Objective To discuss the perioperative care and wound protection of xenotransplantation from genetically edited pigs to monkeys, with the goal of improving the success rate of such experimental procedures. Methods From October 2022 to October 2023, perioperative care and wound protection were performed on 7 recipient rhesus monkeys undergoing xenotransplantation of genetically edited pig tissues and organs. Customized wound protective garments were designed based on monkeys' size and surgical area to protect the wounds, alongside meticulous perioperative care. This included preoperative preparation and medication, intraoperative monitoring of physiological indicators and anesthesia management, and postoperative care comprising wound protection, observation and monitoring, and nutritional support. Results All seven monkeys successfully underwent xenotransplantation. With the aid of protective garments and detailed care, all surgical wounds healed by first intention, and postoperative recovery was satisfactory. Conclusion Proper care and wound protection during xenotransplantation from genetically edited pigs to monkeys not only promote wound healing, but also alleviate pain and harm to animals. This has significant implications for advancing experimental research in pig-monkey xenotransplantation and enhancing animal welfare.

Objective:To analyse the correlation between depression and hip fracture in the middle-aged and elderly population in the Chinese community.Methods:The study data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) database. A total of 16,831 respondents from 12,400 households in the fourth national follow-up data in 2018 were selected as the research sample. The samples were divided into a training set and a test set at a ratio of 7∶3, and the test set data were used for internal validation. For external validation, 2,337 subjects recruited from the Institute of Orthopaedics, the First Affiliated Hospital of Zhejiang Chinese Medical University from 2018 to 2023 were selected as the survey subjects. The Center for Epidemiological Studies Depression Scale (CESD) was used to assess depression. CESD≥16 points were defined as depression, and CESD<16 points were defined as no depression. Binary logistic regression was used to gradually analyze the correlation between depression and hip fracture after adjusting for different covariates.Results:In the training set, statistically significant differences were observed between patients with and without hip fractures in terms of depression prevalence (χ 2=16.310, P<0.001), age (χ 2=9.417, P=0.009), education level ( P<0.001), marital status ( P=0.019), and place of residence ( P=0.035). In the testing set, statistically significant differences were found in depression prevalence (χ 2=10.130, P=0.001), gender (χ 2=4.368, P=0.037), education level ( P=0.013), and smoking history (χ 2=8.804, P=0.012). In the external validation set, significant differences were noted in depression prevalence (χ 2=337.885, P<0.001), age (χ 2=29.475, P<0.001), and smoking history ( P=0.020). After controlling for demographic characteristics, exercise, smoking and drinking history, binary logistic regression showed that the risk of hip fracture in depressed patients was 1.78 times higher in the training set ( OR=1.78, P<0.001), 2.73 times higher in the testing set ( OR=2.73, P=0.002), and 15.21 times higher in the external validation set ( OR=15.21, P<0.001) than that of non-depressed patients, indicating good internal and external validation results. Conclusion:Depression is an independent risk factor for hip fractures among middle-aged and elderly populations in Chinese communities. Early identification and active intervention for depression in this population can help reduce the risk of hip fractures.

Objective:To study the effects of plan-do-check-action (PDCA) cycle in quality improvement of neonatal resuscitation.Methods:From 2016 to 2020, the clinical data of neonates born in our hospital were analyzed. Neonates born during 2016 to 2017 were pre-PDCA group and neonates born during 2018 to 2020 were post-PDCA group. PDCA quality improvement included step-by-step, high-frequency and low-dose training, strengthening teamwork and adding equipment.Results:A total of 7 728 live-birth neonates were delivered before PDCA with 319 cases (4.1%) of asphyxia. 10 174 live-birth neonates were delivered after PDCA with 422 cases (4.1%) of asphyxia. The asphyxia rates showed no significant difference between the two groups ( P>0.05). The incidences of severe asphyxia before and after PDCA were both 0.8% without significant difference ( P>0.05). The success rates of resuscitation for severe asphyxia before and after PDCA was 27.9% and 44.9%, respectively, and the differences were statistically significant ( P<0.05). The mortality rates within 7 d before and after PDCA were 0.5‰ and 0.1‰ respectively, without significant differences ( P>0.05). Conclusions:The implementation of PDCA cycle and step-by-step, high-frequency, low-dose neonatal resuscitation training can effectively improve the success rate of resuscitation in newborns with severe asphyxia.

