The plant F-box protein more axillary growth 2 (MAX2) is a key factor in the signal transduction of strigolactones (SLs) and karrinkins (KARs). As the main component of the SKP1-CUL1-FBX (SCF) complex ubiquitin ligase E3, MAX2 is responsible for specifically recognizing the target proteins, suppressor of MAX2 1/SMAX1-like proteins (SMAX1/SMXLs), which would be degraded after ubiquitination. It can thereby regulate plant morphogenesis and stress responses. There exist homologous genes of MAX2 in the important grain and oil crop soybean (Glycine max). However, its role in plant defense responses has not been investigated yet. Here, GmMAX2b, a homologous gene of MAX2, was successfully cloned from stressed soybean. Bioinformatics analysis revealed that there were two MAX2 homologous genes, GmMAX2a and GmMAX2b, with a similarity of 96.2% in soybean. Their F-box regions were highly conserved. The sequence alignment and cluster analysis of plant MAX2 homologous proteins basically reflected the evolutionary relationship of plants and also suggested that soybean MAX2 might be a multifunctional protein. Expression analysis showed that plant pathogen infection and salicylic acid treatment induced the expression of GmMAX2b in soybean, which is consistent with that of MAX2 in Arabidopsis. Ectopic expression of GmMAX2b compensated for the susceptibility of Arabidopsis max2-2 mutant to pathogen, indicating that GmMAX2b positively regulated plant disease resistance. In addition, yeast two hybrid technology was used to explore the potential target proteins of GmMAX2b. The results showed that GmMAX2b interacted with SMXL6 and weakly interacted with SMXL2. In summary, GmMAX2b is a positive regulator in plant defense responses, and its expression is induced by pathogen infection and salicylic acid treatment. GmMAX2b might exert its effect through interaction with SMXL6 and SMXL2. This study expands the theoretical exploration of soybean disease resistant F-box and provides a scientific basis for future soybean disease resistant breeding.
Glycine max/metabolism* ; Disease Resistance/genetics* ; Plant Diseases/immunology* ; Plant Proteins/genetics* ; Cloning, Molecular ; Gene Expression Regulation, Plant ; F-Box Proteins/genetics* ; Arabidopsis/genetics* ; Phylogeny

Objective To investigate the relationship between the morphology and elasticity of the levator ani muscle(LAM)and stress urinary incontinence(SUI),and to develop a multimodal diagnostic model for SUI based on LAM morphology and elasticity parameters,while evaluating the diagnostic performance of this model.Methods From September 2020 to September 2022,147 female patients with SUI from the Affiliated Hospital of North China University of Science and Technology were enrolled as the SUI group(case group),while 144 women without SUI during the same period were selected as the non-SUI group(control group).Transperineal ultrasonography was conducted to measure the anteroposterior diameter(LH-A1)and transverse diameter(LH-D1)of the levator hiatus at rest,the resting area of the levator hiatus(LA1),as well as the anteroposterior diameter(LH-A2),transverse diameter(LH-D2),and area(LA2)of the levator hiatus during the maximum Valsalva maneuver.Addi-tionally,ultrasonography was used to observe LAM injury(LA-MI)during pelvic muscle contraction.Shear wave elastography(SWE)was also performed transperineally to record the elastic modulus values of the puborectalis muscle at rest(E1)and during pelvic muscle contraction(E3).The differences in ultrasound parameters between the two groups were compared,and a logistic regression model was constructed for multivariate analysis to establish a diagnostic model for SUI.The goodness of fit of the logistic regression model was assessed using the Hosmer-Lemeshow test.The diagnostic performance of individual indicators and the diagnostic model for SUI was evaluated using the receiver operating characteristic(ROC)curve.Finally,the clinical utility of the model was assessed using decision curve analysis.Results There were statistically significant differences in age,BMI,LH-A1,LH-D1,LA1,LH-A2,LH-D2,LA2,LA-MI,E1,and E3 between the two groups(P<0.05).Multivariate logistic regression analysis revealed that age,BMI,LH-A1,LA2,LA-MI,E1,and E3 were significantly associated with SUI(P<0.05).Based on these findings,a diagnostic model for SUI was established:PRESUI=0.261×age+0.904×BMI-4.300×LH-A1+1.166×LA2-2.815×LA-MI+0.587×E1-0.631×E3-1.258.The model demon-strated excellent goodness-of-fit(P=0.983).The ROC curve analysis indicated that age,BMI,LH-A1,LA2,LA-MI,E1,and E3 all exhibited diagnostic efficacy for SUI(AUC>0.500,P<0.05).Notably,the AUC of the constructed diagnostic model for SUI was 0.996(95%CI:0.992～1.000),suggesting that the diagnostic accuracy of the model surpassed that of individual indicators.When the cut-off value of the diagnostic model was set at 0.437,the sensitivity reached 98.0%,and the specificity was 97.2%.Furthermore,the decision curve analysis demon-strated that the diagnostic model provided substantial net clinical benefit within the threshold probability range of 0.1 to 1.0.Conclusions The morphology and elasticity of the LAM are significantly altered in women with SUI.The SWE technique demonstrates potential application value for quantitatively assessing the elasticity of the LAM.Furthermore,the diagnostic model constructed based on age,BMI,LH-A1,LA2,LA-MI,E1,and E3 exhibits high clinical application value.

