Objective:To investigate the clinical characteristics and genetic etiology of fetal Dandy-Walker spectrum (DWS) anomalies.Methods:This retrospective cohort study analyzed 28 fetuses with ultrasonographically confirmed DWS (ten classic Dandy-Walker malformations and 18 Dandy-Walker variants) at the First Affiliated Hospital, Zhengzhou University from January 2019 to June 2024. All cases underwent systematic ultrasonographic evaluation. Genetic analyses included chromosomal karyotyping alone ( n=4) or combined with copy number variation sequencing (CNV-seq) ( n=10). Descriptive statistics and Chi-square tests (or Fisher's exact test) with Bonferroni correction were applied. Results:(1) Among 28 fetuses, seven (25.0%) had isolated DWS and 21 (75.0%) non-isolated DWS. Central nervous system anomalies were most common (53.6%, 15/28). (2) Karyotyping identified abnormalities in four cases (4/14), including two triploidies, one case of mosaicism for a derivative chromosome der(1;10), and one 17p deletion. CNV-seq detected anomalies in six cases (25.0%, 6/24), four of which were missed by karyotyping: 3q23 deletion (encompassing ZIC1/ ZIC4), 13q11 duplication, and other critical variants. (3) Combined testing yielded a higher detection rate (28.6%, 8/28) than karyotyping alone (4/14, χ2=4.62, P=0.032) or CNV-seq alone (25.0%, 6/24, χ2=4.83, P=0.028) ( P=0.048 and 0.044 after Bonferroni correction). Conclusions:DWS demonstrates significant genetic heterogeneity, primarily involving chromosomal numerical anomalies (e.g., triploidy) and copy number variations (e.g., 3q23 deletion). Combined karyotyping and CNV-seq improves detection rates of genetic abnormalities.

Objective To retrospectively analyze pathogen distribution,antimicrobial resistance,and their chan-ging trends in patients with infectious endophthalmitis admitted to a hospital in Xingtai area during the past 10 years.Methods Patients with infectious endophthalmitis and were detected pathogens admitted to Hebei Eye Hos-pital from January 2014 to December 2023 were selected for a retrospective study.Culture results and antimicrobial resistance of pathogens from patients with endophthalmitis were summarized and analyzed.The mutation character-istics of resistance genes and cassette chromosome recombinase genes in methicillin-resistant Staphylococcus epider-midis(MRSE)strains were explored.In vitro virulence between MRSE strains carrying mutant and non-mutant genes was compared using serum killing test.Results A total of 671 patients(671 eyes)with infectious endoph-thalmitis were included in the study,with 484 pathogenic strains(from 484 eyes)isolated.The average age of pa-tients was(65.66±25.14)years old.There were no statistically significant differences in the constituent rates of pathogens among infectious endophthalmitis patients of different genders and ages(both P＞0.05).Incidence of in-fectious endophthalmitis was higher in summer and lower in winter.Except 2018,there were statistically significant differences in the constituent rate of infectious endophthalmitis among different seasons from 2016 to 2023(all P＜0.05).A total of 176 strains of Staphylococcus epidermidis,81 strains of Streptococcus,and 48 strains of Pseudo-monas aeruginosa were isolated.The resistance rates of Staphylococcus epidermidis to penicillin,erythromycin,and oxacillin were all over 40％,with a resistance rate of 64.20％to penicillin.From 2019 to 2023,the resistance rates of Staphylococcus epidermidis to penicillin,erythromycin,oxacillin,compound sulfamethoxazole,and cipro-floxacin were all higher than those from 2014 to 2018,and the differences were all statistically significant(all P＜0.05).The resistance rates of Streptococcus to azithromycin,erythromycin,and clindamycin were all over 80％.The resistance rate of Pseudomonas aeruginosa to both ciprofloxacin and piperacillin exceeded 70％.Among the 113 MRSE strains,the resistance genes ermA,ermB,and ermC accounted for 12.39％(n=14),13.27％(n=15),and 74.34％(n=84),respectively.The cassette chromosome recombinase genes mainly included ccrA1-ccrB1,ccrA2-ccrB2,and ccrA3-ccrB3 types.Gene mutations were detected from all three types of resistance genes,with a mutation rate of 81.42％(92/113).The colony count of antimicrobial-resistant gene-mutated Staphylococcus epi-dermidis was higher than that of non-mutated strains in serum killing test at 2 and 3 hours(both P＜0.05).Conclusion The constituent rates of pathogens in infectious endophthalmitis remained stable over the 10 years,with the highest proportion in summer and the lowest in winter.The detection rate of antimicrobial-resistant pathogens presented rising tendency,and the resistance gene of MRSE was mainly ermC.Testing and monitoring of MRSE strains should be strengthened in clinic to prevent the cloning and spread of resistance genes.

