Objective Objective To analyze the potential spatial factors affecting the genetic differentiation of Oncomelania hupensis robertsoni in Yunnan Province. Methods A total of 13 administrative villages were selected from schistosomiasis-endemic areas of Yunnan Province as O. hupensis snail sampling sites. At least 200 snails were collected in each site, and the spatial variable data of each site were recorded, including longitude, latitude and altitude. Thirty active and Schistosoma japonicum uninfected O. hupensis snails were selected from each sampling site by means of the crawling method and the cercarial shedding method. Genomic DNA was extracted from O. hupensis snails. Following PCR amplification, purification of PCR amplification products and sequencing, the gene sequences of O. hupensis snail samples were spliced and edited using the DNAstar software and the NCBI database to yield the complete mitochondrial sequences of O. hupensis snails at each sampling site, and the mitochondrial genetic distance matrix of O. hupensis robertsoni was calculated at each sampling site. The geographical coordinates of each sampling site were marked using the software ArcGIS 10.2, and the straight-line geographical distance between each sampling site was calculated. The altitude difference, longitude difference and latitude difference between each sampling site were calculated using the Excel software, and the correlation between the mitochondrial genetic distance matrix of O. hupensis robertsoni and each spatial variable matrix was examined by using the Mantel test at 13 sampling sites in Yunnan Province. Results Among the 13 O. hupensis snail sampling sites in Yunnan Province, the largest mitochondrial genetic distance of O. hupensis robertsoni snail populations was seen between Anding Village, Nanjian Yi Autonomous County and Caizhuang Village, Midu County (26.244 2), and the largest geographical distance was seen between Dongyuan Village, Gucheng District and Cangling Village, Chuxiong County (272.64 km). The highest altitude difference was seen between Anding Village, Nanjian Yi Autonomous County and Dongyuan Village, Gucheng District (1 086.10 m), and the largest longitude difference was found between Qiandian Village, Eryuan County and Cangling Village, Chuxiong County (1.86°), while the largest latitude difference was measured between Leqiu Village, Nanjian Yi Autonomous County and Dongyuan Village, Gucheng District (1.81°). In addition, the mitochondrial genetic distance of O. hupensis robertsoni snail populations was positively correlated with altitude at 13 snail sampling sites in Yunnan Province (r = 0.542 8, P < 0.001), and showed no significant correlations with geographical distance (r = 0.093 4, P > 0.05), longitude (r = −0.199 5, P > 0.05) or latitude (r = 0.205 7, P > 0.05). Conclusion Altitude may be a potential spatial factor affecting the genetic differentiation of O. hupensis robertsoni in Yunnan Province.

In recent years, robot-assisted esophagectomy has become increasingly widespread, but the esophagogastric anastomosis step remains relatively complex and cumbersome. Currently, commonly used gastrointestinal reconstruction anastomosis techniques include end-to-end anastomosis, end-to-side anastomosis, and side-to-side anastomosis. Depending on the anastomosis method, they can be further divided into manual anastomosis and mechanical anastomosis, with common instruments including circular staplers and linear staplers. In esophageal cancer surgery, the choice of esophagogastric anastomosis technique is typically based on the tumor’s location and size as well as the surgeon’s preference. Each anastomosis technique has its advantages and disadvantages. With continuous improvements in anastomosis techniques and updates in stapling instruments, the incidence of complications after esophagogastric anastomosis has been effectively reduced. However, safely and efficiently completing gastrointestinal reconstruction during surgery remains a significant challenge. Scholars have made extensive explorations in this field, actively proposing and achieving various reconstruction methods, leading to significant progress. This article reviews the research progress of robot-assisted esophagogastric anastomosis techniques from both the anastomosis techniques and methods perspectives.

