Objective To investigate the predictive value of cerebroplacental ratio(CPR),cerebro-uterine ratio(CUR)combined with cystatin C(CysC)for adverse pregnancy outcomes in preeclampsia(PE)fetuses.Methods A retrospective analysis was conducted on the clinical data of 150 PE patients admitted to the department of obstetrics and gynecology of Nuclear Industry 416 Hospital from January 2019 to December 2024,and patients were divided into the adverse-outcome group and the favorable-outcome group according to pregnancy outcomes.The clinical data,CPR,CUR and CysC level were compared between the two groups.Multivariate Logistic regression was used to analyze the independent influencing factors of adverse pregnancy outcome in PE patients;then,receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive efficiency of each index on adverse pregnancy outcome.Results The adverse-outcome group had shorter/lower gestational age at diagnosis,estimated fetal body weight,CUR,and CPR,but higher body mass index and CysC level compared to those in the favorable-outcome group,with significant differences(P<0.05).Multivariate Logistic regression identified that the elevated CysC level,and decreased CUR and CPR were related influencing factors for adverse pregnancy outcome(P<0.05).ROC curve analysis demonstrated that CUR,CPR and CysC had strong predictive value for adverse pregnancy outcome,with the area under the curve(AUC)of 0.802(95%CI:0.729 to 0.863),0.834(95%CI:0.764 to 0.890),and 0.791(95%CI:0.717 to 0.853),respectively;the combined prediction of CUR,CPR and CysC had grater AUC of 0.909(95%CI:0.851 to 0.950)than the individual prediction of the above three indicators(P<0.05).Conclusion CUR,CPR and CysC are influencing factors of adverse pregnancy outcome in PE patients,and their combined detection demonstrates good predictive value for adverse pregnancy outcome in PE patients.

Objective:To explore the clinical efficacy of coiling dragon needling plus chin tuck against resistance(CTAR)training for post-stroke deglutition disorders and its impact on surface electromyography.Methods:A total of 100 patients with post-stroke deglutition disorders were randomly divided into two groups,with 50 cases in each group.Both groups received the same CTAR training,and the observation group was treated with additional coiling dragon needling.Both groups were treated for 2 weeks.The clinical efficacy,swallowing function,average value of the maximum amplitude of surface electromyography,quality of life,and the difference in adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the standardized swallowing assessment(SSA),aspiration score,and deglutition disorders score of the videofluoroscopic swallowing study(VFSS)in both groups were significantly lower than those before treatment(P<0.05).The average value of the maximum amplitude of surface electromyography in the relaxed state,dry swallowing state,and the state of swallowing water,and the swallowing quality of life questionnaire(SWAL-QOL)score were all significantly higher than those before treatment in the two groups(P<0.05).After treatment,the SSA score,VFSS aspiration score,and VFSS deglutition disorders score in the observation group were lower than those in the control group(P<0.05),and the average value of the maximum amplitude of surface electromyography in the relaxed state,dry swallowing state,and the state of swallowing water,and the SWAL-QOL score in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared to CTAR treatment alone,coiling dragon needling plus CTAR treatment can enhance the clinical efficacy in treating patients with post-stroke deglutition disorders,enhancing the contraction ability of swallowing muscles and improving their swallowing function and quality of life.

OBJECTIVE: To explore the clinical features and genetic characteristics of three patients with Infantile liver failure syndrome type 2 (ILFS2). METHODS: Three children who were diagnosed with ILFS2 at the Children's Hospital Affiliated to Zhengzhou University from February 2023 to February 2024 were selected as the study subjects. Clinical data of the children were collected. Peripheral blood samples of the children and their parents were collected and subjected to whole exome sequencing (WES). Candidate variants of the NBAS gene were verified by Sanger sequencing. This study was approved by the Ethics Committee of the Children's Hospital Affiliated to Zhengzhou University (Ethics No. 2024-k-069). RESULTS: The three children had presented with fever-triggered recurrent acute liver failure. All of them were found to harbor compound heterozygous variants of the NBAS gene, including c.3596G>A and c.1181A>T in child 1, c.2617C>T and c.2T>C in child 2, and c.3596G>A and c.2817_2818insT in child 3. Among these, the c.1181A>T and c.2817_2818insT variants were unreported previously. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), they were respectively classified as variants of uncertain significance (PM2_Supporting+PM3+PP3) and pathogenic (PVS1+PM2_Supporting+PM3). CONCLUSION Combined with the patient's clinical phenotype, the compound heterozygous variants of the NBAS gene probably underlay the pathogenesis of ILFS2 in the three children. For children with fever-related acute liver failure of unknown causes, the possibility of this disease should be suspected, and genetic testing may facilitate the diagnosis. Early diagnosis and timely intervention can significantly improve the prognosis. Discoveries of the c.1181A>T and c.2817_2818insT variants have enriched the mutational spectrum of the NBAS gene.
Humans ; Exome Sequencing ; Genetic Testing/methods* ; Liver Failure, Acute/etiology* ; Mutation ; Child ; Adult ; Neoplasm Proteins

