Objective: Patients with atherosclerotic cardiovascular disease (ASCVD) following percutaneous coronary intervention (PCI) are classified as very-high-risk individuals in cardiovascular disease (CVD) risk stratification. The distribution pattern of traditional Chinese medicine (TCM) syndromes in this patient population, as well as its association with blood lipid profiles and clinical prognosis, remains unclear. The present prospective cohort study aims to investigate these correlations, thereby providing insights to enrich the research fields. Methods: We enrolled consecutive patients with ASCVD who underwent PCI at the Integrated Cardiology Unit of China-Japan Friendship Hospital between September 1, 2020 and December 31, 2022. Demographics and clinical characteristics, signs and symptoms defining each TCM syndrome, and fasting venous blood samples were collected at baseline and follow up or upon major adverse cardiovascular events (MACEs). We analyzed the correlation between TCM syndromes, blood lipid profiles, and MACEs, and developed a new joint prognostic model incorporating both TCM syndromes and blood lipids using logistic regression. The analyses were based on detailed baseline and one-year follow-up data. Results: A per-protocol analysis was performed on 586 patients with complete data ultimately. During the one-year follow-up, 174 patients (29.69%) experienced a MACE. We performed statistical analyses on comorbidities, medication, and biochemical indicators across groups defined by TCM syndrome differentiation. When comparing different TCM syndromes, no significant differences were found in age, body mass index (BMI), history of revascularization, comorbidities, family history of CVD, smoking or drinking, or statin intensity (P > 0.05). Patients with intertwined phlegm and blood stasis syndrome exhibited significantly higher levels of total cholesterol (TC, 5.27 ± 1.18 mmol/L, P < 0.001), triglyceride (TG, 1.96 ± 1.33 mmol/L, P = 0.008), low-density lipoprotein cholesterol (LDL-C, 3.35 ± 0.79 mmol/L, P < 0.001), and high-density lipoprotein cholesterol (HDL-C, 1.24 ± 0.81 mmol/L, P < 0.001) compared with those with other TCM syndromes combined. A multivariable logistic regression model was constructed to predict MACEs. The model included TCM syndrome type [with intertwined phlegm and blood stasis as a predictor, adjusted odds ratio (OR) = 1.413, 95% confidence interval (CI): 0.517 – 3.864, P = 0.501], age (adjusted OR = 0.97, 95% CI: 0.955 – 1.001, P = 0.057), male gender (adjusted OR = 0.698, 95% CI: 0.416 – 1.170, P = 0.173), TC (adjusted OR = 1.004, 95% CI: 0.513 – 1.965, P = 0.990), and LDL-C (adjusted OR = 5.825, 95% CI: 2.214 – 15.326, P < 0.001). This model demonstrated good discriminatory ability for MACEs in post-PCI ASCVD patients [the area under the receiver operating characteristic (ROC) curve (AUC) = 0.865, 95% CI: 0.816 – 0.914]. Conclusion The intertwined phlegm and blood stasis TCM syndrome is associated with a distinct atherogenic lipid profile characterized by elevated levels of TC and LDL-C. The prognostic model that incorporates this TCM syndrome type along with conventional lipid parameters (TC and LDL-C) shows good discriminatory ability for predicting MACEs in ASCVD patients after PCI, underscoring the potential clinical utility of integrating TCM syndrome differentiation into CVD risk assessment.

Fungal infections have emerged as a critical public health issue endangering human health. However, the existing arsenal of antifungal agents is limited in diversity and is commonly plagued by drawbacks including narrow antimicrobial spectrums and the frequent emergence of drug resistance, which severely compromises the efficacy of clinical treatments. Pathogenic fungi can develop extensive adaptability to currently available drugs through multiple mechanisms, which are mainly manifested in three aspects: drug resistance, tolerance and persistence. The molecular mechanisms and regulatory pathways underlying drug resistance, tolerance and persistence in pathogenic fungi were systematically summarized in this review, and the counteractive strategies such as combination therapy and the development of novel antifungal agents were further discussed, which aimed to provide theoretical basis and practical reference for the precision treatment of fungal infections.

