Objective:To investigate the difference in intracranial infection rate between long-tunneled external ventricular drainage(LTEVD)and conventional external ventricular drainage(EVD),as well as the risk factors for intracranial infection.Methods:A retro-spective analysis was performed for the clinical data of 45 patients who were admitted to Department of Neurology Center,The Third Affiliated Hospital of Chongqing Medical University,from January 2020 to December 2022 and underwent EVD,among whom 13 patients underwent LTEVD(LTEVD group)and 32 patients underwent conventional EVD(EVD group).Related data were recorded for both groups,including general information,postoperative catheter-related complications,and postoperative management,to investi-gate the effect on reducing the rate of intracranial infection.According to the presence or absence of intracranial infection after surgery,the patients were divided into the infection group with 10 patients and non-infection group with 35 patients,and related clini-cal data were analyzed to investigate the risk factors for intracranial infection.Results:The LTEVD group had a significantly lower secondary infection rate of catheterization days than the EVD group[2.40‰(1/417)vs.27.19‰(9/331),P=0.009].The duration of catheterization was 14-85 days[27.00(22.50,36.50)days]in the LTEVD group and 8-22 days[9.00(8.00,11.50)days]in the EVD group,suggesting that the LTEVD group had a significantly longer duration of catheterization than the EVD group(P=0.000).The multivariate logistic regression analysis showed that the times of cerebrospinal fluid sampling was an independent risk factor for post-operative intracranial infection in patients undergoing EVD,and the use of LTEVD was a protective factor against intracranial infection after EVD.Conclusion:Compared with conventional EVD,LTEVD can safely prolong the duration of catheterization and reduce the rate of postoperative intracranial infection in patients undergoing EVD.The use of LTEVD procedure and the reduction in the times of cerebrospinal fluid sampling can reduce the risk of postoperative in-tracranial infection.

Objective To explore the interaction between long non-coding RNA growth arrest-specific 5(GAS5)and miR-135b-5p/adenomatous polyposis coli(APC)axis,and to elucidate its biological function in the proliferation,metastasis and invasion of glioma.Methods The relationship of GAS5 expression level with survival rate of glioma patients was analyzed based on CGGA database.qRT-PCR was used to detect the expression level of GAS5 in glioma tissues and cell lines.Human glioma T98 and A172 cell lines were subjected for overexpression and knockdown of GAS5,miR-135b-5p and APC by transfection.Western blotting and qRT-PCR were applied to measure the expression of related genes in glioma tissues or cell lines.CCK-8,Transwell and wound healing assays was conducted to determine the effect of GAS5 on the viability and motility of glioma cells.Moreover,dual luciferase reporter analysis were utilized to elucidate the regulatory mechanisms of GAS5 and miR-135b-5p/APC.Results Analysis on CGGA database showed that the survival rate of glioma patients with low GAS5 expression was significantly decreased(P＜0.001).Western blotting and qRT-PCR indicated that GAS5 was down-regulated in the glioma cell lines and tissues than human normal astrocytes and para-cancer tissues(P＜0.01).The results of CCK-8,Transwell and wound healing assays revealed that overexpression of GAS5 significantly inhibited the viability,invasion and migration abilities in T98 cells when compared with the cells of the vector group(P＜0.01).Dual luciferase reporter analysis displayed that there were binding sites between GAS5 and miR-135b-5p,and the expression of the two was negatively correlated(P=0.019).Further studies suggested that the effect of GAS5 on biological function in glioma cells was through targeting miR-135b-5p,and overexpression of APC reversed the promoting effect of miR-135b-5p on glioma cells(P＜0.01).Western blotting displayed that enhancing miR-135b-5p expression inhibited the expression of APC(P＜0.001),and GAS5 upregulated the expression of APC by targeting miR-135b-5p(P＜0.01).Conclusion GAS5 inhibits the progression of glioma via miR-135b-5p/APC axis,which revealing the molecular regulatory mechanism of GAS5/miR-135b-5p/APC.

