Objective To explore the association between single nucleotide polymorphism(SNP)of Rab37 gene and the age at menarche(AAM).Methods A case-control study design was used to conduct an epidemiologic survey on 2 060 women in a community in Jurong City,Jiangsu Province,and their venous blood samples were collected.ASA chip was used to explore the Rab37 gene genotyping of blood sample DNA to obtain the genotyping results for Rab37 SNPs rs62084865,rs10512597,rs35489971,rs1037170,rs6501732,rs77822106,and rs3178300.Based on menarche time of＜16 years old or≥16 years old,the participants were divided into 2 groups.Linear and logistic regression analyses were used to explore the association between the SNP of Rab37 gene and the age at menarche based on dominant,recessive and allelic models.Results Among the 2 060 healthy women,944 women had normal menstrual periods,while 1 116 women experienced delayed menarche.Linear regression analysis showed that the gene polymorphism of rs3178300 was negatively correlated with the age at menarche in females[recessive model:CC/CT+TT,β=-0.915,95%CI(-1.692,-0.137),P=0.021;allelic model:T/C,β=-0.221,95%CI(-0.410,-0.032),P=0.022].Logistic regression analysis indicated that the gene polymorphism of rs3178300 was significantly associated with the risk of delayed menarche in females[recessive model:CC/CT+TT,OR=0.295,95%CI(0.116,0.751),P=0.010;allelic model:T/C,OR=0.796,95%CI(0.652,0.972),P=0.025].The remaining 6 SNPs showed no significant association with age at menarche.Conclusion The rs3178300 polymorphism of Rab37 gene is significantly associated with delayed menarche in Chinese women.

BACKGROUND:The increase in multi-drug resistant bacterial infections has become a major problem in modern healthcare due to the development of bacterial resistance to antibiotics and the development of new antibacterial alternative drug materials is of great importance. OBJECTIVE:To synthesize and perform a series of characterization of a CeO2 nanoenzyme to investigate its biocompatibility and antibacterial properties against Escherichia coli. METHODS:CeO2 nanoenzymes were synthesized using a hydrothermal method.The morphology,product composition,and chemical composition were analyzed using characterization methods such as X-ray diffraction,X-ray photoelectron spectroscopy,Fourier infrared analysis,Raman spectroscopy,scanning electron microscopy,and transmission electron microscopy.The peroxide-mimetic enzyme activity of CeO2 nanoenzymes was characterized using TMB color development assay.The toxic effect of CeO2 nanoenzymes at different concentrations(10,25,and 50 μg/mL)on mouse fibroblast L929 cells was evaluated using the CCK-8 assay.The antibacterial properties of CeO2 nanoenzymes against Escherichia coli under different conditions were evaluated using the plate coating method.Changes in intra-bacterial reactive oxygen species after treatment with different conditions were detected using a reactive oxygen species detection kit. RESULTS AND CONCLUSION:(1)The morphology of the synthesized CeO2 nanoparticles was rod-shaped,with Ce3+ accounting for 29.87%of the total Ce3+/Ce4+ and an average grain size of 7.4 nm.In a slightly acidic environment containing TMB and pH=5.5,CeO2 nanoenzymes mixed with H2O2 showed excellent peroxidase activity,but did not show peroxidase simulated activity at pH=7.4.(2)There was no statistically significant difference in the toxic effects of CeO2 nanoparticles at various mass concentrations on mouse fibroblast L929 cells.(3)In a slightly acidic environment at pH 5.5,Escherichia coli was inhibited to a certain extent in the presence of CeO2 nanoenzyme alone at a concentration of 10 μg/mL,with a decrease in CFU results of about 0.5 log(P＜0.01);in a slightly acidic environment containing 50 μmol/L H2O2,CeO2 nanoenzyme showed excellent antibacterial effects against Escherichia coli,with a decrease in Escherichia coli CFU results of by about 1.5 log(P＜0.001).After CeO2 nanoenzymes interacted with Escherichia coli,the level of reactive oxygen species in Escherichia coli increased(P＜0.05);after CeO2 nanoenzymes interacted with Escherichia coli together with H2O2,the level of reactive oxygen species in Escherichia coli increased significantly(P＜0.001).(4)The results show that the CeO2 nanoenzymes have good biocompatibility,are inherently antibacterial,and can exhibit peroxidase activity in a slightly acidic environment containing low concentrations of H2O2,and generate reactive oxygen species to kill bacteria,thus showing excellent antibacterial effects.

