Objective: To perform serological identification and molecular analysis of four samples with antibodies against high-frequency antigens, and to track the condition of newborns after delivery. Methods: Blood group serological tests were conducted using tube method, and unexpected antibody screening and identification were performed using polybrene and human globulin card. Gene haplotype analysis of blood group system was performed using PacBio third-generation sequencing. The DNA mutations were confirmed through Sanger sequencing. Results: Four samples showed normal blood types in common blood type systems. However, they were positive in all unexpected antibody screening and identification, with negative direct antiglobulin tests results. Third-generation sequencing revealed 3 cases of c.376C>T homozygous mutation and 1 case of c.421C>A homozygous mutation in the ABCG2 gene. Three pregnant women gave birth to four children, all of whom developed hyperbilirubinemia, accompanied by decreased red blood cell count and normal or low hemoglobin concentration. Conclusion: Four samples were obtained from individuals with the rare Jr(a-) blood group. Immunization during pregnancy led to the production of anti-Jr antibody, which may contribute to hyperbilirubinemia in newborns.

Objective: To analyze the disease burden of chronic obstructive pulmonary disease (COPD) and changes in its risk factors among residents in Zhejiang Province from 1990 to 2021, so as to identify key priorities for COPD prevention and control. Methods: Data on COPD mortality and disability-adjusted life years (DALY) for residents in Zhejiang Province from 1990 to 2021 were collected from the Global Burden of Disease (GBD) 2021 database. Standardized mortality and standardized DALY rate were calculated using the GBD 2021 world population standard structure. Premature mortality was computed via the life table method. The average annual percent change (AAPC) was applied to analyze trends in COPD mortality, DALY rate, and premature mortality. Changes in deaths of COPD risk factors were evaluated using population attributable fraction (PAF). Results: From 1990 to 2021, the standardized COPD mortality in Zhejiang Province decreased from 272.40/100 000 to 70.56/100 000 (AAPC=-4.395%), and the standardized DALY rate declined from 4 167.37/100 000 to 1 071.89/100 000 (AAPC=-4.396%). Similar downward trends were observed in both males (AAPC=-3.933%, -4.173%) and females (AAPC=-4.785%, -4.480%), all P<0.05. Crude mortality and DALY rates increased with age, and the crude mortality and DALY rates of various age groups in Zhejiang Province showed decreasing trends from 1990 to 2021 (all P<0.05). The premature mortality declined from 4.37% to 0.60% from 1990 to 2021 (AAPC=- 6.206%), with consistent trends across males and females (AAPC=- 6.144%, - 6.379%, all P<0.05). From 1990 to 2021, particulate matter pollution showed the largest reduction in PAF (- 56.76%), while ambient ozone pollution had the largest increase (103.07%) in Zhejiang Province. By 2021, smoking became the leading risk factor for deaths of COPD (PAF=43.32%). Conclusions The standardized mortality, standardized DALY rate, and premature mortality for COPD show consistent declining trends in Zhejiang Province from 1990 to 2021. However, risk factors such as smoking and ambient ozone pollution require intensified focus to further reduce disease burden of COPD.

This study aims to investigate the changes in blood biochemical indicators of tongue roll-ing(TR)behavior in cattle and their correlation with changes in oral microbiota,laying a founda-tion for further exploring the relationship between animal oral microbiota,biochemical indicators,and behavioral changes.It also provides theoretical basis for preventing and treating TR behavior through regulating oral microbiota.This study intends to analyze and compare the blood biochemi-cal indicators and changes in oral microbiota of cattle with TR behavior and healthy cattle without TR behavior(healthy control,H),in order to explore the blood biochemical indicators of TR cattle and their correlation with changes in oral microbiota.Blood samples from the caudal vein of cattle in each group were collected for the detection of blood biochemical indicators and stress-related hormone indicators.Oral swabs from cattle in each group were collected for 16S rRNA gene se-quencing to analyze the composition,structure,and functional changes of their oral microbiota.The results of blood biochemical indicators in H and TR groups showed that the concentrations of al-bumin(ALB),aspartate aminotransferase(AST),calcium ion(Ca2+),and cortisol in TR group were significantly higher than those in H group(P＜0.05).There were significant differences in beta diversity of oral microbiota between TR and H groups(P＜0.05).At the genus level,the rela-tive abundances of Pseudomonas,Enterobacter,Xanthomonas,and other genera in the oral micro-biota of TR group were significantly higher than those in H group(P＜0.05).However,the rela-tive abundances of Tessaracoccus,Turicibacter,Monoglobus,Dietzia,Bifidobacterium,and other genera in the oral microbiota of TR group were significantly lower than those in H group(P＜0.05).In the KEGG metabolic pathway at the third level,the relative abundances of thiamine me-tabolism,lipoate metabolism,cysteine and methionine metabolism in the oral microbiota of TR group were significantly lower than those in H group(P＜0.05).Spearman correlation analysis showed that ALB and AST were significantly positively correlated with the relative abundances of Pseudomonas and Stenotrophomonas.Therelative abundances of Pseudomonas,Stenotrophomonas,and Sphingomonas were significantly positively correlated with fatty acid metabolism,phosphate and phosphonate metabolism,and lipoate metabolism.ALB was significantly positively correlated with inositol phosphate metabolism and phosphate and phosphonate metabolism.The study found that there were significant differences in blood biochemical indicators and oral microbiota between TR and H groups.In addition,there is a certain correlation between the composition,structure,and function of oral microbiota and the biochemical function of the host.This indicates that TR behav-ior may be associated with changes in the biochemical indicators of the host and the composition,structure,and function of oral microbiota.