Objective:To explore the clinical efficacy of coiling dragon needling plus chin tuck against resistance(CTAR)training for post-stroke deglutition disorders and its impact on surface electromyography.Methods:A total of 100 patients with post-stroke deglutition disorders were randomly divided into two groups,with 50 cases in each group.Both groups received the same CTAR training,and the observation group was treated with additional coiling dragon needling.Both groups were treated for 2 weeks.The clinical efficacy,swallowing function,average value of the maximum amplitude of surface electromyography,quality of life,and the difference in adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the standardized swallowing assessment(SSA),aspiration score,and deglutition disorders score of the videofluoroscopic swallowing study(VFSS)in both groups were significantly lower than those before treatment(P<0.05).The average value of the maximum amplitude of surface electromyography in the relaxed state,dry swallowing state,and the state of swallowing water,and the swallowing quality of life questionnaire(SWAL-QOL)score were all significantly higher than those before treatment in the two groups(P<0.05).After treatment,the SSA score,VFSS aspiration score,and VFSS deglutition disorders score in the observation group were lower than those in the control group(P<0.05),and the average value of the maximum amplitude of surface electromyography in the relaxed state,dry swallowing state,and the state of swallowing water,and the SWAL-QOL score in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared to CTAR treatment alone,coiling dragon needling plus CTAR treatment can enhance the clinical efficacy in treating patients with post-stroke deglutition disorders,enhancing the contraction ability of swallowing muscles and improving their swallowing function and quality of life.

Objective:This study aimed to investigate the characteristic expression of programmed death-ligand 2(PD-L2)and epithelial-mesenchymal transition(EMT)-related biomarkers in head and neck squamous cell carcinoma(HNSCC)and their mechanism of action in HNSCC metastasis.Methods:Tumor tissue samples from 94 patients with HNSCC were collected from Tianjin Medical University Cancer Hos-pital from January 2018 to July 2023,and their correlation with clinicopathological parameters,including lymph node metastasis,was statist-ically assessed.Western blot was used to detect PD-L2 expression in HNSCC tumor tissues.PD-L2 overexpression and knockdown stably-transfected monoclonal cell lines were generated using lentiviral vectors.Transwell assays were performed to explore the effect of PD-L2 on the invasive migration of the HNSCC cell lines.Additionally,RNA sequencing was used to identify downstream target genes regulated by PD-L2.The expression levels of key EMT markers,including E-cadherin,N-cadherin,and Vimentin,were examined by Western blot to elucidate the molecular mechanism by which PD-L2 promotes tumor cell metastasis through EMT pathway activation.Additionally,RNA sequencing was employed to identify downstream target genes regulated by PD-L2.The expression levels of key EMT markers,including E-cadherin,N-cadherin,and Vimentin,were examined with Western blot analysis to elucidate the molecular mechanism by which PD-L2 promotes tumor cell metastasis through the EMT pathway activation.Results:High expression of PD-L2 is positively correlated with N staging(P<0.05),and elevated PD-L2 expression predicts a poor prognosis in HNSCC patients.Conclusions:PD-L2 regulates the EMT pathway to promote HNSCC metastasis.Targeting PD-L2 is expected to provide a new strategy for the treatment of metastatic HNSCC.

