Objective Rapid eye movement sleep behavior disorder（RBD） is a common sleep disorder in the elderly， and this study aims to investigate the activity of cerebral cortex based on the changes in electroencephalography （EEG） power spectrum and the difference in approximate entropy during the ictal period of RBD. Methods A total of 35 patients with idiopathic RBD who received video polysomnography monitoring were enrolled as RBD group， and 25 normal volunteers matched for age were enrolled as control group.REM EEG results with fewer artifacts was selected for both groups， and the RBD group had an increase in mandibular electromyographic activity or dream-enacting behaviors. The leads containing artifacts were excluded， and finally O1 （or O2 alternative） leads with relatively little interference were selected. After pretreatment， Fourier transform was performed for EEG data from both groups to calculate the absolute power and relative power ratio of EEG in five different frequency bands， i.e.， δ （0.5-3 Hz）， θ （4-7 Hz）， α （8-13 Hz）， β （14-30 Hz）， and γ （30-35 Hz）. The normal distribution of power values in each frequency band was tested for both groups， and the t-test was used for comparison. Approximate entropy was calculated for EEG in both two groups， and the t-test was used for comparison. Results The θ band was the dominant frequency band of REM EEG in both the control group and the RBD group. Compared with the control group， the RBD group had a significant increase in the absolute power of fast-wave activity on REM α band and significant reductions in δ/α and θ/α relative power ratios. There was a significant difference in EEG ApEn value between the control group and the RBD group （P<0.05）， and the RBD group had a higher ApEn value during REM sleep than the NC group， with a significant difference in EEG ApEn value during the phase of dream-enacting behaviors. Conclusion In the RBD group， there are significant increases in the absolute power and nonlinear approximate entropy of fast-wave activity on REM α band during the ictal period of REM， which reflects the hyperactive functional changes of cerebral cortex during the ictal period of RBD， and the involvement of cerebral cortex in RBD neural pathway disorders is an important supplement to the current theory. Moderate inhibition of cerebral cortex hyperactivity is of great significance for the treatment of RBD.

Gyrovirus galga1(GyVg1)and gyrovirus homsa1(GyH1)are two newly discovered cir-coviruses that can cause symptoms related to transmissible viral proventriculitis of chickens.These viruses have been reported in various regions worldwide.This research aims to establish a duplex real-time PCR assay capable of identifying and detecting GyVg1 and GyH1.Specific primers and probes were designed based on the conserved regions of GyVg1 and GyH1 respectively using all genome sequence data currently available in GenBank.After optimizing reaction conditions,the du-plex real-time PCR detection method was established and further validated by comparing it with a conventional PCR assay and sequencing results from an analysis of 256 clinical samples collected in 2023 across eight regions of Nanning,Guangxi.The results showed that GyVg1 and GyH1 could be identified in 1 h by the duplex real-time PCR assay and two pairs of primer probes can amplify effectively but there is no any cross reaction with other pathogens.Besides,the detection limit was determined to be 7.5 copies/μL.The correlation coefficient of standard curves exceeded 0.99,and CV for intra-and inter-assay was less than 0.45％.Based on clinical performance,when the quanti-ty of template was greater than or equal to 100 copies,the agreements between the duplex real-time PCR assay and the conventional PCR assay were 94.3％(GyVg1)and 100％(GyH1).In con-clusion,the newly developed duplex real-time PCR assays exhibited good specificity,sensitivity and repeatability,which could contribute to the rapid detection and differentiation of GyVg1 and GyH1.

