Objective To investigate the relationship between the intraluminal characteristics of the occlusion segment and the degree of the primary collateral circulation(Circle of Willis)opening in patients with acute internal carotid artery occlusion(ICAO)and the occurrence of different subtypes of ipsilateral intracranial watershed infarction(WSI).Methods A total of 63 patients with unilateral acute ICAO accompanied by ipsilateral intracranial WSI were retrospectively included and divided into the internal watershed infarction(IWSI)group and the cortical watershed infarction(CWSI)group.The intraluminal characteristics of the occlusion segment and the degree of the Circle of Willis opening were analyzed using vessel wall magnetic resonance imaging(VW-MRI).Multivariate binary logistic regression analysis was employed to identify independent predictive indicators for the occurrence of CWSI.Results There was no significantly statistical difference in the occlusion range between the two groups.The range of intraluminal high signal involvement,the ratio of intraluminal relative highest signal,the incidence of high signal at the end of occlusion,and the degree of the Circle of Willis opening in the CWSI group were higher than those in the IWSI group(P<0.001).The range of intraluminal high signal involvement,high signal at the end of occlusion,and the degree of the Circle of Willis opening were identified as independent predictive factors for CWSI.Conclusion VW-MRI analysis of the intraluminal characteristics of the occlusion segment and the degree of the Circle of Willis opening can help to elucidate the mechanisms underlying the occurrence of IWSI/CWSI and can provide assistance in formulating etiology-based treatment strategies for clinical practice.

ObjectiveTo retrospectively analyze the epidemiological trends of birth defects in perinatal infants in Fengxian District, Shanghai from 2018 to 2022, so as to provide a scientific evidence for the formulation of related prevention and control strategies. MethodsBased on the data from the National Birth Defects Surveillance System, statistical analysis was conducted on the perinatal birth defects from monitored hospitals within the region from 2018 to 2022. ResultsFrom 2018 to 2022, a total of 20 870 perinatal infants delivered in the monitored hospitals in Fengxian District, with 472 cases with birth defects, showing a significant increase in the prevalence of birth defects (PRR=1.49, 95%CI: 1.39‒1.59). The risk of birth defects increased with maternal age, especially for advanced maternal age (PRR=1.58, 95%CI: 1.12‒2.25). Infants born to mothers with gestational diabetes had a higher prevalence of birth defects compared to those without gestational diabetes (PRR=1.99, 95%CI: 1.46‒2.70). Infants with birth defects were more likely to be born prematurely (PRR=2.07, 95%CI:1.56‒2.76). The top three types of birth defects were congenital heart disease (CHD), other anomalies of the external ear, and polydactyly. ConclusionThe prevalence of birth defects in Fengxian District monitored hospitals showed an upward trend from 2018 to 2022. Advanced maternal age and gestational diabetes were identified as risk factors for birth defects. CHD is the leading type of birth defect in Fengxian District over the five-year period. To reduce the prevalence of birth defects, it is crucial to implement comprehensive prevention and treatment measures for CHD.

