Objective:To analyze the clinical features and prognosis of patients with acute cerebral infarction with different variation coefficients of red blood cell distribution width.Methods:A total of 1 080 patients with acute cerebral infarction diagnosed and treated in the First Affiliated Hospital of Xinjiang Medical University from July 2021 to May 2023 were retrospectively selected as the study objects. The coefficient of variation of red blood cell distribution width was determined for all patients, among which 361 patients with the coefficient of variation of red blood cell distribution width was 11.91% to 14.89%(normal group), and 719 patients with the coefficient of variation of red blood cell distribution width was 14.90% to 23.76% (abnormal group). The clinical characteristics and prognosis of patients with acute cerebral infarction with different coefficient of variation of red blood cell distribution width were compared. Spearman test and Pearson test were used to analyze the correlation between the variation coefficient of red blood cell distribution width and clinical characteristics and prognosis of patients with acute cerebral infarction.Results:There were no significant differences in the proportion of cardiac embolism, arteriole occlusion, partial anterior circulation infarction, posterior circulation infarction and lacunar infarction between the two groups ( P>0.05). The proportion of large atherosclerosis, total anterior circulation infarction, recurrent infarction and prognosis grade 4, 5 and 6 in the normal group was lower than those in the abnormal group :48.48% (175/361) vs. 55.22% (397/719), 8.31% (30/361) vs. 96/719 (13.35%), 16.90% (61/361) vs. 25.03% (180/719), 11.91% (43/361) vs. 42.84% (308/719), 5.26% (19/361) vs. 11.68% (84/719), 0.83% (3/361) vs. 7.93% (57/719); the proportion of grade 0, 1 and 2 prognosis in the normal group were higher than that in the abnormal group: 13.85% (50/361) vs. 0.42% (3/719), 21.05% (76/361) vs. 4.17% (30/719), 21.88% (79/361) vs. 4.73% (34/719), there were statistical differences ( P<0.05). There were statistically significant differences in the variation coefficient of red cell distribution width in patients with acute cerebral infarction among different disease inducements, infarct parts, incidence times and prognosis grades ( P<0.05). Spearman test showed that the variation coefficient of red blood cell distribution width was positively correlated with the infarct volume in patients with acute cerebral infarction ( r = 0.591, P<0.05). The results of Pearson test showed that the variation coefficient of red blood cell distribution width was not correlated with the cause of disease and the location of infarction in patients with acute cerebral infarction ( P>0.05), but was positively correlated with the frequency of incidence and prognosis grade ( r = 0.079, 0.402, P<0.05). Conclusions:Higher coefficients of variation of erythrocyte distribution width are associated with larger infarct size, higher risk of recurrence, and worse prognosis in acute cerebral infarction.

Objective To explore the effect of PCSK9 inhibitor combined with atorvastatin on carotid atherosclerosis and its anti-inflammatory effect in patients with hypertension complicated with type 2 diabetes mellitus.Methods A total of 100 patients with hypertension complicated with type 2 diabetes mellitus who were treated in Nanchang Third Hospital from October 2022 to August 2023 were selected as the research subjects.They were divided into the control group and the study group by the random number table method,with 50 cases in each group.Both groups of patients received conventional antihypertensive,hypoglycemic,and antiplatelet therapy.The control group took 20 mg of atorvastatin calcium tablets orally,once a night.On the basis of the control group,the study group was additionally given 150 mg of evolocumab injection(a PCSK9 inhibitor)by subcutaneous injection,once every two weeks.Both groups of patients were followed up for 24 weeks.The levels of blood lipids,blood glucose,inflammatory cytokines,carotid intima-media thickness(IMT),atherosclerotic plaque score and adverse reactions of the patients in the two groups before and after treatment were detected and compared.Results The levels of TC,TG and LDL-C in the study group after treatment were lower than those before treatment and those in the control group at the same period,and the differences were statistically significant(P＜0.05).The levels of IL-1,IL-6,TNF-α,hs-CRP,as well as the ca-rotid IMT and atherosclerotic plaque score in the study group after treatment were lower than those before treatment and those in the control group at the same period,and the differences were statistically significant(P＜O.05).During the treatment period,there was no significant difference in the occurrence of adverse reac-tions between the two groups(P＞0.05).Conclusion The combination of PCSK9 inhibitor and atorvastatin can effectively regulate the blood lipid levels of patients with hypertension complicated and type 2 diabetes mellitus,alleviate the inflammatory response,and improve the degree of carotid atherosclerosis in these pa-tients.

