Episodic memory, our ability to recall past experiences, is supported by structures in the medial temporal lobe (MTL) particularly the hippocampus, and its interactions with fronto-parietal brain regions. Understanding how these brain regions coordinate to encode, consolidate, and retrieve episodic memories remains a fundamental question in cognitive neuroscience. Non-invasive brain stimulation (NIBS) methods, especially transcranial magnetic stimulation (TMS), have advanced episodic memory research beyond traditional lesion studies and neuroimaging by enabling causal investigations through targeted magnetic stimulation to specific brain regions. This review begins by delineating the evolving understanding of episodic memory from both psychological and neurobiological perspectives and discusses the brain networks supporting episodic memory processes. Then, we review studies that employed TMS to modulate episodic memory, with the aim of identifying potential cortical regions that could be used as stimulation sites to modulate episodic memory networks. We conclude with the implications and prospects of using NIBS to understand episodic memory mechanisms.
Humans ; Memory, Episodic ; Transcranial Magnetic Stimulation/methods* ; Brain/physiology* ; Nerve Net/physiology* ; Mental Recall/physiology* ; Neural Pathways/physiology*

The author analyzed the characteristics of phase Ⅰ clinical trials of macromolecular drugs,the characteristics of evaluation indicators of phase Ⅰ clinical trials of macromolecular drugs,such as safety evaluation,pharmacokinetic and pharmacodynamic evaluation,and efficacy evaluation.And the control points of subjects management,management of experimental macromolecule drugs,and identified and potential risk factors of macromolecule drugs in the implementation of risk management for phase Ⅰ clinical trials of macromolecule drugs were discussed in depth based on previous clinical trial research experience.Through discussion and analysis,the author suggests that each research center can formulate risk control strategies according to the actual situation,improve the efficiency of risk control,and facilitate the smooth implementation of clinical trials and improve the quality of clinical trials.

Lipopolysaccharides (LPS) are major outer membrane components of Gram-negative bacteria. Unlike most Gram-negative bacteria, Acinetobacter baumannii can still survive and acquire polymyxin resistance after complete loss of LPS. Previous studies of LPS-deficient Acinetobacter baumannii mostly focused on LPS-deficient strains induced by polymyxin, whose background was complex and unstable. To investigate LPS loss-mediated polymyxin resistant-Acinetobacter baumannii, this study constructed a stable and clear background LPS-deficient strain by knocking out lpxC gene in Acinetobacter baumannii ATCC 19606 with CIRSPR/Cas9, and then studied the phenotypic changes of the lpxC-deficient strain including morphology, growth rate, antibiotic susceptibility, virulence, membrane permeability, and membrane potential. Animal experiments were approved by the Animal Care and Welfare Committee Institute of Medicinal Biotechnology, CAMS and PUMC (approval number: IMB-20240119D₉). The results indicated that the lpxC gene of Acinetobacter baumannii ATCC 19606 was successfully knocked out. After losing the lpxC, the strain underwent the morphological change from rod-shaped to spherical. Furthermore, it leads to reduced growth rate, enhanced membrane permeability, decreased membrane potential, lower virulence, and increased antibiotic susceptibility to β-lactams, quinolones, aminoglycosides, macrolides, glycopeptides. The lpxC deletion results in significant changes in membrane homeostasis and adaptability of Acinetobacter baumannii. Understanding the phenotypic changes of colistin-resistant Acinetobacter baumannii mediated by LPS loss is useful for exploring the resistance mechanism of Acinetobacter baumannii and developing new therapeutic strategies.

Objective To analyze the incidence and risk factors of hypothermia in elderly patients with malnutrition during proximal femoral nail antirotation(PFNA)internal fixation under general anesthesia.Methods A total of 139 elderly patients underwent PFNA internal fixation under general anesthesia were selected,and the nutritional status scores 1 day before surgery ranged from 0 to 11 points.Univariate and multivariate Logistic binary regression analysis was performed to analyze the related factors that may lead to intraoperative hypothermia.Results Among 139 elderly patients with preoperative nutritional scores of 0 to 11 points,79 cases(56.83%)developed intraoperative hypothermia.The results of univariate and multivariate Logistic binary regression analysis suggested that age≥75 years old,mini nutritional assessment short form(MNA-SF)nutritional score 0 to 7 points,BMI<18.5 kg/m2,duration of general anesthesia≥2 hours,intraoperative flushing fluid volume≥1 000 mL and intraoperative fluid volume≥1 000 mL were the risk factors for the occurrence of intraoperative hypothermia in elderly patients(OR>1,P<0.05).The use of warm blanket insulation was the protective factor against the occurrence of intraoperative hypothermia(OR<1,P<0.05).Conclusion The incidence of intraoperative hypothermia during PFNA internal fixation under general anesthesia in elderly patients with mainutrition before operation is high,and patients with poor nutritional status are more likely to develop intraoperative hypothermia.Patients with older age,poor nutritional status,lower BMI,longer duration of general anesthesia,and more intraoperative flushing fluid volume and intraoperative fluid volume are likely to lead to intraoperative hypothermia.The use of warm blanket can reduce the incidence of intraoperative hypothermia.

