Objective:To investigate the value of implantable cardiac monitor (ICM) in the diagnosis and treatment of patients over 60 years old with unexplained syncope.Methods:This was a multi-center, prospective cohort study. Between June 2018 and April 2021, patients over the age of 60 with unexplained syncope at Beijing Hospital, Fuwai Hospital, Beijing Anzhen Hospital and Puren Hospital were enrolled. Patients were divided into 2 groups based on their decision to receive ICM implantation (implantation group and conventional follow-up group). The endpoint was the recurrence of syncope and cardiogenic syncope as determined by positive cardiac arrhythmia events recorded at the ICM or diagnosed during routine follow-up. Kaplan‐Meier survival analysis was used to compare the differences of cumulative diagnostic rate between the 2 groups. A multivariate Cox regression analysis was performed to determine independent predictors of diagnosis of cardiogenic syncope in patients with unexplained syncope.Results:A total of 198 patients with unexplained syncope, aged (72.9±8.25) years, were followed for 558.0 (296.0,877.0) d, including 98 males (49.5%). There were 100 (50.5%) patients in the implantation group and 98 (49.5%) in the conventional follow-up group. Compared with conventional follow-up group, patients in the implantation group were older, more likely to have comorbidities, had a higher proportion of first degree atrioventricular block indicated by baseline electrocardiogram, and had a lower body mass index (all P<0.05). During the follow-up period, positive cardiac arrhythmia events were recorded in 58 (58.0%) patients in the ICM group. The diagnosis rate (42.0% (42/100) vs. 4.1% (4/98), P<0.001) and the intervention rate (37.0% (37/100) vs. 2.0% (2/98), P<0.001) of cardiogenic syncope in the implantation group were higher than those in the conventional follow-up group (all P<0.001). Kaplan-Meier survival analysis showed that the cumulative diagnostic rate of cardiogenic syncope was significantly higher in the implantation group than in the traditional follow-up group ( HR=11.66, 95% CI 6.49-20.98, log-rank P<0.001). Multivariate analysis indicated that ICM implantation, previous atrial fibrillation, diabetes mellitus or first degree atrioventricular block in baseline electrocardiogram were independent predictors for cardiogenic syncope (all P<0.05). Conclusions:ICM implantation improves the diagnosis and intervention rates in patients with unexplained syncope, and increases diagnostic efficiency in patients with unexplained syncope.

Objective:To evaluate the effect of dexmedetomidine on intestinal injury in severely burned rats.Methods:One hundred and twenty healthy clean-grade male Sprague-Dawley rats, weighing 240-260 g, were divided into 4 groups ( n=30 each) using a random number table method: sham operation group (group Sham), sham plus dexmedetomidine group (group Sham+ Dex), severe burn group (group Burn), and severe burn plus dexmedetomidine group (group Burn+ Dex). Forty percent total body surface area of III degree burn model was developed in chloral hydrate-anesthetized rats.Dexmedetomidine was intravenously infused for 4 h at a rate of 5 μg·kg -1·h -1 starting from 3 h after establishing the model in Sham+ Dex group and Burn+ Dex group.The small intestinal tissues were removed for examination of the pathological changes which were scored and for determination of tumor necrosis factor-alpha (TNF-α) and high-mobility group box 1 protein (HMGB1) contents (by enzyme-linked immunosorbent assay), and expression of occludin and ZO-1 protein (by Western blot). The serum concentrations of 4-kD-FITC were measured at 90, 180, 360 and 720 min after establishing the model. Results:Compared with Sham group, the pathological scores of intestinal tissues, contents of TNF-α and HMGB1, serum concentrations of 4-kD-FITC at each time point were significantly increased, and the expression of occludin and ZO-1 was down-regulated in Burn group and Burn+ Dex group ( P<0.05), and no significant change was found in the parameters mentioned above in Sham+ Dex group ( P>0.05). Compared with Burn group, the pathological scores of intestinal tissues, contents of TNF-α and HMGB1, serum concentrations of 4-kD-FITC at each time point were significantly decreased, and the expression of occludin and ZO-1 was up-regulated in Burn+ Dex group ( P<0.05). Conclusion:Dexmedetomidine can reduce intestinal injury in severely burned rats, and the mechanism may be related to inhibiting inflammatory responses in the intestine.

