[This corrects the article DOI: 10.1016/j.apsb.2021.07.024.].

Using big data and artificial intelligence to establish a multi-point monitoring, early warning, and disposal system to achieve early warning and intervention of infectious disease outbreaks is an important means of controlling the spread of the epidemic. Taking Xiaoshan district as an example, this study analyzes the monitoring contents, warning methods, and application effectiveness of the infectious disease monitoring, early warning and disposal system. Based on Xiaoshan′s health big data resources, the system starts with syndrome, disease diagnosis and etiology. Through advanced technologies such as artificial intelligence and block chain, it realizes early identification of infectious disease outbreaks, data fusion, multi-cross collaboration, and closed-loop management. It has improved the sensitivity of clustered outbreaks monitoring and the effectiveness of epidemic disposal and provided a reference for grassroots disease prevention and control departments to establish an infectious disease monitoring and early warning system.

Using big data and artificial intelligence to establish a multi-point monitoring, early warning, and disposal system to achieve early warning and intervention of infectious disease outbreaks is an important means of controlling the spread of the epidemic. Taking Xiaoshan district as an example, this study analyzes the monitoring contents, warning methods, and application effectiveness of the infectious disease monitoring, early warning and disposal system. Based on Xiaoshan′s health big data resources, the system starts with syndrome, disease diagnosis and etiology. Through advanced technologies such as artificial intelligence and block chain, it realizes early identification of infectious disease outbreaks, data fusion, multi-cross collaboration, and closed-loop management. It has improved the sensitivity of clustered outbreaks monitoring and the effectiveness of epidemic disposal and provided a reference for grassroots disease prevention and control departments to establish an infectious disease monitoring and early warning system.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective To compare the diagnostic value of adrenocorticotropic hormone(ACTH)stimulation test(AST)with different doses of ACTH combined with midnight administration of 1 mg dexamethasone for the determination of the subtypes of primary hyperaldosteronism(PA).Methods This is a prospective observational study.Patients diagnosed with PA in the Department of Endocrinology,the First Medical Center of of Chinese PLA General Hospital from January 1,2020 to September 30,2022 underwent AST with different doses of ACTH.All patients received 1 mg dexamethasone at midnight for inhibition.Then,the patients were randomly assigned to 25-unit and 50-unit ACTH treatment groups by a ratio of 1:2.Subtype classification and diagnosis of aldosterone-producing adenoma(APA)and idiopathic hyperaldosteronism(IHA)was made on the basis of adrenal venous blood samples and/or postoperative pathology and clinical follow-up findings.Receiver operating characteristics(ROC)curves were plotted to examine the diagnostic efficacy and the difference of AST by varying doses of ACTH in distinguishing APA and IHA.Results A total of 82 patients,including 49 patients with APA(59.8%)and 33 patients with IHA(40.2%),were enrolled.There were 29 patients in the 25-unit ACTH group(35.4%)and 53 patients in the 50-unit ACTH group(64.6%).There were no significant differences in age,sex,blood pressure,minimum serum potassium,and biochemical parameters between the 25-unit and 50-unit groups.After ACTH stimulation,plasma aldosterone concentration(PAC),cortisol(F),and PAC/F at different points of time showed no statistical difference between the two groups(P>0.05).The area under the curve(AUC)of PAC in the 25-unit group was higher than that of PAC/F.The AUC of PAC reached the maximum at 90 minutes(0.948,95%confidence interval[CI]:0870-1.000)and the optimal cutoff was 38.0 ng/dL,which had a sensitivity of 92.9%and a specificity of 86.7%for differentiating APA and IHA.Similar to the 25-unit group,the maximum AUC of PAC in the 50-unit group was greater than that of PAC/F.The AUC of PAC reached the maximum 90 minutes(0.930,95%CI:0.840-0.994)and the optimal cutoff was 39.6 ng/dL,which had a sensitivity of 91.2%and a specificity of 83.3%.The AUC of PAC at different points of time in the 25-unit ACTH group(0.862-0.948)was greater than that of 50-unit ACTH group(0.823-0.930),but the difference was not statistical significance.Conclusion AST with 25-unit or 50-unit ACTH combined with small-dose dexamethasone can be used in PA subtype determination,ie,differentiation between APA and IHA.The optimal PAC cut-off values for 25-unit or 50-unit ACTH are similar,being 38.0 ng/dL and 39.6 ng/dL,respectively,and both cutoff values show higher sensitivity and specificity at 90 min.The AST with 25-unit ACTH has the smaller dose and the better safety.Therefore,it is recommended for the diagnosis of PA subtypes.