OBJECTIVE: To proceed the clinical evaluation of DNA microarray for thalassemia gene detection. METHODS: Peripheral blood samples of 166 thalassemia gene test subjects were collected and tested for thalassemia genes by microarray chip method and Gap-PCR method combined with PCR-reverse dot blot hybridization method according to double-blind control test. The specificity, sensitivity, positive predictive value, negative predictive value, and total coincidence rate of the microarray chip method were evaluated. When the two methods were inconsistent, multiplex ligation dependent probe amplification (MLPA) was used to verify the deletional α-thalassemia. RESULTS: Compared with Gap-PCR method, specificity, sensitivity, positive predictive value, negative predictive value, Youden index, and total coincidence rate of microarray chip method was 100% (70/70), 96.88% (93/96), 100% (93/93), 95.89% (70/73), 0.969, and 97.59% (162/166), respectively, while compared with PCR-reverse dot blot hybridization method was 100% (125/125), 100% (41/41), 100% (41/41), 100% (125/125), 1, and 100% (166/166), respectively. CONCLUSION The microarray chip method for α-thalassemia gene detection shows the advantages of high specificity, sensitivity, and throughput.
Genetic Testing ; Humans ; Multiplex Polymerase Chain Reaction ; Oligonucleotide Array Sequence Analysis ; alpha-Thalassemia/genetics*

OBJECTIVE: To perform dried blood spots thalassemia gene detection in patients with positive blood phenotypes by microarray technology, and evaluate its value in clinical detection. METHODS: DNA samples were extracted from dried blood spots of 410 patients. Microarray technology was used to detect 3 deletion and 3 non-deletion types of α-thalassemia and 19 β-thalassemia point mutations which were common gene mutions in China. RESULTS: There were 357 positive cases in all the 410 tested samples with the positive rate 87.07%, among which 299 cases (72.93%) carried deletion or point mutations of α-thalassemia, 29 cases (7.07%) carried point mutations of β-thalassemia and 29 cases (7.07%) carried gene mutations of complex αβ-thalassemia syndrome. The mutations of α-thalassemia were involved with -- CONCLUSION The most common genetic mutations are --
China ; Humans ; Mutation ; Oligonucleotide Array Sequence Analysis ; alpha-Thalassemia/genetics* ; beta-Thalassemia/genetics*

OBJECTIVE: To investigate the distribution of Chinese medicine (CM) syndrome in patients with acute myocardial infarction (AMI) on admission and its impact on prognosis. METHODS: A total of 525 AMI patients were prospectively recruited and classifified into 4 groups based on their clinical characteristics: excess-heat, excess-cold, deficiency-heat and deficiency-cold syndromes. Major adverse cardiovascular events (MACEs) were followed up. RESULTS: The excess syndrome was more common than deficiency syndrome (72.95% vs. 27.05%; P<0.05). Totally 495 (94.29%) of 525 AMI patients were followed up (median 277 days). There were 59 (11.92%) MACEs. After adjusted with confounding factors in Cox regression models, the hazard ratio (95% confifidence interval) of excess-heat, excess-cold, defificiency-heat and defificiency-cold syndrome groups were 1, 1.25 (0.63, 2.49; P<0.05), 2.37 (1.14, 4.94; P<0.05), 3.76 (1.71, 8.28; P<0.05), respectively. CONCLUSIONS Excess syndrome was more common in AMI patients and had better prognosis, while defificiency-cold syndrome had the poorest prognosis. CM syndrome was of value in predicting long-term outcomes in AMI patients.