Objective To retrospectively analyze pathogen distribution,antimicrobial resistance,and their chan-ging trends in patients with infectious endophthalmitis admitted to a hospital in Xingtai area during the past 10 years.Methods Patients with infectious endophthalmitis and were detected pathogens admitted to Hebei Eye Hos-pital from January 2014 to December 2023 were selected for a retrospective study.Culture results and antimicrobial resistance of pathogens from patients with endophthalmitis were summarized and analyzed.The mutation character-istics of resistance genes and cassette chromosome recombinase genes in methicillin-resistant Staphylococcus epider-midis(MRSE)strains were explored.In vitro virulence between MRSE strains carrying mutant and non-mutant genes was compared using serum killing test.Results A total of 671 patients(671 eyes)with infectious endoph-thalmitis were included in the study,with 484 pathogenic strains(from 484 eyes)isolated.The average age of pa-tients was(65.66±25.14)years old.There were no statistically significant differences in the constituent rates of pathogens among infectious endophthalmitis patients of different genders and ages(both P＞0.05).Incidence of in-fectious endophthalmitis was higher in summer and lower in winter.Except 2018,there were statistically significant differences in the constituent rate of infectious endophthalmitis among different seasons from 2016 to 2023(all P＜0.05).A total of 176 strains of Staphylococcus epidermidis,81 strains of Streptococcus,and 48 strains of Pseudo-monas aeruginosa were isolated.The resistance rates of Staphylococcus epidermidis to penicillin,erythromycin,and oxacillin were all over 40％,with a resistance rate of 64.20％to penicillin.From 2019 to 2023,the resistance rates of Staphylococcus epidermidis to penicillin,erythromycin,oxacillin,compound sulfamethoxazole,and cipro-floxacin were all higher than those from 2014 to 2018,and the differences were all statistically significant(all P＜0.05).The resistance rates of Streptococcus to azithromycin,erythromycin,and clindamycin were all over 80％.The resistance rate of Pseudomonas aeruginosa to both ciprofloxacin and piperacillin exceeded 70％.Among the 113 MRSE strains,the resistance genes ermA,ermB,and ermC accounted for 12.39％(n=14),13.27％(n=15),and 74.34％(n=84),respectively.The cassette chromosome recombinase genes mainly included ccrA1-ccrB1,ccrA2-ccrB2,and ccrA3-ccrB3 types.Gene mutations were detected from all three types of resistance genes,with a mutation rate of 81.42％(92/113).The colony count of antimicrobial-resistant gene-mutated Staphylococcus epi-dermidis was higher than that of non-mutated strains in serum killing test at 2 and 3 hours(both P＜0.05).Conclusion The constituent rates of pathogens in infectious endophthalmitis remained stable over the 10 years,with the highest proportion in summer and the lowest in winter.The detection rate of antimicrobial-resistant pathogens presented rising tendency,and the resistance gene of MRSE was mainly ermC.Testing and monitoring of MRSE strains should be strengthened in clinic to prevent the cloning and spread of resistance genes.

Objective:To investigate the clinical characteristics and genetic etiology of fetal Dandy-Walker spectrum (DWS) anomalies.Methods:This retrospective cohort study analyzed 28 fetuses with ultrasonographically confirmed DWS (ten classic Dandy-Walker malformations and 18 Dandy-Walker variants) at the First Affiliated Hospital, Zhengzhou University from January 2019 to June 2024. All cases underwent systematic ultrasonographic evaluation. Genetic analyses included chromosomal karyotyping alone ( n=4) or combined with copy number variation sequencing (CNV-seq) ( n=10). Descriptive statistics and Chi-square tests (or Fisher's exact test) with Bonferroni correction were applied. Results:(1) Among 28 fetuses, seven (25.0%) had isolated DWS and 21 (75.0%) non-isolated DWS. Central nervous system anomalies were most common (53.6%, 15/28). (2) Karyotyping identified abnormalities in four cases (4/14), including two triploidies, one case of mosaicism for a derivative chromosome der(1;10), and one 17p deletion. CNV-seq detected anomalies in six cases (25.0%, 6/24), four of which were missed by karyotyping: 3q23 deletion (encompassing ZIC1/ ZIC4), 13q11 duplication, and other critical variants. (3) Combined testing yielded a higher detection rate (28.6%, 8/28) than karyotyping alone (4/14, χ2=4.62, P=0.032) or CNV-seq alone (25.0%, 6/24, χ2=4.83, P=0.028) ( P=0.048 and 0.044 after Bonferroni correction). Conclusions:DWS demonstrates significant genetic heterogeneity, primarily involving chromosomal numerical anomalies (e.g., triploidy) and copy number variations (e.g., 3q23 deletion). Combined karyotyping and CNV-seq improves detection rates of genetic abnormalities.

