The aim of this study was to clarify the genetic diversity and population history of Ixodes persulcatus in some ar-eas of Inner Mongolia in order to provide accurate data for effective vector control programs and reveal the transmission mecha-nism.Samples were collected in 10 areas of Inner Mongolia during the active tick season(April 2021-July 2023)using the flag-dragging and manual sampling methods.The 16S rRNA and COI gene were sequenced to clarify genetic diversity of I.per-sulcatus.The positivity rates for the COI gene and 16S rRNA were 90.00％and 98.33％respectively.Overall,18 and 15 haplotypes were identified for the COI gene and 16S rRNA,respectively,with a total haplotype diversity＞0.762 and total nucleotide diversity＜0.005.The Tajima's values and Fu's Fs were negative for significance.A nucleotide mismatch map was shown as a single peak.The genetic differentiation index FST of the population indicates a small degree of genetic differ-entiation of the population,while analysis of molecular vari-ance indicates that the variation within populations was greater than between populations.Phylogenetic tree and haplotype network plots showed confounding distributions between hap-lotypes.I.persulcatus from the Hinggan League and Hulun-buir regions can adapt to environmental changes and possess abundant genetic diversity.Genetic differentiation is mainly concentrated within the population and no geographical isolation was observed.

This study was aimed at creating an engineered strain of Bacillus subtilis for efficient expression of biologically active type 2 toxin B(TcdB2)derived from a highly virulent strain of Clostridium difficile.The TcdB2 gene was cloned from ST1/RT027 strain genome DNA,incorporated into the PHT01 vector,and then transformed into B.subtilis strain WB800N for prokaryotic expression.Cell toxicity assays revealed that the recombinant TcdB2 exhibited cytotoxic effects in various cells.The engineered B.subtilis strain effectively expressed biologically active TcdB2,thus providing a basis for further exploration of the pathogenic mechanisms of highly virulent strains of C.difficile and establishing a foundation for potential vaccine can-didate targets.

In order to understand the prevalence and genetic variation of H9N2 subtype avian influ-enza virus in Shandong,a total 492 tracheal and lung tissue samples collected from chicken farms with respiratory symptoms in partial areas in Shandong were detected by H9 subtype AIV real-time RT-PCR,and the positive samples were inoculated with chicken embryos for two generations.Whole genome sequences of the positive strains by applying Illumina Miaseq platform,and genetic evolution and mutation at positions associating with viral pathogenicity and transmissibility were analyzed.The results showed that there were 72 samples were positive for H9 subtype AIV among the 492 samples,with a positive rate of 14.63％.Thirty-four strains of H9 subtype AIV were ob-tained from the positive samples after passing through chicken embryo,meanwhile,the 34 isolates were all H9N2 subtype AIV by whole genome sequencing analysis.By analyzing the evolutionary tree of HA and NA genes,HA and NA genes of the 34 H9N2 AIV strains belonged to Y280-like branch and F/98-like branch,respectively.Meanwhile,based on above branches,there were obvious time node subbranch,which one was"isolates before 2013",another one was"isolates after 2013".The HA cleavage sites of thirty-four H9N2 strains were all 325PSRSSR↓GLF333,which met the se-quence characteristics of the lowly pathogenic avian influenza virus,and the HA receptor binding site 226 amino acid was leucine,which had the characteristics of blinding to a-2,6 mammalian sialic acid receptors.Among the internal amino acid sites that are key to mammalian adaptation,all strains had an I368V mutation in the PB1 gene that enhanced viral transmissibility in mammals and the PB2 genes of some strains were mutated to enhance the mammalian adaptation of I292 V and A588 V.The above results illustrated that the H9N2 subtype AIV gene segments in Shandong have different degrees of recombination and gene variation,so it is necessary to strengthen the monito-ring of virus variation.

