Objective:To explore the factors influencing prognosis of patients with in-hospital cardiac arrest (IHCA).Methods:A retrospective observational study was conducted. The clinical data of patients who developed IHCA and underwent cardiopulmonary resuscitation (CPR) at the Second Xiangya Hospital of Central South University from January 1, 2016, to December 31, 2022 were analyzed. The patients' information, including gender, age, medical history, pre-cardiac arrest related parameters [1-hour pre-cardiac arrest neurological function, 24-hour pre-cardiac arrest hemoglobin (Hb) levels, 1-hour pre-cardiac arrest vital signs], initial CPR-related factors (implementation time and location, initial rhythm, ventilation method, defibrillation and resuscitation drugs) as well as restoration of spontaneous circulation (ROSC) related parameters (vital signs at ROSC and 1 hour after ROSC, 24-hour post-cardiac arrest Hb, and IHCA events), were collected through the hospital's electronic medical record system. The clinical data were compared between ROSC and non-ROSC patients as well as between patients with favorable neurological function [cerebral performance category (CPC) grades 1-2] and unfavorable neurological function (CPC grades 3-5) at 28 days. The factors with statistical significance in univariate analysis and clinical significance were enrolled in a binary multivariate Logistic regression model to analyze the influencing factors of ROSC and neurological function at 28 days after ROSC. The predictive value of factors influencing neurological function at 28 days was assessed using receiver operator characteristic curve (ROC curve).Results:A total of 277 IHCA-CPR patients were enrolled, of which 230 achieved ROSC (83.0%) and 47 were not achieved (17.0%). Compared with non-ROSC patients, ROSC patients had lower prevalence of cerebrovascular disease history and proportion of adrenaline usage, but a higher proportion of initial shockable rhythms. In the multivariate Logistic regression analysis, it was found that using a bag-mask ventilation+endotracheal intubation (compared with a bag-mask ventilation alone) was beneficial for achieving ROSC in IHCA-CPR patients [odds ratio ( OR) = 2.895, 95% confidence interval (95% CI) was 1.204-6.962, P = 0.018], while a initial non-shockable rhythm was not conducive to achieving ROSC in IHCA-CPR patients ( OR = 0.349, 95% CI was 0.147-0.831, P = 0.017). Among the 230 ROSC patients, 42 had good neurological function at 28 days (18.3%), and 188 had poor neurological function (81.7%). Compared with the patients with good neurological function, the patients with the poor neurological function were older and had a higher prevalence of 1-hour pre-cardiac arrest neurological dysfunction and low perfusion, initial non-shockable rhythms, endotracheal intubation, and usage of adrenaline, vasopressors and sodium bicarbonate, a lower proportion of defibrillation and antiarrhythmic medication usage as well as lower 24-hour post-cardiac arrest Hb levels. The multivariate Logistic regression analysis revealed that female ( OR = 6.449, 95% CI was 1.837-22.642, P = 0.004), older age ( OR = 1.054, 95% CI was 1.017-1.093, P = 0.004), 1-hour pre-cardiac arrest neurological dysfunction ( OR = 25.044, 95% CI was 2.737-229.169, P = 0.004), 1-hour pre-cardiac arrest low perfusion ( OR = 3.880, 95% CI was 1.306-11.524, P = 0.028), endotracheal intubation (compared with a bag-mask ventilation; OR = 8.712, 95% CI was 1.402-54.141, P = 0.020) and face mask+endotracheal intubation during CPR (compared with a bag-mask ventilation; OR = 11.089, 95% CI was 3.482-35.320, P = 0.000), IHCA events > 1 time ( OR = 4.221, 95% CI was 1.249-14.226, P = 0.020) were positively associated with poor neurological function at 28 days, which were independent risk factors those were not conducive to 28-day neurological function recovery after ROSC in IHCA-CPR patients. In contrast, usage of antiarrhythmic medication ( OR = 0.345, 95% CI was 0.134-0.890, P = 0.028) and 24-hour post-cardiac arrest Hb ( OR = 0.983, 95% CI was 0.966-0.999, P = 0.043) were negatively associated with poor neurological function at 28 days, which were protective factors those were beneficial for the recovery of neurological function. ROC curve analysis showed that the area under the ROC curve (AUC) of 24-hour post-cardiac arrest Hb for predicting poor neurological function at 28 days after ROSC in IHCA-CPR patients was 0.659 (95% CI was 0.577-0.742), with a cut-off value of 99.5 g/L (sensitivity was 76.2%, specificity was 57.8%). Conclusions:Defibrillation and tracheal intubation during CPR are crucial for IHCA patients. It was also observed that patients with low Hb (< 99.5 g/L should be of high concern), older age, 1-hour pre-cardiac arrest neurological function and hypoperfusion, and IHCA events > 1 time were significantly related to unfavorable neurological outcome in adult resuscitated patients with IHCA.

