Objective:To investigate the indications for prenatal diagnosis using copy number variation-sequencing (CNV-seq) and the abnormalities detected by the method.Methods:This retrospective analysis involved 17 994 singleton pregnant women who underwent prenatal CNV-seq at the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2022. These cases were divided into five groups based on the following indications for CNV-seq: abnormal fetal ultrasound findings, high-risk results indicated by non-invasive prenatal testing (NIPT) or Down's syndrome serological screening (Down's screening), adverse pregnancy history, and advanced maternal age. The proportions of cases with the indications for prenatal CNV-seq, the detection rates of abnormalities (numerical abnormalities of chromosomes, pathogenic/likely pathogenic CNV in structural abnormalities) in the five groups, and the distribution of these abnormalities were analyzed. Statistical analysis was performed using Chi-square test. Results:Among the 17 994 pregnant women, the women with abnormal fetal ultrasound findings, high-risk NIPT results, high-risk Down's screening results, adverse pregnancy history, and advanced maternal age accounted for 32.65% (5 875/17 994), 11.90% (2 142/17 994), 31.62% (5 690/17 994), 11.70% (2 105/17 994), and 12.13% (2 182/17 994), respectively. The detection rates of abnormalities in the five groups were 10.60% (623/5 875), 34.64% (742/2 142), 4.69% (267/5 690), 2.99% (63/2 105), and 3.67% (80/2 182), respectively. The overall detection rate of abnormalities was 9.86% (1 775/17 994). The cases with numerical abnormalities of chromosomes accounted for 68.79% (1 221/1 775), trisomy 21 was predominant (49.30%, 602/1 221). Chromosomal structural abnormalities were detected in 31.21% (554/1 775) of the cases with abnormalities, with 57.76% (320/554) harboring pathogenic CNVs and 42.24% (234/554) harboring likely pathogenic CNVs. The detection rate of chromosomal numerical abnormalities was higher than that of structural abnormalities in the abnormal fetal ultrasound group, NIPT high-risk group, and advanced maternal age group [6.81% (400/5 875) vs. 3.80% (223/5 875), χ2=53.10; 27.96% (599/2 142) vs. 6.68% (143/2 142), χ2=338.40; 2.43% (53/2 182) vs. 1.24% (27/2 182), χ2=8.61; all P<0.01]. A total of 416 microdeletions and 255 microduplications were detected in the 554 cases. The top three regions with the highest frequencies in microdeletions were Xp22.31 (12.74%, 53/416), 22q11.21 (7.93%, 33/416), and 17q12 (5.77%, 24/416); in microduplications, they were 22q11.21 (14.90%, 38/255), 17q12 (3.53%, 9/255), and 7q11.23 (3.53%, 9/255). Conclusions:Abnormal fetal ultrasound findings accounted for the highest proportion of prenatal diagnostic indications. The overall detection rate of abnormalities by CNV-seq is relatively high, especially in those with high-risk NIPT results as an indication for prenatal diagnosis. Among the chromosomal structural abnormalities detected in this study, the frequencies of Xp22.31 microdeletion and 22q11.21 microduplication are higher.

Objective This study aims to summarize the situation,development experiences,and existing problems in the development of Hospital S,and provide relevant suggestions as a reference for the high-quality development path of public hospitals.Methods Thirteen managers of Hospital S(including hospital leaders,functional departments,and clinical depart-ment heads)and eight experts in the field of hospital management were selected as research subjects.The phenomenological re-search method of qualitative research was used,and semi-structured interviews were conducted to collect relevant data.The Co-laizzi phenomenological data analysis method was used to analyze the interview data.Results Through the analysis of the inter-view data,four themes related to high-quality development were identified:medical care,scientific research and teaching,tal-ents,and disciplines.Each theme has specific areas that need priority and focused attention.Under the theme of medical care,there are four sub-themes:medical quality,medical safety,medical technology,and medical services.Scientific research and teaching,as a strategic support for promoting the hospital's sustained high-quality development,includes four sub-themes:re-search innovation,achievement transformation,teaching system,and mentor team.Talents,as the core competitiveness of the hospital,include three sub-themes:top-level design,high-level talents,and training system.The discipline theme includes four sub-themes:development ideas,development opportunities,development directions,and discipline leaders.Conclusion Public hospitals are facing new situations in high-quality development,and accelerating the improvement of medical service capabilities is a direct manifestation of high-quality development.It is necessary to promote key work such as research innovation,teaching management,talent team building,and discipline construction in a coordinated manner to achieve synchronous improvement in quality and efficiency.