Objective:To explore the clinical efficacy and safety of flumatinib mesylate produced in China in patients with newly diagnosed chronic myeloid leukemia in chronic phase(CML-CP).Methods:32 newly diagnosed CML-CP patients admitted to the Hematology Department of the Affiliated Hospital of Southwest Medical University from March 1,2020 to March 31,2022,who had never received any tyrosine kinase inhibitor(TKI)were included in the study.The patients were treated by flumatinib mesylate 600mg once daily.The hematologic,cytogenetic and molecular responses were assessed at 3-,6-and 12-month,and adverse effects of the drug were evaluated.Results:31 patients were treated with flumatinib for≥3 months,of which 24 patients were treated for ≥ 6 months and 14 patients were treated for ≥ 12 months.At 3rd month of treatment,30 out of 31 patients achieved complete hematologic response(CHR);24 patients underwent cytogenetic testing and 22 cases achieved major cytogenetic response(MCyR),of which 21 cases achieved complete cytogenetic response(CCyR);Among 25 patients who underwent molecular testing,22 patients had BCR-ABLIS ≤ 10％,including 10 patients with BCR-ABLIS ≤ 0.1％,and 6 patients with BCR-ABLIS≤0.01％.At 6th month of treatment,23 out of 24 patients achieved CHR;17 patients underwent cytogenetic testing and all achieved CCyR;Among 23 patients who underwent molecular testing,20 patients had BCR-ABLIS ≤1％,including 16 patients with BCR-ABL1S≤0.1％and 12 patients with BCR-ABLIS ≤ 0.01％.At 12nd month of treatment,all 14 patients achieved CHR and CCyR;Among them,10 patients had BCR-ABLIS ≤ 0.1％,including 9 patients with BCR-ABLIS ≤ 0.01％.The grade Ⅲ/Ⅳ leukopenia,thrombocytopenia and anemia rates in the patients were 13.3％,20.0％and 3.3％,respectively.One patient stopped flumatinib therapy due to severe and persistent hematologic toxicity.The major non-hematologic adverse events were abnormal liver function(20％),diarrhea(10％),bone/joint pain(10％),muscle spasm(10％),rash(6.7％),acute kidney injury(6.7％)and nausea(3.3％),most of which were grade Ⅰ-Ⅱ.No patient experienced grade Ⅳnon-hematologic adverse events.No drug toxicity-related death occurred.Conclusion:Flumatinib mesglate,as the first-line treatment for newly diagnosed CML-CP,can enable the patients to achieve early and deep molecular and cytogenetic responses,and shows good safety.

Objective To construct an intervention programme for breastfeeding among mothers of infants with congenital heart disease and to verify its effect.Methods Taking the capability-opportunity-motivation-behaviour model as the theoretical basis,the first draft of the intervention programme was formed through literature search and semi-structured interviews,and 8 experts in the relevant fields were selected to conduct expert validation and determine the content of the program.By the consecutive sampling method,infants and their mothers who attended the cardiothoracic disease clinic of a tertiary-level children's specialist hospital in Shanghai from 4 May to 24 June 2023,with a day-old age of≤14 d and a confirmed diagnosis of CHD,were selected as the study subjects.They were divided into an experimental group and a control group,with 16 cases in each group,by the method of randomized grouping by district.The experimental group received breastfeeding intervention for mothers of infants with CHD on the basis of routine care;the control group received routine care and basic disease education and breastfeeding counselling.At 1 and 3 months of the infants with CHD,the 2 groups were compared in terms of exclusive breastfeeding rate,daily human milk as a percentage of total feeds,weight for age Z-score and height for age Z-score.Results A total of 1 round of expert validation was conducted,with a valid questionnaire recovery rate of 100％and an expert authority coefficient of 0.94.The breastfeeding intervention programme for mothers of infants with CHD is a comprehensive approach that encompasses 3 key dimensions,including capability,opportunity,and motivation.The programme is designed to enhance mothers'ability to recognize feeding signals,master breastfeeding techniques,and maintain successful breastfeeding practices.It also addresses common breastfeeding challenges and provides effective solutions.Additionally,it includes strategies for breastmilk management and fosters family support for breastfeeding.The programme offers medical information support on breastfeeding and aims to elevate mothers'understanding of its benefits.It involves systematic monitoring and recording of breastfeeding volumes,as well as thorough assessments and guidance on infant growth and development,including but not limited to the 10 specific entries related to the infant's progress.The results of the generalized estimating equations and repeated measures analysis of variance revealed statistically significant between-group differences(P＜0.05)in the rates of exclusive breastfeeding,the proportion of daily human milk as a percentage of total feeds,and the weight-for-age(WAZ)and height-for-age(HAZ)z-scores of infants across the 2 groups at various time points.The results of simple effect analysis showed that the differences in exclusive breastfeeding rate,the proportion of daily human milk as a percentage of total feeds,WAZ and HAZ between the 2 groups before intervention were not statistically significant(P＞0.05).At the age of 3 months of the infants after the intervention,the rate of exclusive breastfeeding in the experimental group was higher than that in the control group,and the difference was statistically significant(P=0.003).The proportion of daily human milk as a percentage of total feeds for infants in the intervention group at 1 and 3 months of age was higher than that in the control group,with a statistically significant difference(P＜0.05).At 3 months of age,WAZ of the experimental group was higher than that of the control group,and the difference was statistically significant(P=0.037);HAZ of the experimental group was higher than that of the control group at 1 and 3 months of age after intervention,and the difference was statistically significant(P＜0.05).Conclusion The breastfeeding intervention programme for mothers of infants with CHD,constructed on the basis of the COM-B model in this study,was comprehensive,feasible and acceptable.Implementation of the programme has potential positive effects on increasing exclusive breastfeeding rates and the daily human milk as a percentage of total feeds,and may also have a positive impact on WAZ and HAZ of infants.

