Objective To construct and validate a clinical prediction model for delayed extubation undergoing non-emergency major surgery based on the random forest algorithm.Methods Clinical data of 7 528 patients undergoing non-emergency major surgery under general anesthesia from January 2018 to De-cember 2022 were retrospectively collected.The patients were divided into two groups according to whether extubation was performed within 2 hours after surgery:non-delayed extubation group(≤2 hours)and de-layed extubation group(＞2 hours).All the patients were randomly divided into a training set and a valida-tion set in a ratio of 7 ∶ 3.The predictive factors for delayed extubation after surgery were screened through LASSO regression and Logistic regression.The random forest model was established and verified by random forest algorithm.Results There were 123 patients(1.6%)experienced delayed extubation after surgery.ASA physical status,department,intraoperative use of flurbiprofen ester,dexmedetomidine,glucocorticoid,hypocalcemia,severe anemia,intraoperative blood transfusion,and airway spasm were identified as inde-pendent predictive factors for delayed extubation.The area under curve(AUC)value of the random forest prediction model in the validation set was0.751(95%CI0.742-0.778),and the sensitivity was98.1%,and the specificity was 41.9%.Conclusion The predictive model of delayed extubation undergoing non-e-mergency major surgery based on random forest algorithm has a good predictive value,which may be helpful to prevent delayed extubation undergoing non-emergency major surgery.

Objective:To explore the relationship of anxiety,perceived stress and forbearance in the college students.Methods:Totally 3 056 college students(1 102 males and 1 954 females)in Guangdong Province were re-cruited and assessed with the Generalized Anxiety Disorder 7-item Scale(GAD-7 score of ≥10 indicates positive anxiety symptoms),Perceived Stress Scale(PSS-10),and Forbearance Scale(FS).SPSS Process model 2 was used to test the moderating effect of different types of forbearance.Results:Totally 486(15.9％)college students had anxiety.The PSS-10 scores were positively correlated with the GAD-7 scores(β=0.63),and FS scores of repres-sive forbearance and active forbearance played a moderating role between the PSS-10 scores and the GAD-7 scores respectively(β=0.05,-0.04).Conclusion:It suggests that anxiety and perceived stress are correlated with for-bearance in college students,and repressive forbearance and active forbearance may moderate the relationship be-tween perceived stress and anxiety.

bstract: Objective To elucidate the distribution characteristics of mosquito species and the population genetic diversity of important mosquito species in the Wuyi Mountain Nature Reserve, with the aim of providing a scientific basis for the prevention and control of mosquito-borne diseases in the region. Methods Within Wuyi Mountain Nature Reserve 2022- 2023, 16 sampling sites were selected, where larvae were collected using the pipette method and adult mosquitoes were collected using the mosquito trap lamp method. Mosquito species identification was accomplished by integrating morphological characteristics and molecular identification techniques based on CO Ⅰ and CO Ⅱ gene sequences. Software tools such as ClustalX, DnaSP v5.0, and Network v4.6.1.0 were utilized to analyze the genetic differentiation (Fst), gene flow (Nm) among populations of Aedes japonicus, Aedes albopictus and Armigeres subalbatus. Results The mosquito specimens collected from the Wuyi Mountain Nature Reserve were identified as 30 species belonging to 8 genera within the Culicidae family. Among them, there were 10 species of Aedes, 13 species of Culex, 1 species each of Armigeres, Orthopodomyia, Uranotaenia, Tripyeroides, and Anopheles, and 2 species of Toxorhynchites. Analysis of the genetic structure of important mosquito populations showed that the haplotype diversity index (Hd) of Ae. japonicus was 0.994 7, with a generally moderate degree of differentiation between populations and a higher degree of genetic differentiation between populations 6 and 12; Aedeslbopictus had a haplotype diversity index of 0.634 0, with significant genetic differentiation between populations 1 and 2 compared to other groups; Armigeres subalbatus had a haplotype diversity index of 0.703 3, with substantial genetic differentiation and limited gene flow between population 2 and populations 3, 4, 6, and 7. Conclusions The mosquito species are rich in Wuyi Mountain Nature Reserve. A comprehensive survey of the composition and distribution of mosquito populations was carried out, and the characteristics of the population genetic structure of the important species of Ae. japonicus, Ae. Albopictus, and Ar. subalbatus populations were analyzed, providing valuable scientific data reference for local mosquito-borne ecological research and disease prevention and control.