Objective To investigate the relationship between the morphology and elasticity of the levator ani muscle(LAM)and stress urinary incontinence(SUI),and to develop a multimodal diagnostic model for SUI based on LAM morphology and elasticity parameters,while evaluating the diagnostic performance of this model.Methods From September 2020 to September 2022,147 female patients with SUI from the Affiliated Hospital of North China University of Science and Technology were enrolled as the SUI group(case group),while 144 women without SUI during the same period were selected as the non-SUI group(control group).Transperineal ultrasonography was conducted to measure the anteroposterior diameter(LH-A1)and transverse diameter(LH-D1)of the levator hiatus at rest,the resting area of the levator hiatus(LA1),as well as the anteroposterior diameter(LH-A2),transverse diameter(LH-D2),and area(LA2)of the levator hiatus during the maximum Valsalva maneuver.Addi-tionally,ultrasonography was used to observe LAM injury(LA-MI)during pelvic muscle contraction.Shear wave elastography(SWE)was also performed transperineally to record the elastic modulus values of the puborectalis muscle at rest(E1)and during pelvic muscle contraction(E3).The differences in ultrasound parameters between the two groups were compared,and a logistic regression model was constructed for multivariate analysis to establish a diagnostic model for SUI.The goodness of fit of the logistic regression model was assessed using the Hosmer-Lemeshow test.The diagnostic performance of individual indicators and the diagnostic model for SUI was evaluated using the receiver operating characteristic(ROC)curve.Finally,the clinical utility of the model was assessed using decision curve analysis.Results There were statistically significant differences in age,BMI,LH-A1,LH-D1,LA1,LH-A2,LH-D2,LA2,LA-MI,E1,and E3 between the two groups(P<0.05).Multivariate logistic regression analysis revealed that age,BMI,LH-A1,LA2,LA-MI,E1,and E3 were significantly associated with SUI(P<0.05).Based on these findings,a diagnostic model for SUI was established:PRESUI=0.261×age+0.904×BMI-4.300×LH-A1+1.166×LA2-2.815×LA-MI+0.587×E1-0.631×E3-1.258.The model demon-strated excellent goodness-of-fit(P=0.983).The ROC curve analysis indicated that age,BMI,LH-A1,LA2,LA-MI,E1,and E3 all exhibited diagnostic efficacy for SUI(AUC>0.500,P<0.05).Notably,the AUC of the constructed diagnostic model for SUI was 0.996(95%CI:0.992～1.000),suggesting that the diagnostic accuracy of the model surpassed that of individual indicators.When the cut-off value of the diagnostic model was set at 0.437,the sensitivity reached 98.0%,and the specificity was 97.2%.Furthermore,the decision curve analysis demon-strated that the diagnostic model provided substantial net clinical benefit within the threshold probability range of 0.1 to 1.0.Conclusions The morphology and elasticity of the LAM are significantly altered in women with SUI.The SWE technique demonstrates potential application value for quantitatively assessing the elasticity of the LAM.Furthermore,the diagnostic model constructed based on age,BMI,LH-A1,LA2,LA-MI,E1,and E3 exhibits high clinical application value.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To explore the improvements of high-fat intake on lung injury induced by Paragonimus proliferus infection in rats, and to preliminarily explore the mechanisms underlying the role of cytochrome P450 4A1 (CYP 4A1) in the improve ments. Methods SD rats were randomly assigned into three groups, including the normal control group (n = 10), the infection and normal diet group (n = 12) and the infection and high-fat diet group (n = 12). Rats in the normal control group were fed with normal diet and without any other treatments, and animals in the infection and normal diet group were subcutaneously injected with 8 excysted metacercariae of P. proliferus via the abdominal wall, followed by feeding with normal diet, while rats in the infection and high-fat diet group were subcutaneously injected with 8 excysted metacercariae of