Objective To explore the risk factors for pain after puncturing localization using Hookwire needles for preoperative pulmonary nodules resections,providing theoretical evidences for reducing post-localization complications in patients.Methods For cross-sectional analysis,141 patients undergoing preoperative CT-guided localization using Hookwire needles for preoperative single pulmonary nodule resections in Nanjing Chest Hospital from February 2024 to May 2024.The pain levels of the patients after localization were recorded according to the numerical rating scales(NRS).Comparions the pain levels between patients' genders,ages,BMI,sides,number of intercostals at the puncture point,depths of puncture needle penetration through the chest wall,depths of puncture needle penetration in the lungs,whether the needles were inserted tightly against the ribs,and whether the needle were inserted tightly against the scapula.The influencing factors causing pain were explored by univariate analysis as well as ordered Logistic analysis.Results All 141 patients were successfully localized without serious complications,and the results of univariate analysis showed that BMI,depth of penetration within the thoracic wall of the puncture needle,whether or not the needle was inserted tightly against the ribs,and whether or not it was inserted tightly against the scapula were correlated with the post-positioning pain,and the differences were statistically significant from each other(P＜0.1).Ordered Logistic regression analysis showed that the depth of penetration within the chest wall of the puncture needle(OR=1.484,95％CI=0.033～0.758,P＜0.05),and whether or not the needle was inserted tightly against the rib cage(OR=9.440,95％CI=1.434～3.056,P＜0.05)and tight scapular entry(OR=9.994,95％CI=0.957～3.646,P＜0.05)were risk factors for pain after positioning.Conclusion The deepth of localization needle penetrating in the chest wall and puncturing close to the edge of scapula and ribs are the risk factors for pain after puncturing localization using a Hookwire needle for preoperative pulmonary nodules resection.

Objective:To investigate the effect of dulagopeptide on physical examination indexes,plasma glucose metabolism and islet function in type 2 diabetes mellitus(T2DM)patients with poorly controlled plasma glucose.Methods:135 T2DM patients with poorly controlled plasma glucose who were admitted in our hospital from January 2023 to July 2024 were selected.A prospective randomized controlled design was adopted,they were divided into control group 1(received treatment with sitagliptin,n=45),control group 2(received treatment with insulin glargine,n=45),and observation group(received treatment with dulaglutide,n=45)according to the random number table method.Physical examination indexes,plasma glucose indicators,islet function,and incidence of adverse reactions were compared among the three groups.Results:12 weeks after treatment,body mass index(BMI),waist circumference,fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),and postprandial 2-hour plasma glucose(2hPG)in the observation group were lower than those in control group 1 and control group 2(P＜0.05).12 weeks after treatment,the observation group had the highest HbA1c compliance rate,reaching 71.1％(P＜0.05).12 weeks after treatment,the fasting C-peptide(FC-P)and HOMA-islet(CP-DM)levels in the observation group were higher than those in control group 1 and control group 2(P＜0.05).Conclusion:Dulagopeptide can effectively improve physical examination indexes,plasma glucose indicators,and islet function in T2DM patients with poorly controlled plasma glucose.

