Objective:To analyze the risk factors for postoperative cardiovascular events (PCE) after renal transplantation and their impact on transplant kidney function.Methods:The clinical data of 120 patients who underwent kidney transplant at Xuanwu Hospital, Capital Medical University from March 2020 to March 2022 were retrospectively analyzed. Among them, 23 cases occurred PCE (PCE group), and 97 cases did not occur PCE (non-PCE group). The relevant preoperative and postoperative data were recorded. Multivariate Logistic regression was used to analyze the independent risk factors of PCE in kidney transplant patients.Results:The incidence rate of PCE in kidney transplant patients was 19.17% (23/120). There were no statistical differences in the gender composition, preoperative dyslipidemia rate, preoperative hypertension rate and immunosuppressant use between two groups ( P>0.05); the age, preoperative body mass index>30 kg/m 2 rate, preoperative dialysis time>12 months rate, preoperative diabetes rate, preoperative cardiovascular disease rate, preoperative diabetic nephropathy rate, cadaver kidney transplant rate, postoperative dyslipidemia rate, postoperative serum creatinine >200 μmol/L rate, postoperative new-onset diabetes rate, postoperative delayed failure rate and postoperative acute reaction rate in PCE group were significantly higher than those in non-PCE group, and there were statistical differences ( P<0.01 or <0.05). Multivariate Logistic regression analysis showed that age, preoperative diabetes, preoperative cardiovascular disease, preoperative diabetic nephropathy, postoperative serum creatinine >200 μmol/L and postoperative acute reaction were independent risk factors of PCE in kidney transplant patients ( OR = 2.40, 3.42, 3.85, 1.98, 2.62 and 2.11; 95% CI 1.67 to 3.58, 1.61 to 7.05, 2.61 to 5.55, 1.05 to 3.85, 1.25 to 4.52 and 1.20 to 4.78; P<0.01 or <0.05). There was no statistically significant difference in serum creatinine 3 months after surgery between two groups ( P>0.05); the serum creatinine 6 and 12 months after surgery in PCE group was significantly higher than that in non-PCE group: (139.58 ± 31.54) μmol/L vs. (105.36 ± 21.05) μmol/L and (198.32 ± 40.12) μmol/L vs. (107.63 ± 24.64) μmol/L, and there were statistical differences ( P<0.01). Conclusions:The incidence of PCE in kidney transplant patients is higher, and there are many risk factors for PCE. If relevant measures are taken to correct or remove risk factors, it may reduce the incidence of PCE and prolong survival time in kidney transplant patients.

Objective:To study the biological traits and mutations of the influenza A (H3N2) virus in order to produce a vaccine and offer references for controlling and preventing influenza epidemics.Methods:Four strains of the influenza A(H3N2) virus were chosen from the Huai′an surveillance network laboratory. Nucleic acid extraction, library building, and sequencing (CridION x5 MKI Nanopore) were used to produce the whole-genome sequences. Using homologous alignments of whole-genome sequences, phylogenetic tree construction, and amino acid variant screening, bioinformatics analysis was carried out.Results:The nucleotide identity between 8 gene segments ranged from 97.1% to 100.0%. The gene that differed the most from the reference sequences was HA (97.1%-99.9%), and the gene that differed the least was MP (98.6%-99.9%). The HA gene (3.06%) and MP gene (1.43%) were the regions with the greatest and lowest frequencies of nucleotide site change, respectively. The rates of nucleotide change varied significantly between the genes ( χ2=14.293, P=0.046). Four influenza A(H3N2) virus strains′ whole-genome phylogenies from each of the eight gene segments maintained a roughly consistent topological structure. One strain was linked to the 3C.2a1b.1b clade, which was lost at the 142NWT, 149NGT(HA1), and 436NLS(NA). Three strains were linked to the 3C.2a1b.2a.1a clade lineage. Amantadine and NA inhibitors were effective against all Huai′an strains. Conclusions:The antigenicity of one strain of Huai'an strain changed and its matching with the vaccine strain of that year was low. It is suggested that the genetic surveillance of H3N2 influenza virus should be continuously strengthened to provide scientific basis for influenza prevention and control and influenza vaccine screening.

