Objective To investigate the value of histone deacetylase 3(HDAC3)in evaluating the risk of slow/no reflow in AMI patients after PCI.Methods A total of 280 AMI patients undergo-ing PCI in our hospital from June 2020 to June 2022 were recruited,and according to TIMI blood flow grading,they were divided into slow/no reflow group(TIMI≤grade 11,n=54)and normal flow group(TIMI＞grade Ⅱ,n=226).The demographic characteristics,underlying diseases,baseline data at admission,and preoperative results of coronary angiography and laboratory tests were compared between the two groups.Multivariate logistic regression analysis was used to determine the influencing factors for slow/no reflow in AMI patients after PCI,and ROC curve was drawn to analyze the predictive value of related indicators for slow/no reflow.Results Obvi-ously larger proportions of smoking history and Killip grade Ⅱ,higher heart rate,longer reperfu-sion time,and higher serum levels of LDL-C,NLR,D-D and HDAC3 were observed in the slow/no reflow group than the normal flow group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that reperfusion time,NLR and HDAC3 were influencing factors for slow/no reflow in AMI patients after PCI(P＜0.05,P＜0.01).The AUC value of reperfusion time+NLR in predicting the slow/no reflow after PCI in AMI patients was 0.798(95％CI:0.664-0.922,P=0.002),with a sensitivity and specificity of 0.87 and 0.73,respectively.And when serum HDAC3 level was combined in the prediction,the AUC value was 0.903(95％CI:0.790-0.922,P＜0.01),with a sensitivity and specificity of 0.93 and 0.84,respectively.Conclusion Preoperative HDAC3 level is an influencing factor for slow/no reflow in AMI patients after PCI.Based on reperfusion time and NLR,combination of the 3 indicators can provide additional predictive value for slow/no reflow in these patients.

Objective: To explore the effectiveness of machine learning in predicting adolescent Internet gaming disorder, so as to provide guidance for formulating effective intervention measures. Methods: From June to September，2023，a total of 2 100 students from 3 middle schools and 3 high schools in Bijie City, Qianxi City and Jinsha County, Guizhou Province were selected by stratified random cluster sampling as research subjects. Data was collected by using several instruments, including the Nine item Internet Gaming Disorder Scale-Short From (IGDS9-SF), Parental Psychological Control and Autonomy Support Questionnaire(PPCASQ), Motivation Structure Questionnaire, Relative Deprivation Questionnaire, Deviant Peer Association Questionnaire, and Dual Systems of Self control Scale. Descriptive statistical analysis was conducted to characterize the sample features, and the distribution differences of categorical variables were analyzed by using Chi square test and Mann-Whitney U test. Demographic variables and various influencing factors were served as independent variables, and whether adolescents were addicted to Internet gaming was the dependent variable. Various machine learning algorithms, including random forest, Logistic regression, support vector machine, gradient boosting trees, decision trees, and adaptive boosting were employed to construct predictive models. Results: The detection rate of Internet gaming disorder among adolescents was 4.57% (96 cases). Males and middle school students had higher Internet gaming disorder detection rates (5.52%,6.29%) than females and high school students (3.32%,3.62%), and the differences were statistically significant ( χ 2=5.71,7.86, P ＜0.01).The scores of relative deprivation,deviant peer affiliation, paternal psychological control, maternal psychological control, control motivation, impulsive system and its dimensions (impulsivity, distractibility, low delay of gratification) in Internet gaming disorder group were higher than in non Internet gaming disorder, while the score of parental autonomy support was lower than that in the non Internet gaming disorder group ( Z =-2.88,-9.32,-4.13,-4.48, -6.58 ,-7.50,-7.18,-7.56,-7.43,-2.27, P <0.05). The adaptive boosting algorithm performed the best (accuracy=99%, recall=95%, F1 score=97%, AUC=0.96). Random forest and gradient boosting trees also performed excellently (accuracy=98%, recall=95%, F1 score=97%, 96%, AUC=0.96). Conclusions Compared to other models, the adaptive boosting algorithm shows a good predictive effectiveness for adolescent Internet gaming disorder. Appropriate models should be selected to identify individuals with Internet gaming disorder as early as possible, to develop effective intervention strategies and reduce the risk of Internet gaming disorder.

