Recently, diffusion models have emerged as a promising paradigm for molecular design and optimization. However, most diffusion-based molecular generative models focus on modeling 2D graphs or 3D geometries, with limited research on molecular sequence diffusion models. The International Union of Pure and Applied Chemistry (IUPAC) names are more akin to chemical natural language than the Simplified Molecular Input Line Entry System (SMILES) for organic compounds. In this work, we apply an IUPAC-guided conditional diffusion model to facilitate molecular editing from chemical natural language to chemical language (SMILES) and explore whether the pre-trained generative performance of diffusion models can be transferred to chemical natural language. We propose DiffIUPAC, a controllable molecular editing diffusion model that converts IUPAC names to SMILES strings. Evaluation results demonstrate that our model outperforms existing methods and successfully captures the semantic rules of both chemical languages. Chemical space and scaffold analysis show that the model can generate similar compounds with diverse scaffolds within the specified constraints. Additionally, to illustrate the model's applicability in drug design, we conducted case studies in functional group editing, analogue design and linker design.

The clinical data of a patient with differentiated thyroid carcinoma(DTC)who developed physiological thymic uptake after postoperative iodine-131(131I)therapy were analyzed,and the 3-year follow-up changes in the patient's condition were reviewed.Combined with the literatures and the diagnosis and treatment process,the causes of possible false positives in whole-body scans after iodine therapy for DTC and the mechanism,clinical features,and identification methods of benign thymic 131I uptake were discussed to improve clinicians' understanding and diagnostic ability regarding such conditions and avoid unnecessary multiple iodine treatments.The patient,a 28-year-old female,showed mediastinal imaging after the first 131I treatment,with more pronounced mediastinal iodine uptake during the second treatment.SPECT/CT localized the uptake to enlarged thymus tissue.The stimulated thyroglobulin(Tg)levels before two 131I treatments were high but gradually decreased.Apart from thymic uptake,no other examination evidence suggested DTC metastases.Subsequent follow-up for 3 years showed no pathological changes in the thymus,confirming physiological thymic uptake.Thymic 131I uptake is a common cause of false-positive whole-body scans in post-thyroidectomy patients.When post-131I therapy whole-body imaging shows only mediastinal uptake,especially in the young patients undergoing multiple 131I treatments where thymic 131I uptake intensity increases with successive treatments,even with elevated Tg levels,comprehensive use of imaging results such as SPECT/CT is essential to determine if it is normal thymus,thereby avoiding unnecessary repeated therapies.

Invasive fungal infections (IFIs) have become prominent global health threats, escalating the burden on public health systems. The increasing occurrence of invasive fungal infections is due primarily to the extensive application of chemotherapy, immunosuppressive therapies, and broad-spectrum antifungal agents. At present, therapeutic practices utilize multiple categories of antifungal agents, such as azoles, polyenes, echinocandins, and pyrimidine analogs. Nevertheless, the clinical effectiveness of these treatments is progressively weakened by the emergence of drug resistance, thereby substantially restricting their therapeutic utility. Consequently, there is an imperative need to expedite the discovery of novel antifungal agents. This review seeks to present an exhaustive synthesis of novel antifungal drugs and candidate agents that are either under current clinical investigation or anticipated to progress into clinical evaluation. These emerging compounds exhibit unique benefits concerning their modes of action, antimicrobial spectra, and pharmacokinetic characteristics, potentially leading to improved therapeutic outcomes relative to conventional antifungal regimens. It is anticipated that these novel therapeutic agents will furnish innovative treatment modalities and enhance clinical outcomes in managing invasive fungal infections.

