Objective: To establish a method for determining the molecular weight and molecular weight distribution of Poly(Lactide-co-Glycolide Acid) (PLGA) using Size Exclusion Chromatography-Refractive Index-Multiangle Laser Light Scattering (SEC-RI-MALLS) and Size Exclusion Chromatography-Refractive Index (SEC-RID), and to compare the results obtained from these two methods.
Methods: For SEC-RI-MALLS, tetrahydrofuran was used as the mobile phase, Shodex GPC KF-803L was employed as the chromatographic column with a flow rate of 1 mL·min^-1, column temperature at 30 ℃, and an injection volume of 100 μL. For SEC-RID, tetrahydrofuran was also used as the mobile phase, Agilent PLgel 5 μm MIXD-D was used as the chromatographic column with a flow rate of 1 mL·min^-1, column temperature at 30 ℃, differential detector temperature at 35 ℃, and an injection volume of 20 μL. The molecular weight and molecular weight distribution were calculated using Agilent’s GPC software. The newly established methods were validated methodologically, and the molecular weight and molecular weight distribution of 13 batches of samples were determined.
Results: The precision, accuracy, stability, and repeatability tests for SEC-RI-MALLS showed RSD values of 1.35%, 1.58%, 1.53%, and 1.26%, respectively. The SEC-RID method exhibited good linearity (r=0.999 9), with RSD values for precision, accuracy, stability, and repeatability tests (n=6) of 2.05%, 1.62%, 1.30%, and 2.97%, respectively. The results obtained from SEC-RI-MALLS were lower than those from SEC-RID, and the molecular weight distribution coefficient was smaller, but the results from the paired T-test performed with the value measured by SEC-RID method and the value measured by SEC-RI-MALLS method multiplied a conversion coefficient of 1.5 showed no significant difference between the two methods.
Conclusion: Both methods are stable and reliable, and can be used for the determination of PLGA molecular weight and molecular weight distribution based on the specific situations.

Objective To evaluate the disease risk of Vibrio parahaemolyticus (VP) in aquatic products of raw food in Guangzhou. Methods VP detection was carried out in aquatic products of raw food sold in Guangzhou from 2009 to 2022. Gene sequence and wgSNP analysis of 30 VP strains (including 15 food strains and 15 patient strains) were performed for the detection rate of pathogenic VP. sQMRA was applied to assess VP risk of aquatic products of raw food. Results The detection rate of VP in raw aquatic products in Guangzhou was 7.30% (98/1 343). The detection rate of TDH virulence gene in patient strains was 86.70% (13/15) , and the detection rate of TRH was 6.67% (1/15). In 15 food strains, TDH and TRH were negative. The WgSNP analysis showed that 2 food strains had high similarity with the patient strains, indicating the same cluster. Risk assessment showed that the number of Vibrio parahaemolyticus infection cases caused by intaking aquatic products of raw food in Guangzhou was 384 ever year. Conclusion The detection rate of VP in aquatic products of raw food is high in Guangzhou , and the detection rate of VP virulence genes in aquatic products of raw food is low. Gene sequence and wgSNP analysis can be used for risk assessment of food pathogenic bacteria. The risk of disease of Vibrio parahaemolyticus in aquatic products of raw food is high.

Purpose: This Phase II trial was objected to evaluate the efficacy and safety of adding fulvestrant to neoadjuvant chemotherapy in patients with estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)– locally advanced breast cancer (LABC). Additionally, the study aimed to investigate the association of 16α-18F-fluoro-17β-fluoroestradiol (18F-FES) positron emission tomography (PET)–computed tomography (CT) and metabolites with efficacy. Materials and Methods: Fulvestrant and EC-T regimen were given to ER+/HER2– LABC patients before surgery. At baseline, patients received 18F-FES PET-CT scan, and plasma samples were taken for liquid chromatography–mass spectrometry analysis. The primary endpoint was objective response rate (ORR). Secondary endpoints included total pathologic complete response (tpCR) and safety. Results: Among the 36 patients enrolled, the ORR was 86.1%, the tpCR rate was 8.3%. The incidence of grade ≥ 3 treatment-emergent adverse events was 22%. The decrease in ER value in sensitive patients was larger than that in non-sensitive patients, as was Ki-67 (p < 0.05). The maximum standardized uptake value, mean standardized uptake values, total lesion ER expression of 18F-FES PET-CT in sensitive patients were significantly higher than those in non-sensitive patients (p < 0.05). Moreover, these parameters were significantly correlated with Miller and Payne grade and the change in ER expression before and after treatment (p < 0.05). Thirteen differential expressed metabolites were identified, which were markedly enriched in 19 metabolic pathways. Conclusion This regimen demonstrated acceptable toxicity and encouraging antitumor efficacy. 18F-FES PET-CT might serve as a tool to predict the effectiveness of this therapy. Altered metabolites or metabolic pathways might be associated with treatment response.

