Objective This study sought to accelerate the establishment of a Parkinson's disease mouse model by intracerebral injection of α-synuclein preformed fibrils(α-Syn PFF)into B6-hSNCA-A53T transgenic mice to induce rapid development of Parkinson's-like pathological features.Methods C57BL/6J background α-Syn A53T transgenic mice were selected as the model group,with isogenic C57BL/6J mice as the control group.α-Syn PFF was delivered into the bilateral striatum using stereotactic brain injection.After modeling,the open-field test was used to assess spontaneous activity and anxiety-like behaviors,while the rotarod,grip strength,and pole tests evaluated motor coordination and limb muscle tone.The buried food test was conducted to assess olfactory function.Immunohistochemical staining was performed to investigate neuroinflammation and pathological α-synuclein in the mouse brain.Results Compared with the control group,1 month after the α-Syn PFF injection,model mice showed increased locomotion in the open-field test,with no significant differences in the rotarod,grip strength,or pole tests,but prolonged food-seeking time.Two months after model establishment,the model group showed significantly reduced locomotor activity in open field testing,impaired motor coordination in rotarod,grip strength and pole tests,and olfactory dysfunction in buried food tests.Phosphorylated α-synuclein accumulation was observed in the substantia nigra,cortex,and hippocampus,accompanied by pronounced microglial activation,Lewy body deposition,and substantial dopaminergic neuron loss in the substantia nigra.Conclusions A53T mice developed olfactory dysfunction and motor impairments more rapidly after α-Syn PFF injection.Significant pathological changes were observed,including the aggregation of α-synuclein/Lewy body in the substantia nigra,cortex,and hippocampus,and the loss of dopaminergic neurons in the substantia nigra.This model can serve as a rapidly established animal model for α-synucleinopathy-related Parkinson's disease.

Objective This study sought to accelerate the establishment of a Parkinson's disease mouse model by intracerebral injection of α-synuclein preformed fibrils(α-Syn PFF)into B6-hSNCA-A53T transgenic mice to induce rapid development of Parkinson's-like pathological features.Methods C57BL/6J background α-Syn A53T transgenic mice were selected as the model group,with isogenic C57BL/6J mice as the control group.α-Syn PFF was delivered into the bilateral striatum using stereotactic brain injection.After modeling,the open-field test was used to assess spontaneous activity and anxiety-like behaviors,while the rotarod,grip strength,and pole tests evaluated motor coordination and limb muscle tone.The buried food test was conducted to assess olfactory function.Immunohistochemical staining was performed to investigate neuroinflammation and pathological α-synuclein in the mouse brain.Results Compared with the control group,1 month after the α-Syn PFF injection,model mice showed increased locomotion in the open-field test,with no significant differences in the rotarod,grip strength,or pole tests,but prolonged food-seeking time.Two months after model establishment,the model group showed significantly reduced locomotor activity in open field testing,impaired motor coordination in rotarod,grip strength and pole tests,and olfactory dysfunction in buried food tests.Phosphorylated α-synuclein accumulation was observed in the substantia nigra,cortex,and hippocampus,accompanied by pronounced microglial activation,Lewy body deposition,and substantial dopaminergic neuron loss in the substantia nigra.Conclusions A53T mice developed olfactory dysfunction and motor impairments more rapidly after α-Syn PFF injection.Significant pathological changes were observed,including the aggregation of α-synuclein/Lewy body in the substantia nigra,cortex,and hippocampus,and the loss of dopaminergic neurons in the substantia nigra.This model can serve as a rapidly established animal model for α-synucleinopathy-related Parkinson's disease.