Objective:To investigate the effect of immune checkpoint inhibitors combined with concurrent chemotherapy for non-small cell lung cancer (NSCLC) and the effect of this regimen on serum levels of tumor marker and immune cells of patients.Methods:The clinical data of 60 NSCLC patients in Xuzhou Cancer Hospital from February 2020 to February 2022 were retrospectively analyzed, and they were divided into chemotherapy combined with immune checkpoint inhibitor treatment group (combination treatment group) and conventional chemotherapy group by treatment methods, with 30 cases in each group. Before treatment and 6 weeks after treatment, the patients' serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), vascular endothelial growth factor (VEGF), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) were detected by chemiluminescence immunoassay, and the levels of serum tumorous M2 pyruvate kinase (TuM2-PK) and fatty acid synthase (FAS) were detected by double-antibody sandwich enzyme-linked immunosorbent assay. The levels of T cell subsets were measured by flow cytometry, and the quality of life of patients was evaluated according to the World Health Organization quality of life scale brief version (WHOQOL-BREF). The clinical efficacy, tumor markers levels, immune cells levels, quality of life and adverse reactions were compared between the two groups.Results:The overall effective rate of patients in the combination treatment group was 46.67% (14/30), which was higher than 20.00% (6/30) in the conventional chemotherapy group ( χ2 = 4.80, P = 0.029). The differences in serum CEA, CA125, VEGF, CYFRA21-1, TuM2-PK, FAS levels and the proportions of CD3 +, CD4 +, CD8 + T cells and WHOQOL-BREF scores between the two groups before treatment were not statistically significant (all P > 0.05); the levels of CEA, CA125, VEGF, CYFRA21-1, TuM2-PK, FAS and the proportion of CD8 + T cells at 6 weeks after treatment were lower than those before treatment in both groups (all P < 0.05), and the proportions of CD3 + and CD4 + T cells and WHOQOL-BREF scores were higher than those before treatment (all P < 0.05); the levels CEA, CA125, VEGF, CYFRA21-1, TuM2-PK and the proportions of CD8 + T cells in the combination treatment group at 6 weeks after treatment were higher than those in the conventional chemotherapy group at 6 weeks after treatment (all P < 0.001), and the proportions of CD3 + and CD4 + T cells and WHOQOL-BREF scores were higher than those in the conventional chemotherapy group at 6 weeks after treatment (all P < 0.05). The differences in the incidence of gastrointestinal reactions, alopecia, leukopenia, thrombocytopenia, and liver and kidney function impairment between the two groups were not statistically significant (all P > 0.05). Conclusions:Immune checkpoint inhibitors combined with chemotherapy in NSCLC patients are more effective than conventional chemotherapy, and the combined treatment can more effectively reduce the serum tumor marker levels of patients and enhance the anti-tumor immune effect, with the adverse reactions comparable to conventional chemotherapy.

INTRODUCTION: We aimed to compare the early clinical manifestations, laboratory results and chest computed tomography (CT) images of COVID-19 patients with those of other community-acquired pneumonia (CAP) patients to differentiate CAP from COVID-19 before reverse transcription-polymerase chain reaction results are obtained. METHODS: The clinical and laboratory data and chest CT images of 51 patients were assessed in a fever observation ward for evidence of COVID-19 between January and February 2020. RESULTS: 24 patients had laboratory-confirmed COVID-19, whereas 27 individuals had negative results. No statistical difference in clinical features was found between COVID-19 and CAP patients, except for diarrhoea. There was a significant difference in lymphocyte and eosinophil counts between COVID-19 and CAP patients. In total, 22 (91.67%) COVID-19 patients had bilateral involvement and multiple lesions according to their lung CT images; the left lower lobe (87.50%) and right lower lobe (95.83%) were affected most often, and all lesions were located in the peripheral zones of the lung. The most common CT feature of COVID-19 was ground-glass opacity, found in 95.83% of patients, compared to 66.67% of CAP patients. CONCLUSION Diarrhoea, lymphocyte counts, eosinophil counts and CT findings (e.g. ground-glass opacity) could help to distinguish COVID-19 from CAP at an early stage of infection, based on findings from our fever observation ward.
COVID-19/diagnostic imaging* ; China ; Community-Acquired Infections/diagnostic imaging* ; Diarrhea/pathology* ; Fever ; Humans ; Lung/diagnostic imaging* ; Retrospective Studies ; SARS-CoV-2 ; Tomography, X-Ray Computed/methods*

