Three novel,highly oxygenated polyketides,multioketides A-C(1-3),and three previously described multioxidized aromatic polyketides(4-6),were isolated from an endophytic Penicillium sp.YUD17006 associated with Gastrodia elata.Their chem-ical structures were elucidated using extensive spectroscopic data,electronic circular dichroism calculations,and single X-ray diffrac-tion analysis.All metabolites were characterized by a typical α,β-unsaturated ketone fragment and exhibited a high degree of oxidation.Multioketides A and B were identified as a pair of epimers featuring a rare dihydroisobenzofuranone core.Multioketide C possessed a novel 5/6/6/6 heterotetracyclic chemical architecture with unusual 1,4-dioxin functionalities.Plausible biosynthetic pathways for 1-6 were proposed.Additionally,compound 3 demonstrated weak inhibitory activities against both acetylcholinesterase and protein tyr-osine phosphatase 1B.

BACKGROUND: The HELIOS stent is a sirolimus-eluting stent with a biodegradable polymer and titanium oxide film as the tie-layer. The study aimed to evaluate the safety and efficacy of HELIOS stent in a real-world setting. METHODS: The HELIOS registry is a prospective, multicenter, cohort study conducted at 38 centers across China between November 2018 and December 2019. A total of 3060 consecutive patients were enrolled after application of minimal inclusion and exclusion criteria. The primary endpoint was target lesion failure (TLF), defined as a composite of cardiac death, non-fatal target vessel myocardial infarction (MI), and clinically indicated target lesion revascularization (TLR) at 1-year follow-up. Kaplan-Meier methods were used to estimate the cumulative incidence of clinical events and construct survival curves. RESULTS: A total of 2998 (98.0%) patients completed the 1-year follow-up. The 1-year incidence of TLF was 3.10% (94/2998, 95% closed interval: 2.54-3.78%). The rates of cardiac death, non-fatal target vessel MI and clinically indicated TLR were 2.33% (70/2998), 0.20% (6/2998), and 0.70% (21/2998), respectively. The rate of stent thrombosis was 0.33% (10/2998). Age ≥60 years, diabetes mellitus, family history of coronary artery disease, acute myocardial infarction at admission, and device success were independent predictors of TLF at 1 year. CONCLUSION: The 1-year incidence rates of TLF and stent thrombosis were 3.10% and 0.33%, respectively, in patients treated with HELIOS stents. Our results provide clinical evidence for interventional cardiologists and policymakers to evaluate HELIOS stent. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT03916432.
Humans ; Middle Aged ; Sirolimus/therapeutic use* ; Drug-Eluting Stents/adverse effects* ; Prospective Studies ; Cohort Studies ; Treatment Outcome ; Risk Factors ; Time Factors ; Percutaneous Coronary Intervention/adverse effects* ; Cardiovascular Agents/therapeutic use* ; Coronary Artery Disease/therapy* ; Myocardial Infarction/etiology* ; Thrombosis/complications* ; Polymers ; Registries

Objective: To investigate the correlation between body composition and eating habits among medical students, and to provide evidence for health promotion. Methods: In December 2021, stratified cluster random sampling method was used to conduct a questionnaire survey and body composition assessment among 445 students in grade one to grade four in Jining Medical University. Results: There were 152 girls (53.3%) and 45 boys (28.1%) with low skeletal muscle mass. Totally 167 students ( 37.5% ) had lower muscle mass, including 115 females (40.4%) and 49 males (30.6%). High body fat percentage was found in 259 (58.2%) students, including 179 females (62.8%) and 80 males (50.0%). There were 192 students (43.1%) with abnormal waist to hip ratio, with 139 females (48.8%) and 53 males (33.1%). In addition, emotional eating score of female students was significantly higher than that of male students(6.85±2.24, 6.11±2.69, t =2.96, P <0.05). Cognitive restricted eating was positively correlated with skeletal muscle mass and musde mass( r=0.13, 0.13, P <0.05). Emotional eating was positively correlated with body fat percentage, body fat and waist hip ratio( r =0.20, 0.20, 0.16, P <0.05). Unrestricted eating was positively correlated with body fat percentage, body fat and waist hip ratio( r =0.15, 0.18, 0.15, P <0.05). Multiple linear regression analysis showed that gender, family residence, physical activity and cognitive eating were associated with skeletal muscle mass and muscle mass of medical students( P <0.05). Conclusion With low skeletal muscle mass, low muscle mass, body fat percentage and waist and hip high ratio, reasonable eating habits combined with resistance exercise should be adopted to improve their physical health.

