Objective:To investigate the variation of reference ranges of hemodynamic parameters in normal pregnancy and their relation to maternal basic characteristics.Methods:A total of 598 healthy pregnant women who underwent regular prenatal examination at the Third Affiliated Hospital of Guangzhou Medical University from January to December 2023 were prospectively enrolled, and noninvasive hemodynamic monitors were used to detect changes in hemodynamic parameters of the pregnant women with the week of gestation, including cardiac output (CO), stroke volume (SV), thoracic fluid content (TFC), systemic vascular resistance (SVR), mean arterial pressure (MAP), and heart rate (HR). Relationships between hemodynamic parameters and maternal basic characteristics, including age, height, and weight, were analyzed using restricted cubic spline.Results:(1) CO ( r=0.155, P<0.001), TFC ( r=0.338, P<0.001), MAP ( r=0.204, P<0.001), and HR ( r=0.352, P<0.001) were positively correlated with the week of gestation, and SV was negatively correlated with the week of gestation ( r=-0.158, P<0.001). There was no significant correlation between SVR and gestational age ( r=-0.051, P=0.258). (2) CO exhibited a positive correlation with maternal height and weight (all P<0.001). The taller and heavier of pregnant women, the higher their CO. A linear relationship was observed between maternal weight and SV, MAP and HR (all P<0.01). As maternal weight increased, SV, MAP and HR showed an upward trend. Furthermore, there was an inverse association between maternal age and SVR ( P<0.001). (3) There was a significant nonlinear association observed between TFC and body mass index during pregnancy ( P<0.05). Additionally, a nonlinear relationship was found between SVR and MAP in relation to maternal age (all P<0.05). Notably, when the age exceeded 31 years old, there was an evident upward trend observed in both SVR and MAP. Conclusions:The hemodynamic parameters of normal pregnant women are influenced by their height, body weight, and age. It is advisable to maintain a reasonable weight during pregnancy and give birth at an appropriate age.

Objective:To develop a logistic regression model to predict the prognosis of patients with hepatocellular carcinoma (HCC) based the oxidative stress-related genes.Methods:The HCC dataset was download from the cancer genome atlas (TCGA) database, and the oxidative stress-related genes were extracted from geneontology unifying biology database. Through the difference analysis and univariate Cox regression analysis of normal liver tissue and HCC tissue, the oxidative stress genes associated with HCC-related death were screened out. The least absolute shrinkage and selection opetator (LASSO) regression analysis were used to select prognostic oxidative stress genes, and the genes screened by LASSO regression were incorporated into the logistic regression model to construct the prognosis prediction model. The receiver operating characteristic (ROC) curve were used to assess the performance accuracy of the predictive model. The international cancer genome consortium (ICGC) database was used for external validation of the model.Results:A total of 147 oxidative stress-related genes were differentially expressed between HCC tissues and adjacent non-cancerous tissues (all P<0.05). Forty-three prognostic genes were identified by univariate Cox regression analysis and included in LASSO regression, and subsequently 11 features with nonzero coefficient were obtained. The 11 oxidative stress-related genes were incorporated into the logistic regression model. The findings revealed that HCC patients exhibiting positive expression of SRXN1, G6PD, MAPK7, STK25, GLRX2, ANKZF1, STC2, APEX1, PRKCD, MT3 and EZH2 genes had a significantly increased risk of postoperative death (all P<0.05). The logistic regression model was constructed as follows: 0.100 575×SRXN1+ 0.002 908×ANKZF1+ 0.010 061×MAPK7+ 0.022 816×STK25+ 0.018 489×GLRX2+ 0.004 291×G6PD+ 0.004 790×STC2+ 0.000 135×APEX1+ 0.007 531×PRKCD+ 0.025 770×MT3+ 0.079 615×EZH2. The logistic regression model demonstrated good predictive efficacy for the 1-, 2-, and 3-year survival of HCC patients after surgery, the values in area under the curve of ROC is 0.798, 0.752, and 0.720, respectively. According to the TCGA cohort, a median risk score model of 4.80 was established, which facilitated the division of ICGC patients into two distinct groups: the high-risk ( n=121) and low-risk ( n=122). The Kaplan-Meier survival curves demonstrated a significantly lower cumulative survival rate in the high-risk group ( P=0.003). Conclusion:The constructed logistic regression model of oxidative stress-related genes can be utilized to predict the outcome of HCC patients, thereby facilitating personalized treatment strategies and serving as a valuable reference for clinical decision-making.