Objective:To investigate the effect of circular RNA bromodomain PHD finger transcription factor (circBPTF) targeting microRNA (miR)-224-3p on the damage of human retinal vascular endothelial cells (HRECs) induced by high glucose.Methods:HRECs were divided into control group and high glucose group, which were cultured with medium containing 5.5 mmol/L glucose and 30 mmol/L glucose for 48 hours, respectively.HRECs were transfected with siRNA negative control (si-NC), siRNA of circBPTF (si-circBPTF), miRNA mimic control (miR-NC), and miR-224-3p by Lipofectamine 2000, followed by cultured in 30 mmol/L glucose medium for 48 hours and were recorded as si-NC group, si-circBPTF group, miR-NC group and miR-224-3p group, respectively.HRECs were transfected with si-circBPTF and anti-miR-NC or si-circBPTF and anti-miR-224-3p by double transfection method, and then treated with 30 mmol/L glucose medium for 48 hours and were recorded as anti-miR-NC group and anti-miR-224-3p group, respectively.The expression of circBPTF and miR-224-3p was detected by real-time fluorescence quantitative PCR.Cell apoptosis was detected by flow cytometry.Reactive oxygen species (ROS) level was determined by 2′, 7′-dichlorodihydrofluorescein diacetate probe.Superoxide dismutase (SOD) activity and malondialdehyde (MDA) content were detected by colorimetric method.Expression of cleaved-caspase-3/caspase-3 and cleaved-caspase-9/caspase-9 proteins was detected by Western blot.The interaction between circBPTF and miR-224-3p was identified by the dual luciferase reporter method.Results:Compared with the control group, the apoptosis rate, cleaved-caspase-3/caspase-3 protein expression, cleaved-caspase-9/caspase-9 protein expression, ROS level, MDA content, and circBPTF relative expression were significantly increased and SOD activity and miR-224-3p expression were decreased in the high glucose group (all P<0.05).Compared with the si-NC group, circBPTF relative expression, ROS level, MDA content, cleaved-caspase-3/caspase-3 protein expression, cleaved-caspase-9/caspase-9 protein expression, and cell apoptosis rate were significantly reduced and SOD activity was significantly increased in the si-circBPTF group (all P<0.05).Compared with the miR-NC group, miR-224-3p relative expression and SOD activity were significantly enhanced and ROS level, MDA content, cleaved-caspase-3/caspase-3 protein expression, cleaved-caspase-9/caspase-9 protein expression and cell apoptosis rate were significantly reduced in the miR-224-3p group (all P<0.05).The relative luciferase activity of HRECs after co-transfection of wild type circBPTF and miR-224-3p mimic was 0.43±0.04, which was significantly decreased compared with 0.99±0.06 after co-transfection of wild type circBPTF and miR-NC ( t=23.297, P<0.05).Compared with anti-miR-NC group, the relative expression of miR-224-3p and SOD activity were significantly decreased and ROS level, MDA content, cell apoptosis rate, cleaved-caspase-3/caspase-3 protein expression, and cleaved-caspase-9/caspase-9 protein expression were significantly increased in the anti-miR-224-3p group (all P<0.05). Conclusions:Interfering with circBPTF can inhibit high glucose induced HRECs apoptosis and oxidative stress damage by targeting miR-224-3p.

Objective:To investigate the effect of circular RNA bromodomain PHD finger transcription factor (circBPTF) targeting microRNA (miR)-224-3p on the damage of human retinal vascular endothelial cells (HRECs) induced by high glucose.Methods:HRECs were divided into control group and high glucose group, which were cultured with medium containing 5.5 mmol/L glucose and 30 mmol/L glucose for 48 hours, respectively.HRECs were transfected with siRNA negative control (si-NC), siRNA of circBPTF (si-circBPTF), miRNA mimic control (miR-NC), and miR-224-3p by Lipofectamine 2000, followed by cultured in 30 mmol/L glucose medium for 48 hours and were recorded as si-NC group, si-circBPTF group, miR-NC group and miR-224-3p group, respectively.HRECs were transfected with si-circBPTF and anti-miR-NC or si-circBPTF and anti-miR-224-3p by double transfection method, and then treated with 30 mmol/L glucose medium for 48 hours and were recorded as anti-miR-NC group and anti-miR-224-3p group, respectively.The expression of circBPTF and miR-224-3p was detected by real-time fluorescence quantitative PCR.Cell apoptosis was detected by flow cytometry.Reactive oxygen species (ROS) level was determined by 2′, 7′-dichlorodihydrofluorescein diacetate probe.Superoxide dismutase (SOD) activity and malondialdehyde (MDA) content were detected by colorimetric method.Expression of cleaved-caspase-3/caspase-3 and cleaved-caspase-9/caspase-9 proteins was detected by Western blot.The interaction between circBPTF and miR-224-3p was identified by the dual luciferase reporter method.Results:Compared with the control group, the apoptosis rate, cleaved-caspase-3/caspase-3 protein expression, cleaved-caspase-9/caspase-9 protein expression, ROS level, MDA content, and circBPTF relative expression were significantly increased and SOD activity and miR-224-3p expression were decreased in the high glucose group (all P<0.05).Compared with the si-NC group, circBPTF relative expression, ROS level, MDA content, cleaved-caspase-3/caspase-3 protein expression, cleaved-caspase-9/caspase-9 protein expression, and cell apoptosis rate were significantly reduced and SOD activity was significantly increased in the si-circBPTF group (all P<0.05).Compared with the miR-NC group, miR-224-3p relative expression and SOD activity were significantly enhanced and ROS level, MDA content, cleaved-caspase-3/caspase-3 protein expression, cleaved-caspase-9/caspase-9 protein expression and cell apoptosis rate were significantly reduced in the miR-224-3p group (all P<0.05).The relative luciferase activity of HRECs after co-transfection of wild type circBPTF and miR-224-3p mimic was 0.43±0.04, which was significantly decreased compared with 0.99±0.06 after co-transfection of wild type circBPTF and miR-NC ( t=23.297, P<0.05).Compared with anti-miR-NC group, the relative expression of miR-224-3p and SOD activity were significantly decreased and ROS level, MDA content, cell apoptosis rate, cleaved-caspase-3/caspase-3 protein expression, and cleaved-caspase-9/caspase-9 protein expression were significantly increased in the anti-miR-224-3p group (all P<0.05). Conclusions:Interfering with circBPTF can inhibit high glucose induced HRECs apoptosis and oxidative stress damage by targeting miR-224-3p.

