Objective:To explore the clinical features of Heidenhain variant Creutzfeldt-Jakob disease (HvCJD) to deepen understanding and recognition of this disease.Methods:Clinical data of 1 case of HvCJD admitted to Hainan General Hospital on August 4, 2022, were collected, whose clinical characteristics were reviewed and analyzed, and literature review was conducted.Results:The 59 years old male patient initially experienced symptoms of blurred vision, followed by a rapid decline in cognitive function. Mini-Mental State Examination score was 21/30 and Montreal Cognitive Assessment score was 11/30. Diffusion-weighted magnetic resonance imaging demonstrated the presence of mild ribbon-like hyperintensity within the bilateral frontal-parietal-occipital-insular cortex. T 2WI fluid attenuated inversion recovery imaging exhibited slight hyperintensity within the bilateral parietal cortex. The electroencephalography showed atypical triphasic waves. The examination of cerebrospinal fluid demonstrated 14-3-3 protein with a positive result. Two months after onset of illness, follow-up revealed new symptoms of myoclonus in the patient. Finally, the patient was not effectively treated and died about 2.5 months after onset. Thirty-six relevant literatures of HvCJD were reviewed. Most Heidenhain variant patients exhibited occipital cortical diffusion weighted imaging hyperintensity. Posterior cortical damage may affect primary and higher-level visual processing, leading to various visual disturbances. The early symptoms were mainly visual symptoms, such as visual reduction, blurred vision, visual field defect and color vision impairment. Conclusions:HvCJD patients only present with various visual disorders at the onset, followed by other neurological symptoms. The disease progresses rapidly, and patients often die in a short period of time. The disease is very rare and is often misdiagnosed. Currently, there is no feasible and effective treatment for HvCJD.

Objective This study aims to explore the formation of the dilemma of"giving care"for disabled elderly people in nursing homes from the perspective of active health.Methods Purposive sampling was used to select caregivers and disabled elderly people from a nursing home in Chongqing as research subjects from July 2022 to December 2022.One-on-one in-depth interviews were conducted and Colaizzi's 7-step thematic analysis method was employed to collect and analyze the interview data.Results 4 themes were identified:①the dominance of the"giving"care concept,including the cultural thoughts of filial piety,passive acceptance of care characteristics and consumer psychology regarding paid services;②insufficient"participation"care ability,including lack of knowledge regarding active health and a weakening of skills to promote participation;③the hindrance to"transformation"of care models,including objective limitations in terms of human resources and delays in adapting aging environments;and ④the decline in"utilization"of internal abilities,including excessive avoidance of potential risks,a heavy workload of care and poor quality of individual care.Conclusion The formation of the dilemma of"giving care"for disabled elderly people in nursing homes is affected by multiple factors such as social background,service system,supply resources,and management mode.Transforming disabled elderly individuals from a state of"passive giving care"to"active participation in their health"is an important measure to realize the concept of positive aging and healthy aging.

