Objective To explore the application value of emergency temporal body surface positioning for single drain dual-target thalamic hematoma ventricular drainage in the treatment of thalamic hemorrhage breaking into ventricle with hydrocephalus.Methods A retrospective analysis was conducted on 223 patients with thalamic hemorrhage breaking into the ventricles with hydrocephalus,including a study group of 115 cases who underwent emergency single drain dual-target thalamic hematoma ventricular drainage surgery with temporal body surface positioning,and a control group of 108 cases who underwent emergency ventricular drainage first and then underwent stereotactic thalamic hematoma drainage surgery after the condition stabilized.Compare the differences in postoperative complications and treatment outcomes between two groups of patients,and evaluate the application value of temporal surface positioning for single drain dual-target thalamic hematoma ventricular drainage surgery in the treatment of thalamic hemorrhage breaking into the ventricle with hydrocephalus.Results The postoperative rebleeding rates,hematoma clearance and death were 5.2％,87.5％±7.3％and 13.9％in the study group and 4.7％,90.2％±8.5％and 15.7％in control group,respectively.There was no significant difference between the two groups(P＞0.05).The tube time,postoperative intracranial infection,Shunt dependent hydrocephalus,effective treatment and favorable prognosis of and the control group were(75.5±18.4)h,3.5％,19.1％,53.9％and 51.3％in the study group and(130.8±22.9)h,13.9％,35.1％,38.7％and 38.0％,respectively.The difference between the two groups was statistically significant(P＜0.05).Conclusion Body surface landmark-guided emergency single drain dual-target thalamic hematoma ventricular drainage surgery for the treatment of thalamic hemorrhage breaking into the ventricle with hydrocephalus is safe and reliable,and can improve the patient's prognosis.

Background and aim:A genome-wide association study has indicated the association of numerous genes in the 6p21.3 region with chronic hepatitis B virus(HBV)infection.In this study,we screened 12 representative single-nucleotide polymorphisms(SNPs)from the 6p21.3 region and investigated their association with the risk of chronic hepatitis B(CHB)to better understand the molecular etiology un-derlying CHB risk in the Han Chinese population. Methods:Between March 2021 and November 2022,we included 183 patients with CHB(case group)and 196 with natural HBV clearance(control group).Allele typing of the selected SNPs was performed using snapshot technology.The correlation between the 12 chosen SNPs and the risk of chronic HBV infection was examined using binary logistic regression analysis.Interacting genes of the variants were identified,and expression quantitative trait loci(eQTL)were analyzed using the 3DSNP database. Results:We validated 12 previously reported CHB susceptibility sites,including rs1419881 of tran-scription factor 19(TCF19),rs3130542 and rs2853953 of human leukocyte antigen(HLA)-C,rs652888 of euchromatic histone-lysine-methyltransferase 2(EHMT2),rs2856718,rs9276370,rs7756516,and rs7453920 of HLA-DQ,rs378352 of HLA-DOA,and rs3077,rs9277535,and rs9366816 of HLA-DP.Logistic regression analyses revealed that polymorphisms such as rs9276370,rs7756516,rs7453920,rs3077,rs9277535,and rs9366816 were positively correlated with natural HBV clearance in the dominant model.Conversely,rs3130542 and rs378352 were identified as risk factors for CHB.Haplotype analysis revealed that rs9276370,rs7756516,and rs7453920 in HLA-DQ were TTG and GCA haplotypes.Although the TTG haplotype was positively correlated with a higher risk of CHB,the GCA haplotype significantly influenced the natural clearance of HBV.Bioinformatics analysis demonstrated that rs378352,rs3077,and rs9366816 were located within enhancer states;rs3077 and rs9366816 overlapped with nine tran-scription factor-binding sites,whereas rs378352 altered five sequence motifs.Furthermore,eQTL analysis demonstrated the functional tendencies of eight statistically significant SNPs(rs3130542,rs9276370,rs7756516,rs7453920,rs378352,rs3077,rs9277535,and rs9366816). Conclusions:Genetic variations within the 6p21.3 region were associated with chronic HBV infection in the Han Chinese population in southern China.Furthermore,the GCA haplotype including rs9276370,rs7756516,and rs7453920 of HLA-DQ contributed significantly to natural HBV clearance,implying that multiple SNPs exert a cumulative allelic effect on HBV infection.

Objective:To explore any effect of standing balance dynamic lifting training on balance, motor functioning and the life quality of hemiplegic stroke survivors.Methods:Eighty stroke survivors were randomly divided into a control group and an experimental group, each of 40. Both groups received routine rehabilitation training, while the experimental group additionally underwent standing balance dynamic lifting training. Before the intervention, and 2 and 4 weeks later, everyone′s balance and motor functioning were evaluated using the Brunel balance assessment (BBA) and the timed " up and go" test (TUGT). Life quality was quantified using the stroke special quality of life scale (SS-QOL).Results:Significant improvement in the average walking function score, BBA total score and TUGT time was observed in both groups, with significantly greater improvement after 4 weeks than after two. The improvements in the experimental group were significantly greater than in the control group. After 4 weeks the average total SS-QOL score and the scores on all of its dimensions had increased significantly in the experimental group. The scores for energy, language, motor function, emotions, self-care ability, upper limb function and the average SS-QOL total score were all then significantly better in the experimental group.Conclusions:Standing balance dynamic lifting training can effectively improve the balance, motor function and life quality of stroke survivors with hemiplegia.

