Objective To analyze the parameter characteristics of three-dimensional nystagmus during repositioning in patients with posterior semicircular canal canalolithiasis(PSC-Can)and its clinical efficacy.Methods Clinical data were collected from 76 PSC-Can patients who underwent Epley repositioning assisted by three-dimensional video nystagmography.According to the presence or absence of nystagmus during repo-sitioning,patients were divided into Group A(with positive nystagmus,n=25),Group B(without nystag-mus,n=35),and Group C(with reverse nystagmus,n=16).The study analyzed the parameters of nystagmus occurring during repositioning and the nystagmus in the first position,as well as the efficacy of repositioning across the three groups.Results The differences in maximum slow-phase velocity of horizontal component nystagmus,vertical component nystagmus,and torsional component nystagmus in the primary position were statistically significant(P<0.05).The maximum slow-phase velocity of the vertical component in the left PSC-Can was greater than that in the right PSC-Can,with a statistically significant difference(P<0.05).A-mong the three groups,the differences in duration and maximum slow-phase velocity of the vertical and tor-sional components were statistically significant(P<0.05).In groups A and C,the maximum slow-phase ve-locity of torsional component nystagmus in the primary position was greater than that during the repositioning process.The cure rate was highest in group A,followed by group B,and lowest in group C,with statistically significant differences(P<0.05).Conclusion In patients with posterior semicircular canal canalolithiasis(PSC-Can),in the right-beating nystagmus group,nystagmus is strong and short-lived with optimal repositioning efficacy;in the left-beating nystagmus group,nystagmus is weak and prolonged with poor repositioning efficacy.

Objective:To prepare rabbit polyclonal antibody against human FAM21 and analyze antibody specificity.Methods:Using the plasmid encoding human FAM21 full-length gene as a template,the nucleotide sequence of its 2 431～3 006 base was amplified by PCR and connected to the pGEX-6p-1 prokaryotic expression vector to construct pGEX-6P-1-FAM21 recombinant plasmid expressing the 811～1 002 amino acid fragment of FAM21.The recombinant plasmid was transformed into BL21(DE3)compe-tent Escherichia coli and was expressed inductively,and the protein was purified using GST fusion protein purification magnetic beads.The purified GST fusion protein was used as an antigen to immunize New Zealand rabbits,and the collected antiserum was purified by an agarose column containing GST protein.The specificity of antibody was detected by Western blot and immunofluorescence assay in stable FAM21 knockdown HeLa cells.Results:The pGEX-6p-1-FAM21 prokaryotic expression plasmid was successfully constructed and induced to express in BL21(DE3)competent Escherichia coli.The purified GST fusion protein had a molecular weight of approxi-mately 50 kD,and the purified antibody titer from immunized New Zealand rabbits was greater than 1∶128 000,with high specificity.Conclusion:The pGEX-6p-1-FAM21 prokaryotic expression plasmid is successfully constructed,and the rabbit polyclonal antibody against human FAM21 is prepared for Western blot and immunofluorescence assay.

Objective:To prepare rabbit polyclonal antibody against human FAM21 and analyze antibody specificity.Methods:Using the plasmid encoding human FAM21 full-length gene as a template,the nucleotide sequence of its 2 431～3 006 base was amplified by PCR and connected to the pGEX-6p-1 prokaryotic expression vector to construct pGEX-6P-1-FAM21 recombinant plasmid expressing the 811～1 002 amino acid fragment of FAM21.The recombinant plasmid was transformed into BL21(DE3)compe-tent Escherichia coli and was expressed inductively,and the protein was purified using GST fusion protein purification magnetic beads.The purified GST fusion protein was used as an antigen to immunize New Zealand rabbits,and the collected antiserum was purified by an agarose column containing GST protein.The specificity of antibody was detected by Western blot and immunofluorescence assay in stable FAM21 knockdown HeLa cells.Results:The pGEX-6p-1-FAM21 prokaryotic expression plasmid was successfully constructed and induced to express in BL21(DE3)competent Escherichia coli.The purified GST fusion protein had a molecular weight of approxi-mately 50 kD,and the purified antibody titer from immunized New Zealand rabbits was greater than 1∶128 000,with high specificity.Conclusion:The pGEX-6p-1-FAM21 prokaryotic expression plasmid is successfully constructed,and the rabbit polyclonal antibody against human FAM21 is prepared for Western blot and immunofluorescence assay.