[Purpose]To analyze the compliance and its influencing factors of lung cancer screening using low-dose computed tomography(LDCT)among high-risk population in urban districts of Chongqing from 2013 to 2021.[Methods]The lung cancer screeing of Cancer Early Diagnosis and Treatment Project was conducted among permanent residents aged 40～69 years old from 14 urban districts of Chongqing selected by cluster sampling method from 2013 to 2021.The questionnaire survey was performed to assess the risk level of lung cancer,and individuals with high risk were advised to have LDCT examination.The compliance rate of LDCT examination among high-risk populations was calculated and compared using Chi-square test among residents with different de-mographic features;the influencing factors of compliance was analyzed with generalized linear mixed models.[Results]A total of 316 066 residents completed the risk assessment questionnaire survey,52 858 people were assessed as high-risk(17.17％).Among the high-risk population,20 398 completed LDCT screening,with an overall compliance rate of 38.59％.The generalized linear mixed model showed that male participants(OR=0.871,95％CI:0.823～0.922)and smokers(light smokers:OR=0.829,95％CI:0.775～0.886;heavy smokers:OR=0.842,95％CI:0.792～0.896)had lower compliance rates;while people with higher education level(OR=1.347,95％CI:1.265～1.435),occupational exposure to harmful substances(OR=1.400,95％CI:1.340～1.463),passive smoking for 20 years or more(OR=1.472,95％CI:1.376～1.576),infrequent physical exercise(OR=1.203,95％CI:1.152～1.256),family history of lung cancer(OR=2.312,95％CI:2.201～2.429),and those having media promotion by community staff(OR=1.365,95％CI:1.223～1.524),and trained community staff(OR=1.343,95％CI:1.227～1.470)had higher compliance rates.Comorbidities were also factors influencing compliance,and there was an increasing trend of compliance rate with the increase of comorbidity numbers(P＜0.001).[Conclusion]The compli-ance rate of LDCT examination for lung cancer screening in Chongqing needs to be improved,and more precise health education should be implemented for groups with different characteristics to improve the compliance among high-risk population.

Objective To investigate residents'willingness to use"internet+nursing services"of a community in Xiamen City and provide reference for the code of practice to promote the service.Methods A total of 350 community residents in Xiamen City were investigated by convenience sampling from January to December 2023.The questionnaire was self-designed with regard to their willingness to use"internet+nursing services".Results 336 questionnaires were effectively collected.The total score of willingness to use"internet+nursing services"of community residents in Xiamen City was(68.80±8.73)points,but only 19.6％of residents knew about"internet+nursing services".There were statistically significant differences in willingness to use among community residents with different ages,medical payment type,whether they knew"internet+nursing services"or not,and the number of service items needed(P＜0.05).Among them,age,whether they knew"internet+nursing services"or not and the number of service items needed were the main influencing factors of willingness to use(P＜0.05).Conclusion Community residents in Xiamen City show above the middle level of willingness to use"internet+nursing services".However,the popularity of"internet+nursing services"has a large room for improvement.The publicity to the residents should be strengthened,and the care needs of residents with different demographic characteristics should be considered.The supporting application functions of such platforms should be designed to meet the health needs of community residents,especially elderly patients with great demand for services.

AIM To study the chemical constituents from Gymnema tingens Spreng.and their in vitro hypoglycemic activity.METHODS The 70％ethanol extract was isolated and purified by macroporous resin,silica gel,sephadex LH-20,and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical propeties and spectral data.The in vitro hypoglycemic activity was evaluated by glucose uptake test in L6 cells.RESULTS Seventeen compounds were isolated and identified as 7-desoxyneocynapanogenin A(1),glaucogenin(2),cynatratoside A(3),atratcynoside F(4),(+)-lyoniresinol(5),(+)-lyoniresinol 3-O-α-D-rhamnopyranoside-(1→6)-β-D-glucopyranoside(6),fernandoside(7),3,4-dimethoxy-phenyl-1-O-β-D-apiofuranosyl-(1→2)-β-D-glucopyranoside(8),khaephuoside A(9),khaephuoside B(10),3,4,5-trimethoxy-phenyl-O-β-D-glucopyranoside(11),liquiritigenin(12),7,3'-dihydroxy-flavanone-4'-O-β-D-glucopyranoside(13),pinoresinol(14),syringaldehyde(15),(+)-1-hydroxy-pinoresinol-1-β-D-glucopyranoside(16),β-amyrin(17).Compounds 2-5、7、9、10、12、17 could promote the glucose uptake in L6 cells.CONCLUSION Compound 1 is a new compound,and 2-9、11-13、15-17 are isolated from this plant for the first time.Compounds 2-5、7、9、10、12、17 have good hypoglycemic activity.