Objective:Investigate the characteristics of hospitalized patients infected with parvovirus B19 (B19V) and the potential impact of B19V on disease progression and clinical outcomes in patients.Methods:The subjects of this observational retrospective study were 62 hospitalized patients who tested positive for B19V among 3 129 inpatients who visited Peking University People′s Hospital between April 1, 2022, and August 31, 2023, and underwent metagenomic next-generation sequencing (mNGS) for pathogens. Patient data regarding pathogen detection, clinical characteristics, and outcomes were collected, along with other laboratory test results, to assess hospitalization duration, incidence of mixed infections during hospitalization, and clinical outcomes within 30 days. The chi-square test was utilized to analyze differences in patient mortality rates and other relevant factors.Results:B19V infection waspobserved in patients with hematological disorders and solid organ transplant recipients (79.03%, 49/62). Additionally, B19V frequently coexists with other pathogens (40/62), with the highest rates of mixed infections involving human herpesvirus 6, cytomegalovirus, and Epstein-Barr virus, having 20, 9, and 8 cases respectively. The most common site of B19V detection is peripheral blood (χ 2=0.000 3, P<0.001), although it can also be detected in other bodily fluid samples. The 30 day mortality rate among B19V infected patients was 19.35% (12/62) 10 out of 12 deceased patients had concurrent mixed infections with other pathogens. Moreover, patients with mixed B19V infections exhibited a higher mortality rate compared to those with B19V infection alone (χ 2=4.546, P=0.033). Comparative analysis of 24 patients who underwent multiple mNGS tests revealed that patients with chronic B19V infection (12 cases) had a higher mortality rate compared to those with transient B19V infection (12 cases) (χ 2=12, P<0.001). Conclusions:Parvovirus B19 (B19V) infection is more commonly observed in patients with hematological disorders and solid organ transplant recipients, often coexisting with other pathogens. The mortality rate within 30 days of B19V infection is elevated, particularly when accompanied by concurrent mixed infections with other pathogens. Moreover, patients with chronic and persistent B19V infection face an increased risk of mortality.

【Objective】 To explore the causes and management of nephrostomy catheter following percutaneous nephrostolithotomy (PCNL) entering the inferior vena cava. 【Methods】 A retrospective analysis was performed on the management of two cases of nephrostomy catheter entering the inferior vena cava. The causes, changes of minimally invasive treatment and prevention plans were discussed. 【Results】 Two patients underwent digital subtraction angiography (DSA) to restore the nephrostomy tube to the renal pelvis collecting system. No renal vein rupture or bleeding occurred during the operation, and the patients’ vital signs were stable. Nephrostomy tube was removed successfully after operation. The wound healing was good, and there was no secondary hemorrhage such as perirenal hematoma. The prognosis was good. 【Conclusion】 Although intravenous nephrostomy tube misplacement is an uncommon PCNL complication, the consequences are serous. One-step retraction displacement of nephrostomy tube to the renal collecting system can effectively manage nephrostomy catheter entering the inferior vena cava.

Objective:To investigate the expression and clinical significance of cAMP response element-binding protein 3-like 1 (CREB3L1) in gastric cancer.Methods:A total of 97 patients who received surgical resection of gastric cancer in Lanzhou University Second Hospital from Jan. 2019 to Dec. 2020 were selected as the study subjects. Immunohistochemistry was used to detect the expression level of CREB3L1 in gastric cancer tissues and matched paracancer tissues. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expression level of CREB3L1 in gastric cancer and adjacent tissues. Statistical methods were used to analyze the relationship between the expression level of CREB3L1 in gastric cancer tissues and the degree of differentiation of tumor cells, tumor size, depth of invasion, TNM staging and other clinicopathological data, and Logistic regression analysis was used to study the risk factors of gastric cancer. To explore the clinical significance of CREB3L1 expression level in gastric cancer.Results:Immunohistochemical results showed that CREB3L1 protein was mainly expressed in the nucleus. The positive rate in gastric cancer tissues was 17.5% (17 cases), which was lower than that in normal adjacent tissues 84.5% (82 cases), and the difference was statistically significant ( χ2=87.15, P<0.001). qRT-PCR was used to detect the expression of CREB3L1 in gastric cancer and adjacent tissues. The results showed that the expression level of CREB3L1 was significantly higher in adjacent tissues than in cancer cells. The results were statistically significant ( P<0.05). The positive expression rate of CREB3L1 was decreased in the cancer tissues of gastric cancer patients, and its expression level was correlated with the degree of tumor differentiation, tumor size, invasion depth and TNM stage ( P<0.05), but not with Lauren classification and tumor location ( P>0.05). Logistic regression analysis showed that the positive expression level of CREB3L1 was correlated with the degree of tumor differentiation in gastric cancer patients ( P<0.05). Conclusion:The expression of CREB3L1 is decreased in gastric cancer, which is related to the degree of tumor differentiation, tumor size, invasion depth and TNM stage, which is of great value in early and accurate diagnosis of benign and malignant gastric cancer.