Objective To assess the effectiveness of infectious source control at various stages of transmission control of schistosomiasis in Eryuan County of Yunnan Province, so as to provide insights into the further monitoring and management of infectious sources of schistosomiasis. Methods Wenbi Village, a plateau subtype region and Qiandian Village, a mountain subtype region in Eryuan County were selected as the study areas. The species, schistosome infection and transmission capability of infectious sources were investigated in Wenbi and Qiandian villages in 2011 and 2018 and were compared. Results Schistosome infections were detected in human, bovine, horse, dog and mouse in Qiandian Village in 2011, with positive rates of 1.19%, 0.91%, 1.25%, 3.13% and 0.95%, respectively, and human, bovine and dog were found to have schistosome infections, with positive rates of 0.76%, 1.66% and 9.30%, respectively. However, no infections were identified in human, bovine, horse, pig, dog, sheep or mouse in these two villages in 2018. A total of 731 wild feces were collected in both villages in 2011. In Qiandian Village, horse, bovine and dog feces accounted for 34.40%, 29.80% and 20.20% of all fecal samples, and dog and horse feces were found to have schistosome infections (11.94% and 6.90% positive rates, respectively). In Wenbi Village, dog, bovine and human feces accounted for 44.59%, 39.83% and 14.29% of all fecal samples, and dog, human and bovine feces were found to have schistosome infections (16.95%, 9.52% and 2.33% positive rates, respectively). In 2018, a total of 204 wild feces were collected in both villages, and no schistosome infections were identified. Sheep, dog and bovine feces accounted for 36.27%, 33.33% and 27.45% of all fecal samples in Qiandian Village, and dog, bovine and human feces accounted for 72.55%, 11.76% and 10.78% of all fecal samples in Wenbi Village. Conclusions A remarkable achievement has been obtained in the control of infectious sources of schistosomiasis in Eryuan County, and the role of human and bovine as the major infectious sources of schistosomiasis has been effectively controlled. In the future, the integrated strategy with emphasis on the control of infectious sources should be intensified, and the management of reservoir hosts including dog and mouse should be strengthened.

Objective To observed the clinical efficacy and safety of high pressure-resistant double-lumen peripherally inserted central catheter (Power PICC) and central venous catheter (CVC) in patients with stem cell transplantation.Methods This was a matched cross-sectional study with 60 patients with leukemia who were treated with catheterization of central venous (30 cases receiving Power PICC vs.30 cases receiving CVC) during stem cell transplantation in the First Affiliated Hospital of Chinese PLA General Hospital.Indwelling time,success rate of catheterization,complications,velocity and stem cell engraftment time were recorded and compared between the Power PICC group and CVC group.Results There were significant differences between the two groups on indwelling time [(18.47±4.44) min vs.(14.43± 1.72) min,t =3.719,P＜0.001],complications [6.67％ (2/30) vs.30％ (9/30),x2 =48.445,P=0.002] and velocity.However,no significant difference was found in success rate of catheterization and stem cell engraftment time (P＞0.05).Conclusion Power PICC performed better than CVC with well tolerability and satisfactory efficacy,which is worthy of promotion and application in the future.

OBJECTIVETo observe the clinical effects of closed reduction and percutaneous double K-wires internal fixation in treating multisegmental fracture of humeral shaft.

METHODSFrom January 2009 to April 2015, 27 patients with multisegmental fracture of humeral shaft were treated with closed reduction and percutaneous double K-wires internal fixation, including 10 males and 17 females, ranging in age from 26 to 81 years with an average of 52 years;the disease course ranged from 2 hours to 6 days with an average of 1.5 days. Operative time, intraoperative blood loss, hospital stay, fracture healed time, complications were observed and recovery of shoulder joint function was evaluated by Constant-Murley shoulder score.

RESULTSAll the patients were followed up from 12 to 24 weeks with an average of 16 weeks. Operative time was 20 to 40 min with an average of 28 min; intraoperative blood loss was 5 to 25 ml with an average of 10 ml;hospital stay was 3 to 5 days with an average of 3.5 days. All fractures got bone healing and healed time was 12 to 22 weeks with average of 14 weeks. Postoperatively 1 case complicated with wire tail bulging and local irritation symptoms, and the symptoms disappeared when the wire was removed out after the fracture healing; 1 case complicated with local infection after wire tail disengaging, and recovered through anti-septic treatment. According to the Constant-Murley standard of shoulder joint function, 10 cases got excellent results, 15 good, 2 fair, with scores of 89.1±2.7.

CONCLUSIONSClosed reduction and percutaneous double K-wires fixation for the treatment of multisegmental fractures of humeral shaft have advantages of simpler manipulating, less bleeding, less invasive, less complications, and shoulder and elbow joint can obtain good recovery. But closed reduction and percutaneous double K-wires internal fixation cannot be effective against rotation and provide axial stability, the immoblization with a sling or other auxiliary methods should be applied.