Objective To investigate the expression and clinical significance of multiple endocrine neoplasia type 1(MEN1)gene in breast cancer.Methods The Cancer Genome Atlas(TCGA)database was used to analyze the relationship between MEN1 gene and clinicopathological characteristics of breast cancer.Kaplan-Meier method was used to observe the effect of MEN1 on survival of breast cancer patients.Gene Ontology(GO),Kyoto Encyclopedia of Genes and Genomes(KEGG),and gene set enrichment analysis(GSEA)were used to predict the function and signaling pathways of MEN1 related and interacting genes.Tumor Immune Estimation Resource(TIMER)and single sample gene set enrichment analysis(ssGSEA)were used to investigate the correlation between the level of immune infiltration and MEN1 expression in breast cancer.Results MEN1 was highly expressed in breast cancer patients,and its expression level was related to PAM50 subtype and menopause status(both P＜0.05).Kaplan-Meier survival analysis showed that high MEN1 expression was associated with poor clinical outcome(P=0.019).GO and KEGG enrichment analysis showed that MEN1 related and interacting genes were involved in biological processes(histone modification,histone-lysine methylation),cell components(methyltransferase complex and histone methyltransferase complex),molecular functions(histone-methyltransferase activity),and functional pathways(transcriptional disorders in tumors).GSEA identified that the highly expressed MEN1 phenotype was involved in vesicle-mediated transport,complement cascade,B-cell receptor signaling,lymphocyte-non-lymphocyte interaction,interleukin signaling,and cytokine signaling pathways in the immune system.CancerSEA single cell sequencing results indicated that the expression of MEN1 was positively correlated with angiogenesis in MDA-MB-231 cells(P＜0.05).TIMER analysis found that MEN1 in breast cancer was negatively correlated with the infiltration levels of macrophages and CD8+T cells,and positively correlated with the infiltration level of CD4+T cells(all P＜0.05).ssGSEA showed that the infiltration levels of 18 types of immune cells were negatively correlated with MEN1 expression(all P＜0.05).Conclusion High MEN1 level is associated with poor survival and immune infiltration in breast cancer patients.

Objective:To analyze the clinical features and prognosis of patients with acute cerebral infarction with different variation coefficients of red blood cell distribution width.Methods:A total of 1 080 patients with acute cerebral infarction diagnosed and treated in the First Affiliated Hospital of Xinjiang Medical University from July 2021 to May 2023 were retrospectively selected as the study objects. The coefficient of variation of red blood cell distribution width was determined for all patients, among which 361 patients with the coefficient of variation of red blood cell distribution width was 11.91% to 14.89%(normal group), and 719 patients with the coefficient of variation of red blood cell distribution width was 14.90% to 23.76% (abnormal group). The clinical characteristics and prognosis of patients with acute cerebral infarction with different coefficient of variation of red blood cell distribution width were compared. Spearman test and Pearson test were used to analyze the correlation between the variation coefficient of red blood cell distribution width and clinical characteristics and prognosis of patients with acute cerebral infarction.Results:There were no significant differences in the proportion of cardiac embolism, arteriole occlusion, partial anterior circulation infarction, posterior circulation infarction and lacunar infarction between the two groups ( P>0.05). The proportion of large atherosclerosis, total