Objective:To construct an evaluation index system of internal control medical equipment based on the internal control theory of The Committee of Sponsoring Organizations of the Treadway Commission(COSO)and combined with the current situation of medical equipment internal management in public hospitals,so as to provide reference and suggestions for the evaluation of internal control of medical equipment in public hospitals.Methods:Through literature research and expert consultation,the evaluation index system of internal control of medical equipment was preliminarily determined.Using the Delphi method,15 experts from 1 medical college and 3 tertiary hospitals in Beijing who were engaged in the use and management of medical equipment were selected to conduct two rounds of consultation on the evaluation index system of internal control of medical equipment,and the evaluation indicators were scored and screened.The analytic hierarchy process(AHP)was used to determine the index weights,and the internal control evaluation index system of medical equipment in public hospitals based on COSO was constructed.Results:The coefficient of the two rounds of expert consultation was 100%.The authority degree of consulting experts was 0.867.Finally,the evaluation index system of internal control of medical equipment in tertiary public hospitals was formed,which included 5 first-level indicators,17 second-level indicators and 50 third-level indicators.Conclusion:The evaluation index of internal control of medical equipment in public hospitals based on COSO has high expert enthusiasm,authority and coordination.The evaluation index system includes the unit level and the business level of internal control,with a wide coverage,which makes up for the limitations of traditional internal evaluation of medical equipment,which can make up for the limitations of the internal evaluation of traditional medical equipment,improve the internal control system of medical equipment in public hospitals,and optimize the medical equipment management system.

Objective:To explore the latent classes of doctors′ behaviors in the process of shared decision-making between doctors and patients, and analyze the influencing factors for the latent classes.Methods:From August to September 2023, doctors from 4 tertiary hospitals in Dongcheng district, Beijing were selected using convenience sampling method. The general information questionnaire, shared decision making questionnaire-physician version(SDM-Q-Doc), doctor patient relationship questionnaire, the Jefferson scale of empathy health professionals, physician trust in the patient scale were administered to the participants. Latent profile analysis was performed based on the items of SDM-Q-Doc. The ordinal logistic regression analysis was conducted to explore the influencing factors of the latent classes of shared decision making.Results:A total of 480 doctors were included in the study. The results of latent profile analysis showed that doctors could be classified into 3 subgroups by shared decision making, namely shared decision missing group(17.3%, 83/480), collective balance deficiency group(52.5%, 252/480), and shared decision making group(30.2%, 145/480). The results of ordinal logistic regression analysis showed that career development opportunity( OR=0.509, 95% CI: 0.269-0.965, P=0.038), working years( OR=1.103, 95% CI: 1.016-1.196, P=0.019), empathic ability( OR=1.096, 95% CI: 1.079-1.113, P<0.001) and doctor-patient trust( OR=1.053, 95% CI: 1.027-1.080, P<0.001) were independent influencing factors of doctors′ shared decision making. Conclusions:The shared decision making of doctors showed significant population heterogeneity. Longer working years, sufficient career opportunities, high empathy ability and strong doctor-patient trust could enhance shared decision making behavior of the doctors. Intervention can be planned based on above factors from the perspectives of hospital managers and doctors in the future.

Objective:To investigate the clinicopathological, immunophenotypic and molecular genetic characteristics, and differential diagnosis of NTRK-rearranged spindle cell neoplasms (NTRK-RSCNs) in the gastrointestinal tract.Methods:Two NTRK-RSCNs diagnosed at the Department of Pathology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China and one case diagnosed at Zhengzhou Central Hospital, Zhengzhou, China from 2019 to 2022 were collected. The clinical data, histopathology, immunophenotypes and prognosis were analyzed. Fluorescence in situ hybridization (FISH) and next-generation sequencing (NGS) were used to detect NTRK gene rearrangements, while relevant literature was also reviewed and discussed.Results:Two patients were male and one was female, with the age of 17, 47 and 62 years, respectively. The tumors were located in the duodenum, ascending colon and descending colon, respectively. The tumors were protuberant masses with gray and rubbery sections. Their maximum diameter was 2.5, 5.0 and 10.0 cm, respectively. Histologically, the tumors invaded mucosa, intrinsic muscle and serosal adipose tissue. Tumor cells consisted of spindle or oval shaped cells with monotonous morphology and arranged in bundles or stripes pattern. Spindle cells were mildly to moderately atypical, with slightly eosinophilic cytoplasm and inconspicuous nucleoli. Necrosis and mitotic figures were observed in one high-grade tumor. All tumors expressed CD34, S-100 and pan-TRK in varying degrees. FISH analysis showed that NTRK1 gene was break-apart in 1 case and NTRK2 gene break-apart in 2 cases. NGS technologies showed LMNA::NTRK1 fusion in one case, STRN::NTRK2 fusion in another case. All patients recovered well after the surgery without recurrence at the end of the follow-up.Conclusions:NTRK-RSCN is rarely diagnosed in the gastrointestinal tract and has significant variations in morphology. It overlaps with various other mesenchymal tumors which should be considered as differential diagnoses. Be familiar with the features of histological morphology in combination with immunophenotype and molecular genetic characteristics can not only help diagnose NTRK-RSCNs, but provide therapeutic targets for clinical treatment.

