OBJECTIVE To investigate the current status and existing problems in pretreatment of digestive endo-scopes in medical institutions of Jiangsu Province so as to optimize the pretreatment procedures.METHODS From Nov.7,2024 to Nov.17 2024,a questionnaire was preliminarily designed based on the current endoscope-related guidelines and standards by the infection control team of digestive endoscopy center of The Affiliated Drum Tower Hospital of Nanjing University Medical School.A cross-sectional survey was conducted for various levels of medi-cal institutions of Jiangsu Province by Wenjuanxing platform.The content of the survey covered basic information of the digestive endoscopy center,implementation status of pretreatment,operation status of pretreatment,quali-ty monitoring and management.RESULTS A total of 122 medical institutions were finally included in the survey,61 of which were tertiary hospitals,35 were secondary hospitals,and 26 were primary hospitals.97.54％of the medical institutions could implement the pretreatment procedures after every endoscopes use,while there was significant difference in the concrete details of pretreatment among the various grades of hospitals.64.75％of the medical institutions used dedicated buttons for pretreatment,however,there was significant difference in the cause for failed change of dedicated buttons among the various grades of medical institutions(x2=14.657,P＜0.001).76.23％of the medical institutions carried out the pretreatment for special sites of the endoscopes(pli-ers' pipelines,auxiliary water rinsing pipelines).Gas and water insufflation were maintained for over 10 seconds(77.87％).The suction duration was judged mainly based on subjective knowledge.The enzyme solution was the major pretreatment solution(94.26％).The changing frequency was dominated by'one use per change'(45.08％).There was significant difference in the time interval between pretreatment and cleaning among the va-rious grades of medical institutions(x2=10.032,P=0.012).57.38％of the medical institutions evaluated the quality of the pretreatment,and visual observation was the major method for quality assessment(53.28％).There was significant difference in the establishment of pretreatment system among the various grades of medical institu-tions(x2=7.033.P=0.030).CONCLUSIONS The pretreatment of the endoscopes is overall performed well in the 122 medical institutions of Jiangsu Province;however,the details of pretreatment procedure,quality monito-ring and management need to be improved.It is suggested that the related departments should accelerate the revi-sion of endoscope pretreatment-related standards so as to standardize professional behavior.

OBJECTIVE To investigate the current status and existing problems in pretreatment of digestive endo-scopes in medical institutions of Jiangsu Province so as to optimize the pretreatment procedures.METHODS From Nov.7,2024 to Nov.17 2024,a questionnaire was preliminarily designed based on the current endoscope-related guidelines and standards by the infection control team of digestive endoscopy center of The Affiliated Drum Tower Hospital of Nanjing University Medical School.A cross-sectional survey was conducted for various levels of medi-cal institutions of Jiangsu Province by Wenjuanxing platform.The content of the survey covered basic information of the digestive endoscopy center,implementation status of pretreatment,operation status of pretreatment,quali-ty monitoring and management.RESULTS A total of 122 medical institutions were finally included in the survey,61 of which were tertiary hospitals,35 were secondary hospitals,and 26 were primary hospitals.97.54％of the medical institutions could implement the pretreatment procedures after every endoscopes use,while there was significant difference in the concrete details of pretreatment among the various grades of hospitals.64.75％of the medical institutions used dedicated buttons for pretreatment,however,there was significant difference in the cause for failed change of dedicated buttons among the various grades of medical institutions(x2=14.657,P＜0.001).76.23％of the medical institutions carried out the pretreatment for special sites of the endoscopes(pli-ers' pipelines,auxiliary water rinsing pipelines).Gas and water insufflation were maintained for over 10 seconds(77.87％).The suction duration was judged mainly based on subjective knowledge.The enzyme solution was the major pretreatment solution(94.26％).The changing frequency was dominated by'one use per change'(45.08％).There was significant difference in the time interval between pretreatment and cleaning among the va-rious grades of medical institutions(x2=10.032,P=0.012).57.38％of the medical institutions evaluated the quality of the pretreatment,and visual observation was the major method for quality assessment(53.28％).There was significant difference in the establishment of pretreatment system among the various grades of medical institu-tions(x2=7.033.P=0.030).CONCLUSIONS The pretreatment of the endoscopes is overall performed well in the 122 medical institutions of Jiangsu Province;however,the details of pretreatment procedure,quality monito-ring and management need to be improved.It is suggested that the related departments should accelerate the revi-sion of endoscope pretreatment-related standards so as to standardize professional behavior.