Background: Prediabetes leads to declines in physical function in older adults, but the impact of prediabetes progression or regression on physical function is unknown. This study assessed this longitudinal association, with physical function objectivelymeasured by grip strength, walking speed, and standing balance, based on the Health and Retirement Study enrolling United States adults aged >50 years. Methods: Participants with prediabetes were followed-up for 4-year to ascertain prediabetes status alteration (maintained, regressed, or progressed), and another 4-year to assess their impacts on physical function. Weak grip strength was defined as <26 kg for men and <16 kg for women, slow walking speed was as <0.8 m/sec, and poor standing balance was as an uncompleted fulltandem standing testing. Logistic and linear regression analyses were performed. Results: Of the included 1,511 participants with prediabetes, 700 maintained as prediabetes, 306 progressed to diabetes, and 505 regressed to normoglycemia over 4 years. Grip strength and walking speed were declined from baseline during the 4-year followup, regardless of prediabetes status alteration. Compared with prediabetes maintenance, prediabetes progression increased the odds of developing weak grip strength by 89% (95% confidence interval [CI], 0.04 to 2.44) and exhibited larger declines in grip strength by 0.85 kg (95% CI, –1.65 to –0.04). However, prediabetes progression was not related to impairments in walking speed or standing balance. Prediabetes regression also did not affect any measures of physical function. Conclusion Prediabetes progression accelerates grip strength decline in aging population, while prediabetes regression may not prevent physical function decline due to aging.

The many-banded krait, Bungarus multicinctus, has been recorded as the animal resource of JinQianBaiHuaShe in the Chinese Pharmacopoeia. Characterization of its venoms classified chief phyla of modern animal neurotoxins. However, the evolutionary origin and diversification of its neurotoxins as well as biosynthesis of its active compounds remain largely unknown due to the lack of its high-quality genome. Here, we present the 1.58 Gbp genome of B. multicinctus assembled into 18 chromosomes with contig/scaffold N50 of 7.53 Mbp/149.8 Mbp. Major bungarotoxin-coding genes were clustered within genome by family and found to be associated with ancient local duplications. The truncation of glycosylphosphatidylinositol anchor in the 3'-terminal of a LY6E paralog released modern three-finger toxins (3FTxs) from membrane tethering before the Colubroidea divergence. Subsequent expansion and mutations diversified and recruited these 3FTxs. After the cobra/krait divergence, the modern unit-B of β-bungarotoxin emerged with an extra cysteine residue. A subsequent point substitution in unit-A enabled the β-bungarotoxin covalent linkage. The B. multicinctus gene expression, chromatin topological organization, and histone modification characteristics were featured by transcriptome, proteome, chromatin conformation capture sequencing, and ChIP-seq. The results highlighted that venom production was under a sophisticated regulation. Our findings provide new insights into snake neurotoxin research, meanwhile will facilitate antivenom development, toxin-driven drug discovery and the quality control of JinQianBaiHuaShe.

Transporters are traditionally considered to transport small molecules rather than large-sized nanoparticles due to their small pores. In this study, we demonstrate that the upregulated intestinal transporter (PCFT), which reaches a maximum of 12.3-fold expression in the intestinal epithelial cells of diabetic rats, mediates the uptake of the folic acid-grafted nanoparticles (FNP). Specifically, the upregulated PCFT could exert its function to mediate the endocytosis of FNP and efficiently stimulate the traverse of FNP across enterocytes by the lysosome-evading pathway, Golgi-targeting pathway and basolateral exocytosis, featuring a high oral insulin bioavailability of 14.4% in the diabetic rats. Conversely, in cells with relatively low PCFT expression, the positive surface charge contributes to the cellular uptake of FNP, and FNP are mainly degraded in the lysosomes. Overall, we emphasize that the upregulated intestinal transporters could direct the uptake of ligand-modified nanoparticles by mediating the endocytosis and intracellular trafficking of ligand-modified nanoparticles via the transporter-mediated pathway. This study may also theoretically provide insightful guidelines for the rational design of transporter-targeted nanoparticles to achieve efficient drug delivery in diverse diseases.