Objective To investigate the expression levels and clinical significance of serum long chain non coding RNA cancer susceptibility candidate 11(lncRNA CASC11)and Testis-associated highly-conserved oncogenic long non-coding RNA(lncRNA THOR)in esophageal cancer patients.Methods Esophageal cancer patients diagnosed in our hospital from January 2017 to January 2021 were selected as the observation group(n=129),and healthy individuals who underwent physical examination in our hospital(n=129)were as the control group.Serum lncRNA CASC11 and lncRNA THOR expression levels were detected by RT-qPCR;the 3-year survival rate was analyzed by Kaplan-Meier method;and the diagnostic value was analyzed by ROC curve.Results The expression levels of serum lncRNA CASC11(1.48±0.35 vs 1.01±0.20)and lncRNA THOR(1.54±0.28 vs 1.11±0.15)in the observation group were obviously higher than those in the control group(P＜0.05).The proportions of high expression of serum lncRNA CASC11 and lncRNA THOR in patients with infiltration depth of T3～T4,tumor diameter＞4 cm,TNM staging of Ⅲ-Ⅳ,and lymph node metastasis were obviously higher than those in patients with infiltration depth T1～T2,tumor diameter ≤ 4 cm,TNM staging Ⅰ-Ⅱ,and no lymph node metastasis(P＜0.05).After 3-year of follow-up,52 out of 129 esophageal cancer patients died and 77 survived.The 3-year survival rate of patients with high expression of lncRNA CASC11(32.20％vs 82.86％)and lncRNA THOR(36.07％vs 80.88％)was obviously lower than that of patients with low expression of lncRNA CASC11 and lncRNA THOR(P＜0.05).The area under the curve(AUC)of serum lncRNA CASC11 and lncRNA THOR levels for diagnosing esophageal cancer was 0.888 and 0.914,respectively,with cutoff value of 1.29 and 1.32.The AUC of the combined diagnosis of the two was 0.946,and the combined diagnosis of the two was superior to their individual diagnosis(Zcombination-lncRNA CASC11=2.410,Zcombination-lncRNA THOR=2.167,P=0.010,0.040).Conclusion The serum levels of lncRNA CASC11 and lncRNA THOR in patients with esophageal cancer are upregulated,they are obviously associated with the 3-year survival rate of patients,and the combination of the two has higher efficacy in the diagnosis of esophageal cancer.

Objective To investigate the expression levels and clinical significance of serum long chain non coding RNA cancer susceptibility candidate 11(lncRNA CASC11)and Testis-associated highly-conserved oncogenic long non-coding RNA(lncRNA THOR)in esophageal cancer patients.Methods Esophageal cancer patients diagnosed in our hospital from January 2017 to January 2021 were selected as the observation group(n=129),and healthy individuals who underwent physical examination in our hospital(n=129)were as the control group.Serum lncRNA CASC11 and lncRNA THOR expression levels were detected by RT-qPCR;the 3-year survival rate was analyzed by Kaplan-Meier method;and the diagnostic value was analyzed by ROC curve.Results The expression levels of serum lncRNA CASC11(1.48±0.35 vs 1.01±0.20)and lncRNA THOR(1.54±0.28 vs 1.11±0.15)in the observation group were obviously higher than those in the control group(P＜0.05).The proportions of high expression of serum lncRNA CASC11 and lncRNA THOR in patients with infiltration depth of T3～T4,tumor diameter＞4 cm,TNM staging of Ⅲ-Ⅳ,and lymph node metastasis were obviously higher than those in patients with infiltration depth T1～T2,tumor diameter ≤ 4 cm,TNM staging Ⅰ-Ⅱ,and no lymph node metastasis(P＜0.05).After 3-year of follow-up,52 out of 129 esophageal cancer patients died and 77 survived.The 3-year survival rate of patients with high expression of lncRNA CASC11(32.20％vs 82.86％)and lncRNA THOR(36.07％vs 80.88％)was obviously lower than that of patients with low expression of lncRNA CASC11 and lncRNA THOR(P＜0.05).The area under the curve(AUC)of serum lncRNA CASC11 and lncRNA THOR levels for diagnosing esophageal cancer was 0.888 and 0.914,respectively,with cutoff value of 1.29 and 1.32.The AUC of the combined diagnosis of the two was 0.946,and the combined diagnosis of the two was superior to their individual diagnosis(Zcombination-lncRNA CASC11=2.410,Zcombination-lncRNA THOR=2.167,P=0.010,0.040).Conclusion The serum levels of lncRNA CASC11 and lncRNA THOR in patients with esophageal cancer are upregulated,they are obviously associated with the 3-year survival rate of patients,and the combination of the two has higher efficacy in the diagnosis of esophageal cancer.

