Objective:To investigate the epidemiological characteristics and trends of birth defects related to assisted reproductive technology (ART) in Jiangxi Province from 2014 to 2023, and to explore the correlation factors of birth defect occurrence.Methods:A retrospective collection of ART treatment data and follow-up results from January 2014 to December 2023 across 18 reproductive centers in Jiangxi Province was conducted. The trend of birth defects and the rank order of defect types were analyzed. Exact probability methods were used to estimate the 95% confidence intervals ( CI) of the incidence rates, and Poisson regression was applied to identify independent correlation factors. Results:A total of 65 003 ART offspring were included in this study, comprising 2 025 offspring from intrauterine insemination (IUI) and 62 978 from in vitro fertilization and embryo transfer (IVF-ET). The overall incidence of birth defects was 13.46‰ (95% CI: 12.59‰-14.38‰), with 9.38‰ (95% CI: 5.66‰-14.61‰) for IUI and 13.59‰ (95% CI:12.70‰-14.53‰) for IVF-ET. The incidence of birth defects showed a decreasing trend from 2014 to 2023 (17.11‰ to 11.47‰, Ptrend=0.003). The top three birth defect types were circulatory system defects (3.71‰, 95% CI: 3.25‰-4.21‰), musculoskeletal system defects (2.37‰, 95% CI: 2.01‰-2.77‰), and congenital malformations of the face, ears, eyes, and neck (1.23‰, 95% CI: 0.98‰-1.53‰). Univariate analysis indicated that male offspring from IVF-ET had a higher incidence of birth defects than that in female offspring (14.72‰ vs. 12.31‰, P=0.009). Additionally, gestational age, birth weight, fetal number, cause of infertility, and year of delivery were significantly associated with birth defect incidence in IVF-ET offspring ( P<0.001, P<0.001, P<0.001, P=0.025, P=0.037). Multivariate analysis showed that in singleton pregnancies, male offspring, gestational age 32-36 weeks birth weight <1 500 g, and infertility with bilateral factors were independent risk factors for birth defects ( OR=1.21, 95% CI: 1.00-1.47, P=0.046; OR=1.90,95% CI: 1.41-2.56, P<0.001; OR=3.37, 95% CI: 1.33-8.51, P=0.010; OR=1.38, 95% CI: 1.12-1.69, P=0.003), while in multiple pregnancies, male offspring, gestational age <32 weeks, gestational age 32-36 weeks, birth weight <1 500 g, birth weight 1 500-2 499 g, maternal age 25-29 years and maternal age 30-34 years were independent risk factors ( OR=1.25, 95% CI: 1.03-1.52, P=0.023; OR=2.06, 95% CI: 1.35-3.15, P=0.001; OR=1.32,95% CI: 1.05-1.66, P=0.016; OR=1.98,95% CI: 1.19-3.28, P=0.009; OR=2.06,95% CI: 1.64-2.60, P<0.001; OR=2.00, 95% CI: 1.31-3.06, P=0.001; OR=1.90,95% CI: 1.24-2.92, P=0.003). Conclusion:Over the past 10 years, the incidence of birth defects in ART offspring in Jiangxi Province has shown a decreasing trend annually, with circulatory system malformations being the most common. The occurrence of birth defects in IVF offspring is primarily associated with maternal and infant characteristics, such as gender, gestational age, birth weight, number of fetuses, and cause of infertility, independent of ART treatment factors.

Trifluridine-tipiracil(TAS-102),as a novel fluorouracil-based chemotherapeutic agent,effectively overcomes fluorouracil resistance in colorectal cancer(CRC)through its unique pharmacological mechanisms,providing a critical treatment option for advanced CRC patients.Probiotics have shown unique value in CRC prevention and adjuvant therapy by regulating intestinal flora homeostasis and modulating host immune response.It is worth noting that the combination of chemotherapeutic drugs and probiotics not only enhances the anti-tumor activity through synergistic effects,but also reduces the adverse effects caused by chemotherapeutic drugs.Based on this,this paper systematically reviews the pharmacological properties of TAS-102 and describes its synergistic effects in combination with other antitumor drugs.It also summarizes the synergistic effect of fluorouracil drugs combined with probiotics to enhance the effectiveness and reduce the toxicity,and discusses the potential value of the combination of TAS-102 and probiotics,which provides a new research direction for optimizing the precision treatment of CRC and a scientific basis for improving the quality of life of patients.

With the rising incidence of breast cancer and the widespread use of chemotherapy,the efficacy and adverse effects of chemotherapeutic agents have become a focus of attention.There is a potential association between microorganisms and breast cancer development and therapeutic response,and the potential value of probiotics with the role of regulating intestinal flora and other effects in breast cancer chemotherapy has been increasingly valued.In this paper,we review the regulatory role of intestinal flora in the efficacy of breast cancer chemotherapy and post-chemotherapy adverse reactions,predict its impact on chemotherapeutic effects and adverse reactions to chemotherapy,and focus on the positive role of probiotics in improving post-chemotherapeutic adverse reactions to breast cancer chemotherapy,to provide the scientific basis for the improvement of the quality of life of breast cancer patients,optimization of the chemotherapy regimen for breast cancer,and enhancement of the comprehensive effect of chemotherapy for breast cancer.

