Objective To investigate the relationship between serum levels of long non-coding RNA(ln-cRNA)nuclear-enriched abundant transcript 1(NEAT1)and microRNA miR-23c in patients with diabetic ne-phropathy(DN).Methods A total of 136 DN patients admitted to the hospital from May 2019 to May 2020 were enrolled in the study as the DN group.Fifty-eight healthy people who underwent physical examination in the hospital during the same period were enrolled as the control group.Real-time fluorescence quantitative PCR(qPCR)was used to detect serum lncRNA NEAT1,miR-23c,kidney injury molecule-1(KIM-1),neutro-phil gelatinase-associated lipocalin(NGAL),tumor necrosis factor-α(TNF-α)mRNA and interleukin-6(IL-6)mRNA in the two groups.Pearson/Spearman correlation was used to analyze the correlation of serum ln-cRNA NEAT1 and miR-23c with KIM-1,NGAL,TNF-α,IL-6 mRNA levels and eGFR in DN patients.DN pa-tients were divided into different CKD stages,and the levels of serum lncRNA NEAT1,miR-23c,KIM-1,NGAL,TNF-α,and IL-6 mRNA in patients in different CKD stages were compared.Multivariate ordered Lo-gistic regression was used to analyze whether serum levels of lncRNA NEAT1 and miR-23c were influencing factors for the progression of DN.Results Compared with the control group,the serum levels of lncRNA NEAT1,KIM-1,NGAL,TNF-α and IL-6 mRNA in the DN group were increased,while miR-23c and esti-mated glomerular filtration rate(eGFR)were decreased,and the differences were all statistically significant(P＜0.05).The serum levels of lncRNA NEAT1,KIM-1,NGAL,TNF-α and IL-6 mRNA in DN patients in G1-G5 stages were increased in order,and the level of miR-23c was decreased in order(P＜0.05).Serum ln-cRNA NEAT1 in DN patients was positively correlated with KIM-1,NGAL,TNF-α and IL-6 mRNA levels(P＜0.05),and negatively correlated with miR-23c and eGFR(P＜0.05).The level of serum miR-23c was negatively correlated with the mRNA levels of KIM-1,NGAL,TNF-α and IL-6(P＜0.05),and positively cor-related with eGFR(P＜0.05).lncRNA NEAT1(OR=2.177,95％CI:2.113-2.441)was an independent risk factor for DN progression,while miR-23c(OR=0.595,95％CI:0.543-0.726)was an independent pro-tective factor(P＜0.05).Conclusion Elevated serum lncRNA NEAT1 levels and reduced miR-23c levels in DN patients are closely associated with the progression of DN disease.

Objective:To investigate the professional identity status of nursing students in higher vocational colleges in Shanghai, China, and to analyze the influencing factors.Methods:By cluster sampling, we selected 308 nursing students of grade 2019 from a higher vocational college in Shanghai for a survey with the General Information Questionnaire, Professional Identity Questionnaire for Nurse Students (PIQNS), Stanford Presenteeism Scale-6 (SPS-6), Wong and Law Emotional Intelligence Scale (WLEIS), Workplace Social Capital (WSC), and Nurse Psychological Capital Questionnaire (PCQ). SPSS 22.0 was used for descriptive analysis, the independent samples t-test, one-way analysis of variance, Pearson correlation analysis, and multiple linear regression analysis. Results:The total PIQNS score of the students was (64.93±12.83), the total SPS-6 score was (15.91±4.40), the total WLEIS score was (80.57±15.52), the total WSC score was (32.38±6.33), and the total PCQ score was (95.47±18.63). The PIQNS score was negatively correlated with the SPS-6 score ( r=-0.282, P<0.01), positively correlated with the WLEIS score ( r=0.712, P<0.01), positively correlated with the WSC score ( r=0.659, P<0.01), and positively correlated with the PCQ score ( r=0.681, P<0.01). The multiple linear regression analysis showed that personal interest, emotional intelligence, and psychological capital significantly affected the professional identity of nursing students, entering the regression equation for professional identity. Conclusions:The professional identity of higher vocational nursing students in Shanghai is at a medium level, and personal interest, emotional intelligence, and psychological capital are the main factors influencing professional identity.