Objective:To understand the epidemiological characteristics of central obesity and pre-central obesity and influencing factors in residents in Jilin Province, and provide reference for the prevention and control of central obesity and pre-central obesity.Methods:Based on the results of early screening and comprehensive intervention program in high-risk groups of cardiovascular disease in Jilin dyring 2017-2018, a total of 11 903 participants aged 35-75 years in 6 project areas in Jilin were included as the survey subjects for physical examination, laboratory test and questionnaire survey. The prevalence of central obesity and pre-central obesity in populations with different characteristic and health status were analyzed by χ2 test, trend χ2 test, F-test. Multivariate logistic regression model was used for influencing factor analysis. Results:The central obesity rate was 33.35% (3 970/11 903), the standardized rate was 31.73%, the pre-central obesity rate was 28.79% (3 427/11 903), the standardized rate was 28.86%. Multifactor analysis results showed that being rural resident ( OR=1.99, 95% CI: 1.78-2.23), being woman ( OR=1.76, 95% CI: 1.57-1.97), 65-75 years old ( OR=1.21, 95% CI: 1.03-1.45), senior high school and technical secondary school education level ( OR=1.38, 95% CI: 1.17-1.63), annual family income >100 000 yuan ( OR=1.65, 95% CI: 1.20-2.26), overweight ( OR=9.27, 95% CI: 8.26-10.41), obesity ( OR=82.82, 95% CI: 62.63-109.52), normal high blood pressure ( OR=1.49, 95% CI: 1.27-1.74), hypertension ( OR=1.70, 95% CI: 1.42-2.04), diabetes ( OR=2.30, 95% CI: 1.94-2.73), dyslipidemia ( OR=1.33, 95% CI: 1.18-1.50) were positively related to the risk for central obesity and pre central obesity. Conclusions:The prevalence rates of central obesity and pre central obesity in residents in Jilin were at high levels, being rural resident, being woman, older age, senior high school and technical secondary school education level, high income, overweight and obesity, normal high blood pressure and hypertension, diabetes, dyslipidemia were risk factors for central obesity and pre-central obesity in Jilin.

Objective To investigate the role of SDH2 gene in the environmental adaptability of Candida albicans. Methods Wild-type C. albicans strain SC5314, SDH2 gene knockout mutant sdh2Δ/Δ and reintegrated strain sdh2Δ/SDH2 were used as experimental objects. Spot assay was conducted to assess the sensitivity of the WT C. albicans strain SC5314, SDH2 gene knockout mutant sdh2Δ/Δ and reintegrated strain sdh2Δ/SDH2 to external stress stimulants and antifungal drugs. The effect of SDH2 gene deletion on drug efflux ability of C. albicans was determined by rhodamine 6G efflux assay. Results After SDH2 gene deletion, C. albicans showed slight tolerance to cell wall stress stimulants caffeine, oxidative stress stimulators diamide and menadione. Notably, the sensitivity of SDH2 gene knockout mutant sdh2Δ/Δ to azole antifungal drugs was significantly increased. The drug efflux capacity of C. albicans was decreased due to the deletion of SDH2 gene. Conclusion SDH2 gene deletion lead to changes in environmental adaptability of C. albicans, including changes in response to external environmental stress and increased sensitivity to azole antifungal drugs. The development of fungal-specific inhibitor targeting SDH2 gene may lead to the discovery of new antifungal drugs which have synergistic effect with azole drugs.

Objective:To understand the molecular epidemic characteristics and genes of human astrovirus (HAstV) in infantile diarrhea patients in Jilin province from 2017 to 2020.Methods:Fecal samples of hospitalized infants with diarrhea under 5 years of age from January 2017 to December 2020 were collected. The nucleic acids of fecal samples were amplified by reverse transcription-polymerase chain reaction (RT-PCR), the positive amplification products were sequenced, and the phylogenetic tree was constructed.Results:A total of 2 019 fecal samples were collected, of which 71 were positive for HAstV, with a positive rate of 3.5%. Among the cases with positive samples of HAstV, 42 had mixed infection with other viruses causing diarrhea, accounting for 59.2% of the total number of positive cases, half of which were mixed infection with rotavirus and HAstV. From 2017 to 2020, the positive rates of HAstV were 4.69%, 1.98%, 5.93% and 0.43% per year, respectively. There were two epidemic peaks every year and one epidemic peak year every two years. The positive rate of 36-47 months old was the highest, followed by 0-2 months old. A total of 55 sequences were obtained in this study. Phylogenetic tree analysis showed that they all belonged to classical HAstV, including 42 HAstV-1a subtypes, 8 HAstV-1b subtypes and 5 HAstV-5 subtypes.Conclusions:HAstV is one of the important pathogens of diarrhea in children under 5 years of age in Jilin province. The epidemic law has obvious seasonal and age differences. The dominant strain is HAstV-1a.