The complement component 4 binding protein alpha(C4BPA)gene is the alpha chain of complement binding protein 4.As a plasma protein involved in the complement and coagulation systems,it can influence immune responses and lipid metabolism.In order to study the polymor-phism of C4BPA gene and its correlation with milk quality traits in Chinese Holstein cows,genom-ic DNA was extracted from blood samples of 92 Chinese Holstein cows,and the target fragment of C4BPA gene was amplified by PCR,and the association analysis was performed by using direct se-quencing to obtain the SNP loci and milk quality traits.The results showed that among the four SNPs found at the third intron of the C4BPA gene,I3-11 G＞A was highly significantly correlated with milk protein and urea nitrogen(P＜0.05),I3-291 T＞G was significantly correlated with lac-tose(P＜0.05),I3-374 C＞T was highly significantly correlated with lactose and urea nitrogen(P＜0.05),and I3-375 T＞G was highly significantly correlated with lactose(P＜0.05),milk pro-tein and urea nitrogen.The chi-square test values for each point indicated that the population was in genetic equilibrium.Individuals of haplotype combination H1 H1 had the highest lactose content,and haplotype combination H1H2 can be used as the best haplotype combination in the molecular selection work of dairy cows.

Glycogen storage disease type Ⅱ,also known as Pompe disease,is an autosomal recessive metabolic myopathy with pulmonary hypertension as a rare complication.We reported a case of pulmonary hypertension in adult with late-onset glycogen storage disease type Ⅱ.Her arterial blood gas results indicated type Ⅱ respiratory failure,lung function indicated severe restricted ventilation dysfunction,sleep monitoring indicated severe sleep apnea hypopnea,severe nocturnal hypoxemia,echocardiography-derived systolic pulmonary pressure was 62 mmHg(1 mmHg=0.133 kPa),electromyography indicated myogenic lesion,and whole exon sequencing indicated GAA gene mutation.Supportive therapy and enzyme replacement therapy are applied in this patient.

Objectives:To observe the effectiveness and safety of recombinant human brain natriuretic peptide(rhBNP)for the treatment of patients with right heart failure caused by pulmonary arterial hypertension(PAH).Methods:A total of 421 patients with right heart failure caused by PAH who were hospitalized in Fuwai Hospital from January 2019 to June 2024 were retrospectively included in this study.All patients were treated with rhBNP on top of conventional therapy.24 h urine volume,body weight,liver and renal function index,electrolyte,uric acid,red blood cell distribution width(RBCDW),cardiac function,blood pressure and heart rate before and after the treatment of rhBNP were compared.Clinical symptoms,signs and the occurrence of adverse events during treatment were also observed.Results:Compared with baseline,after treatment with rhBNP,the 24 h urine volume increased.The levels of body weight,transaminase,total bilirubin,direct bilirubin,uric acid,RBCDW,systolic blood pressure,heart rate,and N-terminal pro-B-type natriuretic peptide significantly decreased(all P<0.05).There were no statistically significant differences in the levels of serum creatinine,and tricuspid annular plane systolic excursion to pulmonary artery systolic pressure ratio(both P>0.05).Dyspnea and lower limbs edema were improved in 75.2%cases(227/302)and 66.9%cases(281/420)respectively.The incidence of adverse events and severe adverse events during rhBNP treatment were 1.2%(5/421)and 0.5%(2/421)respectively.Conclusions:Adding rhBNP on top of standard medication can effectively increase 24 h urine volume,reduce body weight,improve some prognostic indicators,improve the clinical symptoms and signs of heart failure without negatively affecting the renal function in right heart failure patients caused by PAH.Blood pressure should be closely monitored during the treatment process.

Ancient Chinese medicine books are the foundation of traditional Chinese medicine inheritance,innovation,and development,and the vast amount of knowledge they contain is worthy of in-depth mining.However,if researchers only rely on manual sorting,research progress will inevitably be slow.To overcome this,previous studies have attempted to extract knowledge from ancient Chinese medicine books automatically with natural language processing technology,which has made certain progress in the last decade.In this paper,we first introduce the text data-oriented knowledge extraction technology,then review the research progress of existing technologies in the two tasks of entity recognition and entity relationship extraction of ancient Chinese medicine books.Finally,we analyze the shortcomings of this research field and recommend standardizing data annotation,expanding entity categories,and paying attention to procedural knowledge.This review aims to provide a reference for the mining and utilization of ancient traditional Chinese medicine books in the era of artificial intelligence.