Objective To construct a prediction model for the long-term prognosis of elderly pa-tients heart failure with preserved ejection fraction(HFpEF)based on two-dimensional speckle tracking technology.Methods A total of 312 elderly HFpEF patients admitted in our hospital from January 2017 to December 2018 were prospectively enrolled,and then randomly divided into a training set(218 cases)and a validation set(94 cases)in a ratio of 7∶3.After 5 years of follow-up,they were divided into a death group(n=128)and a survival group(n=184)according to having experienced cardiovascular death events or not.The main clinical characteristics were com-pared between the two groups,and the risk factors for cardiovascular death events were analyzed.A clinical prediction model was constructed based on the relevant risk factors with R4.0.3 statisti-cal software.Results The age,age ≥80 years,atrial fibrillation,chronic obstructive pulmonary disease(COPD),and early strain rate of global systole(GSRs)in the death group were signifi-cantly higher than those in the survival group,with statistical significances[(76.68±8.73)years vs(70.98±7.74)years,P＜0.01;34.4％vs 20.7％,P＜0.01;25.0％vs 11.4％,P＜0.01;26.6％vs 9.2％,P＜0.01;(-0.84±0.24)/s vs(-1.24±0.31)/s,P＜0.01].Multivariate logistic regression analysis showed that age ≥80 years,atrial fibrillation,COPD and GSRs＞-1.035 1/s were inde-pendent risk factors for cardiovascular death events(RR=2.196,95％CI:1.217-3.962,P=0.009;RR=2.242,95％CI:1.136-4.424,P=0.020;RR=3.631,95％CI:1.787-7.377,P=0.000;RR=6.199,95％CI:3.624-10.602,P=0.000).The AUC value of the training set was 0.822(95％CI:0.765-0.879),and that of the validation set was 0.790(95％CI:0.698-0.882).Conclusion Our constructed nomogram prediction model has high predictive value and reliability in predicting cardiovascular death events.

The advantages of fluorescence detection of uric acid were introduced compared to the traditional detection methods.The preparation process,detection principle and performance of organic,inorganic and organic-inorganic hybrid fluorescent probes were reviewed.The advantages and disadvantages of kinds of fluorescent probes were analyzed when used for uric acid detection,and the futural directions were pointed out for related research.[Chinese Medical Equipment Journal,2024,45(6):93-104]

Objective To investigate the control status of bronchial asthma(referred to as"asthma")in school-age children with normal pulmonary ventilation function and the occurrence of acute attacks within 1 year of follow-up.Methods A retrospective analysis was conducted on clinical data of 327 children aged 6-14 years with bronchial asthma and normal pulmonary ventilation function from April to September 2021.Based on the measured value of one second rate(FEV1/FVC),the children were divided into the ≥80％group(267 cases)and the＜80％group(60 cases).The pulmonary ventilation function,asthma control level,and occurrence of acute attacks within 1 year were compared between the two groups.Results The baseline pulmonary ventilation function in the＜80％group was lower than that in the ≥80％group,and the proportion of small airway dysfunction was higher than that in the ≥80％group(P＜0.05).After standardized treatment for 1 year,the small airway function indices in the＜80％group improved but remained lower than those in the ≥80％group(P＜0.05).The rate of incomplete asthma control at baseline was 34.6％(113/327),and the asthma control level in the＜80％group was lower than that in the ≥80％group(P＜0.05).After standardized treatment for 1 year,the asthma control level in the＜80％group remained lower than that in the ≥80％group,and the proportion of acute asthma attacks was higher than that in the ≥80％group(P＜0.05).Conclusions Approximately one-third of school-age children with asthma still have incomplete asthma control when their pulmonary ventilation function is normal.Among them,children with measured FEV1/FVC＜80％have an increased risk of acute asthma attacks and require close follow-up and strengthened asthma management.