ObjectiveTo investigate the relationship between mosquito density fluctuations and meteorological factors, so as to provide a scientific basis for mosquito surveillance analysis, risk assessment, and comprehensive prevention and control. MethodsMosquito surveillance and monitoring data of 2020‒2023 was obtained from on-site supervisory sampling by Songjiang Center for Disease Control and Prevention, and meteorological data was obtained from the Wheat A wheat malt-agro-meteorological big data system. Excel 2019 and SPSS 25.0 software were used to organize and analyze the mosquito number, species composition, and seasonal changes in mosquito density captured by the CO₂-light trap at rach monitoring site. Circular distribution method was used to calculate the peak time of mosquito density, combined with the meteorological data of the same period to explore the impact of meteorological factors on the results of mosquito surveillance. ResultsThere was a statistical difference in the overall distribution of mosquito quantity in different habitats(H=23.11, P<0.05), 2020‒2023. In addition, the results showed that July 28th was the peak day for mosquito density, and the duration from June 13th to September 11th was the seasonal peak period for mosquitoes. Pearson correlation analysis showed a positive correlation between mosquito density and average air temperature, average highest air temperature, average lowest air temperature, extreme maximum air temperature, extreme minimum air temperature, precipitation, and number of precipitation days (all P<0.01). While, there was no significant correlation between average wind speed and mosquito density (P>0.05). Multiple stepwise regression analysis resulted in the equation of Y=0.151X_{extreme minimum temperature}+0.321X_{number of precipitation days}+1.002X_{SQRT precipitation}-1.288 (F=102.635, P<0.05). ConclusionThe CO₂-light trap is advisable to monitor the habitats of farmers, livestock sheds, residential areas, parks, hospitals, and other external environments. Air temperature and precipitation have a significant impact on mosquito density. It is recommended to implement comprehensive prevention and control measures to reduce mosquito density and prevent mosquito-borne diseases before the peak period of mosquitoes.

Objective:This study aims to compare the antiviral treatment similarities and differences in the population covered by the 2024 version of the World Health Organization's (WHO) hepatitis B prevention and treatment guidelines and the current Chinese hepatitis B prevention and treatment guidelines, so as to explore their impact on the indications for antiviral therapy in Chinese patients with chronic hepatitis B (CHB).Methods:The information of patients with chronic hepatitis B virus infection who did not receive antiviral treatment was collected through the registration database of the China Clinical Research Platform for Hepatitis B Elimination. Descriptive statistics were conducted on the demographic, blood, biochemical, and virological levels of patients according to the treatment recommendations of the two versions of the guidelines. The Mann-Whitney U test and χ2 test were used to compare the differences and proportional distribution of the treatment populations covered by the two guidelines. The χ2 test was used to analyze the coverage rate of different antiviral treatment indications.Results:A total of 21,134 CHB patients without antiviral treatment were enrolled. 69.4% of patients met the 2024 versions of the WHO guidelines' recommendations. 85.0% of patients met the current Chinese hepatitis B prevention and treatment guidelines. The WHO guidelines for antiviral therapy indications were met in younger patients with higher levels of ALT, AST, and APRI scores, as well as greater proportion of patients with higher viral loads (P<0.001). The WHO guidelines recommended a cut-off value of APRI>0.5, which raised the proportion of patients on antiviral therapy from 6.6% to 30.9%. 45.7% of patients met the antiviral indications for HBV DNA >2000 IU/ml with abnormal transaminase (ALT>30 U/L for males and ALT>19 U/L for females). The reduced APRI diagnostic cut-off value and ALT treatment threshold had further increased the treatment coverage rate by 91.6% in patients with chronic HBV infection in line with the 2024 versions of WHO guidelines.Conclusion:The reduction of the APRI diagnostic cut-off value and the ALT treatment threshold, based on the current hepatitis B guidelines of China, will further improve the treatment coverage of CHB patients.