P. proliferus via the abdominal wall, followed by feeding with high-fat diet. All rats were sacrificed 28 weeks post-infection, and serum samples and lung specimens were collected. Following hematoxylin-eosin (HE) staining of rat lung specimens, the rat lung injury was observed under an optical microscope, and alveolitis was evaluated using semi-quantitative scoring. Serum interleukin-1β (IL-1β) and tumor necrosis factor alpha (TNF-α) levels were measured using enzyme-linked immunosorbent assay (ELISA), and the cytochrome P450 4A1 (CYP 4A1) expression was quantified in rat lung specimens at transcriptional and translational levels using quantitative real-time PCR (qPCR) and Western blotting assays. Results Alveolar wall thickening, edema and inflammatory cell infiltration were alleviated 28 weeks post-infection with P. proliferus in rats in the infection and high-fat diet group relative to the infection and normal diet group, and no alveolar consolidation was seen in the infection and high-fat diet group. The semi-quantitative score of alveolitis was significantly higher in the infection and normal diet group [(2.200 ± 0.289) points] than in the normal control group [(0.300 ± 0.083) points] and the infection and high-fat diet group [(1.300 ± 0.475) points] (both P values < 0.05), and higher serum IL-1β [(151.586 ± 20.492)] pg/mL and TNF-α levels [(180.207 ± 23.379) pg/mL] were detected in the infection and normal diet group than in the normal control group [IL-1β: (103.226 ± 3.366) pg/mL; TNF-α: (144.807 ± 1.348) pg/mL] and the infection and high-fat diet group [IL-1β: (110.131 ± 12.946) pg/mL; TNF-α: (131.764 ± 27.831) pg/mL] (all P values < 0.05). In addition, lower CYP 4A1 mRNA (3.00 ± 0.81) and protein expression (0.40 ± 0.02) was quantified in lung specimens in the infection and normal diet group than in the normal control group [(5.03 ± 2.05) and (0.84 ± 0.14)] and the infection and high-fat diet group [(11.19 ± 3.51) and (0.68 ± 0.18)] (all P values < 0.05). Conclusion High-fat intake may alleviate lung injuries caused by P. proliferus infection in rats through up-regulating CYP 4A1 expression in lung tissues at both translational and transcriptional levels.

Objective:To investigate the clinical manifestations, pathological characteristics, treatment and prognosis of pediatric rheumatic carditis with the initial symptom of acute heart failure, and to improve the clinical understanding of the disease.Methods:The clinical data, laboratory examination results, imaging findings, treatment and prognosis data of 10 cases with acute rheumatic carditis were collected and analyzed retrospectively.The patients pre-sented with acute heart failure as the first symptom and were treated in Shenzhen Children′s Hospital from January 2015 to February 2022.Results:There were 4 males and 6 females in this study.The mean age was 9.1 years (3 years and 1 month to 11 years and 3 months), and the average onset age was (9.3 ± 3.2) days (4-14 days). All the 10 cases had circulation symptoms.Besides, 4 cases were also complicated with joint symptoms, 3 cases with neurological symptoms and 2 cases with skin symptoms.Echocardiography revealed mitral valve diseases in all cases.More specifically, combined valve diseases were found in 5 cases, pure mitral regurgitation in 3 cases, and mixed mitral valve diseases (mitral regurgitation complicated with mitral stenosis) in 2 cases.After receiving antibiotic therapy, anti-infection treatment and anti-heart failure therapy, symptoms improved in all patients and valve lesions were alleviated.All patients were followed up for 6 months to 6 years.Six cases had persistent rheumatic heart disease during the follow up.Conclusions:Pediatric rheumatic carditis with the initial symptom of acute heart failure is characterized by early onset and the typical manifestation of rheumatic fever.Mitral valve disease is the commonest lesion.Echocardiography is of great value for the early diagnosis of the disease.Medical treatment is effective, but the incidence of chronic rheumatic heart disease is still high.