Objective To investigate the relationship between sleep disorders and coronary heart disease through big data combined with Mendelian randomization analysis.Methods Data from 2005 to 2018 National Health and Nutrition Examination Survey in the United States were utilized.Logistic regression analysis was employed to evaluate the association between sleep disorders and coronary heart disease,while analyzing relevant influencing factors.A two-sample Mendelian randomization approach was implemented using Genome-Wide Association Studies to establish causal relationships.Results Logistic regression analysis demonstrated a significant association between sleep disorders and coronary heart disease(P＜0.001),with the neutrophil-to-lymphocyte ratio serving as a mediating factor in this relationship(P＜0.001).Mendelian randomization analysis revealed a positive correlation between sleep disorders and coronary heart disease(OR=1.030,95％CI:1.01-1.04).Conclusion Sleep disorders can increase the risk of coronary heart disease by activating inflammatory factors.

Recently,diffusion models have emerged as a promising paradigm for molecular design and optimization.However,most diffusion-based molecular generative models focus on modeling 2D graphs or 3D geom-etries,with limited research on molecular sequence diffusion models.The International Union of Pure and Applied Chemistry(IUPAC)names are more akin to chemical natural language than the simplified molecular input line entry system(SMILES)for organic compounds.In this work,we apply an IUPAC-guided conditional diffusion model to facilitate molecular editing from chemical natural language to chemical language(SMILES)and explore whether the pre-trained generative performance of diffusion models can be transferred to chemical natural language.We propose DiffIUPAC,a controllable molecular editing diffusion model that converts IUPAC names to SMILES strings.Evaluation results demonstrate that our model out-performs existing methods and successfully captures the semantic rules of both chemical languages.Chemical space and scaffold analysis show that the model can generate similar compounds with diverse scaffolds within the specified constraints.Additionally,to illustrate the model's applicability in drug design,we conducted case studies in functional group editing,analogue design and linker design.

Objective To investigate the relationship between sleep disorders and coronary heart disease through big data combined with Mendelian randomization analysis.Methods Data from 2005 to 2018 National Health and Nutrition Examination Survey in the United States were utilized.Logistic regression analysis was employed to evaluate the association between sleep disorders and coronary heart disease,while analyzing relevant influencing factors.A two-sample Mendelian randomization approach was implemented using Genome-Wide Association Studies to establish causal relationships.Results Logistic regression analysis demonstrated a significant association between sleep disorders and coronary heart disease(P＜0.001),with the neutrophil-to-lymphocyte ratio serving as a mediating factor in this relationship(P＜0.001).Mendelian randomization analysis revealed a positive correlation between sleep disorders and coronary heart disease(OR=1.030,95％CI:1.01-1.04).Conclusion Sleep disorders can increase the risk of coronary heart disease by activating inflammatory factors.

Objective To compile nursing guidelines for diabetic patients undergoing ultrasound-guided islet transplantation through percutaneous portal vein puncture and catheterisation,providing valuable insights for the care of such patients during the surgical procedure.Methods Between December 2017 to September 2023,a total of 27 patients underwent 44 surgical procedures for ultrasound-guided islet transplantation via percutaneous portal vein puncture and catheterisation at our hospital.Nursing assistance was provided preoperatively,intraoperatively and postoperatively for all the procedures.Results All 27 patients who had undergone 44 surgical procedures successfully went through the ultrasound-guided islet transplantation via percutaneous portal vein puncture and catheterisation.Among the 44 surgical procedures,3(6.8%)resulted in upper abdominal and liver area pain,nausea and vomiting during surgery,8(18.2%)had transient increase of portal vein pressure during transplantation,and 6(13.6%)encountered active bleeding following the removal of the portal vein catheters.None of the patients developed delayed portal vein bleeding or complication such as portal vein thrombosis after the surgery.Conclusions Nursing interventions play a crucial role in ensuring the successful outcomes of ultrasound-guided islet transplantation.Following measures are the keys and they play an important roles in ensuring the smooth completion of ultrasound-guided islet transplantation:preoperatively,carefully assess the condition of recipients and provide them with psychological supports and patient education.Intraoperatively,closely monitor the vital signs,portal vein pressure and blood glucose as well as to prevent complications.Postoperatively,implement the nursing measures to prevent the recipients from postoperative bleeding of portal vein.

