Objective To study the relationship between economic level and cognitive level of the elderly, and to test the mediating effect of social participation between the two. Methods SPSS 26.0 was used for data processing. Ordinary least squares (OLS) linear regression was used to analyze the relationship between economic level, social participation and cognitive level. The mediation effect test was used to test the mediating effect of social participation between economic level and cognitive level. Results In the OLS regression model, model 2 showed that the estimation of economic level was 0.000 003 52, model 3 showed that the estimation of social participation was -0.316 907 5, and model 4 showed that the economic level was -0.000 003 39, all of which were significant at the level of 1%. The mediating effect size of social participation was 0.298 295 45, and the robustness test showed that the correlation coefficient between economic level and cognitive level orientation was 0.000 002 15, which was highly significant at the 1% level. Conclusion There is a positive correlation between the economic level and cognitive level of the elderly, and there is a positive correlation between the social participation and cognitive level of the elderly. The economic level of the elderly improves their cognitive level through the mediating effect of social participation, and the impact effect of social participation is 29.83%.

Maintaining the homeostasis of gut microbes is essential for the maintenance of human health.The evolution of the human gut microbiota is involved in many physiological functions.Besides，changes in gut flora can be traced back to early life.The prevalence of malnutrition in infants and young children is persistently high，especially in low-and middle-income countries.More and more researches have confirmed that the immature development of intestinal microbiota and abnormal metabolites are related to malnutrition.Due to nutritional diet is the most important factor affecting the microbiota，studies have begun to assess the therapeutic potential of microbiota oriented food interventions in improving infant and young child malnutrition.Therefore，this review summarizes the latest advances in the field and recommend further progress towards finding new treatments for the malnutrition of infant and young child.

Objective:To investigate the effectiveness and feasibility of whole exome sequencing (WES), as a molecular diagnosis technique, for adult patients with genetic diseases.Methods:The present retrospective analysis included 445 adult patients (ages 18-80 years) with suspected genetic diseases who underwent whole exome sequencing (WES) from August 2021 to December 2022. The pathogenicity classification of each variant was assessed in accordance with the recommendations developed by the American Society of Medical Genetics and Genomics.Results:The overall positive rate of WES among adult patients with suspected genetic diseases was 28.08% (125/445). The highest positive rate was observed in the age group of 41-50 years (34.33%, 23/67). Among the diagnosed genetic diseases, those affecting the cardiovascular system (63.16%, 84/133), nervous system (18.05%, 24/133), and endocrine system (13.53%, 18/133) ranked as the top three. The most common genetic diseases identified through WES in adult patients were hypertrophic cardiomyopathy (18.80%, 25/133), dilated cardiomyopathy (16.54%, 22/133), Marfan syndrome (15.04%, 20/133), epilepsy (9.02%, 12/133), and familial hypercholesterolemia (4.51%, 6/133). The main causative genes identified included FBN1 (14.29%, 19/133), MYBPC3 (9.02%, 12/133), MYH7 (9.02%, 12/133), LDLR (3.76%, 5/133), TTN (3.76%, 5/133), and TNNI3 (3.01%, 4/133).Conclusion:Applying the WES technique in clinical practice can improve the diagnostic rate of adult genetic diseases, especially in adult patients with suspected genetic conditions involving the cardiovascular system, nervous system, and endocrine system.

The effect of anti-programmed cell death 1 (anti-PD-1) immunotherapy is limited in patients with hepatocellular carcinoma (HCC). Yes-associated protein 1 (YAP1) expression increased in liver tumor cells in early HCC, and Akkermansia muciniphila abundance decreased in the colon. The response to anti-PD-1 treatment is associated with A. muciniphila abundance in many tumors. However, the interaction between A. muciniphila abundance and YAP1 expression remains unclear in HCC. Here, anti-PD-1 treatment decreased A. muciniphila abundance in the colon, but increased YAP1 expression in the tumor cells by mice with liver tumors in situ. Mechanistically, hepatocyte-specific Yap1 knockout (Yap1^LKO) maintained bile acid homeostasis in the liver, resulting in an increased abundance of A. muciniphila in the colon. Yap1 knockout enhanced anti-PD-1 efficacy. Therefore, YAP1 inhibition is a potential target for increasing A. muciniphila abundance to promote anti-PD-1 efficacy in liver tumors. Dihydroartemisinin (DHA), acting as YAP1 inhibitor, increased A. muciniphila abundance to sensitize anti-PD-1 therapy. A. muciniphila by gavage increased the number and activation of CD8⁺ T cells in liver tumor niches during DHA treatment or combination with anti-PD-1. Our findings suggested that the combination anti-PD-1 with DHA is an effective strategy for liver tumor treatment.

OBJECTIVE To establish a high-performance liquid chromatographic method for the detection of 10 related substances in 20(S)-protopanaxadiol bulk drug. METHODS Used an ACQUITY UPLC BEH C18 chromatographic column with ultrapure water(A)-acetonitrile(B) as mobile phase. The flow rate was 0.20-0.25 mL·min-1, the detection wavelength was set at 203 nm, the column temperature was maintained at 35℃, and the injection volume was 5 μL. RESULTS 20(S)-protopanaxadiol and various impurities had reached an effective separation with a good linear relationship; the sample recovery(n=9) was ranging from 94.8% to 102.2%. The RSD values were <2.0%; the intra-day and inter-day precision RSD values were<2.0%, with a good precision; the related substances C, F, H, and I were stable in solution with RSD values<2.0% in 48 h at the room temperature; while impurities A, B, D, E, G and J were unstable under the same condition with RSD>2.0%. CONCLUSION The method is simple, sensitive and accurate, which can simultaneously determine 10 related substances in API 20(S)-protopanaxadiol, which can effectively identify the relevant substances in API and provide reference for the improvement of its production process and quality control.