Objective To investigate the relationship between the intraluminal characteristics of the occlusion segment and the degree of the primary collateral circulation(Circle of Willis)opening in patients with acute internal carotid artery occlusion(ICAO)and the occurrence of different subtypes of ipsilateral intracranial watershed infarction(WSI).Methods A total of 63 patients with unilateral acute ICAO accompanied by ipsilateral intracranial WSI were retrospectively included and divided into the internal watershed infarction(IWSI)group and the cortical watershed infarction(CWSI)group.The intraluminal characteristics of the occlusion segment and the degree of the Circle of Willis opening were analyzed using vessel wall magnetic resonance imaging(VW-MRI).Multivariate binary logistic regression analysis was employed to identify independent predictive indicators for the occurrence of CWSI.Results There was no significantly statistical difference in the occlusion range between the two groups.The range of intraluminal high signal involvement,the ratio of intraluminal relative highest signal,the incidence of high signal at the end of occlusion,and the degree of the Circle of Willis opening in the CWSI group were higher than those in the IWSI group(P<0.001).The range of intraluminal high signal involvement,high signal at the end of occlusion,and the degree of the Circle of Willis opening were identified as independent predictive factors for CWSI.Conclusion VW-MRI analysis of the intraluminal characteristics of the occlusion segment and the degree of the Circle of Willis opening can help to elucidate the mechanisms underlying the occurrence of IWSI/CWSI and can provide assistance in formulating etiology-based treatment strategies for clinical practice.