anterior circulation infarction, recurrent infarction and prognosis grade 4, 5 and 6 in the normal group was lower than those in the abnormal group :48.48% (175/361) vs. 55.22% (397/719), 8.31% (30/361) vs. 96/719 (13.35%), 16.90% (61/361) vs. 25.03% (180/719), 11.91% (43/361) vs. 42.84% (308/719), 5.26% (19/361) vs. 11.68% (84/719), 0.83% (3/361) vs. 7.93% (57/719); the proportion of grade 0, 1 and 2 prognosis in the normal group were higher than that in the abnormal group: 13.85% (50/361) vs. 0.42% (3/719), 21.05% (76/361) vs. 4.17% (30/719), 21.88% (79/361) vs. 4.73% (34/719), there were statistical differences ( P<0.05). There were statistically significant differences in the variation coefficient of red cell distribution width in patients with acute cerebral infarction among different disease inducements, infarct parts, incidence times and prognosis grades ( P<0.05). Spearman test showed that the variation coefficient of red blood cell distribution width was positively correlated with the infarct volume in patients with acute cerebral infarction ( r = 0.591, P<0.05). The results of Pearson test showed that the variation coefficient of red blood cell distribution width was not correlated with the cause of disease and the location of infarction in patients with acute cerebral infarction ( P>0.05), but was positively correlated with the frequency of incidence and prognosis grade ( r = 0.079, 0.402, P<0.05). Conclusions:Higher coefficients of variation of erythrocyte distribution width are associated with larger infarct size, higher risk of recurrence, and worse prognosis in acute cerebral infarction.

Objective:To analyze the prognostic outcomes of 1 147 patients who underwent liver transplantation at Qingdao University Affiliated Hospital and to summarize measures to enhance the efficacy of liver transplantation.Methods:A retrospective analysis was conducted on the clinical and follow-up data of 1 147 liver transplant patients at Qingdao University Affiliated Hospital.Results:The overall postoperative 1-, 3-, and 5-year survival rates for the 1 147 liver transplant patients were 87.20%, 73.40%, and 65.60%, respectively. The survival rates for benign disease liver transplant recipients were 88.01%, 84.98%, and 81.39% at 1, 3, and 5 years post-transplant, respectively, compared to recipients transplanted for malignancies of 78.11%, 64.41%, and 60.06% (all P<0.001). Among the mid vs more recent period, patients' 1-year and 3-year postoperative survival rates were 84.20%, 70.80% vs 90.50%, 71.70%, respectively,significantly in favor of recently enrolled patients ( P=0.022). In the complex surgery group, patients' 1-, 3-, and 5-year survival rates were 82.70%, 65.50%, 56.70%, while in less complicated group, it was 89.00%, 76.50%, 69.20% ( P<0.001). The primary causes of death for benign disease recipients were multi-organ failure (4.1%), while in recipients with malignant disease primary cause of death was tumor recurrence (23.7%). Postoperative complications included primary graft dysfunction, delayed graft function recovery, portal vein thrombosis, hepatic artery thrombosis, biliary stricture, post-transplant lymphoproliferative disorder, and graft-versus-host disease, with occurrence rates of 1.05%, 6.89%, 1.92%, 0.44%, 2.00%, 0.61%, and 0.44%, respectively. Conclusions:With the continuous improvement in surgical techniques and perioperative care levels, the 3-year survival rate of recipients at our center has increased. Malignant diseases and complex liver transplantation remain crucial factors affecting recipient prognosis, highlighting the need to further enhance comprehensive treatment capabilities for patients with malignant diseases and complex surgeries.