Objective To investigate the effects of menaquinone-4(MK4)on the activation and function of CD8+T cells.Methods An in vitro culture system for primary mouse CD8+T cells was established by isolating these cells from the spleen using CD8a T cell isolation kit.The isolated CD8+T cells were then incubated and activated in a 96-well plate coated with anti-CD3/CD28 antibodies.The impact of MK4 on the activation and cytokine secretion of CD8+T cells was explored by quantifying the expression levels of CD8+T cell activation receptors and cytokines using flow cytometry.Additionally,the concentrations of these cytokines in the culture supernatant were measured by enzyme-linked immunosorbent assay(ELISA).The influence of MK4 on the anti-tumor function of CD8+T cells was evaluated by co-culturing colorectal cancer MC38 cells of mice with CD8+T cells at different ratios,and the effect of MK4 was assessed by detecting tumor cell apoptosis.Results High-purity primary CD8+T cells of mice(97.5％)were isolated using the magnetic bead,which could be activated by pre-coated CD3/CD28 antibodies and showed proliferation.Compared with the control group,the MK4-treated group exhibited increased expressions of CD25,CD69 and CD44 on CD8+T cells,as well as higher production and secretion levels of interleukin-2(IL-2),interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α)and granzyme B.In addition,CD8+T cells in the MK4-treated group induced a higher percentage of tumor cell apoptosis(36.7％)compared with the control group(29.1％).Conclusion MK4 can enhance the activation of CD8+T cells and promote anti-tumor functions.

ObjectiveTo investigate the characteristics of intrahepatic and extrahepatic organ failure at the onset of acute－on－chronic liver failure（ACLF）， to explore the features of a new clinical classification system of ACLF， and to provide a basis for the diagnosis， treatment， prognostic analysis of the disease. MethodsA retrospective analysis was performed for the clinical data of the patients who were hospitalized Beijing YouAn Hospital， Capital Medical University， from January 2015 to October 2022 and were diagnosed with ACLF for the first time. According to the conditions of intrahepatic and extrahepatic organ failure at disease onset， they were classified into type Ⅰ ACLF and type Ⅱ ACLF. Type Ⅰ ACLF referred to liver failure on the basis of chronic liver diseases， and type Ⅱ ACLF referred to acute decompensation of chronic liver diseases combined with multiple organ failure. The clinical features of patients with type Ⅰ or type Ⅱ ACLF were analyzed， and the receiver operating characteristic （ROC） curve was used to assess the value of MELD， MELD－Na， and CLIF－C ACLF scoring system in predicting the 90－day prognosis of ACLF patients with type Ⅰ or type Ⅱ ACLF. The independent－samples t test was used for comparison of normally distributed continuous data between two groups， and the Wilcoxon rank－sum test was used for comparison of non－normally distributed continuous data between two groups； the chi－square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsA total of 582 patients with ACLF were enrolled， among whom there were 535 patients with type Ⅰ ACLF and 47 patients with type Ⅱ ACLF. Hepatitis B and alcoholic liver disease were the main causes in both groups， with no significant difference between the two groups （P>0.05）. Chronic non－cirrhotic liver disease （28.2%） and compensated liver cirrhosis （56.8%） were the main underlying liver diseases in type Ⅰ ACLF， while compensated liver cirrhosis （34.0%） and decompensated liver cirrhosis （61.7%） were the main underlying liver diseases in type Ⅱ ACLF， and there was no significant difference in underlying liver diseases between the patients with type Ⅰ ACLF and those with type Ⅱ ACLF （P<0.001）. The patients with type Ⅱ ACLF had significantly higher median MELD score， MELD－Na score， and CLIF－C ACLF score than those with type Ⅰ ACLF （all P<0.001）. The patients with type Ⅱ ACLF had significantly higher 28－ and 90－day mortality rates than those with type Ⅰ ACLF （38.3%/53.2% vs 15.5%/27.5%， P<0.001）. For the patients with type Ⅰ ACLF who did not progress to multiple organ failure， the patients with an increase in MELD score accounted for 63.7% in the death group and 10.1% in the survival group （P<0.001）， while for the patients with type Ⅰ ACLF who progressed to multiple organ failure， there was no significant difference in the change in MELD score between the survival group and the death group （P>0.05）. In the patients with type Ⅰ ACLF， MELD score， MELD－Na score， and CLIF－C ACLF score had an area under the ROC curve （AUC） of 0.735， 0.737， and 0.740， respectively， with no significant difference between any two scores （all P>0.05）. In the patients with type Ⅱ ACLF， CLIF－C ACLF score had a significantly higher AUC than MELD score （0.880 vs 0.560， P<0.01） and MELD－Na score （0.880 vs 0.513， P<0.01）. ConclusionThere are differences in underlying liver diseases， clinical features， and prognosis between type Ⅰ and type Ⅱ ACLF， and different prognosis scoring systems have different emphases， which provide a basis for the new clinical classification system of ACLF from the perspective of evidence－based medicine.

OBJECTIVE: To observe the anatomical features and relative position of the brachiocephalic trunk and the trachea to provide an anatomical basis for diagnosis and treatment of mechanical airway obstruction and for facilitating the performance of tracheotomy. METHODS: A total of 91 formalin- fixed adult cadavers (70 male and 21 female) were used in this study. The whole length of the larynx and the trachea were separated and exposed from the neck to the chest, followed by separation of the aortic arch and its 3 branches to observe the anatomical position of the brachiocephalic trunk and the trachea. RESULTS: The brachiocephalic trunk and the trachea did not intersect in 3.30%, partially intersected in 71.43%, and completely intersected in 25.27% of the 91 cadaveric specimens. The male specimens all showed greater outer diameter of the aortic arch, the brachiocephalic trunk and the trachea with a greater length of the trachea than the female specimens (P < 0.05), while the distances from the aortic arch to the brachiocephalic trunk or the cricoid cartilage did not differ significantly between them (P > 0.05). The number of the tracheal cartilage rings above the brachiocephalic trunk ranged from 3 to 10, and the mean number did not differ significantly between the male and female specimens (P > 0.05). CONCLUSION The brachiocephalic trunk has complex anatomical relationship with the trachea, and caution should be taken to avoid injuries of the brachiocephalic trunk and the aortic arch in the diagnosis and treatment of mechanical respiratory obstruction and during tracheotomy.
