OBJECTIVE To compare the efficacy and safety of different daily doses of aspirin in the prevention of preeclampsia （PE）. METHODS The case-control studies and prospective randomized controlled trials on aspirin with daily dose ≥ 100 mg （trial group） vs. ＜100 mg （control group） in the prevention of PE were retrieved from PubMed， Medline， Embase， the Cochrane Library， CNKI， China Biomedical Literatue Database and Wanfang Data from base-building to January 2025. After literature screening， data extraction and quality evaluation， meta-analysis was performed by using RevMan 5.3 software. RESULTS A total of 11 literatures were included， involving 3 052 pregnant women. Meta-analysis showed the incidence of PE [RR＝0.63， 95%CI （0.53，0.76）， P＜0.000 01]， gestational hypertension [RR＝0.69， 95%CI （0.50，0.94），P＝0.02]， preterm birth [RR＝0.56， 95%CI （0.47，0.66）， P＜0.000 01]， and intrauterine growth retardation [RR＝0.73，95%CI （0.61，0.87），P＝0.000 5] in trial groups were significantly lower than control group. The incidence of postpartum hemorrhage between the two groups had no statistically significant difference [RR＝1.17， 95%CI （0.90，1.53），P＝0.25]. Subgroup analysis showed that the incidence of PE in Chinese pregnant women taking 150 mg of aspirin was significantly higher than taking 100 mg of aspirin [RR＝3.40， 95%CI （1.29， 8.93）， P＝0.01]； but there was no significant difference between the two groups in the incidences of postpartum hemorrhage， preterm birth （P＞0.05）. CONCLUSIONS Aspirin with daily dose ≥100 mg is more effective in preventing PE than daily dose ＜100 mg， with lower rates of gestational hypertension， preterm birth， and intrauterine growth retardation. It does not increase the risk of postpartum hemorrhage. For pregnant women in China， daily dose 100 mg of aspirin may be more effective in preventing PE than 150 mg.

Objective To evaluate the technical feasibility and safety of upper arm vein approach in the implantation of totally implantable venous access port(TIVAP)under the guidance of ultrasound combined with DSA.Methods The clinical data of 1 546 patients with malignant tumors,who received TIVAP implantation via upper arm vein access under the guidance of ultrasound combined with DSA at the Affiliated Renji Hospital,School of Medicine of Shanghai Jiao Tong University of China between January 2020 and January 2022,were retrospectively analyzed.The implantation success rate,single-puncturing success rate,operation time,and complications were compared between the PICC catheterization room and the DSA operating room.Results The technical success rate in the 1546 patients was 100％,with a single-puncturing success rate of 99.48％.In 766 patients the TIVAP implantation was performed in the PICC catheterization room(PICC group),and in 780 patients the TIVAP implantation was carried out in the DSA operating room(DSA group).The mean operation time in the DSA group was(20.1±1.3)min,which was obviously shorter than(25.4±1.9)min in the PICC group,and the incidence of primary catheter misplacement in the DSA group was 0％,which was remarkably lower than 0.78％in the PICC group(P＜0.05).No statistically significant differences in the incidences of complications,including infection,thrombosis,upper limb movement disorder,catheter occlusion,exposure of infusion port body,and overturn of infusion port body,existed between the two groups(P＞0.05).Conclusion Ultrasound-guided TIVAP via upper arm vein approach is a safe and effective infusion route for patients with malignancy receiving chemotherapy.The combination use of ultrasound guidance and intraoperative DSA guidance can reduce the operation time as well as the incidence of operation-related complications.