Objective:To explore the effect of staged intervention based on the theory of planned behavior (TPB) on breastfeeding self-efficacy and exclusive breastfeeding among women with gestational diabetes mellitus (GDM) .Methods:From January to May 2019, continuous sampling was used to select 380 delivery women who were diagnosed with GDM in Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University and met the inclusion and exclusion criteria as the research object. According to the random number table method, the delivery women were divided into the control group and the intervention group, 190 cases in each group. The delivery women in the control group received routine breastfeeding health education, while the delivery women in the intervention group implemented the TPB-based staged intervention on the basis of routine breastfeeding health education. The exclusive breastfeeding rate, knowledge and self-efficacy were compared between the two groups. As of four months postpartum, 169 delivery women were included in the intervention group and 157 delivery women in the control group.Results:The exclusive breastfeeding rate of delivery women in the intervention group at four months postpartum was 63.3% (107/169) , which was higher than that [47.1% (74/157) ] in the control group, with a statistically significant difference ( P<0.05) . The breastfeeding knowledge scores of the intervention group and the control group were (15.01±2.04) and (13.05±2.78) respectively, and the difference was statistically significant ( P<0.01) . The GDM breastfeeding knowledge scores were (8.86±1.85) and (4.80±2.76) , and the difference was statistically significant ( P<0.01) . There were significant differences in breastfeeding self-efficacy scores between the two groups at 38 to 40 weeks before delivery, three days, 42 days, and four months after delivery ( P<0.01) . There were significant differences in the exclusive breastfeeding rates between the two groups of GDM women at different time points ( P<0.05) . Conclusions:The staged intervention based on TPB can improve the effect of breastfeeding in GDM women, enhance maternal knowledge and self-efficacy, and increase the rate of exclusive breastfeeding.

Objective:To construct a standard index system for the outpatient job competency of midwife, and to clarify the midwives' abilities when providing outpatient services, so as to improve the midwives' core competencies and service satisfaction.Methods:A research group was established in December 2018. On the basis of literature review and survey of midwives' outpatient needs in the early stage, referring to expert opinions, and taking job competency theory as the theoretical framework, the standard index system for the outpatient job competency of midwife were initially constructed. From December 2018 to March 2019, convenience sampling was used to select 24 experts from different ClassⅢ Grade A hospitals of Beijing, and the Delphi method was used to conduct 2 rounds of expert consultations.Results:Among 2 rounds of expert consultations, the effective recovery rates of the questionnaires were all 100.0% (24/24) , the positive coefficient of experts was 100.0%, and the coefficient of authority of experts was 0.786. The Kendall coordination coefficients of the 2 rounds of correspondence were 0.030 and 0.400, respectively ( P<0.05) . The final construction of standard index system for the outpatient job competency of midwife included 4 first-level indicators, 9 second-level indicators and 24 third-level indicators of knowledge and skills, professional quality, health education ability, and ability to improve the quality of professional services. Conclusions:The standard index system for the outpatient job competency of midwife is scientific and reasonable, comprehensive in content, and strong in specialty, which can provide a reference for the training and assessment of midwife.

Objective To analyze and compare pore characteristics and mechanical properties of models with solid and sheet triply periodic minimal surface (TPMS) structures, and build a porous structure with high specific surface area, low stiffness and high strength. Methods The solid TPMS and sheet TPMS models of D, G, and P units with the same porosity were established, and pore characteristics of the model such as pore diameter, rod diameter and specific surface area were compared; mechanical properties of the model were analyzed by finite element method. The porous titanium samples were made by additive manufacturing technology, pore characteristics of porous titanium were observed by microscope and scanning electron microscope, and mechanical properties of porous titanium were detected by compression test. Results The specific surface area of the sheet structure with the same unit was significantly higher than that of the solid structure; mechanical properties of the sheet structure with the same were significantly better than those of the solid structure. Among them, the D unit sheet TPMS model had the most significant advantages, with the specific surface area of 13.00 mm-1, and the elastic modulus, yield strength and compressive strength of the sheet porous titanium sample were (5.65±0.08) GPa, (181.03±1.30) MPa and (239.83±0.45) MPa, respectively, which were 43.87%, 55.08% and 67.21% higher than those of the solid porous titanium sample. Conclusions While retaining low rigidity of the porous structure, the sheet TPMS model of the same unit has a larger specific surface area, which is beneficial for cell adhesion and growth, and its low stiffness and high strength mechanical properties can effectively reduce stress shielding and provide sufficient mechanical support. It is an ideal pore structure model for bone defect repair substitutes.

