Objective To compare the synergies between the transcutaneous needle electrodes and the ETT surface electrodes used for neurological surveillance in thyroidology,and explore how to identify and protect recurrent laryngeal nerve and vagus nerve when the patient is not suitable for oral plug or surface electrodes are failure.Methods To collect and analyze the clinical data of 32 patients undergoing surgical treatment for thyroid disease,a total of 40 neurons of the recurrent laryngeal nerves and vagus nerves were monitored,and the amplitude and latency were recorded using ETT surface electrodes and transcutaneous needle electrodes for nerve monitoring,respectively.SPSS 26.0 software was used for statistical analysis,paired t-tests were used to analyze and compare the latency periods,and the rank sum test was used to analyze whether there is a difference in the amplitude obtained from stimulation of transcutaneous needle electrodes and ETT surface electrodes.Results When the transcutaneous needle electrodes were used in thyroid surgery,we identified all the nerves,obtained two-phase electrical signals similar to the latency and amplitude of the ETT surface electrodes,and could effectively identify the recurrent laryngeal nerve and vagus nerve[(3.22±0.50)ms vs.(3.85±1.00)ms,P＜0.05]through the incapacity period,with no obvious difference in the monitoring effect from the ETT surface electrodes[(3.04±0.58)ms vs.(3.89±1.07)ms,P＜0.05].At the same time,the visualization and safety of transcutaneous needle electrodes were higher,with great advantages.Conclusion Transcutaneous needle electrodes can effectively assist in identifying and protecting the recurrent laryngeal nerve and vagus nerve,and thus are an important supplement to ETT surface electrodes.

Laboratory medicine is an important subject of auxiliary clinical diagnosis, and the postgraduate education of clinical laboratory diagnostics is the key to cultivating high-end laboratory talents. This study analyses the differences in the postgraduate education model of clinical laboratory diagnostics between China and Australia from the four aspects of academic degree system, curriculum setting, teaching methods, and autonomous learning ability training and discusses the postgraduate education reform of laboratory medicine in China. With reference to the advanced experience of countries with a well-developed education system, the education reform in China can improve the comprehensive quality of postgraduate student in laboratory medicine and enhance the medical level of China.

AIM: To evaluate the efficacy of high-intensity focused ultrasound cyclo plasty(UCP)in the treatment of glaucoma and to investigate related influencing factors.METHODS: The study involved a total of 110 patients(134 eyes)who received UCP treatment between January 2019 and January 2022 at three medical centers: Tianjin Eye Aier Eye Hospital, Chongqing Aier Eye Hospital, and Chongqing Nanping Aier Eye Hospital. Patients were classified into three categories: primary angle-closure glaucoma, primary open-angle glaucoma, and secondary glaucoma. Best corrected visual acuity, intraocular pressure, and the usage of anti-glaucoma medications, etc., were recorded at 6 and 12 mo postoperatively.RESULTS: After 6 months of the UCP procedure, statistically significant differences in intraocular pressure were observed across all groups(all P<0.05). At 12 mo postoperatively, intraocular pressure of the primary angle-closure and primary open-angle glaucoma groups showed differences(all P<0.05). Notably, there were no significant changes in visual acuity at either the 6 or 12 mo compared to preoperative values across all patient groups(all P>0.05). Furthermore, the study identified a statistically significant correlation between the changes in intraocular pressure at 6 mo and factors such as age, history of previous glaucoma surgery, baseline white-to-white(corneal diameter), and the extent of UCP treatment(all P<0.05).CONCLUSION: The UCP procedure has been demonstrated to effectively lower intraocular pressure in patients with glaucoma. The efficacy appears to be influenced by variables including patient age, previous glaucoma surgery history, baseline white-to-white(corneal diameter), and the scope of UCP treatment. Importantly, UCP treatment did not adversely affect visual acuity, underscoring its favorable safety profile.

OBJECTIVE To compare the consistency between the semi-quantitative detection of HPV E6/E7 mRNA and the detection of p16 IHC and E6/E7RNA ISH in the tissues,and the feasibility of detecting high-risk HPV in head and neck mucosal lesions by HPV E6/E7 mRNA detection in the swabs was discussed.METHODS A total of 100 cases of head and neck mucosal lesions treated by the Department of Head and Neck Surgery,Beijing Tongren Hospital Affiliated to Capital Medical University from September 2022 to August 2023 were collected.Semi-quantitative detection of HPV E6/E7 mRNA was performed in oropharynx,lesion surface swab and lesion tissue specimen,and p16 immunohistochemical staining(IHC)and E6/E7 mRNA in situ hybridization(ISH)were detected in lesion tissue,and the consistency and difference of different detection results were studied.RESULTS Among the 100 patients,83 met the inclusion criteria and were divided into 21 papilloma cases,10 polyps/chronic inflammation cases,19 laryngeal cancer cases,13 oropharyngeal cancer cases,and 20 hypopharyngeal cancer cases according to pathological diagnosis.The HPV E6/E7 mRNA semi-quantitative results of oropharyngeal swab and lesion surface swab showed moderate or near high consistency with p16 IHC results.The results of HPV E6/E7 mRNA semi-quantitative in diseased tissue were highly consistent with those of p16 IHC(Kappa=0.780).In the diagnostic efficacy analysis,both swabs showed high consistency with HPV E6/E7 mRNA ISH(Kappa=0.690 and 0.708).CONCLUSION In the head and neck mucosal lesions,the HPV semi-quantitative detection results of oropharyngeal and lesion surface swab showed good consistency compared with classical p16 IHC and gold standard HPV E6/E7 mRNA ISH.It is a simple and reliable method for clinical high-risk HPV detection,which is helpful for the screening and individualized precise prevention and control of HPV infection in head and neck mucosal lesions.