Objective:To investigate the role of D-amino acid oxidase (DAAO) in arsenic exposure induced learning memory impairment in offspring mice.Methods:Eighteen Kunming pregnant mice were randomly divided into a non-treatment group (distilled water, n = 6) and an arsenic exposed group [60 mg/L sodium arsenite (NaAsO 2) in drinking water, n = 12] by randomized numerical table method. From the first day of pregnancy until weaning, the mother mice were exposed to arsenic. After weaning, the offspring mice were exposed to arsenic through free drinking water until the end of the experiment. Six weeks after birth, the offspring mice of the arsenic exposed group were divided into a NaAsO 2 group and a NaAsO 2 + DAAO inhibitor 6-chlorobenzo [d] isoxazol-3-ol (CBIO) group according to the group of mother mice. The offspring mice of non-treatment group as the control group. The offspring mice of the control group and NaAsO 2 group were given intraperitoneal injection of 0.5% sodium carboxymethylcellulose, while the NaAsO 2 + CBIO group was given intraperitoneal injection of 60 mg/kg CBIO for two consecutive weeks. At the end of the intervention, the spatial learning and memory abilities of the offspring mice were measured using a Y-maze experiment. After cardiac perfusion, brain tissue was taken from the offspring mice and the hippocampus was isolated. Hematoxylin-eosin (HE) staining was used to observe the morphology of the hippocampal neurons in the offspring mice. D-serine content was determined by ultra-high performance liquid chromatography tandem triple quadrupole mass spectrometry (UHPLC-MS/MS). The mRNA levels of synaptophysin (SYP), synaptosomal-associated protein 25 (SNAP25), postsynaptic density 95 (PSD95), DAAO, and N-methyl-D-aspartate receptor (NMDAR) subunits NR1, NR2A, NR2B were measured by real-time fluorescence quantitative PCR. Results:There was a statistically significant difference in the offspring mice alternating response rate of the Y-maze experiment among the control, NaAsO 2, and NaAsO 2 + CBIO groups [ (58.06 ± 3.78) %, (48.61 ± 5.75)%, (56.25 ± 6.76)%, F = 4.87, P = 0.023], and the NaAsO 2 group was significantly lower than the control and NaAsO 2 + CBIO groups ( P < 0.05). The HE staining results showed that the control group had a higher number of neuronal cells in the CA1 and CA3 regions of the hippocampal tissue, and they were in good condition. The number of neuronal cells in the NaAsO 2 group decreased, with irregular morphology and unclear cell contours. The NaAsO 2 + CBIO group had a higher number of neuronal cells, improved cell morphology and contour, and reduced tissue damage. There were statistically significant differences in D-serine content and mRNA levels of SYP, SNAP25, PSD95, DAAO, NR1, NR2A, and NR2B in the hippocampus of the offspring mice from the control, NaAsO 2, and NaAsO 2 + CBIO groups ( F = 5.41, 4.41, 10.16, 7.60, 6.98, 5.63, 6.53, 4.33, P = 0.017, 0.031, 0.002, 0.005, 0.007, 0.015, 0.009, 0.033). Among them, the D-serine content and mRNA levels of SYP, SNAP25, PSD95, NR1, and NR2B in the hippocampus of the NaAsO 2 group were significantly lower than those in the control group and NaAsO 2 + CBIO group, the mRNA level of NR2A was significantly lower than that in the control group, and the mRNA level of DAAO was significantly higher than that in the control and NaAsO 2 + CBIO groups ( P < 0.05). Conclusions:Arsenic exposure can induce the learning and memory impairment in offspring mice, reduce D-serine content in the hippocampus, as well as the transcription level of NMDAR subunits and synapse-associated proteins, up-regulate the transcription levels of DAAO; and inhibit DAAO, leading to increased D-serine content, the transcription levels of NMDAR subunits and synapse-associated proteins, improving arsenic exposure induced learning and memory impairment in the offspring mice.

Objective To investigate the diagnostic value of serum levels of leukocyte cell derived chemo-taxin 2(LECT2)and tumor necrosis factor ligand-related molecule-1A(TL1A)in children with atopic der-matitis(AD).Methods A total of 83 children with AD who were adimitted to the hospital from August 2021 to August 2023 were selected as the AD group,and 83 healthy children who underwent physical examination in the hospital during the same period were selected as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to measure the expression levels of LECT2 and TL1A in serum.Spearman method was applied to analyze the correlation between serum LECT2,TL1A,and AD integral index(SCORAD).Multiva-riate Logistic regression was applied to analyze the factors that affected the severity of AD in children.Receiv-er operating characteristic(ROC)curve was applied to analyze the diagnostic efficacy of serum LECT2 and TL1A levels on the severity of AD in children.Results Compared with the control group,the expression lev-els of LECT2 and TL1A in the serum of the AD group were significantly increased(P＜0.05).Compared with the low-grade group,the serum LECT2,TL1 A,SCORAD score,EOS and total IgE in the moderate and severe groups were significantly increased in turn(P＜0.05).According to Spearman correlation analysis,the serum levels of LECT2 and TL1A in the AD group were positively correlated with the SCORAD score(r=0.776,0.693,both P＜0.05).According to the results of multivariate Logistic regression analysis,serum LECT2、TL1 A、EOS and total IgE were risk factors affecting the severity of AD in children(P＜0.05).In ad-dition,the combination of serum LECT2 and TL1A had the highest AUC for diagnosing the severity of AD in children,which was better than the individual diagnosis of serum LECT2 and TL1A(Z=2.249,1.989,P=0.025,0.047).Conclusion The elevated levels of serum LECT2 and TL1A in children with AD are closely re-lated to the severity of the disease,and the combination of the two can better evaluate the severity of the dis-ease in children with AD.