In order to investigate the teaching effectiveness of artificial intelligence(AI)in molecular bi-ology,this study selected students from the Animal Medicine major of the College of Animal Science and Technology at Hebei North University in 2022 and 2023 as research subjects.There was no significant difference in professional foundation,admission scores,and other aspects between the two grades,and they were taught by the same lecturer to ensure the reliability of research results.The 2022 students will adopt the traditional teaching mode,while the 2023 students will implement the AI-enabled teaching mode,which includes four stages:pre class exploration,in class assistance,post class learning support,and teaching reflection and improvement.Before class,the teaching team pushes teaching videos of vari-ous knowledge points in the course and relevant preview materials organized by the AI system to students to complete self-learning,and use AI systems to track students' learning difficulties.In class,the teacher uses various teaching methods such as case teaching,group discussions,AI animation demonstrations and virtual experiments,etc..Thus,they provide in-depth explanations of key contents based on the feed-back data from the intelligent learning companion AI system,promoting students' understanding of the knowledge.After class,the AI system generates personalized learning plans for students and provides dif-ferent levels of learning resources to broaden their horizons.At the same time,the AI system provides teachers with students'learning data analysis reports,and teachers can adjust and optimize their teaching plans accordingly.Research has found that students in the 2023 AI-empowered teaching class have signif-icantly higher satisfaction in multiple dimensions such as learning interest,understanding and mastery of knowledge points,and cultivation of scientific research thinking than those in the 2022 traditional teach-ing class.In terms of student participation in comprehensive activities,the proportion of 2023 students participating in subject competitions and innovation and entrepreneurship activities has significantly in-creased.In terms of academic performance,the mid-term,laboratory,and final grades of 2023 students are higher than those of 2022 students,with a significant increase in the excellence rate and a significant decrease in the failure rate.The results indicate that the application of AI technology in molecular biology teaching has stimulated students' interest in learning,helped them better understand and master knowl-edge,significantly improved their academic performance.In sum,it has a positive impact on improving teaching quality.

Background:Ideal bowel preparation is the prerequisite for the successful diagnostic and therapeutic colonoscopy.The retention of intestinal bubbles can seriously affect the clarity of the intestinal mucosa and subsequently decrease the detection rate of colonoscopy.Aims:To investigate the application value of dyclonine hydrochloride mucilage in bowel preparation for colonoscopy.Methods:This study was a randomized double-blinded placebo-controlled trial.Patients who underwent colonoscopy from October 2020 to October 2023 at Hainan West Central Hospital were enrolled and randomly allocated into the dyclonine hydrochloride mucilage group and the control group.3 L polyethylene glycol(PEG)+dyclonine hydrochloride mucilage and 3 L PEG+placebo were given for bowel preparation,respectively.The quality of bowel preparation was evaluated by Boston bowel preparation scale(BBPS)score and bubble score.Furthermore,a questionnaire was conducted.The cecal intubation time,withdrawal time,adenoma detection rate and adverse reaction were compared between the two groups.Results:A total of 482 patients who underwent colonoscopy were included.No significant differences in clinical characteristics such as gender,age,body mass index(BMI)and main reasons for colonoscopy were found between the dyclonine hydrochloride mucilage group and the control group(all P>0.05).Compared with the control group,no significant differences existed in total BBPS score and segment scores for right,transverse,and left colon in the dyclonine hydrochloride mucilage group(all P>0.05),but the total bubble score and segment scores for right,transverse,and left colon were significantly decreased(all P<0.001).The withdrawal time in the dyclonine hydrochloride mucilage group was significantly decreased compared to the control group(P<0.001),and the adenoma detection rate was significantly increased(P=0.001).However,no significant differences in cecal intubation time and incidence of adverse reaction were found between the two groups(all P>0.05).Conclusions:Administration of dyclonine hydrochloride mucilage during bowel preparation for colonoscopy can reduce the formation of intestinal bubbles,shorten the withdrawal time and increase the adenoma detection rate.

