013) in peripheral blood were independent risk factors for the occurrence of POCD in elderly patients. Conclusions:Low-expression COX7C, UQCRQ and COX7A2 are risk factors for POCD in elderly patients undergoing hip fracture surgery.

Objectives:This study aims to establish a calcified aortic valve disease(CAVD)-related gene regulatory network,and clarify the impact of interactions between CAVD-related genes on CAVD.Methods:Differential expression gene method was used to screen candidate genes,and STRING software was used to construct protein-protein interaction networks for screened genes.The networks and genes with the highest scores were obtained.Monte Carlo method was used to rank the importance of genes in CAVD,and the top 1%genes were identified.Genes identified by these two methods are intersected to obtain the key genes.The correlation between the key genes and CAVD were confirmed by biological verification method.Then,key genes were used as query genes to establish CAVD gene regulatory module with a co-expression patterns-based gene regulatory network identifying method.Specifically,we first detected the underlying co-expression patterns of the seemingly uncorrelated genes,and then pieced the isolated gene pairs up into gene regulatory network with the help of the bridging genes.Finally,we verified the function of the established gene regulatory network through enrichment analysis and literature analysis.Results:We identified the CAVD gene regulatory network containing 211 genes from 18 084 candidate genes.Functional enrichment analysis indicate that the established gene regulatory network included genes with both known interactions and potential novel pathway interactions related to CAVD,serving as candidates for further experimental CAVD studies.Conclusions:Methodologically,the proposed method avoids the problem of complex computation,and relies only on available biological priors.It is also able to detect underlying co-expression patterns.The results will advance the understanding of the interactions of the CAVD-related genes and this method provides a novel way to identify underlying gene co-expression patterns in the setting of CAVD.

Purpose/Significance To investigate and analyze the current status and influencing factors of digital health literacy(DHL)of the elderly,and to provide references for relevant departments.Method/Process The eHEALS scale is used to investigate the DHL status of 419 elderly people aged 60 and above in Shanghai through convenience sampling,and the influencing factors are explored through binary logistic regression analysis.Result/Conclusion Low education,smoking,and health anxiety are risk factors,while regular physical exami-nation is protective factor.Relevant departments should focus on the elderly people with lower education,and strengthen research and edu-cation on health examinations,smoking hazards,and the alleviation of anxiety.

Information construction helps hospitals to accurately manage the blood glucose levels of hospitalized patients and improve the quality and safety of medical care. In July 2022, a large tertiary public hospital launched an information management of perioperative patient blood glucose. By establishing a multidisciplinary support and information management team, building an information-based blood glucose management system, establishing standardized management processes, implementing automatic hierarchical blood glucose warning, blood glucose critical value warning and control, abnormal blood glucose consultation, and insulin pump management, the hospital had achieved the information sharing of blood glucose perioperative patients, as well as timely warning and handling of abnormal blood glucose, ensuring patient safety. As of June 2023, the hospital had deployed a total of 364 intelligent blood glucose meters in clinical departments, and monitored blood glucose levels for 12 216 perioperative patients. The blood glucose compliance rate of perioperative patients increased from 81.81% in July 2022 to 82.95% in June 2023. This practice brought convenience to the work of clinical departments, improved the overall quality of medical services in hospitals, and could provide references for other hospitals to carry out blood glucose information management.

Objective:To study the distribution and antibiotics resistance of the main pathogens of neonatal purulent meningitis in different regions of China.Methods:A retrospective descriptive clinical epidemiological study was conducted in children with neonatal purulent meningitis which admitted to 18 tertiary hospitals in different regions of China between January 2015 to December 2019. The test results of blood and cerebrospinal fluid, and drug sensitivity test results of the main pathogens were collected. The distributions of pathogenic bacteria in children with neonatal purulent meningitis in preterm and term infants, early and late onset infants, in Zhejiang Province and other regions outside Zhejiang Province, and in Wenzhou region and other regions of Zhejiang Province were analyzed. The chi-square test was used for statistical analysis.Results:A total of 210 neonatal purulent meningitis cases were collected. The common pathogens were Escherichia coli ( E. coli)(41.4%(87/210)) and Streptococcus agalactiae ( S. agalactiae)(27.1%(57/210)). The proportion of Gram-negative bacteria in preterm infants (77.6%(45/58)) with neonatal purulent meningitis was higher than that in term infants (47.4%(72/152)), and the difference was statistically significant ( χ2=15.54, P=0.001). There were no significant differences in the constituent ratios of E. coli (36.5%(31/85) vs 44.8%(56/125)) and S. agalactiae (24.7%(21/85) vs 28.8%(36/125)) between early onset and late onset cases (both P>0.05). The most common pathogen was E. coli in different regions, with 46.7%(64/137) in Zhejiang Province and 31.5%(23/73) in other regions outside Zhejiang Province. In Zhejiang Province, S. agalactiae was detected in 49 out of 137 cases (35.8%), which was significantly higher than other regions outside Zhejiang Province (11.0%(8/73)). The proportions of Klebsiella pneumoniae, and coagulase-negative Staphylococcus in other regions outside Zhejiang Province (17.8%(13/73) and 16.4%(12/73)) were both higher than those in Zhejiang Province (2.9%(4/137) and 5.1%(7/137)). The differences were all statistically significant ( χ2=14.82, 12.26 and 7.43, respectively, all P<0.05). The proportion of Gram-positive bacteria in Wenzhou City (60.8%(31/51)) was higher than that in other regions in Zhejiang Province (38.4%(33/86)), and the difference was statistically significant ( χ2=6.46, P=0.011). E. coli was sensitive to meropenem (0/45), and 74.4%(32/43) of them were resistant to ampicillin. E. coli had different degrees of resistance to other common cephalosporins, among which, cefotaxime had the highest resistance rate of 41.8%(23/55), followed by ceftriaxone (32.4%(23/71)). S. agalactiae was sensitive to penicillin, vancomycin and linezolid. Conclusions:The composition ratios of pathogenic bacteria of neonatal purulent meningitis are different in different regions of China. The most common pathogen is E. coli, which is sensitive to meropenem, while it has different degrees of resistance to other common cephalosporins, especially to cefotaxime.

In order to afford new antiplatelet agents with higher potency, a series of paeonol oxime derivatives (4a-4y) were designed and synthesized from paeonol.Their structures were confirmed by HRMS, 1H NMR spectra.The anti-platelet aggregation activity of the target compounds was evaluated.The results revealed that most of them had moderate to good anti-platelet aggregation activity.Among them, compound 4h and 4j were the most potent on adenosine diphosphate (ADP)-induced platelet aggregation and collagen-induced platelet aggregation. Furthermore, the target compound 4h not only showed strong antiplatelet aggregation activity, but also exhibited good water-solubility and drug-like properties, which can be used as a new antiplatelet active compound for further research.