Objective·To explore the molecular regulatory mechanism of neural tube defect(NTD)induced by retinoic acid(RA)in mouse embryos,and reveal the gene expression regularity of neural tube closure in mice.Methods·Based on the high-quality brain vesicle transcriptome data of mouse embryo during the critical period of neural tube closure[embryonic day 8.5(E8.5),E9.5 and E10.5],the gene expression trend data of the NTD group and the control group were obtained by using Short Time-series Expression Miner(STEM)software.Gene Ontology(GO)enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis were performed for genes with different expression trends between the NTD group and the control group.Some candidate genes were screened for validation.Pregnant mice were divided into the NTD group and control group,with 9 mice in each group.Pregnant mice in the NTD group were treated with RA and those in the control group were treated with sesame oil by gavage at E7.5.Foetal rat brain vesicle tissues were collected at E8.5,E9.5 and E10.5 for experiments.Based on the above animal tissues,the screened candidate genes were validated by quantitative real-time PCR(RT-PCR).Results·A total of 18 255 genes were detected in the transcriptome data of the control group,and the expression patterns of these genes could be summarized into 7 significant profiles.A total of 19 037 gene expression data were detected in the transcriptome data of the NTD group,and gene expression patterns could be summarized into 6 profiles with significant significance.A total of 46 genes in the control group showed an upward trend but a downward trend in the NTD group.They were enriched in the positive and negative regulation of organ development,neuronal apoptosis,oligodendrocyte proliferation,and fibroblast growth factor signaling pathway at the biological process level.At the cellular component level,they were mainly involved in the basic structure of cells and neurons;At the molecular functional level,they were mainly related to the binding of fibroblast growth factor receptor.A total of 61 genes showed a downward trend in the control group but an upward trend in the NTD group.These genes were enriched in functions such as cell lysis and amino acid/ion transport at the biological process level.At the cellular component level,they were enriched in intracellular molecules,particles,extracellular region,intercellular space,etc.At the molecular function level,they were related to the activity of a series of enzymes and transporters.The results of RT-qPCR showed that the transcriptome sequencing data were authentic and reliable.Conclusion·RA intervention causes abnormal cellular activities and stress responses during mouse embryo development,leading to abnormal embryo development,activation of signalling pathways related to organismal self-protection,and suppression of genes that maintain normal embryo development.

Objective To examine the process of the initial ethical review of drug clinical trials in medical institutions in Shaanxi province,analyze the current situation of initial reviews,and make suggestions to expedite the speed of initial ethical review of drug clinical trial projects.Methods Based on the drug clinical trial institutions in Shaanxi recorded in the"drug and medical device clinical trial institutions for the record management information system".This study involved retrieving information through hospital website,WeChat public accounts,and conducting telephone consultations to usnderstand the process.The analysis focused on the initial review requirements,documents submission,and approval documents.Results A total of 44 drug clinical trial institutions were assessed.63.6% of these institutions had clearly issued ethical review/application guidelines,with some lacking detailed provisions on the initial review submission list,simplified data and seal requirements.31.8% of the institutions had established ethics review management systems.The average time of obtaining ethics approval was from 5.13 to 6 d.Conclusion It is recommended to further improve ethical review guidelines,standardize the initial review process,refine the initial ethical review documents and institutional project approval documents,build an information management platform,reduce the time for initial review of drug clinical trial projects,and improve the speed of clinical trial initiation.

Background: Biofilms, such as those from Staphylococcus epidermidis, are generally insensitive to traditional antimicrobial agents, making it difficult to inhibit their formation. Although quercetin has excellent antibiofilm effects, its clinical applications are limited by the lack of sustained and targeted release at the site of S. epidermidis infection. Objectives: Polyethylene glycol-quercetin nanoparticles (PQ-NPs)-loaded gelatin-N,Ocarboxymethyl chitosan (N,O-CMCS) composite nanogels were prepared and assessed for the on-demand release potential for reducing S. epidermidis biofilm formation. Methods: The formation mechanism, physicochemical characterization, and antibiofilm activity of PQ-nanogels against S. epidermidis were studied. Results: Physicochemical characterization confirmed that PQ-nanogels had been prepared by the electrostatic interactions between gelatin and N,O-CMCS with sodium tripolyphosphate. The PQ-nanogels exhibited obvious pH and gelatinase-responsive to achieve on-demand release in the micro-environment (pH 5.5 and gelatinase) of S. epidermidis.In addition, PQ-nanogels had excellent antibiofilm activity, and the potential antibiofilm mechanism may enhance its antibiofilm activity by reducing its relative biofilm formation, surface hydrophobicity, exopolysaccharides production, and eDNA production. Conclusions This study will guide the development of the dual responsiveness (pH and gelatinase) of nanogels to achieve on-demand release for reducing S. epidermidis biofilm formation.