Objective:To explore the age of onset and consultation, the main clinical manifestations, common types of combined malformations, the relationship of endometriosis, surgical prognosis and different types of proportion of adolescent female reproductive system dysplasia.Methods:The medical records of 356 patients (aged 10-19) with female reproductive system dysplasia in Women′s Hospital, School of Medicine, Zhejiang University from January 2003 to August 2018 were collected and retrospectively analyzed.Results:(1) Among the 356 adolescent dysplasia patients, uterine dysplasia (23.6%, 84/356), oblique vaginal septum syndrome (OVSS; 22.5%, 80/356) and vaginal dysplasia (21.6%, 77/356) were the most frequent ones, followed by multi-sectional dysplasia (16.0%, 57/356), other types of developmental abnormalities like external genitaliaand urogenital fistula (13.5%, 48/356) and Mayer-Rokitansky-Küster-Hauser syndrome (MRKH syndrome; 2.8%, 10/356). (2) There were significant differences between the median age of onset and the age of consultation of patients with OVSS and other types of abnormalities except hymen atresia (both P<0.05). In contrast, there were no significant differences between the age of onset and the age of consultation of the patients of uterine dysplasia, vaginal dysplasia, hymen atresia, MRKH syndrome and multi-sectional dysplasia (all P>0.05). (3) The clinical manifestations were lack of specificity, and mainly abnormal finding was lower abdominal pain. (4) After admission, the majority of patients underwent comprehensive cardiopulmonary examination (71.3%, 254/356) and urinary system examination (63.5%, 226/356). Only 18.3% (65/356) of patients had completed abdominal organ examination, and 5.9% (21/356) skeletal system examination. About other systemic malformations, urological malformations were the most common (27.5%, 98/356), followed by anorectal malformation (0.6%, 2/356), heart malformations (0.3%, 1/356), and spinal malformations (0.3%, 1/356). 46.4% (84/181) of the surgical patients were diagnosed with combined endometriosis. Patients with obstructive genital tract malformations were more likely to combine with endometriosis than non-obstructive ones [50.3% (74/147) vs 29.4% (10/34); P<0.05]. However, there was no significant difference between the severity of endometriosis of those two kinds ( P>0.05). (5) Totally 308 patients were followed up successfully with a median of 25.0 years old, and 20 cases were treated again; 12.0% (37/308) of them were suffering from menstrual disorder and 33.1% (102/308) of them with dysmenorrhea. Totally 130 patients had sexually active reported no sexual problems. Conclusions:Uterine dysplasia, OVSS and vaginal dysplasia are the most common syndromes in adolescent female reproductive system dysplasia along with frequent cases of coexisting urinary malformations and increasing risks of endometriosis. Meanwhile, the lack of specificity of clinical manifestations might delay the timely diagnosis and treatment after the onset of symptoms. Nonetheless, most patients could achieve good surgical outcomes.

Objective:To compare the characteristics of gait disorders between patients with idiopathic normal pressure hydrocephalus(iNPH)and Parkinson's disease(PD)patients.Methods:General clinical data and gait assessment results of 16 iNPH patients, 20 PD patients, and 23 healthy adults seeking treatment at Tianjin Huanhu Hospital between January 2020 and December 2020 were retrospectively analyzed.Gait analysis was conducted using the Mobility Lab? system with APDM Opal sensors from the US.Results:The 16 patients in the iNPH group had a mean age of(68.81±8.73), the 20 patients in the PD group had a mean age of(65.05±10.15), and the 23 adults in the control group had a mean age of(59.96±6.20).There was no significant difference in age between the iNPH group and the PD group( P>0.05).However, the iNPH group was older than the healthy control group( t=3.71, P<0.05).The disease duration of the iNPH group was(22.94±23.19)months, which was shorter than(92.60±53.70)months in the PD group( t=5.23, P<0.05).The mini-mental state examination(MMSE)score(17.13±7.08)and the Montreal Cognitive Assessment(MoCA)score(11.75±5.43)of the iNPH group were significantly lower than those in the PD group[(24.17±4.73), t=3.45, P<0.05、(21.29±5.82), t=4.86, P<0.05]and the control group[(26.70±1.61), t=5.31, P<0.05、(22.78±3.30), t=7.89, P<0.05].Compared with the PD group, the iNPH group had a significantly lower foot clearance[right: (1.65±0.76)cm vs.(2.56±1.30)cm]and smaller bilateral toe-off angles[left: (20.59±6.11)° vs.(28.43±6.36)°; right: (20.78±6.88)° vs.(28.12±7.49)°, t=3.74、3.02, respectively, all P<0.05].There were statistically significant differences in all gait parameters in iNPH patients compared with the control group( P<0.05). Conclusions:iNPH patients exhibit clear gait disturbance, which is more prominent than in PD patients.The wearable gait analysis system can accurately assess gait disorders in iNPH patients, and can be applied to gait assessment and the development of rehabilitation plans.