The research literature on the mechanism of Achyranthis Bidentatae Radix and its main components in the treatment of osteoporosis was reviewed. It was found that Achyranthis Bidentatae Radix could promote the osteogenic differentiation of bone marrow mesenchymal stem cells, enhance the activity of osteoblasts, inhibit the activity of osteoclasts, regulate estrogen levels, and achieve the effects of preventing and treating osteoporosis. It mainly regulates Wnt/β-catenin, Notch, PI3K/Akt and other signaling pathways. The mechanism of Achyranthis Bidentatae Radix in the treatment of OP shows the characteristics of multi-component, multi-target and multi-pathway.

Objective:To investigate the differences in glucose homeostasis and amino acid metabolism between patients with new-onset T2DM with qi-yin deficiency syndrome and those with spleen deficiency and phlegm-dampness syndrome.Methods:This study was a cross-sectional and cohort study. From January 2021 to December 2022, 136 T2DM inpatients were selected from the Department of Metabolic Diseases of Shanxi Traditional Chinese Medicine Hospital, and 18 patients were screened to meet the inclusion criteria of new-onset T2DM, and were identified as qi-yin deficiency syndrome and sspleen deficiency and phlegm-dampness syndrome, and were included in corresponding qi-yin and deficiency group and spleen deficiency and phlegm-dampness group, with 9 cases in each group. All patients wore a dynamic blood glucose monitoring system to calculate the 24-h mean standard deviation of blood glucose (SDBG), the coefficient of variation of blood glucose (GLU cv), the maximum value of blood glucose (GLU max), the minimum value of blood glucose (GLU min), the maximum amplitude of glucose fluctuation (LAGE), the average amplitude of glucose fluctuation (MAGE), and the proportion of time within the target range of blood glucose (TIR). Blood specimens were retained for amino acid metabolism testing to screen for differential metabolites and metabolic pathways in the 2 groups of syndromes. Results:Patients in the spleen deficiency and phlegm-dampness group had mAlb [27.61 (13.60,40.45) mg/L vs. 5.10 (1.95, 9.70) mg/L, Z=-2.34], GLU-0 h [(14.83±4.79) mmol/L vs. (9.72±2.35) mmol/L, t=2.87], GLU-1 h [(24.40±5.23) mmol/L vs. (17.71±2.68) mmol/L, t=3.42], GLU-2 h [(25.17±4.43) mmol/L vs. (19.69±3.11) mmol/L, t=3.03], HOMA2-IR [1.83 (1.46, 3.19) vs. 1.14 (0.90, 1.35), Z=-2.14] were higher than those in the qi-yin deficiency syndrome ( P<0.05), GLU cv [16.86 (13.58, 26.20)% vs. 28.30 (23.17, 40.87)%, Z=-2.08] was lower than that of the qi-yin deficiency syndrome ( P<0.05) and had severe blood glucose fluctuations. Screening of 2 groups of differential metabolites identified threonine, alanine, and glutamine as potential metabolic markers for T2DM with qi-yin deficiency versus spleen deficiency and phlegm-dampness. Analysis of the 2 groups of differential metabolite pathways for different TCM syndromes revealed that Aminoacyl-tRNA biosynthesis was the most significantly enriched pathway. Conclusion:Patients with T2DM spleen deficiency and phlegm dampness syndrome had worse insulin function and glucose homeostasis than those with qi-yin deficiency syndrome; differences in amino acid metabolism were important influences on the development of the 2 types of the syndromes, namely, spleen deficiency and phlegm dampness syndrome versus qi-yin deficiency syndrome; and Aminoacyl-tRNA biosynthesis participates in the development of early diabetes mellitus, which plays a key role in the pathogenesis of T2DM.

Background::Genetic variants of dopaminergic transcription factor-encoding genes are suggested to be Parkinson’s disease (PD) risk factors; however, no comprehensive analyses of these genes in patients with PD have been undertaken. Therefore, we aimed to genetically analyze 16 dopaminergic transcription factor genes in Chinese patients with PD.Methods::Whole-exome sequencing (WES) was performed using a Chinese cohort comprising 1917 unrelated patients with familial or sporadic early-onset PD and 1652 controls. Additionally, whole-genome sequencing (WGS) was performed using another Chinese cohort comprising 1962 unrelated patients with sporadic late-onset PD and 1279 controls.Results::We detected 308 rare and 208 rare protein-altering variants in the WES and WGS cohorts, respectively. Gene-based association analyses of rare variants suggested that MSX1 is enriched in sporadic late-onset PD. However, the significance did not pass the Bonferroni correction. Meanwhile, 72 and 1730 common variants were found in the WES and WGS cohorts, respectively. Unfortunately, single-variant logistic association analyses did not identify significant associations between common variants and PD. Conclusions::Variants of 16 typical dopaminergic transcription factors might not be major genetic risk factors for PD in Chinese patients. However, we highlight the complexity of PD and the need for extensive research elucidating its etiology.

