Objective: To understand the changing trends and related factors of knowledge, attitude and practice (KAP) regarding the three major infectious diseases (acquired immunodeficiency syndrome, tuberculosis, hepatitis B) among freshmen in Jiangsu from 2019 to 2022, so as to provide a reference basis for the health education of infectious diseases in schools. Methods: From 2019 to 2022, a total of 33 944 freshmen from 20 universities in Jiangsu Province were randomly selected for four consecutive years to investigate their KAP levels online through self designed questionnaires on three major infectious diseases. The multiple linear regression model was used to analyze the changing trends of students KAP levels of the three major infectious diseases, and to explore the influencing factors of KAP. Results: From 2019 to 2022, the knowledge scores(18.0±3.1,18.4±3.2,18.7±3.2,18.8±3.2), related to the three major infectious diseases showed an upward trend ( F=436.50, P <0.01), and the positive attitude reporting rates were 81.77%, 81.46%, 82.68% and 81.74%, respectively. The reporting rates of positive practice were 80.11%, 79.25%, 79.08 % and 79.04%, respectively. Multiple linear regression showed that school type, parental education level, mother s occupation, average income per person in family and living arrangements during high school all had an impact on the knowledge ( β = -1.510 -0.559), attitudes ( β =-0.043-0.065) and practice ( β =-0.028-0.027) of the three major infectious diseases ( P < 0.05 ). The family residence areas only affected the reporting rate of positive attitude scores ( β =0.002-0.065), and whether only children or not affected the reporting rate of positive practice scores ( β =0.009)( P <0.05). The knowledge score showed an upward trend ( β= 0.297, P <0.01), the positive attitude reporting rate showed no statistically significant change ( β=0.001, P =0.22), and the positive practice reporting rate showed a downward trend ( β=-0.005, P <0.01). Conclusions Freshman in Jiangsu Province from 2019 to 2022 have shown a separation in KAP scores regarding the three major infectious diseases. Targeted measures should be taken to improve their health practice level.

Objective: To examine the causal association and potential mechanisms between bone mineral density in different age groups and primary malignant bone tumor based on two sample Mendelian randomization (MR), so as to provide a reference for the prevention and treatment of primary malignant bone tumor. Methods: The genome-wide association study (GWAS) of bone mineral density was obtained from the GEFOS database,which included 66 628 subjects divided into five age groups (0-15, 15-30, 30-45, 45-60, and >60 years) based on the phases of human bone development. The GWAS of primary malignant bone tumor was sourced from the FinnGen database, including 648 cases and 378 749 controls. Using bone mineral density of five age groups as the exposure and primary malignant bone tumor as the outcome, an MR analysis was performed with the inverse-variance weighted (IVW) method. Sensitivity analysis were conducted using Cochran's Q test, MR-Egger regression, MR-PRESSO test and MR Steiger test. The potential mechanisms underlying the causal association between bone density and primary malignant bone tumors were explored using Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Results: The MR analysis results showed that there was a negative causal association between bone density and primary malignant bone tumors in the 30-45 age group (OR=0.301, 95%CI: 0.126-0.721). No statistically significant associations between bone density and primary malignant bone tumors were found in the 0-15, 15-30, 45-60, and >60 age groups (all P>0.05). Sensitivity analysis did not detect heterogeneity, pleiotropy (all P>0.05) and reverse causality. KEGG enrichment analysis revealed that genes highly associated with bone density and primary malignant bone tumors were enriched in the mTOR signaling pathway and the Wnt signaling pathway, among which Low Density lipoprotein Receptor Related protein 5 and Wnt Family Member 16 are key regulatory genes. Conclusion The decrease in bone mineral density among individuals aged 30-45 may increase the risk of primary malignant bone tumors through the mTOR signaling pathway and the Wnt signaling pathway.