OBJECTIVE: To present on a prenatally diagnosed case with complex structural rearrangements of chromosome 8. METHODS: Chromosome karyotyping, chromosomal microarray analysis (CMA) and fluorescence in situ hybridization (FISH) were carried out for a fetus with increased nuchal thickness. RESULTS: The karyotype of the amniotic fluid sample showed extra materials on 8p. FISH revealed a centromeric signal at the terminal of 8p with absence of telomeric signal. CMA revealed partial deletion of 8p23.3 [(208049_2256732)×1], partial duplication of 8p23.3p23.2 [(2259519_3016818)×3], and partial duplication of 8q [8q11.1q12.2(45951900_60989083)×3]. CONCLUSION The complex structural rearrangements of chromosome 8 in this case has differed from the commonly seen inv dup del(8p).
Female ; Pregnancy ; Humans ; Chromosomes, Human, Pair 8/genetics* ; In Situ Hybridization, Fluorescence ; Gene Rearrangement ; Prenatal Diagnosis ; Centromere

OBJECTIVE: To report on a case of mosaicism 13q inversion duplication, analyze its mechanism, and discuss the correlation between its genotype and phenotype. METHODS: Amniotic fluid and umbilical cord blood were collected at 23 and 32 weeks of gestation, respectively. Combined with G-banding chromosome karyotyping analysis, single nucleotide polymorphism array (SNP-array) and fluorescence in situ hybridization (FISH) were used to confirm the result. RESULTS: The karyotype of the fetus was determined as 47,XY,+inv dup(13)(q14.3q34)/46,XY. After careful counseling, the couple decided to continue with the pregnancy, and had given birth to a boy at 40 weeks' gestation. Except for a red plaque (hemangioma) on the nose bridge, no obvious abnormality (intelligence to be evaluated) was discovered. CONCLUSION To provide reference for clinical genetic counseling and risk assessment, the location and proportion of new centromere formation should be fully considered in the case of mosaicism 13q inversion duplication.
Amniocentesis ; Chromosome Inversion/genetics* ; Comparative Genomic Hybridization ; Female ; Fetus ; Humans ; In Situ Hybridization, Fluorescence ; Male ; Mosaicism ; Pregnancy ; Prenatal Diagnosis

Objective:To explore the effect of a new teaching mode, which includes bridge-in, outcome, pre-test, participation, post-test and summary (BOPPPS), on the online teaching of radiobiology related knowledge for cancer radiotherapy practitioners.Methods:Taking the cell survival curve, cell cycle and radiosensitivity as examples, the radiotherapy practitioners in multiple university-affiliated hospitals were organized to carry out a multicenter prospective randomized control study. All practitioners were randomly divided into BOPPPS group and control group. The courses for BOPPPS group were designed as an online classroom, consisting of pre-class preparation, online teaching and post-class stages. The online teaching stage included video viewing, basic knowledge learning, literature discussion, group discussion and others. The control group employed the traditional teaching mode. The χ2 test was used to compare the consistency of general conditions between the two groups, and nonparametric test was used to compare the differences in scores between two or more groups. Results:The score of the pre-class test was 58.56 ± 0.99. Post-class average score for BOPPPS group was 85.48±0.85 and for control group 77.79±1.10, with the former being higher 7.69 ( Z=5.31, P<0.001) than the latter. The average answer time was (296.62±15.40) s for BOPPPS group and (386.41±21.27) s for control group, with the former being shorter 89.79 s ( Z=3.34, P=0.001) than latter. Subgroup analysis shown that the scores of BOPPPS group were significantly rising, regardless of whether or not the students had studied radiobiology courses. Among the students who have not studied these courses, the scores were rising greatly. Moreover, From the analysis of different positions, it was found that both the scores of BOPPPS group and control group have risen, especially for doctors, deputy chief doctors, physicists and technicians. There were also statistically differences between different degrees, with significantly rise in scores for undergraduate and doctoral students ( Z=3.64, 4.18, P<0.001). Conclusions:The flexible application of BOPPPS teaching mode to the online education of such boring disciplines, like radiobiology, is of great significance to raise the theoretical basis of radiotherapy practitioners.