Objective:To develop a logistic regression model to predict the prognosis of patients with hepatocellular carcinoma (HCC) based the oxidative stress-related genes.Methods:The HCC dataset was download from the cancer genome atlas (TCGA) database, and the oxidative stress-related genes were extracted from geneontology unifying biology database. Through the difference analysis and univariate Cox regression analysis of normal liver tissue and HCC tissue, the oxidative stress genes associated with HCC-related death were screened out. The least absolute shrinkage and selection opetator (LASSO) regression analysis were used to select prognostic oxidative stress genes, and the genes screened by LASSO regression were incorporated into the logistic regression model to construct the prognosis prediction model. The receiver operating characteristic (ROC) curve were used to assess the performance accuracy of the predictive model. The international cancer genome consortium (ICGC) database was used for external validation of the model.Results:A total of 147 oxidative stress-related genes were differentially expressed between HCC tissues and adjacent non-cancerous tissues (all P<0.05). Forty-three prognostic genes were identified by univariate Cox regression analysis and included in LASSO regression, and subsequently 11 features with nonzero coefficient were obtained. The 11 oxidative stress-related genes were incorporated into the logistic regression model. The findings revealed that HCC patients exhibiting positive expression of SRXN1, G6PD, MAPK7, STK25, GLRX2, ANKZF1, STC2, APEX1, PRKCD, MT3 and EZH2 genes had a significantly increased risk of postoperative death (all P<0.05). The logistic regression model was constructed as follows: 0.100 575×SRXN1+ 0.002 908×ANKZF1+ 0.010 061×MAPK7+ 0.022 816×STK25+ 0.018 489×GLRX2+ 0.004 291×G6PD+ 0.004 790×STC2+ 0.000 135×APEX1+ 0.007 531×PRKCD+ 0.025 770×MT3+ 0.079 615×EZH2. The logistic regression model demonstrated good predictive efficacy for the 1-, 2-, and 3-year survival of HCC patients after surgery, the values in area under the curve of ROC is 0.798, 0.752, and 0.720, respectively. According to the TCGA cohort, a median risk score model of 4.80 was established, which facilitated the division of ICGC patients into two distinct groups: the high-risk ( n=121) and low-risk ( n=122). The Kaplan-Meier survival curves demonstrated a significantly lower cumulative survival rate in the high-risk group ( P=0.003). Conclusion:The constructed logistic regression model of oxidative stress-related genes can be utilized to predict the outcome of HCC patients, thereby facilitating personalized treatment strategies and serving as a valuable reference for clinical decision-making.

Objective:To investigate the work requirement and training needs of general practitioners in Shenzhen during the outbreak of coronal virus disease 2019 (COVID-19).Methods:From February 19 to February 29, 2020, the questionnaires of "Coping with COVID-19 epidemic of genereal practitioners in Shenzhen region" were distributed to 4 002 general practitioners in Shenzhen hospitals and communities through the Questionnaire Star software. The changes of job content, education parttern, and the perception of roles before and during the epidemic were surveyed; the different roles of doctors engaged in general medicine before and after 2008 in education and community work were compared; the needs for training in epidemic prevention related knowledge for general practitioners were investigated.Results:A total of 382 questionnaires were recovered, of which 361 were valid, and the effective rate was 94.5%. The 83.1% (300/361) of general practitioners believed that the number of patients during the epidemic was significantly reduced. The main work was to screen community residents in epidemic areas (68.9%, 249/361), telephone counseling (54.0%, 195/361), and screening and follow-up of close contacts (42.9%, 155/361); 98.9% (357/361) of community doctors participated in outpatient education. Experienced doctors (starting work before 2008) were more willing to undertake management work in the epidemic (χ 2=77.370, P<0.05) . General practitioners′ needs for training were psychological interventions for residents under quarantine (80.6%, 291/361), home protection knowledge in the community (74.2%, 268/361), and isolation measures of the family with suspected patients (67.3%, 243/361), wearing and taking off protective gowns (65.1%, 235/361), collecting pharyngeal swab specimens (57.3%, 207/361) and patient referral procedures (52.4%, 189/361). The 60.6% (219/316) of general practitioners preferred information from the government press conference, expert opinion or the intranet of the organization (such as the hospital management department). Conclusion:General practitioners in Shenzhen took important screening, public education and counseling works during the COVID-19 epidemic, meanwile the training in the psychological intervention, the prevention and control knowledge related to the epidemic should be strengthend to better cope with the epidemics.