Objective:To establish a novel laryngopharyngeal reflux model in Bama minipigs excluding concurrent gastroesophageal reflux through endoscopic cricopharyngeal myotomy.Methods:Twelve 8-month-old male Bama minipigs were randomly assigned to three groups: Group 1 underwent cricopharyngeal myotomy alone, Group 2 underwent combined cricopharyngeal and lower esophageal sphincter myotomy, and Group 3 served as the control group. Following a one-week acclimatization period, the respective surgical procedures were performed. At 2 weeks postoperatively, laryngopharyngeal pH monitoring was conducted on all pigs. At 8 weeks, histopathological assessment using hematoxylin and eosin (HE) staining, transmission electron microscopy of the laryngopharyngeal mucosa, and quantification of pepsin in the laryngopharyngeal and distal esophageal mucosa were performed to analyze intergroup differences and to elucidate the occurrence and pathologic featuresof LPR.Results:Two weeks postoperatively, experimental groups exhibited laryngopharyngeal reflux episodes with pH<5.0, in contrast to the control group. HE staining at 8 weeks revealed inflammatory changes in the laryngopharyngeal mucosa of Groups 1 and 2, accompanied by increased intercellular spaces and decreased desmosome density under electron microscopy, indicating a pathogenic mechanism involving disruption of intercellular junctions by refluxate. Statistically significant differences in pepsin expression ofthe vocalcords mucosal were observed among groups( F=88.427, P<0.001).Group 2 exhibited elevated pepsin expression in the distal esophageal mucosa than Groups 1 and 3, suggesting concurrent GERD only occured in Group 2. Conclusion:Endoscopic cricopharyngeal myotomy induces LPRD in Bama minipigs without concurrent GERD by reducing upper esophageal sphincter pressure, thereby offering a model that closely resembles the clinical features of LPRD.

Objective To examine the differential expression of plasma circRNA in individuals with type 2 diabetes mellitus(T2DM)and to elucidate the potential role of circRNA in the pathogenesis and progression of T2DM.Methods A total of 33 newly diagnosed T2DM patients who were hospitalized in the Department of Endocrinology of Heze Municipal Hospital and 33 healthy subjects with normal glucose tolerance(NC)were enrolled in this study from March 2022 to March 2023.Three subjects with T2DM and 3 with NC were randomly selected from study population and underwent high-throughput sequencing to identify differentially expressed circRNA.Six circRNA with significant differences were selected,and validated in the remaining study population using Real-Time Quantitative Polymerase Chain Reaction(RT-qPCR).Bioinformatics analyses were conducted on the differentially expressed circRNA-associated genes,and their interaction with microRNA(miRNA)was predicted.Results Microarray analysis revealed 166 significantly differentially expressed circRNA(FC≥2,P<0.05)in the T2DM group compared with NC group.Among them,137 were up-regulated and 29 were down-regulated.RT-qPCR validation of six circRNA showed that the expression level of hsa_circ_0000705 was significantly higher,while the expression levels of hsa_circ_0005362 and hsa_circ_0042839 were significantly lower in T2DM group,consistent with the microarray results.However,hsa_circ_0117392,hsa_circ_0008311,and hsa_circ_0087641 showed no significant changes.Conclusion Differentially expressed circRNA are present in T2DM patients.Hsa_circ_0005362 was significantly down-regulated and may be involved in the development of T2DM through the regulation of related signaling pathways by targeting miR-128-1-5p.

A novel technology is proposed for non-contact and real-time detection of atrial fibrillation using millimeter-wave radar.A 60 GHz PCR millimeter wave radar is used to continuously detect the chest echo signal of the subject.After signal acquisition,I-Q signal is generated through I-Q demodulation,and the signal phase information is extracted using effective points phase trend evaluation for obtaining the signals from oscillations in the chest wall,from which the respiratory signals and cardiac signals are extracted through digital filtering for the analysis of cardiac movement.Whether the atrial fibrillation occurs or not is determined by the characteristics of atrial fibrillation wave in the time domain.The effective points phase trend evaluation for extracting more accurate signal phase information and the time-domain method for real-time atrial fibrillation detection are the innovations of the study.The experimental results show that the proposed method achieves a detection accuracy of 99.2%in clinic.