Objective To investigate the predictive value of acute ischemic stroke associated pneumonia score (AIS-APS) combined with systemic immune inflammation index (SII) in the early clinical outcome of stroke-associated pneumonia (SAP). Methods A retrospective study method was conducted involving 287 AIS patients who were diagnosed and treated in Zhujiang Hospital,Southern Medical University from January 2022 to December 2023. The patients were divided into SAP group (79 cases) and non-SAP group (208 cases) according to whether SAP occurred. Collect the following data,include the patient's basic information[gender,age,body mass index (BMI),smoking history],previous history[atrial fibrillation,congestive heart failure,chronic obstructive pulmonary disease (COPD),diabetes history],laboratory test results[biochemical indicators:blood glucose,triglycerides (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),glycated hemoglobin (HbA1c) and blood indicators:white blood cell count (WBC),neutrophilic count (NEU),lymphocyte count (LYM),platelet count (PLT)],SII,National Institutes of Health Stroke Scale (NIHSS) score at admission,AIS-APS,the difference of the above indexes between the two groups with different prognosis was compared. The risk factors for SAP were screened by Logistic regression analysis,and the predictive value of AIS-APS and SII for SAP was evaluated by receiver operator characteristic curve (ROC curve). Patients were followed up for 90 days to analyze the association between AIS-APS and SII and early outcomes. Use Pearson correlation analysis to analyze the correlation between SII and AIS-APS risk levels and patient prognosis. Results Compared with non-SAP group,patients with atrial fibrillation,congestive heart failure,COPD and proportion of patients with smoking history and TG,WBC,NEU,SII,NIHSS and AIS-APSY were significantly higher in SAP group[atrial fibrillation:13.92％ (11/79) vs. 7.12％ (15/208),congestive heart failure:32.92％ (26/79) vs. 26.44％ (55/208),COPD:34.17％ (27/79) vs. 24.52％ (51/208),smoking history:15.18％ (12/79) vs. 7.69％ (16/208),TG (mmol/L):1.79 (1.31,2.53) vs. 1.40 (1.03,1.99),WBC (×109/L):8.98 (6.78,9.15) vs. 6.02 (4.29,8.17),NEU (×109/L):5.20 (4.03,7.99) vs. 4.69 (3.31,5.53),SII:1145.9 (895.50,1346.3) vs. 545.80 (385.50,639.10),NIHSS score:6.00 (3.00,11.00) vs. 2.00 (1.00,4.75),AIS-APS:28.02 (14.29,33.17) vs. 22.98 (19.78,28.15),all P<0.05],while LYM was significantly decreased[×109/L:1.13 (0.95,2.25) vs. 1.62 (1.29,2.67),P<0.05]. Logistic regression analysis showed that atrial fibrillation,congestive heart failure,COPD,TG,SII and AIS-APS were all independent risk factors for AIS occurrence of SAP[odds ratio (OR) were 1.258,1.040,1.338,1.583,1.631 and 1.407,respectively,95％ confidence interval (95％CI) were 1.093-1.210,1.006-1.109,1.145-1.274,1.205-1.874,1.504-1.759,and 1.267-1.673,respectively;P values were 0.002,0.045,0.037,0.034,0.010,0.018,respectively]. ROC curve analysis shows:SII,AIS-APS and their combined detection had predictive value for the occurrence of SAP. When SII and AIS-APS were combined,area under the curve (AUC) increased to 0.894,the sensitivity increased to 83.67％,and the specificity increased to 88.65％,P=0.012,which was significantly better than SII and AIS-APS alone. At 90 days of follow-up,SII and AIS-APS risk levels were found to be strongly associated with the prognosis of AIS patients,with higher SII and AIS-APS risk levels predicting poor prognosis. Pearson correlation analysis showed that both SII and AIS-APS risk levels were positively correlated with the prognosis of AIS patients (r values were 0.906 and 0.418,respectively,both P<0.05). Conclusion AIS-APS combined with SII can effectively predict the risk of SAP and is closely related to the early clinical outcomes of patients.