Objective:To search and summarize the best evidence for preoperative prehabilitation in patients with lung cancer complicated by chronic obstructive pulmonary disease and to inform the management of preoperative prehabilitation in patients with lung cancer combined with COPD by clinical providers.Methods:Systematically guideline websites, professional society websites, evidence-based databases, and comprehensive databases were searched for types of literature including clinical decision making, guidelines, expert consensus, evidence summaries, systematic evaluations, Meta-analyses, and randomized controlled trials. The time for the retrieval was from the inception of databases until October 31th, 2023. And the quality of the included literature was evaluated and evidence was extracted, evaluated the quality of the included literature, and extracted evidence.Results:Finally, 18 articles were included, including 8 guidelines, 8 expert consensus, and 2 systematic reviews. Summarized the 30 best evidence in 4 areas of prerehabilitation: need, timing, location, content (including smoking cessation management, respiratory exercise, exercise, nutritional support, and medication management).Conclusions:This study summarizes the best evidence for preoperative prehabilitation in patients with lung cancer combined with chronic obstructive pulmonary disease, and healthcare professionals should be mindful of the need to develop preoperative prehabilitation protocols judiciously, taking into account the specific clinical context during the subsequent translation of the evidence to the clinic.

Using the liquid chromatography-tandem mass spectrometry (LC-MS/MS) to determine the plasma level of Lyso-GL3 in patients with Fabry disease and to analyze the clinical application of the method.

BACKGROUND:In the past,it was necessary to cut off the pronator quadratus muscle in the treatment of distal radius fractures.Failure to repair the pronator quadratus muscle can lead to a series of complications. OBJECTIVE:To explore the clinical efficacy of different methods of preserving the pronator quadratus muscle combined with a palmar steel plate in the treatment of distal radius fractures. METHODS:Clinical data of 66 patients with distal radius fractures were retrospectively included,divided into the traditional Henry approach group(group A),the split brachioradialis tendon approach group(group B),and the posterior pronator quadratus muscle approach group(group C),with 22 patients in each group.Postoperative internal fixation,fracture healing,and postoperative complications were observed in the three groups.The visual analog scale score of postoperative wrist pain and forearm rotation angle were compared among the three groups.The Dienst Joint Scale was used to evaluate the wrist function of patients. RESULTS AND CONCLUSION:(1)The surgical time,intraoperative blood loss,and fracture healing time of groups B and C were significantly lower than those of group A(P<0.01).There was no significant difference in intraoperative blood loss and fracture healing time between groups B and C,but the surgical time was shorter in group B.(2)The anteroposterior and lateral wrist X-ray examination 3 days and 1 and 3 months after surgery exhibited that there were no significant differences in radial height,palm angle,and ulnar deviation angle among the three groups(P>0.05).No significant difference was detected in various indicators during the same phase among the three groups(P>0.05).(3)At a follow-up of 12 months after surgery,there were no significant differences in visual analog scale scores and forearm rotation angle among the three groups.However,the evaluation results at 1 and 3 months after surgery demonstrated significant differences in visual analog scale scores and forearm rotation angle among the three groups(P<0.05).Among them,group C had a lower visual analog scale score and a larger forearm rotation angle.(4)According to the Dienst joint scoring standard,the excellent and good rate of wrist joint function evaluation was 86%(19/22),91%(20/22),and 95%(21/22)in groups A,B,and C,respectively 12 months after surgery.(5)All patients did not experience any postoperative vascular or neurological damage or surgical site infection.Group A had three cases of tendon irritation,two cases of traumatic arthritis,and two cases of carpal tunnel syndrome.In group B,tendon irritation occurred in 1 case and joint stiffness in 1 case.There was 1 case of traumatic arthritis and 1 case of carpal tunnel syndrome in group C.(6)It is suggested that different surgical methods for treating distal radius fractures have achieved good clinical results.Placing a steel plate under the pronator muscle can alleviate early postoperative pain,promote early activity,and restore normal life.The brachioradialis tendon approach has more advantages in exposing intraoperative fractures and can shorten the surgical time.