Huntington's disease (HD) is a deadly neurodegenerative disease with abnormal expansion of CAG repeats in the huntingtin gene. Mutant Huntingtin protein (mHTT) forms abnormal aggregates and intranuclear inclusions in specific neurons, resulting in cell death. Here, we tested the ability of a natural heat-shock protein 90 inhibitor, Gedunin, to degrade transfected mHTT in Neuro-2a cells and endogenous mHTT aggregates and intranuclear inclusions in both fibroblasts from HD patients and neurons derived from induced pluripotent stem cells from patients. Our data showed that Gedunin treatment degraded transfected mHTT in Neuro-2a cells, endogenous mHTT aggregates and intranuclear inclusions in fibroblasts from HD patients, and in neurons derived from induced pluripotent stem cells from patients in a dose- and time-dependent manner, and its activity depended on the proteasomal pathway rather than the autophagy route. These findings also showed that although Gedunin degraded abnormal mHTT aggregates and intranuclear inclusions in cells from HD patient, it did not affect normal cells, thus providing a new perspective for using Gedunin to treat HD.

Objective To study the relationship between regional cerebral blood flow (rCBF) in matter lesion (WML) and cognitive impairment by arterial spin labeling (ASL).Methods Fourteen WML patients served as a WML group and 9 WML-free subjects served as a control group.Their neuropsychology was assessed and their rCBF was measured by ASL.Results The MoCA score,positive rate of symbol digit modalities test (SDMT),verbal fluency test (VFT) and digital span test forward and backward (DST F and B) were significantly lower while the trail making test-A (TMT-A) score and positive rate of Stroop B test and psychomotion speed test were significantly higher in WML group than in control group (P＜0.05,P＜0.01).The rCBF in regional WML was significantly slower in right and left semioval center,anterior and posterior horn of right and left lateral ventricle than that in normal white matter region (P＜0.01).The rCBF in WML was positively related with DST F and B (P＜0.05).The rCBF in NAWM was positively related with VFT (P＜0.01).Conclusion ASL can show the relationship between rCBF and cognitive impairment,especially executive function,attention and memory in elderly WML patients and decreased rCBF can thus increase their risk of cognitive impairment and dementia.

Objective:To investigate the public cognition,attitude and coping style of medical disputes among 2910 citizens from Hangzhou,Ningbo and Wenzhou and other cities in Zhejiang Province.Methods:Totally 11 cit-ies in Zhejiang Province were selected using the method of random sampling and a questionnaire survey was conduc-ted based on the principle of voluntary.Results:The public legal awareness was not strong,of which the primary influencing factors were the excessive prescription and medical professionals'unsatisfying attitude.Conclusion:In view of the existing problems,this paper put forward the optimization countermeasures including popularizing legal knowledge,enhancing citizens' sense of security,strengthening media management,correctly guiding public opin-ion,strengthening psychological intervention,and avoiding emotional stress.

In this paper , based on the analysis of the facing predicament of current situation of medical ethics education , the authors combined with the practice of medical ethics education and the school experience , based on the theory of life education , put forward to experience the activities of public medical treatment building practice of medical students medical ethics education system , promote the educational work to carry out the practice of medical colleges, improve the teaching quality of medical ethics education .

The education on medical students career planning is an important part not only in the field of higher medical education but also for the employment guidance of the higher medical colleges.According to the reality of the medical students'career planning education,the article proposes some new thinkings about how to strengthen the education on the medical students about their career planning.