Purpose To development a model to predict mixed cerebral palsy(CP)in infants with periventricular white matter injury(PWMI).Materials and Methods This study retrospectively included infants with PWMI on MRI aged 6 to 24 months and were diagnosed as CP after age of 2 years in the First Affiliated Hospital of Henan University of Chinese Medicine,from September 2015 to October 2022.The eligible infants were divided into mixed group and spastic CP group.Multivariable Logistic regression model was used to select the MRI features associated with PWMI and mixed CP,and was internal validated by using the five-fold cross and repeated cross validation.Model performance was evaluated by the discrimination,calibration and decision curve.The correlation between independent MRI features and the gross motor function classification system levels was evaluated.Results A total of 135 infants with PWMI and CP were included in this study,100 with spastic CP,and 35 with mixed CP.Multivariable Logistic regression analysis found that the involvement of ventralateral of thalamus(OR=27.500,95%CI 8.293-90.942),posterior putamen(OR=13.700,95%CI 4.489-41.549),hippocampus(OR=7.200,95%CI 1.702-30.813)and caudate nucleus(OR 5.800,95%CI 1.973-16.950)were associated with PWMI and mixed CP.A prediction model was constructed using the above four MRI features.The model yielded an area under the receiver operating characteristic curve of 0.960(95%CI 0.934-0.988)and 0.95,0.96 in the five-fold cross and repeated cross validation,respectively.The model had good calibration(χ2=3.712,P=0.529)and clinical application.Furthermore,the four MRI variables were associated with gross motor function classification system levels(r=0.559,0.581,0.171,0.409,all P<0.05).Conclusion The model can early and accurately predict infants with PWMI at high risk of mixed CP.

Purpose To predict the 2015 American thyroid association(ATA)recurrence risk stratification based on ultrasonographic features and Hashimoto's thyroiditis(HT)-specific antibody status of papillary thyroid carcinoma(PTC)in the context of HT.Materials and Methods A retrospective analysis was conducted on the ultrasonographic and clinical data of 479 patients with coexisting PTC and HT,who underwent their first thyroid surgery at the First Medical Center of Chinese PLA General Hospital from January 2017 to December 2019.All patients were divided in chronological order into a training group(n=327)and a validation group(n=152).Multivariate Logistic regression analysis was utilized to identify independent factors associated with high recurrence risk stratification according to the ATA guidelines.Predictive models were constructed and screened,and the efficacy of these models was evaluated using the area under the curve,calibration curves and Brier scores.Results Multivariate Logistic regression analysis identified the following as independent predictive factors for high recurrence risk stratification:multifocal malignancy of nodules(OR=3.812,95％CI 1.275-11.397,P=0.017),nodule contact with the capsule(OR=8.012,95％CI 1.647-38.972,P=0.010),microcalcifications(OR=4.220,95％CI 1.302-13.678,P=0.016),an aspect ratio＞1(OR=4.017,95％CI 1.286-12.548,P=0.017),abundant nodule vascularity(OR=6.120,95％CI 2.225-16.832,P＜0.001),maximum nodule diameter ≥1 cm(OR=4.784,95％CI 1.360-16.833,P=0.015),a glandular echo characteristic of typical HT(OR=0.114,95％CI 0.039-0.330,P＜0.001),and anti-thyroid peroxidase antibody monopositivity(OR=0.088,95％CI 0.006-1.299,P=0.077).The predictive model demonstrated strong performance,as evidenced by the area under the curve of 0.942(95％CI 0.911-0.972)in the training set and 0.933(95％CI 0.878-0.990)in the validation set.Both groups exhibited well-fitting calibration curves.The Brier scores were 0.054 and 0.058 for the training and validation sets,respectively,indicating excellent predictive efficacy of the model.Conclusion The preoperative prediction model,based on ultrasonographic features combined with antibody status,demonstrates good efficacy in assessing ATA recurrence risk stratification for coexisting PTC and HT patients,which can assist clinicians in formulating treatment plans.