ObjectiveTo study the intervention effect of Bixie Fenqingwan on hyperuricemia （HUA） rats by regulating urate transporters. MethodSixty healthy rats were randomly divided into normal， model， allopurinol （0.03 g·kg^-1）， and Bixie Fenqingwan low-， medium- and high-dose （0.8， 1.6， 3.2 g·kg^-1） groups， 10 in each group. Except the normal group， the other rats were given potassium oxonate 1.5 g·kg^-1 and adenine 0.1 g·kg^-1 for 28 consecutive days to establish the HUA rat model， and rats with increased serum uric acid （SUA） were considered successfully modeled. After modeling， corresponding drugs were given to the groups， once per day. Urine and blood was collected after 24 h of the final administration. The levels of urine uric acid （UUA）， SUA， blood urea nitrogen （BUN） and serum creatinine （SCr） were measured by enzymatic colorimetry. The rat kidneys were taken and weighed to calculate the kidney index. The pathological changes of kidney tissue were observed by haematoxylin-eosin （HE） staining. The protein and mRNA expressions of urate transporter 1 （URAT1）， glucose transporter 9 （GLUT9）， adenosine triphosphate-binding cassette transporter protein G2 （ABCG2）， organic anion transporter 1 （OAT1） and organic anion 3 transporter （OAT3） in kidney tissue were detected by immunohistochemistry and real-time quantitative polymerase chain reaction （Real-time PCR）， respectively. ResultCompared with the conditions in the normal group， the kidney index， levels of SUA， BUN and SCr， and protein and mRNA expressions of URAT1 and GLUT9 in kidney tissue were increased （P<0.05）， while the UUA level and protein and mRNA expressions of OAT1， OAT3 and ABCG2 were decreased in the model group （P<0.05）. In addition， there was compensatory dilatation with urate crystals and protein casts in renal tubules in the model group. Compared with the model group， the intervention groups had lowered kidney index （P<0.05）， reduced levels of SUA， BUN and SCr （P<0.05）， down-regulated protein and mRNA expressions of URAT1 and GLUT9 （P<0.05）， elevated UUA level （P<0.05） and up-regulated protein and mRNA expressions of OAT1， OAT3 and ABCG2 （P<0.05）， and the kidney tissue lesions were alleviated （P<0.05）. ConclusionBixie Fenqingwan has intervention effect on HUA， and its mechanism may be related to regulating urate transporters.

Objective:To study the genetic profiles and clinical characteristics of neonatal-onset genetic epilepsy.Methods:From July 2016 to May 2021, patients with neonatal-onset genetic epilepsy admitted to our hospital and received second-generation genetic sequencing were enrolled in this study. According to the types of genetic variations, the patients were assigned into ion channel group and non-ion channel group. Clinical characteristics, treatments and prognosis of the two groups were compared.Results:A total of 36 patients with identified genetic variations were enrolled, involving 15 epilepsy-related genes. KCNQ2, SCN2A and STXBP1 were the most common pathogenic genes. 20 cases (55.6%) were in the ion channel group and 16 cases (44.4%) in the non-ion channel group. No significant differences existed in their general status, seizure types, EEG characteristics, treatments and outcomes between the two groups ( P>0.05). Among all 36 cases, the age of onset ranged from 10 min to 24 d after birth and 28 cases (78.8%) developed epilepsy within 1 week after birth. Developmental and epileptic encephalopathies were diagnosed in 20 patients. 7 patients were diagnosed with self-limited neonatal epilepsy, 2 were pyridoxine dependence, 2 were Zellweger syndrome and 1 case of self-limited familial neonatal-infantile epilepsy, Turner type mental retardation with epilepsy, PURA syndrome, Rett syndrome and 22q11.2 deletion syndrome, each. The patients received antiepileptic drugs including phenobarbital, levetiracetam, oxcarbazepine, topiramate, valproic acid, benzodiazepines (nizepam/clonazepam /clobazam/midazolam), lacosamide and lamotrigine. 5 patients died after giving up treatment. 31 patients were followed up for 6 to 50 months. 22 cases (71.0%) were controlled at 1- to 35-month-old including 21 cases (56.7%) with developmental delay. 6 cases (19.4%) had ineffective seizure control and 3 cases (9.7%) showed reduced seizures, all with varying degrees of developmental delay. Conclusions:Neonatal-onset epilepsy is correlated with multiple genes. KCNQ2, SCN2A, STXBP1 are the common pathogenic genes with multiple variants of KCNQ2 gene. Most patients have seizures within 1 week after birth. More than half of patients have ion channel related gene variations. Sodium channel blockers have certain effects as treatment.