Objective To explore the changes in cognitive neural networks in AD patients at differ-ent stages of disease progression to provide electrophysiological basis for the pathogenesis and early diagnosis and treatment of AD.Methods A total of 84 patients admitted to Department of Neurology of General Hospital of Tianjin Medical University from September 2018 to June 2022 were prospectively recruited,and divided into AD patients group(42 cases)and MCI group(42 cases)according to their disease severity.Another 42 healthy individuals who taking physical examination during the same period were subjected and served as HC group.Post-resting EEG data were analyzed with Matlab software,and coherence analysis was performed by self-programmed program.Univariate analysis of variance was used to compare the interhemispheric and intra-hemispheric coherence values of six frequency bands in the three groups.Results The cohe-rence values of the related electrode pairs in the anterior head(frontal region+anterior tem-poral region)were significantly lower in the AD group than in the HC group(P＜0.05),with the Alpha and Beta dominant bands and dominant hemispheres dominant,while the values of related electrode pairs in the posterior head(temporal region)were obviously higher in the AD group than the HC group(P＜0.05),with the Gamma band dominant.In all the frequency bands except the Alpha band,the AD group had higher coherence values in most of the electrode pairs than the HC group,and the Gamma band was the most extensive.In the MCI group,only the coherence value of the electrodes in the occipito-posterior temporal region(O2-T6)in the right Alpha band was higher than that in the HC group(P＜O.05).Except Gamma band,the coherence value of the related electrode pairs in the frontal region was notably lower in the AD group than the MCI group(P＜0.05),and the Alpha and Beta bands were dominant.The results of interhemispheric cohe-rence showed that most of the electrode pairs in the AD group had higher coherence values than the MCI group in all the frequency bands and the Gamma band(P＜0.05).Conclusion EEG coherence can provide electrophysiological basis for the pathogenesis and early diagnosis of AD.

Objective To explore the clinical efficacy of the regimen based on sacubitril/valsartan and empagliflozin in the treatment of elderly hypertension patients with type 2 diabetes(T2DM)and determine the impact on left ventricular remodeling.Methods A prospective randomized trial was conducted on 100 elderly patients with essential hypertension combined with T2DM admitted in our hospital from January 2022 to January 2023.All of them had left ventricular hypertrophy(LVH).They were randomly divided into an observation group(n=50,empagliflozin combined with sacubitril/valsartan)and a control group(n=50,empagliflozin combined with valsartan).Baseline data,and SBP,DBP,left ventricular ejection fraction,left ventricular mass(LVM),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),and LVM index(LVMI)before and at 3 and 6 months after treatment were recorded and compared between the two groups.The incidence of adverse events was also compared between them.Results Repeated measures ANOVA showed that the values of SBP,DBP,IVST,LVPWT,LVM and LVMI were gradually reduced in the two groups with the extension of treatment time,and reached the lowest levels at 6 months of treatment(Ftime=4.829,10.037,121.202,65.784,214.796,162.801,P＜0.05,P＜0.01).With the elapse of treatment time,the observation group obtained more significant declines in terms of SBP,DBP,IVST,LVPWT,LVM and LVMI(Ftreatment×time=5.252,5.685,4.574,6.239,8.292,11.660,P＜0.05,P＜0.01).The inter-group effect was statistically significant.After 6 months of treatment,the values of above indicators were notably lower in the observation group than the control group(Ftreatment=79.151,97.673,4.250,8.080,9.598,20.091,P＜0.05,P＜0.01).SBP(129.80±7.67 mm Hg vs 138.48±12.35 mm Hg.P＜0.01),DBP(79.76±5.96 mm Hg vs 87.46±9.57 mm Hg,P＜0.01),IVST,LVPWT,LVM and LVMI were obviously lower in the observation group than the control group.Both valsartan+empagliflozin and sacubitril/valsartan+empagliflozin showed good safety.Conclusion Sacubitril/valsartan can effectively improve blood pressure,cardiac function,and left ventricular remodeling in elderly hypertensive patients with T2DM and LVH,with good safety.