Cerebral edema is characterized by fluid accumulation, and the glymphatic system (GS) plays a pivotal role in regulating fluid transport. Using the Tenecteplase system, magnesium salt of salvianolic acid B/ginsenoside Rg1 (SalB/Rg1) was injected intravenously into mice 4.5 h after middle cerebral artery occlusion and once every 24 h for the following 72 h. GS function was assessed by Evans blue imaging, near-infrared fluorescence region II (NIR-II) imaging, and magnetic resonance imaging (MRI). SalB/Rg1 had significant effects on reducing the infarct volume and hemorrhagic transformation score, improving neurobehavioral function, and protecting tissue structure, especially inhibiting cerebral edema. Meanwhile, the influx/efflux drainage of GS was enhanced by SalB/Rg1 according to NIR-II imaging and MRI. SalB/Rg1 inhibited matrix metalloproteinase-9 (MMP-9) activity, reduced cleaved β-dystroglycan (β-DG), and stabilized aquaporin-4 (AQP4) polarity, which was verified by colocalization with CD31. Our findings indicated that SalB/Rg1 treatment enhances GS function and attenuates cerebral edema, accompanying the regulation of the MMP9/β-DG/AQP4 pathway.
Animals ; Ginsenosides/administration & dosage* ; Brain Edema/etiology* ; Male ; Benzofurans/administration & dosage* ; Glymphatic System/diagnostic imaging* ; Mice ; Infarction, Middle Cerebral Artery/drug therapy* ; Aquaporin 4/metabolism* ; Disease Models, Animal ; Mice, Inbred C57BL ; Matrix Metalloproteinase 9/metabolism* ; Neuroprotective Agents/pharmacology* ; Depsides

OBJECTIVE To explorer the association between the clearance of serum procalcitonin(PCTc)and the risk of 28-day in-hospital mortality of the sepsis patients.METHODS A total of 270 patients who were diagnosed with sepsis in Huiya Hospital,the First Affiliated Hospital of Sun Yat-sen University from Jan.2022 to Jan.2025 were recruited as the research subjects and were divided into the low decline group with 76 cases,the moderate de-cline group with 74 cases and the high-level stability group with 120 cases according to the change of serum PCTc within 1 to 7 days after the admission.The association between the trajectory of change of PCTc and the risk of 28-day mortality of the sepsis patients was observed by Cox regression analysis method.The rough risk ratios(RRs)of complications of the different changing trajectories of PCTc were calculated by binary log-binomial regres-sion model.RESULTS The red blood cell(RBC)counts,white blood cell(WBC)counts,thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),D-dimer(D-D),C-reactive protein(CRP)and neutrophil to lymphocyte ratio(NLR)were higher in the low decline group than in the moderate de-cline and the high-level stability group(P＜0.05);while the levels of platelet(PLT)and fibrinogen(FIB)of the high-level stability group were higher than those of the low and moderate decline group(P＜0.05).Kaplan-meier survival curve analysis showed that the accumulative survival rate was 46.62％in the low decline group,64.31％in the moderate decline group and 81.24％in the high-level stability group,there was significant differ-ence(x2=25.479,P＜0.001).CONCLUSION The trajectory of change of PCTc can be served as an early-warn-ing index for the risk of in-hospital mortality and complications,which may provide important basis for develop-ment of individualized treatment program.