Objective To investigate the changing trend and correlation of platelet count and spleen diameter in patients with digestive system malignancy receiving oxaliplatin-based chemotherapy. Methods We retrospectively analyzed clinical data of 72 patients with digestive system cancer, recorded and analyzed platelet count and spleen diameter during and after oxaliplatin-based chemotherapy. Results The incidence of thrombocytopenia in all patients was 65.3%. The median time of thrombocytopenia after the beginning of chemotherapy was 2.53±0.49 months, and the median cumulative dose of oxaliplatin was 520±35.81 mg/m²; the median time of lowest platelet count after the beginning of chemotherapy was 4.03±0.49 months, and the median cumulative dose of oxaliplatin was 780±36.32 mg/m². Splenomegaly occurred in 52(72.2%) patients during the follow-up. The median increase rate was (18.82±0.01)%. The median time of splenomegaly after the beginning of chemotherapy was 2.15±0.19 months, the median time for the largest spleen diameter was 4.68±2.89 months; after the end of chemotherapy, the median time for spleen contraction was 3.28±0.44 months, and the median time for spleen recovery was 8.80±1.05 months. Conclusion Oxaliplatin-based chemotherapy can cause thrombocytopenia and splenomegaly, and it is difficult to recover to baseline for a long time after the end of chemotherapy. The increase of spleen diameter was positively correlated with splenomegaly and thrombocytosis.

Objective To explore the expression changes of SIRT1 and related inflammatory regula-tors in peripheral blood of patients with major depressive disorder and analyze the correlation between SIRT1, depression and inflammatory regulators. Methods Forty patients with major depressive disorder and forty healthy controls were selected. Hamilton Depression Scale (HAMD-17) was used to assess the degree of de- pression in patients with depressive disorder. Quantitative Real-time PCR( RT-PCR) was used to detect the relative expression levels of SIRT1,Elf-1,NF-κB,IL-1β,GM-CSF mRNA,and enzyme linked immunosorbent assay(ELISA) was used to detect the expression levels of SIRT1,Elf-1,NF-κB,IL-1β,GM-CSF proteins. The correlation between the severity of depression disorder and SIRT1 and the correlation between SIRT1 and Elf-1 and NF-κB were analyzed. Results (1)Compared with the control group,SIRT1 mRNA expression significantly decreased in the case group (P<0. 01),while Elf-1,NF-κB,IL-1β,GM-CSF mRNA expression significantly increased in the case group (P<0. 01). ( 2) The expression of plasma SIRT1 protein((8. 23± 1. 78)ng/ml) in the case group was lower than that in the control group (P<0. 01). The expressions of plas-ma Elf-1 protein((1 921. 67±271. 07)pg/ml),NF-κB protein((2 057. 29±260. 44)pg/ml),IL-1β protein ((186. 60±31. 00) pg/ml) and GM-CSF protein((183. 69±28. 87) pg/ml) were higher than those in the control group((1 512. 92±284. 54)pg/ml,(1537. 18±313. 82) pg/ml,(144. 79±31. 48) pg/ml,(162. 82± 27. 90) pg/ml,respectively,all P<0. 01). (3) SIRT1 mRNA expression level was negatively correlated with the severity of major depressive disorder (r=-0. 51, P<0. 01) and was negatively correlated with the mRNA expression levels of Elf-1 and NF-κB (r=-0. 66,P<0. 01,r=-0. 64,P<0. 01). Conclusion The expres-sion level of SIRT1 in peripheral blood of patients with major depressive disorder is correlated with the sever-ity of depression. This may be related to the decrease of SIRT1 expression in peripheral blood leukocytes of patients with major depressive disorder,which activates the pathway of NF-κB and Elf-1 and increase expres-sion of GM-CSF and IL-1β.