Objective To investigate the influence of a disintegrin and metalloproteinase 12(ADAM12),S100 calcium binding protein A8(S100A8),and serum tumor markers on chemotherapy outcomes and prognosis in patients with triple-negative breast cancer.Methods A totla of 300 patients with breast cancer admitted between January 2020 and January 2021 were included.Based on pathological immunohistochemistry findings,the patients were divided into a triple-negative group(n=98,triple-negative breast cancer)and a non-triple-negative group(n=202,non-triple-negative breast cancer).Serum tumor markers(carcinoembryonic antigen[CEA]and carbohydrate antigen 125[CA125]),the levels of ADAM12 and S100A8,and tissue protein expression levels of ADAM12 and S100A8 were compared between the two groups.The relationship between the protein levels of ADAM12 and S100A8 in the cancer tissues and the clinicopathological characteristics of the triple-negative group was analyzed.Differences in the protein levels of ADAM12 and S100A8 between patients with different chemotherapy outcomes(remission vs.non-remission)and different follow-up outcomes(survival vs.death)were analyzed.Kaplan-Meier survival analysis was used to examine the relationship between the protein levels of ADAM12 and S100A8 in cancer tissues and the prognosis.Results The protein expression levels of ADAM12 and S100A8 in cancer tissues from the triple-negative group were higher than those in the non-triple-negative group(P＜0.05).The protein expression levels of ADAM12 and S100A8 in cancer tissues were correlated with tumor diameter,histological grading,axillary lymph node metastasis,TNM staging,and differentiation degree in the triple-negative group(P＜0.05).The levels of CEA,CA125,ADAM12,and S100A8,as well as the protein expression levels of ADAM12 and S100A8 in cancer tissues in the non-remission group,were higher than those in the remission group(P＜0.05).Similarly,these markers were also significantly elevated in the death group compared to those in the survival group(P＜0.05).After 3 years of follow-up,the overall survival(OS)of patients with low ADAM12 expression was 36.0(8.0,36.0)months,while that of patients with high ADAM12 expression was 32.5(4.0,36.0)months,showing a statistically significant difference(log rank x2=12.913,P＜0.001).The OS of patients with low S100A8 expression was 36.0(7.0,36.0)months,while that of the high-expression group was 31.0(4.9,36.0)months,also showing a statistically significant difference(log rank x2=24.151,P＜0.001).Conclusion ADAM12 and S100A8 protein expression levels in triple-negative breast cancer tissues are higher than those in non-triple-negative breast cancer tissues.Serum tumor markers and ADAM12 and S100A8 protein expression levels(in both serum and tumor tissues)affect the chemotherapy outcomes and prognosis of triple-negative breast cancer patients,among which the expression levels of ADAM12 and S100A8 proteins in tumor tissues can serve as predictors of patient prognosis.

Objective To clarify the distribution of traditional Chinese medicine(TCM)pattern and its associated risk factors after percutaneous coronary intervention(PCI),and evaluate the re-porting quality of existing studies to guide future research standardization. Methods English databases including PubMed,Cochrane Library,and Web of Science,as well as Chinese databases including China National Knowledge Infrastructure(CNKI),China Scientific Journal Database(VIP),and Wanfang Database were searched to retrieve papers about PCI.The time span for the paper retrieval was set from the foundation of the databases to October 1,2023.Statistical analyses were performed using Stata 12 and Python(V 3.9).The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)statement was used to assess the reporting quality of included studies. Results Overall,1 356 articles were selected,and 40 cross-sectional studies were included with 10 270 participants.The most common TCM patterns before,one to two weeks after,and six months to one year after PCI was Qi stagnation and blood stasis(n=261,36.45%),inter-twined phlegm and blood stasis(n=109,27.18%),and Qi deficiency and blood stasis(n=645,37.03%),respectively.Smoking[odds ratio(OR)=1.15,95%confidence interval(CI)(0.83-1.47),I2=24.7%,P=0.257],pattern of congealing cold and Qi stagnation[OR=4.62,95%CI(1.37-7.86),I2=61.6%,P=0.074],and low-density lipoprotein(LDL)[OR=1.38,95%CI(0.92-1.85),I2=12.2%,P=0.286]were risk factors for restenosis.Hypertension[OR=7.26,95%CI(3.54-14.88),I2=91.6%,P=0.001],and overweight[i.e.,body mass index(BMI)>23][OR=1.20,95%CI(1.07-1.35),I2=85.3%,P=0.009]were significant risk factors of concomi-tant anxiety. Conclusion This systematic review and meta-analysis revealed that patients with different TCM pattern types have distinct characteristics and risk factors after PCI.More high-quality studies are warranted to provide supportive evidence for future research and clinical practice.