Objective: To evaluate the disinfection efficacy of peracetic acid disinfectant (type Ⅲ ) on gastrointestinal endoscopy. Methods: Endoscopes were disinfected respectively by 2% glutaraldehyde (GA group) and peracetic acid disinfectant (type Ⅲ ) (PAA group) according to the process by the 2016 version of "Regulation for cleaning and disinfection technique of flexible endoscope" , and then samples were collected through biopsy channel at the specified steps. The bacterial count and pathogenic bacteria of these samples were detected. Hepatitis B virus surface antigen (HBsAg), hepatitis C virus (HCV) antibody and Treponemia pallidum antibody (TP-Ab) were detected by chemiluminesent microparticle immunoassay (CMIA) in the PAA group. The PAA group were continuously sampled for 5 days. Results: A total of 56 gastroscopes and 16 colonoscopes were disinfected in the GA group, and 46 gastroscopes and 15 colonoscopes were disinfected in the PAA group. Compared with pre-disinfection, the bacterial count was both significantly reduced in the two groups after disinfection (P<0.05). The qualified rate of gastroscopes disinfection and total qualified rate of the PAA group were higher than those of the GA group [the qualified rate of gastroscopes: 97.83% (45/46) VS 92.86% (52/56), P>0.05; total qualified rate: 98.36% (60/61) VS 94.44% (68/72), P>0.05]. The qualified rate of colonoscopes in the two groups were both 100.00% (15/15, 16/16). After disinfecting by peracetic acid disinfectant (Type Ⅲ), HBsAg, anti-HCV and TP-Ab were negative. There were no significant differences on colonies number at different steps in a 5-day continuous sampling (P>0.05). Conclusion Peracetic acid disinfectant (type Ⅲ) can provide a satisfied disinfectant effect, and be applied in clinic to meet the requests of high-level disinfection for gastrointestinal endoscopy.

Objective To explore the short-term and long-term curative effects of proprioception training for pre-term infants with functional dysphagia. Methods Seventy premature infants with functional dysphagia were ran-domly divided into a control group and an observation group, each of 35. Thirty infants of the control group and 32 from the observation group completed the whole study. Both groups were given routine medication and interventions such as touching and passive exercise training. The observation group additionally received a comprehensive interven-tion based on proprioception training. The intervention lasted from the initial stabilization of their condition to the age of 3 months. They were trained twice a day, about 20 minutes each time. The clinical manifestations and complica-tions of dysphagia were evaluated on the 28th day after their birth. At the age of 3 months, the average body mass and development quotient (DQ) were compared between the two groups. Results At the age of twenty-eight days there were significant differences between the two groups in the average number of cases of oral milk residue and coughing or oral-nasal reflux after feeding, as well as in the total number of infants with complications. However, no significant differences were found in the incidence of aspiration pneumonia or dyspnea after feeding. The average body mass and developmental quotient of the observation group were significantly better than those of the control group at the age of 3 months. Conclusion The comprehensive intervention based on proprioception training has a good clinical effect on functional dysphagia among premature infants. It can improve their life quality in both the near and longer term, and it is worth popularizing.

The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.

Objective To explore the effect of sequential and comprehensive preventative measures on the development of premature infants' intelligence.Methods A cohort of 120 premature infants was randomly divided into an observation group and a control group,each of 60.Both groups were given routine premature infant care,but the observation group was additionally provided with sequential and comprehensive preventive intervention.It included neonatal screening,inpatient-outpatient link-up,and their parents' watching CDs explaining early childhood education and health education.All of the infants were followed up from birth to 3 years old.Their adaptive capacity,fine motor skills,language acquisition,gross motor skills and social communication were evaluated at 12,24 and 36 months old using a child intelligence developmental scale for neurological development.Development intelligence quotients (DQs) were calculated and compared.Results After 12 months,significant inter-group differences were observed in adaptability and fine motor control.At 24 and 36 months old there were also significant differences in language skills.At one,two and 3 years old the average DQ of the observation group was significantly higher than that of the control group.Significant within-group differences in average DQ were observed in both groups between 1 and 2 years old,but not between 2 and 3.Conclusion Intervention within two years after birth is critical for premature infants.Timely,sequential,integrated,preventive intervention can promote the development of intelligence and better life quality for premature infants.

Based on thorough analysis of the present healthcare big data,and present problems found in precision medicine,the paper proposed the implementation approach of precision medicine driven by healthcare big data.Citing the practice of the hospital as an example,the authors centered on clinical data to build a precision medicine knowledge system,and leveraged in-depth data mining to develop integrated analysis technology for precision medicine.These efforts aim at application development of precision medicine series upon a panoramic medicine knowledge display,so as to enhance medical quality and diagnosis efficiency and translated use of healthcare big data in precision medicine.