Objective:To explore the feasibility of constructing an objective tinnitus subtype model based on peripheral blood differentially expressed genes (DEGs) using a combination of Weighted Gene Co-expression Network Analysis (WGCNA) and Random Forest algorithm (RF).Methods:From October 2019 to June 2020, peripheral blood DEGs were obtained from 37 patients (from the Third Affiliated Hospital of Sun Yat-sen University)with chronic subjective high-frequency tinnitus (21 unbothersome type, 16 bothersome type) and 20 healthy volunteers through high-throughput sequencing. WGCNA was used to construct gene modules with different expression patterns and analyze their relationships with tinnitus characteristics. Subsequently, RF was employed to build subtype models, which were evaluated by the area under the receiver operating characteristic curve (AUC), accuracy, and F1-score.Results:A total of 12 351 intergroup DEGs were divided into 9 gene modules. Among them, MEblue, MEgreen, and MEbrown showed significant negative correlations with the healthy volunteer group, while MEpink showed a significant positive correlation with the tinnitus distress group. The "Tinnitus vs. Normal" and "Compensatory vs. Decompensatory" subtype models, based on MEblue and MEpink respectively, both had AUCs greater than 0.80, accuracies above 90%, and F1-scores above 0.90, indicating good performance.Conclusions:Peripheral blood DEGs are potential biological indicators for objective classification of subjective tinnitus. The combined application of WGCNA and the Random Forest algorithm should be a viable approach to constructing an objective tinnitus subtype model. However, further exploration and refinement are needed to validate the model′s generalizability, cross-dataset performance, and algorithm optimization.

The construction of a medication safety culture is important for medication safety management and rational drug use.The construction of medication safety culture standards is formulated based on relevant national policies and regulations,accreditation standards for hospitals,expert opinions,the current situation,and the development trend of the healthcare industry.With scientificity,general applicability,instructive guidance,and practicality,they standardized basic requirements,management processes,and improvement of the construction of medication safety culture.To facilitate understanding and the implementation of the standards,we describe the process of standards formulation and explain the key points of the standards.

TROP-2, a tumor-associated antigen, has been implicated in the progression of various epithelial tumors. Due to its favorable expression profile, TROP-2 has emerged as a promising target for antibody-drug conjugates (ADCs) based anti-tumor therapies. Although ADCs have shown efficacy in cancer treatment, their application in solid tumors is hindered by their high molecular weight, poor tumor penetration, and release of cytotoxic molecules. Therefore, a recombinant immunotoxin was developed based on a shark-derived variable domain of immunoglobulin new antigen receptor (VNAR) antibody. VNARs are only one-tenth the size of IgG antibodies and possess remarkable tissue penetration capabilities and high stability. In this study, a shark VNAR phage display library was created, leading to the identification of shark VNAR-5G8 that targets TROP-2. VNAR-5G8 exhibited a high affinity and cellular internalization ability towards cells expressing high levels of TROP-2. Epitope analysis revealed that VNAR-5G8 recognizes a hidden epitope consisting of CRD and TY-1 on TROP-2. Subsequently, VNAR-5G8 was fused with a truncated form of Pseudomonas exotoxin (PE38) to create the recombinant immunotoxin (5G8-PE38), which exhibited significant anti-tumor activity in vitro and in vivo. Overall, this study highlights the promise of 5G8-PE38 as a valuable candidate for cancer therapy.

Objective:To investigate the effects of tibial second toe free flap bridged with blood flow and nerve in the treatment of severe flexion contracture of the proximal interphalangeal joint.Methods:A retrospective observational study was conducted. From March 2013 to October 2019, 9 patients with severe flexion contracture (type Ⅲ) of the proximal interphalangeal joint after trauma operation, conforming to the inclusion criteria, were hospitalized in Suzhou Ruihua Orthopaedic Hospital, including 5 males and 4 females, aged from 17 to 62 years. After the contracture tissue affecting the extension of the proximal interphalangeal joint was cut off, and the scar tissue was resected, the size of the volar wound near the proximal interphalangeal joint in extended position was 2.0 cm×1.0 cm-2.5 cm×1.5 cm, with the length of proper digital artery and nerve defect being 1.0-1.5 cm. A free flap of the same size as the wound was cut from the tibial side of the second toe and transplanted to repair the wound, and the defective proper digital artery and nerve was repaired by bridging with the tibial proper plantar digital artery and nerve of about 1.5 cm in length. The full-thickness skin graft was taken from the proximal tibial side of the lower leg to repair the wound at flap donor site. The wound at skin graft donor site was sutured directly. The survival of flap and skin graft was observed after operation. The patients were followed up, and at the last follow-up, the recovery of the affected finger and the second toe, including the donor and recipient areas were observed, the two-point discrimination distances of the flap repaired site and the pulp of the affected finger were observed and measured at the same time, the blood flow patency of bridged vessel of the affected finger was examined by Allen test, and the function of the proximal interphalangeal joint of the affected finger was evaluated according to Chinese Medical Association's standard for the range of motion of proximal interphalangeal joint.Results:The flaps and skin grafts survived smoothly after operation. The follow-up after operation lasted for 5 to 22 months, with a mean of 10 months. At the last follow-up, the flap repaired site had good shape, good color and texture, with the two-point discrimination distance being 9-12 mm, and the two-point discrimination distance of the pulp of the affected finger was 6-10 mm; the Allen test results of the affected fingers were all negative (i.e., the bridged vessels had good blood flow patency), with no recurrence of flexion contracture, and the function of the proximal interphalangeal joint was evaluated as excellent; the skin graft area of the second toe was not ruptured but was a little pigmented, and the flexion and extension activities of toe were good.Conclusions:The tibial second toe free flap bridged with blood flow and nerve has reliable therapeutic effect in the treatment of severe flexion contracture of the proximal interphalangeal joint, and the color and texture of the flap repaired area are good. Bridging to repair the severely contracted proper digital artery and nerve is beneficial to improve the blood supply of the finger body and rebuild the sensation.