To unravel the genetic mechanisms of disease and physiological traits, it requires comprehensive sequencing analysis of large sample size in Chinese populations. Here, we report the primary results of the Chinese Academy of Sciences Precision Medicine Initiative (CASPMI) project launched by the Chinese Academy of Sciences, including the de novo assembly of a northern Han reference genome (NH1.0) and whole genome analyses of 597 healthy people coming from most areas in China. Given the two existing reference genomes for Han Chinese (YH and HX1) were both from the south, we constructed NH1.0, a new reference genome from a northern individual, by combining the sequencing strategies of PacBio, 10× Genomics, and Bionano mapping. Using this integrated approach, we obtained an N50 scaffold size of 46.63 Mb for the NH1.0 genome and performed a comparative genome analysis of NH1.0 with YH and HX1. In order to generate a genomic variation map of Chinese populations, we performed the whole-genome sequencing of 597 participants and identified 24.85 million (M) single nucleotide variants (SNVs), 3.85 M small indels, and 106,382 structural variations. In the association analysis with collected phenotypes, we found that the T allele of rs1549293 in KAT8 significantly correlated with the waist circumference in northern Han males. Moreover, significant genetic diversity in MTHFR, TCN2, FADS1, and FADS2, which associate with circulating folate, vitamin B12, or lipid metabolism, was observed between northerners and southerners. Especially, for the homocysteine-increasing allele of rs1801133 (MTHFR 677T), we hypothesize that there exists a "comfort" zone for a high frequency of 677T between latitudes of 35-45 degree North. Taken together, our results provide a high-quality northern Han reference genome and novel population-specific data sets of genetic variants for use in the personalized and precision medicine.

Objective To investigate the acceptance of HPV self-sampling mode in cervical cancer screening population and explore its feasibility. Methods From March 5 to 15, 2018, researchers investigated women who participated in cervical cancer screening organized by Beijing Shunyi Women＇s and Children＇s Hospital in the form of questionnaires. Questionnaires were conducted on their acceptance status and the factors that affect the self-sampling experience. The specific contents of the questionnaires were as follows: (1) the experience of using self-sampling included operability, comfortable, sample time-consuming, bleeding or not after sampling; (2) psychological changes after self-sampling, including the willingness to accept self-sampling again, the worrying problems during self-sampling process. According to whether or not have operating video guidance, the self-sampling experience and psychological changes after self-sampling were compared. Results (1) There were 1 375 women participated in the questionnaire survey, and 86.55% (1 190/1 375) of them thought the self-sampling was convenient, 78.40% (1 078/1 375) thought it was not uncomfortable, 88.58% (1 218/1 375) thought the sampling time was fast (less than 5 minutes), 94.04% (1 293/1 375) self-sampling without bleeding; and 83.27% (1 145/1 375) were willing to self-sampling for cervical cancer screening again, 85.82% (1 180/1 375) were afraid of inaccurate sampling. (2) Among the 1 375 women, 1 202 were in the video guidance group and 173 were in the non-guidance group. The self-sampling experience of women in video guidance group was better than those of non-guidance group in operability, comfortable, sampling time-consuming and bleeding after sampling. The proportion of women who willing to self-sampling again was higher than that of non-guidance group (86.69% vs 59.54%, respectively). The proportion of women who worried operating incorrectly was lower than that of non-guidance group (11.23% vs 32.37%, respectively). The differences were significant (all P<0.05). Conclusions Self-sampling for HPV testing in cervical cancer screening is easy to operate and has little discomfort complaint. It is feasible in cervical cancer screening. Operational video guidance during the screening process could effectively improve the women＇s experience and willingness to self-sampling again in the future.

Objective To teach neurosurgical residents of standardized training by using teaching method with multi-modality visualization and to explore its application effects.Methods Total 122 students were randomly divided into two groups:multi-modality visualization teaching group (n=61) and traditional teaching group (n=61).The evaluation of teaching effect was conducted by questionnaire of students and the analysis of test scores after the course.Comparison between the two groups was made by using independent sample t test.Results Questionnaire showed that the satisfaction of teaching mode (88.5％),learning efficiency (93.4％),and training results (90.1％) with multi-modality visualization teaching group were statistically higher than traditional group (P＜0.05).Test score showed that results of theory test (88.5 ± 5.1),on-spot examination (91.6 ± 5.5),and overall score (89.3 ± 5.2) were also statistically higher in multi-modality visualization teaching group than that of control group (P＜0.05).There was no significant difference in clinical skills assessment between two groups.Conclusions Teaching with multi-modality visualization can significantly improve the efficiency of neurosurgical clinical teaching and promote the training effect of students,which provides a new strategy of neurosurgical clinical teaching.