Sheep pox is widespread worldwide and is the most severe animal pox virus infection. This study aimed to identify the key microRNAs (miRNAs) differentially expressed in the exosomes of sheep poxvirus-infected cells and their target genes and related pathways and provide a theoretical basis for an in-depth understanding of the molecular mechanisms of sheep poxvirus-infected cells. In this study, the differentially expressed miRNAs were verified by quantitative polymerase chain reaction (qPCR), and the target genes of miRNAs were predicted and analyzed by bioinformatics. The qPCR results showed that the expression trends of oar-miR-21, oar-miR-10b, oar-let-7f, oar-let-7b, and oar-miR-221 were consistent with the sequencing results. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes results showed that differentially expressed miRNAs were mainly involved in the immune system processes of the Arf6 downstream pathway. The target genes Reactome pathways were mainly enriched in the RAC1 GTPase cycle, CDC42 GTPase cycle, RHO GTPase cycle, RHOV GTPase cycle, and post-transcriptional silencing of small RNAs. The transcription factors SP4, NKX6-1, MEF2A, SP1, EGR1, and POU2F1 that may be connected to sheep pox virus (SPPV)-infected cells were discovered by transcription factor annotation screening. In conclusion, this study screened for differentially expressed miRNAs in SPPV-infected cells and performed a series of bioinformatic analyses of their target genes to provide a theoretical basis for the molecular mechanism of sheep pox virus infections of cells. The data can be used as basic information in future studies on the defense mechanisms against poxvirus infections.

Objective:To evaluate the efficacy of adjusted Narcotrend Index (NI) value guidancecombined with small-dose esketamine for program-controlled closed-loop target-controlled infusion (TCI) system.Methods:Forty-eight American Society of Anesthesiologists Physical Status classificationⅠ or Ⅱpatients, regardless of gender, aged 18-55 yr, with body mass index of 18-25 kg/m 2, scheduled for elective laparoscopic surgery under general anesthesia, were assigned to control group (group C, NI baseline value median 36) and esketamine group(group E, NI baseline value median 46) using a random number table method, with 24 cases in each group. Anesthesia induction and maintenance were carried out using effect-site concentration TCI(Schnider model for propofol infusion and Minto model for remifentanil infusion). After the NI value was maintained at 26-46 during anesthesia maintenance, a small dose of esketamine was given (as an intravenous bolus 0.2 mg/kg, followed by an infusion of 5 μg·kg -1·min -1for 30 min) in group E, and the equal volume of normal saline was given instead in group C. Program-controlled closed-loop TCI was then started, and the target effect-site concentrations of propofol and remifentanil were adjusted every 5 min according to the corresponding preset NI baseline value. The main outcome measures were the percentage of time of NI value maintained in the target range within 1 h after administration of esketamine. Secondary outcome measures were the consumption of propofol and remifentanil, postoperative recovery time, incidence of nausea and vomiting, pain and shivering within 1 h after surgery. Patients were followed for intraoperative awareness on 2nd day after operation. Results:The performance of the program-controlled closed-loop TCI systems was within the safe clinical threshold, with no intraoperative awareness occurred in both groups. The consumption of propofol and remifentanil was significantly reduced in group E as compared to group C( P<0.05). There were no statistically significant differences in the percentage of time of NI value maintained in the target range, postoperative recovery time and incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Adjusted NI value guidance combined with small-dose esketamine provides better efficacy when used for program-controlled closed-loop TCI system.