Objective: To explore the mediating effect and gender difference of mobile phone use in the association between different types of childhood abuse experiences and sleep quality of medical students, so as to provide reference for promoting sleep quality of medical students. Methods: A longitudinal study design method was used to select freshmen and sophomores in two medical colleges in Anhui Province from November to December 2019, follow up data were collected from May to June 2020, and a total of 6 879 students were included in this study. Spearman correlation was used to analyze the association between baseline childhood abuse experiences, baseline mobile phone use and follow up sleep quality. Bootstrap program and Process software were applied to test the mediating effect of mobile phone use in the relationship between childhood abuse and sleep quality. Results: Childhood abuse experiences were positively correlated with mobile phone use and sleep quality score ( r = 0.27 , 0.24, P <0.01), and mobile phone use was positively correlated with sleep quality score ( r =0.31, P <0.01). In the total sample, after adjusting for confounding factors, mobile phone use played a partial mediating role in childhood abuse experiences (including emotional abuse, physical abuse, sexual abuse) and sleep quality, and the mediating effect was 18.08% (18.12%, 17.15%, 24.09%). The mediating effect of mobile phone use on the relationship between childhood emotional abuse, sexual abuse, childhood abuse and sleep quality in girls(18.32%, 28.05%, 18.24%) was higher than in boys(17.81%, 18.94%, 17.63%). Conclusion Mobile phone use has a mediating effect on the relationship between childhood abuse and sleep quality, controlling mobile phone overuse may contribute to improving the sleep quality for those who have experienced childhood abuse.

Objective: To explore the associations between sleep duration and negative emotions among junior college students,and to provide reference for mental health promotion among college students. Methods: Cluster sampling method were used to select 2 524 freshmen from a college in Huainan, Anhui Province. Questionnaires were used to investigate general demographic characteristics, sleep timing, negative emotions and other information. The restricted cubic spline and multivariate Logistic regression were used to analyze the relationship between sleep duration and negative emotion among junior college students. Results: The prevalence of depressive symptoms, anxiety symptoms, stress associated symptoms were 19.41%(490), 28.2%(713), 9.9%(250) respectively．The prevalence of negative emotions was higher among boys(24.3%,34.0%,19.1%) than girls(18.7%,27.4%,8.5%). The differences between groups were statistically significant( P <0.01). After adjusting for confounding factors, sleep duration and negative emotions showed a non linear dose response relationship. Compared with the reference group(8-<9 h), sleep duration <7 h was significantly associated with an increased risk of depressive symptoms and stress symptoms, and <8 h was associated with an increased risk of anxiety symptoms. The additional sleep time on weekends ≥5 h was associated with negative emotions compared with the reference group(<1 h)( P <0.01). Conclusion Short sleep duration and extra weekend sleep are associated with negative emotions. Reasonable sleep schedule among junior college students might be helpful for the prevention and control of negative emotions.

Objective To analyze the risk factors for renal function deterioration in patients with lupus nephritis. Methods Clinical data of patients with lupus nephritis admitted to the Third and the First Affiliated Hospital of Zunyi Medical College from June 2013 to June 2015 were reviewed and retrospectively analyzed. Of them ,62 lupus nephritis patients with the rapid deterioration of renal function were selected as an observation group ,and 62 patients were selected randomly from 200 lupus nephritis patients with normal renal function and were considered as a control group.Risk factors for the rapid deterioration of renal function in patients with lupus nephritis were analyzed by univariate analysis. Furthermore ,multivariate Logistic regression analysis was used to identify the independent risk factors for the rapid deterioration of renal function in patients with lupus nephritis. Results Univariate analysis revealed that infection , lupus activity , anemia , hypoproteinemia and hypertriglyceridemia were risk factors for the rapid deterioration of renal function in patients with lupus nephritis (P ＜ 0.05).Multivariate logistic regression analysis showed that infection ,lupus activity and hypoproteinemia were the independent risk factors for the rapid deterioration of renal function in patients with lupus nephritis(OR=3.109 ,3.669 and 2.691 ,P=0.003 ,0.004 and 0.033 , respectively ). Conclusions Infection ,lupus activity and hypoproteinemia are the independent risk factors for the rapid deterioration of renal function in patients with lupus nephritis. Early prevention and intervention can improve clinical outcome and quality of life in lupus nephritis patients.