Adult ; Female ; Male ; Humans ; Trachea ; Brachiocephalic Trunk ; Larynx ; Cadaver ; Formaldehyde

Objective: To observe the effect of the acupuncture plus medication on the expression of silent information regulator of transcription 1 (SIRT1) and transcription factor forkhead box protein O3a (FOXO3a) in the hippocampus, the malondialdehyde (MDA) content, and the superoxide dismutase (SOD) activity of rats with Alzheimer disease (AD), and to explore the possible mechanism of combining acupuncture and medication in improving AD-related neurological symptoms. Methods: Sixty male Sprague-Dawley rats were divided into a normal group, a model group, an electroacupuncture (EA) group, a drug group, and an acupuncture-medication combined group by the random number table method, with 12 rats in each group. The model was established by micro-injection of streptozotocin into the bilateral lateral ventricles. After successful modeling, rats in the EA group received EA at Zusanli (ST36) and Dazhui (GV14), those in the drug group received intragastric administration of resveratrol at a dose of 44 mg/(kg·bw), and those in the acupuncture- medication combined group received the combined intervention of EA and resveratrol. Rats in each group received intervention once a day for 4 consecutive weeks. Morris water maze was used to detect the rat behavioral changes. Nissl staining method was used to observe the cell morphology and changes in the number of rat hippocampal neurons. Western blotting and immunohistochemical staining methods were used to observe the expression changes of SIRT1 and FOXO3a. The thiobarbituric acid method was used to detect the MDA content. SOD activity was determined by the hydroxylamine method. Results: Compared with the normal group, the escape latency was significantly prolonged (P<0.05); the percentage of stay in the target quadrant was reduced (P<0.05), the hippocampal neuronal cells were shrunken, nucleoli were unclear, and cell number was reduced (P<0.05); the SIRT1 expression and SIRT1 positive cell number were decreased, while the FOXO3a expression and FOXO3a positive cell number were increased significantly (P<0.05); the MDA content was increased significantly, and the SOD activity was decreased significantly (P<0.05) in the model group. Compared with the model group, the escape latency was shortened (P<0.05); the percentage of stay in the target quadrant was increased (P<0.05); the shape and number of hippocampal neurons tended to be normal (P<0.05); the SIRT1 protein expression and the SIRT1 positive cell numbers were increased, the FOXO3a protein expression and the FOXO3a positive cell number were decreased (P<0.05); the MDA content was significantly decreased, and the SOD activity was significantly increased (P<0.05) in the EA group, the drug group, and the acupuncture-medication combined group. The changes in the acupuncture-medication combined group were more obvious (P<0.05). Conclusion: Both EA and resveratrol improve the learning and memory ability of AD rats by regulating the expression of SIRT1 and FOXO3a and improving the levels of MDA and SOD in the hippocampus and protect the hippocampal neurons, while the combined use of EA and medication is more effective than EA or resveratrol alone, suggesting that this combined treatment is more effective in AD treatment.

Objective To investigate the factors for gestational diabetes mellitus (GDM) in pregnant women with chronic hepatitis B virus (HBV) infection, their pregnancy outcome, and related influence on neonates. Methods A retrospective analysis was performed for 317 pregnant women with chronic HBV infection who were treated, gave birth, and were followed up in Beijing YouAn Hospital, Capital Medical University, from January to December 2017, and according to the presence or absence of GDM, they were divided into chronic HBV+GDM group and chronic HBV control group. Related data were recorded, including HBV serology, liver function, HBV DNA quantification, pregnancy comorbidities, mode of delivery, and the condition of neonates at birth. The t -test or t ′-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups; a binary logistic regression analysis was used to investigate the risk factors for GDM in mothers with chronic HBV infection. Results Among the 317 mothers, 64 (20.19%) had chronic HBV infection and GDM, and there were 253 mothers (79.81%) in the control group. Compared with the control group, the chronic HBV+GDM group had significantly higher age ( Z =-2.652, P < 0.05), baseline alanine aminotransferase ( Z =-4.393, P < 0.05), baseline aspartate aminotransferase ( Z =-2.457, P < 0.05), and HBV DNA quantification ( P < 0.05). The logistic regression analysis showed that HBV DNA quantification (odds ratio [ OR ]=23.40, 95% confidence interval [ CI ]: 7.10-77.14, P < 0.001) and old age ( OR =10.10, 95% CI : 1.02-1.17, P =0.01) were independent risk factors for GDM in pregnant women with chronic HBV infection. The pregnant women with chronic HBV infection and GDM were more likely to experience premature rupture of membranes during delivery ( χ 2 =4.514, P =0.034), and the neonates born to these women were more likely to experience preterm birth ( χ 2 =9.293, P =0.002) and fetal intrauterine distress ( P =0.018). Conclusion HBV DNA quantification and old age are risk factors for GDM in mothers with chronic HBV infection, and GDM in pregnant women with chronic HBV infection may increase the incidence rate of premature rupture of membranes, fetal intrauterine distress, and premature delivery.