Transmembrane 6 superfamily member 2 (TM6SF2) is a recently discovered gene,which is located on the chromosome 19 (19p12) and encodes a protein consisting of 351 amino acids.Presently,many studies have reported that the single-nucleotide polymorphism of TM6SF2 rs58542926 and plasma lipids are closely related to the incidence and development of diseases,such as non-alcoholic fatty liver disease (NAFLD),cardiovascular disease (CVD),liver cancer,and hepatitis C.This review will summarize the research progress conducted in these areas.

Objective To investigate the effect of optimizing protocol activity on the cardiac function in patients with hypertension.Methods One hundred and one patients with mild and moderate hypertension in Navy General Hospital were enrolled in the study.The patients took regular exercise(6 min walking activity and treadmill test),Echocardiogram was performed 24 h after 6 min walking activity and treadmill test.The cardiac function related parameters were obtained through M-mode,2DE,pulse Doppler and DTI detection to compare the effect of 6 min walking activity and treadmill test on cardiac function.Results The results showed that in the male hypertensive patients,EF and E/E' after treadmill test were superior to those after 6 min walking activity (EF:(59.33±4.46)% vs.(56.05±4.57)%;E/E':(4.12±1.66)vs.(4.95±1.79)),the differences were statistically significant(P=0.02,0.01),while among the female hypertensive patients,there were no significant differences in cardiac function(P>0.05).Conclusion Appropriate activity can improve the cardiac function in male hypertensive patients.EF and E/E' after the treadmill test performed better than those after the 6 min walking activity,while its influence on female hypertensive patients was not significant.

Objective To evaluate the antibacterial activity of Resveratrol(RES)against Staphylococcus aureus standard strains.Methods Minimal inhibitory concentrations was tested.Growth curve of RES were used to study.Results The MIC of Staphylococus were 0.256 mg/ml.RES inhibit growth of Staphylococal reference culture.Conclusion RES had strong antibacterial activity agains Staphylococal reference culture.

Resveratrol(RES)is a kind of antitoxin material produced by plant angainst fungi,it has many biological activites, which can restrain a variety of microorganisms.RES was reviewed in this paper with a variety of inhibition microbial func-tions in recent years,and summarized the antibacterial mechanisms of interfering with cell wall protein synthesis,cell mem-brane damage and RsbA mediating antibacterial factor formation.

Objective To investigate the etiology and clinical characters of ileocecal inflammatory mass and to improve the diagnosis and therapy of ileocecal inflammatory mass.Methods From July 2006 to July 2011,the data of ileocecal inflammatory mass cases were collected,including disease history,clinical manifestations,complications,imaging results,colonscopy results,pathological results and diagnosis.The clinical characters were summarized.Results A total of 241 cases with ileocecal inflammatory mass were collected and 83 cases of them were Crohn's disease,79cases were appendicitis with periappendiceal abscess,54 cases were intestinal tuberculosis,eight cases were intestinal malignant lymphoma and 17 cases were undefined.The main manifestations of 85patients were abdominal pain,right inferior abdominal mass and fever,among which 56 patients were Crohn's disease.Among 90 patients with surgical operation,44 patients were Crohn's disease,among which 12 patients received operation because of appendicitis with periappendiceal abscess at first while the pathological examination after operation for the recurrence of ileocecal inflammatory masses proved Crohn's disease.During the course of disease,69 cases had complications of intestinal obstruction,in whom 44 cases were Crohn's disease.Nine cases had intestinal fistula,24 cases had upper gastrointestinal ulcers,one case had impetigo,and all of the above cases were Crohn's disease.Conclusions The common etiologies of ileocecal inflammatory mass were Crohn's disease.Ileocecal inflammatory mass recurrence after surgery,ileocecal inflammatory mass complicated with intestinal obstruction and abenteric manifestations were more common in Crohn's disease.