Informed consent is an important ethical symbol in clinical research,and researchers have the responsibility to fully inform participants of the research information before conducting clinical research.However,it is difficult to obtain complete informed consent form participants or their guardians within a narrow treatment time period in clinical research conducted in emergency situations.Currently,in addition to traditional general informed consent,there are also reality-accepted informed consent,including exemption of informed consent,broad informed consent,and deferred informed consent.By introducing the origin and development process of deferred informed consent in clinical research,this paper sorted out the current application status of deferred informed consent,proposed the prerequisites for applying deferred informed consent in emergency situations,and explored the issues that need to be noted during the application process of deferred informed consent.It is hoped to provide an ethical defense and ethical procedure for the application of deferred informed consent in clinical research in emergency situations.

Objective:To explore the association between weight status and early changes in blood pressure, cardiac structure and function in children at 4 years of age.Methods:A cross-sectional study of the relationship between weight status and cardiovascular parameters was performed on the platform of "Shanghai Birth Cohort" in Shanghai Xinhua Hospital between 2017 and 2020. Height, weight, blood pressure and echocardiography were measured in 1 477 children at 4 years of age. According to body mass index (BMI), participants were classified into five groups: underweight, lean, normal weight, overweight and obese. Blood pressure, cardiac structure and function indexes were compared among different groups using one-way ANOVA. The associations between blood pressure, cardiac structure and function and weight status in children were analyzed by linear regression models. Multivariate logistic regression models were used to analyze whether weight status was an independent risk factor for elevated blood pressure or left ventricular hypertrophy (LVH) in children.Results:A total of 1 477 children including 772 boys and 705 girls were included in this study. There were 115 overweight and obese boys (14.9%) and 68 overweight and obese girls (9.6%). The majority of children had normal weight (916 cases, 62.0%), followed by underweight (303 cases, 20.5%), overweight (130 cases, 8.8%), lean (75 cases, 5.1%), and obese (53 cases, 3.6%). With the increase of BMI, systolic blood pressure, diastolic blood pressure, left ventricular mass index (LVMI), left ventricular posterior wall thickness in systole, left ventricular posterior wall thickness in diastole, left ventricular diameter in end-systole, left ventricular diameter in end-diastole, interventricular septum thickness in systole and left ventricular ejection fraction showed significantly positive trend, and the differences among the groups were significant (F=31.73, 6.59, 14.22, 4.96, 3.01, 31.50, 39.79, 5.91, 3.09, all P<0.05). Multiple linear regression showed that overweight and obese were all positively associated with systolic blood pressure (β=5.2, 95% CI 3.6-6.8), LVMI (β=1.9, 95% CI 0.8-3.1), left ventricular diameter in end-systole (β=1.3, 95% CI 0.9-1.8), and left ventricular diameter in end-diastole (β=1.6, 95% CI 1.0-2.2). In the Logistic regression model, compared with normal weight children, overweight ( OR=2.37, 95% CI 1.37-4.41) and obese children ( OR=10.90, 95% CI 4.47-26.60) both had significantly increased risk of elevated blood pressure. However, the risk of LVH did not significantly increased. Conclusions:Overweight and obesity in 4-year-old children are associated with increased blood pressure, increased left ventricle diameter and LVMI. Overweight and obesity are independent risk factors for elevated blood pressure in children at 4 years of age.

The cultivation and production of cucumber are seriously affected by downy mildew caused by Pseudoperonospora cubensis. Downy mildew damages leaves, stems and inflorescences, and then reduces the yield and quality of cucumber. This review summarized the research advances in cucumber downy mildew, including pathogen detection and defense pathways, regulatory factors, mining of pathogens-resistant candidate genes, proteomic and genomic analysis, and development of QTL remarks. This review may facilitate clarifying the resistance mechanisms of cucumber to downy mildew.
Cucumis sativus/genetics* ; Oomycetes/genetics* ; Peronospora ; Plant Diseases/genetics* ; Proteomics

Objective:To investigate the therapeutic effect of conjoint fascia sheath suspension and levator palpebrae muscle shortening on congenital severe blepharoptosis.Methods:From June 2014 to December 2018, 30 cases (40 eyes) of congenital severe ptosis were treated in Ningbo First Hospital and Shaoxing Women and Children＇s Hospital. All patients were corrected by conjoint fascia sheath suspension and levator palpebrae muscle shortening. Six months after operation, the distance between the middle point of upper eyelid margin and corneal reflex point was measured to evaluate the correction effect of blepharoptosis; the improvement of upper eyelid appearance was evaluated by 5-point Likert scale (LS), and the incidence of complications was counted.Results:Thirty patients (40 eyes) were followed up for 6-12 months. Correction effect showed that preoperative marginal reflex distance (MRD) was (0.10±0.05) and postoperative MRD was (3.80±0.55); the difference was statistically significant ( t=0.95, P<0.05); 38 eyes (95%) were corrected and 2 eyes (5%) were undercorrected; appearance of upper eyelid showed that preoperative LS was (0.50±0.05) and postoperative LS (3.80±0.55); the difference was statistically significant ( t=0.98, P<0.05). Only one case was complicated with keratitis caused by improper early nursing after incomplete closure exposure, and the patient was cured by sealing the eyes combined with drug conservative treatment. Conclusions:Combined conjoint fascial sheath suspension and levator palpebrae shortening in the treatment of severe blepharoptosis has significant effect, with the advantages of simple operation, small surgical trauma, low recurrence rate, low incidence of complications, high predictability of surgical results and high satisfactory rate of patients.