One case of COVID-19 infection secondary to pulmonary mucormycosis in a recipient of simultaneous pancreas-kidney transplantation was described. Early identification of the pathogen was achieved by metagenomic next-generation sequencing. On the basis of disease status and liver function changes, targeted treatments included intravenous amphotericin B liposome, amphotericin B nebulization& gargling and subsequently a maintenance therapy of oral posaconazole. This regimen resulted in the absorption of lung infection, stabilization of transplanted pancreas function and reduced levels of creatinine and urea as compared to pre-infection period. The therapeutic efficacy was decent.

Objective:To summarize the distributional characteristics of postoperative occurrence of multi-drug resistant organism (MDRO) infections and their risk factors in simultaneous pancreas-kidney transplantation (SPK) recipients and examine the impact of MDRO infections on the survival of SPK recipients.Method:From January 2016 to December 2022, the relevant clinical data were retrospectively reviewed for 218 SPK recipients. The source of donor-recipient specimens and the composition percentage of MDRO pathogens were examined. According to whether or not MDRO infection occurred post-transplantation, they were assigned into two groups of MDRO (98 cases) and non-MDRO (120 cases). The clinical data of two groups of donors and recipients were analyzed. And the risk factors for an onset of MDRO infection were examined by binary Logistic regression. The survival rate of two recipient groups was compared by Kaplan-Meier method.Result:A total of 98/218 recipients (45%) developed MDRO infections. And 46 (46.9%) of sputum and 34 (34.7%) of urine were cultured positively and 49 (50%) pathogens expressed extended spectrum beta-lactamase. There were pneumonia (46 cases, 46.9%), urinary tract infections (34 cases, 34.7%), abdominal infections (16 cases, 16.3%) and bloodstream infections (2 cases, 2.0%). Univariate regression analysis revealed that length of renal failure ( P=0.037), length of hospitalization ( P<0.001), length of antibiotic use ( P<0.001), novel antibiotics ( P=0.014), albumin ( P<0.001) and leukocyte count ( P<0.001) were risk factors for an onset of MDRO infections. The results of multifactorial regression indicated that low albumin ( OR=0.855, 95% CI: 0.790~0.925, P<0.001) and leukopenia ( OR=0.656, 95% CI: 0.550~0.783, P<0.001) were independent risk factors for an onset of MDRO infections. The survival rates of recipients in MDRO group at Year 1/3 post-operation were 92.9% (91/98) and 89.8% (88/98). And the survival rate of recipients in non-MDRO group was 96.7% (116/120) at Year 1/3 post-operation. Inter-group difference was not statistically significant in 1-year survival rate of two recipient groups ( P=0.201); statistically significant inter-group difference in 3-year survival rate between two recipient groups ( P=0.041) . Conclusion:Low albumin and leukopenia are risk factors for MDRO infection. Infection with MDRO has some impact on the survival of recipients.

