Objective:To analyze the genetic evolution and molecular characteristics of H7N9 avian influenza virus (AIV) isolated in a live poultry market.Methods:Samples such as poultry feces, sewage, and hair removal machine and chopping board swabs were collected. Real-time fluorescent quantitative PCR was used to detect influenza A virus and H7N9 AIV in the samples. The whole genome of H7N9 AIV was amplified with influenza A virus universal primers and sequenced. BLAST and MEGA X were used for sequence alignment, phylogenetic analysis and molecular characterization.Results:Seven poultry-related environment samples were collected in the live poultry market in Xuchang city in February 2023, and four were positive for H7N9 AIV. The whole genome sequences of three H7N9 AIV isolates were successfully obtained, and the isolates shared high nucleotide identity in different genes (98.37%-100.00%). BLAST analysis showed they were highly identical to H7N9 strains isolated from domestic poultry in China from 2020 to 2021. Genetic evolution analysis showed that the three isolates clustered in the same branch and were closer to the recent environmental isolates than to the recent strains isolated from human or avian. Through comparison with the sequences of the representative strains in different periods, it was found that the isolated strains in this study showed high avian pathogenicity with four amino acids KRAA inserted at the cleavage site; the hemagglutinin receptor-binding site was QSG, which was an avian binding receptor; there was a G186I mutation in hemagglutinin. Mammalian-adaptive mutation E627K was not detected in polymerase basic protein 2. Mutations (R292K and I38T) associated with drug resistance to neuraminidase inhibitor (oseltamivir) and polymerase acidic protein inhibitor (baloshavir) were not detected, suggesting that these isolates remained susceptible to these drugs. A S31N mutation was found in M2 protein, indicating they were resistant to alkamines.Conclusions:The three H7N9 AIV strains isolated in the live poultry market have high avian pathogenicity, but there are no significant increase in mutations related to the binding ability to human receptors, mammalian pathogenicity, viral transmissibility, or drug resistance as compared with previous representative strains causing human or avian infection.

Objective: To understand the attitudes and perceptions of traditional Chinese medicine (TCM) practitioners in Beijing TCM hospitals regarding the use of Ephedra sinica Stapf (E. sinica, Ma Huang). Methods: A two-stage cross-sectional study was conducted using a questionnaire survey of TCM practitioners in Beijing TCM hospitals between April 2023 and March 2024. The questionnaire included demographic information, the clinical background of TCM practitioners, and the clinical application of E. sinica. Logistic regression analysis was used to analyze the relevant influencing factors when using E. sinica. Results: Of the 465 questionnaires collected, 441 were valid. Among these, 84.81% (374/441) reported having used E. sinica in clinical practice at least once. The commonly used doses of E. sinica—excluding the pediatric department—were 10 g for high doses, 6 g for medium, and 3 g for low. The three most frequently used formulas for E. sinica included Maxing Shigan decoction, Mahuang decoction, and Xiao Qing Long decoction. The most common TCM patterns treated with a high dose of E. sinica were wind-cold exterior pattern, wind-cold invading the lung, and wind and water combat with meridians congealed by cold. The top three Western medical diagnoses when using E. sinica for treatment were common cold, pneumonia, and upper respiratory tract infections. Nearly half of the respondents reported experiencing adverse reactions from the oral administration of E. sinica, with the most common being palpitations, insomnia, and restlessness. Starting with a low dose and gradually increasing it as appropriate was identified as an effective approach. Conclusion This study investigated the attitudes and perceptions of TCM practitioners in Beijing TCM hospitals regarding the dose–efficacy–adverse reaction relationship of E. sinica, providing a reference for the safe and effective clinical use of E. sinica.

