Objective To explore the predictive value of serum homocysteine(Hcy)and stromal cell-derived factor(SDF)-1 levels in patients with acute ischemic stroke(AIS)for early neurological deterioration(EDN)after thrombolysis.Methods From April 2023 to July 2024,134 AIS patients treated in Jiaxing Second Hospital were selected as subjects.According to the National Institutes of Health stroke scale(NIHSS)evaluation 24 hours after thrombolysis,they were divided into EDN group(n=45)and non EDN group(n=89).Enzyme-linked immunosorbent assay(ELISA)method was applied to detect serum Hcy and SDF-1 levels.Pearson method was applied to analyze correlation.Logistic regression was applied to analyze and test the influencing factors.The receiver operating characteristic curve was applied to analyze the predictive value of indicators for EDN.Results The serum Hcy,SDF-1 levels,admission to puncture time,and baseline NIHSS score in EDN group were higher than those in non EDN group(P＜0.05).The levels of serum Hcy and SDF-1 in AIS patients were positively correlated with admission to puncture time and baseline NIHSS score(P＜0.05).Hcy and SDF-1 were independent influencing factors for EDN in AIS patients after thrombolysis(P＜0.05).The area under the curve of Hcy and SDF-1 combination for predicting EDN was 0.963,with sensitivities of 88.98％,and specificities of 94.43％,respectively.The prediction critical values of Hcy and SDF-1 were 25.31μmol/L and 159.10μg/L.Conclusion Serum Hcy and SDF-1 levels increase in AIS patients with EDN after thrombolysis.The combination of the two has important clinical predictive value for EDN.

Objective To explore the predictive value of serum homocysteine(Hcy)and stromal cell-derived factor(SDF)-1 levels in patients with acute ischemic stroke(AIS)for early neurological deterioration(EDN)after thrombolysis.Methods From April 2023 to July 2024,134 AIS patients treated in Jiaxing Second Hospital were selected as subjects.According to the National Institutes of Health stroke scale(NIHSS)evaluation 24 hours after thrombolysis,they were divided into EDN group(n=45)and non EDN group(n=89).Enzyme-linked immunosorbent assay(ELISA)method was applied to detect serum Hcy and SDF-1 levels.Pearson method was applied to analyze correlation.Logistic regression was applied to analyze and test the influencing factors.The receiver operating characteristic curve was applied to analyze the predictive value of indicators for EDN.Results The serum Hcy,SDF-1 levels,admission to puncture time,and baseline NIHSS score in EDN group were higher than those in non EDN group(P＜0.05).The levels of serum Hcy and SDF-1 in AIS patients were positively correlated with admission to puncture time and baseline NIHSS score(P＜0.05).Hcy and SDF-1 were independent influencing factors for EDN in AIS patients after thrombolysis(P＜0.05).The area under the curve of Hcy and SDF-1 combination for predicting EDN was 0.963,with sensitivities of 88.98％,and specificities of 94.43％,respectively.The prediction critical values of Hcy and SDF-1 were 25.31μmol/L and 159.10μg/L.Conclusion Serum Hcy and SDF-1 levels increase in AIS patients with EDN after thrombolysis.The combination of the two has important clinical predictive value for EDN.

Objective:To explore the changes in acoustic features of 9-10-year-old primary school students with depressive symptoms, and based on these features and the random forest (RF) algorithm, construct a model for identifying depressive symptoms in primary school students, so as to provide an intelligent psychological health screening tool for schools and education departments.Methods:This was a case-control study.A total of 1 186 primary school students aged 9-10 from three primary schools in three regions of Jiangsu Province were selected as research subjects for psychological health screening from October 26, 2022 to February 13, 2023.Their demographic data, Depression-Anxiety-Stress Scale (DASS-21) scores, Insomnia Severity Index scores, and voice recordings were collected.Based on the DASS-21 scores, the participants were divided into a control group ( n=1 086) and a depression group ( n=100).Voice recordings were made using the neutral text " The North Wind and the Sun". openSMILE was used to extract 523 acoustic features from the pre-processed voice recordings.Group differences were assessed using independent-samples t-tests or chi-square tests.Pearson correlation analysis was conducted to examine the relationship between acoustic features and depression scores.Depressive symptoms were set as the dependent variable, and the correlated acoustic features were set as the independent variable to construct a classification model using the RF algorithm.The model performance was assessed using the receiver operating characteristic (ROC) curve, the area under the curve (AUC), precision, accuracy, recall, and F1 score. Results:Compared with the control group, the depression group showed significant differences in 105 acoustic features (44 spectral features, 49 source features, and 12 prosodic features) (all P<0.05).Correlation analysis showed that 12 acoustic features (7 spectral features, 4 source features, and 1 prosodic feature) were significantly correlated with the depression score (all P<0.05).Among the RF algorithm-based classification models, the spectral features demonstrated superior performance compared to source features and prosodic features (AUC=0.793), and the performance of the model based on the combination of these features was the best (AUC=0.818). Conclusions:Acoustic features may be an objective indicator to identify the depression of 9-10-year-old primary school students, and the classification model established based on acoustic features can identify the depressed primary school students.