OBJECTIVE: To evaluate the psychometric properties and applicability of the 6-item University of California Los Angeles (UCLA) Loneliness Scale (ULS-6) in adults. METHODS: We conducted 2 surveys to assess the validity of different measurement scales and questionnaires. In Survey 1, a total of 1480 adults were measured using the UCLA Loneliness Scale (ULS), Patient Health Questionnaire-9 (PHQ-9) and Perceived Social Support Scale (PSSS), and the data were used for item analysis and assessment of the reliability, validity and measurement invariance. In Survey 2, UCLA Loneliness Scale was used for measurement in 652 college students, and the data were used for analysis of the criterion validity of ULS-6; 3 weeks later, 300 of the students were retested using ULS-6 to assess the retest reliability of the scale. RESULTS: Item analysis suggested that the items in ULS-6 all had good discrimination power with discrimination indexes all above 0.775 (r=0.775-0.820, P < 0.001). Measuring only one dimension, ULS-6 had an internal consistency reliability of 0.891, a split-half reliability of 0.875, and a retest reliability of 0.726. The correlation coefficients of ULS-6 with ULS, ULS-8, PHQ-9 and PSSS were 0.882, 0.967, 0.528 and -0.532, respectively. The measurement invariances of ULS-6 across genders and age groups were all acceptable. Among the adult participants, the mean total score of ULS-6 was 12.97 ± 3.96; While only 20% of the adults had no loneliness, 80% of them exhibited varying degrees of loneliness, ranging from mild (39.6%) and moderate (25.7%) to intense (14.7%) feelings of loneliness. CONCLUSION The ULS-6 has good reliability, validity and applicability for measurement of loneliness in Chinese adults.
Adult ; Female ; Humans ; Male ; Asian People ; Emotions ; Reproducibility of Results ; Students ; Loneliness

OBJECTIVE To investigate the improvement effects of Jinkui shenqi pills on polycystic ovary syndrome （PCOS） model rats and the mechanism. METHODS Totally 40 rats were given letrozole suspension instragastrically （1 mg/kg， once a day， for consecutive 21 d） to induce PCOS model. Model rats were divided into model group， ethinylestradiol and cyproterone acetate tablets （short for diane-35）+metformin group （diane-35 0.2 mg/kg + metformin 230 mg/kg， as positive control）， Jinkui shenqi pills low-dose， medium-dose and high-dose groups （0.5， 1.0， 2.0 g/kg）， with 10 rats in each group. Other 10 healthy rats were included in normal group. Each group was given the corresponding drugs， once a day， for consecutive 30 d. Twelve hours after the last administration， serum levels of blood glucose， insulin， estrogen （E2）， testosterone （T）， gonadotropin-releasing hormone （GnRH）， follicle-stimulating hormone （FSH） and luteinizing hormone （LH） were measured. The insulin resistance indexes were calculated， and the ovary coefficients of rats were calculated. The pathological changes of ovary were observed. The protein and mRNA expressions of liver kinase B1 （LKB1） and AMP-activated protein kinase （AMPK） in ovary tissue were detected. RESULTS Compared with normal group， the levels of blood glucose， insulin， insulin resistance index， serum levels of T， GnRH and LH and ovarian indexes were significantly increased （P＜0.05）， while serum levels of E2 and FSH as well as protein and mRNA expressions of LKB1 and AMPK in ovary tissue were decreased significantly （P＜0.05）； collagenization of ovarian cortex， increased number of atresia follicles and cystic follicles without cumulus， and follicular cystic lesions could be seen. Compared with model group， most of above indexes of Jinkui shenqi pills groups were reversed significantly （P＜0.05）； the number of follicle at each level was increased and no follicular cystic lesion was found in Jinkui shenqi pills medium-dose and high-dose groups. CONCLUSIONS Jinkui shenqi pills can significantly improve the abnormal level of sex hormones， insulin resistance and 222102310139） ovarian cystic changes， the mechanism of which may be related to up-regulating the activation of LKB1/AMPK signaling pathway.