Objective:To investigate the clinical and pathological characteristics of primary thoracic synovial sarcoma (PTSS).Methods:Forty-two PTSS cases diagnosed at the Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China from October 2011 to April 2024 were analyzed. All cases were retrospectively studied using hematoxylin-eosin staining and immunohistochemistry. Their clinicopathological features were also reviewed. SS18 rearrangement was assessed in 28 cases using fluorescence in situ hybridization (FISH). Next generation sequencing (NGS) was performed on 8 cases.Results:Among the 42 cases, there were 23 biopsies and 19 surgically-removed specimens. One case was a specimen resected after neoadjuvant chemotherapy. There were 22 males and 20 females, with an age ranging from 6 to 68 years. Twenty-nine cases occured in the lung, 6 in mediastinum, 4 in pericardium, 1 in visceral pleura, and 1 in right atrium. One case did not show any unequivocal primary site. Computed tomography showed the tumors were manifested as a cystic mass, a solid mass, or thickening of the pleura and pericardium. Thirty-two cases had respiratory symptoms, while 19 had pleural effusion. One case had a history of radiotherapy for papillary thyroid carcinoma. Nineteen patients were treated with surgery, while 19 were treated with chemotherapy without surgery. Four patients were diagnosed and discharged, without specific treatment on the record. Morphologically, 1 case was biphasic type, 39 cases were monophasic type, and 2 cases were poorly differentiated type. In addition to the typical morphology of synovial sarcoma, tumors also showed pulmonary bullous changes, stromal collagen hyalinization, hemangiopericytoma-like vasculature, stromal edematous myxoid changes, and microcystic structure. Immunohistochemically, all cases were diffusely positive for TRPS1 (22/22), TLE1 (21/22), CD99 (26/26), SS18-SSX (25/25) and INI1 (12/12), including 3 cases with decreased expression of INI1. Twenty-one cases were focally positive for EMA (21/30), 4 cases for SMA (4/23), 2 cases for S-100 (2/28), and 2 cases (2/35) for CKpan. Twenty-eight cases (28/28) had SS18 rearrangement displaying a split signal on FISH analysis. Eight cases were found to have mutations in SMC1A, NOTCH2, CDK12, SPRY4, BRCA1, STK11, NF2, and PDGFRα genes using NGS. Eighteen of the 29 patients survived and 16 showed disease progression.Conclusions:PTSS is more commonly found in the lungs than other sites and has non-classical morphological features of various types, which need to be differentiated from other tumors. TRPS1 is highly expressed in PTSS and has certain diagnostic values. The diagnosis of PTSS also requires combination of patient′s medical history with thorough imaging studies.

AIM:To investigate the expression profile and biological significance of long noncoding RNA(lncRNA)zinc finger antisense 1(ZFAS1)in the brains of mice with diabetic encephalopathy(DE).METHODS:Ten db/m mice served as the normal control group,while twenty 22-week-old db/db mice were used to establish the DE model and randomly divided into two subgroups:ten as the db/db model control and the remaining ten receiving ZFAS1 gene knockdown(db/db+sh-ZFAS1)via lentiviral transfection.Weekly measurements of body weight and blood glucose levels were performed.Brain tissues were collected for Nissl staining to evaluate neuronal damage,TUNEL assay to detect apop-tosis,and immunofluorescence staining to examine neural biomarker expression.Serum levels of tumor necrosis factor-α(TNF-α)and oxidative stress markers,including reactive oxygen species(ROS),malondialdehyde(MDA),superoxide dismutase(SOD),catalase(CAT)and glutathione peroxidase(GSH-Px),were determined.Western blot was conducted to quantify the protein expression levels of B-cell lymphoma-2(Bcl-2),Bcl-2-associated X protein(Bax),p38 mitogen-activated protein kinase and phosphorylated p38(p-p38)in brain tissues.The expression levels of ZFAS1 and caspase-3 mRNA were determined by RT-qPCR.RESULTS:Knockdown of ZFAS1 in db/db mice significantly improved cognitive function,alleviated hippocampal neuronal damage,and reduced body weight and blood glucose levels(P<0.01).More-over,oxidative stress was mitigated,as evidenced by decreased MDA and ROS levels(P<0.01)and increased activity of antioxidant enzymes,GSH-Px,SOD and CAT(P<0.01 or P<0.05).Meanwhile,ZFAS1 silencing down-regulated Bax and p-p38/p38 protein expression(P<0.01 or P<0.05)while up-regulating Bcl-2(P<0.01).Consistently,RT-qPCR confirmed significant down-regulation of ZFAS1 and caspase-3 mRNA levels(P<0.01).CONCLUSION:lncRNA ZFAS1 is highly expressed in the hippocampus of DE mice.Down-regulation of ZFAS1 expression enhances cognitive func-tion,suppresses oxidative stress,and inhibits neuronal apoptosis,thereby attenuating neural damage in DE.