Objective:To preliminarily explore the association of pregnancy factors with cow's milk protein allergy in infants.Methods:This study was based on data from a subcohort of a study called ge-netic susceptibility to cow's milk allergy in Chinese children,including infants born in Peking University People's Hospital between March 1,2020,and December 31,2020.The infants were divided into a cow's milk protein allergy(CMPA)group and a control group according to whether they had developed cow's milk protein allergy at the age of 1 year.We retrospectively collected the clinical data of infants and their mothers before and during pregnancy,and analyzed the association of multiple factors during pregnancy with cow's milk protein allergy in infants.Results:A total of 278 infants were enrolled in this study,including 52 infants with CMPA and 226 infants without CMPA.Among them,there were 143 boys and 135 girls.The proportion of male infants in the CMPA group(69.2％)was higher than that in the control group(47.3％),and the difference was statistically significant(P=0.004).There were no significant differences in the distribution of birth weight,gestational age at birth,low-birth-weight in-fants,premature,umbilical cord entangle neck,and neonatal asphyxia between the CMPA group and the control group(P＞0.05).The proportion of mothers complicated with autoimmune diseases,anemia or antibiotics exposure during pregnancy in the CMPA group was higher than that in the control group,and there were statistical differences between the two groups(P＜0.05).There was no significant difference in the distribution of other pregnancy complications between the two groups(P＞0.05),such as eclamp-sia/preeclampsia,chronic hypertension/gestational hypertension,diabetes/gestational diabetes,thyroid diseases,and so on.There was no significant difference in the overall distribution of some blood routine indexes during pregnancy between the CMPA group and the control group(P＞0.05).Multivariate Lo-gistic regression analysis showed that male infant,mothers complicated with autoimmune diseases or ane-mia,antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy.Conclusion:Male infant,mothers complicated with autoimmune diseases or anemia,antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy.

Objective:Based on the forgetting curve principle to construct a model for the popularization of cardiopulmonary resuscitation among college students and validate its effectiveness, providing reference for the promotion of cardiopulmonary resuscitation.Methods:A randomized controlled trial was conducted. In October 2021, a multistage random sampling method was used to select 262 freshmen and sophomores from the School of Mathematics and Physics at Leshan Normal University as the control group, and 262 freshmen and sophomores from the School of Electronic Information and Artificial Intelligence as the experimental group.The control group received conventional training, while the experimental group, in addition to conventional training, received cardiopulmonary resuscitation retraining based on the Ebbinghaus forgetting curve at three time intervals: within 1 week, within 1 month, and within 1 to 6 months after training. The retraining included online self-learning, on-site observation reinforcement, and social practice sublimation. The cardiopulmonary resuscitation knowledge awareness rate and cardiopulmonary resuscitation skill assessment of the two groups were compared before training, immediately after training, and 6 months after training.Results:The final number of participants was 256 in the control group (126 males and 130 females) and 224 in the experimental group (110 males and 114 females). There were no statistically significant differences in cardiopulmonary resuscitation knowledge awareness rate and cardiopulmonary resuscitation skill scores between the two groups before and immediately after training (both P>0.05). Immediately after training, the average cardiopulmonary resuscitation knowledge awareness rate in the experimental and control groups were 91% (1 626/1 792) and 88% (1 806/2 048), respectively, which were significantly higher than the pre-training rates of 55% (989/1 792) and 55% (1 129/2 048) ( χ2=8.46, 7.30, both P<0.01). The cardiopulmonary resuscitation skill scores were (42.00 ± 3.55) and (41.68 ± 3.40), respectively, higher than the pre-training scores of (15.41 ± 4.85) and (15.92 ± 4.66) ( t=84.47, 45.56, both P<0.05). Six months after training, the awareness rates of determination of consciousness and cardiac arrest judgment, cardiopulmonary resuscitation steps, chest compression location, frequency, depth, and the ratio of chest compressions to artificial ventilation in the experimental group in college students were 90% (201/224), 93% (208/224), 92% (206/224), 93% (208/224), 89% (200/224), and 94% (210/224), respectively, higher than those in the control group, which were 62% (158/256), 71% (182/256), 77% (198/256), 73% (186/256), 70% (178/256), and 69% (176/256) ( χ2 values were 4.21-7.03, all P<0.01). The cardiopulmonary resuscitation skill score in the experimental group was (49.77 ± 3.68), higher than the control group′s (34.95 ± 4.79) ( t=38.25, P<0.01). The proportion of students confident in using cardiopulmonary resuscitation to save others was 92% (206/224) in the experimental group, higher than 58% (148/256) in the control group ( χ2=7.68, P<0.01). Six months after training, the cardiopulmonary resuscitation skill score in the experimental group was (49.77 ± 3.68), higher than the immediate post-training score of (42.00 ± 3.55), whereas the control group's cardiopulmonary resuscitation skill score was (34.95 ± 4.79), lower than the immediate post-training score of (41.68 ± 3.40) ( t=22.74, 18.33, both P<0.01). Conclusions:The cardiopulmonary resuscitation popularization model for college students based on the forgetting curve is conducive to mastering cardiopulmonary resuscitation knowledge and skills among trained college students, enhancing their confidence in using cardiopulmonary resuscitation techniques to rescue others. Moreover, it helps save the human, financial, and material resources required for cardiopulmonary resuscitation training to a certain extent and is worthy of promotion.