Postoperative pain seriously affects the recovery process of patients, resulting in prolonged hospital stay and increased care costs. Appropriate application of patient-controlled analgesia devices can effectively relieve perioperative acute pain. In 1994 patient-controlled analgesia began to be used in Peking Union Medical College Hospital, and the Acute Pain Service Working Group was established in 2004. With the cooperation of anesthesiologists and specialist nurses, the group jointly has implemented the whole process and standardized management based on patient-controlled analgesia, and constantly improved and innovated working methods, laying a solid foundation for the development of postoperative pain management. This paper systematically reviews and summarizes the work from the aspects of clinical focus, nursing management experience, promotion and dissemination of pain treatment concepts, and development of acute pain service model under the new situation, with the hope of providing valuable reference for comprehensively strengthening pain management in the process of diagnosis and treatment, and enhancing patients' satisfaction with perioperative analgesia services.

Epidural labor analgesia aims to provide effective medical services to alleviate labor pain in parturients, while adhering to the principles of voluntary participation and clinical safety. In 2018, Peking Union Medical College Hospital(PUMCH)became one of the first pilot units for labor analgesia in China, and has achieved satisfactory results in high-quality development of labor analgesia. This article mainly introduces the achievements and experience of labor analgesia at PUMCH, including: (1) prioritizing maternal and infant safety, arranging personnel rationally, and developing standardized treatment processes through multidisciplinary collaboration to ensure safe and comfortable childbirth; (2) leveraging the hospital's comprehensive capabilities in emergency treatment, and improving collaborative rescue plans for critically ill parturients and newborns; (3) implementing advanced teaching methods to effectively train and conduct simulated drills for labor analgesia and rescue of critically ill parturients; (4) conducting patient education and informative lectures to help parturients acquire a scientific understanding of labor analgesia. We hope that this experience can provide reference and inspiration for other hospitals.

Objective:To establish a novel laryngopharyngeal reflux model in Bama minipigs excluding concurrent gastroesophageal reflux through endoscopic cricopharyngeal myotomy.Methods:Twelve 8-month-old male Bama minipigs were randomly assigned to three groups: Group 1 underwent cricopharyngeal myotomy alone, Group 2 underwent combined cricopharyngeal and lower esophageal sphincter myotomy, and Group 3 served as the control group. Following a one-week acclimatization period, the respective surgical procedures were performed. At 2 weeks postoperatively, laryngopharyngeal pH monitoring was conducted on all pigs. At 8 weeks, histopathological assessment using hematoxylin and eosin (HE) staining, transmission electron microscopy of the laryngopharyngeal mucosa, and quantification of pepsin in the laryngopharyngeal and distal esophageal mucosa were performed to analyze intergroup differences and to elucidate the occurrence and pathologic featuresof LPR.Results:Two weeks postoperatively, experimental groups exhibited laryngopharyngeal reflux episodes with pH<5.0, in contrast to the control group. HE staining at 8 weeks revealed inflammatory changes in the laryngopharyngeal mucosa of Groups 1 and 2, accompanied by increased intercellular spaces and decreased desmosome density under electron microscopy, indicating a pathogenic mechanism involving disruption of intercellular junctions by refluxate. Statistically significant differences in pepsin expression ofthe vocalcords mucosal were observed among groups( F=88.427, P<0.001).Group 2 exhibited elevated pepsin expression in the distal esophageal mucosa than Groups 1 and 3, suggesting concurrent GERD only occured in Group 2. Conclusion:Endoscopic cricopharyngeal myotomy induces LPRD in Bama minipigs without concurrent GERD by reducing upper esophageal sphincter pressure, thereby offering a model that closely resembles the clinical features of LPRD.

