Objective     To explore the efficacy of prone positioning ventilation in patients with acute respiratory distress syndrome (ARDS) after acute Stanford type A aortic dissection (STAAD) surgery. Methods     From November 2019 to September 2021, patients with ARDS who was placed prone position after STAAD surgery in the Xiamen Cardiovascular Hospital of Xiamen University were collected. Data such as the changes of blood gas, respiratory mechanics and hemodynamic indexes before and after prone positioning, complications and prognosis were collected for statistical analysis. Results    A total of 264 STAAD patients had surgical treatment, of whom 40 patients with postoperative ARDS were placed prone position. There were 37 males and 3 females with an average age of 49.88±11.46 years. The oxygen partial pressure, oxygenation index and peripheral blood oxygen saturation 4 hours and 12 hours after the prone positioning, and 2 hours and 6 hours after the end of the prone positioning were significantly improved compared with those before prone positioning ventilation (P<0.05). The oxygenation index 2 hours after the end of prone positioning which was less than 131.42 mm Hg, indicated that the patient might need ventilation two or more times of prone position. Conclusion     Prone position ventilation for patients with moderate to severe ARDS after STAAD surgery is a safe and effective way to improve the oxygenation.

N6-methyladenosine(m6A)is produced by methylation of the 6th nitrogen atom of ade-nine.The m6A methylation modification is the most common internal modification of RNA,and the modifica-tion process mainly relies on m6A-related enzymes,including methyltransferases,demethylases and binding proteins.The core structure of the methyltransferase complex(MTC)is methyltransferase-like 3(METTL3).The pathogenesis of osteoarthritis(OA)is intricate and complex,and various factors interact with each other.This paper summarizes the mechanism of action of m6A and related enzymes,and elaborates the pathogenesis of os-teoarthritis from the aspects of chondrocytes,proteases,cytokines and signaling pathways,emphatically intro-duces the regulatory role of METTL3 on OA in m6A methylated modification.The aim is to provide new per-spectives on the pathogenesis of osteoarthritis in order to provide new ideas and approaches for the treatment of osteoarthritis.

Clustered regular interspaced short palindromic repeats (CRISPR) system has been widely used in recent years. Compared with traditional genome editing technology, CRISPR/Cas system has notable advantages, including high editing efficiency, high specificity, low cost and the convenience for manipulation. Type Ⅱ and Ⅴ CRISPR/Cas system only requires a single Cas9 protein or a single Cpf1 protein as effector nucleases for cutting double-stranded DNA, developed as genome editing tools. At present, CRISPR/Cas9 technology has been successfully applied to the genome editing of eukaryotes such as zebrafish, mice and human cells, whereas limited progress has been made in the genome editing of bacteria. In our review, we describe CRISPR/Cas system, its mechanism and summarize the optimization and progress of genome editing in bacteria.
Animals ; Bacteria ; CRISPR-Cas Systems ; Endonucleases ; Gene Editing ; Humans ; Mice

In this study, the necessity of professional master's degree training in clinical pharmacy was analyzed by means of literature research and practice summary, and the existing problems in current professional curriculum, tutor team and practice teaching were discussed. In view of the existing problems, this paper puts forward that medical colleges and universities should give full play to their medical resources, draw lessons from the talents training experience of clinical pharmacists training base, adopt measures such as optimizing curriculum system, selecting tutors, attaching importance to practical teaching, so as to improve the quality of postgraduate training in clinical pharmacy, train high-level clinical pharmacists, and promote the development of clinical pharmacy in China.

OBJECTIVETo assess the value of droplet digital PCR (ddPCR) for non-invasive prenatal diagnosis of single gene disease in two families.

METHODSPaternal mutation in cell-free DNA derived from the maternal blood and amniotic fluid DNA was detected by ddPCR. Suspected mutation in the amniotic fluid DNA was verified with Sanger sequencing.

RESULTSThe result of ddPCR and Sanger sequencing indicated that the fetuses have carried pathogenic mutations from the paternal side in both families.

CONCLUSIONDroplet digital PCR can accurately detect paternal mutation carried by the fetus, and it is sensitive and reliable for analyzing trace samples. This method may be applied for the diagnosis of single gene diseases caused by paternal mutation using peripheral blood sample derived from the mother.

Fathers ; Female ; Genetic Diseases, Inborn ; diagnosis ; Humans ; Male ; Maternal Serum Screening Tests ; Mutation ; Polymerase Chain Reaction ; methods ; Prenatal Diagnosis ; methods ; Sequence Analysis, DNA

OBJECTIVETo detect mutation of GLI3 gene in a family affected with autosomal dominant synpolydactyly.

METHODSGenomic DNA was extracted from peripheral blood samples from members of the family and 100 unrelated healthy controls. Potential mutation was screened by next-generation sequencing and confirmed by Sanger sequencing.