Objective To explore the establishment of a prognostic model based on machine learning algorithm to predict primary graft dysfunction(PGD)in patients with idiopathic pulmonary fibrosis(IPF)after lung transplantation.Methods Clinical data of 226 IPF patients who underwent lung transplantation were retrospectively analyzed.All patients were randomly divided into the training and test sets at a ratio of 7∶3.Using regularized logistic regression,random forest,support vector machine and artificial neural network,the prognostic model was established through variable screening,model establishment and model optimization.The performance of this prognostic model was assessed by the area under the receiver operating characteristic curve(AUC),positive predictive value,negative predictive value and accuracy.Results Sixteen key features were selected for model establishment.The AUC of the four prognostic models all exceeded 0.7.DeLong and McNemar tests found no significant difference in the performance among different models(both P＞0.05).Conclusions Based on four machine learning algorithms,the prognostic model for grade 3 PGD after lung transplantation is preliminarily established.The overall prediction performance of each model is similar,which may predict the risk of grade 3 PGD in IPF patients after lung transplantation.

BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-associated coagulopathy(SAC)criteria in identifying overt-DIC and pre-DIC status in sepsis patients. METHODS:Data from 419 sepsis patients were retrospectively collected from July 2018 to December 2022.The performances of the SIC and SAC were assessed to identify overt-DIC on days 1,3,7,or 14.The SIC status or SIC score on day 1,the SAC status or SAC score on day 1,and the sum of the SIC or SAC scores on days 1 and 3 were compared in terms of their ability to identify pre-DIC.The SIC or SAC status on day 1 was evaluated as a pre-DIC indicator for anticoagulant initiation. RESULTS:On day 1,the incidences of coagulopathy according to overt-DIC,SIC and SAC criteria were 11.7％,22.0％and 31.5％,respectively.The specificity of SIC for identifying overt-DIC was significantly higher than that of the SAC criteria from day 1 to day 14(P＜0.05).On day 1,the SIC score with a cut-off value＞3 had a significantly higher sensitivity(72.00％)and area under the curve(AUC)(0.69)in identifying pre-DIC than did the SIC or SAC status(sensitivity:SIC status 44.00％,SAC status 52.00％;AUC:SIC status 0.62,SAC status 0.61).The sum of the SIC scores on days 1 and 3 had a higher AUC value for identifying the pre-DIC state than that of SAC(0.79 vs.0.69,P＜0.001).Favorable effects of anticoagulant therapy were observed in SIC(adjusted hazard ratio[HR]=0.216,95％confidence interval[95％CI]:0.060-0.783,P=0.018)and SAC(adjusted HR=0.146,95％CI:0.041-0.513,P=0.003). CONCLUSION:The SIC and SAC seem to be valuable for predicting overt-DIC.The sum of SIC scores on days 1 and 3 has the potential to help identify pre-DIC.

ObjectiveTo investigate the effect of exogenous H₂O₂ on secondary metabolism in Atractylodes chinensis and its mechanism. MethodFresh rhizomes of A. chinensis were treated with 5.0， 1.0， 0.2， 0.04 mmol·L^-1 H₂O₂ solution and clean water， and the relationships between the contents of reactive oxygen species， activities of antioxidant enzymes， activities of key enzymes of secondary metabolites， and contents of secondary metabolites in A. chinensis were compared. ResultUnder treatment with exogenous H₂O₂， the content of reactive oxygen species and malondialdehyde （MDA） in the fresh rhizomes of A. chinensis were significantly elevated on the 4th day， and returned to normal level on the 6th-8th day. The activities of superoxide dismutase （SOD）， catalase （CAT） and peroxidase （POD） were all increased first and then decreased， and reached the peak on the 4th， 4^th-6^th and 2^th-4^th day， respectively. The activities of 3-hydroxy-3-methyl glutaryl coenzyme A reductase （HMGR） and acetyl CoA carboxylase （ACC）， key enzymes of the secondary metabolites， were remarkably enhanced， and under treatments with different concentrations of H₂O₂， the activities of key synthetic enzymes of the secondary metabolites in 0.2 mmol·L^-1 H₂O₂ group were increased most， with the highest biosynthesis of secondary metabolites. The contents of atractylodin， β-eudesmol， atractylone， atractylenolide Ⅱ， and atractylenolide Ⅲ on the 6th day of 0.2 mmol·L^-1 H₂O₂ treatment were 89.5%， 108.7%， 308.8%， 64.7% and 9.3%， respectively higher than those in the control. ConclusionThe antioxidant enzymes and secondary metabolites in A. chinensis synergistically maintain the balance of reactive oxygen species， and exogenous H₂O₂ can improve the medicinal quality of A. chinensis remarkably.