Objective To use cyclic amplified fluorescence immunoassay method and electrochemiluminescence immunoassay method for quantitative detection of procalcitonin (PCT),and to evaluate the consistency of the test results.Methods With the method of electrochemiluminescence used as the contrast method and the cyclic enhanced fluorescence immunoassay method used as experimental method,samples of 219 hospitalized patients were measured in two ways.The results were divided into three groups:the serum group (Core serum group) and the micro blood group (Core micro blood group) which were detected in cyclic amplified fluorescence immunoassay method and the serum group (Roche serum group) which was detected by electrochemiluminescence immunoassay method.The data of three groups were compared with each other in paired t test,and correlation analysis,the relative sensitivity,the relative specificity,and Jorden index at the medical decision level (0.5 ng/mL and 2.0 ng/mL) were calculated and the Kappa Consistency Test was calculated.Results There were no statistical differences in three groups (P＞0.05).The Core serum group was positively correlated with the Roche serum group (r =0.993,P＜0.01).The linear regression equation was Y =-0.061+1.041X(0.04≤X≤60).The Core micro blood group was positively correlated with the Roche serum group(r=0.989,P＜0.01).The linear regression equation was Y=0.022+1.023X(0.04≤X≤60).The Core micro blood group was positively correlated with the Core serum group (r=0.986,P＜0.01).The linear regression equation was Y=0.129+0.973X(0.04≤X≤60).The relative sensitivity of the three comparison groups was greater than 92％ and the relative specificity was greater than 95％ at the medical decision level (0.5 ng/mL and 2.0 ng/mL),and the Jorden index and Kappa values were greater than 0.9.It indicated a better consistency.Conclusion Cyclic amplified fluorescence immunoassay and electrochemiluminescence immunoassay detection results were very consistent,which meet the clinical testing requirements.

Paraquat dichloride (N,N-dimethyl-4-4'-bipiridinium, PQ) is an extremely toxic chemical that is widely used in herbicides. PQ generates reactive oxygen species (ROS) and causes multiple organ failure. In particular, PQ has been reported to be an immunotoxic agrochemical compound. PQ was shown to decrease the number of macrophages in rats and suppress monocyte phagocytic activity in mice. However, the effect of PQ on macrophage cell viability remains unclear. In this study, we evaluated the cytotoxic effect of PQ on the mouse macrophage cell line, RAW264.7 and its possible mechanism of action. RAW264.7 cells were treated with PQ (0, 75, and 150 muM), and cellular apoptosis, mitochondrial membrane potential (MMP), and intracellular ROS levels were determined. Morphological changes to the cell nucleus and cellular apoptosis were also evaluated by DAPI and Annexin V staining, respectively. In this study, PQ induced apoptotic cell death by dose-dependently decreasing MMP. Additionally, PQ increased the cleaved form of caspase-3, an apoptotic marker. In conclusion, PQ induces apoptosis in RAW264.7 cells through a ROS-mediated mitochondrial pathway. Thus, our study improves our knowledge of PQ-induced toxicity, and may give us a greater understanding of how PQ affects the immune system.
Animals ; Annexin A5 ; Apoptosis* ; Caspase 3 ; Cell Death ; Cell Line ; Cell Nucleus ; Cell Survival ; Herbicides ; Immune System ; Macrophages ; Membrane Potential, Mitochondrial ; Mice ; Mitochondria ; Monocytes ; Multiple Organ Failure ; Paraquat* ; Rats ; Reactive Oxygen Species

Objective To evaluate the clinical value and experience of endoscopic thyroidectomy.Methods Thyroidectomy with endoscopic instruments through chest-wall approach was done for 52 patients who had thyroid adenoma nodular goiter or thyroid cancer.We observed the results and complications of these operations.Results All 52 cases of operation were successful with no conversion.There was no nerve damage or postoperative hemorrhage.Average operation duration was (100 ± 22) min.The mean time of hospitalization after operation was (3 ± 0.5) d.Conclusion With the advantages of minimal and hidden incision,sooner recovery and satisfactory cosmetic effect,the endoscopic thyroidectomy will prevail in selected cases in the future.