Objective To investigate the distribution and antimicrobial resistance profiles of common pathogens isolated from cerebrospinal fluid(CSF)in CHINET program from 2015 to 2021.Methods The bacterial strains isolated from CSF were identified in accordance with clinical microbiology practice standards.Antimicrobial susceptibility test was conducted using Kirby-Bauer method and automated systems per the unified CHINET protocol.Results A total of 14 014 bacterial strains were isolated from CSF samples from 2015 to 2021,including the strains isolated from inpatients(95.3％)and from outpatient and emergency care patients(4.7％).Overall,19.6％of the isolates were from children and 80.4％were from adults.Gram-positive and Gram-negative bacteria accounted for 68.0％and 32.0％,respectively.Coagulase negative Staphylococcus accounted for 73.0％of the total Gram-positive bacterial isolates.The prevalence of MRSA was 38.2％in children and 45.6％in adults.The prevalence of MRCNS was 67.6％in adults and 69.5％in children.A small number of vancomycin-resistant Enterococcus faecium(2.2％)and linezolid-resistant Enterococcus faecalis(3.1％)were isolated from adult patients.The resistance rates of Escherichia coli and Klebsiella pneumoniae to ceftriaxone were 52.2％and 76.4％in children,70.5％and 63.5％in adults.The prevalence of carbapenem-resistant E.coli and K.pneumoniae(CRKP)was 1.3％and 47.7％in children,6.4％and 47.9％in adults.The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)and Pseudomonas aeruginosa(CRPA)was 74.0％and 37.1％in children,81.7％and 39.9％in adults.Conclusions The data derived from antimicrobial resistance surveillance are crucial for clinicians to make evidence-based decisions regarding antibiotic therapy.Attention should be paid to the Gram-negative bacteria,especially CRKP and CRAB in central nervous system(CNS)infections.Ongoing antimicrobial resistance surveillance is helpful for optimizing antibiotic use in CNS infections.

Objective To investigate the antimicrobial resistance of clinical isolates from elderly patients(≥65 years)in major medical institutions across China.Methods Bacterial strains were isolated from elderly patients in 52 hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program during the period from 2015 to 2021.Antimicrobial susceptibility test was carried out by disk diffusion method and automated systems according to the same CHINET protocol.The data were interpreted in accordance with the breakpoints recommended by the Clinical and Laboratory Standards Institute(CLSI)in 2021.Results A total of 514 715 nonduplicate clinical isolates were collected from elderly patients in 52 hospitals from January 1,2015 to December 31,2021.The number of isolates accounted for 34.3％of the total number of clinical isolates from all patients.Overall,21.8％of the 514 715 strains were gram-positive bacteria,and 78.2％were gram-negative bacteria.Majority(90.9％)of the strains were isolated from inpatients.About 42.9％of the strains were isolated from respiratory specimens,and 22.9％were isolated from urine.More than half(60.7％)of the strains were isolated from male patients,and 39.3％isolated from females.About 51.1％of the strains were isolated from patients aged 65-＜75 years.The prevalence of methicillin-resistant strains(MRSA)was 38.8％in 32 190 strains of Staphylococcus aureus.No vancomycin-or linezolid-resistant strains were found.The resistance rate of E.faecalis to most antibiotics was significantly lower than that of Enterococcus faecium,but a few vancomycin-resistant strains(0.2％,1.5％)and linezolid-resistant strains(3.4％,0.3％)were found in E.faecalis and E.faecium.The prevalence of penicillin-susceptible S.pneumoniae(PSSP),penicillin-intermediate S.pneumoniae(PISP),and penicillin-resistant S.pneumoniae(PRSP)was 94.3％,4.0％,and 1.7％in nonmeningitis S.pneumoniae isolates.The resistance rates of Klebsiella spp.(Klebsiella pneumoniae 93.2％)to imipenem and meropenem were 20.9％and 22.3％,respectively.Other Enterobacterales species were highly sensitive to carbapenem antibiotics.Only 1.7％-7.8％of other Enterobacterales strains were resistant to carbapenems.The resistance rates of Acinetobacter spp.(Acinetobacter baumannii 90.6％)to imipenem and meropenem were 68.4％and 70.6％respectively,while 28.5％and 24.3％of P.aeruginosa strains were resistant to imipenem and meropenem,respectively.Conclusions The number of clinical isolates from elderly patients is increasing year by year,especially in the 65-＜75 age group.Respiratory tract isolates were more prevalent in male elderly patients,and urinary tract isolates were more prevalent in female elderly patients.Klebsiella isolates were increasingly resistant to multiple antimicrobial agents,especially carbapenems.Antimicrobial resistance surveillance is helpful for accurate empirical antimicrobial therapy in elderly patients.