BackgroundMigraine is a common chronic neurological disease， and patent foramen ovale （PFO） has been closely associated with migraine. Current research primarily focuses on the pathological mechanism and the therapeutic effects of interventional closure， with limited attention paid to the impact of PFO on sleep quality in migraine patients. ObjectiveTo compare the difference in sleep quality between PFO-positive and PFO-negative migraine patients， and to analyzes influencing factors of sleep quality in PFO-positive migraine patients， so as to provide references for clinical interventions to improve sleep quality in PFO-positive migraine patients. MethodsA total of 673 migraine patients who met the diagnostic criteria of migraine in the International Classification of Headache Disorders， third edition （ICHD-3）， and all patients underwent contrast-enhanced transcranial Doppler （c-TCD） and transthoracic echocardiographic right heart contrast echocardiography （cTTE） in the Third Hospital of Mianyang from January 2020 to October 2024. Basic demographic data were collected using a self-designed questionnaire， headache severity was assessed with the Visual Analogue Scale （VAS）， and sleep quality was invaluated using the Pittsburgh Sleep Quality Index （PSQI）. PFO patients was diagnosed through c-TCD combined with c-TTE. Binary logistic regression analysis was employed to examine the influencing factors of sleep quality in PFO-positive migraine patients. ResultsA total of 673 （100.00%） migraine patients were enrolled， including 223 PFO-positive cases （33.14%） and 450 PFO-negative cases（66.86%）. The PFO-positive group showed significantly more severe headache severity （χ²=15.799， P<0.01） and poorer sleep quality （χ²=14.377， P<0.01） compared with PFO-negative group. PFO-positive patients demonstrated significantly higher barrier factor scores of sleep quality， sleep latency， sleep efficiency， sleep disturbance， hypnotic medication use， and daytime dysfunction compared with PFO-negative counterparts （t=3.634， 3.269， 2.785， 3.428， 2.907， 3.637， Bonferroni adjust P<0.05/7=0.007）.By contrast， no significant difference was noted in sleep duration scores between the two groups（t=2.349， Bonferroni adjust P>0.05/7=0.007）.The Binary Logistic regression analysis revealed that age （OR=1.021， 95% CI： 1.001~1.041）， headache severity （OR=6.030， 95% CI： 4.085~8.901）， and PFO grade （OR=1.893，95% CI： 1.288~2.784）were significant influencing factors for sleep quality in migraine patients with PFO. ConclusionMigraine patients with PFO-positive exhibited poorer sleep quality compared wtih PFO-negative patients. Older age， higher headache servity， and more severe PFO grade are identified as risk factors for impaired sleep quality in PFO-positive migraine patients.

Objective:By analyzing visually field of standardized residency training from 2008 to 2018, and exploring the field research hotspots and the frontier trend, to provide direction and reference for the field of standardized residency training in our country.Methods:Using CiteSpace visualized analysis software as a research tool, a statistical analysis was conducted on 1 120 pieces of literature in the field of standardized residency training retrieved from the core database of Web of Science.Results:The research strength of standardized residency training was mainly concentrated in the United States, with a total output of 697 papers, accounting for 62.23% of the total number of articles published in the past decade. High yield author Gillespie C published 8 papers, and highly cited author Aggarwal R's paper was cited 54 times. Acad Med, a highly cited journal, was cited the most frequently, with 470 citations in past 10 years. High frequency key words were "resident", "education", "performance", etc. Mutators included "system", "older adult", "operating room", and so on.Conclusion:The research hotspots in the field of standardized residency training in recent ten years include the teaching of residents, the assessment of clinical ability of residents, the standardized patients, etc. Frontier trends focus on resident self-assessment system, surgical training, resident professional core competences, etc.

The professional identity formation and development of medical students is a gradual process.Its aim is to offer a reference for further research of medical students' professional identity and the improvement of medical practice education in the current medical environment by analyzing the aspects at home and abroad in the research method and research content of medical students' professional identity formation and measurement as well as the present intervention measures that can cultivate medical students' professional identity formation.