Objective:To analyze the effects of fertilization methods, quality of inner cell mass (ICM) and trophectoderm (TE) on the sex ratio at birth (SRB) during single blastocyst transfer cycles.Methods:5 367 single blastocyst transfer cycles in in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) of patients with successful pregnancy and delivery in Reproductive Medical Center of Zhanjiang Jiuhe Hospital from January 2010 to December 2022 were included in this retrospective cohort study. According to different types of embryos, the cycles were divided into fresh embryo group ( n=1 487, total population; n=1 258, ≤35 years old) and frozen-thawed embryo group ( n=3 880, total population; n=3 199, ≤35 years old). According to different fertilization methods, the cycles were divided into IVF group ( n=4 424, total population; n=3 667, ≤35 years old) and ICSI group ( n=943, total population; n=780, ≤35 years old). Chi-square test was used to analyze the differences of SRB among all the patients and the patients aged ≤35 years who underwent different embryo types and fertilization methods, and logistic regression was used to analyze the effects of ICM and TE ratings on SRB in each group of blastocysts. Results:There were 917 male infants (61.7%, 917/1 487) in the fresh embryo transfer group and 2 317 male infants (59.7%, 2 317/3 880) in frozen-thawed embryo transfer group. The SRB of the fresh embryo transfer group (160.9∶100) was slightly higher than that in frozen-thawed embryo transfer group (148.2∶100), but the difference was not statistically significant ( P=0.201). There were 2 732 male infants (61.8%, 2 732/4 424) in IVF group and 502 male infants (53.2%, 502/943) in ICSI group. The SRB of IVF group (161.5∶100) was significantly higher than that of ICSI group (113.8∶100), and the difference was statistically significant ( P<0.001). In female patients aged ≤35 years, the effects of different embryo transfer methods and different fertilization methods on SRB were consistent with the results of total population. Univariate logistic regression analysis showed that the SRB of patients with ICSI was lower than that of patients with IVF, except for 3-6AA. There were significant differences in SRB between ICSI cycles patients (88.8∶100; 72.8∶100; 156.1∶100) and IVF cycles patients (130.7∶100; 124.8∶100; 206.3∶100) when the blastocyst grade was 3-6BB ( OR=0.679, 95% CI: 0.516-0.896, P=0.006), 3-6AB( OR=0.583, 95% CI: 0.421-0.809, P=0.001) and 3-6BA OR=0.757, 95% CI: 0.585-0.979, P=0.034). Taking 3-6BB blastocysts as reference, the SRB of 3-6AA and 3-6BA blastocysts were higher (IVF: OR=1.527, 95% CI: 1.258-1.854, P<0.001; OR=1.579,95% CI: 1.341-1.859, P<0.001; ICSI: OR=2.566, 95% CI: 1.661-3.966, P<0.001; OR=1.758, 95% CI: 1.250-2.472, P=0.001). Compared with 3-6BA, the SRB of 3-6BC blastocysts was lower (IVF: OR=0.621, 95% CI: 0.447-0.862, P=0.004; ICSI: OR=0.442, 95% CI: 0.238-0.818, P=0.009). Taking 3-6AB as reference, the SRB of 3-6AA blastocysts was higher (IVF: OR=1.600, 95% CI: 1.307-1.958, P<0.001; ICSI: OR=3.130, 95% CI: 1.964-4.987, P<0.001). Conclusion:The SRB of fresh embryo group is slightly higher than that of frozen-thawed group in single blastocyst transfer cycles. Different fertilization methods can affect SRB, and the SRB in IVF is significantly higher than that in ICSI group. The quality of blastocysts can affect SRB, and blastocysts with higher quality TE have significantly increased SRB, while ICM quality have no significant effect on SRB.

Objective:To analyze the effects of fertilization methods, quality of inner cell mass (ICM) and trophectoderm (TE) on the sex ratio at birth (SRB) during single blastocyst transfer cycles.Methods:5 367 single blastocyst transfer cycles in in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) of patients with successful pregnancy and delivery in Reproductive Medical Center of Zhanjiang Jiuhe Hospital from January 2010 to December 2022 were included in this retrospective cohort study. According to different types of embryos, the cycles were divided into fresh embryo group ( n=1 487, total population; n=1 258, ≤35 years old) and frozen-thawed embryo group ( n=3 880, total population; n=3 199, ≤35 years old). According to different fertilization methods, the cycles were divided into IVF group ( n=4 424, total population; n=3 667, ≤35 years old) and ICSI group ( n=943, total population; n=780, ≤35 years old). Chi-square test was used to analyze the differences of SRB among all the patients and the patients aged ≤35 years who underwent different embryo types and fertilization methods, and logistic regression was used to analyze the effects of ICM and TE ratings on SRB in each group of blastocysts. Results:There were 917 male infants (61.7%, 917/1 487) in the fresh embryo transfer group and 2 317 male infants (59.7%, 2 317/3 880) in frozen-thawed embryo transfer group. The SRB of the fresh embryo transfer group (160.9∶100) was slightly higher than that in frozen-thawed embryo transfer group (148.2∶100), but the difference was not statistically significant ( P=0.201). There were 2 732 male infants (61.8%, 2 732/4 424) in IVF group and 502 male infants (53.2%, 502/943) in ICSI group. The SRB of IVF group (161.5∶100) was significantly higher than that of ICSI group (113.8∶100), and the difference was statistically significant ( P<0.001). In female patients aged ≤35 years, the effects of different embryo transfer methods and different fertilization methods on SRB were consistent with the results of total population. Univariate logistic regression analysis showed that the SRB of patients with ICSI was lower than that of patients with IVF, except for 3-6AA. There were significant differences in SRB between ICSI cycles patients (88.8∶100; 72.8∶100; 156.1∶100) and IVF cycles patients (130.7∶100; 124.8∶100; 206.3∶100) when the blastocyst grade was 3-6BB ( OR=0.679, 95% CI: 0.516-0.896, P=0.006), 3-6AB( OR=0.583, 95% CI: 0.421-0.809, P=0.001) and 3-6BA OR=0.757, 95% CI: 0.585-0.979, P=0.034). Taking 3-6BB blastocysts as reference, the SRB of 3-6AA and 3-6BA blastocysts were higher (IVF: OR=1.527, 95% CI: 1.258-1.854, P<0.001; OR=1.579,95% CI: 1.341-1.859, P<0.001; ICSI: OR=2.566, 95% CI: 1.661-3.966, P<0.001; OR=1.758, 95% CI: 1.250-2.472, P=0.001). Compared with 3-6BA, the SRB of 3-6BC blastocysts was lower (IVF: OR=0.621, 95% CI: 0.447-0.862, P=0.004; ICSI: OR=0.442, 95% CI: 0.238-0.818, P=0.009). Taking 3-6AB as reference, the SRB of 3-6AA blastocysts was higher (IVF: OR=1.600, 95% CI: 1.307-1.958, P<0.001; ICSI: OR=3.130, 95% CI: 1.964-4.987, P<0.001). Conclusion:The SRB of fresh embryo group is slightly higher than that of frozen-thawed group in single blastocyst transfer cycles. Different fertilization methods can affect SRB, and the SRB in IVF is significantly higher than that in ICSI group. The quality of blastocysts can affect SRB, and blastocysts with higher quality TE have significantly increased SRB, while ICM quality have no significant effect on SRB.

