The neural circuit is the material carrier for the realization of brain function,consisting of a complex network of different neurons.Neural circuit identification technology tracks the structure and activity of specific neural circuits,to study their adequacy and necessity for brain function,which is crucial for understanding the pathogenesis of brain diseases.As a high-tech tool in the fields of neuroscience and brain science,neural circuit identification technology has been gradually introduced into basic traditional Chinese medicine(TCM)research in recent years.This systematic review considers the principles of neural circuit identification technology and progress in its application in the field of TCM neuroscience.We note that future developments in this field should be based on the overall concept of TCM characteristics and the design of syndrome differentiation and treatment.Further research on the neural circuit mechanisms of diverse method of TCM in diseases will help to promote the deep integration of TCM and modern neuroscience.

OBJECTIVE To evaluate the efficacy and safety of antibody-drug conjugates （ADC） in the treatment of breast cancer， so as to provide an evidence-based reference for clinical medication. METHODS Retrieved from CNKI， Wanfang database， VIP， PubMed， the Cochrane Library， Embase， and Web of Science， randomized controlled trials （RCTs） about trastuzumab emtansine， trastuzumab deruxtecan and sacituzumab govitecan （trial group） versus chemotherapy or other anti-tumor drugs （control group）， were collected during the inception to April 2023. After screening the literature， extracting data， and evaluating the quality of the literature， a meta-analysis was conducted by using RevMan 5.4.1 software. RESULTS A total of 8 RCTs were included， with a total of 5 577 patients. The results of the meta-analysis showed that the progression-free survival （PFS） [HR＝0.76， 95%CI （0.69， 0.83）， P＜0.000 01]， overall survival （OS） [HR＝0.87， 95%CI （0.81， 0.93）， P＜0.000 1]， and clinical benefit rate （CBR） [OR＝2.70， 95%CI （1.15， 6.33）， P＝0.02] of the trial group were significantly higher than control group. There was no statistically significant difference in objective response rate （ORR） between the two groups [OR＝2.34， 95%CI （0.59， 9.33）， P＝0.23]. The results of subgroup analysis showed that the PFS of HER2-positive patients and HER2-negative patients， and the OS of HER2-positive patients in the trial group were significantly higher than control group （P＜0.05）. The incidence of anemia and increase of aspartic acid transaminase （AST） in the trial group was significantly higher than control group （P＜0.05）. The results of sensitivity analysis showed that the results obtained with PFS， OS， and ORR as indicators were relatively robust， while the results obtained with CBR as indicators lacked robustness. CONCLUSIONS ADC drugs have significant effects on breast cancer， but will increase the risk of anemia and elevated AST.

Objective To investigate the clinical and imaging features of testicular interstitial lesions in children.Methods The clinical and imaging data of 8 children with testicular interstitial lesions confirmed by pathology were analyzed retrospectively.Results There were 8 cases of precocious puberty,5 cases of elevated sex hormones,and 2 cases of congenital adrenal hyperplasia(CAH).The lesions were located in the unilateral testis in 6 cases,bilateral in 2 cases,single in 4 cases,and multiple in 4 cases,with diameters 3-14 mm,all of them with clear boundaries.4 cases of leydig cell hyperplasia(LCH)showed heterogeneous hypoechoic lesions,with slightly significant blood flow signal on color Doppler flow imaging(CDFI);CT showed iso-density lesions with mild enhanced after enhancement;MRI showed iso-signal on T1WI,and T2WI fat suppression were iso-signal mainly with mild enhanced after enhancement.2 cases of leydig cell tumor(LCT)showed heterogeneous hypoechoic lesions with significant blood flow signals inside and around on CDFI,CT showed iso and slightly low density with low-density necrosis,which were inhomogeneously and significantly enhanced after enhancement.2 cases of testicular adrenal rest tumor(TART)showed heterogeneous hypoechoic lesions with significant blood flow signals inside and around on CDFI;CT showed iso and slightly low density,with inhomogeneouly and significantly enhanced after enhancement;MRI showed iso-signal mainly on T1WI,and T2WI fat suppression were slightly low signal mainly with mixed signal,which were inhomogeneously and significantly enhanced after enhancement,complicated with adrenal hyperplasia.Conclusion The imaging findings of testicular interstitial lesions in children have certain characteristics,and the combination of clinical manifestations,basic diseases,laboratory and a variety of imaging examinations are helpful in improving diagnostic efficiency.