Objective: To explore the risk factors of allogeneic blood transfusion during lung transplant surgery and prognostic effects of transfusion by analyzing the basic data, surgical details, laboratory tests results, and intraoperative blood transfusion details during the perioperative period of lung transplant, so as to guide clinical blood use. Methods: A retrospective analysis was conducted on the data of 319 patients who underwent lung transplantation surgery in our hospital from January 2022 to December 2023. The patients were divided into a non-transfusion group (n=70) and a transfusion group (n=249) based on their intraoperative blood transfusion status. The clinical data, surgical details, perioperative laboratory results and other relevant preoperative and postoperative parameters were compared between the two groups, and the postoperative prognosis (improvement, non-recovery, and death) was analyzed. Results: After comparison between the two groups of patients, it was found that the non-transfusion group had higher levels of preoperative Hb (g/L)(144.41±17.66 vs 129.78±20.44), preoperative Hct [43.25(40.23, 47.5) vs 40.7(37, 43.55)], preoperative TBIL (μmol/L)[11.45(9.15, 15.3)vs 9.9(6.88, 13.33)], and postoperative PLT (×10 /L)(167.74±64.43 vs 132.37±54.84) than the transfusion group (all P<0.05). The non-transfusion group had lower levels of preoperative pCO (mmHg)[41.4(37.4, 45.8)vs 45.3(40, 52.48)], postoperative TBIL (μmol/L)[25.45(17.68, 33.95)vs 30.8(21.55, 43.05)], postoperative pH (7.41±0.09 vs 7.45±0.10), bilateral lung transplantation [27(38.6%) vs 157(63.1%)], surgical duration (h) [5(4, 7)vs 6.5(5, 8)], use of ECMO [52(74.3%) vs 232(93.2%)], and intraoperative blood loss (mL)[600(500, 800)vs 1 000(800, 1 500)] compared to the transfusion group (all P<0.05). The items with P<0.1 in the compared indicators were included in the binary logistic regression analysis, and the results showed that bilateral lung transplantation, intraoperative blood loss, preoperative TBIL, postoperative PLT, postoperative TBIL, preoperative pCO2, and postoperative pH were significantly correlated with whether blood transfusion was performed (P<0.05). The P values of the Chi-square test for postoperative improvement and mortality in the non transfusion group and transfusion group were both greater than 0.05, indicating no statistically significant difference in the prognosis rate between the two groups of patients. Conclusion: Bilateral lung transplantation, intraoperative blood loss, preoperative TBIL, and preoperative pCO are risk factors for blood transfusion during lung transplantation. Intraoperative blood transfusion has a significant impact on postoperative PLT, postoperative TBIL, and postoperative pH indicators, but has no significant effect on prognosis. A comprehensive evaluation of laboratory indicators and surgical details can help developing blood transfusion strategies more effectively.

Objective To develop an erythrocyte-based delivery system for butyrylcholinesterase(BChE)that is capable of prophylaxis against organophosphorus nerve agents.Methods Recombinant BChE was produced and analyzed for oligomerization via polyacrylamide gel electrophoresis(PAGE)and Western blotting.A modified hypotonic preswelling method was employed to prepare BChE-loaded erythrocytes.The drug loading capacity and encapsulation efficiency were quantified using enzyme-linked immunosorbent assay(ELISA).Catalytic activity was assessed in vitro with an activity detection kit.The system was characterized via scanning electron microscopy(SEM),flow cytometry and a hematology analyzer.Results Recombinant BChE predominantly existed as dimers(85％dimer,15％monomer).The optimized volume ratio of erythrocytes to hypotonic solution was determined as 1:7.Compared with native and empty erythrocytes,BChE-loaded erythrocytes exhibited significantly higher catalytic activity(P＜0.001).The mean corpuscular volume of BChE-loaded erythrocytes increased(P＜0.001),while the mean content of corpuscular hemoglobin and hemoglobin in erythrocytes per 100 mL decreased(P＜0.001).SEM revealed no morphological differences(biconcave disc shape).Hypotonic preswelling moderately increased erythrocyte apoptosis(P＜0.001),but no statistical difference was observed between BChE-loaded and hypotonic-treated erythrocytes(P＞0.05).CD47 expression remained unchanged compared to native erythrocytes(P＞0.05).Conclusion The modified hypotonic preswelling method can generate BChE-loaded erythrocytes that retain the characteristics of native erythrocytes while conferring catalytic activity,offering a novel strategy for clinical intervention against organophosphorus poisoning.