Limb preservation techniques of severed limbs play an important role in autologous replantation or allografting. At present, static cold storage (SCS) remains the gold standard for the in vitro preservation of severed limbs, which minimizes oxygen and energy metabolism. However, with a relatively short time window of 4-6 hours, SCS is insufficient for clinical transfer, injury management and other medical resources. To address this issue, researchers have initiated investigations into alternative methods of supplying oxygen and nutrients to severed limbs, leading to the development of mechanical perfusion technology and per-sufflation technology. Mechanical perfusion technology aims to clear metabolic waste and provide essential nutrients by mimicking a physiological state, thereby prolonging the preservation time and improving the outcome of the repair. Per-sufflation technology aims to deliver oxygen directly to the tissue using a vascular system to maintain tissue integrity. With these emerging technologies showing great promise, further exploration and refinement are needed to address their time constraints and complexity in clinical work. Furthermore, for severed limbs that are not suitable for immediate reimplantation, autologous heterotopic parasitism techniques and temporary endovascular shunts offer promising avenues for preservation. Autologous heterotopic parasitism techniques maintain tissue viability by constructing a temporary parasitic environment, while temporary endovascular shunts establish a temporary vascular access at the damaged site to deliver donor blood, thereby maintaining blood flow and promoting repair. Xenogeneic cross-circulation techniques combine recent advances from multiple disciplines and demonstrate remarkable potential; however, they currently face challenges such as ethics, immune rejection, and technical complexity. The combination of these novel techniques has led to a significant advancement in the field of limb preservation and repair. This article aims to provide an overview of the current research status and development of static cold storage, pre-sufflation, mechanical perfusion preservation and temporary ectopic parasitic preservation techniques in limb preservation over recent years, providing information for clinical work, promoting the development of limb reimplantation and transplantation techniques in China and further consolidating China's leadership in the field of amputation reimplantation and allograft transplantation.

The negative effects of low temperature can readily induce a variety of diseases. We sought to understand the reasons why cold stress induces disease by studying the mechanisms of fine-tuning in macrophages following cold exposure. We found that cold stress triggers increased macrophage activation accompanied by metabolic reprogramming of aerobic glycolysis. The discovery, by genome-wide RNA sequencing, of defective mitochondria in mice macrophages following cold exposure indicated that mitochondrial defects may contribute to this process. In addition, changes in metabolism drive the differentiation of macrophages by affecting histone modifications. Finally, we showed that histone acetylation and lactylation are modulators of macrophage differentiation following cold exposure. Collectively, metabolism-related epigenetic modifications are essential for the differentiation of macrophages in cold-stressed mice, and the regulation of metabolism may be crucial for alleviating the harm induced by cold stress.
Acetylation ; Animals ; Cold-Shock Response ; Epigenesis, Genetic ; Macrophages/metabolism* ; Mice ; Mitochondria/metabolism*