Objective:To explore the consistency between modified 12+ X prostate biopsy under transrectal interventional ultrasound and postoperative Gleason score in prostate cancer patients.Methods:A retrospective study was conducted on 312 patients diagnosed with prostate cancer and underwent radical resection at Zhongshan People′s Hospital from January 2020 to December 2022. All patients underwent modified 12+ X prostate biopsy and prostate system biopsy under transrectal interventional ultrasound before surgery. Using the Gleason score of postoperative pathological specimens as the " gold standard", the detection rates of prostate cancer and clinically significant prostate cancer using modified 12+ X prostate biopsy and prostate system biopsy under transrectal interventional ultrasound were compared, and the consistency between the two methods alone or in combination and postoperative Gleason score was compared.Results:Among 312 patients, the positive detection rate of the improved 12+ X puncture biopsy combined with the system puncture biopsy was significantly higher than that of the individual detection (95.51% vs 80.77% vs 76.92%), with a statistically significant difference ( P<0.05). The improved 12+ X puncture biopsy combined with system puncture biopsy showed a clinically significant higher detection rate of prostate cancer in positive patients compared to the two tests alone (94.63% vs 77.78% vs 80.00%), with a statistically significant difference ( P<0.05). There was no statistically significant difference in the detection rate of clinically significant prostate cancer among patients who missed diagnosis, either alone or in combination with biopsy ( P>0.05). The upgrade rate of Gleason score after prostate improvement 12+ X puncture biopsy (25.00%) was significantly lower than that of prostate system puncture (44.17%), which was significantly higher than combined puncture biopsy (11.74%), with a statistically significant difference ( P<0.05). After 312 patients received combined puncture biopsy, urinary retention was found in 14 cases (4.49%), hematuria in 30 cases (9.62%), fever in 28 cases (8.97%), and blood in stool in 18 cases (5.77%). After symptomatic treatment, they basically improved within 3 days after puncture. Conclusions:The combination of modified 12+ X prostate biopsy with systematic biopsy under transrectal interventional ultrasound can improve the detection rate of prostate cancer, and has good consistency with the postoperative Gleason score of prostate cancer patients, which has good clinical application value.

Objective:To investigate the value of ultrasound-guided coaxial trocar biopsy combined with contrast-enhanced ultrasound in peripheral pulmonary lesions.Methods:From April 2019 to October 2020, 110 patients with peri-pulmonary lesions underwent ultrasound-guided coaxial trocar biopsy and contrast-enhanced ultrasound (CEUS) in Zhongshan People′s Hospital were retrospectively analyzed. All patients were performed contrast-enhanced ultrasound, at the same time, under the guidance of ultrasound, coaxial cannula was used for precise positioning and puncture biopsy of peripheral lung tumors. The times of puncture, the situation of sampling, pathological diagnosis and complications after puncture were recorded.Results:There were 110 lesions in 110 patients with peripheral lesions, and the maximum diameter of the lesions was (3.4±1.2)cm. Ultrasound guided coaxial trocar can be used for multiple, multi angle and multi-layer deep biopsy. The average number of sampling was 1-3, and the success rate of puncture was 100%(110/110). The pathological diagnosis rate was 95.5%(105/110), among which 83 cases (79.0%) were malignant: 42 cases of adenocarcinoma, 19 cases of squamous cell carcinoma, 7 cases of metastatic adenocarcinoma, 4 cases of lymphoepitheliomatoid carcinoma, 4 cases of small cell carcinoma, 2 cases of non-small cell carcinoma, 2 cases of non-keratinized undifferentiated carcinoma, 2 cases of poorly differentiated carcinoma, and 1 case of rhabdomyosarcoma. 22 benign cases (21.0%): 10 inflammatory lesions, 4 pneumonia, 3 necrotic tissue, 2 tuberculosis, 1 atypical adenomatoid hyperplasia of alveolar epithelium, 1 pulmonary cryptococcosis, and 1 inflammatory pseudotumor. The postpuncture complications included pneumothorax 2.7%(3/110) and hemoptysis 0.9%(1/110).Conclusions:Percutaneous ultrasound-guided coaxial puncture biopsy combined with contrast-enhanced ultrasound has high success rate, rapid sampling, clear display of lesions, identification of tumor activity and necrosis area, accurate positioning of puncture target, multi-point sampling in case of one puncture, reducing puncture time and complications, and high clinical application value.