Purpose: This Phase II trial was objected to evaluate the efficacy and safety of adding fulvestrant to neoadjuvant chemotherapy in patients with estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)– locally advanced breast cancer (LABC). Additionally, the study aimed to investigate the association of 16α-18F-fluoro-17β-fluoroestradiol (18F-FES) positron emission tomography (PET)–computed tomography (CT) and metabolites with efficacy. Materials and Methods: Fulvestrant and EC-T regimen were given to ER+/HER2– LABC patients before surgery. At baseline, patients received 18F-FES PET-CT scan, and plasma samples were taken for liquid chromatography–mass spectrometry analysis. The primary endpoint was objective response rate (ORR). Secondary endpoints included total pathologic complete response (tpCR) and safety. Results: Among the 36 patients enrolled, the ORR was 86.1%, the tpCR rate was 8.3%. The incidence of grade ≥ 3 treatment-emergent adverse events was 22%. The decrease in ER value in sensitive patients was larger than that in non-sensitive patients, as was Ki-67 (p < 0.05). The maximum standardized uptake value, mean standardized uptake values, total lesion ER expression of 18F-FES PET-CT in sensitive patients were significantly higher than those in non-sensitive patients (p < 0.05). Moreover, these parameters were significantly correlated with Miller and Payne grade and the change in ER expression before and after treatment (p < 0.05). Thirteen differential expressed metabolites were identified, which were markedly enriched in 19 metabolic pathways. Conclusion This regimen demonstrated acceptable toxicity and encouraging antitumor efficacy. 18F-FES PET-CT might serve as a tool to predict the effectiveness of this therapy. Altered metabolites or metabolic pathways might be associated with treatment response.

Purpose: This Phase II trial was objected to evaluate the efficacy and safety of adding fulvestrant to neoadjuvant chemotherapy in patients with estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)– locally advanced breast cancer (LABC). Additionally, the study aimed to investigate the association of 16α-18F-fluoro-17β-fluoroestradiol (18F-FES) positron emission tomography (PET)–computed tomography (CT) and metabolites with efficacy. Materials and Methods: Fulvestrant and EC-T regimen were given to ER+/HER2– LABC patients before surgery. At baseline, patients received 18F-FES PET-CT scan, and plasma samples were taken for liquid chromatography–mass spectrometry analysis. The primary endpoint was objective response rate (ORR). Secondary endpoints included total pathologic complete response (tpCR) and safety. Results: Among the 36 patients enrolled, the ORR was 86.1%, the tpCR rate was 8.3%. The incidence of grade ≥ 3 treatment-emergent adverse events was 22%. The decrease in ER value in sensitive patients was larger than that in non-sensitive patients, as was Ki-67 (p < 0.05). The maximum standardized uptake value, mean standardized uptake values, total lesion ER expression of 18F-FES PET-CT in sensitive patients were significantly higher than those in non-sensitive patients (p < 0.05). Moreover, these parameters were significantly correlated with Miller and Payne grade and the change in ER expression before and after treatment (p < 0.05). Thirteen differential expressed metabolites were identified, which were markedly enriched in 19 metabolic pathways. Conclusion This regimen demonstrated acceptable toxicity and encouraging antitumor efficacy. 18F-FES PET-CT might serve as a tool to predict the effectiveness of this therapy. Altered metabolites or metabolic pathways might be associated with treatment response.