RESULTSA heterozygous frameshift mutation c.480dupC was identified in the GLI3 gene among all patients from the family. The same mutation was not found in unaffected family members and the 100 healthy controls.

CONCLUSIONThe c.480dupC of the GLI3 gene probably underlies the synpolydactyly in this family.

Adolescent ; Adult ; Amino Acid Sequence ; Female ; Humans ; Male ; Middle Aged ; Mutation ; genetics ; Nerve Tissue Proteins ; genetics ; Pedigree ; Syndactyly ; genetics ; Zinc Finger Protein Gli3 ; genetics

Objective To discuss the influence of gestational hypothyroxinemia to the pregnancy outcomes and fetus development,and find the evidence of hormone replacement therapy.Methods The clinical data of 1141 gravida admitted from Nov.2014 to Oct.2015 were retrospectively analyzed,including the data of systematic antenatal examination,all the data of pregnancy,the materials of delivery,the last ultrasound examination,production status and the thyroid stimulating hormone (TSH) of the newborn etc.,to find the difference of related index.Results Of the 1141 gravida with integral data,200 had past history of thyroid disease,189 showed below normal of free thyroxine (FT4) and 752 were normal ones.The 189 gravida with normal TSH but lower FT4 were divided into group A (0-5％ lower than the normal FT4 value,n=60),group B (5％-10％ lower than the normal FT4 value,n=40) and group C (10％ and above lower than the normal FT4 value,n=89).The ones with both normal TSH and FT4 value served as control group.Compared to the control group,the higher premature delivery rate,incidence of gestational diabetes mellitus and cesarean delivery rate (P＜0.05) were found in group C,and more gravida in group B had a history of hypertension and dyslipidemia during pregnancy (P＜0.05).The cesarean delivery rate of group B and C were higher than group A.Meanwhile,the rate of group B was higher than control group (P＞0.05).At delivery,the maternal weight,BMI,diastolic pressure,and head circumference of fetus in the last ultrasound examination were higher in group C than in control group (P＜0.01),but the gestational weeks of the newborn were shorter in group C (38.55 ± 1.86 weeks) than in control group (39.14 ± 1.57 weeks,P＜0.01).The 189 gravida with lower FT4 were divided into two groups according to the thyroid peroxidase antibody (TPOAb) level.The head circumference of fetus in the last ultrasound examination was higher in TPOAb(+) group than in TPOAb(-) group (45.99 ± 62.36cm vs.33.23 ± 2.08cm,P＜0.01).Conclusions The influence of gestational hypothyroxinemia to pregnancy outcomes and fetus development cannot be ignored,especially for the pregnant women with lower FT4 value (10％ and above lower than the normal) or with positive TPOAb.It is suggested to take the thyroid function test in the early stage of pregnancy for those pregnant women mentioned above.

To investigate the relationship of the variation of virulence and the external capsid proteins of the pandemic duck hepatitis A virus type 1(DHAV-1) isolates,the virulence,cross neutralization assays and the complete sequence of the virion protein 1(VP1) gene of nine virulent DHAV-1 strains,which were isolated from infected ducklings with clinical symptoms in Shandong province of China in 2007-2008,were tested.The fifth generation duck embryo allantoic liquids of the 9 isolates were tested on 12-day-old duck embryos and on 7-day-old ducklings for the median embryonal lethal doses(ELD50s) and the median lethal doses(LD50s),respectively.The results showed that the ELD5s of embryonic duck eggs of the 9 DHAV-1 isolates were between 1.9 × 106/mL to 1.44 × 107/mL,while the LD50s were 2.39 × 105/mL to 6.15 × 106/mL.Cross-neutralization tests revealed that the 9 DHAV-1 isolates were completely neutralized by the standard serum and the hyperimmune sera against the 9 DHAV-1 isolates,respectively.Compared with other virulent,moderate virulent,attenuated vaccine and mild strains,the VP1 genes of the 9 strains shared 89.8％-99.7％ similarity at the nucleotide level and 92.4％-99.6％ at amino acid level with other DHAV-1 strains.There were three hypervariable regions at the C-terminus(as 158-160,180-193 and 205-219) and other variable points in VPI protein,but which didn't cause virulence of DHAV-1 change.

Under the guidance of the principle of combining practice with employment,we make the exploration to enhance the quality of graduation practice in pharmaceutical education by establishing the corresponding system as the basis,mobilizing students to practice actively as the gurantee,and keeping effective management of papers as the strategy means.

OBJECTIVE:To study the development of community pharmaceutical care.METHODS:The significance of community pharmaceutical care was elaborated based on its status quo analysis,and the way to improve the pharmaceutical care was discussed theoretically.RESULTS&CONCLUSIONS:Patient-centered community pharmaceutical care is the primary responsibility of community pharmacists,the community pharmacists should strengthen their study,update their knowledge structure and play an important role in community pharmaceutical care.