This study aims to investigate the changes in blood biochemical indicators of tongue roll-ing(TR)behavior in cattle and their correlation with changes in oral microbiota,laying a founda-tion for further exploring the relationship between animal oral microbiota,biochemical indicators,and behavioral changes.It also provides theoretical basis for preventing and treating TR behavior through regulating oral microbiota.This study intends to analyze and compare the blood biochemi-cal indicators and changes in oral microbiota of cattle with TR behavior and healthy cattle without TR behavior(healthy control,H),in order to explore the blood biochemical indicators of TR cattle and their correlation with changes in oral microbiota.Blood samples from the caudal vein of cattle in each group were collected for the detection of blood biochemical indicators and stress-related hormone indicators.Oral swabs from cattle in each group were collected for 16S rRNA gene se-quencing to analyze the composition,structure,and functional changes of their oral microbiota.The results of blood biochemical indicators in H and TR groups showed that the concentrations of al-bumin(ALB),aspartate aminotransferase(AST),calcium ion(Ca2+),and cortisol in TR group were significantly higher than those in H group(P＜0.05).There were significant differences in beta diversity of oral microbiota between TR and H groups(P＜0.05).At the genus level,the rela-tive abundances of Pseudomonas,Enterobacter,Xanthomonas,and other genera in the oral micro-biota of TR group were significantly higher than those in H group(P＜0.05).However,the rela-tive abundances of Tessaracoccus,Turicibacter,Monoglobus,Dietzia,Bifidobacterium,and other genera in the oral microbiota of TR group were significantly lower than those in H group(P＜0.05).In the KEGG metabolic pathway at the third level,the relative abundances of thiamine me-tabolism,lipoate metabolism,cysteine and methionine metabolism in the oral microbiota of TR group were significantly lower than those in H group(P＜0.05).Spearman correlation analysis showed that ALB and AST were significantly positively correlated with the relative abundances of Pseudomonas and Stenotrophomonas.Therelative abundances of Pseudomonas,Stenotrophomonas,and Sphingomonas were significantly positively correlated with fatty acid metabolism,phosphate and phosphonate metabolism,and lipoate metabolism.ALB was significantly positively correlated with inositol phosphate metabolism and phosphate and phosphonate metabolism.The study found that there were significant differences in blood biochemical indicators and oral microbiota between TR and H groups.In addition,there is a certain correlation between the composition,structure,and function of oral microbiota and the biochemical function of the host.This indicates that TR behav-ior may be associated with changes in the biochemical indicators of the host and the composition,structure,and function of oral microbiota.

Objective:To explore the influencing factors of hematoma enlargement in patients with hypertensive intracerebral hemorrhage and construct a corresponding risk prediction nomogram. The screening effects of the constructed model and different hematoma enlargement risk assessment tools were compared and analyzed.Methods:Two hundred and thirty-two patients with hypertensive intracerebral hemorrhage from the Department of Neurosurgery, Lianyungang First People's Hospital from April 2021 to February 2022 were selected as the research subjects. Multivariate Logistic regression was used to analyze the risk factors of hematoma expansion in patients with hyperhemamic intracerebral hemorrhage, and R software was used to construct a nomo diagram. The receiver operating characteristic curve (ROC) and Hosmer-Lemeshow (H-L) goodness-of-fit were used to evaluate the discrimination and calibration of the model, and the decision curve was used to analyze the clinical validity of the model. The constructed Nomo diagram, nine-point method and BRAIN score were used to assess the risk of hematoma enlargement in the included patients and used them as test variables, and the ROC curve was plotted to compare and analyze the area under the ROC curve, sensitivity and specificity of the constructed Nomo diagram, nine-point method and BRAIN score. The Kappa test was used to analyze the consistency between the Nomo diagram, the nine-point method, and the BRAIN score and the hematoma expansion results.Results:The results of multivariate logistic regression analysis showed that blood pressure was poorly controlled ( OR=13.290, 95% CI: 3.676-48.049), ventricular penetration ( OR=4.825, 95% CI: 1.458-15.975), early neurological deterioration ( OR=27.740, 95% CI: 8.713-88.314), Glasgow Coma Scale(GCS)≤8 points ( OR=25.883, 95% CI: 6.542-102.404) was the main influencing factor for hematoma expansion in patients with hypertensive intracerebral hemorrhage (The P values were <0.001, 0.010, <0.001, and <0.001, respectively). The H-L test results of Nomogram for predicting hematoma enlargement were χ2=3.20, P=0.525, the calibration curve was close to the ideal curve, and the mean absolute error was 0.015, and the decision curve analysis showed that the model had good clinical validity. The ROC results showed that the area under the ROC curve of the constructed Neumo diagram, nine-point method and BRAIN score were 0.971 (95% CI: 0.941-0.989), 0.696 (95% CI: 0.632-0.755), and 0.778 (95% CI: 0.719-0.830)(all P<0.001). The sensitivities were 94.37%, 71.83%, and 84.51%, and the specificities were 90.68%, 58.39%, and 65.84%, respectively. The results of Kappa test showed that the Kappa values of Nuomo diagram, nine-point method and BRAIN score were 0.806 , 0.264 and 0.429 (all P<0.001). Conclusion:The main influencing factors of hematoma enlargement in patients with hypertensive intracerebral hemorrhage were poor blood pressure control, intraventricular hemorrhage, early neurological deterioration, and GCS score. The effect of the constructed Nuomo diagram model in predicting hematoma expansion in patients with hypertensive intracerebral hemorrhage is better than that of the nine-point method and the BRAIN score, which has clinical application value.