Objective:To compare the effect of extracorporeal membrane oxygenation(ECMO)on pulmonary transplantation(LTx)in patients with idiopathic pulmonary fibrosis(IPF)complicated with pulmonary hypertension(PH).Methods:From January 2017 to December 2020, clinical data were retrospectively reviewed for 112 IPF patients complicated with PH undergoing LTx assisted by venous ECMO(VV-ECMO group, n=68)or venous arterial ECMO(VA-ECMO group, n=44). Gender, age, mechanical ventilation time, oxygenation index, cold ischemic time, preoperative gender, age, smoking history, PO 2, PCO 2, PH degree, NYHA cardiac function grade, right cardiac function, ejection fraction(EF)and complications(hypertension & diabetes)of two groups were compared. Intraoperative approach, operative duration, ECMO transfer time, blood loss, blood transfusion, urine volume, postoperative blood transfusion, mechanical ventilation time, ICU stay time, re-thoracotomy, pulmonary infection, primary graft dysfunction(PGD)and renal insufficiency were recorded. And the effects of two different diversion modes on early postoperative complications and short-term outcomes of LTx were further analyzed by multiple factors. Cox proportional risk model was employed for comparing VV-ECMO and VA-ECMO flow patterns with factors related to recipient survival after transplantation. Results:The preoperative PO 2 of 58.3(51.3, 72.0)mmHg was significantly lower in VV-ECMO bypass group than that of 73.2(63.3, 96.8)mmHg in VA-ECMO group and the difference was statistically significant( P<0.006). Compared with VV-ECMO group, 24(54.5%), 15(34.1%)and 22(50.0%)had NYHA class Ⅲ, severe PH and preoperative right heart enlargement in VA-ECMO group respectively and the differences were statistically significant compared with 17(25.0%), 6(8.8%)and 16(23.5%)in VV-ECMO group( P<0.05 for all). No significant inter-group differences existed in postoperative PGD, postoperative mechanical ventilation time(≥3 d), pulmonary infection, postoperative thoracotomy ratio, postoperative renal insufficiency, ICU stay, hospital stay and other aspects( P>0.05). And 6-month postoperative survival rates of VV-ECMO and VA-ECMO groups were 80.9% and 61.4%, respectively and no significant inter-group difference existed in short-term survival rate(6 months)after adjustment by multivariate Cox regression model( P>0.05). Multivariate statistics indicated that the risk of delayed postoperative withdrawal was 14.452-fold higher in VV-ECMO group than in VA-ECMO group and the inter-group difference was statistically significant(95% CI: 2.448-85.323, P=0.03). Conclusions:No differences exist in postoperative complications or short-term survival rate between IPF recipients with mild PH on VV-ECMO mode and IPF recipients with severe PH on VA-ECMO mode. VV-ECMO flow reversal can delay the transplant back-off time.

Non-image forming functions of eyes include the regulation of biological circadian rhythm and biological magnetoreception.Biological magnetoreception means that various organisms including human obtain the direction and position information through the geomagnetic field.Creatures with retina realize magnetoreception regarding retinal cryptochrome as magnetoreceptor.Hypotheses of magnetoreception contain the radical-pair theory and the biological compass theory.The two theories both reckon retinal elements as possible receptor protein of magnetoreception, and eyes as receptor organ.The radical-pair theory suggests that change of radical spin influences the structure of retinal cryptochrome, leading to different downstream chemical reaction products, which makes the variable magnetic field information perceivable.And the biological compass theory proposes a rod-like complex composed of polymerized cryptochromes and magnetoreceptor proteins, which can point to different directions due to light and magnetic signals.These changes in retina transmit geomagnetic field signal to the brain, and then sense of direction is formed.Researching biological magnetoreception promotes a novel perspective in the diagnosis and treatment of eye and brain diseases, and brings innovation in magnetic material field.In this article, non-image forming functions of eyes, hypotheses of magnetoreception and possible mechanism of non-image forming functions of eyes in magnetoreception were reviewed.