Objective:To analyze TCM tongue diagnosis related research on coronary heart disease (CHD) at home and abroad using the method of bibliometrics; To provide reference for further research on clinical diagnosis and treatment of CHD.Methods:Research literature about TCM tongue diagnosis for CHD was retrieved from CNKI, VIP, CBM, Wanfang Data, PubMed, Embase, Cochrane Library and Web of Science from the establishment of the databases to December 31st, 2022. The key features of literature related to tongue diagnosis from CHD, including publication volume, region, institution, authors, and research hotspots, were analyzed using BICOMBS2.0, CiteSpace 6.1.R6, and Excel 2019 software.Results:Totally 364 Chinese articles and 5 English articles were included. Liaoning University of Traditional Chinese Medicine was the institution that published the most relevant research in Chinese, and Shanghai University of Traditional Chinese Medicine was the institution that published the most relevant research in English. Professor Wang Yiqin of Shanghai University of Traditional Chinese Medicine was the author with the largest number of publications in both Chinese and English, and the authors with the largest number of publications on Chinese research worked closely cooperate with each other. Chinese research focused on syndrome characteristics of CHD, objectification of tongue diagnosis and data mining based on the clinical experience of renowned TCM practitioners; the English research topic included modern data collection and analysis and expert consensus.Conclusions:The research team of tongue diagnosis for CHD in China has begun to take shape. There are few English articles on tongue diagnosis for CHD, and the development level is relatively lagging behind. In the future, different institutions and researchers need to strengthen international cooperation to enhance the international influence of TCM diagnostics.

Objective To investigate the value of a nomogram model constructed from intratumoral and peritumoral magnetic resonance imaging radiomics combined with clinical characteristics in predicting the status of lymphovascular space invasion(LVSI)in cervical cancer.Methods A retrospective analysis was conducted on 178 cervical cancer patients confirmed by postoperative pathology,with 70 cases of LVSI(+)and 108 cases of LVSI(-).The patients were divided into a training set[142 cases,including 54 cases of LVSI(+)and 88 cases of LVSI(-)]and a test set[36 cases,including 16 cases of LVSI(+)and 20 cases of LVSI(-)]at a ratio of 8:2.All underwent magnetic resonance imaging before surgery,and regions of interest were manually delineated layer by layer on the T2WI sequence,with the peritumoral region being uniformly expanded outward.Univariate logistic analysis was performed on clinical factors to select independent factors for cervical cancer LVSI(+).Radiomic features were extracted separately from the intratumoral region,the peritumoral region,and the intratumoral-peritumoral region to construct radiomics models,and the differences between the peritumoral and the intratumoral-peritumoral models were compared.A combined model was established based on the radiomics scores of the optimal intratumoral-peritumoral model and clinical independent predictive factors,and a nomogram was plotted.Receiver operating characteristic curves were used to evaluate the diagnostic performance of each model,and decision curve analysis was used to assess the clinical value of the models.Results The combined model demonstrated the best performance among the various models,with AUC of 0.970 in the training set and 0.803 in the test set.Conclusion Intratumoral and peritumoral magnetic resonance imaging radiomics combined with clinical characteristics can effectively predict LVSI in cervical cancer.

Objective To explore the characteristics of TCM syndromes in patients with coronary heart disease complicated with hypertension and diabetes based on latent structure model.Methods A multi-center cross-sectional study was used to collect the four diagnostic information of patients with coronary heart disease by using the Four Diagnostic Collection Scales of TCM developed by our research group,and a clinical database was established.Combined with frequency analysis and expert opinions,the four diagnostic information was screened to construct a latent structure model.Results Totally 702 patients with coronary heart disease complicated with hypertension and diabetes were collected.A total of 40 high-frequency four-diagnosis symptoms were screened,and 18 latent variables were obtained by latent structure model analysis.The model BIC score was-17 604.38.The latent variables in the model were comprehensively clustered,and it was found that the syndrome elements of disease location in patients with coronary heart disease complicated with hypertension and diabetes were mainly heart,liver,kidney,etc.,and the syndrome elements of disease nature were mainly qi deficiency,yin deficiency,qi stagnation,phlegm turbidity,blood stasis,etc.The syndrome types were mainly phlegm and blood stasis syndrome,spleen and kidney yang deficiency syndrome,liver depression and qi stagnation syndrome,liver and kidney yin deficiency syndrome,damp-heat intrinsic syndrome,and the mutual information and information coverage between each syndrome type and the four diagnostic information were suggested.Conclusion Latent structure model analysis can provide a qualitative and quantitative basis for the syndrome classification of patients with coronary heart disease complicated with hypertension and diabetes.

Background: and Purpose The eye-movement examination can be applied as a noninvasive method to identify multiple-system atrophy (MSA). Few studies have investigated eye movements during the early stage of MSA with predominant parkinsonism (MSA-P). We aimed to determine the characteristic oculomotor changes in the early stage of MSA-P. Methods: We retrospectively selected 17 patients with MSA-P and 40 with Parkinson’s disease (PD) with disease durations of less than 2 years, and 40 age-matched healthy controls (HCs).Oculomotor performance in the horizontal direction was measured in detail using videonystagmography. Results: We found that the proportions of patients with MSA-P and PD exhibiting abnormal eye movements were 82.4% and 77.5%, respectively, which were significantly higher than that in the HCs (47.5%, p<0.05). Compared with HCs, patients with MSA-P presented significantly higher abnormal proportions of fixation and gaze-holding (17.6% vs. 0%), without-fixation (47.1% vs. 0%), prolonged latency in reflexive saccades (29.4% vs. 5.0%), memory-guided saccades (93.3% vs. 10.0%), and catch-up saccades in smooth-pursuit movement (SPM, 41.2% vs. 0) (all p<0.05). Compared with those with PD, patients with MSA-P presented a significantly higher proportion of catch-up saccades in SPM (41.2% vs. 2.5%, p<0.001). Conclusions MSA-P presented the characteristic of catch-up saccades in SPM in the early stage, which may provide some value in differentiating MSA-P from PD.