Objective:To assess the diagnostic performance of a panel of autoantibodies against multiple tumor-associated antigens (BRCA2, P53, ANXA11, PARP1, TRIM21, ATAD2, NY-ESO-1 and CAGE) in the detection of breast cancer.Methods:This was a retrospective case-control study. A total of 545 patients diagnosed with breast cancer (BC) by pathological examination, and eligible for enrolment at Jiangsu Cancer Hospital from January 2022 to December 2023 were selected as the patient group. In the same period, 200 patients with benign breast disease (BD) and 200 healthy individuals (HC) were included. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of tumor-associated autoantibodies in each group. The tumor markers including carcinoembryonic antigen (CEA), glycoconjugate antigen 125 (CA125) and glycoconjugate antigen 153 (CA153) were detected using electrochemiluminescence. Univariate and multivariate logistic regression analyses were used to screen the factors associated with breast cancer. The receiver operating characteristic (ROC) curve was applied to evaluate diagnostic value.Results:The levels of seven autoantibodies against BRCA2, P53, ANXA11, PARP1, ATAD2, NY-ESO-1 and CAGE were significantly higher in the BC group compared to HC group (all P<0.05). Additionally, the levels of six autoantibodies against BRCA2, P53, PARP1, ATAD2, NY-ESO-1 and CAGE were significantly higher in the BC group than those in BD group (all P<0.05). The levels of PARP1 and ATAD2 in the BD group were higher than those in HC group ( P<0.05). Logistic multivariate analysis revealed that BRCA2 ( OR=1.099, 95% CI 0.824-1.107), P53 ( OR=1.534, 95% CI 0.813-2.898), NY-ESO-1( OR=1.159, 95% CI 0.789-1.712) and CA153 ( OR=1.029, 95% CI 0.778-1.495) were potential indicators for breast cancer (all P<0.05). The ROC curves indicated that the AUCs for breast cancer using BRCA2, P53, NY-ESO-1, and CA153 were 0.602 (95% CI 0.549-0.635), 0.688 (95% CI 0.642-0.734), 0.729 (95% CI 0.677-0.781), 0.714 (95% CI 0.663-0.764), respectively. The sensitivities were 0.405, 0.588, 0.683 and 0.653, while the specificities were 0.770, 0.825, 0.851 and 0.790, respectively. The AUC of the combined detection including BRCA2, P53, NY-ESO-1, and CA153 for breast cancer was 0.857 (95% CI 0.832-0.883), with a sensitivity of 0.719 and a specificity of 0.835. Conclusions:The levels of tumor-associated autoantibodies to BRCA2, P53 and NY-ESO-1 were significantly elevated in breast cancer patients, and the combination of the three autoantibodies and CA153 has high diagnostic value for breast cancer.