Objective:To investigate the clinical characteristics and predisposing factors associated with preoperative anemia in adult femoral shaft fractures.Methods:A retrospective analysis of clinical data from 157 patients presenting with femoral shaft fractures admitted to the department of orthopedics at Nanjing Drum Tower Hospital between June 2018 and June 2022 was conducted. The study cohort comprised 106 males and 51 females, with an average age of 45.06 ± 14.32 years (range: 18-65 years). Based on hemoglobin levels measured within 2 days of admission, patients were stratified into two groups: anemia group (Hb<120 g/L in adult males and Hb<110 g/L in adult females) and non-anemia group. General demographic information, AO fracture types, and clinical characteristics, as well as the results of laboratory examinations for both groups were collected. Subsequently, univariate and multivariate logistic regression analyses were conducted.Results:Out of the 157 patients with femoral shaft fractures, 118 (75.2%) exhibited preoperative anemia (the anemia group). Among them, 75 cases were male, and 43 cases were female, with an average age of 45.84±14.23 years (range: 18-65 years). In terms of fracture AO type, 41 cases were classified as 32A, 19 as 32B, and 58 as 32C. Regarding fracture location, 14 were situated in the upper 1/3 of the femoral shaft, 67 in the middle 1/3, and 37 in the lower 1/3. The causes of injury included 63 cases of motor vehicle accidents, 5 cases of blunt trauma, 40 cases of falls, and 10 cases of other falls, with 65 cases involving multiple injuries. Conversely, 39 patients (24.8%) did not exhibit preoperative anemia (the non-anemia group). Of these, 31 were male, and 8 were female, with an average age of 42.72 ± 14.51 years (range: 19-65 years). In terms of fracture AO type, 24 cases were classified as 32A, 5 as 32B, and 10 as 32C. Regarding fracture location, 3 were situated in the upper 1/3 of the femoral shaft, 19 in the middle 1/3, and 17 in the lower 1/3. The causes of injury included 13 cases of motor vehicle accidents, 5 cases of blunt trauma, 20 cases of falls, and 1 other fall, with 8 cases involving multiple injuries. Univariate analysis revealed statistically significant differences between preoperative anemia and AO fracture type, mechanism of injury, multiple injuries, time from injury to hospital admission, albumin levels, and age ( P< 0.05). Multifactorial logistic regression analysis identified AO type 32C ( OR=3.12, P=0.020), blunt trauma injuries ( OR=0.13, P=0.021), reduced albumin levels ( OR=9.90, P=0.037), and multiple injuries ( OR=3.65, P=0.016) as risk factors for preoperative anemia. Multifactorial logistic regression further revealed that multiple injuries ( OR=5.20, P=0.004) and reduced albumin levels ( OR=5.47, P=0.001) were risk factors for the severity of anemia. Conclusion:AO type 32C fractures, blunt trauma injuries, reduced albumin levels, and multiple injuries were identified as potential contributors to the development of preoperative anemia, with multiple injuries and reduced albumin levels exacerbating the severity of anemia. Clinicians should be vigilant for the occurrence of preoperative anemia in adult femoral shaft fracture patients, particularly those with blunt trauma injuries, multiple injuries, hypoalbuminemia, and AO type 32C fractures.