Objective:To compare the awakening effects of enriched environmental quantitative stimulation and conventional rehabilitation on patients with consciousness disorder after traumatic brain injury (TBI).Methods:A retrospective cohort study was conducted to analyze the clinical data of 60 patients with consciousness disorder after TBI admitted to Hospital of Zhejiang Provincial Armed Police Corps from October 2021 to October 2022, including 38 males and 22 females, aged 26-72 years [(41.6±13.2)years]. The injury was located at the frontal and temporal lobe in 37 patients, at the brain stem in 9, and at the thalamus in 14. The types of injury included cerebral contusion and laceration in 36 patients and intracerebral hematomas in 24 patients. The Glasgow Coma Scale (GCS) score on admission was 5-8 points in 11 patients, 9-12 in 34, and 13-15 in 15. Disease course was (19.2±5.4)days. A total of 30 patients received conventional rehabilitation treatment (conventional rehabilitation group) and 30 patients received enriched environmental quantitative stimulation on the basis of conventional rehabilitation treatment, which lasted 4 cycles in 28 days (quantitative stimulation group). The Coma Recovery Scale-Revised (CRS-R) score, Activities of Daily Living (ADL) score, and brainwave α/δ ratio (ADR) before treatment and at the second and fourth treatment cycles were compared between the two groups. The incidence of complications at the end of the fourth treatment cycle and the rate of favorable outcome of Glasgow Outcome Scale (GOS) at the last follow-up were compared between the two groups.Results:All the patients were followed up for 6-12 months [(8.3±2.5)months]. There were no significant differences in CRS-R score, ADL score, or brainwave ADR between the two groups before treatment ( P>0.05). At the second treatment cycle, they were (13.03±0.73)points, (14.83±0.95)points and 0.35±0.11 respectively in the quantitative stimulation group, which were all higher than those in the conventional rehabilitation group [(11.18±0.14)points, (8.74±0.43)points and 0.29±0.09 respectively] ( P<0.05). At the fourth treatment cycle, they were (17.83±0.23)points, (52.93±10.75)points and 0.44±0.11 respectively in the quantitative stimulation group, which were all higher than those in the conventional rehabilitation group [(13.67±0.35)points, (40.56±7.15)points and 0.37±0.07 respectively] ( P<0.05). The CRS-R score, ADL score, and brainwave ADR at the second treatment cycle were significantly higher than those before treatment, and they were even higher at the fourth treatment cycle than those at the second treatment cycle ( P<0.05). At the end of the fourth treatment cycle, the incidence of complications in the quantitative stimulation group was 13.3% (4/30), which was lower than that of the conventional rehabilitation group [36.7% (11/30)] ( P<0.05). At the last follow-up, the favorable outcome rate of GOS was 80.0% (24/30) in the quantitative stimulation group, which was superior to 66.7% (20/30) in the conventional rehabilitation group ( P<0.05). Conclusion:Compared with the conventional rehabilitation treatment, enriched environmental quantitative stimulation for patients with consciousness disorder after TBI achieves enhanced consciousness level, activity of daily life and electroencephal reactivity, together with decreased incidence of complications and improved prognosis.

Objective:To analyze the body composition and influencing factors of lean non-alcoholic fatty liver disease in population receiving health examination.Methods:This is a cross-sectional study. Between January 2020 and December 2021, 1 342 individuals who had complete and reliable results of liver transient elastography and body composition testing, with a body mass index (BMI)<24 kg/m 2 and who met the inclusion criteria, were selected from the physical examination population at the Health Management Center of Jiangsu Provincial People′s Hospital. The results of body composition analysis, blood biochemical indexes and liver examination were collected from the subjects for analysis. Method of inter-group comparison: quantitative data that conform to normal distribution were tested using independent sample t-test, while non-conforming data were tested using rank sum test; count data were tested using chi-square test. The binary logistic regression analysis was used to analyze the influencing factors of body composition in lean non-alcoholic fatty liver disease in health examinees. Results:The detection rate of non-alcoholic fatty liver disease was 13.3% in all participants, and it was significantly higher in men than that in women (23.3% (125/537) vs 6.6% (53/805)). The fasting blood glucose (5.15, 5.08 mmol/L), hemoglobin A1c (HbA 1c)(5.5%, 5.6%), triglyceride (TG)(1.70, 1.64 mmol/L), low density lipoprotein cholesterol (LDL-C)(3.37, 3.27 mmol/L), alanine aminotransferase (ALT)(27.0, 21.9 U/L), aspartate aminotransferase (AST)(24.1, 24.0 U/L), gamma-glutamyltransferase (31.4, 21.1 U/L), uric acid (UA)(391, 296 μmol/L), body fat percentage (23.9%, 33.7%), waist-to-hip ratio(0.90, 0.89) and visceral fat area (70.3, 97.0 cm 2) in men and women with lean nonalcoholic fatty liver disease were all higher than those in the population without fatty liver, while the density lipoprotein cholesterol (1.25, 1.32 mmol/L) was lower. Logistic regression analysis showed that BMI, HbA 1c, TG, UA and waist-to-hip ratio were risk factors for lean nonalcoholic fatty liver disease in men, while BMI, HbA 1c, TG, UA and body fat percentage were risk factors for lean nonalcoholic fatty liver disease in women (all P<0.05). Conclusion:BMI, HbA 1c, TG, UA, body fat percentage and waist-to-hip ratio are associated with the development of lean nonalcoholic fatty liver disease.

