Objective To explore the influencing factors of pregnancy outcome after re-pregnancy in patients with unexplained recurrent spontaneous abortion based on ultrasound endometrial receptability parameters and lymphocyte immunophenotype.Methods A total of 166 re-pregnant patients with unexplained recurrent spon-taneous abortion admitted to Nantong Maternal and Child Health Hospital from April to August 2022 were included in the study.According to the pregnancy outcome,the patients were divided into the delivery group and the abortion group.The endometrial receptability parameters and peripheral blood T lymphocytes were detected to screen the influencing factors of abortion.Results Among 166 patients,102 cases(61.45%)had successful delivery and 64 cases(38.55%)had abortion again.The delivery group showed thicker endometrial thickness,larger endometrial volume,and higher VFI,but lower CD4+ and CD4+/CD8+ compared to the abortion group(P<0.05).CD4+ and CD4+/CD8+ were observed to be the risk factors for pregnancy failure(P<0.05),and endometrial thickness,endo-metrial volume,and vascularized flow index(VFI)were found to be the protective factors for pregnancy failure(P<0.05).Conclusion The pregnancy outcome of patients with unexplained recurrent spontaneous abortion is related to endometrial thickness,endometrial volume,VFI,CD4+,and CD4+/CD8+.

Objective:To establish a HPLC characteristic spectrum method of Centipeda minima based on standard decoction; To evaluate the correlation of materia medica, decoction pieces, standard decoction, intermediates and formula granule; To provide a reference for the quality standard research of Centipeda minima formula granules.Methods:The materia medica, decoction pieces, standard decoction, intermediates and formula granules of Centipeda minima were analyzed by a HPLC characteristic spectrum method, and the software "Similarity Evaluation System for Chromatographic Fingerprint of TCM" was employed to conform the common peaks. The clustering analysis (CA), principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) were adopted to find out the correlation of materia medica, decoction pieces, standard decoction, intermediates and formula granules of Centipeda minima. The Iconic components which can make differences was screened at the same time.Results:The characteristic chromatogram of materia medica, decoction pieces, standard decoction, intermediates and formula granules of Centipeda minima shared high similarity with the respective control chromatogram. Fourteen common peaks were confirmed, and eleven chromatographic peaks were identified. The results of CA and PCA were consistent, and the standard decoction, intermediates and formula granules of Centipeda minima were closer. Six differential components with VIP values greater than 1 were screened by OPLS-DA.Conclusions:The method is stable, accurate and characteristic. The study can provide a reference for the quality standard research of Centipeda minima Formula Granules by analyzing the correlation of characteristic spectrum of materia medica, decoction pieces, standard decoction, intermediates and formula granules.

Objective To investigate the role of RNA-binding motif protein X-linked(RBMX)in regulating the proliferation,migration,invasion and glycolysis in human bladder cancer cells.Methods A lentivirus vectors system and RNA interference technique were used to construct bladder cancer 1376 and UC-3 cell models with RBMX overexpression and knockdown,respectively,and successful cell modeling was verified using RT-qPCR and Western blotting.Proliferation and colony forming ability of the cells were evaluated using EdU assay and colony-forming assay,and cell migration and invasion abilities were determined using Transwell experiment.The expressions of glycolysis-related proteins M1 pyruvate kinase(PKM1)and M2 pyruvate kinase(PKM2)were detected using Western blotting.The effects of RBMX overexpression and knockdown on glycolysis in the bladder cancer cells were assessed using glucose and lactic acid detection kits.Results RT-qPCR and Western blotting confirmed successful construction of 1376 and UC-3 cell models with RBMX overexpression and knockdown.RBMX overexpression significantly inhibited the proliferation,clone formation,migration and invasion of bladder cancer cells,while RBMX knockdown produced the opposite effects.Western blotting results showed that RBMX overexpression increased the expression of PKM1 and decreased the expression of PKM2,while RBMX knockdown produced the opposite effects.Glucose consumption and lactate production levels were significantly lowered in the cells with RBMX overexpression(P<0.05)but increased significantly following RBMX knockdown(P<0.05).Conclusion RBMX overexpression inhibits bladder cancer progression and lowers glycolysis level in bladder cancer cells by downregulating PKM2 expression,suggesting the potential of RBMX as a molecular target for diagnosis and treatment of bladder cancer.