Objective:To investigate the relationship between gestational weight gain (GWG) in twin pregnancies and adverse perinatal outcomes.Methods:This retrospective study included twin pregnant women with live births at≥25 weeks of gestation and their offspring, who delivered at Peking University People's Hospital from January 2012 to October 2022. Total GWG was standardized according to gestational age and categorized into three groups based on the 2009 Institute of Medicine (IOM) guidelines: insufficient GWG (GWG below IOM recommendations), appropriate GWG (GWG within IOM recommendations), and excessive GWG (GWG above IOM recommendations). Comparisons between data of the three groups used analysis of variance, Kruskal-Wallis test or Bonferroni correction or Chi-square partitions. Multivariable logistic regression models and generalized estimating equations with logistic regression models were used to analyze the independent effects of GWG on maternal and neonatal outcomes. Results:A total of 794 twin pregnant women and their 1 588 live-born neonates were included in the study. There were 360 women (45.3%) with appropriate GWG, 356 (44.8%) with insufficient GWG, and 78 (9.8%) with excessive GWG. Both insufficient and excessive GWG were associated with an increased risk of preterm birth [adjusted ORs of 1.39 (95% CI: 1.04-1.88) and 1.70 (95% CI: 1.05-2.78), respectively]. Insufficient GWG was associated with an increased risk of gestational diabetes mellitus (adjusted OR=1.42, 95% CI: 1.00-2.01) and low birth weight infants (adjusted OR=2.04, 95% CI: 1.57-2.66). Insufficient GWG was also associated with a reduced risk of eclampsia or preeclampsia (adjusted OR=0.50, 95% CI: 0.33-0.75), cesarean section (adjusted OR=0.48, 95% CI: 0.30-0.77), discordant twin growth (adjusted OR=0.56, 95% CI: 0.37-0.85), and large for gestational age infants (adjusted OR=0.46, 95% CI: 0.35-0.61). Excessive GWG was associated with an increased risk of eclampsia or preeclampsia (adjusted OR=2.85, 95% CI: 1.65-4.91), and large for gestational age infants (adjusted OR=2.49, 95% CI: 1.60-3.86), while with a decreased risk of low birth weight infants (adjusted OR=0.42, 95% CI: 0.27-0.65). Conclusions:More than half of the twin pregnancies have GWG outside the recommended range of the IOM guidelines. Both insufficient and excessive GWG are associated with adverse perinatal outcomes, particularly an increased risk of preterm birth.