Objective To analyze the influencing factors for postoperative anastomotic leak (AL) in carcinoma of the esophagus and gastroesophageal junction and construct a nomogram predictive model. Methods The patients who underwent radical esophagectomy at Jinling Hospital Affiliated to Nanjing University School of Medicine from January 2018 to June 2020 were included in this study. Relevant variables were screened using univariate and multivariate logistic regression analyses. A nomogram was then developed to predict the risk factors associated with postoperative AL. The predictive performance of the nomogram was validated using the receiver operating characteristic (ROC) curve. Results A total of 468 patients with carcinoma of the esophagus and gastroesophageal junction were included in the study, comprising 354 males and 114 females, with a mean age of (62.8±7.2) years. The tumors were predominantly located in the middle or lower esophagus, and 51 (10.90%) patients experienced postoperative AL. Univariate logistic regression analysis indicated that age, body mass index (BMI), tumor location, preoperative albumin levels, diabetes mellitus, anastomosis technique, anastomosis site, and C-reactive protein (CRP) levels were potentially associated with AL (P<0.05). Multivariate logistic regression analysis identified age, BMI, tumor location, diabetes mellitus, anastomosis technique, and CRP levels as independent risk factors for AL (P<0.05). A nomogram was developed based on the findings from the multivariate logistic regression analysis. The area under the receiver operating characteristic (ROC) curve was 0.803, indicating a strong concordance between the actual observations and the predicted outcomes. Furthermore, decision curve analysis demonstrated that the newly established nomogram holds significant value for clinical decision-making. Conclusion The predictive model for postoperative AL in patients with carcinoma of the esophagus and gastroesophageal junction demonstrates strong predictive validity and is essential for guiding clinical monitoring, early detection, and preventive strategies.

Objective:From the dual perspectives of time and space,a quantitative evaluation of the policies for special outpatient chronic diseases in 31 cities in China over the years is carried out,so as to provide targeted suggestions for relevant departments in the design of medical insurance policies for chronic disease prevention and control.Methods:Combining the relevant literature and the content of the policy text,the policy consistency index model is constructed and quantitative evaluation is carried out based on the results.Results:Of the 421 policies,176 were"Narrowly covered"(41.81%),113 were"Meets expectations"(26.84%),109 were"Focused"(25.89%),and 23 were"Reasonably complete"(5.46%);while 30 cities were"qualified"or above in policy content(χ1),20 cities were"qualified"or above in policy audience(χ2),26 cities were"qualified"or above in policy inclination(χ3),4 cities were"qualified"or above in policy cohesion(χ4),and 24 cities were"qualified"or above in policy objective(χ5).Conclusion:The policies for special outpatient chronic diseases in 31 cities in China are characterized by rich content,wide audience coverage,and diverse policy linkages.To further enhance the security capabilities,it is recommended that sustained efforts be made to consolidate the foundation by standardizing the scope of disease types,strengthening the management of medical treatment in other places and optimizing the interface with other policies.

Objective:To explore the current status and influencing factors of quality of life in patients with thyroid-associated ophthalmopathy (TAO) .Methods:From January to July 2024, convenience sampling was used to select TAO patients of the Department of Ophthalmology of Peking University Third Hospital as research subjects. The patients were surveyed using the General Information Questionnaire, Graves' Ophthalmopathy Quality of Life Questionnaire (GO-QOL), Negative Physical Self Scale-Appearance (NPSS-A), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Perceived Social Support Scale (PSSS). Spearman correlation analysis was used to explore the correlation between GO-QOL scores and NPSS-A, SAS, SDS, and PSSS scores. Multiple linear regression was used to analyze the factors influencing the quality of life of TAO patients.Results:A total of 234 questionnaires were distributed, and 203 valid questionnaires were collected, with a valid response rate of 86.75%. The GO-QOL visual function and social function dimensions scores of 203 TAO patients were [78.57 (50.00, 100.00) ] and [43.75 (18.75, 62.50) ], respectively. Multiple linear regression analysis showed that age, eye movement disorders, eyelid retraction, and disease grading, were the influencing factors of the visual function dimension of GO-QOL ( P<0.05). Age, social support, and body image were the influencing factors on the social function dimension of GO-QOL ( P<0.05) . Conclusions:The quality of life of TAO patients is poor. Healthcare professionals should develop coping strategies based on factors affecting different dimensions of quality of life, so as to improve patients' quality of life.