Objective To investigate the role of RNA-binding motif protein X-linked(RBMX)in regulating the proliferation,migration,invasion and glycolysis in human bladder cancer cells.Methods A lentivirus vectors system and RNA interference technique were used to construct bladder cancer 1376 and UC-3 cell models with RBMX overexpression and knockdown,respectively,and successful cell modeling was verified using RT-qPCR and Western blotting.Proliferation and colony forming ability of the cells were evaluated using EdU assay and colony-forming assay,and cell migration and invasion abilities were determined using Transwell experiment.The expressions of glycolysis-related proteins M1 pyruvate kinase(PKM1)and M2 pyruvate kinase(PKM2)were detected using Western blotting.The effects of RBMX overexpression and knockdown on glycolysis in the bladder cancer cells were assessed using glucose and lactic acid detection kits.Results RT-qPCR and Western blotting confirmed successful construction of 1376 and UC-3 cell models with RBMX overexpression and knockdown.RBMX overexpression significantly inhibited the proliferation,clone formation,migration and invasion of bladder cancer cells,while RBMX knockdown produced the opposite effects.Western blotting results showed that RBMX overexpression increased the expression of PKM1 and decreased the expression of PKM2,while RBMX knockdown produced the opposite effects.Glucose consumption and lactate production levels were significantly lowered in the cells with RBMX overexpression(P<0.05)but increased significantly following RBMX knockdown(P<0.05).Conclusion RBMX overexpression inhibits bladder cancer progression and lowers glycolysis level in bladder cancer cells by downregulating PKM2 expression,suggesting the potential of RBMX as a molecular target for diagnosis and treatment of bladder cancer.

Objective:To explore the effectiveness of modified objective structured clinical examination (OSCE) for evaluating the core competencies of new nurses on standardized training in neurosurgery.Methods:Thirty-seven new nurses on standardized training in neurosurgery were evaluated using a modified OSCE protocol that was focused on core competencies required for clinical nursing practice on the basis of a clinical case library, which consisted of diagnostic assessment upon entrance, process teaching evaluation during training, and outcome assessment upon exit, at five OSCE stations (nursing assessment, skill practice, clinical thinking, health education, and humanistic care). SPSS 26.0 was used to perform the t-test and rank sum test. Results:The nurses highly recognized the effectiveness of modified OSCE and were largely satisfied with teaching. There were significant differences at entrance and exit in terms of the mean OSCE score ( t=24.21, P<0.001), independent learning ability ( t=10.29, P<0.001), and the scores of core competencies—good personal traits ( Z=5.24, P<0.001), clinical nursing ability ( Z=5.07, P<0.001), support and interpersonal communication ability ( Z=5.12, P<0.001), critical clinical thinking ability ( Z=5.17, P<0.001), professional construction and self-development ( Z=5.05, P<0.001), and the total score ( Z=5.27, P<0.001). Conclusions:The modified OSCE can comprehensively evaluate the core competencies of new nurses in neurosurgery standardized training, with good feasibility and effectiveness, which provides a reference for teaching management of standardized training programs.

Ischemic stroke is the main cause of death and disability in adults, and its incidence is increasing year by year. Obstructive sleep apnea (OSA) is the most common type of sleep-disordered breathing, which can increase the risk of ischemic stroke and affect the outcomes of patients. There is an increasing amount of research on the relationship between OSA and ischemic stroke. This article reviews the bidirectional relationship between OSA and ischemic stroke, the mechanism of OSA causing ischemic stroke, and the diagnosis and treatment of OSA in patients with ischemic stroke.

Carotid atherosclerosis is closely associated with ischemic stroke. Research shows that the rupture of vulnerable carotid plaque is an important reason for carotid atherosclerosis leading to thromboembolic events. Therefore, early identification of vulnerable carotid plaques is of great significance for the diagnosis, treatment, and prevention of ischemic stroke. This article reviews the pathophysiological features, imaging evaluation of carotid plaque and its relationship with ischemic stroke.

Objective:To explore the feasibility of applying an ArcCHECK detector to the dose verification for ultra-long target volumes of cervical cancer.Methods:This study retrospectively selected patients suffering from cervical cancer with ultra-long target volumes (lengths: ≥ 26 cm; 50 cases; the ultra-long target volume group) and conventional target volumes (lengths: < 26 cm; 50 cases; the conventional target volume group). Subsequently, this study designed treatment plans using the Volumetric Modulated Arc Therapy (VMAT) technique and then collected and verified doses using an ArcCHECK detector. The dose detection for the conventional target volume group was performed at the central point of the detector (marked by iso and Short-0 cm). Then, the detector was moved for 5 cm along the bed exit direction (marked by iso 1), followed by the dose verification of the ultra-long target volume group (marked by Long-5 cm) and conventional target volume group (marked by Short-5 cm). The geometric parameters (the length and volume of a target volume), mechanical parameters (machine hop count and the duration of irradiation), and gamma pass rates (GPRs) under different detection conditions of each group were analyzed.Results:The target lengths, target volumes, machine hop counts, and irradiation durations of the ultra-long target group were higher than those of the conventional target group ( t = 2.61-18.56, P < 0.05). For the conventional target group, the GPRs at iso 1 were significantly lower than those at iso ( t = 2.14-8.17, P < 0.05). Meanwhile, the GPRs at iso 1 of the ultra-long target volume group were significantly lower than those of the conventional target volume group ( t = -4.70 to -2.73, P < 0.01). The GPRs of each group met clinical requirements for criteria of both 3%/3 mm and 3%/2 mm. Conclusions:The deviation of the positioning center and the length of the target volume serve as primary factors affecting the dose verification result of cervical cancer. For ultra-long target volumes, dose verification can be performed by moving the positioning center, thus ensuring treatment accuracy for cervical cancer patients.