OBJECTIVE: To analyze the prenatal diagnosis procedure for a 45,X male fetus. METHODS: A 31-year-old women underwent amniocentesis due to a moderate risk of trisomy 21. The fetal cells were subjected to chromosomal karyotyping, BACs-on-Beads (BoBs) assay, chromosomal microarray analysis and fluorescence in situ hybridization. RESULTS: Combined analyses revealed that the whole of Yp has translocated to 21p, which yielded a fetal karyotype of 45,X,dic(Y;21)(q11;p11).ishdic(Y;21)(SRY+,CEPY+;CEP21+). CONCLUSION BoBs and modified N-banding method are helpful for the diagnosis of 45,X male fetus with Yp translocation.

Background: Endoscopic screening is an effective approach for detecting early gastric cancer. The interval of endoscopic surveillance should be defined based on the risk stratification of gastric cancer, so as to improve the screening efficiency. Aims: To investigate whether gastric cancer risk could be stratified according to endoscopic atrophic gastritis grading. Methods: Subjects who underwent gastroscopy at least two times between Jan. 2015 and Dec. 2019 at the 900th Hospital of Joint Logistics Support Force, PLA were enrolled in a retrospective study. The demographic data and information on endoscopy were recorded. The extent and degree of gastric atrophy under endoscopy was graded using Kimura-Takemoto classification system. Then the subjects were allocated into mild group (none atrophy and C-1), moderate group (C-2 and C-3) and severe group (O-1, O-2 and O-3) based on the grading. The correlation of endoscopic grading of atrophy with the risk of gastric cancer was analyzed. Results: A total of 8 736 subjects were enrolled, 4 154 were in mild group (47.6%), 2 409 in moderate group (27.6%), and 2 173 in severe group (24.9%). The mean endoscopic follow-up time was (1 052±643) d, and the mean endoscopic surveillance interval was (518±271) d. The overall coincidence rate of endoscopic diagnosis and pathological diagnosis for atrophy was 88.9%. During the follow-up period, gastric cancer was detected in 41 cases; the detection rates of mild group, moderate group and severe group were 0.07%, 0.54% and 1.15%, respectively (P<0.001). Conclusions: The risk of gastric cancer can be stratified according to the endoscopic atrophic gastritis grading, which is helpful for the decision of individualized endoscopic surveillance interval.

Accurate identification of compound-protein interactions (CPIs) in silico may deepen our understanding of the underlying mechanisms of drug action and thus remarkably facilitate drug discovery and development. Conventional similarity-or docking-based computational methods for predicting CPIs rarely exploit latent features from currently available large-scale unlabeled com-pound and protein data and often limit their usage to relatively small-scale datasets. In the present study, we propose DeepCPI, a novel general and scalable computational framework that combines effective feature embedding (a technique of representation learning) with powerful deep learning methods to accurately predict CPIs at a large scale. DeepCPI automatically learns the implicit yet expressive low-dimensional features of compounds and proteins from a massive amount of unla-beled data. Evaluations of the measured CPIs in large-scale databases, such as ChEMBL and Bind-ingDB, as well as of the known drug-target interactions from DrugBank, demonstrated the superior predictive performance of DeepCPI. Furthermore, several interactions among small-molecule compounds and three G protein-coupled receptor targets (glucagon-like peptide-1 recep-tor, glucagon receptor, and vasoactive intestinal peptide receptor) predicted using DeepCPI were experimentally validated. The present study suggests that DeepCPI is a useful and powerful tool for drug discovery and repositioning. The source code of DeepCPI can be downloaded from https://github.com/FangpingWan/DeepCPI.