Objective:To summarize the clinical features of primary segmental volvulus (PSV) in neonates.Methods:A retrospective analysis was conducted on the clinical data of neonates with PSV who were admitted to the Department of Neonatal Surgery, Children's Hospital Affiliated to Capital Institute of Pediatrics from May 2014 to May 2023. The clinical manifestations, auxiliary examinations, treatment and prognosis of the neonates were summarized, and descriptive statistical analysis was performed on the collected data.Results:A total of 10 neonates with PSV were included, with a mean gestational age of (34.1±3.0) weeks and birth weight of (2 291±646) g. Eight cases had an onset age of 3 d or less, and 2 cases had an onset age of more than 3 d. Abdominal distension was observed as the main manifestation in all cases, while bilious vomiting occurred in seven cases and hematochezia in five cases. Imaging examinations mainly revealed low intestinal obstruction without specific manifestations. Laboratory tests showed metabolic acidosis and varing degrees of anaemia. Nine cases underwent diagnostic abdominal puncture, of which five had bloody ascites, two had clear ascites, one had bloody mixed with fecal-like ascites, and one had chylous ascites. All the cases underwent emergency exploratory laparotomy and segmental small bowel resections with either primary intestinal anastomosis or enterostomy. All cases were successfully cured and had been followed up to the age of 4 months to 9 years with good growth and development as normal children of the same age.Conclusions:Neonatal PSV is an independent abdominal emergency characterized by non-specific clinical manifestations and difficult preoperative diagnosis, but the overall prognosis is favorable after active surgical treatment.

Objective:To analyze the changes and management in perioperative circulatory function in neonates with congenital diaphragmatic hernia (CDH).Methods:A retrospective analysis was conducted on 52 cases of CDH children who were prenatally consulted and postnatally intubated and transported to the Neonatal Surgery Department of Children's Hospital, Capital Institute of Pediatrics from May 2021 to May 2023. The cases were divided into a survival group (42 cases) and a death group (10 cases) based on perioperative mortality. General data, left ventricular ejection fraction (LVEF) and pulmonary hypertension (PH) grading at different times (on the day of birth and seven days post-birth), as well as vasoactive inotropic score (VIS), treprostinil dosage, and urine output within 48 h post-surgery, were analyzed. Statistical analyses were performed using independent sample t-tests, rank-sum tests, Chi-square tests (or Fisher's exact test), or Wilcoxon non-parametric rank-sum tests. Results:(1) The gestational age at the first detection of CDH in the death group was earlier than that in the survival group [(22.9±3.0) weeks vs. (26.3±4.7) weeks, t=－2.17], and the proportion of liver herniation was higher in the death group [6/10 vs. 14% (6/42), χ2=10.56] (both P<0.05). In the death group, six cases underwent surgery, while four cases had unstable vital signs and no surgical opportunity. The proportion of open surgery and the use of patches were higher in the death group than in the survival group [4/6 vs. 14% (6/42); 4/6 vs. 9% (4/42); Fisher's exact test, both P<0.05]. (2) Among the operated cases in the death group, the VIS and treprostinil dosage within 48 h post-surgery were higher than those in the survival group {22.5 points (13.0-36.6 points) vs. 13.0 points (11.5-26.3 points), Z=－2.54; 19.5 ng/(kg·min) [8.0-22.5 ng/(kg·min)] vs. 9.0 ng/(kg·min) [4.8-20.0 ng/(kg·min)], Z=－2.52}; and the urine output was less than that in the survival group {1.4 ml/(kg·h) [0.7-2.0 ml/(kg·h)] vs. 3.0 ml/(kg·h) [2.8-3.7 ml/(kg·h)], Z=－2.61, all P<0.05)}. The LVEF on the day of birth and at 7 days post-birth in the death group were lower than those in the survival group [(63.8±8.5)% vs. (68.7±5.5)%, t=－2.09; (58.0±10.8)% vs. (69.6±4.8)%, t=－4.69; P<0.05], and the proportion of moderate to severe PH was higher than that in the survival group [moderate and severe on the day of birth were 0/10 vs. 33.3% (14/42) and 10/10 vs. 61.9% (26/42), χ2=－2.31; at seven days post-birth were 1/10 vs. 26.2% (11/42) and 9/10 vs. 7.1% (3/42), χ2=4.82; all P<0.05]. Conclusion:Infants with CDH often have circulatory dysfunction after birth, with more severe dysfunction in critically ill CDH infants. The rational use of vasoactive drugs, combined control of persistent pulmonary hypertension of the newborn with multiple drugs, and reasonable volume control may help improve the circulatory function of infants with CDH.