The count and recognition of white blood cells in blood smear images play an important role in the diagnosis of blood diseases including leukemia. Traditional manual test results are easily disturbed by many factors. It is necessary to develop an automatic leukocyte analysis system to provide doctors with auxiliary diagnosis, and blood leukocyte segmentation is the basis of automatic analysis. In this paper, we improved the U-Net model and proposed a segmentation algorithm of leukocyte image based on dual path and atrous spatial pyramid pooling. Firstly, the dual path network was introduced into the feature encoder to extract multi-scale leukocyte features, and the atrous spatial pyramid pooling was used to enhance the feature extraction ability of the network. Then the feature decoder composed of convolution and deconvolution was used to restore the segmented target to the original image size to realize the pixel level segmentation of blood leukocytes. Finally, qualitative and quantitative experiments were carried out on three leukocyte data sets to verify the effectiveness of the algorithm. The results showed that compared with other representative algorithms, the proposed blood leukocyte segmentation algorithm had better segmentation results, and the mIoU value could reach more than 0.97. It is hoped that the method could be conducive to the automatic auxiliary diagnosis of blood diseases in the future.
Algorithms ; Leukocytes

Objective:To observe the effect of gaze stabilization exercises on the balance of stroke patients.Methods:Forty stroke patients were randomly divided into an experimental group ( n=20) and a control group ( n=20). Both groups were given conventional rehabilitation therapy, while the experimental group was additionally provided with gaze stabilization exercises, once a day, five days a week, for a total of four weeks. Each session lasted 30 minutes. Before and after the four weeks, both groups were evaluated in terms of their envelope ellipse area and the plantar pressure distribution on the affected side in static standing and using the anterior-posterior center of pressure displacement velocity (AP-COPV). They were also assessed using the Berg Balance Scale (BBS), the timed up-and-go test (TUGT), and the Activities-specific Balance Confidence Scale (ABC). Results:After the gaze stabilization exercises, the average envelope ellipse area, the plantar pressure distribution of the affected side with the eyes open and closed, AP-COPV, BBS score, TUGT time and ABC score of the experimental group were significantly superior to the control group′s averages and to the results four weeks previously.Conclusions:Gaze stabilization exercises can improve balance, weight shifting and one-leg standing after a stroke. That should enhance balance confidence and reduce the risk of falling.

Objective To investigate the distribution and epidemiological characteristics of disease spectrum in patients with pre-hospital care in Urumqi, so as to provide reference for the establishment of mature pre-hospital care system. Methods Data retrieved from Urumqi Emergency Medical Center Command System were collected, and stratified random sampling method was used to selected 2400 patients from 8 districts and counties. The disease spectrum was analyzed, then the epidemiological characteristics was analyzed from the aspects of age, gender, season and aid time. Results The top 6 diseases were trauma in 696 cases (29.00%), cardiovascular disease in 521 cases (21.71%), poisoning in 328 cases (13.67%), respiratory system disease in 245 cases (10.21%), nervous system disease in 202 cases (8.42%) and digestive system disease in 139 cases (5.79%). Trauma and cardiovascular disease were the main types of pre-hospital care for both males and females, moreover, the incidence of trauma, nervous system disease, digestive system disease and other diseases in male was significantly higher than that in female (P<0.05). The distribution of trauma, cardiovascular and cerebrovascular disease, poisoning, respiratory disease, nervous system disease, digestive system disease and other diseases showed significant difference among patients in difference age groups (P<0.05). The distribution of trauma, cardiovascular and cerebrovascular diseases, poisoning, respiratory system diseases, nervous system disease and digestive system diseases showed significant difference in different seasons (P<0.05). The emergency calls in three shifts were the most on middle shift and were the least on night shift in Urumqi, accounting for 43.88%( 1 053 / 2 400) and 15.33% (368 / 2 400). Conclusion The distribution of disease types of pre-hospital care in Urumqi varies with gender, age, season and times, so relevant departments should improve the professional abilities of first aid and allocate first aid resources reasonably.