Objective To evaluate the effectiveness and safety of different Chinese patent medicine in improving blood lipid and microcirculation in coronary heart disease patients with phlegm-blood stasis syndrome based on network meta-analysis.Methods The randomized controlled trials(RCTs)of different Chinese patent medicine in the treatment of blood lipid and microcirculation in coronary heart disease patients with phlegm-blood stasis syndrome were collected by searching CNKI,Wanfang,VIP,SinoMed,PubMed,EMbase,Cochrane Library,and Web of science databases from the establishment of the database to April 3,2023.Literature quality evaluation and network meta-analysis were conducted using Review Manager 5.4 and Stata15.1 software.Results Thirty-seven RCTs were included,with a total sample size of 4 064 cases,involving 15 different Chinese patent medicines.The network meta-analysis showed that the efficacy of Chinese patent medicine combined with conventional Western medicine is often better than that of conventional Western medicine alone.There are no serious adverse reactions.The top three Chinese patent medicines with cumulative probability of total clinical efficacy were Guanmai Zaitong soft extract,Gualoupi Injection and Quyu Xiaoban Capsule.In terms of improving triglyceride(TG)and low-density lipoprotein(LDL-C),the top three Chinese patent medicines were Gualoupi Injection,Huxinkang Tablet and Guanxin Shutong Capsule.In terms of improving plasma viscosity and fibrinogen,the top three Chinese patent medicines were Ginkgo Damo Injection,Gualoupi Injection and Guanxin Shutong Capsule.In terms of improving endothelial function[nitric oxide(NO)and endothelin-1(ET-1)],the top three Chinese patent medicines were Ginkgo Damo Injection,Danlou Tablet and Tongmai Yuxin Pill.In terms of reducing inflammation hypersensitivity C-reactive protein(hs-CRP),the top three Chinese patent medicines were Ginkgo Damo Injection,Huxinkang Tablet and Guanxin Shutong Capsule.Conclusion The current evidence shows that the combination of TCM,which is used for the treatment of phlegm-blood stasis syndrome,with conventional Western medicine in the treatment of coronary heart disease has advantages in improving clinical efficacy,blood lipids and microcirculation.TCM especially for the treatment of phlegm-blood stasis syndrome shows more obvious advantage,such as Guanmai Zaitong soft extract and Gualoupi injection,which can be taken into consideration as part of the clinical guidelines.However,due to the limited number and quality of the included literatures,the research results still need to be verified by more high-quality,multi-center,double-blind randomized trials.The purpose is to provide more reliable evidence-based medical reference.

Sheep pox is widespread worldwide and is the most severe animal pox virus infection. This study aimed to identify the key microRNAs (miRNAs) differentially expressed in the exosomes of sheep poxvirus-infected cells and their target genes and related pathways and provide a theoretical basis for an in-depth understanding of the molecular mechanisms of sheep poxvirus-infected cells. In this study, the differentially expressed miRNAs were verified by quantitative polymerase chain reaction (qPCR), and the target genes of miRNAs were predicted and analyzed by bioinformatics. The qPCR results showed that the expression trends of oar-miR-21, oar-miR-10b, oar-let-7f, oar-let-7b, and oar-miR-221 were consistent with the sequencing results. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes results showed that differentially expressed miRNAs were mainly involved in the immune system processes of the Arf6 downstream pathway. The target genes Reactome pathways were mainly enriched in the RAC1 GTPase cycle, CDC42 GTPase cycle, RHO GTPase cycle, RHOV GTPase cycle, and post-transcriptional silencing of small RNAs. The transcription factors SP4, NKX6-1, MEF2A, SP1, EGR1, and POU2F1 that may be connected to sheep pox virus (SPPV)-infected cells were discovered by transcription factor annotation screening. In conclusion, this study screened for differentially expressed miRNAs in SPPV-infected cells and performed a series of bioinformatic analyses of their target genes to provide a theoretical basis for the molecular mechanism of sheep pox virus infections of cells. The data can be used as basic information in future studies on the defense mechanisms against poxvirus infections.

Sheep pox is widespread worldwide and is the most severe animal pox virus infection. This study aimed to identify the key microRNAs (miRNAs) differentially expressed in the exosomes of sheep poxvirus-infected cells and their target genes and related pathways and provide a theoretical basis for an in-depth understanding of the molecular mechanisms of sheep poxvirus-infected cells. In this study, the differentially expressed miRNAs were verified by quantitative polymerase chain reaction (qPCR), and the target genes of miRNAs were predicted and analyzed by bioinformatics. The qPCR results showed that the expression trends of oar-miR-21, oar-miR-10b, oar-let-7f, oar-let-7b, and oar-miR-221 were consistent with the sequencing results. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes results showed that differentially expressed miRNAs were mainly involved in the immune system processes of the Arf6 downstream pathway. The target genes Reactome pathways were mainly enriched in the RAC1 GTPase cycle, CDC42 GTPase cycle, RHO GTPase cycle, RHOV GTPase cycle, and post-transcriptional silencing of small RNAs. The transcription factors SP4, NKX6-1, MEF2A, SP1, EGR1, and POU2F1 that may be connected to sheep pox virus (SPPV)-infected cells were discovered by transcription factor annotation screening. In conclusion, this study screened for differentially expressed miRNAs in SPPV-infected cells and performed a series of bioinformatic analyses of their target genes to provide a theoretical basis for the molecular mechanism of sheep pox virus infections of cells. The data can be used as basic information in future studies on the defense mechanisms against poxvirus infections.