Objective:To analyze the changes and management in perioperative circulatory function in neonates with congenital diaphragmatic hernia (CDH).Methods:A retrospective analysis was conducted on 52 cases of CDH children who were prenatally consulted and postnatally intubated and transported to the Neonatal Surgery Department of Children's Hospital, Capital Institute of Pediatrics from May 2021 to May 2023. The cases were divided into a survival group (42 cases) and a death group (10 cases) based on perioperative mortality. General data, left ventricular ejection fraction (LVEF) and pulmonary hypertension (PH) grading at different times (on the day of birth and seven days post-birth), as well as vasoactive inotropic score (VIS), treprostinil dosage, and urine output within 48 h post-surgery, were analyzed. Statistical analyses were performed using independent sample t-tests, rank-sum tests, Chi-square tests (or Fisher's exact test), or Wilcoxon non-parametric rank-sum tests. Results:(1) The gestational age at the first detection of CDH in the death group was earlier than that in the survival group [(22.9±3.0) weeks vs. (26.3±4.7) weeks, t=－2.17], and the proportion of liver herniation was higher in the death group [6/10 vs. 14% (6/42), χ2=10.56] (both P<0.05). In the death group, six cases underwent surgery, while four cases had unstable vital signs and no surgical opportunity. The proportion of open surgery and the use of patches were higher in the death group than in the survival group [4/6 vs. 14% (6/42); 4/6 vs. 9% (4/42); Fisher's exact test, both P<0.05]. (2) Among the operated cases in the death group, the VIS and treprostinil dosage within 48 h post-surgery were higher than those in the survival group {22.5 points (13.0-36.6 points) vs. 13.0 points (11.5-26.3 points), Z=－2.54; 19.5 ng/(kg·min) [8.0-22.5 ng/(kg·min)] vs. 9.0 ng/(kg·min) [4.8-20.0 ng/(kg·min)], Z=－2.52}; and the urine output was less than that in the survival group {1.4 ml/(kg·h) [0.7-2.0 ml/(kg·h)] vs. 3.0 ml/(kg·h) [2.8-3.7 ml/(kg·h)], Z=－2.61, all P<0.05)}. The LVEF on the day of birth and at 7 days post-birth in the death group were lower than those in the survival group [(63.8±8.5)% vs. (68.7±5.5)%, t=－2.09; (58.0±10.8)% vs. (69.6±4.8)%, t=－4.69; P<0.05], and the proportion of moderate to severe PH was higher than that in the survival group [moderate and severe on the day of birth were 0/10 vs. 33.3% (14/42) and 10/10 vs. 61.9% (26/42), χ2=－2.31; at seven days post-birth were 1/10 vs. 26.2% (11/42) and 9/10 vs. 7.1% (3/42), χ2=4.82; all P<0.05]. Conclusion:Infants with CDH often have circulatory dysfunction after birth, with more severe dysfunction in critically ill CDH infants. The rational use of vasoactive drugs, combined control of persistent pulmonary hypertension of the newborn with multiple drugs, and reasonable volume control may help improve the circulatory function of infants with CDH.