Objective To investigate the clinical efficacy of Jiawei Tai Yuan Yin combined with allylestradiol tablets for the treatment of early threatened abortion complicated by subchorionic hematoma(SCH).Methods A total of 120 patients with early threatened miscarriage combined with SCH were selected and divided into the observation group(Jiawei Tai Yuan Yin+allylestradiol tablets,60 cases)and the control group(allylestradiol tablets,60 cases)according to the treatment regimen.Seven days was one course of treatment,and both groups of patients were treated for two courses.Changes of traditional Chinese medicine(TCM)syndrome score before treatment and 14 days after treatment,clinical efficacy,SCH area,the ratio of SCH area to gestational sac area,vaginal bleeding(duration and volume),the miscarriage rate in the early stage of pregnancy,the ratio of auxiliary T cells to inhibitory T cells(Th/Ts)and the level of carbohydrate antigen 125(CA125)were observed.Results After 14 days of treatment,TCM syndrome scores,SCH area,the ratio of SCH area to gestational sac area,the Th/Ts ratio and the CA125 level were decreased in the two groups,and those of the observation group were lower than those of the control group(P＜0.05).After 14 days of treatment,the total effective rate was higher in the observation group than that of the control group(P＜0.05).During the treatment period,the duration of vaginal bleeding,the amount of vaginal bleeding and the miscarriage rate in the early stage of pregnancy were lower in the observation group than those in the control group(P＜0.05).Conclusion The combination of Jiawei Tai Yuan Yin and allylestradiol tablets can effectively treat early threatened miscarriage with SCH,thereby reducing the miscarriage rate in early pregnancy.

Objective To investigate the clinical efficacy of Jiawei Tai Yuan Yin combined with allylestradiol tablets for the treatment of early threatened abortion complicated by subchorionic hematoma(SCH).Methods A total of 120 patients with early threatened miscarriage combined with SCH were selected and divided into the observation group(Jiawei Tai Yuan Yin+allylestradiol tablets,60 cases)and the control group(allylestradiol tablets,60 cases)according to the treatment regimen.Seven days was one course of treatment,and both groups of patients were treated for two courses.Changes of traditional Chinese medicine(TCM)syndrome score before treatment and 14 days after treatment,clinical efficacy,SCH area,the ratio of SCH area to gestational sac area,vaginal bleeding(duration and volume),the miscarriage rate in the early stage of pregnancy,the ratio of auxiliary T cells to inhibitory T cells(Th/Ts)and the level of carbohydrate antigen 125(CA125)were observed.Results After 14 days of treatment,TCM syndrome scores,SCH area,the ratio of SCH area to gestational sac area,the Th/Ts ratio and the CA125 level were decreased in the two groups,and those of the observation group were lower than those of the control group(P＜0.05).After 14 days of treatment,the total effective rate was higher in the observation group than that of the control group(P＜0.05).During the treatment period,the duration of vaginal bleeding,the amount of vaginal bleeding and the miscarriage rate in the early stage of pregnancy were lower in the observation group than those in the control group(P＜0.05).Conclusion The combination of Jiawei Tai Yuan Yin and allylestradiol tablets can effectively treat early threatened miscarriage with SCH,thereby reducing the miscarriage rate in early pregnancy.

This study aims to investigate the changes in blood biochemical indicators of tongue roll-ing(TR)behavior in cattle and their correlation with changes in oral microbiota,laying a founda-tion for further exploring the relationship between animal oral microbiota,biochemical indicators,and behavioral changes.It also provides theoretical basis for preventing and treating TR behavior through regulating oral microbiota.This study intends to analyze and compare the blood biochemi-cal indicators and changes in oral microbiota of cattle with TR behavior and healthy cattle without TR behavior(healthy control,H),in order to explore the blood biochemical indicators of TR cattle and their correlation with changes in oral microbiota.Blood samples from the caudal vein of cattle in each group were collected for the detection of blood biochemical indicators and stress-related hormone indicators.Oral swabs from cattle in each group were collected for 16S rRNA gene se-quencing to analyze the composition,structure,and functional changes of their oral microbiota.The results of blood biochemical indicators in H and TR groups showed that the concentrations of al-bumin(ALB),aspartate aminotransferase(AST),calcium ion(Ca2+),and cortisol in TR group were significantly higher than those in H group(P＜0.05).There were significant differences in beta diversity of oral microbiota between TR and H groups(P＜0.05).At the genus level,the rela-tive abundances of Pseudomonas,Enterobacter,Xanthomonas,and other genera in the oral micro-biota of TR group were significantly higher than those in H group(P＜0.05).However,the rela-tive abundances of Tessaracoccus,Turicibacter,Monoglobus,Dietzia,Bifidobacterium,and other genera in the oral microbiota of TR group were significantly lower than those in H group(P＜0.05).In the KEGG metabolic pathway at the third level,the relative abundances of thiamine me-tabolism,lipoate metabolism,cysteine and methionine metabolism in the oral microbiota of TR group were significantly lower than those in H group(P＜0.05).Spearman correlation analysis showed that ALB and AST were significantly positively correlated with the relative abundances of Pseudomonas and Stenotrophomonas.Therelative abundances of Pseudomonas,Stenotrophomonas,and Sphingomonas were significantly positively correlated with fatty acid metabolism,phosphate and phosphonate metabolism,and lipoate metabolism.ALB was significantly positively correlated with inositol phosphate metabolism and phosphate and phosphonate metabolism.The study found that there were significant differences in blood biochemical indicators and oral microbiota between TR and H groups.In addition,there is a certain correlation between the composition,structure,and function of oral microbiota and the biochemical function of the host.This indicates that TR behav-ior may be associated with changes in the biochemical indicators of the host and the composition,structure,and function of oral microbiota.