Objective By analyzing the characteristics of hidden poisoning homicide cases,provide scientific references for grass-roots forensic examination and toxicological screening and provide direction for the efficient discovery of hidden or missed cases of poisoning homicide in non-natural death cases.Methods Poisoning incidents in Hunan Province from 2018 to 2023 were retrospectively analyzed and compiled using Origin and EXCEL software.Results There were a total of 149 poisoning homicide cases,with 15 occurring in urban areas(accounting for 10.1%)and 134 in rural areas(accounting for 89.9%).Out of the 46 cases that led to casualties,rodenticide poisoning was the most prevalent(accounting for 52.2%),followed by cyanide(4.3%),nitrite(4.3%),thallium(2.2%),and other forms of poisoning.These incidents were primarily concentrated in urban areas.The main way of poisoning was to mix poisons into drinking water(accounting for 28.3%),meals(26.1%),and dark or heavy seasoning(8.7%).There was no significant disparity in the gender distribution of suspects,although the number of male victims was notably higher than that of female victims.The suspects were predominantly between the ages of 19 and 45,while the victims were mostly between the ages of 46 and 60.Among the 103 cases that did not result in injury or death,99%occurred in rural areas,with more than 95%of the involved poisons included pungent pesticides or herbicides,while rodenticides accounted for the least(1.9%).Conclusion There are obvious urban-rural differences in the case occurrence areas and types of involved poisons in poisoning homicide cases.Therefore,it is imperative to focus on both urban and rural areas during the investigation and evidence collection process in suspected poisoning cases.

Objective:To observe the occurrence of perioperative adverse events of carotid endarterectomy in patients with carotid artery stenosis, and analyze the influencing factors of perioperative adverse events.Methods:The clinical data of 120 carotid artery stenosis patients underwent carotid endarterectomy from October 2021 to October 2022 in Xuanwu Hospital, Capital Medical University were retrospectively analyzed. Among them, 42 patients experienced perioperative adverse events (adverse events group), and 78 patients did not experience perioperative adverse events (non-adverse events group). The baseline data, imaging findings, laboratory indexes, surgical indexes and postoperative complications were recorded. Multivariate Logistic regression was used to analyze the independent risk factors of perioperative adverse events of carotid endarterectomy in patients with carotid artery stenosis.Results:The rates of history of cerebrovascular disease, severe stenosis or occlusion of anterior cerebral artery, patch repair and plaque ulceration in adverse events group were significantly higher than those in non-adverse events group: 35.71% (15/42) vs. 15.38% (12/78), 52.38% (22/42) vs. 26.92% (21/78), 50.00% (21/42) vs. 20.51% (16/78) and 61.90% (26/42) vs. 24.36% (19/78), and there were statistical differences ( P<0.05 or <0.01). Multivariate Logistic regression analysis result showed that the severe stenosis or occlusion of anterior cerebral artery, patch repair and plaque ulceration were the independent risk factors of perioperative adverse events of carotid endarterectomy in patients with carotid artery stenosis ( OR = 2.874, 2.632 and 3.214; 95% CI 1.421 to 3.654, 1.748 to 3.287 and 2.101 to 4.697; P<0.05 or <0.01). Conclusions:The severe stenosis or occlusion of anterior cerebral artery, patch repair and plaque ulceration are the independent risk factors of perioperative adverse events of carotid endarterectomy in patients with carotid artery stenosis. Identifying and taking effective measures to prevent the perioperative adverse events can effectively reduce disability and mortality rates.