Recently,the substance P(SP)/neurokinin-1 receptor(NK-1R)system has been found to be involved in various human pathophysiological disorders including the symptoms of coronavirus disease 2019(COVID-19).Besides,studies in the oncological field have demonstrated an intricate correlation between the upregulation of NK-1R and the activation of SP/NK-1R system with the progression of multiple carcinoma types and poor clinical prognosis.These findings indicate that the modulation of SP/NK-1R system with NK-1R antagonists can be a potential broad-spectrum antitumor strategy.This review updates the latest potential and applications of NK-1R antagonists in the treatment of human diseases and cancers,as well as the underlying mechanisms.Furthermore,the strategies to improve the bioavailability and efficacy of NK-1R antagonist drugs are summarized,such as solid dispersion systems,nanonization,and nanoencapsulation.As a radiopharmaceutical therapeutic,the NK-1R antagonist aprepitant was originally developed as radioligand receptor to target NK-1R-overexpressing tumors.However,combining NK-1R antagonists with other drugs can produce a synergistic effect,thereby enhancing the therapeutic effect,alleviating the symptoms,and improving patients'quality of life in several diseases and cancers.

Objective:To investigate the clinical effect of postauricular island flap in reconstruction of anterior auricular defect.Methods:Twelve patients with auricular tumors were retrospectively analyzed in the Department of Aesthetic Plastic and Craniofacial Surgery, the First Affiliated Hospital of Xi'an Jiaotong University. After the tumors were completely removed, the skin defects were repaired with retroauricular island flaps, and the clinical results of the flaps were observed.Results:All the twelve postauricular island flaps were survived postoperatively. One of the flaps had the disorder of blood supply. After puncture with the needle, the congestion was drained out and the flap survived finally. During 1 to 2 years' follow-up, all patients were well satisfied with the surgical results.Conclusions:The posterior auricular island flap in reconstruction of anterior auricular defect has the advantages of simple and easy operation, high survival rate, small scar in the donor area and good aesthetic effect, which is worthy of clinical promotion.

Objective:To explore the correlation between serum creatinine/cystatin C(Scr/CysC)ratio and sarcopenia, and search for serum markers specific to sarcopenia.Methods:A retrospective case-control study of 142 hospitalized patients in the Department of Geriatrics, Xiangya Second Hospital, Central South University from November 2020 to February 2022 were collected, including 43 sarcopenia cases and 99 non sarcopenia cases.The correlation between Scr/CysC ratio and sarcopenia was analyzed and explored.Results:The Scr/CysC ratio of 71.5±12.5 in the sarcopenia group was significantly lower than that of 81.9±15.8 in the non-sarcopenia group( t=3.823, P<0.001), and Scr/CysC was positively correlated with muscle mass and grip strength( r=0.52, 0.69, both P<0.001).The results of the analysis of receiver operating characteristic curves of the subjects showed that in male inpatients, the area under the curve(AUC)of the Scr/CysC ratio in the diagnosis of sarcopenia was 0.770(95% CI: 0.655 to 0.886, P<0.001), with a diagnostic reference value of 80.97, which gave a sensitivity of 72.2% and a specificity of 68.4%.In female inpatients the AUC was 0.621(95% CI: 0.474 to 0.768, P=0.099), with a diagnostic reference value of 65.20, giving a sensitivity of 77.8% and a specificity of 58.3%. Conclusions:The serum Scr/CysC ratio may be a serum marker for male sarcopenia patients, and sarcopenia may be considered when it is below 80.97; The diagnostic value in female sarcopenia needs further research.