【Objective】 To investigate the influencing factors behind the follow-up compliance of patients with low/no phenylketonuria (PKU) for special medical use, in order to provide a basis for regulating the follow-up of PKU patients and ensuring the effectiveness of special diet treatment. 【Methods】 A survey was conducted on PKU patients treated in Urumqi Maternal and Child Health Hospital for over 1 year, from January 2010 to December 2020. Interviews and questionnaires were conducted with their caregivers to collect and analyze the current status of PKU patients undergoing special diet treatment, and to identify the influencing factors behind their compliance with follow-up treatment. 【Results】 Patients who had received neonatal disease screening, neonatal gene diagnosis, and maternal Down′s screening during pregnancy had better compliance, with statistically significant differences (χ²=5.753, 10.993, 9.189, P<0.05). PKU children with parents who had a college education or above showed significantly higher adherence to special diet treatment (χ²=8.321, 7.415, P<0.05). PKU children with parents having a fixed occupation also showed higher compliance, with a statistically significant difference (χ²=20.626, 7.895, P<0.05). Patient age, interval of buying special diet, number of blood samples sent and enrollment of normal age, all had a significant impact on the follow-up compliance of PKU patients with special diet (χ²=19.443, 8.090, 69.482, 12.001, P<0.05). 【Conclusions】 PKU is a treatable genetic metabolic disease. Strengthening health education, formulating standardized follow-up plans and procedures, and improving follow-up treatment compliance are crucial in enhancing the treatment and follow-up effectiveness of PKU patients.

Objective To investigate the application prospect of the most extensive genome engineering pig internationally in preclinical xenotransplantation. Methods Porcine endogenous retrovirus (PERV) knockout combined with 3 major heterologous antigen gene knockouts and 9 humanized genes for inhibition of complement activation, regulation of coagulation disorders, anti-inflammatory and anti-phagocytosis were transferred into a pig (PERV-KO/3-KO/9-TG) as a donor, and the heart, liver and kidney were obtained and transplanted to 3 Rhesus macaque recipients respectively to establish a preclinical research model of pig-to-Rhesus macaque xenotransplantation. The functional status of xenografts after blood flow reconstruction was observed and the survival of recipients was summarized. The hemodynamics of xenografts were monitored. The change of hematological indexes of each recipient was compared. The histopathological manifestation of xenografts was observed. Results After the blood flow was reconstructed, all xenografts showed ruddy color, soft texture and good perfusion. The transplant heart, liver and kidney showed full arterial and venous blood flow and good perfusion at 1 d after operation. The postoperative survival time of heart, liver, and kidney transplant recipients was 7, 26, and 1 d, respectively. The levels of creatine kinase, creatine kinase isoenzyme, and lactate dehydrogenase increased in heart transplant recipient at 1 d after operation, and gradually recovered to near normal levels at 6 d after operation. All indexes increased sharply at 7 d after operation. The level of aspartate aminotransferase increased in liver transplant recipients at 2 d after operation, and the alanine aminotransferase basically returned to normal at 10 d after operation, but the total bilirubin continued to increase. Both aspartate aminotransferase and alanine aminotransferase increased at 12 d after operation, and reached a peak at 15 d after operation. The kidney transplant recipient developed mild proteinuria at 1 d after operation, and died of sudden severe arrhythmia. Histopathology showed that the tissue structure of cardiac and renal xenografts was close to normal, and liver xenografts presented with patchy necrosis, the liver tissue structure was disordered, accompanied by inflammatory damage, interstitial hemorrhage and thrombotic microangiopathy. Conclusions PERV-KO/3-KO/9-TG pig shows advantages in overcoming hyperacute rejection, mitigating humoral rejection and coagulation dysregulation. However, whether it can be used as potential donor for clinical xenotransplantation needs further evaluation.