AIM: To investigate the effect of an effective component total sterone (TSR) of Echinops latifolius Tausch, the main component of a Chinese patent medicine Cuiru Keli (national drug standard WS3-413 (Z-085)-2003 (Z), on lactation and its possible mechanism. METHODS: After mating between male and female SD rats, 60 female rats were randomly divided into normal control group, model group, TSR low-dose and high-dose groups and prolactin granule positive control group, with 12 female rats in each group and 8 newborn rats in each nest. In addition to the normal control group, the rats in each group were intraperitoneally injected with levodopa 2 mg/kg once a day for 7 days from the second day of delivery. The rats in the normal control group were given normal saline by gavage once a day for 14 days. From the beginning of self-sufficiency, the single lactation of the female rats was measured every day until the 14th day, and then the female rats in each group were killed. Pathological HE staining was used to observe the morphological changes of mammary gland tissue in each group. ELISA was used to detect the levels of serum prolactin (PRL) and 5-hydroxytryptamine (5-HT). Immunohistochemistry was used to detect the distribution of PRL in mammary gland tissue of each group. Furthermore, Real-time qPCR was used to detect the expression of milk protein, milk fat related genes β-casein, FAS, ACC and the expression of canonical Wnt signaling pathway related genes β-catenin, c-Myc, CCND1, SFRP4, DNMT1, MeCP2 in mammary gland of each group. RESULTS: Both low and high dose TSR could significantly increase the single lactation volume, improve the pathological morphology of mammary gland, and increase the serum levels of PRL and 5-HT. TSR increased the distribution of PRL and up-regulated the expression of milk protein, milk fat related genes β-casein, FAS, ACC and canonical Wnt signaling pathway related genes β-catenin, c-Myc, CCND1, SFRP4, DNMT1, MeCP2.CONCLUSION: TSR can significantly promote lactation in lactation deficient rats, and its mechanism may be related to promoting the release of PRL and 5-HT in serum, increasing the distribution of PRL in mammary gland, up-regulating the milk protein and milk fat related genes and activating the canonical Wnt signal.

Objective:To verify the value of whole genomic copy number variation (WGCNV) detection and scoring system in the diagnosis and prognosis of lung adenocarcinoma.Methods:Seventy-six lung adenocarcinoma specimens including ninety-one tumor samples and twenty adjacent non-tumor lung tissue samples were collected using Laser capture microdissection (LCM). Whole genomic amplification (WGA) was used to enrich DNA and construct a sequencing library for next generation sequencing (NGS). Changes of larger than 5Mb CNV in this study were analyzed and scored. The nuclear grading and score of tumor cells in the surgery and pleural effusion cytology of lung adenocarcinoma specimens were evaluated separately. For each case, we evaluated (1) nuclear size, (2) mitotic counts, (3) nuclear atypia, (4) atypical mitoses. The data of disease-free survive (DFS) and overall survive (OS) were collected for assessing the prognostic value of WGCNV score. Meanwhile, receiver operating characteristic (ROC) and area under curve (AUC) were used to define a cut-off value and evaluate the diagnostic significance in lung adenocarcinoma.Results:The WGCNV scores of twenty adjacent non-tumor lung tissue samples were treated as normal control and all of WGCNV scores of tumor samples range from 0 to 9.95, the median score was 2.7. The WGCNV scores were divided into three groups: low score group <1.74, medium score grade 1.74~4.23, high score grade >4.23. The WGCNV score was positively associated with the nuclear grade scoring ( r=0.780 90, P<0.001). The result for evaluation of prognostic value of the WGCNV scores showed that comparing with low WGCNV score group, Hazard Ratio (HR) of medium score group was 4.11 (95% CI=0.72~23.57) and high score group was 2.07 (95% CI=0.30~14.12). These results suggested that the risks of the medium and high WGCNV score group elevated. According to the analysis results of ROC curve, when the cut off value was 0.01, the sensitivity and specificity for lung adenocarcinoma diagnosis were 97.8% and 95.0% respectively, the positive predictive value (PPV) and negative predictive value (NPV) were 99.0% and 90.1%, respectively, the AUC was 0.981. In the differentiation of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) group and invasive adenocarcinoma group, when the cut off value was 1.8, the sensitivity and specificity between the two groups were 78.1% and 94.4%, and the PPV and NPV were 98.0% and 52.0%, respectively, the AUC was 0.896. Conclusion:This study verifies that WGCNV scoring system has a potential diagnostic and prognostic value in lung adenocarcinoma.