Objective:To evaluate the effectiveness and prognosis of emergent transcatheter aortic valve replacement (TAVR) and to provide standardized procedural suggestion for the development of emergent TAVR in China.Methods:From January 2020 to April 2021, 12 patients who underwent emergent or salvage TAVR in the Second Affiliated Hospital Zhejiang University School of Medicine were retrospectively enrolled from the TORCH registry (Transcatheter Aortic Valve Replacement Single Center Registry in Chinese Population, a prospective cohort study; NCT02803294). Baseline, periprocedural and 30-day follow up data were collected. Post-operative data were compared with pre-operative data using Paired-Samples test.Results:Patients’ median Society of Thoracic Surgeons score (STS score) was 15.432%. There was a significant decrease of mean gradient after emergent TAVR procedure (1.69 m/s vs. 4.90 m/s, P<0.01). During the 30-day follow up, there were 1 patient (8.3%) died and 2 patients received permanent pacemaker implantation. No disabling stroke, acute kidney injury, major vascular complication occurred during the first month after emergent TAVR. Among the survival patients, there was a significant releasing of heart failure symptoms to New York Heart Association function stage Ⅰ/Ⅱ in 81.8% patients at 30-day follow up. Left ventricular ejection fraction also improved significantly from (47.4±9.5)% to 58.8±8.0% ( P= 0.026). The mean gradient were (1.57±0.30) cm 2 and no patients had a moderate or severe paravalvular leakage. Besides, a significant decrease of pro-B-type natriuretic peptide (1 089.9 pg/mL vs. 12 215.5 pg/mL , P=0.001) and troponin T (0.020 ng/mL vs. 0.337 ng/mL, P=0.003) were found at 30 days after emergent TAVR. Conclusions:For patients with severe aortic stenosis and acute cardiac decompensated, emergent TAVR is a safe and effective rescue treatment.

Objective:To study the clinical features and drug resistance profile of neonatal sepsis caused by different species of Klebsiella.Methods:From January 2009 to December 2018, cryopreserved Klebsiella strains from blood culture of neonatal sepsis cases in NICU of our hospital were reactivated. Molecular identification and antimicrobial susceptibility tests were performed. Clinical features, laboratory tests, drug resistance profile and prognosis of these patients were analyzed retrospectively.Results:A total of 29 strains of Klebsiella were reactivated. Molecular identification assigned 22 cases (75.9%) into Klebsiella pneumoniae (Kpn) group and 7 cases (24.1%) into Klebsiella quasipneumoniae (Kqu) group. Gestational age and birth weight of Kpn group were higher than Kqu group [(33.1±3.2) weeks vs. (30.6±0.9) weeks, (1 847±677) g vs. (1 416±121) g] ( P<0.05). Abdominal distension was more common in Kqu group than Kpn group [42.9% (3/7) vs. 4.5% (1/22), P<0.05]. No significant differences existed in the laboratory tests including white blood cell count, platelet count, hypersensitive C-reactive protein and procalcitonin between the two groups ( P>0.05). Kpn was 100.0% sensitive to Cefazolin-Tazobactam and Amikacinto and less sensitive to Imipenem and Cefperazone-Sulbactam, Meropenem and Ertapenem. Kqu was generally more sensitive than Kpn and the sensitivity of Kqu to Imipenem was 100.0%. No significant differences existed of the prognosis between the two groups ( P>0.05). Conclusions:Kpn is the main pathogen of neonatal Klebsiella sepsis. Kqu sepsis is more common in neonates with smaller gestational age and lower birth weight. Abdominal distention is common presenting symptom in Kpn sepsis and sensitive antibiotics should be used early.

Objective:To explore a new training mode for nursing professionals suitable for the 1+X certificate system, and realize the training goal of "one specialty and multi-ability" compound technical nursing talents.Methods:To take the "1+ X" certificate standard as the basis for the construction of nursing specialty, to reconstruct the talent training program of integration of graduation certificate and certificate. To take the content of "1+X" certificate as the basis for the construction of professional courses, construct the core curriculum system of integration of curriculum and certificate. To build a "new double-qualified" teaching staff and constructing of new double-qualified teachers and accelerate the development of quality resources.Results:The talent training mode of integration of graduation certificate and certificate under the 1+X certificate system was constructed. The curriculum structure has been optimized. The teachers′ability of teaching, training and examination was improved.Conclusions:The new mode of training nursing professionals under the 1+X certificate system meets 1 degree education and X vocational training of nursing students and achieve a "1" and "X" seamless convergence. It provides innovative ideas for the promotion and implementation of 1+X certificate system pilot work in the field of nursing education nationwide.