Objective:To investigate the risk factors for preoperative hypoxemia in geriatric patients with hip fracture.Methods:A case-control study was used to analyze the clinical data of 99 geriatric patients with hip fracture admitted to Zhongda Hospital affiliated to Southeast University between November 2020 and August 2021. There were 29 males and 70 females, aged 67-96 years [(82.6±6.2)years]. The patients were divided into hypoxemia group ( n=51) and non-hypoxemia group ( n=48) using partial arterial partial pressure of oxygen (PaO 2)<80 mmHg while breathing room air at emergency as the reference standard. The two groups were compared in terms of sex, age, fracture types, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, pulmonary diseases diagnosed by preoperative chest CT [atelectasis, pleural effusion, chronic obstructive pulmonary disease (COPD)], time from injury to visit, New York Heart Association (NYHA) classification, Barthel index, KATZ index, modified Medicine Research Council (mMRC) dyspnea scale, numeric rating scale (NRS), smoking, drinking, comorbidities (hypertension, diabetes mellitus, Parkinson′s disease, Alzheimer′s disease, cerebral infarction, coronary atherosclerotic heart disease), body temperature, blood routine test at first examination (erythrocyte count, leukocyte count, C-reactive protein, hemoglobin), biochemistry (serum albumin, blood glucose, blood creatinine, blood urea nitrogen), electrolyte (serum potassium, serum sodium), and other related examinations [D-dimer, brain natriuretic peptide (BNP), lactic acid]. Univariate analysis was performed to the correlation of those indicators with preoperative hypoxemia. Multivariate Logistic regression analysis was used to identify the independent risk factors for preoperative hypoxemia in geriatric patients with hip fracture. Results:Differences in sex, age, fracture types, BMI, pulmonary diseases diagnosed by preoperative chest CT, time from injury to visit, Barthel index, KATZ index, NRS, smoking, drinking, comorbidities, body temperature, first laboratory results of erythrocyte count, biochemistry, electrolyte and other related examinations were not statistically significant between the two groups (all P>0.05). The two groups showed statistical differences in ASA classification, NYHA classification, mMRC dyspnea scale, leukocyte count at first examination, C-reaction protein and hemoglobin (all P<0.05). Univariate analysis indicated that ASA classification, NYHA classification, mMRC dyspnea scale, leukocyte count at first examination and C-reaction protein were correlated with the occurrence of preoperative hypoxemia in geriatric patients with hip fracture (all P<0.05). Multivariate Logistic regressions analysis indicated that higher mMRC dyspnea scale ( OR=2.30, 95% CI 1.10-4.81, P<0.05), higher leukocyte count at first examination ( OR=1.24, 95% CI 1.05-1.45, P<0.05), higher level of C-reaction protein ( OR=1.02, 95% CI 1.01-1.03, P<0.05) and higher level of hemoglobin ( OR=1.04, 95% CI 1.01-1.07, P<0.05) were significantly correlated with the occurrence of preoperative hypoxemia in geriatric patients with hip fracture. Conclusion:Higher mMRC dyspnea scale, higher leukocyte count, higher level of C-reaction protein and higher level of hemoglobin are independent risk factors for preoperative hypoxemia in geriatric patients with hip fracture.

[摘 要] 目的：探索南蛇藤提取物齐墩果烷型五环三萜（28-hydroxy-3-oxoolean-12-en-2-oic acid）协同miR-451对人胃癌AGS细胞增殖、迁移的影响及其可能的分子机制。方法：用miR-451过表达慢病毒感染AGS细胞，并用盐酸多西环素（DOX）10或100 ng/ml诱导24 h，构建过表达miR-451的细胞AGS/miR-451+。采用10、20、40、80、160 μmol/L的齐墩果烷型五环三萜处理AGS/miR-451+细胞，MTT法、划痕实验分别检测细胞增殖和迁移能力的变化，WB法检测细胞中mTOR通路及凋亡相关蛋白表达水平的变化。结果：成功构建过表达miR-451的AGS/miR-451+细胞。与未加药对照组相比，齐墩果烷型五环三萜处理后AGS/miR-451+细胞的增殖抑制率均呈时间和浓度依赖性升高（P<0.05或P<0.01），细胞迁移率均显著降低（P<0.05或P<0.01）。齐墩果烷型五环三萜处理组细胞中，mTOR 信号通路相关蛋白的表达量均有所降低（P<0.05或P<0.01）；凋亡相关蛋白中，Bcl2的表达量下降，BAX、caspase-3、caspase-1及细胞色素c的表达量升高（P<0.05或P<0.01）。结论：齐墩果烷型五环三萜能够协同miR-451抑制人胃癌AGS细胞的增殖与迁移，其机制可能与影响凋亡和mTOR信号通路相关蛋白的表达有关。

To monitor genetic variation of porcine reproductive and respiratory syndrome virus (PRRSV),RT-PCR was used to identify a sample suspected of PRRSV infection.A PRRSV named SC-GY strain was obtained,and its Nsp2,ORF5 and ORF3 genes were used for sequence alignment and phylogenetic tree construction.The results showed that SC-GY strain is highly pathogenic PRRSV American variant strains with Nsp2 gene discontinuous deletion of 30 amino acids,ORF3 gene aa17 a serine (S) insert.Comparing to VR2332,CH-1a,JXA1,HUN4,NADC30,HENAN-XINX and SC2012,the Nsp2,ORF5 and ORF3 of SC-GY shared 70.3％-97.9％,82.4％-97.6％ and 83.1％-98.2％ of nucleotide similarity,and 62.3％-96.3％,78.0％-95.7％ and 81.6％-96.5％ of deduced amino acid similarity;and compared to LV they shared only 18.9％,60.8％ and 63.7％ of nucleotide similarity,and 14.0％,54.9％ and 57.2％ of deduced amino acid similarity.The phylogenetic tree revealed that the SC-GY formed independent small branches although it belonged to the same subgroup as highly pathogenic PRRSV strains.The results showed that in high frequency live vaccine immunization of currently PRRSV,the gene of PRRSV epidemic strain is still in constant variation.Vaccination of live PRRSV vaccines should be reduced and surveillance of PRRSV strains should be enhanced.