Objective: To compare the tear related indexes of patients with type-2 diabetes and the healthy subjects, analyze the functions of tear film of these two groups and provide significant theoretical evidences for the causes of the increased prevalence of dry eye in patients with type-2 diabetes and their pathogenesis. Methods: A case-control study was designed.During the epidemiological investigation of dry eye in communities, 79 patients with diabetes and 74 normal healthy subjects were randomly selected as participants in this case-contol study.Dry eye tests including tear film break-up time (BUT), SchirmerⅠtest (SⅠt) and corneal fluorescein staining were performed.The tears were collected to detect mucoprotein-5AC (MUC-5AC), matrix metalloproteinase 9 (MMP-9), receptor of advanced glycation endproducts (RAGEs) and the content of insulin.The diagnosis standard referred to Experts Consensus on Clinical Diagnosis and Treatment of Dry Eye published in 2013.The study was followed the Declaration of Helsinki.This study protocol was approved by Medical Ethics Committee of the Shanghai General Hospital, Shanghai Jiaotong University(No.2016KY005), and written informed consent was obtained from all subjects. Results: There were significant differences between 79 diabetes patients and 74 normal healthy subjects in the value of BUT, SⅠt and corneal fluorescein staining (all at P<0.05). The value of BUT and SⅠt in patients with diabetes were lower than those in the control group, while the corneal fluorescein staining scores of patients were higher than those of normal healthy subjects, with significant differences (P<0.05). In addition, compared with normal healthy subjects, the diabetic patients were higher in the value of MMP-9 and RAGEs, but lower in the content of insulin and MUC-5AC, with significant differences (P<0.05). There were significant differences in gender, diabetes duration, MMP-9, and MUC-5AC between the dry and non-dry eyes in the diabetic group (P<0.05). Women were more likely to develop dry eyes with a significant difference (t=4.35, P=0.04). The duration of diabetes in dry eye group was higher than that in non-dry eye group, with a significant difference (t=2.56, P=0.01); the value of MMP-9 in dry eye group was (1 052.37±157.68)pg/ml, which was significantly higher than that in non-dry eye group ([459.11±258.67]pg/ml)(t=11.92, P<0.01); the value of MUC-5AC in dry eye group was (867.83±121.82)pg/ml, which was significantly lower than in non-dry eye group ([972.93±153.52] pg/ml)(t=-3.30, P<0.01). There was no statistical difference in age and insulin between the two groups.Pearson correlation analysis showed that MMP-9 was negatively correlated with BUT (r=-0.349, P<0.01), and positively correlated with corneal fluorescein staining (r=0.181, P=0.026). MUC-5AC was positively correlated with SⅠt (r=0.367, P<0.01). Conclusions Dry eye prevalence is significantly related with the decrease in MUC-5AC and the increase in MMP-9 in community-based diabetic patients.

Objective To investigate the influence of combined spinal-epidural anesthesia and general anesthesia on short-term cogni-tive function of elderly patients with lacunar infarction after surgery.Methods A total of 50 patients with lacunar infarction who underwent abdominal surgery in our hospital from June 2012 to December 2013 were selected as the research object,who were divided into spinal-epi-dural anesthesia group (combined group)and general anesthesia group (general group).The incidence of postoperative cognitive dysfunction of two groups were observed and compared.The mini-mental state examination(MMSE)and Montreal cognitive Assessment(MoCA)were used to evaluated the cognitive function before and postoperative 1 day.Results The probability of postoperative cognitive dysfunction (POCD)of combined group and the general group were 12% and 32%,respectively,and the POCD probability of combined group was lower than that of general group,the difference was significant(P <0.05).The MMSE score and MoCA score at postoperative 1 day of two groups were lower than those before anesthesia,the difference was significant(P <0.05).The MMSE score and MoCA score of combined group at postoperative 1 day were lower than that of general group,the difference was significant(P <0.05).Conclusion The anesthesia can cause a certain cognitive dysfunction for elderly patients with lacunar infarction,while the spinal-epidural anesthesia can reduce the incidence rate of POCD compared anesthesia.