Diabetes mellitus is a relative contraindication of dental implant therapy, that limits the application of implant therapy severely. Diabetic status often leads to secondary vascular and bone lesions, which affect treatment adversely and lead to an increased failure rate. Therefore, how to implement implant therapy for diabetic patients has become a difficult question for dentists. According to the research and experience over the years on diabetic patients, and referring to the current research progress on this topic, the authors will discuss the clinical characteristics of diabetic patients and the details of treatment process, for reference.

Objective:To investigate the effect of guided bone regeneration (GBR) on marginal bone loss (MBL) in the region of the mandibular posterior tooth by using a retrospective cohort study, in order to provide reference for clinical practice.Methods:The research subjects were patients who received dental implants from October 2008 to June 2011 in the region of the mandibular posterior tooth at the Department of Oral Implantology, School of Stomatology, The Fourth Military Medical University. According to whether GBR was performed or not and the time of implant insertion, the patients were divided into the controls group (patients without bone grafting), simultaneous GBR implantation group, and delayed GBR implantation group. On this basis, the MBL was measured according to radiographs by comparing the marginal bone level from that of immediate postoperation 10 years ago. General data was collected and compared among groups, including modified plaque index (mPI), modified sulcus bleeding index (mSBI), probing depth (PD), and gingival papilla height.Results:The controls group (patients without bone grafting), implantation group, and delayed GBR implantation group followed 58, 76, 26 implants in 26, 32, 13 patients aging at (46.5±9.9), (45.5±10.7), (58.3±6.4) respectively. The duration of the follow-up was (11.2±0.7), (11.1±0.8), (11.1±0.9) years respectively. The 10-year implant survival rate was 100% (58/58), 100% (76/76), 100% (26/26). The MBL was (0.91±0.28), (0.84±0.27), (1.01±0.27) mm respectively. The MBL difference of patients with simultaneous GBR implantation and delayed GBR implantation showed statistical significance ( P<0.05), but these two groups showed no statistical significance compared with the controls group ( P>0.05). The mPI, mSBI, PD, and gingival papilla height of the three groups all had no significance on statistics ( P>0.05). Conclusions:It can be concluded that there is no difference in long-term marginal bone resorption between simultaneous and delayed implantation with or without GBR (using autologous blood mixed with granular bone meal) in the posterior mandibular area.

In 2017, there were 451 million people (ages 18 to 99) with diabetes worldwide, and this number is expected to grow to 592 million by 2035. A series of complications in diabetic patients often leads to oral vascular and bone lesions. Therefore, dental implant doctors urgently need to understand the clinical characteristics of diabetes mellitus patients to provide the best treatment. For dental implant doctors, the following problems still exist in the treatment of diabetic patients with poor blood sugar control: ① alveolar fossa healing in diabetic patients is slow after extraction, and bone regeneration is often needed, which prolongs the treatment cycle and increases the pain of patients; ② the rate of new bone formation in diabetic patients after alveolar bone grafting is slow; ③ it takes a long time for the body to achieve effective bone bonding after dental implantation in diabetic patients, and the outcomes are poor; ④ the health of the tissue around dental implants is affected by blood sugar level, which is difficult to maintain in diabetic patients. Current studies suggest that the long-term success rate of implants is predictable in diabetic patients when blood sugar levels are well controlled (HbA1c < 6%). This article will review the current research status of dental implantation therapy for diabetic patients to provide a reference for clinical practice.