Objective:To explore the changes of gait flexibility and stability in patients with Parkinson's disease (PD) 2 years after deep brain stimulation (DBS).Methods:Twenty PD patients accepted DBS in Department of Neurosurgery, Tianjin Huanhu Hospital from October 2019 to November 2021 were enrolled. Motor symptoms were evaluated by Movement Disorder Society-unified Parkinson's disease rating scale III (MDS-UPDRS-III) at preoperative medication-off state, postoperative medication-off state, and postoperative medication-on state. Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were used to assess the cognition and 39-item Parkinson's disease questionnaire (PDQ-39) was used to evaluate the quality of life at preoperative medication-on state and postoperative medication-on state. A three-dimensional gait analyzer was used to record the gait parameters during Instrumented Stand and Walk test (ISAW) at preoperative medication-off state, postoperative medication-off state, and postoperative medication-on state. Differences in motor symptom scores, cognitive scores, quality of life scores, as well as changes in gait flexibility and stability were compared before and after DBS.Results:(1) The MDS-UPDRS-Ⅲ scores at preoperative medication-off state, postoperative medication-off state, and postoperative medication-on state ([45.30±12.57], [24.95±10.74], [15.80±7.19]) were decreased successively, with significant differences ( P<0.05).(2) Compared with those before surgery, PD patients had significantly lower levodopa equivalent daily dose (LEDD), total scores of PDQ-39, and scores of question 9 "degree of concern about falling" in PDQ-39 at 2 years after DBS ([711.84±343.99] mg/d vs. [549.30±301.08] mg/d, 47.00[30.00, 64.00] vs. 13.50[7.75, 27.00], 2.00[0.00, 3.00] vs. 0.00[0.00, 1.75], P<0.05). (3) Compared with that at preoperative medication-off state, the arm swing velocity at postoperative medication-on state statistically increased in PD patients ( P<0.05); compared with those at preoperative medication-off state, the arm swing range and turning speed at postoperative medication-off and medication-on states significantly increased in PD patients ( P<0.05); compared with that at preoperative medication-off state, the turning duration at postoperative medication-off state statistically decreased in PD patients ( P<0.05). Compared with that at preoperative medication-off state, the range of motion of the trunk in the horizontal plane at postoperative medication-off and medication-on states increased significantly in PD patients ( P<0.05); compared with that at preoperative medication-off state, the range of motion in the sagittal plane of the lumbar, coronal plane of the trunk, and sagittal plane of the trunk all increased significantly in PD patients at postoperative medication-on state ( P<0.05); the mean velocity and root mean square acceleration at postoperative medication-on state increased significantly in PD patients compared with that at preoperative medication-off state ( P<0.05); conversely, the swing frequency at postoperative medication-off state decreased significantly in PD patients compared with that at preoperative medication-off state ( P<0.05). Conclusion:Two years after DBS, PD patients exhibit obviously improved gait, with enhanced flexibility, and dynamic and static stability.

Objective To explore the alterations in gray matter volume(GMV)in adolescents with bipolar disorder(BD).Methods 36 BD patients(BD group)and 37 healthy controls(HC group)who underwent magnetic resonance imaging(MRI)for artificial visual inspection in Affiliated Hangzhou First People's Hospital,School of Medicine,Westlake University from September 2019 to December 2021 were selected.Structural MRI data were processed by using FreeSurferv6.0.0,and statistical analysis were conducted by using SPSS 26.0 and R language software.Receiver operating characteristic(ROC)curve were employed to assess the diagnostic efficacy of various brain regions.Results Compared to HC group,patients in BD group exhibited significant reductions in GMV in the right superior frontal gyrus,right nucleus accumbens,left insula,right lateral orbitofrontal cortex,and right medial orbitofrontal cortex(P＜0.05).ROC curve analysis indicated that area under the curve(AUC)for the right superior frontal gyrus and right nucleus accumbens were 0.739 and 0.712 respectively,while the combined AUC for multiple brain regions was 0.820.Conclusion Adolescents with BD show significant reductions in GMV in specific brain regions,provide reference for the early identification and pathological mechanism research of BD.