Objective:To explore the effects of sandplay combined with sensory integration therapy on cognitive function in children with attention deficit hyperactivity disorder (ADHD).Methods:60 children with ADHD diagnosed in Baoji Maternal and Child Health Hospital from June 2018 to June 2019 were randomly divided into study group and control group.The children in the control group were treated by sandplay, while the patients in the study group were treated by sandplay combined with sensory integration.Results:There was no significant difference in Parent Symptom Questionnaire (PSQ) score, Combined Raven Test (CRT) results and attention test results between the two groups before treatment ( P>0.05), and there was no significant difference in PSQ score of control group after treatment ( P>0.05); The behavioral problems (0.92±0.23), anxiety (0.51±0.26), impulse/hyperactivity (1.06±0.31) and hyperactivity index (0.88±0.14) in the study group were significantly lower than those in the control group [behavioral problems (1.12±0.21), anxiety (0.79±0.45), impulse/hyperactivity (1.42±0.34) and hyperactivity index (1.16±0.17) ( P<0.05)]. There was no significant difference in the scores of mental disorders and learning problems between the two groups [(0.42±0.20), (1.28±0.44) vs (0.52±0.28), (1.37±0.48)] ( P>0.05). The results of CRT in the study group were (6.6±0.3, 7.3±0.2, 9.1±0.1, 5.5±0.2, 2.7±0.1, 117.3±4.4), which were higher than those in the control group (6.2± 0.1, 6.7±0.1, 8.7±0.1, 5.0±0.1, 2.2±0.1, 110.0±3.8) ( P<0.05). The slip time (52.4±0.1), error number (55.9±0.2) and missed report number (60.2 ±0.1) of the study group were significantly lower than those of the control group [slip time (56.1±0.2), error number (60.3±0.1) and missed report number (70.8±0.3)] ( P<0.05). Conclusions:Combination of sandplay and sensory integration can significantly improve the cognitive and behavioral abilities of children with attention deficit hyperactivity disorder, and improve the balance function of children, which is conducive to clinical application.

The aim of this study was to screen the active regions and transcription factor binding sites in the promoter of the CBD103 gene related to Arctic fox coat color, and to provide a basis for revealing the molecular genetic mechanism of CBD103 gene regulating the coat color formation. The 5'-flanking region fragment 2 123 bp of Arctic fox CBD103 gene was cloned, and 4 truncated promoter reporter vectors of different lengths were constructed. The promoter activity was detected by the dual-luciferase reporter assay system. Point mutations were performed on the 3 predicted specificity protein 1 (Sp1) transcription factor binding sites in the highest promoter active region, and 3 mutant vectors were constructed. The activity was then detected by the dual-luciferase reporter assay system. The results showed that the region 1 656 (-1 604/+51) had the highest activity in the 4 truncated promoters of different lengths, and the promoter activity of the three mutant vectors constructed in this region were significantly lower than that of the wild type (fragment 1 656). The region of -1 604 /+51 was the core promoter region of CBD103 gene in Arctic fox and -1 552/-1 564, -1 439/-1 454 and -329/-339 regions were positive regulatory regions. This study successfully obtained the core promoter region and positive regulation regions of the Arctic fox CBD103 gene, which laid a foundation for further study on the molecular genetic mechanism of this gene regulating Arctic fox coat color.
Animals ; Binding Sites ; Foxes ; Luciferases ; Promoter Regions, Genetic ; Sp1 Transcription Factor ; beta-Defensins

At present, number of puerpera with gestational diabetes mellitus (GDM) is increasing. However, the rate of breast feeding decreases among GDM puerpera which has a large difference with the target of breast feeding by World Health Organization. As a special group of puerpera, breast feeding of GDM puerpera has not been paid attention to. This paper reviewed the status, influencing factors and interventions of breast feeding among GDM puerpera at home and abroad so as to provide a reference for exploring the deep researches and effective methods of breast feeding among GDM puerpera in the future.

Objective: To compare the dosimetric differences in forward intensity-modulated radiotherapy using field-in-field (FIF-F-IMRT) and inverse intensity-modulated radiotherapy (I-IMRT) for the left-sided breast cancer. Methods: A total of 18 patients with left-sided breast cancer undergoing breast-conserving surgery in Shanxi Provincial People's Hospital from January to July 2015 were enrolled. For each patient, two treatment plans were designed. The plans were compared by means of target dose distribution and dose for organ at risk. Results: The two methods met the requirements of the prescribed doses. There were no differences for maximal dose (D_max), mean dose (D_mean), and 100%, 105%, 110% prescription dose percent volume (V₁₀₀, V₁₀₅, V₁₁₀) of the target (all P > 0.05). The percentage volume of heart receiving 5 Gy (V₅), 20 Gy (V₂₀), 30 Gy (V₃₀), D_mean of heart of FIF-F-IMRT [(11±4)%, (7±4)%, (8±3)%, (15±3) Gy] were lower than those of I-IMRT [(42±8)%, (14±10)%, (14±4)%, (18±7) Gy] (t values were 29.457, 5.542, 5.064, 4.165, all P = 0.000). V₅ of left-sided lung of FIF-F-IMRT [(26±6)%] was lower than that of I-IMRT [(47±12)%] (t = 6.708, P = 0.000), but there was no significant difference between the two groups in V₂₀, V₃₀, V₄₀, D_mean of left-sided lung (all P≥0.05). V₅ of right-sided lung and right-sided breast, D_mean of right-sided lung of FIF-F-IMRT [(7±4)%, (26±5)%, (60±19) Gy] were lower than those of I-IMRT [(31±9)%, (48±11)%, (489±67) Gy] (t values were 12.304, 6.708, 42.489, all P = 0.000). The number of the monitor units and spending time of FIF-F-IMRT were lower than those of I-IMRT (t values were 12.214 and 29.899, both P = 0.000). Conclusion FIF-F-IMRT has a good dose distribution in the target volume, and could reduce the dose for organ at risk, especially reduce the unnecessary low dose irradiation, and consume less planning time and equipment consumption.