Objective To investigate the predictive value of acute ischemic stroke associated pneumonia score (AIS-APS) combined with systemic immune inflammation index (SII) in the early clinical outcome of stroke-associated pneumonia (SAP). Methods A retrospective study method was conducted involving 287 AIS patients who were diagnosed and treated in Zhujiang Hospital,Southern Medical University from January 2022 to December 2023. The patients were divided into SAP group (79 cases) and non-SAP group (208 cases) according to whether SAP occurred. Collect the following data,include the patient's basic information[gender,age,body mass index (BMI),smoking history],previous history[atrial fibrillation,congestive heart failure,chronic obstructive pulmonary disease (COPD),diabetes history],laboratory test results[biochemical indicators:blood glucose,triglycerides (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),glycated hemoglobin (HbA1c) and blood indicators:white blood cell count (WBC),neutrophilic count (NEU),lymphocyte count (LYM),platelet count (PLT)],SII,National Institutes of Health Stroke Scale (NIHSS) score at admission,AIS-APS,the difference of the above indexes between the two groups with different prognosis was compared. The risk factors for SAP were screened by Logistic regression analysis,and the predictive value of AIS-APS and SII for SAP was evaluated by receiver operator characteristic curve (ROC curve). Patients were followed up for 90 days to analyze the association between AIS-APS and SII and early outcomes. Use Pearson correlation analysis to analyze the correlation between SII and AIS-APS risk levels and patient prognosis. Results Compared with non-SAP group,patients with atrial fibrillation,congestive heart failure,COPD and proportion of patients with smoking history and TG,WBC,NEU,SII,NIHSS and AIS-APSY were significantly higher in SAP group[atrial fibrillation:13.92％ (11/79) vs. 7.12％ (15/208),congestive heart failure:32.92％ (26/79) vs. 26.44％ (55/208),COPD:34.17％ (27/79) vs. 24.52％ (51/208),smoking history:15.18％ (12/79) vs. 7.69％ (16/208),TG (mmol/L):1.79 (1.31,2.53) vs. 1.40 (1.03,1.99),WBC (×109/L):8.98 (6.78,9.15) vs. 6.02 (4.29,8.17),NEU (×109/L):5.20 (4.03,7.99) vs. 4.69 (3.31,5.53),SII:1145.9 (895.50,1346.3) vs. 545.80 (385.50,639.10),NIHSS score:6.00 (3.00,11.00) vs. 2.00 (1.00,4.75),AIS-APS:28.02 (14.29,33.17) vs. 22.98 (19.78,28.15),all P<0.05],while LYM was significantly decreased[×109/L:1.13 (0.95,2.25) vs. 1.62 (1.29,2.67),P<0.05]. Logistic regression analysis showed that atrial fibrillation,congestive heart failure,COPD,TG,SII and AIS-APS were all independent risk factors for AIS occurrence of SAP[odds ratio (OR) were 1.258,1.040,1.338,1.583,1.631 and 1.407,respectively,95％ confidence interval (95％CI) were 1.093-1.210,1.006-1.109,1.145-1.274,1.205-1.874,1.504-1.759,and 1.267-1.673,respectively;P values were 0.002,0.045,0.037,0.034,0.010,0.018,respectively]. ROC curve analysis shows:SII,AIS-APS and their combined detection had predictive value for the occurrence of SAP. When SII and AIS-APS were combined,area under the curve (AUC) increased to 0.894,the sensitivity increased to 83.67％,and the specificity increased to 88.65％,P=0.012,which was significantly better than SII and AIS-APS alone. At 90 days of follow-up,SII and AIS-APS risk levels were found to be strongly associated with the prognosis of AIS patients,with higher SII and AIS-APS risk levels predicting poor prognosis. Pearson correlation analysis showed that both SII and AIS-APS risk levels were positively correlated with the prognosis of AIS patients (r values were 0.906 and 0.418,respectively,both P<0.05). Conclusion AIS-APS combined with SII can effectively predict the risk of SAP and is closely related to the early clinical outcomes of patients.