Objective To investigate the clinical efficacy of Chinese medicine sequential therapy combined with Clomiphene in the treatment of ovulatory disorder infertility(ODI),and to observe the effects of the combined therapy on the endometrial thickness,ovarian diameter,ovulation rate and pregnancy rate of the patients.Methods A total of 120 patients with ODI admitted to the Department of Obstetrics and Gynecology of the 7th People's Hospital of Zhengzhou from July 2021 to August 2023 were randomly divided into the control group and the observation group,with 60 patients in each group.The two groups were treated with Clomiphene,and additionally the observation group was treated with Chinese medicine sequential therapy of"nourishing yin and enriching blood,warming kidney to resolve phlegm and unblock collaterals,and tonifying kidney and strengthening spleen"in accordance with the menstrual cycle.Three menstrual cycles constituted a course of treatment.Before and after treatment,the changes in the traditional Chinese medicine(TCM)syndrome scores of the two groups were observed.After treatment for three menstrual cycles,the clinical efficacy,endometrial thickness,follicle diameter,ovulation rate,pregnancy rate,incidence of biphasic basal body temperature(BBT),and the incidence of adverse reactions after in the two groups were compared.Results(1)After three menstrual cycles of treatment,the total effective rate of the observation group was 96.67％(58/60)and that of the control group was 83.33％(50/60),and the comparison between the two groups showed that the efficacy of the observation group was significantly superior to that of the control group,the difference being statistically significant(x2=5.926,P＜0.05).(2)After three menstrual cycles of treatment,the TCM scores of patients in both groups were decreased significantly compared with those before treatment(P＜0.01),and the decrease of the scores in the observation group was significantly superior to that in the control group,with statistically significant differences(P＜0.01).(3)After three menstrual cycles of treatment,the follicle diameter of the observation group was longer than that of the control group,and the incidence of biphasic BBT[60.00％(36/60)],ovulation rate[63.33％(38/60)],and pregnancy rate[25.00％(15/60)]were higher than those of the control group,which were 31.67％(19/60),41.67％(25/60),and 10.00％(6/60),respectively.The differences of the above four indicators between the two groups were statistically significant(P＜0.05 or P＜0.01).However,the differences of endometrial thickness and the incidence of adverse reactions between the two groups were not statistically significant(P＞0.05).Conclusion Chinese medicine sequential therapy combined with Clomiphene exerts certain efficacy in treating patients with ODI,which can effectively relieve clinical symptoms,improve the BBT conditions,enhance the ovulation rate and pregnancy rate,with high safety.

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent inflammation and joint damage, accompanied by the accumulation of plasma cells, which contributes to its pathogenesis. Understanding the genetic alterations occurring during plasma cell differentiation in RA can deepen our comprehension of its pathogenesis and guide the development of targeted therapeutic interventions. Here, our study elucidates the intricate molecular mechanisms underlying plasma cell differentiation by demonstrating that PRDX1 interacts with DOK3 and modulates its degradation by the autophagy-lysosome pathway. This interaction results in the inhibition of plasma cell differentiation, thereby alleviating the progression of collagen-induced arthritis. Additionally, our investigation identifies Salvianolic acid B (SAB) as a potent small molecular glue-like compound that enhances the interaction between PRDX1 and DOK3, consequently impeding the progression of collagen-induced arthritis by inhibiting plasma cell differentiation. Collectively, these findings underscore the therapeutic potential of developing chemical stabilizers for the PRDX1-DOK3 complex in suppressing plasma cell differentiation for RA treatment and establish a theoretical basis for targeting PRDX1-protein interactions as specific therapeutic targets in various diseases.