Objective To study and analyze the effects of vertebral basilar artery stenosis on posterior circulation cerebral infarction (CI) and prognosis of the patients.Methods A total of 150 patients with vertebral basilar artery stenosis were selected as the research subjects and divided into the non plaque group (n=36),the stable plaque group (n=62) and the unstable plaque group (n=52) according to results of CT angiography.The incidence of posterior circulation CI,the National Institutes of Health Stroke Scale (NIHSS) score,the Barthel index score,the European version of neurological deficit scale (ESS) score,the Mini Mental State Examination (MMSE) score on admission were observed and compared between two groups.The patients with CI were followed for 2 years,the recurrence rate in the follow-up period of CI patients was observed and compared.Results The constituent ratio of the patients with posterior circulation CI in the unstable plaque group was significantly higher than that in the non plaque group or the stable plaque group (P<0.05).The NHISS score of the patients in the unstable plaque group was significantly higher than that in the non plaque group or the stable plaque group,while MMSE score,Barthel score,ESS score were significantly lower than those in the non plaque group and the stable plaque group (P<0.05).The recurrence rate of the CI in the unstable plaque was higher than that in the non plaque group or the stable plaque group (P<0.05).Conclusion The quality of vertebral basilar artery plaque is correlated with the patient''s condition,the incidence of CI and the prognosis of patients.

Objective To observe and analyze the risk factors of early vascular cognitive impairment (VCI) after ischemic stroke (IS).Methods A total of 200 IS patients were selected.The patients were divided into the VCI group (n=84) and the non VCI group (n=116) according to whether complicated with VCI in the early period, and they were also divided into the stress hyperglycemia group (n=43) and the non stress hyperglycemia group (n=66) according to whether complicated with stress hyperglycemia in acute period.The age, the gender, the education level, the smoking history, the drinking history, the hypertension condition, the dyslipidemia condition, the diabetes condition, the coronary heart disease condition, the atrial fibrillation condition, the plasma homocysteine (Hcy) level, the serum high sensitive C reactive protein (hs-CRP) level and the National Institute of Health stroke scale (NIHSS) score of the all the patients were observed and analysis.Results There were significant differences in the gender, the education level, the smoking history, the drinking history, the hypertension condition, the dyslipidemia condition, the diabetes condition, the coronary heart disease condition, the atrial fibrillation condition, the plasma Hcy level, the serum hs-CRP level and the NIHSS score between the VCI group and the non VCI group (P<0.05).The NIHSS score and the incidence rate of VCI in the patients in the stress hyperglycemia group were significantly higher than those in the non stress hyperglycemia group, and the MoCA score was significantly lower than that in the non stress hyperglycemia group (P<0.05).Logistic regression analysis results showed the incidence of VCI in the early period of IS was correlated with diabetes, the hypertension, the plasma Hcy level and the serum hs-CRP level (P<0.05).Conclusion The incidence of VCI in the early period of IS is correlated with diabetes, the hypertension, the plasma Hcy level and the serum hs-CRP level.

Objective To study and analyze the effects of vertebral basilar artery stenosis on posterior circulation cerebral infarction (CI) and prognosis of the patients.Methods A total of 150 patients with vertebral basilar artery stenosis were selected as the research subjects and divided into the non plaque group (n=36),the stable plaque group (n=62) and the unstable plaque group (n=52) according to results of CT angiography.The incidence of posterior circulation CI,the National Institutes of Health Stroke Scale (NIHSS) score,the Barthel index score,the European version of neurological deficit scale (ESS) score,the Mini Mental State Examination (MMSE) score on admission were observed and compared between two groups.The patients with CI were followed for 2 years,the recurrence rate in the follow-up period of CI patients was observed and compared.Results The constituent ratio of the patients with posterior circulation CI in the unstable plaque group was significantly higher than that in the non plaque group or the stable plaque group (P<0.05).The NHISS score of the patients in the unstable plaque group was significantly higher than that in the non plaque group or the stable plaque group,while MMSE score,Barthel score,ESS score were significantly lower than those in the non plaque group and the stable plaque group (P<0.05).The recurrence rate of the CI in the unstable plaque was higher than that in the non plaque group or the stable plaque group (P<0.05).Conclusion The quality of vertebral basilar artery plaque is correlated with the patient''s condition,the incidence of CI and the prognosis of patients.