ObjectiveTo study the effect of anodal transcranial direct current stimulation (atDCS) combined with mirror therapy (MT) on upper limb function for stroke patients. MethodsFrom July, 2018 to June, 2019, 54 stroke patients from the Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, were randomly divided into groups A, B and C, with 18 cases in each group. All the patients received routine medication and rehabilitation training, while group A accepted 60 minutes of MT, group B accepted 20 minuts of atDCS first and then 40 minuts of MT, and group C accepted 40 minutes of MT first and then 20 minuts of atDCS in addittion; for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT), Motor Assessment Scale (MAS) and modified Barthel Index (MBI) before and after treatment. ResultsThe main effect of time was significant in scores of FMA-UE (F = 159.811, P < 0.001), ARAT (F = 353.227, P < 0.001), MAS (F = 513.494, P < 0.001) and MBI (F = 85.982, P < 0.001), and all of them improved after treatment. The main effect of groups was significant in scores of FMA-UE (F = 12.502, P < 0.001), ARAT (F = 20.095, P < 0.001), MAS (F = 16.371, P < 0.001) and MBI (F = 11.882, P < 0.001). The interacted-effect between time and groups was significant in scores of FMA-UE (F = 37.659, P < 0.001), ARAT (F = 78.681, P < 0.001), MAS (F = 97.997, P < 0.001) and MBI (F = 48.015, P < 0.001); while all the scores were the best in group B (P < 0.01), and there was no significant difference between groups A and C (P > 0.05). ConclusionThe combination of atDCS first and then MT can promote the recovery of motor function of the affected limbs for stroke patients.

Objective:To investigate any effect of combining mirror visual feedback (MVF) training with robot-assisted gait training (RGT) in promoting the recovery of lower limb motor function among stroke survivors.Methods:Sixty stroke survivors were randomly divided into a combined treatment group, an RGT group and a control group, each of 20. In addition to traditional rehabilitation, the RGT group received 30min of RGT 5 days a week for 4 weeks, while the combined treatment group underwent 30min of RGT and also 20min of MVF training with the same frequency and duration. Before and after the treatment, the lower extremities motor functioning and walking ability of all of the patients were assessed using the Fugl-Meyer Assessment for the lower extremities (FMA-LE), the Berg Balance Scale (BBS) and Functional Ambulation Categories (FAC).Results:There were no systematic differences in any of the measurements before the treatment. After the 4 weeks, however, the average FMA-LE, BBS and FAC scores of the combined treatment and RGT groups were significantly better than the control group′s averages, and those of the combined treatment group were significantly superior to the RGT group′s. All of the groups had, however, improved significantly compared with before the treatment.Conclusions:Robot-assisted gait training is more effective in enhancing the motor functioning of the lower extremities and walking ability when it is combined with MVF.

Objective:To investigate the influence of ferri ion on the growth, reproduction and energy metabolism of Leptospira interrogans ( L. interrogans), and to identify whether the LA_2690 and LA_3598 gene products functioned as ferritin and ferroxidase. Methods:Petroff-Hausser counting method was used to analyze the influence of ferri ion deficiency on the growth and reproduction of L. interrogans serogroup Icterohaemorrhagiae serovar Lai strain 56601 in EMJH medium. Spectrophotometry and Chemiluminescence method was used to detect whether ferri ion deficiency inhibited the synthesis of DNA and ATP in L. interrogans. The structures and functions of L. interrogans LA_2690 and LA_3598 genes were analyzed using bioinformatic softwares. Prokaryotic expression systems for LA_2690 and LA_3598 genes were established and the target proteins, rLep2690 and rLep3598, were extracted by Ni-NTA affinity chromatography. The ferroxidase activity of rLep2690 and rLep3598 was detected by spectrophotometry. After L. interrogans strain 56601 was used to infect human umbilical vein endothelial cells (HUVEC) and monocytes (THP-1), changes in the expression of LA_2690 and LA_3598 genes at transcription level were detected using real-time fluorescence quantitative RT-PCR (qRT-PCR). Results:In the ferri ion-absent EMJH medium, the growth and reproduction of L. interrogans as well as the DNA and ATP synthesis levels were significantly decreased ( P<0.05). The products of LA_2690 and LA_3598 genes were predicted as bacterioferritin (Bfr) and DNA-binding ferritin containing ferroxidase diiron centers, but the latter lacked the heme-binding site and ferroxidase core. The prokaryotic expression systems for LA_2690 and LA_3598 genes could efficiently express the target recombinant proteins. Both the purified rLep2690 and rLep3598 showed a single band on SDS-PAGE. The ferroxidase activity of rLep2690 and rLep3598 was 1 238.619 U/L and 60.052 U/L, respectively. The expression of LA_2690 and LA_3598 genes of L. interrogans at mRNA level was significantly elevated during infection of the two types of cells ( P<0.05). Conclusions:Ferri ion participates in the growth and reproduction of L. interrogans as well as the synthesis of DNA and ATP. LA_2690 and LA_3598 genes were essential for L. interrogans to infect cells, and the product of LA_2690 gene possessed a stronger ferroxidase activity.