Objective:To verify the value of whole genomic copy number variation (WGCNV) detection and scoring system in the diagnosis and prognosis of lung adenocarcinoma.Methods:Seventy-six lung adenocarcinoma specimens including ninety-one tumor samples and twenty adjacent non-tumor lung tissue samples were collected using Laser capture microdissection (LCM). Whole genomic amplification (WGA) was used to enrich DNA and construct a sequencing library for next generation sequencing (NGS). Changes of larger than 5Mb CNV in this study were analyzed and scored. The nuclear grading and score of tumor cells in the surgery and pleural effusion cytology of lung adenocarcinoma specimens were evaluated separately. For each case, we evaluated (1) nuclear size, (2) mitotic counts, (3) nuclear atypia, (4) atypical mitoses. The data of disease-free survive (DFS) and overall survive (OS) were collected for assessing the prognostic value of WGCNV score. Meanwhile, receiver operating characteristic (ROC) and area under curve (AUC) were used to define a cut-off value and evaluate the diagnostic significance in lung adenocarcinoma.Results:The WGCNV scores of twenty adjacent non-tumor lung tissue samples were treated as normal control and all of WGCNV scores of tumor samples range from 0 to 9.95, the median score was 2.7. The WGCNV scores were divided into three groups: low score group <1.74, medium score grade 1.74~4.23, high score grade >4.23. The WGCNV score was positively associated with the nuclear grade scoring ( r=0.780 90, P<0.001). The result for evaluation of prognostic value of the WGCNV scores showed that comparing with low WGCNV score group, Hazard Ratio (HR) of medium score group was 4.11 (95% CI=0.72~23.57) and high score group was 2.07 (95% CI=0.30~14.12). These results suggested that the risks of the medium and high WGCNV score group elevated. According to the analysis results of ROC curve, when the cut off value was 0.01, the sensitivity and specificity for lung adenocarcinoma diagnosis were 97.8% and 95.0% respectively, the positive predictive value (PPV) and negative predictive value (NPV) were 99.0% and 90.1%, respectively, the AUC was 0.981. In the differentiation of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) group and invasive adenocarcinoma group, when the cut off value was 1.8, the sensitivity and specificity between the two groups were 78.1% and 94.4%, and the PPV and NPV were 98.0% and 52.0%, respectively, the AUC was 0.896. Conclusion:This study verifies that WGCNV scoring system has a potential diagnostic and prognostic value in lung adenocarcinoma.

Objectives To investigate the ability of T1 mapping and intravoxel incoherent motion imaging (IVIM) parameters for evaluating renal allografts at the early stage after renal transplantation. Methods This prospective study protocol was approved by the local ethics committee, and written informed consent was obtained from all subjects. Sixty two recipients 2 to 4 weeks after kidney transplantation and 20 healthy volunteers (control group) underwent routine MRI, T1 mapping, and IVIM imaging (11 b values, 0 to 700 s/mm2). Recipients were divided into two groups base on their estimated glomerular filtration rate (eGFR):37 recipients with good allograft function (eGFR≥60 ml·min-1·1.73 m-2) and 25 recipients with impaired allograft function (eGFR<60 ml·min-1·1.73 m-2). The ADC, true diffusion coefficient (ADCslow), pseudo-diffusion coefficient (ADCfast), perfusion fraction (f) and T1 values were measured on both cortex and medulla. Differences among groups were compared using the one-way analysis of variance. Correlations between eGFR and the parameters in renal allografts were assessed by using Pearson correlation analysis. ROC was performed to assess the diagnostic utilities of using these parameters to discriminate allografts with impaired function from good function. Results Excepting for cortical T1, ADCfast and medullary T1, f values, allografts with good function showed no differences in other parameters compared with healthy control. Excepting for medullary T1 and ADCfast,the other values showed significantly differences in allografts with impaired function compared to allografts with good function (all P<0.05). Excepting for medullary f and ADCfast values, allografts with impaired function showed significantly differences in the parameters compared with good function group(all P<0.05). In renal allografts, excepting for medullary T1, ADCfast, and f values, cortical T1 exhibited a negative correlation with renal function, and there was a significant positive correlation between eGFR and other parameters. Cortical T1 value showed high sensitivity(91.9%) to discriminate renal allografts with different function, with the threshold of 17.36 × 102 ms, and ADC value showed high specificity(96.0%)with the threshold of 1.98 × 10-3 mm2/s. Conclusion T1 mapping and IVIM technique may be useful for detecting renal allograft dysfunction, and be a reliable imaging for evaluating and monitoring allograft function.