OBJECTIVE To separate and identify the chemical constituents of the n-butanol fraction from the stems of Clerodendrum trichotomum ，and to investigate their antitumor activities in vitro . METHODS The ethanol extracts were obtained with 85% ethanol from dried stems of C. trichotomum. After dispersed with water ，ethanol extracts were distributed by petroleum ether，ethyl acetate and n-butanol in turn ，then concentrated under reduced pressure to obtain the fractions of each extraction part . The n-butanol fraction from the stems of C. trichotomum was isolated and purified by macroporous resin D 101 column chromatography and various chromatographic techniques including silica gel ，hydroxypropyl glucan gel and Toyopearl HW -40F macroporous resin and so on . The structures of them were identified by physical and chemical properties ，MS and NMR . All these compounds were evaluated for cytotoxic activities against 4 kinds of human tumor cells such as cultured K 562，MCF-7，A549 and HepG2，using the MTT assay . RESULTS Fourteen chemical constituents were isolated and identified as teuvincenone B （1）， uncinatone（2），villosin C （3），syringaresinol（4），syringaresinol-4ʹ-O-β-glucopyranoside（5），3，12-O-β-D-diglucopyranosyl-11，16- dihydroxyabieta-8，11，13-triene（6），glypentoside C （7），martynoside（8），isomartynoside（9），2-（4-hydroxyphenyl）ethanol-O-β-D- glucopyranosyl-（1→2）-O- β -D-glucopyranoside（10），3，4-dimethoxyphenyl-1-O- β -D-apiofuranosyl （1→2） - β -D- glucopyranoside（11）， 2，6-dimethoxy-4-hydroxy-1-O- β -D- glucopyranoside（12），adenosine（13）and cistanoside F （14）. In vitro anti-tumor activity studies showed that compounds 1-3 showed certa in inhibitory activities against tumor cellproliferation，among which compound 2 displayed the strongest inhibitory activity against MCF -7，A549 and HepG 2 cells，and their IC 50 values were 25.00，22.34 and 12.50 μmol/L respectively ；only compound 3 showed stronger inhibitory activity against K562 cell with IC 50 of 28.41 μmol/L. CONCLUSIONS Among them ，compounds 10 to 13 are isolated from genus Clerodendrum for the first time ，compounds 4，5，14 were isolated from C. trichotomum for the first time . The abietane diterpenoids （compounds 1-3）have better inhibitory activities against above four tumor cell lines .

To report the clinical, imaging, and pathological feature of a rare case of central precocious puberty with primary pigmented nodular adrenocortical disease(PPNAD), and to conduct a retrospective analysis of PPNAD with relevant literatures. The pubic hair was found in the child for more than one year. Physical examination showed Cushing′s syndrome. ACTH in blood decreased, cortisol rhythm was disordered, 24-hour urine free cortisol increased and the paradoxical increase of urine free cortisol after high dose dexamethasone suppression test. Adrenal enhancement computed tomography(CT)showed multiple small nodular shadows in bilateral adrenal glands. Gonadotropin releasing hormone(GnRH)stimulation test supported central precocious puberty and GnRH analogue was used to control the sexual development. PPNAD was supported by pathology result. The symptoms of Cushing′s syndrome were relieved partially after left adrenalectomy.

Growth plate,the developmental center of endochondral osteogenesis,can be divided morphologically and functionally into a resting zone,a proliferative zone,a prehypertrophic zone and a hypertrophic zone.Injuries to growth plate often lead to bone growth defects including limb length discrepancy and angulation deformity in children.Currently,their orthopedic corrective surgeries are invasive and limitedly effective and no effective biotherapy has been available.Previous studies on animal models of growth plate damage have investigated the related cellular and molecular events in the repair of damaged growth plates in the 4 distinct inflammatory,fibrogenic,osteogenic and remodeling phases.Related molecules involved in the regulation of the above processes,such as inflammatory cytokines tumor necrosis factor alpha,mitogenic platelet-derived growth factor and bone morphogenetic protein,are found to participate in the regulation of growth plate injury.Exploration of the mechanisms may provide new targets for biotherapy.In addition,development of cartilage tissue engineering,especially application of mesenchymal stem cells,also provides potential interventions for growth plate injury.

Objective To explore the feasibility of differential diagnosis of Gleason score (GS)(3+4)and (4+3)in prostate cancer (PCa) based on texture parameters of T2 WI and ADC maps.Methods A total of 77 patients with GS 7 points in PCa confirmed by pathology were enrolled in this retrospective study,including 45 GS(3+4)cases and 32 GS(4+3)cases.ROI was manually drew on the largest section of tumor on the axial T2 WI and ADC maps,and five texture parameters were extracted,namely,angular second moment (ASM),contrast, correlation,inverse difference moment and entropy,and the texture parameters between groups were analyzed statistically,then ROC curve was used to evaluate the diagnostic efficiency of texture parameters with statistical differences.Results There was no significant difference in age and prostate specific antigen (PSA)between GS (3 + 4)and GS (4 + 3)groups (P＞0.05).There were significant differences in ASM and entropy between T2 WI and ADC (P＜0.05),but there was no statistical difference in contrast,correlation and inverse difference moment (P＞0.05).Except for the AUC of T2 WIASM,there were statistical differences among T2 WIentropy ,ADCASM and ADCentropy.The AUC of ADCASM and ADCentropy were larger than that of T2 WIASM and T2 WIentropy.The AUC of ADCentropy had the largest AUC (0.732),the cut off value was 5.71 ,with the sensitivity was 97.6% and specificity was 5 9.5%.Conclusion MRI texture analysis can be used to differentiate GS (3 + 4)from GS (4 + 3)in PCa,and the ADCentropy have the best diagnostic efficacy.