OBJECTIVE To investigate the inhibitory effect and mechanism of Modified qifang weitong granules on gastric cancer based on in vitro and in vivo experiments. METHODS Human gastric cancer HGC-27 cells were divided into the following groups: control group （treated with fetal bovine serum）， 10% drug-containing serum group， 15% drug-containing serum group， 20% drug-containing serum group， and 5-fluorouracil （5-Fu） group （positive control， 3.90 μg/mL）. After culturing the cells in each group with the corresponding serum/drug solution， their proliferation， migratory and invasive abilities， as well as the cell cycle， were assessed. Additionally， the expression levels of epithelial-mesenchymal transition （EMT）-related proteins [E-cadherin， N-cadherin， and vimentin] in the cells were measured. Logarithmic-phase HGC-27 cells were harvested and subcutaneously injected into the right axillary region of nude mice to establish a subcutaneous xenograft tumor model in nude mice. The successfully modeled tumor-bearing nude mice were randomly divided into model group， low-， medium- and high-dose groups of Modified qifang weitong granules （17.65， 35.29 and 70.58 g/kg， respectively）， and 5-Fu group （25 mg/kg）， with 5 mice in each group. After 14 days of treatment with the corresponding drugs in each group， the histopathological morphology of the tumor tissues in the nude mice was observed. Immunohistochemistry and Western blot assay were employed to detect the expression levels of EMT- related proteins in the tumor tissues of the nude mice. RESULTS In the cell experiment， compared with the control group， the cell proliferation rate， migration rate， number of invasive cells， as well as the expression levels of N-cadherin and vimentin proteins， and the percentage of cells in the G2/M phase were all significantly decreased/reduced in the 15% drug-containing serum group， 20% drug-containing serum group （P＜0.05）. Conversely， the percentage of cells in the G0/G1 phase and the expression level of E- cadherin protein were significantly increased （P＜0.05）. In animal experiment， compared with the model group， the high-dose group of Modified qifang weitong granules exhibited significantly reduced tumor mass and expression levels of N-cadherin and vimentin proteins in the tumor tissues of nude mice （P＜0.05）， while the expression level of E-cadherinprotein in the tumor tissues was significantly increased （P＜0.05）. Additionally， the tumor cells varied in size and showed extensive necrosis. CONCLUSIONS Modified qifang weitong granules effectively inhibit gastric cancer in both in vitro and in vivo models， and the mechanism of action is related to the suppression of EMT.

Objective To investigate the risk factors of platelet transfusion refractoriness(PTR)in patients undergoing hematopoietic stem cell transplantation(HSCT)and its influence on the prognosis of the patients.Methods A total of 104 patients who underwent HSCT in The First Affiliated Hospital of Naval Medical University from February 2018 to February 2021 were enrolled and assigned to PTR group(n=36)or non-PTR group(n=68).The clinical data of the two groups were collected to investigate PTR-related factors in HSCT patients.The patients were followed up for 3 years after transplantation,and the survival and the influence of PTR on the prognosis were analyzed.Results The proportions of no platelet antibody matching,blood transfusion≥6 times,high fever,splenomegaly,infection,and skin and mucous membrane bleeding in the PTR group were significantly higher than those in the non-PTR group(P<0.05).The platelet count on admission in the PTR group was significantly lower than that in the non-PTR group(P<0.05).No platelet antibody matching(β=-0.837),blood transfusion≥6 times(β=0.905),high fever(β=0.516),splenomegaly(β=0.773),and infection(β=0.695)were independent risk factors of PTR in HSCT patients(P<0.05).The rates of overall survival(OS)and recurrence-free survival(RFS)in the PTR group were significantly lower than those in the non-PTR group(P<0.05).After multivariate adjustment,PTR was associated with poorer OS(HR=2.764,95%CI:1.267-6.643)and RFS(HR=2.139,95%CI:1.046-5.114).Conclusion The occurrence of PTR in HSCT patients is related to platelet antibody matching,blood transfusion frequency,high fever,splenomegaly,and infection.PTR can affect the prognosis of HSCT patients,and shorten the OS and RFS.