Objective:To investigate the surgical efficacy of split liver transplantation.Methods:Patients who underwent liver transplantation at the Affiliated Hospital of Qingdao University between January 2015 and December 2022 were retrospectively analyzed. They were divided into split liver transplantation group ( n=60) and whole liver transplantation group ( n=765)according to graft types.In the split liver transplantation group, there were 23 males and 37 females, aged (52.5±10.2) years, and the body mass index was (22.4±3.3) kg/m 2. In the whole liver transplantation group, there were 630 males and 135 females, aged (51.2±9.6) years, and body mass index was (24.5±3.7) kg/m 2.The basic data of the two groups were matched 1∶1 using the propensity score matching method. The independent sample t test and χ2 test were used to compare the intraoperative and postoperative recovery of the two groups of donors and recipients. The overall survival rate and the graft survival rate of the two groups were analyzed by Kaplan-Meier method and the cumulative survival rate was compared by the Log-rank test. Results:Fifty-one well-matched pairs of data with similar baseline characteristics were obtained. The ratio of graft mass to recipient body weight in the matched split liver transplantation group was (1.78±0.55)%. Operation time( M(IQR))(10.8(1.5)hours vs. 8.0(1.9)hours, U=6.608, P<0.01) and cold ischaemia time(5.4(1.3)hours vs. 4.6(2.2)hours, U=2.825, P=0.005) were significantly longer in the split liver transplantation group than those in the whole liver transplantation group. Intra-operative anhepatic phase(53.0(15.0)minutes vs. 57.0(24.0)minutes, U=1.048, P=0.295),bleeding volume(1 000(1 400)ml vs. 1 200(1 200)ml, U=0.966, P=0.334) and intraoperative instillation of red blood cells(9.0(6.5)U vs. 11.0(11.0)U, U=1.732, P=0.083) were not significantly different between the two groups. However,the split liver transplantation group showed significantly longer postoperative intensive care unit stay(5.0(3.0)days vs. 4.0(4.0)days, U=2.677, P=0.007) and postoperative hospital stay(30.0(15.0)days vs. 26.0(15.0)days, U=2.237, P=0.025) and significantly higher incidence of postoperative complications(56.8%(29/51) vs. 36.6%(19/51), χ2=3.935, P=0.047) than the whole liver transplantation group. Furthermore,levels of alanine transaminase and aspartate aminotransferase were significantly higher on postoperative days 1,4 and 7 in the split liver transplantation group(all P<0.05) than in the whole liver transplantation group;however,there were no significant differences in these levels on postoperative days 14 and 28. The time to restoration of normal liver function in both groups(12.5(13.7)days vs. 9.0(12.5)days, U=1.607, P=0.108) was not statistically significant. Furthermore,the median follow-up time after surgery was 25.6 months in both groups. In postoperative years 1,2,3 and 5, the graft survival rates were 88.1%,80.8%,77.8% and 66.7% in the whole liver transplantation group and 80.3%,70.3%,67.3% and 60.5% in the split liver transplantation group( P=0.171),respectively. The patient survival rates in post-operative years 1,2,3 and 5 were 88.1%,80.8%,77.8% and 66.7% in the whole liver transplantation group and 80.3%,75.9%,70.3% and 63.3% in the split liver transplantation group,respectively( P=0.252). However,the differences of graft survival rates and patient survival rates between the two groups were not significant. Conclusion:Although it affects the early recovery of patients after liver transplantation,split liver transplantation has no effect on long-term survival rates and demonstrates surgical efficacy similar to that of whole liver transplantation.

Circular RNAs (circRNAs) are endogenous non-coding RNAs with covalently closed structures, which have important functions in plants. However, their biogenesis, degradation, and function upon treatment with gibberellins (GAs) and auxins (1-naphthaleneacetic acid, NAA) remain unknown. Here, we systematically identified and characterized the expression patterns, evolutionary conservation, genomic features, and internal structures of circRNAs using RNase R-treated libraries from moso bamboo (Phyllostachys edulis) seedlings. Moreover, we investigated the biogenesis of circRNAs dependent on both cis- and trans-regulation. We explored the function of circRNAs, including their roles in regulating microRNA (miRNA)-related genes and modulating the alternative splicing of their linear counterparts. Importantly, we developed a customized degradome sequencing approach to detect miRNA-mediated cleavage of circRNAs. Finally, we presented a comprehensive view of the participation of circRNAs in the regulation of hormone metabolism upon treatment of bamboo seedlings with GA and NAA. Collectively, our study provides insights into the biogenesis, function, and miRNA-mediated degradation of circRNAs in moso bamboo.
RNA, Circular/metabolism* ; Multiomics ; Poaceae/metabolism* ; Seedlings/genetics* ; Hormones/metabolism* ; MicroRNAs/metabolism* ; Gene Expression Regulation, Plant