Objective:To investigate the indications for prenatal diagnosis using copy number variation-sequencing (CNV-seq) and the abnormalities detected by the method.Methods:This retrospective analysis involved 17 994 singleton pregnant women who underwent prenatal CNV-seq at the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2022. These cases were divided into five groups based on the following indications for CNV-seq: abnormal fetal ultrasound findings, high-risk results indicated by non-invasive prenatal testing (NIPT) or Down's syndrome serological screening (Down's screening), adverse pregnancy history, and advanced maternal age. The proportions of cases with the indications for prenatal CNV-seq, the detection rates of abnormalities (numerical abnormalities of chromosomes, pathogenic/likely pathogenic CNV in structural abnormalities) in the five groups, and the distribution of these abnormalities were analyzed. Statistical analysis was performed using Chi-square test. Results:Among the 17 994 pregnant women, the women with abnormal fetal ultrasound findings, high-risk NIPT results, high-risk Down's screening results, adverse pregnancy history, and advanced maternal age accounted for 32.65% (5 875/17 994), 11.90% (2 142/17 994), 31.62% (5 690/17 994), 11.70% (2 105/17 994), and 12.13% (2 182/17 994), respectively. The detection rates of abnormalities in the five groups were 10.60% (623/5 875), 34.64% (742/2 142), 4.69% (267/5 690), 2.99% (63/2 105), and 3.67% (80/2 182), respectively. The overall detection rate of abnormalities was 9.86% (1 775/17 994). The cases with numerical abnormalities of chromosomes accounted for 68.79% (1 221/1 775), trisomy 21 was predominant (49.30%, 602/1 221). Chromosomal structural abnormalities were detected in 31.21% (554/1 775) of the cases with abnormalities, with 57.76% (320/554) harboring pathogenic CNVs and 42.24% (234/554) harboring likely pathogenic CNVs. The detection rate of chromosomal numerical abnormalities was higher than that of structural abnormalities in the abnormal fetal ultrasound group, NIPT high-risk group, and advanced maternal age group [6.81% (400/5 875) vs. 3.80% (223/5 875), χ2=53.10; 27.96% (599/2 142) vs. 6.68% (143/2 142), χ2=338.40; 2.43% (53/2 182) vs. 1.24% (27/2 182), χ2=8.61; all P<0.01]. A total of 416 microdeletions and 255 microduplications were detected in the 554 cases. The top three regions with the highest frequencies in microdeletions were Xp22.31 (12.74%, 53/416), 22q11.21 (7.93%, 33/416), and 17q12 (5.77%, 24/416); in microduplications, they were 22q11.21 (14.90%, 38/255), 17q12 (3.53%, 9/255), and 7q11.23 (3.53%, 9/255). Conclusions:Abnormal fetal ultrasound findings accounted for the highest proportion of prenatal diagnostic indications. The overall detection rate of abnormalities by CNV-seq is relatively high, especially in those with high-risk NIPT results as an indication for prenatal diagnosis. Among the chromosomal structural abnormalities detected in this study, the frequencies of Xp22.31 microdeletion and 22q11.21 microduplication are higher.

Objective This study aims to summarize the situation,development experiences,and existing problems in the development of Hospital S,and provide relevant suggestions as a reference for the high-quality development path of public hospitals.Methods Thirteen managers of Hospital S(including hospital leaders,functional departments,and clinical depart-ment heads)and eight experts in the field of hospital management were selected as research subjects.The phenomenological re-search method of qualitative research was used,and semi-structured interviews were conducted to collect relevant data.The Co-laizzi phenomenological data analysis method was used to analyze the interview data.Results Through the analysis of the inter-view data,four themes related to high-quality development were identified:medical care,scientific research and teaching,tal-ents,and disciplines.Each theme has specific areas that need priority and focused attention.Under the theme of medical care,there are four sub-themes:medical quality,medical safety,medical technology,and medical services.Scientific research and teaching,as a strategic support for promoting the hospital's sustained high-quality development,includes four sub-themes:re-search innovation,achievement transformation,teaching system,and mentor team.Talents,as the core competitiveness of the hospital,include three sub-themes:top-level design,high-level talents,and training system.The discipline theme includes four sub-themes:development ideas,development opportunities,development directions,and discipline leaders.Conclusion Public hospitals are facing new situations in high-quality development,and accelerating the improvement of medical service capabilities is a direct manifestation of high-quality development.It is necessary to promote key work such as research innovation,teaching management,talent team building,and discipline construction in a coordinated manner to achieve synchronous improvement in quality and efficiency.