Objective:Inhaler satisfaction is an important factor affecting inhaler adherence and the efficacy of inhalers in chronic airway diseases.Using a scientific and effective method to assess patients'satisfaction with inhalers is of great significance for improving clinical outcomes.The Feeling of Satisfaction with Inhaler-10(FSI-10)is specifically designed to assess patients'inhaler satisfaction in chronic airway diseases,but the application research on this scale is not available in China.This study aims to evaluate the reliability and validity of the Chinese version of FSI-10,describe the current status of inhaler satisfaction and discuss the associated variables in Chinese patients with chronic airway disease. Methods:Based on the English version of FSI-10,items of the Chinese version of FSI-10 were determined after forward-backward translation and cultural adaption.Totally,322 patients with chronic obstructive pulmonary disease(COPD)and asthma were enrolled from the Second Xiangya Hospital of Central South University from June to October 2022.We collected associated clinical variables and inhaler satisfaction using the Chinese version of FSI-10.The content validity of the scale was expressed by content validity index(CVI)and the construct validity was analyzed by exploratory factor analysis(EFA).The reliability of the scale was expressed by Cronbach's α coefficient,the split-half reliability and test-retest reliability.A multivariate logistic regression was conducted to examine variables related to inhaler satisfaction. Results:The reliability and validity analysis showed that the CVI was 0.983.One factor was extracted from the Chinese version of FSI-10 and the cumulative variance contribution rate was 73.114%.The Cronbach's α of the scale was 0.913,the Guttman's half-reliability coefficient was 0.905,and the test-retest reliability was 0.727(P<0.001).In addition,the total score of the scale for patients was 38.92±4.26 points and the proportion of high satisfaction(the score of FSI-10≥40)in patients with COPD was significantly lower than that in asthma patients(71.3%vs 87.9%,P<0.01).Older age(age≥70 years)was a risk factor of lower inhaler satisfaction and asthma diagnosis was a protective factor. Conclusion:The Chinese version of FSI-10 has good reliability and validity in patients with COPD and asthma,which may be further promoted and applied in patients with chronic airway disease in China.Doctors should regularly evaluate the inhaler satisfaction of patients with chronic airway diseases,especially for those elder or with severe symptoms and a long course of illness.

Objective:To analyze the diagnostic value of cell-free plasma metagenomic next-generation sequencing (mNGS) pathogen identification for severe aplastic anemia (SAA) bloodstream infection.Methods:From February 2021 to February 2022, mNGS and conventional detection methods (blood culture, etc.) were used to detect 33 samples from 29 consecutive AA patients admitted to the Anemia Diagnosis and Treatment Center of the Hematology Hospital of the Chinese Academy of Medical Sciences to assess the diagnostic consistency of mNGS and conventional detection, as well as the impact on clinical treatment benefits and clinical accuracy.Results:①Among the 33 samples evaluated by mNGS and conventional detection methods, 25 cases (75.76%) carried potential pathogenic microorganisms. A total of 72 pathogenic microorganisms were identified from all cases, of which 65 (90.28%) were detected only by mNGS. ②All 33 cases were evaluated for diagnostic consistency, of which 2 cases (6.06%) were Composite, 18 cases (54.55%) were mNGS only, 2 cases (6.06%) were Conventional method only, 1 case (3.03%) was both common compliances (mNGS/Conventional testing) , and 10 cases (30.3%) were completely non-conforming (None) . ③All 33 cases were evaluated for clinical treatment benefit. Among them, 8 cases (24.24%) received Initiation of targeted treatment, 1 case (3.03%) received Treatment de-escalation, 13 cases (39.39%) received Confirmation, and the remaining 11 cases (33.33%) received No clinical benefit. ④ The sensitivity of 80.77%, specificity of 70.00%, positive predictive value of 63.64%, negative predictive value of 84.85%, positive likelihood ratio of 2.692, and negative likelihood ratio of 0.275 distinguished mNGS from conventional detection methods (21/12 vs 5/28, P<0.001) . Conclusion:mNGS can not only contribute to accurately diagnosing bloodstream infection in patients with aplastic anemia, but can also help to guide accurate anti-infection treatment, and the clinical accuracy is high.