Objective To investigate the role of MBP-1 in proliferation,apoptosis and invasion of human esophageal cancer cells Ec109.Methods The human esophageal cancer cells Ec109 were cultured,and divided into the MBP-1 mimics group,siRNA-MBP-1 group,negative control group and blank control group.The cell proliferation activity of each group was detected by tetrazolium blue (MTT) method;flow cytometry was used to detect cell apoptosis and cell cycle;Transwell assay was used to detected the invasion ability and the expressions of cellular cycle related C-myc,Cyclin D1 and Cyclin E were detected by western blot.Results Compared with the negative control group and blank control group,the expression of MBP-1 in esophageal cancer cells Ec109 of the MBP-1 mimics group was up-regulated (P＜0.05),the proliferation ability of esophageal cancer cells was decreased,increased the proportion of apoptosis,decreased the proportion of G0/G1 phase cells,inhibited the number of invasive cells was decreased and the expressions of C-myc,Cyclin D1 and Cyclin E proteins.After silencing MBP-1,the expression of MBP-1 in esophageal cancer cells Ec109 in the siRNA-MBP-1 group was down-regulated,the proliferation ability of esophageal cancer cells was increased,the proportion of apoptosis was decreased,the proportion of G0/G1 phase cells was increased.the number of invasive cells was increased and the expressions of C-myc,Cyclin D1 and Cyclin E proteins were up-regulated.Conclusion MBP-1 is closely correlated with the cell proliferation,cell apoptosis and invasion ability of human esophageal cancer cell line Ec109,and its mechanism might be related to cell cycle abnormality.

Objective To explore the effects of psychological crisis intervention in amputation patients with limbs high-voltage burns. Methods A total of 68 amputation patients with limbs high-voltage burns who were treated in Harbin Fifth Hospital from January 2011 to December 2016 were selected in this study using purposive sampling. The participants were randomly divided into the observation group (n=34) and the control group (n=34). The control group received routine psychological nursing care while the observation group was given psychological crisis intervention. The Stress Reaction (SR), SAS, and SDS were used to evaluate the effects of the intervention. Results The observation group had significantly lower scores of SR, SAS, and SDS compared with the control group [(17.89±3.66) vs. (26.89±3.98) for SR; (42.31±8.48) vs. (50.32±10.25) for SAS; (45.32±8.96) vs. (52.77±11.18) for SDS; (t=17.328,4.512,3.581;P<0.05)]. Conclusions The psychological crisis intervention can effectively improve negative emotions such as anxiety and depression in amputation patients with limbs high-voltage burns. It helps patients to develop positive attitudes towards the reality of amputation.

PURPOSE: Metastasis and local recurrence are the primary causes of treatment failure and patient death in breast cancer. The aim of this study was to validate a metastasis- and local recurrenceassociated biomarker for prognostic evaluation and planning treatment strategies. METHODS: Formalin-fixed, paraffin-embedded tissues from a cohort of 312 patients (all stage II and III) were used. The prevalence of CD49f⁺ cells in the patients' tumors was analyzed and correlated with clinical characteristics to determine its prognostic and clinical implications. RESULTS: CD49f⁺ tumor cells were found in a minority of tumors, with 62.8% of the samples showing not a single cell of this subtype. In the clinical characteristics analysis, which were performed with t-tests, CD49f⁺ tumors were not associated with age, tumor size, World Health Organization grade, nodal status, human epidermal growth factor receptor 2 status, progesterone receptor status, or estrogen receptor status, although they were significantly associated with disease recurrence (distant metastasis or/and local recurrence). Univariate survival analysis using the Kaplan-Meier method showed that CD49f⁺ tumors were associated with markedly decreased disease-free survival (DFS); the same result was found using multivariate Cox analysis, even when only chemotherapy-treated patients were analyzed. CONCLUSION: Our results indicated that breast tumors with CD49f⁺ cancer cells are associated with an increased risk for disease recurrence after initial surgery with poor clinical outcomes (decreased DFS). Therefore, as it requires testing for only one additional protein, adding CD49f testing to conventional surgical pathology is a strategy that has great potential for prognostic and treatment-guidance purposes.
Breast Neoplasms* ; Breast* ; Cohort Studies ; Disease-Free Survival ; Estrogens ; Humans ; Integrin alpha6 ; Methods ; Neoplasm Metastasis ; Neoplastic Stem Cells ; Pathology, Surgical ; Prevalence ; Prognosis ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone ; Recurrence* ; Treatment Failure ; World Health Organization