Objective To assess the value of arterial spin labeling(ASL) MRI in the staging of early renal allograft function. Methods Sixty two renal allograft recipients (2 to 4 weeks after kidney transplantation) and 20 age match volunteers were included in this study. All subjects underwent conventional MRI and ASL MRI which was performed in the oblique-sagittal plane. Recipients were divided into two groups according to the estimated glomerular filtration rate (eGFR), recipients with good allograft function (eGFR≥60 ml · min-1 · 1.73 m-2,n=37) and recipients with impaired allograft function (eGFR<60 ml · min - 1 · 1.73 m - 2,n=25). Renal blood flow (RBF) was measured and an intra-class correlation coefficient (ICC) was calculated to confirm the reproducibility of the measured results from two doctors. One-way analysis of variance (ANOVA) and Bonferroni were used to compare the different cortical RBF among three groups. Correlation of RBF with eGFR was evaluated using Pearson correlation coefficients. The receiver operating characteristic (ROC) curve was performed to assess the diagnostic efficacy of using cortical RBF to discriminate allografts with impaired function from good function. Results RBF values showed good reproducibility between doctors with an ICC larger than 0.90 in different group. Mean cortical RBF were (390 ± 61),(290 ± 69),(201 ± 86) ml · 100 g-1 · min-1 for healthy controls, recipients with good and impaired allograft function, respectively(F=37.313,P<0.01). RBF exhibited a significant correlation with renal function as determined by eGFR for recipients (r=0.60,P<0.01). Mean cortical RBF showed a high area under the ROC curve (0.773) to discriminate renal allografts with different function, with a sensitivity of 56.0% (14/25) and a specificity of 89.2% (33/37). Conclusion ASL MRI can assess the early renal allografts perfusion, and provide valuable information in the staging of renal function. It could be a useful method for evaluating renal function noninvasively.

[Objective] Preliminarily clear the effective substance of Fuzi in treatment of AA by comparing the NO, TNF-α and toe volume in AA rats affected by diester alkaloids,monoester alkaloids and non-ester alkaloids. [Methods]Male wistar rats were randomly divided into comparing group and model group. FCA was given in the left rear toe of rat in model group(once a day,0.1mL each). After 2 weeks ’injection, model rats were randomly divided into model group, diester alkaloids group, monoester alkaloids group and non-ester alkaloids group. Rats in comparing group and model group were given physiological saline and others were given corresponding alkaloids. Detect the NO,TNF-αand toe volume after 2 weeks. [Results]Compared with the model group, the weight gain of rats in other group was suppressed(P<0.05). Compared with the model group, the toe volume and the NO, TNF-αof rats in the alkaloids groups reduced significantly(P<0.01).The toe volume of rats in monoester alkaloids group reduced more obviously. The NO of rats in diester alkaloids group and non-ester alkaloids group reduced more significantly than the rats in monoester alkaloids group( P<0.05). [ Conclusion] The diester alkaloids, monoester alkaloids and non-ester alkaloids in Fuzi al have a significant effect on AA rats and the effect of the monoester alkaloids is the best.