OBJECTIVE To investigate th e intervention effect of Jinkui shenqi pills on renal fibrosis （RF）model rats and its mechanism based on transforming growth factor β1/Smads（TGF-β1/Smads）and TGF-β1/extracellular signal regulated kinase （ERK） signaling pathway. METHODS Male SD rats were given adenine suspension （250 mg/kg）to induce RF model. After modeling ， they were randomly divided into model group ，Colchicine tablet group （positive control ，0.45 mg/kg）and Jinkui shenqi pills low-dose，medium-dose and high-dose groups （0.5，1，2 g/kg），with 10 rats in each group. Other 10 healthy rats were selected as normal group. The rats in administration groups were given the corresponding drugs intragastrically ；normal group and model group were given 0.1％ sodium carboxymethyl cellulose solution ，once a day ，for consecutive 30 d. After last medication ，the serum levels of creatinine （Cr）and blood urea nitrogen （BUN），renal weight and body weight were detected. The ratio of BUN/Cr and renal coefficient were calculated. The pathological morphology of renal tissue in rats were observed. The protein and mRNA expressions of TGF-β1，Smad2，Smad3，ERK1 and ERK 2 were detected. RESULTS Compared with normal group ，serum levels of Cr and BUN and renal coefficient were all increased significantly in model group （P＜0.05），while the ratio of BUN/Cr was decreased significantly （P＜0.05）. The volume of the kidney was significantly increased ，and the surface was seriously granulated. Mesangial hyperplasia ，dilation or atrophy of renal tubules ，accompanied by large-area collagen deposition，could be found. Protein and mRNA expressions of TGF-β 1，Smad2，Smad3，ERK1 and ERK 2 were increased significantly in renal tissue （P＜0.05）. Compared with model group ，above indexes of Jinkui shenqi pills groups were all reversed significantly （P＜0.05）；dilation or atrophy of renal tubules was relieved ，and collagen deposition was reduced to different extents. CONCLUSIONS Jinkui shenqi pills can improve renal function of RF model rats ，the mechanism of which may be associated with inhibiting TGF-β1/Smads and TGF-β1/ERK signaling pathway.

Fermentation engineering is an industrial process that uses the transformation of microorganisms or other cells to produce a specific product in a specific bioreactor. Fermentation engineering has developed from an ancient food fermentation relying solely on experience accumulation to an important production mode of food, agriculture, medicine, chemical industry and other means of production and life. It has become a key technology to support the sustainable development of human beings, and is inseparable from the continuous progress of interdisciplinary technology. The interdisciplinary integration and the continuous upward movement of China's global industrial chain will inevitably put forward higher requirements for the cultivation of fermentation engineering composite talents in the new situation. In order to constantly improve the interdisciplinary fermentation engineering compound talent training system, in recent years, the research lab has been refining and improving the concept of talent training, and actively deepening the reform of talent training system. Systematic research and practice have been carried out around the aspects of training program, enrollment system, teacher background, subject setting, scientific research practice, evaluation system, etc., which has promoted the technological progress of fermentation engineering and related supporting industries, and contributed an important force to the transformation of China from a big fermentation country to a powerful fermentation country.
Agriculture ; China ; Fermentation ; Humans ; Industry

Objective:To study the clinical features and prognosis of infantile hepatic hemangioendothelioma-arteriovenous fistula (IHHE-AVF) complicated with heart failure in neonates.Method:From May 2016 to June 2020, neonates with IHHE-AVF complicated with heart failure admitted were retrospectively studied. The clinical presentation, treatment and outcomes were analyzed.Result:A total of 11 cases of IHHE-AVF complicated with heart failure were enrolled (male 5, female 6). The onset age of heart failure was 12.0 (0.0, 17.0) d. 6 cases showed IHHE on fetal ultrasound. All patients had significantly enlarged heart on chest X-ray. All patients had decreased left ventricular systolic function and pulmonary hypertension on echocardiography. All patients required respiratory support and 6 of them were intubated. 3 cases received conservative treatment (all dead). 1 case received surgery (dead). 7 cases received interventional therapy at the age of (25.6±18.5) d. 1 case was dead, and the other 6 cases were improved and discharged. All the 6 cases were followed up to 3~18 months. None of them had heart failure again. The IHHE were shrunk or completely disappeared. Coagulation function and platelet count were normal.Conclusion:The fatality rate of neonatal-onset IHHE-AVF complicated with heart failure is extremely high. Interventional therapy may be more effective than conservative therapy and surgery.