Objective:To investigate the application effects of self-developed rapid tracheotomy apparatus for acute tracheotomy.Methods:A total of 120 patients who underwent an acute tracheotomy in the Weihai Branch of The 970 Hospital of PLA Joint Logistics Support Force from January 2019 to December 2020 were included in this study. These patients were randomly divided into a rapid group and a conventional group, with 60 patients in each group. Patients in the rapid group underwent tracheotomy with a self-developed rapid tracheotomy apparatus. Patients in the conventional group underwent the standard steps of traditional tracheostomy. The operation time, incision length, amount of bleeding, and incidence of postoperative complications were compared between the two groups.Results:The operation time in the rapid group was significantly shorter than that in the conventional group [(4.5 ± 0.9) minutes vs. (19.3 ± 4.7) minutes, t = 23.86, P < 0.001]. The length of incision in the rapid group was significantly shorter than that in the conventional group [(2.8 ± 0.3) cm vs. (4.2 ± 1.3) cm, t = 8.68, P < 0.001]. The amount of bleeding during the surgery in the rapid group was significantly less than that in the conventional group [(4.4 ± 1.6) mL vs. (11.8 ± 4.1) mL, t = 12.99, P < 0.001]. The incidence of postoperative complications in the rapid group was significantly lower than that in the conventional group ( χ2 = 4.66, P = 0.031). Conclusion:The self-developed rapid tracheotomy apparatus for acute tracheotomy can be used to establish an artificial airway quickly and minimally invasively by simplifying the operational steps. It is remarkably innovative to increase safety with open-view operations and decrease the incidence of complications. It can be repeatedly sterilized and reused, which is worthy of clinical application and popularization.

Objective:To explore the outcome of sponge forceps assisted threading with Speedbridge technique for the treatment of acute closed Achilles tendon rupture.Methods:A retrospective case series study was conducted on 20 patients with acute closed Achilles tendon rupture treated in Zhengzhou Orthopedic Hospital from December 2019 to December 2021. There were 18 males and 2 females, with age range of 24-43 years [(29.5±7.6)years]. All patients were with unilateral injury, involving the left side in 13 patients and right side in 7. Examinations revealed a palpable defect in the Achilles tendon and positive Thompson test. A longitudinal incision was made at the medial edge of the ruptured tendon. Three nonabsorbable sutures were passed through the proximal stump with sponge forceps, bypassed the rupture site and fixed directly into the calcaneal bone. The disrupted tendon ends were aligned by the tendon-bundle technique using 4-0 absorbable sutures. The operation time and incision length were documented. The ankle joint range of motion (dorsiflexion/plantar flexion), American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Achilles tendon total rupture score (ATRS) in the affected and healthy side were compared at 3, 6 and 12 months postoperatively. The wound healing and complications were observed.Results:All patients were followed up for 12-16 months [(13.2±2.5)months]. The operation time was 40-66 minutes [(52.0±10.3)minutes], with the incision length of 3-4 cm [(3.3±0.7)cm]. In the affected side at 3 and 6 months postoperatively, the ankle joint dorsiflexion [(5.6±1.5)°, (10.5±0.2)°] and plantar flexion [(28.4±3.2)°, (33.5±1.5)°] showed statistically significant difference compared with the healthy side (all P<0.05). The ankle joint dorsiflexion [(13.9±0.7)°] and plantar flexion [(38.3±4.4)°] in the affected side were not statistically different from that of the healthy side at 12 months postoperatively (all P>0.05). The AOFAS ankle-hindfoot score was (58.3±5.4)points, (84.9±7.1)points and (91.8±6.3)points at 3, 6 and 12 months postoperatively, showing a gradual rise (all P<0.05). The ATRS was (60.5±4.9)points, (85.5±9.0)points and (93.1±5.7)points at 3, 6 and 12 months postoperatively, showing a gradual rise (all P<0.05). All incisions were healed primarily. No patients had wound infection, nerve injury or re-rupture. Pain at the anchor insertion site occurred in 2 patients at 1 month after operation and relieved after active functional rehabilitation at 4 months after operation. Transient pain at the Achilles tendon insertion occurred in 1 patient at 6 months after operation, and relieved after 2 weeks of oral non-steroidal anti-inflammatory drugs treatment. Conclusion:For acute closed Achilles tendon rupture, sponge forceps assisted threading with Speedbridge technique can attain short operation time, small incision and good functional recovery, with few complications.