Objective We aimed to evaluate the efficacy and safety of Shengxuebao Mixture in the treatment of cancer-related anemia(CRA)presenting with syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood.Methods A randomized,double-blind,placebo-controlled,multicenter clinical trial was conducted.Eligible patients with malignant tumors meeting the inclusion and exclusion criteria were enrolled from 26 hospitals,including Dongzhimen Hospital,Beijing University of Chinese Medicine,Xiaogan Central Hospital,and Yangzhou Hospital of Traditional Chinese Medicine,from June 1,2022,to September 30,2024.Patients were allocated 1:1 to either the experimental group receiving Shengxuebao Mixture or the control group receiving its simulator(placebo)using a block randomization method under double-blind conditions.Both groups received 15 mL orally three times daily for 28 consecutive days.The primary efficacy indicators included the hemoglobin(Hb)improvement rate(RHb)and the traditional Chinese medicine(TCM)syndrome improvement rate(RTCM)at week 4 of treatment.The secondary efficacy indicators encompassed Hb and red blood cell(RBC)count,Karnofsky Performance Status(KPS)score,TCM syndrome score,individual TCM symptom scores,and changes in each of these indicators compared to the baseline period at weeks 2,4,and 6 of treatment.Safety evaluations were conducted at week 4 of treatment.Results A total of 239 patients were enrolled,with 225 cases included in the Full Analysis Set(FAS)(109 in the experimental group vs.116 control group),163 in the Per Protocol Set(PPS)(77 vs.86),and 225 in the Safety Set(SS)(109 vs.116).Baseline characteristics between groups showed no significant differences.Significant differences were observed between the experimental and control groups in RHb at week 4(FAS:49.51%vs.35.24%,P<0.05;PPS:53.25%vs.36.05%,P<0.05)and RTCM at week 4(FAS:61.54%vs.39.62%,P<0.01;PPS:64.94%vs.40.70%,P<0.01).At weeks 2,4,and 6,the experimental group showed greater improvements in Hb and RBC counts than the control group.Additionally,the TCM syndrome scores were lower in the experimental group than in the control group at these time points.Except for week 2 in PPS,the KPS improvement was better in the experimental group than in the control group(P<0.05).The experimental group also demonstrated a greater reduction in scores for individual TCM symptoms such as spiritlessness and weakness,poor appetite and reduced food intake at weeks 4 and 6 compared to the control group(P<0.05,P<0.01).Furthermore,the reduction in vertigo score was more pronounced in the experimental group at week 6(P<0.01).For the score of pale and lusterless complexion,only in the PPS was the reduction from baseline more significant in the experimental group than in the control group at weeks 4 and 6(P<0.05).No significant differences were observed between the experimental and control groups in the incidence of all adverse events or drug-related adverse reactions.Conclusion Shengxuebao Mixture demonstrates significant efficacy in patients with CRA presenting syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood,effectively increasing Hb levels,ameliorating TCM syndromes,alleviating clinical symptoms,and enhancing functional status,with no significant difference in adverse drug reactions compared to the placebo.

With the extended survival period of breast cancer patients and the increasing health demands, the concomitant diseases of breast cancer have gradually attracted the attention of both doctors and patients, and it is imperative to conduct comprehensive management of these diseases, in which the general practitioners, as the more comprehensive and complex medical talents, have not yet played their due roles. In this article, we report two cases of comprehensive management of concomitant diseases of breast cancer through collaboration of general practitioners and specialists (integrated general and specialist care). The role and function of general practitioners in this process were deeply analyzed, and the establishment of a consultation-liaison general practice model to further promote the role of integrated general and specialist care in integrated oncology care was advocated.

In order to investigate the teaching effectiveness of artificial intelligence(AI)in molecular bi-ology,this study selected students from the Animal Medicine major of the College of Animal Science and Technology at Hebei North University in 2022 and 2023 as research subjects.There was no significant difference in professional foundation,admission scores,and other aspects between the two grades,and they were taught by the same lecturer to ensure the reliability of research results.The 2022 students will adopt the traditional teaching mode,while the 2023 students will implement the AI-enabled teaching mode,which includes four stages:pre class exploration,in class assistance,post class learning support,and teaching reflection and improvement.Before class,the teaching team pushes teaching videos of vari-ous knowledge points in the course and relevant preview materials organized by the AI system to students to complete self-learning,and use AI systems to track students' learning difficulties.In class,the teacher uses various teaching methods such as case teaching,group discussions,AI animation demonstrations and virtual experiments,etc..Thus,they provide in-depth explanations of key contents based on the feed-back data from the intelligent learning companion AI system,promoting students' understanding of the knowledge.After class,the AI system generates personalized learning plans for students and provides dif-ferent levels of learning resources to broaden their horizons.At the same time,the AI system provides teachers with students'learning data analysis reports,and teachers can adjust and optimize their teaching plans accordingly.Research has found that students in the 2023 AI-empowered teaching class have signif-icantly higher satisfaction in multiple dimensions such as learning interest,understanding and mastery of knowledge points,and cultivation of scientific research thinking than those in the 2022 traditional teach-ing class.In terms of student participation in comprehensive activities,the proportion of 2023 students participating in subject competitions and innovation and entrepreneurship activities has significantly in-creased.In terms of academic performance,the mid-term,laboratory,and final grades of 2023 students are higher than those of 2022 students,with a significant increase in the excellence rate and a significant decrease in the failure rate.The results indicate that the application of AI technology in molecular biology teaching has stimulated students' interest in learning,helped them better understand and master knowl-edge,significantly improved their academic performance.In sum,it has a positive impact on improving teaching quality.