Baeyer-Villiger monooxygenases, a well-studied class of flavin-dependent enzymes, catalyze the conversion of ketones to lactones or esters and the oxygenation of heteroatoms, which possesses great practical prospect in synthetic chemistry and biocatalysis. In this review, we focus on Baeyer-Villiger oxidations involved in biosynthesis of microbial secondary metabolites and discuss the characteristics of these Baeyer-Villiger oxidations and Baeyer-Villiger monooxygenases, to provide reference for the protein engineering of Baeyer-Villiger monooxygenases.
Biocatalysis ; Catalysis ; Mixed Function Oxygenases ; Oxidation-Reduction ; Protein Engineering

Objective To study the effects of serum C-type natriuretic peptide (CNP) ,insulin-like growth factor II (IGF-Ⅱ ) , endothelin (ET) ,neuron-specific enolase (NSE) and S100B protein(S100B) on the prognosis of the patients with traumatic brain injury .Methods A total of 110 patients with craniocerebral trauma admitted in our hospital from January 2016 to January 2017 se-lected as the craniocerebral trauma group and further divided into the mild ,moderate and severe craniocerebral trauma groups ac-cording to the Glasgow Coma Scale (GCS) .Then the levels of serum CNP ,IGF-Ⅱ ,ET ,NSE and S100B in all cases were analyzed by enzyme-linked immunosorbent assay (ELISA) .Their influence on the prognosis of the patients with craniocerebral trauma and the correlation among various indicators were analyzed .Results The levels of CNP and IGF-Ⅱat admission in the craniocerebral trauma group were significantly decreased ,while the levels of ET ,NSE and S100B were significantly increased ,the difference com-pared with the control group was statistically significant (P<0 .05) .Serum CNP and IGF-Ⅱlevels in the death group ,plant survival group and disabled group were significantly decreased .The difference was statistically significant (P<0 .01) .Serum CNP and IGF-Ⅱlevels in the moderate and severe craniocerebral trauma groups were gradually increased with the disease course progress ,while serum ET ,NSE and S100B levels were gradually decreased with the disease course progress ,the difference was statistically signifi-cant(P<0 .05) .In the patients with craniocerebral trauma ,the positive correlation existed between CNP and IGF-Ⅱ ,between ET and S100B ,between ET and NSE ,and between NSE and S100B(P<0 .01) ,while the negative correlation existed between IGF-Ⅱand ET ,between IGF-Ⅱ and S100B ,between CNP and ET ,and between IGF-Ⅱand NSE (P<0 .01) .Conclusion Serum CNP , IGF-Ⅱ ,ET ,NSE and S100B are correlated to the severity of craniocerebral trauma ,which has a higher clinical application value for judging the disease condition ,evaluating the prognosis in cradiocerebral trauma .

Fibrinogen (Fib) is one of the most common coagulation proteins,plays an important role in the coagulation cascade,and has a closed relationship with tumor.Studies indicate that the level of Fib has elevated in many kinds of cancer,and Fib is also closely correlated with the progression,metastasis and prognosis of tumor.Though the mechanism of the interaction of Fib and tumor is still unclear,Fib as a tumor marker and new therapy for these malignancies has been a new hotspot.