Sonodynamic therapy is a novel treatment for killing malignant tumors with sonic sensitizers and low-intensity ultrasound,which via ultrasonic mechanical stress,the effects of ultrasonic cavitation and the combined production of ultrasound and acoustic sensitizers produce reactive oxygen species induces apoptosis co-destructing target cells.Compared with traditional approaches for the treatment of malignancy,sonodynamic therapy has advantages of greater accuracy,deeper tissue penetration,better patient dependency,and less side effects.Ultrasound microsphere contrast agents can significantly enhance the effects of cavitation as synthetic cavitation nuclei,and precise regulation of the effects of cavitation is a key factor in improving the efficiency of sonodynamic therapy.The combination of ultrasonic microspheres and adjustable cavitation have broad prospects in the field of sonodynamic therapy for malignant tumors.

Chronic aortic stenosis and regurgitation can cause left ventricular remodeling.Whether these changes are reversible and their reversibility after valve replacement are the main determinants affecting the timing and prognosis of surgery.Imaging techniques are commonly used to evaluate myocardial structure and function,in which echocardiography and enhanced CT are helpful to evaluate artificial flap function and monitor left ventricular deformation,while cardiac MR and PET/CT are helpful to identify the progression and regression of postoperative cardiac fibrosis.The combined application of these new techniques can improve clinical outcomes by early diagnosis and non-invasive detection of postoperative left ventricular reverse remodeling.This paper reviews the evaluation and application of multi-modal imaging techniques for left ventricular reverse remodeling after aortic valve replacement.

Purpose To investigate the value of contrast-enhanced ultrasonography(CEUS)features in differentiating molecular subtypes of breast cancer.Materials and Methods The clinical data of 122 patients who underwent routine ultrasound examination and CEUS of breast mass before surgery and were pathologically diagnosed as breast cancer after surgery and whose immunohistochemical results were obtained in the Affiliated Hospital of Inner Mongolia Medical University from January 2020 to July 2022 were retrospectively analyzed,all patients were divided into Luminal A,Luminal B,HER-2 overexpression and triple negative breast cancers(TNBC)groups.The characteristics and parameters of CEUS among different molecular types of breast cancer were analyzed.Results The average age and expression of Ki-67 were significantly different in different molecular subtypes of breast cancer(F=12.856,χ2=211.370,P<0.05).The average age of HER-2 was the oldest,and Ki-67 was more common in Luminal B and TNBC subtypes.CEUS characteristics indicated that Luminal A and Luminal B had high,equal,or low enhancement in 17,15,28,and 27 cases,respectively,while HER-2 and TNBC had a higher proportion of high enhancement(16,12)(χ2=3.235,P=0.039).At the peak of perfusion,Luminal A,Luminal B,HER-2 were mainly unclear(15 cases,24 cases,16 cases),and TNBC was mainly clear(13 cases).HER-2 type was characterized by perfusion defect(14 cases)and peripheral perforator blood flow(11 cases),while Luminal A and Luminal B were characterized by peripheral convergence(24 cases,41 cases).Time-intensity curve parameters showed that were significant differences in ΔPeak and ΔAUC among different molecular types of breast cancer(H=12.558,22.683,P<0.05),ΔPeak and ΔAUC of HER-2 overexpression type were higher than those of other subtypes(P<0.05),which could be used as predictors of HER-2 overexpression type,while there was no statistical significance in ΔTP and ΔSharpness of different molecular types of breast cancer(P>0.05).Conclusion There may be some characteristics in the qualitative and quantitative parameters of contrast-enhanced ultrasound in different molecular subtypes of breast cancer.The typical image features of contrast-enhanced ultrasound can help to identify the molecular subtypes of breast cancer.