Objective To study the degradation behavior and mechanical properties of magnesium alloy plate on treatment of tibial fracture in New Zealand rabbits. Methods Thirty-six adult New Zealand rabbits were randomly divided into experimental group (magnesium alloy bone plate group, n=18) and control group (titanium alloy bone plate group, n=18). Tibial fractures in experimental group and control group were fixed with magnesium alloy bone plate and titanium alloy bone plate, respectively. After operation, X-ray, scanning electron microscopy, energy spectrum analysis, weight loss test and four-point bending test were performed in each group to analyze the degradation behavior and mechanical properties of magnesium alloy plate after tibial fracture treatment. Results Magnesium alloy bone plate could be degraded gradually in vivo. The degradation of magnesium alloy bone plate was deepened gradually with the implantation time, and the surface was corroded uniformly. The mechanical properties of magnesium alloy bone plate decreased gradually with the degradation in vivo. Conclusions Magnesium alloy bone plate can degrade gradually with fracture healing in vivo, and its mechanical properties gradually decline, but it can still meet the requirements of fracture internal fixation, and is a kind of good new degradable orthopedic implant material.

Objective:To study the effect of early hyperbaric oxygen combined with rehabilitation training on neurological rehabilitation and prognosis of patients with hypertensive intracerebral hemorrhage after borehole drainage.Methods:Eighty-five patients with hypertensive intracerebral hemorrhage admitted to Zhejiang Xin'an International Hospital from January 2018 to March 2020 were enrolled, and all of them were treated with minimally invasive drilling and drainage and they were divided into two groups by the order of admission. The control group (41 cases) received rehabilitation training after 48 h of stable vital signs. The research group(44 cases) was treated on the base of the control group combined with early hyperbaric oxygen therapy. The levels of neuron-specific enolase (NSE), S100β and scores of National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Barthel index, cerebral blood flow, and Glasgow Outcome Scale (GOS) were observed in the two groups before and after treatment.Results:After treatment, the levels of NSE and S100β in the two groups were decreased and those in the research group were lower than those in the control group: (14.38 ± 1.47) μg/L vs. (18.04 ± 2.95) μg/L, (0.24 ± 0.03) μg/L vs. (0.32 ± 0.04) μg/L, the differences were statistically significant ( P<0.05). The scores of NIHSS in the two groups were decreased, while the scores of FMA and Barthel index were increased, while the scores of NIHSS in the research group was lower than that in the control group: (9.18 ± 1.02) scores vs. (11.85 ± 1.47) scores; the scores of FMA and Barthel index in the research group were higher than those in the control group: (68.38 ± 8.93) scores vs.(61.42 ± 8.01) scores, (63.25 ± 7.65) scores vs. (56.11 ± 6.04) scores, the differences were statistically significant ( P<0.05). The average cerebrovascular blood flow and flow rate of patients in both groups were higher than those before treatment, and the peripheral cerebrovascular resistance of patients in both groups was lower than that before treatment, while the average cerebrovascular blood flow and flow rate in the research group were higher than those in the control group: (17.85 ± 2.48) ml/s vs. (15.12 ± 2.01) ml/s, (20.61 ± 2.88) cm/s vs. (17.04 ± 2.47) cm/s; the peripheral cerebrovascular resistance in the research group were lower than that in the control group: (1 328.95 ± 114.29) kPa·s/m vs. (1 558.13 ± 157.21)kPa·s/m, the differences were statistically significant ( P<0.05). The good prognosis rate of research group was higher than that of control group: 84.09%(37/44) vs. 60.98%(25/41), the difference was statistically significant ( χ2 = 4.634, P<0.05). Conclusions:Early hyperbaric oxygen combined with rehabilitation training can promote the recovery of neurological function of patients with hypertensive intracerebral hemorrhage after borehole drainage, and can improve cerebral blood flow and prognosis.