Objective: To investigate the response to neoadjuvant chemotherapy (NAC) among different molecular subtypes of breast cancers using molecular classification with Ki-67 (ER+ PR+ HER2+ Ki-67) or without Ki-67 (ER+ PR+ HER2). Methods: One hundred and twenty-seven cases of invasive breast cancer confirmed by core needle biopsy before NAC were collected from January 2007 to December 2009 and diagnosed at West China Hospital, Sichuan University. The cases were classified into different molecular subtypes using molecular classifications with or without Ki-67. Their clinical and pathological response to NAC was evaluated and compared. Results: The different subtypes using both molecular classifications showed significant difference in clinical response(with Ki-67: χ²=22.40, P<0.01; without Ki-67: χ²=9.202, P=0.027)but not pathological(P>0.05) response to NAC. By multivariate analysis, Ki-67 was predictive for a clinical complete response (P=0.041) and clinical overall response (P<0.01); also Ki-67 was the only clinicopathological factor predictive of pathological response(P=0.041). Conclusion The molecular classification with Ki-67 is better to predict breast cancers responsiveness to NAC than the molecular classification without Ki-67.

The present study aimed to explore the neuroprotective effect and possible mechanisms of rhGLP-1 (7–36) against transient ischemia/reperfusion injuries induced by middle cerebral artery occlusion (MCAO) in type 2 diabetic rats. First, diabetic rats were established by a combination of a high-fat diet and low-dose streptozotocin (STZ) (30 mg/kg, intraperitoneally). Second, they were subjected to MCAO for 2 h, then treated with rhGLP-1 (7–36) (10, 20, 40 µg/kg i.p.) at the same time of reperfusion. In the following 3 days, they were injected with rhGLP-1 (7–36) at the same dose and route for three times each day. After 72 h, hypoglycemic effects were assessed by blood glucose changes, and neuroprotective effects were evaluated by neurological deficits, infarct volume and histomorphology. Mechanisms were investigated by detecting the distribution and expression of the nuclear factor erythroid-derived factor 2 related factor 2 (Nrf2) in ischemic brain tissue, the levels of phospho-PI3 kinase (PI3K)/PI3K ratio and heme-oxygenase-1 (HO-l), as well as the activities of superoxide dismutase (SOD) and the contents of malondialdehyde (MDA). Our results showed that rhGLP-1 (7–36) significantly reduced blood glucose and infarction volume, alleviated neurological deficits, enhanced the density of surviving neurons and vascular proliferation. The nuclear positive cells ratio and expression of Nrf2, the levels of P-PI3K/PI3K ratio and HO-l increased, the activities of SOD increased and the contents of MDA decreased. The current results indicated the protective effect of rhGLP-1 (7–36) in diabetic rats following MCAO/R that may be concerned with reducing blood glucose, up-regulating expression of Nrf2/HO-1 and increasing the activities of SOD.
Animals ; Blood Glucose ; Brain ; Diet, High-Fat ; Hypoglycemic Agents ; Infarction ; Infarction, Middle Cerebral Artery ; Malondialdehyde ; Neurons ; Neuroprotective Agents ; Phosphotransferases ; Rats* ; Reperfusion ; Reperfusion Injury* ; Streptozocin ; Superoxide Dismutase