In China and abroad, Traditional Chinese Medicine (TCM) have been applied and developed. That is depended on doctors and scholars of the past dynasties to inseparable from the inheritance, protection, development, and innovation of Traditional Knowledge of Chinese Medicine. With the progress of modern society and people's awareness of traditional culture protection, people are also improving the understanding of TCM. Through the analysis of the situation and significance of the protection of Traditional Knowledge of Chinese Medicine and the development of Japanese Kampo medicines, recognized that the development of Kampo medicines ignored the source. Their original intention and purpose of protection the Traditional Knowledge of Medicine are completely different from China. The protection of Traditional Knowledge of Chinese Medicine should be in accordance with the basic national conditions, and the system of the protection of Traditional Knowledge of Chinese Medicine should be formulated and perfected to ensure the sustainable development of TCM.

Objective:To understand cytomegalovirus (CMV) infection status in hospitalized preterm infants who were fed by their own mother's frozen breast milk.Methods:This retrospective study enrolled breastfed neonates with gestational age less than 32 weeks or birth weight less than 1 500 g who were born and admitted to Gynecology and Obstetrics Hospital of Fudan University from January 2018 to December 2020. Clinical data of the babies and their mothers were collected and analyzed, including CMV DNA results of breast milk and urine samples of the subjects by fluorescence quantitative polymerase chain reaction. Chi-square test (or Fisher's exact probability test), two independent samples t test, and Mann-Whitney U test were used for the statistical analysis. Results:A total of 94 parturients and their 103 premature infants (including nine pairs of twins) were included. CMV DNA of breast milk was noted for positive in 75 cases (including eight pairs of twins) and for negative in 28 cases (including one pair of twins). Out of the 75 preterm infants born to mothers with positive CMV DNA breast milk, 67 (including eight pairs of twins) were switched to frozen breast milk (－20 ℃ for 72 h), and six of them were infected by CMV(9.0%) without any treatment. All of the 103 infants were divided into two groups: the frozen milk fed group ( n=67) or fresh milk fed group ( n=36). In the frozen milk fed group, the CMV DNA was mainly detected during 2-8 weeks postpartum with copy number reaching the peak at 8th week. And those infants in the frozen milk fed group, whose mother's breast milk CMV DNA was positive, was further divided into CMV infected ( n=6) or CMV non-infected groups ( n=61) according to the urine test results. Moreover, compared with the non-infected group, the average [22.7(3.0-95.7)×10 3 copies/ml vs 5.0(0.5-89.5)×10 3 copies/ml, Z=－2.218) and the highest[45.9(5.9-261.0)×10 3 copies/ml vs 9.8(1.2-766.0)×10 3 copies/ml, Z=－2.218] copy number of CMV DNA in the breast milk were higher in the CMV infected group (both P<0.05). The incidence of feeding intolerance[37.3% (25/67) vs 50.0% (18/36), χ2=1.550], neonatal necrotizing enterocolitis [0.7% (1/67) vs 0.0% (0/36)], bronchopulmonary dysplasia [28.4% (19/67) vs 27.8% (10/36), χ2=0.004], retinopathy of prematurity [20.9% (14/67) vs 8.3%(3/36), χ2=2.682], and late-onset sepsis [22.4% (15/67) and 30.6% (11/36), χ2=0.828] did not differ significantly between the frozen or fresh milk fed groups (all P>0.05). Conclusions:The incidence of breast milk-related CMV infection in those fed with frozen breast milk was low and does not increase the without increasing risks of related complications or leading to obvious clinical manifestations after infection. For preterm infants with gestational age <32 weeks or birth weight <1 500 g, frozen breast milk can be an alternative for mothers with CMV DNA positive breast milk.