Objective Advances in synthetic DNA technology have made it much easier to fake human DNA samples.There are literature reports that fake human DNA can be synthesized by different methods and implanted in the field to confuse the investigation or mislead the trial.Therefore,distinguishing authentic human DNA from synthetic DNA and performing individual identification has become a critical scientific challenge.Methods We define a novel composite genetic marker(methylation-microhaplotype)by combining CpG sites stably hypermethylated or hypomethylated in natural human DNA and nearby immediately adjacent microhaplotype sites.A total of 19 locis were obtained according to the screening criteria,and a composite detection system for methylation-microhaplotypes was established using MPS technology.Random volunteer DNA samples were extracted and synthetic DNA samples were prepared based on whole genome amplification techniques.Population DNA samples were analyzed to evaluate forensic parameters and methylation variability of the methylation-microhaplotype markers.Comparative analyses of human and synthetic DNA were conducted to assess the markers'ability to discriminate between the two and to detect/type both components in mixed mixed samples.Results The composite detection system composed of 19 locis demonstrated high individual identification ability,achieving a cumulative individual identification probability of 0.999 999 999 996 86.12 hypermethylated locis and 7 hypomethylated locis had relatively stable methylation levels in 57 human DNA samples.According to the allele methylation rate(Ram)value,the system can effectively identify natural and synthetic DNA samples.Meanwhile,for mixed DNA samples,the presence of human and synthetic DNA samples can be found and genotyped.Conclusion Methylation-microhaplotype genetic markers,which can discover human DNA and synthetic DNA and can detect the presence and genotyping of them from mixed samples,is a potential useful tool for forensic DNA analysis.

Objective:To explore the current status and influencing factors of quality of life in patients with thyroid-associated ophthalmopathy (TAO) .Methods:From January to July 2024, convenience sampling was used to select TAO patients of the Department of Ophthalmology of Peking University Third Hospital as research subjects. The patients were surveyed using the General Information Questionnaire, Graves' Ophthalmopathy Quality of Life Questionnaire (GO-QOL), Negative Physical Self Scale-Appearance (NPSS-A), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Perceived Social Support Scale (PSSS). Spearman correlation analysis was used to explore the correlation between GO-QOL scores and NPSS-A, SAS, SDS, and PSSS scores. Multiple linear regression was used to analyze the factors influencing the quality of life of TAO patients.Results:A total of 234 questionnaires were distributed, and 203 valid questionnaires were collected, with a valid response rate of 86.75%. The GO-QOL visual function and social function dimensions scores of 203 TAO patients were [78.57 (50.00, 100.00) ] and [43.75 (18.75, 62.50) ], respectively. Multiple linear regression analysis showed that age, eye movement disorders, eyelid retraction, and disease grading, were the influencing factors of the visual function dimension of GO-QOL ( P<0.05). Age, social support, and body image were the influencing factors on the social function dimension of GO-QOL ( P<0.05) . Conclusions:The quality of life of TAO patients is poor. Healthcare professionals should develop coping strategies based on factors affecting different dimensions of quality of life, so as to improve patients' quality of life.

Objective:From the dual perspectives of time and space,a quantitative evaluation of the policies for special outpatient chronic diseases in 31 cities in China over the years is carried out,so as to provide targeted suggestions for relevant departments in the design of medical insurance policies for chronic disease prevention and control.Methods:Combining the relevant literature and the content of the policy text,the policy consistency index model is constructed and quantitative evaluation is carried out based on the results.Results:Of the 421 policies,176 were"Narrowly covered"(41.81%),113 were"Meets expectations"(26.84%),109 were"Focused"(25.89%),and 23 were"Reasonably complete"(5.46%);while 30 cities were"qualified"or above in policy content(χ1),20 cities were"qualified"or above in policy audience(χ2),26 cities were"qualified"or above in policy inclination(χ3),4 cities were"qualified"or above in policy cohesion(χ4),and 24 cities were"qualified"or above in policy objective(χ5).Conclusion:The policies for special outpatient chronic diseases in 31 cities in China are characterized by rich content,wide audience coverage,and diverse policy linkages.To further enhance the security capabilities,it is recommended that sustained efforts be made to consolidate the foundation by standardizing the scope of disease types,strengthening the management of medical treatment in other places and optimizing the interface with other policies.