Using chemoproteomic techniques, we first identified EIF2AK2, eEF1A1, PRDX3 and VPS4B as direct targets of berberine (BBR) for its synergistically anti-inflammatory effects. Of them, BBR has the strongest affinity with EIF2AK2 via two ionic bonds, and regulates several key inflammatory pathways through EIF2AK2, indicating the dominant role of EIF2AK2. Also, BBR could subtly inhibit the dimerization of EIF2AK2, rather than its enzyme activity, to selectively modulate its downstream pathways including JNK, NF-κB, AKT and NLRP3, with an advantage of good safety profile. In EIF2AK2 gene knockdown mice, the inhibitory IL-1β, IL-6, IL-18 and TNF-α secretion of BBR was obviously attenuated, confirming an EIF2AK2-dependent anti-inflammatory efficacy. The results highlight the BBR's network mechanism on anti-inflammatory effects in which EIF2AK2 is a key target, and inhibition of EIF2AK2 dimerization has a potential to be a therapeutic strategy against inflammation-related disorders.

Objective To explore the effect of eversion carotid endarterectomy(eCEA)on the cog-nitive function in elderly carotid artery stenosis patients with different ages.Methods A total of 56 elderly patients undergoing eCEA in Department of Vascular Surgery of No.920 Hospital of Joint Logistics Support Force from May 2019 to May 2022 were enrolled and divided into a 60-69 year old group(31 cases)and a 70-80 year old group(25 cases).Mini-mental state examination(MMSE)Scale was used to analyze the patients within 1 week before surgery and 1 and 6 months after surgery.Results In the 60-69 years old group,their MMSE scores in 1 and 6 months after surgery were significantly higher than those before surgery(24.71±3.67 vs 23.52±3.70,P＜0.05;25.48±3.19 vs 23.52±3.70,P＜0.01).For the 70-80 year old group,the MMSE score in 6 months after surgery was obviously higher than that before surgery and that in 1 month after sur-gery(25.44±3.42 vs 23.76±3.81,P＜0.01;25.44±3.42 vs 23.90±3.65,P＜0.01).The improve-ment of MMSE score between 1 month after surgery and before surgery was notably more obvi-ous in the 60-69 year old group than the 70-80 year old group,but the improvement between 6 months and 1 month after surgery was statistically declined in the 60-69 year old group than the 70-80 year old group(P＜0.05).Conclusion eCEA can significantly improve cognitive function in elderly patients with carotid artery stenosis,and obvious efficacy is observed in the early stage in the 60-69 years old patients.

Objective:To investigate the mechanism of Mycobacterium tuberculosis ( Mtb) WhiB2 in the pathogenesis of tuberculosis. Methods:A recombinant vector of pET28a-WhiB2 for heterogeneous expression of WhiB2 was constructed. The target protein WhiB2 and the inclusion bodies were purified. The differences between denatured and non-denatured WhiB2 were analyzed by circular dichroism and nuclear magnetic resonance. Ferrous ion (Fe 2+ ) was used to restore the iron-sulfur cluster of WhiB2. The interaction between WhiB2 and the upstream promoter sequence of the WhiBMtb gene was analyzed by nuclear magnetic resonance. The tertiary structure of WhiB2 and interacting proteins were analyzed and protein structure alignment was performed based on bioinformatics. Results:The structure of the renatured WhiB2 was basically the same as that of the non-denatuous WhiB2. In addition, Fe 2+ could restore the iron-sulfur cluster of WhiB2. It was found that WhiB2 could bind to the upstream promoter sequence of the WhiBMtb/WhiB2Ms gene. Conclusions:Mtb WhiB2 played a key role in the pathogenesis of tuberculosis, which would contribute to future exploration of novel targets against Mtb.

Objective:To evaluate the auxiliary role of the Python-based handover database in online teaching activities for medical clerks and to complete the teaching tasks during the COVID-19 epidemic.Method:Sixteen teachers were randomized into two groups, experimental group and control group, with 8 ones in each group. The experimental group used the self-built handover database, while the control group used the hospital's HIS system. To make multimedia courseware for medical students, suitable cases were screened. The time to acquire cases and picture data, and the index like numbers were statistically analyzed, and the quality of multimedia courseware was scored. All the data were analyzed by SPSS 25.0 statistical software.Results:The time for the two groups of teachers to acquire target cases during making multimedia coursewares were (8.88±3.48) min and (43.50±5.26) min respectively; the time to obtain the pictures were (5.62±1.92) min and (30.25±5.39) min; the numbers of obtained pictures were (11.12±2.17) and (6.12±2.80); and the scores of coursewares were (92.62 ± 4.93) points and (84.75 ± 6.20) points respectively, all with significant differences.Conclusion:The application of the self-made handover database can significantly improve the speed of teachers' access to related teaching data, and also can improve the quality of multimedia courseware.