Objective:To explore the clinical and pathological features and survival outcomes of patients with early-onset intrahepatic cholangiocarcinoma (EOICC).Methods:This is a multicenter, retrospective cohort study. Data of 1 160 intrahepatic cholangiocarcinoma patients undergoing radical resection in 14 tertiary Grade A hospitals in China from January 2010 to November 2021 were retrospectively collected. The cohort included 632 males and 528 females, aged( M (IQR)) 61 (14) years (range: 22 to 93 years). ICC aged ≤50 years at the time of diagnosis was defined as EOICC and >50 years as late-onset intrahepatic cholangiocarcinoma (LOICC). Of these, there were 247 cases in the EOICC group and 913 cases in the LOICC. The clinical and pathological characteristics of both groups were analyzed and compared using the independent sample t-test, Mann-Whitney U test or Kaplan-Meier method. Univariate and multivariate Cox regression models for patient outcomes were constructed and forest graphed. Results:Compared with the patients in the LOICC group, patients in the EOICC group had lower carcinoembryonic antigen levels (2.5(4.0) μg/L vs. 3.1(5.2)μg/L, U=124 899, P=0.009) and CA19-9 level (63.4(524.7)U/ml vs. 77.9(611.3)U/ml, U=120 320, P=0.013), higher levels of ALT (29(35)U/L vs. 24(26)U/L, U=101 214, P=0.013), a lower score of the Eastern US Cooperative Oncology Group (0 score patients: 54.7% vs. 44.1%, χ2=12.472, P=0.014), higher TNM stage ( χ2=11.807, P=0.038), and proportion of lymph node dissection (62.3% vs. 54.1%, χ2=5.355, P=0.021). Patients in the two groups in sex, first diagnosis symptoms, intrahepatic bile duct stone history, nail protein, albumin, total bilirubin, transaminase, liver function Child-Pugh grade, T stage, stage, N stage, preoperative laparoscopic exploration proportion, tumor diameter, vascular invasion proportion, differentiation, margin, intraoperative bleeding, postoperative complications, postoperative hospital days were no statistical significance (all P>0.05). Patients in the EOICC group had better outcomes than the LOICC group (median survival time: 29.7 months vs. 25.0 months, 3-year overall survival: 45.1% vs. 37.8%, P=0.027). Conclusion:EOICC patients are better than LOICC patients in carcinoembryonic antigen, CA19-9, ALT, physical strength status and TNM stage, and the long-term prognosis is also better than LOICC patients.

Objective To evaluate the safety and feasibility of remote robot-assisted thoracoscopic surgery utilizing 5G technology. Methods Clinical data from five patients who underwent 5G remote robot-assisted thoracoscopic surgery at the Thoracic Surgery Center of Gansu Provincial People's Hospital from May to October 2024 were retrospectively analyzed. Results Finally, five patients were included. There were 2 males and 3 females at median age of 50 (42-63) years. All five surgeries (including 1 patient of lobectomy, 3 patients of partial lung resection and 1 patient of mediastinal lesion resection) were successfully completed without conversion to thoracotomy, complications, or mortality. The median intraoperative signal delay across the patients was 39 (37-42) ms. The median psychological load score for the surgeons was 9 (3-13). The median operation time was 100 (80-122) minutes with a median intraoperative blood loss of 100 (30-200) mL. Catheter drainage lasted a median of 4 (3-5) days, and the median drainage volumes on the first, second, and third postoperative day were 200 (100-300) mL, 150 (60-220) mL, and 80 (30-180) mL, respectively. The median postoperative hospital stay was 4 (3-7) days, and the median pain scores on the third postoperative day were 3 (1-4), 3 (0-3), and 1 (0-3), respectively. Conclusion 5G remote robot-assisted thoracoscopic surgery is safe and effective, with good surgical experience, smooth operation and small intraoperative delay.

Objective:To explore the clinical and pathological features and survival outcomes of patients with early-onset intrahepatic cholangiocarcinoma (EOICC).Methods:This is a multicenter, retrospective cohort study. Data of 1 160 intrahepatic cholangiocarcinoma patients undergoing radical resection in 14 tertiary Grade A hospitals in China from January 2010 to November 2021 were retrospectively collected. The cohort included 632 males and 528 females, aged( M (IQR)) 61 (14) years (range: 22 to 93 years). ICC aged ≤50 years at the time of diagnosis was defined as EOICC and >50 years as late-onset intrahepatic cholangiocarcinoma (LOICC). Of these, there were 247 cases in the EOICC group and 913 cases in the LOICC. The clinical and pathological characteristics of both groups were analyzed and compared using the independent sample t-test, Mann-Whitney U test or Kaplan-Meier method. Univariate and multivariate Cox regression models for patient outcomes were constructed and forest graphed. Results:Compared with the patients in the LOICC group, patients in the EOICC group had lower carcinoembryonic antigen levels (2.5(4.0) μg/L vs. 3.1(5.2)μg/L, U=124 899, P=0.009) and CA19-9 level (63.4(524.7)U/ml vs. 77.9(611.3)U/ml, U=120 320, P=0.013), higher levels of ALT (29(35)U/L vs. 24(26)U/L, U=101 214, P=0.013), a lower score of the Eastern US Cooperative Oncology Group (0 score patients: 54.7% vs. 44.1%, χ2=12.472, P=0.014), higher TNM stage ( χ2=11.807, P=0.038), and proportion of lymph node dissection (62.3% vs. 54.1%, χ2=5.355, P=0.021). Patients in the two groups in sex, first diagnosis symptoms, intrahepatic bile duct stone history, nail protein, albumin, total bilirubin, transaminase, liver function Child-Pugh grade, T stage, stage, N stage, preoperative laparoscopic exploration proportion, tumor diameter, vascular invasion proportion, differentiation, margin, intraoperative bleeding, postoperative complications, postoperative hospital days were no statistical significance (all P>0.05). Patients in the EOICC group had better outcomes than the LOICC group (median survival time: 29.7 months vs. 25.0 months, 3-year overall survival: 45.1% vs. 37.8%, P=0.027). Conclusion:EOICC patients are better than LOICC patients in carcinoembryonic antigen, CA19-9, ALT, physical strength status and TNM stage, and the long-term prognosis is also better than LOICC patients.