In order to overcome the shortcomings of high false positive rate and poor generalization in the detection of microcalcification clusters regions, this paper proposes a method combining discriminative deep belief networks (DDBNs) to automatically and quickly locate the regions of microcalcification clusters in mammograms. Firstly, the breast region was extracted and enhanced, and the enhanced breast region was segmented to overlapped sub-blocks. Then the sub-block was subjected to wavelet filtering. After that, DDBNs model for breast sub-block feature extraction and classification was constructed, and the pre-trained DDBNs was converted to deep neural networks (DNN) using a softmax classifier, and the network is fine-tuned by back propagation. Finally, the undetected mammogram was inputted to complete the location of suspicious lesions. By experimentally verifying 105 mammograms with microcalcifications from the Digital Database for Screening Mammography (DDSM), the method obtained a true positive rate of 99.45% and a false positive rate of 1.89%, and it only took about 16 s to detect a 2 888 × 4 680 image. The experimental results showed that the algorithm of this paper effectively reduced the false positive rate while ensuring a high positive rate. The detection of calcification clusters was highly consistent with expert marks, which provides a new research idea for the automatic detection of microcalcification clusters area in mammograms.
Algorithms ; Breast Neoplasms/diagnostic imaging* ; Calcinosis/diagnostic imaging* ; Early Detection of Cancer ; Humans ; Mammography ; Neural Networks, Computer

OBJECTIVE： To establish GC-MS method for the content determination of three toxic impurities in glycerophosphorylcholine raw materials ，such as epichlorohydrin ，glycidyl，3-chloro-1，2-propanediol. METHODS ：Four batches of glycerophosphorylcholine raw materials were used as test samples. The determination was performed on ZB-WAXplus TM column， and the injector temperature was 200 ℃；the sample injection adopted splitless injection mode ，using helium （He）as carrier gas ， in constant current mode ；the temperature program for the column was initially heating at 30 ℃ for 1 min，rising to 220 ℃ at a speed of 30 ℃/min then remaining 5 min. The ion source was electrospray ion source （EI），the ion source temperature was 200 ℃，and the ionization energy was 70 eV；transmission interface temperature was 250 ℃，and mass spectrum monitoring mode was selected ion （SIM）. Detection ions were epichlorhydrin [mass charge ratio （m/z）49，57，62]，glycidyl（m/z 31，43，44）， 3-chloro-1，2-propanediol（m/z 44，61，79）. The solvent delay time was 3 min. RESULTS ：The linear range of epichlorhydrin ， glycidyl and 3-chloro-1，2-propanediol were 29.86-746.48，172.91-922.18，21.18-211.85 ng/mL，respectively（all r＞0.999 0）. The detection limits were 19.91，115.27，10.59 ng/mL，respectively. The limits of quantitation were 29.86，172.91，21.18 ng/mL， respectively. RSDs of precision （n＝6），reproducibility （n＝6） and stability （placed at room temperature for 12 h，n＝8） tests were all lower than 10％. The average recoveries were 93.88％，91.45％，91.86％，and RSDs were 5.10％，3.10％，2.49％ （n＝9），respectively. In the 4 batches of glycerophosphorylcholine raw materials ，three toxic impurities were all not detected. CONCLUSIONS：Established GC-MS method is simple ，efficient，accurate and repeatable ，and it can be used to determine the contents of three toxic impurities in glycerophosphorylcholine raw materials ，such as epichlorohydrin ，glycidyl，3-chloro-1， 2-propanediol.

OBJECTIVE: To carry out mutation analysis for a Chinese family affected with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). METHODS: Whole exome sequencing (WES) was used to screen potential mutations within genomic DNA extracted from the proband. Suspected mutation was validated by combining clinical data and results of Sanger sequencing. RESULTS: A homozygous deletional mutation c.3665_3675delGTGCTGTCTTA (p.S1222fs) was found in the proband, for which her parents were both heterozygous carriers. CONCLUSION WES is capable of detecting mutation underlying this disorder and facilitating genetic counseling and prenatal diagnosis for the affected family. A novel pathogenic mutation of the SACS gene was discovered.
Female ; Genes, Recessive ; Heat-Shock Proteins ; genetics ; Humans ; Muscle Spasticity ; Mutation ; Spinocerebellar Ataxias ; congenital