Methods: This paper introduces the concept of “order parameters” and proposes a method for establishing an order parameter model of gas discharge visualization (GDV) based on the principle of “mastering both permanence and change (MBPC)”. The method involved the following three steps. First, average luminous intensity () and average area () of the GDV images were calculated to construct the phase space, and the score of the health questionnaire was calculated as the health deviation index (H). Second, the k-means++ clustering method was employed to identify subclasses with the same health characteristics based on the data samples, and to statistically determine the symptom-specific frequencies of the subclasses. Third, the distance (d) between each sample and the “ideal health state”, which determined in the phase space of each subclass, was calculated as an order parameter describing the health imbalance, and a linear mapping was established between the d and the H. Further, the health implications of GDV signals were explored by analyzing subclass symptom profiles. We also compare the mean square error (MSE) with classification methods based on age, gender, and body mass index (BMI) indices to verify that the phase space possesses the ability to portray the health status of the human body. Results: This study preliminarily tested the reliability of the order parameter model on data samples provided by 20 participants. Based on the discovered linear law, the current model can use d calculated by measuring the GDV signal to predict H (R2 > 0.77). Combined with the symptom profiles of the subclasses, we explain the classification basis of the phase space based on the pattern identification. Compared with common classification methods based on age, gender, BMI, etc., the MSE of phase space-based classification was reduced by an order of magnitude. Conclusion In this study, the GDV order parameter model based on MBPC can identify subclasses and characterize individual health levels, and explore the TCM health meanings of the GDV signals by using subjective-objective methods, which holds significance for establishing mathematical models from TCM diagnosis principles to interpret human body signals.

Objective:To describe the implementation status of home enteral nutrition (HEN) in pediatric patients, providing reference for the management of HEN in pediatric patients.Methods:This study was a cross-sectional study. From March 2020 to May 2021, convenience sampling was used to select 161 pediatric patients who were discharged from the Children's Hospital of Fudan University and underwent HEN as participants. The survey questionnaire was designed to collect clinical data based on the research purpose.Results:Among the 161 pediatric patients who underwent HEN, congenital malformations, digestive system diseases, neurological diseases, malignant tumors, and respiratory system diseases accounted for 38.5% (62/161), 21.7% (35/161), 19.3% (31/161), 11.2% (18/161), and 9.3% (15/161), respectively. A total of 120 pediatric patients were followed up and recorded with nutritional supplements, 49 pediatric patients received whole protein nutritional supplements, 19 received amino acid nutritional supplements, 16 received whole protein nutritional supplements with homemade homogenization, 15 received short peptide nutritional supplements, seven received breast milk with whole protein nutritional supplements, five received homemade homogenization, five received animal milk, two received breast milk, and two received amino acid nutritional supplements with homemade homogenization. A total of 118 pediatric patients were followed up with tube feeding, including 107 cases using intermittent feeding, nine cases using continuous feeding, and two cases using intermittent combined continuous feeding. There were 46 children with tube slippage, nine cases of vomiting, six cases of tube blockage, three cases of abdominal pain and bloating, two cases of diarrhea, one case of nasal redness, one case of aspiration pneumonia, and one case of exudation around the stoma. After a short-term HEN, 74 cases continued to receive tube feeding, 49 cases were successfully removed from the tube and switched to oral feeding, three cases were switched to tube and oral combined feeding, five cases died due to severe illness.Conclusions:Pediatric patients undergoing HEN have a wide range of diseases and a high incidence of tube slippage. Education should be provided to family caregivers to enhance their ability to identify and handle complications, as well as to make correct choices in feeding formulations and methods. We should also establish a sound follow-up system, closely monitor the nutritional status of pediatric patients, and actively assist in preventing complications.

The SNP loci of ACOX1 gene in 83 China Holstein cows were detected by PCR amplifica-tion and direct sequencing,and the association between the genetic polymorphism loci of ACOX 1 gene and milk quality traits of China Holstein cows was analyzed by SPSS 25.0 software.The re-sults showed that a SNP locus I3-2 267 G→C was found in the third intron of ACOX1 gene,it was moderately polymorphic and in Hardy Weinberg equilibrium in the population.By correlation anal-ysis,it was found that the SNP locus was significantly related to the somatic cell content and cor-rected milk quantity of dairy cows.The I3-2 267 G→C locus of ACOX1 gene can be used as a mo-lecular marker of quality traits of Holstein cows in China,and provide reference for the study of quality traits of Holstein cows in China.