ObjectiveTaking Shengxuebao as the model traditional Chinese medicine（TCM）， this study aims to explore the methodologies and transfer patterns in the composition changes of TCM compound preparations from liquid to solid dosage forms. MethodBased on the previously established ultra-high performance liquid chromatography（UPLC） qualitative and quantitative methods for Shengxuebao， the fingerprint profiles of three preparations of Shengxuebao（homemade decoction， commercially available granules and mixtures） were established， and nineteen components were quantitatively analyzed. The similarities of fingerprint profiles among these three preparations were assessed using the Similarity Evaluation System for Chromatographic Fingerprint of TCM（2012 edition） and the total quantum statistical moment similarity method， respectively. The molecular connectivity index （MCI） and the average molar MCI of the chemical components in the three preparations were calculated. Seventy-two MCI values across 0-8 orders， including 8 subclasses， were calculated. The average molar MCI of 0-3 orders was used to study the "imprint template" structural characteristics and transfer patterns of the medicinal component groups. ResultThe similarities of the fingerprint profile of the decoction with those of the control， granules， and mixtures were 0.971， 0.888 and 0.799， respectively， indicating that the chemical composition of the granules and mixtures differed from that of the decoction， and that the 19 components were able to basically respond to the overall situation of the component group of Shengxuebao decoction. The total mass fractions of the detectable major components in Shengxuebao decoction， granules and mixtures was measured to be 5.498 6， 2.282 0， 1.416 6 mg·g^-1， respectively. The average molar MCI of 0-3 orders showed a gradual decrease across the three preparations， with the trend of decoction>granules>mixtures， indicating subtle changes in the overall structural characteristics of the chemical components in the samples of the three preparations. ConclusionAmong the three formulations of Shengxuebao， the traditional decoction contained the highest variety and quantity of components and carried the most substantial amount of component information， with a decreasing order observed in the granules and mixtures. This study further validates that traditional decoction is a reliable and fundamental dosage form， providing a reference for the modernization of TCM dosage forms and the quality consistency evaluation of compound preparations.

Objective:To analyze the factors influencing the ADL ability and the improvement degree of ADL ability at discharge of hospitalized patients with TBI and to establish prediction models. Method:Data of 220 patients with traumatic brain injury hospitalized in the department of neurorehabilitation,Beijing Boai hospital from september 2017 to september 2020 were retrospectively collected.They were ran-domly divided into training set and validation set according to 3:1,and descriptive analysis was conducted for all variables.BI score at discharge and BI score difference between admission and discharge were used as out-come indexes.Firstly,univariate analysis was used to screen the statistically significant influencing factors,and then multivariate logistic regression analysis was used to establish the prediction model.Receiver operating characteristic(ROC)curve,calibration curve and Hosmer-Lemeshow test were used to evaluate the differentia-tion and calibration of the model in the training set and validation set. Result:Two prediction models were established by multivariate logistic regression:①Duration of disease at ad-mission,FMB at admission and BI at admission were significant influencing factors of BI at discharge.The ar-ea under the curves of the prediction model with BI at discharge was 0.957(95％CI:0.930-0.983)and 0.917(95％CI:0.839-0.994)in the training set and validation set,respectively,showing good model differentiation.Hosmer-lemeshow test results were P=0.196 and P=0.551,respectively,indicating a good calibration degree of the model.The sensitivity,specificity,and Youden index of the logistic regression model were 91.4％(95％CI:0.833-0.959)、83.3％(95％CI:0.723-0.907)and 0.747,respectively.②The duration of disease,length of stay and age at admission significantly affected the BI difference.The areas of the established prediction mod-el under the curves of training set and validation set were 0.773(95％CI:0.702-0.844)and 0.747(95％CI:0.613-0.881),and Hosmer-Lemeshow test results were P=0.721 and P=0.274,respectively,indicating good model differentiation and calibration.The sensitivity,specificity,and Youden index of the logistic regression model were 77.2％(95％CI:0.670-0.850)、64.4％(95％CI:0.522-0.750)and 0.416,respectively. Conclusion:The established two prediction models will help rehabilitation doctors to preliminarily judge the level of functional independence at discharge and the degree of functional improvement during hospitalization according to the status of patients with TBI at admission,and provide reference for rehabilitation medical work.