Objectives:To explore the correlation between angiography-derived microcirculatory resistance(AMR)and microvascular obstruction(MVO)extent,and AMR's predictive value for ventricular remodeling in patients with ST-segment elevation myocardial infarction(STEMI)post-primary percutaneous coronary intervention(PCI).Methods:This retrospective study included STEMI patients who underwent PCI at Beijing Anzhen Hospital from April 2019 to January 2023.Patients underwent acute and follow-up cardiac magnetic resonance(CMR)examinations 3-7 days and 3 months post-PCI.Ventricular remodeling was defined as a 20%or more increase in left ventricular end-diastolic volume at follow-up.Patients were divided into ventricular remodeling and non-ventricular remodeling groups.Baseline clinical characteristics,AMR values and CMR indices of both groups were compared.Pearson's correlation coefficient was used to explore the correlation between AMR and MVO extent on CMR.Logistic regression and receiver operating characteristic curve analysis were employed to evaluate the predictive performance of AMR for ventricular remodeling.Results:A total of 168 STEMI patients([56.4±11.4]years,139[82.7%]males)were included,with 49(29.2%)in the ventricular remodeling group and 119(70.8%)in the non-ventricular remodeling group.AMR was positively correlated with MVO extent on CMR(r=0.42,P<0.01).Compared to the non-ventricular remodeling group,patients in the ventricular remodeling group exhibited a higher AMR value(3.00[2.56,3.52]mmHg?s/cm vs.2.48[2.20,2.74]mmHg?s/cm,1 mmHg=0.133 kPa,P<0.01).Multivariate logistic analysis showed that AMR was independently associated with ventricular remodeling post-PCI in STEMI patients.For every 0.2 mmHg·s/cm increase in AMR,the risk for ventricular remodeling increased 45.1%(adjusted OR=1.451,95%CI:1.228-1.714,P<0.01).Area under the curve of AMR for predicting ventricular remodeling was 0.769.Conclusions:AMR is positively correlated with MVO extent and is an independent predictor for ventricular remodeling in STEMI patients post-PCI.

Chronic thromboembolic pulmonary hypertension is characterised by the persistent obstruction of the proximal pulmonary arteries by organized thrombi and peripheral microvascular disease,which can lead to right-sided heart failure and mortality.Pulmonary endarterectomy enables complete removal of visible obstructive elements within the pulmonary arteries and is recommended for operable patients.Nevertheless,over 40%of patients are precluded from pulmonary endarterectomy because of factors such as surgically inaccessible lesions,compromised general health status,or concurrent comorbidities or still with residual pulmonary hypertension after pulmonary endarterectomy.For inoperable patients or those with residual pulmonary hypertension after pulmonary endarterectomy,balloon pulmonary angioplasty is an effective therapeutic option,which could significantly improve the hemodynamic,exercise tolerance and outcome of the patients.With the emerging accumulation of clinical experience and evidence,2022 European Society of Cardiology/European Respiratory Society guidelines of pulmonary hypertension recommend balloon pulmonary angioplasty as an alternative therapeutic option for these patients.However,different types of lesions may have their own lesion characteristics,the strategy and device of balloon pulmonary angioplasty should thus be individually considered for different lesions,in fact,the success rate of treatment and the incidence rate of complications are varied significantly.Therefore,the aim of this review is to comprehensively summarize the existing studies on balloon pulmonary angioplasty treatment strategies for different types of lesions and the management of complications to provide guidance and reference for clinicians.

In order to explore the potential of nanoparticles from ethanol extracts of Euphorbia he-lioscopia L.(ZQNPs)in antibacterial application.In this study,ZQNPs were prepared by the self-assembly method using alcohol extract of Euphorbia helioscopia L.,polylysine and polyethylene glycol 1 000 as raw materials.The morphology and structure of ZQNPs were characterized by transmission electron microscopy,UV-vis spectrophotometer,and Fourier transform infrared spec-troscopy.The growth and biofilm inhibition of ZQNPs against methicillin-resistant Staphylococcus aureus(MRSA)were tested by broth microdilution,crystal violet,and checkerboard assays.The broad-spectrum antibacterial activity and antibacterial activity of ZQNPs against three clinical strains were evaluated by broth microdilution method.Finally,the antibacterial mechanism of ZQNPs was preliminarily explored by morphological observation and soluble protein detection of MRSA.The results showed that ZQNPs were self-assembled and cross-linked multi-faceted spheres with an average diameter of 67 nm.The MIC of ZQNPs against MRSA was 8 mg/L,and the antibacterial effect was much better than that of Euphorbia helioscopia L.mongolicum alcohol extract(MIC＞32 mg/L).The time killing curve again showed that ZQNPS had a good antibacteri-al effect on MRSA(8 mg/L)biofilm inhibition rate of 89％,and the antibacterial effect of ZQNPS combined with cefquinome sulfate showed additive results.The mics of ZQNPs against Gram-posi-tive bacteria(S.aureus)and gram-negative bacteria(E.coli)were 16 mg/L and 8 mg/L,respec-tively.The mics of ZQNPS against E.coli clinical strains were stable between 8 and 16 mg/L.The MIC of Salmonella clinical strains was 32-64 mg/L,and the MIC of S.aureus clinical strains was 8-64 mg/L.Preliminary antibacterial mechanism showed that ZQNPs could destroy the membrane structure of MRSA,lead to the release of intracellular substances,and affect the growth of MRSA.These results indicate that ZQNPs have a good antibacterial effect and have potential application value in antimicrobial therapy.