Objective:To explore the influencing factors of hematoma enlargement in patients with hypertensive intracerebral hemorrhage and construct a corresponding risk prediction nomogram. The screening effects of the constructed model and different hematoma enlargement risk assessment tools were compared and analyzed.Methods:Two hundred and thirty-two patients with hypertensive intracerebral hemorrhage from the Department of Neurosurgery, Lianyungang First People's Hospital from April 2021 to February 2022 were selected as the research subjects. Multivariate Logistic regression was used to analyze the risk factors of hematoma expansion in patients with hyperhemamic intracerebral hemorrhage, and R software was used to construct a nomo diagram. The receiver operating characteristic curve (ROC) and Hosmer-Lemeshow (H-L) goodness-of-fit were used to evaluate the discrimination and calibration of the model, and the decision curve was used to analyze the clinical validity of the model. The constructed Nomo diagram, nine-point method and BRAIN score were used to assess the risk of hematoma enlargement in the included patients and used them as test variables, and the ROC curve was plotted to compare and analyze the area under the ROC curve, sensitivity and specificity of the constructed Nomo diagram, nine-point method and BRAIN score. The Kappa test was used to analyze the consistency between the Nomo diagram, the nine-point method, and the BRAIN score and the hematoma expansion results.Results:The results of multivariate logistic regression analysis showed that blood pressure was poorly controlled ( OR=13.290, 95% CI: 3.676-48.049), ventricular penetration ( OR=4.825, 95% CI: 1.458-15.975), early neurological deterioration ( OR=27.740, 95% CI: 8.713-88.314), Glasgow Coma Scale(GCS)≤8 points ( OR=25.883, 95% CI: 6.542-102.404) was the main influencing factor for hematoma expansion in patients with hypertensive intracerebral hemorrhage (The P values were <0.001, 0.010, <0.001, and <0.001, respectively). The H-L test results of Nomogram for predicting hematoma enlargement were χ2=3.20, P=0.525, the calibration curve was close to the ideal curve, and the mean absolute error was 0.015, and the decision curve analysis showed that the model had good clinical validity. The ROC results showed that the area under the ROC curve of the constructed Neumo diagram, nine-point method and BRAIN score were 0.971 (95% CI: 0.941-0.989), 0.696 (95% CI: 0.632-0.755), and 0.778 (95% CI: 0.719-0.830)(all P<0.001). The sensitivities were 94.37%, 71.83%, and 84.51%, and the specificities were 90.68%, 58.39%, and 65.84%, respectively. The results of Kappa test showed that the Kappa values of Nuomo diagram, nine-point method and BRAIN score were 0.806 , 0.264 and 0.429 (all P<0.001). Conclusion:The main influencing factors of hematoma enlargement in patients with hypertensive intracerebral hemorrhage were poor blood pressure control, intraventricular hemorrhage, early neurological deterioration, and GCS score. The effect of the constructed Nuomo diagram model in predicting hematoma expansion in patients with hypertensive intracerebral hemorrhage is better than that of the nine-point method and the BRAIN score, which has clinical application value.