Objective:To explore the effect of case three-dimensional teaching method (CTTM) combined with multimedia teaching on the practice teaching of liver infectious diseases.Methods:Twenty-five interns of liver infectious diseases received by The Second Hospital of Nanjing from May 2019 to January 2020 were taken as the control group, and 25 interns of liver infectious diseases received from February 2020 to October 2020 were taken as the observation group. The control group was given the conventional teaching mode including the conventional case teaching and the conventional multimedia teaching, while the observation group was given CTTM integrated with multimedia teaching method, and both groups were taught for 4 weeks. After teaching, the examination results of liver infectious disease related theory and practice, the changes of core competence before and after teaching, and the recognition of teaching were compared between the two groups. SPSS 25.0 was used for t test and chi-square test. Results:After teaching, the examination results of liver infectious disease related theory [(92.45±7.23) vs. (81.21±7.11)] and practice [(93.27±6.68) vs. (81.23±6.26)] in the observation group were higher than those in the control group. There was no significant difference in the scores of core competence between the two groups before teaching; after teaching, the scores of autonomous learning, problem analysis and solving, doctor-patient communication and teamwork ability of the two groups were higher than those before teaching, and the scores of observation group were significantly higher than those of the control group ( P<0.05). The recognition rates of interns in the observation group were higher than those in the control group in the improvement of learning initiative, the consolidation of theoretical knowledge, the enhancement of practical ability and the improvement of learning efficiency ( P<0.05). Conclusion:In the teaching of liver infectious disease interns, CTTM integrated with multimedia teaching method can not only improve the examination results, and enhance the core competence, but also improve the recognition of interns on the teaching mode.

ObjectiveThe effect of inoculation with different organophosphate-resolving bacteria or compound bacteria on the quality of Paris polyphylla var. yunnanensis medicinal materials and rhizosphere soil fertility were studied to provide a reference for the development and application of biological bacterial fertilizer in artificial cultivation of P. polyphylla var. yunnanensis. MethodThe three dominant species of organophosphate-solubilizing bacteria were inoculated separately and in combination in sterilized soil by single-factor indoor pot planting， and no inoculation was used as the control group. The effect of inoculation of organophosphate-solubilizing bacteria on total saponins content in rhizomes of P. polyphylla var. yunnanensis， as well as microbial numbers， enzyme activities and nutrient contents in rhizosphere soil were analyzed. ResultIn the seven treatments inoculated with organophosphate-solubilizing bacteria， the total saponin content in the rhizomes of Paris polyphylla var. yunnanensis was increased by 16.42%， 3.83%， 16.86%， 33.69%， 2.11%， 13.44%， and 28.83%， respectively， compared with the control. Inoculation with organophosphate-solubilizing bacteria increased the number of soil microorganisms to varying degrees， and the effects of S6 and S7 treatments were the most significant. Inoculation with organophosphate-solubilizing bacteria improved the enzyme activity， and the effect of S7 treatment was the most significant. The activities of acid phosphatase， neutral phosphatase， alkaline phosphatase， protease， invertase and catalase were 49.96% and 104.67% ， 110.17%， 99.61%， 26.26%， 11.29% higher than those of the control， respectively. Inoculation with organophosphate-solubilizing bacteria reduced the pH of the rhizosphere soil and increased the content of soil available nutrients. Under the S7 treatment， the contents of alkaline hydrolyzable nitrogen， available phosphorus and available potassium in the rhizosphere soil of P. polyphylla var. yunnanensis were 181.46%， 51.64% and 42.62% higher than those of the control， respectively. Correlation analysis showed that there was a significant positive correlation between total saponins and phosphatase activities， a significant positive correlation between soil microorganisms and soil enzyme activities， and a very significant positive correlation between soil nutrients. ConclusionInoculation of different organophosphate-resolving bacteria or compound bacteria can improve the quality and rhizosphere soil fertility of P. polyphylla var. yunnanensis. Among them， the mixed inoculation of three kinds of bacteria and the mixed inoculation of B. mycoides and B. wiedmannii have the best effect.

In this research,a new phospholipid based monolith was fabricated by in situ co-polymerization of 1-dodecanoyl-2-(11-methacrylamidoundecanoyl)-sn-glycero-3-phosphoethanolamine and ethylene dimethacrylate to mimick bio-membrane environment.Excellent physicochemical properties of this novel monolith that were achieved included column efficiency,stability,and permeability.Moreover,the biomimetic monolith showed outstanding separation capability for a series of intact proteins and small molecules.In particular,it exhibited good potential as an alternative to the commercial immobilized artificial membrane(IAM)column(IAM.PC.DD2)for studying drug-membrane interactions.This study not only enriched the types of IAM stationary phases,but also provided a simple model for the prediction of phosphatidylethanolamine related properties of drug candidates.