Objective:To explore the clinical characteristics and treatment strategies for Chlamydia psittaci pneumonia confirmed using metagenomic next-generation sequencing (mNGS). Methods:A total of 26 patients with Chlamydia psittaci pneumonia admitted to the Huizhou Municipal Central People′s Hospital and Huizhou First People′s Hospital from January 2020 to December 2021 were enrolled. The clinical data were collected, including basic information, clinical manifestations, laboratory examinations, chest computed tomography (CT) findings, mNGS results, treatment outcomes and prognosis. Results:Twenty (76.9%) of the 26 cases with Chlamydia psittaci pneumonia had a definite bird or poultry contact history. The onset season was mostly in winter (57.7%, 15/26). All 26 cases had symptoms of high fever, chill, fatigue, anorexia and cough, 21 cases (80.8%) had dyspnea, 19 cases (73.1%) had relative infrequent pulse, 12 cases (46.2%) had headache, myalgia, and seven cases (26.9%) had disturbance of consciousness. Among the 26 cases, the white blood cell count was normal in 17 cases (65.4%), and the lymphocyte count was decreased in 21 cases (80.8%). All 26 cases had increased hypersensitive C-reactive protein and procalcitonin. D-dimer was elevated in 24 cases (92.3%), aspartate aminotransferase was elevated in 18 cases (69.2%), and alanine aminotransferase was elevated in 15 cases (57.7%). Chest CT mainly showed lung consolidation, and 20 cases (76.9%) had multiple lobes of the lungs involved, 18 cases (69.2%) had the lower lobe of the lung as the main lesion. Among the results of mNGS of 26 cases, nine cases (34.6%) had only Chlamydia psittaci detected, and 17 cases (65.4%) had other pathogenic microorganisms detected. After targeted anti-infection treatment, two cases died of multiple organ failure and the remaining 24 patients recovered. Conclusions:The common manifestations of Chlamydia psittaci pneumonia are high fever, dyspnea, relative bradycardia, normal white blood cell count, and lung consolidation. mNGS is helpful for early diagnosis of disease, and appropriate treatment can improve the prognosis.

OBJECTIVE：To study the regulatory effects of stilbene glucosid e（TSG）on c-Jun N-terminal kinase （JNK）and protein phosphortase 2B（PP2B）in APP/PS1/Tau transgenic dementia （3×Tg-AD）mice，and to explore its potential mechanism of anti-Alzheimer’s disease （AD）. METHODS ：Totally 45 male 3×Tg-AD mice were randomly divided into model group ，positive control group （huperzine A ，0.15 mg/kg），TSG low-dose ，medium-dose and high-dose groups （0.033，0.1，0.3 g/kg），with 9 mice in each group. Another 9 normal male C 57BL/6J mice were included into normal control group. Administration groups were given relevant medicine intragastrically ，once a day ，for consecutive 60 d. Normal control group and model group were given constant volume of normal saline intragastrically. After medication ，Morris water maze experiment was used to test the spatial learning and memory ability of mice in each group ；Nissl staining was used to observe the changes of Nissl bodies in cerebral cortex and hippocampus ；mRNA and protein expressions of JNK and PP 2B were detected by qRT-PCR and Western blotting assay. RESULTS：Compared with normal control group ，the escape latency was significantly prolonged （P＜0.01），the retention time of the original platform quadrant was significantly shortened （P＜ and the times of crossing the platform was significantly reduced in model group （P＜0.01）；the number of Nissl bodies in cerebral cortex and hippocampus was significantly 729011126@qq.com reduced，the staining was slight ；the relative expressions of JNK mRNA and protein were significantly increased （P＜ 0.01），and the relative expressi ons of PP 2B mRNA and protein were significantly decreased （P＜0.01）. Compared with model group ，the escape latency was significantly shortened in positive control group and TSG groups （P＜0.01）；the retention time of the original platform quadrant was significantly prolonged （P＜0.01）；the times of crossing the platform was significantly increased （P＜0.01）；the number of Nissl bodies in cerebral cortex and hippocampus was increased significantly ，the staining was heavy ；the relative expression of JNK protein was significantly decreased（P＜0.05 or P＜0.01），the relative expressions of PP 2B mRNA and protein were significantly increased （P＜0.01）， while the relative expression of JNK mRNA was significantly decreased in TSG high-dose group （P＜0.05）. CONCLUSIONS ：TSG can improve the learning and memory ability and neuronal damage of 3 × Tg-AD mice. The mechanism may be related to down-regulating the transcription and expression of protein kinase JNK ，up-regulating the transcription and expression of protein phosphatase PP 2B.