OBJECTIVE To prepare apigenin silk fibroin（API@SF）nanoparticles and to evaluate their safety and anti-tumor activity. METHODS API@SF nanoparticles were prepared by nanoprecipitation method ，and their morphology ，particle size ，Zeta potential，drug loading amount and in vitro release were characterized. The safety of nanoparticles was evaluated by hemolysis test and HE staining. MTT assay was adopted to evaluate inhibitory effects of API@SF nanoparticles on breast cancer 4T1 cells in mice. RESULTS The prepared API@SF nanoparticles were spherical with uniform distribution. The average particle size was 406.61 nm， the polydispersity index was 0.154，the Zeta potential was －18.4 mV，and the average drug-loading amount was 5.20％. The in vitro release results showed that the release rate of the nanoparticles was relatively fast in the release medium of pH 5.0 and relatively slow in the release medium of pH 7.4. Results of hemolysis test and HE staining showed that the nanoparticles had good biocompatibility. Results of MTT assay showed that the inhibitory effect of API@SF nanoparticles on 4T1 cells was significantly higher than that of API raw materials （P＜0.05），and its mechanism may be related to increasing the level of reactive oxygen species in cells. CONCLUSIONS API@SF nanoparticles are prepared successfully ，which possess good safety and anti-tumor activity.

Objective:To review and summarize the main problems that have occurred in the history of manned spaceflight worldwide and the experience of the medical rescue support for astronauts at the main landing site since the first manned spaceflight mission of the Shenzhou-5 in China in 2003, focus on the technical status and return characteristics during the construction of the space station since the Shenzhou-12, and formulate a targeted injury treatment plan to ensure the safety of astronauts.Methods:This article summarized the lessons of accidental injuries of astronauts in foreign aerospace history, especially in the space station stage, combined with the experience of medical support of astronauts in manned spaceflight in China, and put forward a series of organizations, plans and treatments according to the mission characteristics of long-term orbits and adjustments of the main landing sites of space station mission spacecraft.Results:On the basis of the original pre-cabin emergency and helicopter ICU comprehensive rescue platform, the emergency procedures were further optimized, and the treatment plans under different complex terrains and the principles of rapid treatment and evacuation of astronauts were formulated.Conclusions:The effective treatment of astronauts returning from the space station in various situations could be ensured by the comprehensive rescue plan for the medical rescue of the space station mission and the construction and organization of the helicopter rescue platform.

Objective:This study aims to analyze the characteristics and basic principles of emergency surgery risks and anesthesia care of medical support at the landing site for China’s taikonauts of the Shenzhou-12, and to summarize China’s experience in medical support at the landing site for manned spaceflight, and ensure supports in special environments such as an emergency return of manned spaceflight.Methods:This study was carried out through literature research on relevant reports on the emergency surgery risks and aids of domestic and foreign astronauts at the landing sites, and summaries of the experience in medical support for taikonauts of spacecrafts from Shenzhou-5 to Shenzhou-11 at the landing sites. At the same time, according to the characteristics of Shenzhou-12 such as the long on-orbit time, the adjustment in the landing area, the optimization of the mission mode, and new search and rescue power, a series of organization, pre-arranged planning, equipment allocation, and effective anesthesia treatment plan were proposed and inspected in practice.Results:Based on the original anesthesia care plan of medical support, the first-aid carrier was adjusted and modified, the first-aid procedure was optimized, a new generation of supraglottic airway opening tool, video laryngoscope, portable ultrasound, and other devices were added, and the anesthesia care plan at the landing site for manned spaceflight was formulated to provide strong support for the medical care of taikonauts that had stayed in the outer space for a long time.Conclusions:Upon the targeted improvement and process optimization, the anesthesia care plan of medical support for taikonauts of Shenzhen-12 in the landing area fully meets the anesthesia requirement of medical support in special environments such as the emergency return of the taikonauts that have stayed in the outer space for a long time under the new orbital altitude.

Objective:Summarize the experience of the medical rescue team at the main landing site of China's manned space mission, analyze the new characteristics of the Shenzhou 12 space station mission, and take corresponding countermeasures and measures to ensure the strong medical rescue guarantee for astronauts.Methods:Search the publications about astronaut medical aid domestic and abroad, summarize the rescue and medical aid experiences from Shenzhou 5 to Shenzhou 11. In consideration of prolonged on-orbit time, Location adjustment of the landing site and the new characteristics of the complex terrain, new targeted strategies were presented.Results:The astronauts flew in orbit for 90 days, and the main landing site and launch site are in the same area. The medical security includes three parts: launch section, running section and return section. Desert rescue model were added. Ten injuries were simulated and each injury first-aid procedure was standardized.Conclusion:After targeted improvement and optimization, the Shenzhou 12 astronauts medical rescue support program ensures the safety of the whole process, all-weather and all-terrain emergency and rear delivery of the astronauts in the new mission environment and complex terrain.