【Objective】 To explore the effect of online and offline collaborative and integrated mode (Internet + blood donation souvenirs), and develop diversified scientific ways of caring for voluntary blood donors in combination with the potential expectation of the target population, ao as to recruit and retain more blood donors. 【Methods】 A total of 4 000 blood donors from Yichang Central Blood Station from January 1 to June 30, 2022 were selected, and they could collect souvenirs from online and offline. The intelligent platform V9.5 of modern blood station management information system of Qiao Technology was used to classify the data of online and offline souvenir distribution, and digital intelligent comparison and analysis on age, occupation, education, type (first-time blood donors or repeat blood donors), region (main urban districts of Yichang and other counties and suburban districts) and gender were carried out. 【Results】 A total of 1 400 blood donors chose online souvenirs, who were mainly under 25 years old, students, female, college education or above, urban areas and regular donors; 2 600 chose offline souvenirs, who were mainly over 25 years old, male, junior college degree or below, occupations other than students (medical workers, educators, etc.), counties and suburban districts, and first-time blood donors. The collaborative and integrated mode of the two distribution methods were complementary and had a good incentive effect on blood donor recruitment. 【Conclusion】 The online and offline collaborative and integrated mode demonstrates a good effect and meets the needs of different population. Digital intelligence system is helpful to develop diversified and scientific ways of caring for voluntary blood donors, recruit and retain more blood donors, achieve high-quality development of blood collection and supply, therefore guarantee the increasing demand for clinical blood use.

【Objective】 To explore the prediction of clinical red blood cells (RBCs) consumption under major public health emergencies, so as to provide scientific basis for blood collection and blood inventory management. 【Methods】 The clinical consumption of different types of RBCs in Yichang from 2001 to 2017 was analyzed and modeled using the recurrent neural network (RNN) model, and the clinical RBCs consumption between January 2019 and December 2021(36 months) were scientifically predicted. 【Results】 The RNN model showed good prediction performance. The root mean square errors (RMSE) of RNN prediction values of A, B, O, AB type of RBCs were 156.7, 133.4, 204.2 and 51.3, respectively, with the average relative errors (MRE) at 6.4%, 6.6%, 8.5% and 7.1%, respectively. The model predicted the changing trend of RBCs consumption during the first round of COVID-19 outbreak (January to June, 2020) and forecasted the lowest level of consumption in February 2020 and a subsequent recovery in growth. The prediction of RBCs consumption during the second round of COVID-19 pandemic (January to June, 2021) was of high accuracy. For example, the relative errors of RNN models for A type RBCs consumption were 5.2% in Feb 2021 (the lowest level, 1 621.5 U) and 2.5% in May 2021 (the highest level, 2 397.0 U). 【Conclusion】 The artificial intelligence RNN model can predict clinical RBCs consumption well under major public health emergencies.

【Objective】 To observe the regulation of autonomic nerves in blood donors during blood donation by heart rate variability analysis and explore the possible mechanism of donation related vasovagal reaction. 【Methods】 Electrocardiogram (ECG) of 90 blood donors was monitored by Fontaine Ⅰlead during the whole process of blood donation, and the 5-min heart rate variation before, during and after blood donation was analyzed. 【Results】 During the whole process of blood donation, the sympathetic HRV index (LF nu) and the sympathetic and vagal balance ability index (LF/HF) increased, whereas the vagal nerve index (pNN50, RMSSD, HFnu) and heart rate variability index (SDNN, Total power) decreased. For baseline heart rate variability of different blood donors (first-time vs. repeated, male vs. female, 18-24 years old vs. ≥25 years old, <400 mL vs. 400 mL) before blood donation, the pNN50, RMSSD and Total power of 18-24 years old blood donors were higher, but other indicators showed no significant difference. There were differences in HRV indexes of different types of blood donors during blood donation compared with before blood donation. The decrease of pNN50 and HFnu and the increase of LF/HF were larger in experienced blood donors than in first-time blood donors. The decrease of RMSSD was larger in male blood donors than in female blood donors; the change of LF/HF was larger in blood donors aged≥25 years than in blood donors aged 18-24 years; other indicators had no significant difference. 【Conclusion】 Blood donation leads to reflex readjustment of the cardiac autonomic tone: the sympathetic nerve is excited while the vagal nerve is suppressed. The cardiac autonomic nerve function of first-time blood donors, female donors and low-age (18-24 years old) donors to blood donation stress is not fully regulated. Donation related vasovagal reaction may be related to the autonomic nerve regulation function of blood donors.