Objective To quantitatively assess the virucidal activities of three commercial disin-fectants against human infected highly pathogenic avian influenza viruses subtype H5. Methods The 50%tissue culture infective dose ( TCID50 ) of avian influenza viruses was calculated. Quantitative suspension test was performed to evaluate the efficacy of three disinfectants. In that test, 105 TCID50 of avian influenza viru-ses were exposed to different disinfectants at different concentrations for different times with or without the in-terference with fetal bovine serum ( FBS) simulating the contaminated condition. The residual infectivity was determined by endpoint titration in Madin-Darby canine kidney ( MDCK) cells. The detail steps were that the mixture of viruses and disinfectants was inoculated at 37℃ with 5% CO2 for 1 hour. Then, it was re-placed by virus dilution medium and further incubated for 18 to 20 hours. ELISA was performed for the cal-culation of TCID50 . The titers of residual viruses were calculated according to Reed and Muench method. The low pathogenic avian influenza virus H9N2 was chosen as the control in this study. Results The re-mained infectivities of three viruses after 1 minute exposure to 1% Virkon solution were below the limit of de-tection (1. 0 lgTCID50/100 μl). Exposing to 0. 5% Virkon solution decreased the viral titers of H5N1 and H9N2 viruses below the detection limit and reduced the titer of H5N6 virus to 1. 75 lgTCID50/100 μl. The virucidal efficacy of 0. 25% Virkon solution against some of the detected viruses was achieved by increasing the exposure time to 5 minutes. The 84 Disinfectant solutions at concentrations of 10%, 5% and 2. 5% low-ered the viral titers of three viruses below the detection limit of 1. 0 lgTCID50/100 μl, but the 1. 25% 84 Disinfectant solution only lowered the viral titers to 1. 25-2. 5 lgTCID50/100 μl. The similar results were ob-served in groups treated with SOLARSEPT solutions. 1% 84 Disinfectant solution didn′t show any virucidal activity against the three viruses after 1 minute of exposure even when the exposure time was extended to 5 minutes. Under the contaminated condition, 1% Virkon solution, 10% and 5% 84 Disinfectant solutions as well as 100% and 50% SOLARSEPT solutions lowered the viral titers below 1. 0 lgTCID50/100μl. Conclu-sion The three commercial disinfectants (1% Virkon solution, 10% 84 Disinfectant solution and SOLAR-SEPT solution) were efficient virucides for highly pathogenic avian influenza viruses subtype H5 even under the contaminated condition. Increasing the exposure time had no significant effects on the efficacy of three disinfectants after the virucidal activities were neutralized by enough viruses. No significant differences in vi-rucidal activities of three disinfectants against HPAI H5 viruses and LPAI H9 virus were observed.

Objective To understand the antigenic and genetic characteristics of highly pathogenic avian influenza H5N1 viruses isolated from poultry related environments of surrounding areas of Qinghai Lake.Methods Poultry and wild birds related environments from surrounding areas of Qinghai lake were collected and handled.Viruses were isolated with embryonated chicken eggs.The virus subtyping was performed by real-time RT-PCR.The highly pathogenic avian influenza H5N1 viruses were chosen to conduct next generation sequencing and hemagglutination inhibition ( HI) assay.Results In total of 19 H5N1 virus strains were isolated, they were all from poultry related environments and collected in January-March of year 2013.Seven representative highly pathogenic avian influenza H5N1 viruses were sequenced and analyzed for antigenicity.According to phylogenetic analysis of HA gene, 6 viruses were belong to clade 2.3.2.1c except A/Environment/Qinghai/XN02032/2013 which belongs to clade 7.2.Antigenic analysis showed that 6 viruses were antigenically similar to A/Barn swallow/Hong Kong/D10-1161/2010, while A/Environment/Qinghai/XN02032/2013 presented low reaction with all reference antisera.Conclusions The existence of highly pathogenic avian influenza H5N1viruses in poultry related environments of surrounding areas of Qinghai Lake was confirmed.The status of highly pathogenic avian influenza H5N1 viruses with evolution diversity emphasized the necessary of strengthening the avian influenza surveillance in these areas.