The SWOT model of management was used to analyze the advantages(S),disadvantages(W),opportunities(O)and challenges(T)of the transformation of scientific and technological achievements in a large general hospital in Shandong Province.According to the matrix form,four kinds of strategies are formed,including SO strategy using internal advantages to seize opportunities,ST strategy using internal advantages to resist external threats,WO strategy using external opportunities to o-vercome internal weaknesses and WT strategy overcoming internal weaknesses to avoid external threats,and effective strategies to promote the transformation of scientific and technological achievements in large general hospitals are discussed.

Background::Hypothermia therapy has been suggested to attenuate myocardial necrosis; however, the clinical implementation as a valid therapeutic strategy has failed, and new approaches are needed to translate into clinical applications. This study aimed to assess the feasibility, safety, and efficacy of a novel selective intracoronary hypothermia (SICH) device in mitigating myocardial reperfusion injury.Methods::This study comprised two phases. The first phase of the SICH was performed in a normal porcine model for 30 minutes ( n = 5) to evaluate its feasibility. The second phase was conducted in a porcine myocardial infarction (MI) model of myocardial ischemia/reperfusion which was performed by balloon occlusion of the left anterior descending coronary artery for 60 minutes and maintained for 42 days. Pigs in the hypothermia group ( n = 8) received hypothermia intervention onset reperfusion for 30 minutes and controls ( n = 8) received no intervention. All animals were followed for 42 days. Cardiac magnetic resonance analysis (five and 42 days post-MI) and a series of biomarkers/histological studies were performed. Results::The average time to lower temperatures to a steady state was 4.8 ± 0.8 s. SICH had no impact on blood pressure or heart rate and was safely performed without complications by using a 3.9 F catheter. Interleukin-6 (IL-6), tumor necrosis factor-α, C-reactive protein (CRP), and brain natriuretic peptide (BNP) were lower at 60 min post perfusion in pigs that underwent SICH as compared with the control group. On day 5 post MI/R, edema, intramyocardial hemorrhage, and microvascular obstruction were reduced in the hypothermia group. On day 42 post MI/R, the infarct size, IL-6, CRP, BNP, and matrix metalloproteinase-9 were reduced, and the ejection fraction was improved in pigs that underwent SICH.Conclusions::The SICH device safely and effectively reduced the infarct size and improved heart function in a pig model of MI/R. These beneficial effects indicate the clinical potential of SICH for treatment of myocardial reperfusion injury.

The SWOT model of management was used to analyze the advantages(S),disadvantages(W),opportunities(O)and challenges(T)of the transformation of scientific and technological achievements in a large general hospital in Shandong Province.According to the matrix form,four kinds of strategies are formed,including SO strategy using internal advantages to seize opportunities,ST strategy using internal advantages to resist external threats,WO strategy using external opportunities to o-vercome internal weaknesses and WT strategy overcoming internal weaknesses to avoid external threats,and effective strategies to promote the transformation of scientific and technological achievements in large general hospitals are discussed.

Noxious mechanical information is transmitted through molecularly distinct nociceptors, with pinprick-evoked sharp sensitivity via A-fiber nociceptors marked by developmental expression of the neuropeptide Y receptor 2 (Npy2r) and von Frey filament-evoked punctate pressure information via unmyelinated C fiber nociceptors marked by MrgprD. However, the molecular programs controlling their development are only beginning to be understood. Here we demonstrate that Npy2r-expressing sensory neurons are in fact divided into two groups, based on transient or persistent Npy2r expression. Npy2r-transient neurons are myelinated, likely including A-fiber nociceptors, whereas Npy2r-persistent ones belong to unmyelinated pruriceptors that co-express Nppb. We then showed that the transcription factors NFIA and Runx1 are necessary for the development of Npy2r-transient A-fiber nociceptors and MrgprD C-fiber nociceptors, respectively. Behaviorally, mice with conditional knockout of Nfia, but not Runx1 showed a marked attenuation of pinprick-evoked nocifensive responses. Our studies therefore identify a transcription factor controlling the development of myelinated nociceptors.