Objective To understand the influencing factors of stroke symptoms in middle-aged and elderly patients with hypertension in the community, and to provide reference for the prevention and control of stroke. Methods A total of 410 cases of middle-aged and elderly hypertensive patients registered in community health service centers (or health centers) were randomly selected from 2 administrative regions of Wuhan to conduct a unified questionnaire survey. Chi-square test, analysis of variance and multivariate logistic regression were used to analyze the influencing factors of stroke symptoms in hypertensive patients. Results Of 31.83% the study subjects had stroke symptoms. The analysis of the results showed that high monthly per capital household income, adequate fruit intake and high level of dietary knowledge were protective factors for stroke symptoms in middle-aged and elderly patients with hypertension. Hypertension complications, annual medical check-ups in the hospital and a history of stroke / heart disease in immediate family members were risk factors for stroke symptoms. Conclusion Improving the health awareness of middle-aged and elderly people, vigorously promoting health education and raising the level of social security for low-income groups can reduce the risk of stroke in middle-aged and elderly patients with hypertension.

As a typical BCS Ⅱ drug, felodipine exhibits low solubility and high permeability. We herein investigated the effects of different solubilization strategies on the oral absorption of felodipine. Firstly felodipine tablets based on 200 μm, 150 μm and 25 μm particle size of bulk drug were prepared. Meanwhile, felodipine solid dispersion and felodipine nanosuspension with average particle size of (168.90 ± 6.22) nm, PDI of 0.11 ± 0.06 were prepared. The absorption rate, apparent permeability coefficient (Papp), absorption quality in duodenum, jejunum, ileum and colon of rats and in vivo pharmacokinetics of the above different felodipine preparations were investigated. The results of rat single-pass intestinal perfusion showed that the absorption of felodipine preparations in duodenum, jejunum and ileum was better than in colon. Felodipine had a wide absorption window in the small intestine, with the best absorption site in the small intestine. Papp of different felodipine preparations was greater than 2.0 × 10-5 cm/s. Thus, the low solubility was the main factor limiting the absorption. In vivo pharmacokinetic experiments demonstrated the solubilization strategies significantly improved the bioavailability. The bioavailabilities of felodipine tablets with particle sizes of 150 and 25 μm, as well as nanosuspension, and solid dispersion were 138.75%, 173.01%, 208.65% and 314.53% that of the tablets with particle size of 200 μm, respectively. Solubilization strategies can significantly improve the gastrointestinal absorption rate and absorption quality of felodipine, and thus improve its bioavailability, which provides some reference for the research on the improvement of oral absorption of BCS II drugs.

Objective     To observe and describe anatomical types of the pulmonary arteries to keep safety of lung resection. Methods     Between November 25, 2005 and January 22, 2013, 194 patients who underwent right upper lobectomy/sleeve lobectomy or combined lung resection including right upper lobectomy were included in Peking University Cancer Hospital. There were 128 males with a median age of 59 (37-86) years and 66 females with a median age of 60 (42-77) years. We separated the pulmonary arteries and recorded the number and positions of them. Some patients were recorded photographically. Results     There were 10 types of right upper lobe pulmonary artery branches in this study. Type 1: 1 apicoanterior segmental artery, 1 ascending segmental artery, 96 patients (49.5%); Type 2: 1 apicoanterior segmental artery, 2 ascending segmental arteries, 48 patients (24.7%); Type 3: 2 apicoanterior segmental arteries, 1 ascending segmental artery, 28 patients (14.4%); Type 4: 2 apicoanterior segmental arteries, 2 ascending segmental arteries, 9 patients (4.6%); Type 5: 1 apicoanterior segmental artery only, 6 patients (3.1%); Type 6: 1 apicoanterior segmental artery, 3 ascending segmental arteries, 3 patients (1.5%); Type 7: 4 apicoanterior segmental arteries, 1 ascending segmental artery, 1 patient (0.5%); Type 8: 3 apicoanterior segmental arteries, 1 ascending segmental artery, 1 patient (0.5%); Type 9: 2 apicoanterior segmental arteries, 1 patient (0.5%); Type 10: 3 apicoanterior segmental arteries, 2 ascending segmental arteries, 1 patient (0.5%). Conclusion     The types of pulmonary artery branches are predictable in some way. It would be helpful to reduce the risk of pulmonary artery injury and improve the operation safety by following   the rules. Variations of pulmonary artery should be noticed to avoid the major bleeding due to the pulmonary artery injury.