BackgroundWomen may develop severe symptoms of stress disorder following childbirth， which may be exposed to a risk of developing mental health problems， and even lead to the recurrence of the illness in female patients with schizophrenia， while comparatively limited research has been undertaken concerning the clinical characteristics and treatment of puerperal schizophrenia in China. ObjectiveTo explore the clinical characteristics of puerperal schizophrenia， so as to provide references for the clinical treatment. MethodsA total of 24 patients with puerperal schizophrenia who were hospitalized in the female ward of adult psychiatry department of the Affiliated Brain Hospital of Guangzhou Medical University from 2012 to 2020 and met the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） diagnostic criteria for schizophrenia were included as puerperal group. Another 48 non-puerperal women with schizophrenia were concurrently enrolled as control group. Then the basic data， scores on Positive and Negative Symptom Scale （PANSS） and the discharge medication were recorded. ResultsThe percentages of newly onset and positive family history of psychosis in puerperal group were larger than those in control group， with statistical significance （χ²=9.321， 5.240， P<0.05 or 0.01）. Puerperal group scored higher on PANSS excitement factor （t=-2.220， P<0.05） and lower on negative factor （t=3.377， P<0.01） compared with control group. In terms of discharge medication， puerperal group reported a higher dosage of antipsychotic drugs （t=-2.095， P<0.05）， and a larger proportion of combined use of benzodiazepines or antidepressants （χ²=21.316， 5.114， P<0.05 or 0.01） compared with control group， with statistical significance. ConclusionPatients with puerperal schizophrenia display increased ratings of excitement symptoms and decreased ratings of negative symptoms， which necessitates the use of high doses of antipsychotic drugs， and combined use of benzodiazepines and antidepressants.

The STAR tool was used to evaluate and analyze the science, transparency, and applicability of Chinese pathology guidelines and consensus published in medical journals in 2022. There were a total of 18 pathology guidelines and consensuses published in 2022, including 1 guideline and 17 consensuses. The results showed that the guideline score was 21.83 points, lower than the overall guideline average (43.4 points). Consensus ratings scored an average of 27.87 points, on par with the overall consensus level (28.3 points). Areas that scored above the overall level were "conflict of interest" and "working groups", while areas that scored below the overall level were "proposals", "funding", "evidence", "consensus approaches" and "accessibility". To sum up, the formulation of pathology guidelines and consensuses in 2022 is not standardized, and the evidence retrieval process, evidence evaluation methods and grading criteria for recommendations on clinical issues are not provided in the formulation process; the process and method for reaching consensus are not provided, the plan is lacking, and registration is not carried out. It is therefore suggested that guidelines/consensus makers in the field of pathology should attach importance to evidence-based medical evidence, strictly follow guideline formulation methods and processes, further improve the scientific, applicable and transparent guidelines/consensuses in the field, and better provide support for clinicians and patients.

Objective To construct a theoretical model of venous thromboembolism(VTE)risk perception in pregnant women,so as to provide a scientific basis for promoting pregnant women to form a correct risk perception of VTE and actively take preventive behaviors.Methods A qualitative research approach guided by the procedural grounded theoiy was adopted.Data were collected by a semi-structured deep interview on 18 pregnant women who received prenatal examination in the outpatient department of a tertiary A obstetrics and gynecology hospital in Nanjing from June to July 2023,and the data were analyzed by three-level coding and continuous comparison method.Results The VTE risk perception of pregnant women was affected by 6 factors including social coupling system,self health status,life behavior habits,knowledge on disease,compliance behavior and emotional stimulation.Pregnant women perceived VTE risk from 3 aspects:threats to maternal and child safety,increased family economic burden and increased time cost,impact on social roles.Thus,3 health behavior decisions were formed,including taking preventive behaviors,overcoming implementation barriers,and seeking knowledge behaviors,in order to reduce their own risk of VTE,and prevent the occurrence of VTE.Conclusion The theoretical model of VTE risk perception of pregnant women can guide medical staff to comprehensively consider the influencing factors of VTE risk perception of pregnant women,optimize the form and content of VTE health education,give pregnant women individualized and sustainable VTE prevention guidance,and strengthen pregnant women's perception of VTE risk and the benefits of preventive behavior,so as to actively take the correct health behavior decisions.