Surgical operation is the first choice for most patients who suffer from early non-small cell lung cancer. The risk of ordinary thoracic surgery is between intermediate and high risk. Due to the high incidence of postoperative pulmonary complications after thoracic surgery, preoperative cardiopulmonary reserve assessment is extremely necessary and important. In recent years, lots of assessment tools are clinically used, including pulmonary function tests, arterial blood gas analysis, breath-holding test and 6-minute walk test. In addition, cardiopulmonary exercise test is used extensively. This article reviews the current status of preoperative cardiopulmonary reserve assessment in thoracic surgery to guide clinical decisions, reduce postoperative complications and improve outcomes.

Lysine acetylation is one of the major post-translational modifications and plays critical roles in regulating gene expression and protein function. Histone deacetylases (HDACs) are responsible for the removal of acetyl groups from the lysines of both histone and non-histone proteins. The RPD3 family is the most widely studied HDACs. This article summarizes the regulatory mechanisms of Arabidopsis RPD3 family in several growth and development processes, which provide a reference for studying the mechanisms of RPD3 family members in regulating plant development. Moreover, this review may provide ideas and clues for exploring the functions of other members of HDACs family.
Arabidopsis/metabolism* ; Histone Deacetylases/metabolism* ; Histones ; Plant Development/genetics*

Flowering is a critical transitional stage during plant growth and development, and is closely related to seed production and crop yield. The flowering transition is regulated by complex genetic networks, whereas many flowering-related genes generate multiple transcripts through alternative splicing to regulate flowering time. This paper summarizes the molecular mechanisms of alternative splicing in regulating plant flowering from several perspectives, future research directions are also envisioned.
Alternative Splicing/genetics* ; Arabidopsis/metabolism* ; Arabidopsis Proteins/genetics* ; Flowers/genetics*

Objective The purpose of this study was to investigate the differential expression of circRNAs in human blood, as a diagnostic marker for pre-diabetes and type 2 diabetes mellitus( T2DM). Methods Microarray analysis was used to select several differentially expressed circRNAs from three normal patients and three T2DM patients. Enlarge the sample size(normal controls,n=20;subjects with impaired glucose regulation,n=20;and type 2 diabetes mellitus,n=20) to determine a circRNA which the most evident differentially expressed by fluorescence quantitative PCR( Q-PCR). Then they were verified with expanded samples ( normal controls, n= 50; impaired glucose regulations,n=50;type 2 diabetes mellitus, n=50) by Q-PCR. Results A total of 2 953 differentially expressed circRNAs were found in microarray analysis, of which 1 439 were up-regulated and 1 514 were down-regulated. Nine differentially expressed circRNAs were selected from the 1 439 circRNAs that were up-regulated(hsa-circ-103838, hsa-circ-103965, hsa-circ-104227, hsa-circ-002117, hsa-circ-000094, hsa-circ-101226, hsa-circ-101720, hsa-circ-400029, and hsa-circ-100633). The Q-PCR results of the expanded sample( n=60) showed that the difference expression of hsa-circ-000094(Alias:has-circ-0000247) in the nine circRNAs was the most obvious one among the 3 groups, the area under the maximum curve was found by ROC curve analysis, SIGR=0. 802 5[ 95% confidence interval (0.665 5-0.939 5), P=0.001]; ST2DM=0.77[95% confidence interval (0.624-0.916), P=0.003]. In order to verify the clinical diagnostic ability of hsa-circ-000094, the experiment was conducted to further expand the sample ( n=150). The results showed that the expression of hsa-circ-000094 in the three groups was different, the difference and ROC curve analysis were statistically significant, SIGR=0. 673 3 [ 95% confidence interval (0.575 7-0. 771 0), P＜0. 01]; ST2DM=0. 723 1 [ 95% confidence interval ( 0. 632 7-0. 813 4), P＜ 0.01]. Conclusion The higher expression of hsa-circ-000094 in peripheral blood provides a certain diagnostic basis for pre-diabetes as well as type 2 diabetes mellitus.