Objective: To retrospectively analyze the laboratory findings and ultrasonographic features in acute phase of children suffering from Kawasaki disease (KD) with stable hemodynamics and Kawasaki disease shock syndrome (KDSS), so as to provide the evidence for early diagnosis, timely treatment and improvement of prognosis of KDSS. Methods: Four hundred and eighteen patients with KD diagnosed at Shenzhen Children′s Hospital from November 2016 to May 2018 were selected, including 23 KDSS patients(KDSS group) and 395 cases with stable hemodynamic(KD without shock group). The clinical characteristics, laboratory index and ultrasonic examination data of the 2 groups were collected and compared for statistical conclusion. Results: (1)The level of C-reaction protein(CRP)[166.20 mg/L (74.40 mg/L)], γ-glutamyl transpeptidase(γ-GT)[88.00 IU/L (126.00 IU/L)], creatine kinase isoenzyme(CKI)[1.78 μg/L (5.17 μg/L)], troponin(TP)[0.01 μg/L (0.39 μg/L)] in the KDSS group in acute phase were all higher than those in the KD without shock group[70.50 mg/L (54.30 mg/L), 40.00 IU/L (89.00 IU/L), 1.20 μg/L (0.85 μg/L), 0.01 μg/L (0.01 μg/L)], hemoglobin(Hb)[90.00 g/L (15.00 g/L)], ablumin [24.20 g/L (4.30 g/L)], serum sodium[130.90 mmol/L (5.60 mmol/L)] levels in the KDSS group were lower than those in the KD without shock group[107.00 g/L (14.00 g/L), 33.40 g/L (4.08 g/L), 136.10 mmol/L (3.25 mmol/L)], and the differences were statistically significant (all P<0.05). (2)The incidence rates of impaired left ventricular ejection fraction(LVEF)[<55%: 3 cases (13.03%) vs.8 cases (2.00%)], coronary artery abnormalities[left anterior descending branch(LAD) Z-score>2.5: 6 cases (26.09%) vs.35 cases (8.86%)]and valvular regurgitation[tricuspid regurgitation(TR)≥moderate: 3 cases (13.03%) vs.5 cases (1.26%)]in the KDSS group were higher than those in the KD without shock group, and the differences were statistically significant (all P<0.05). (3)Among acute phase in KDSS group, 9 cases (39.13%) had liver enlargement, 9 cases (39.13%) had peritoneal effusion, 3 cases (13.04%) had diffuse renal lesions, 3 cases (13.04%) had joint effusion (2 cases of knee joint effusion, 1 case of hip joint effusion), and 2 cases (8.70%) had enteritis.In the KD without shock group, only 3 cases (0.76%) had hepatomegaly and 2 cases (0.51%) had a small amount of knee effusion. Conclusions Laboratory findings of KDSS group showed higher level of CRP, CKI, TP as well as γ-GT than those in KD without shock group, who are more prone to suffer from hypohemoglobin, hyponatremia and hypoalbuminemia.Ultrasound examination showed that KDSS children were more prone to have heart or multiple-organ damage.Clinicians should raise their awareness to provide comprehensive assessment as well as timely and effective treatment.