Objective:To assess the diagnostic performance of a panel of autoantibodies against multiple tumor-associated antigens (BRCA2, P53, ANXA11, PARP1, TRIM21, ATAD2, NY-ESO-1 and CAGE) in the detection of breast cancer.Methods:This was a retrospective case-control study. A total of 545 patients diagnosed with breast cancer (BC) by pathological examination, and eligible for enrolment at Jiangsu Cancer Hospital from January 2022 to December 2023 were selected as the patient group. In the same period, 200 patients with benign breast disease (BD) and 200 healthy individuals (HC) were included. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of tumor-associated autoantibodies in each group. The tumor markers including carcinoembryonic antigen (CEA), glycoconjugate antigen 125 (CA125) and glycoconjugate antigen 153 (CA153) were detected using electrochemiluminescence. Univariate and multivariate logistic regression analyses were used to screen the factors associated with breast cancer. The receiver operating characteristic (ROC) curve was applied to evaluate diagnostic value.Results:The levels of seven autoantibodies against BRCA2, P53, ANXA11, PARP1, ATAD2, NY-ESO-1 and CAGE were significantly higher in the BC group compared to HC group (all P<0.05). Additionally, the levels of six autoantibodies against BRCA2, P53, PARP1, ATAD2, NY-ESO-1 and CAGE were significantly higher in the BC group than those in BD group (all P<0.05). The levels of PARP1 and ATAD2 in the BD group were higher than those in HC group ( P<0.05). Logistic multivariate analysis revealed that BRCA2 ( OR=1.099, 95% CI 0.824-1.107), P53 ( OR=1.534, 95% CI 0.813-2.898), NY-ESO-1( OR=1.159, 95% CI 0.789-1.712) and CA153 ( OR=1.029, 95% CI 0.778-1.495) were potential indicators for breast cancer (all P<0.05). The ROC curves indicated that the AUCs for breast cancer using BRCA2, P53, NY-ESO-1, and CA153 were 0.602 (95% CI 0.549-0.635), 0.688 (95% CI 0.642-0.734), 0.729 (95% CI 0.677-0.781), 0.714 (95% CI 0.663-0.764), respectively. The sensitivities were 0.405, 0.588, 0.683 and 0.653, while the specificities were 0.770, 0.825, 0.851 and 0.790, respectively. The AUC of the combined detection including BRCA2, P53, NY-ESO-1, and CA153 for breast cancer was 0.857 (95% CI 0.832-0.883), with a sensitivity of 0.719 and a specificity of 0.835. Conclusions:The levels of tumor-associated autoantibodies to BRCA2, P53 and NY-ESO-1 were significantly elevated in breast cancer patients, and the combination of the three autoantibodies and CA153 has high diagnostic value for breast cancer.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To evaluate the clinical efficacy of single-wide-tunnel endoscopic submucosal dissection with single-clip-line traction (W-ESTD) for the treatment of early esophageal cancer and precancerous lesions with large area (≥ 3/4 circumference).Methods:A retrospective analysis was performed on patient data of large early esophageal cancer or precancerous lesions treated with digestive endoscopy at the Affiliated Huai'an NO.1 People's Hospital of Nanjing Medical University from January 2018 to January 2023. Patients were divided into W-ESTD group and endoscopic submucosal double-tunnel dissection (D-ESTD) group based on the technique used. Surgical speed, en bloc resection rate, R0 resection rate, curative resection rate, intraoperative and postoperative complications were compared between the two groups.Results:A total of 44 patients with large early esophageal cancer or precancerous lesions were included in this study, including 23 cases in the W-ESTD group and 21 cases in the D-ESTD group. There was no statistically significant difference in baseline data between the two groups ( P>0.05). The operating speeds of W-ESTD and D-ESTD groups were 29.97±11.89 mm2/min and 22.65±6.30 mm2/min, respectively, with significant difference ( t=2.580, P=0.014). There was no statistically significant difference between the two groups in terms of en bloc resection rate [95.7% (22/23) VS 100.0% (21/21), P=1.000], R0 resection rate [87.0% (20/23) VS 90.5% (19/21), P=1.000], or curative resection rate [73.9% (17/23) VS 85.7% (18/21), P=0.462]. No recurrence occurred. Intraoperative muscular injury occurred in 3 cases in the W-ESTD group and 5 cases in the D-ESTD group, and postoperative esophageal stricture occurred in 11 cases and 8 cases respectively, with no significant differences between the two groups ( P>0.05). Conclusion:Compared to D-ESTD, W-ESTD can significantly improve surgical speed and demonstrate itself as a safe and effective approach for treating large early esophageal cancer and precancerous lesions.