Objective To discuss the strategies and efficacies of surgical treatment in medulla oblongata cavernous malformations.Methods The clinical and follow-up data of 9 patients with medulla oblongata cavernous malformations,admitted to our hospital from October 201 1 to February 2015,were retrospectively analyzed.Five patients underwent surgical treatment:posterior midline transcerebellomedullary fissure approach was used in 4,far-lateral transcondylar approach in one,and all cavernous malformations were excised completely.Conservative treatment and regular observation were done in 4 patients.Follow-up was performed for 10-40 months.Results Symptoms improved after surgery in 4 patients;postoperative hemiplegia appeared in one,and at the end of follow-up,the muscle strength of hemiplegic limbs recovered to level Ⅳ.Minor re-hemorrhage was noted in one of the 4 patients with conservative treatment at the end of the follow-up,and no changes were noted in the rest patients.Karnofsky Performance Scale scores were 82.2 ±6.7,which were significantly increased as compared with those before treatment (73.3±11.2,P＜0.05).Conclusion After strict preoperative evaluation,surgical treatment is a feasible way,enjoying good prognosis in medulla oblongata cavernous malformations;but,patients with deep site,small malformations or no obvious bleeding symptoms should not be operated.

Objective To understand the genetic background of the specific pathogen-free Yorkshire and Landrace pigs, imported from Canada by Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences.Methods The population genetics were investigated by using 19 pairs of microsatellite primers.Results In the Yorkshire pigs and Landrace pigs, 84 and 89 alleles, respectively, were detected at 19 microsatellites loci.The average polymorphic informa-tion content and mean heterozygosity in the Yorkshire pigs were 0.5271 and 0.5877, and in the Landrace population were 0.5652 and 0.6066, respectively.Because of the significant ( P<0.01) differences of alleles in different loci such as S0155,S0143,S0178,Sw857 and Sw936, it made them possible to be used to identify Yorkshire and Landrace pigs′breed. F-statistics showed that the differentiation within the population was small and genetic structure was stable.Conclusions Compare with the domestic pedigree large White and Landrace pigs, the SPF pedigree pigs imported from Canada are more stable in genetic structure, and can be used as laboratory animal models in animal science research.

Background and objective Most small cell lung cancer (SCLC) patients relapse or progress and have low survival rate although they have signiifcant response to initial chemotherapy and radiotherapy. hTis study intends to explore the factors affecting the relapse (or progression) of nonoperative SCLC and to explore the correlations between progression-free survival (PFS) and overall survival (OS). Methods Clinical data of 182 patients diagnosed with SCLC between January 2009 and December 2011 at Shanghai Chest Hospital has been reviewed and retrospectively analyzed. All of these patients ac-cepted chemotherapy combined (or not combined) with radiotherapy, and relapsed or progressed atfer ifrst-line therapy. Uni-variate Kaplan-Meier survival estimates as well as multivariate Cox regression survival analysis were used to locate the potential factors affecting PFS. hTe correlation between PFS and OS was analyzed via Bivariate Correlation Analysis method. Results hTe univariate estimates showed that the TNM stage, liver metastasis or not, brain metastasis or not, ifrst-line chemotherapy cycles, effect of initial chemotherapy, and thoracic radiotherapy combined or not were the signiifcant contributive factors to PFS. In the subgroup of the patients without brain metastases, those received prophylactic cranial irradiation (PCI) had longer PFS. Cox regression indicated that the three independent variables of ifrst-line chemotherapy cycles, effect of initial chemo-therapy and thoracic radiotherapy combined or not were closely related to PFS. In addition, signiifcant positive correlation between PFS and OS had been observed. Conclusion PFS could be prolonged by having more ifrst-line chemotherapy cycles (>4 cycles), obtaining better effect of initial chemotherapy (partial response or complete response), combining with thoracic radiotherapy and implementing PCI for patients without brain metastasis.