【Objective】 To establish an enzyme-linked immunosorbent assay (ELISA) method for the determination of residual human coagulation factor Ⅺ in human prothrombin complex and validate the method. 【Methods】 Human factor Ⅺ was reacted with the capture antibody coated on the microtiter plate. After appropriate washing steps, biotinylated primary antibody was bound to the captured protein. Excess primary antibody was washed away and bound antibody was reacted with horseradish peroxidase conjugated streptavidin. TMB substrate was used for color development at 450 nm. The dilution reliability, accuracy, specificity, repeatability, intermediate precision, linearity, range and durability were verified. 【Results】 The verification results showed that the accuracy and specificity of this method met the experimental requirements, with an average recovery rate of 109.2% and RSD of 6.93%. The repeatability RSD was 6.78%, and the intermediate precision RSD was 6.75%, indicating good precision. The linear regression correlation coefficient of standard curve was 0.999 9, showing good accuracy and precision within the linear range. The durability was verified by the incubation time and the validity period of reagent kit opening. The results showed that the RSD of the incubation time change was 6.62%, indicating that the incubation time of this detection method was controlled between 28 to 32 minutes, and there was no significant impact on the results. The RSD of the detection results before and after the reagent kit was opened and stored under conditions for 7 days was 3.84%, indicating that the preservation of the reagent kit according to the conditions for 7 days after opening has no effect on the FⅪ detection results. Both indicated that the method had good durability. The dilution reliability results showed that there was a "hook" effect in the detection of FⅪ residue in human prothrombin complex, which could be solved by diluting 100 to 200 times. 【Conclusion】 This method can be used for the determination of FⅪ residues of human prothrombin complex in laboratory.

Objective:To improve the prognosis stratification, especially early mortality(EM), of elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:In this retrospective study, univariate and multivariate Cox regression analysis were conducted to identify the independent prognostic factors associated with overall survival(OS)and the chi-square test and multivariate Logistic analysis were used to identify the prognostic factors associated with EM in 223 elderly patients(age≥65 years)with NDMM from three centers in the country.Results:Increased NT-pro-BNP(≥300 pg/ml), ECOG-PS≥2 and stage Ⅲ R-ISS were identified as three independent adverse prognostic factors of OS.The rates of EM3, EM6, EM12 and EM24 were 12.1%, 20.1%, 32.2% and 60%, respectively.The most common cause for EM6(particularly EM3)was disease-related complications resulting from ineligibility for treatment due to poor physical performance, severe organ dysfunction or treatment discontinuation due to treatment intolerance, while the most common cause for EM12(particularly EM24)was disease progression or relapse mainly as a result of inadequate treatment.R-ISS staging failed to predict EM, while decreased eGFR, ECOG-PS≥2, and increased NT-pro-BNP were able to estimate the risk of EM, with increased NT-pro-BNP as a common independent factor for EM12( P=0.03)and EM24( P=0.015). Conclusions:R-ISS staging, which primarily reflects MM biology, cannot predict EM.However, factors such as NT-pro-BNP, eGFR and ECOG-PS associated with frailty and impairment of organ functions can be used to estimate the risk of EM, among which NT-pro-BNP may be the most important independent factor for EM.Therefore, incorporation of these frailty-related biomarkers into R-ISS staging may be able to more precisely estimate the prognosis and particularly early death of elderly patients with NDMM.

Objective:To assess the prognosis of sinonasal adenoid cystic carcinoma with hard palatine invasion treated by transnasal endoscopic total maxillectomy. Methods:Clinical data of twenty-six patients with sinonasal adenoid cystic carcinoma invading hard palatine treated by transnasal endoscopic total maxillectomy between May 2014 and December 2020 was analyzed retrospectively. Survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Cox regression was used to investigate the prognosis factors. Masticatory function after maxillectomy has also been assessed using the questionnaire of patients' satisfaction about masticatory function. Results:Margins in 8 patients（30%） were positive. The median time of follow-up was 38 months（6 to 85 months）. Twenty-five patients recurred. Four patients died of distant metastasis. The 5-year overall survival rate and relapse-free survival rate was 79.5% and 89.1%, respectively. Independent predictors of outcome on multivariate analysis were positive margin（P=0.018）, recurrence（P=0.006） and distant metastasis（P=0.04）. Conclusion:Transnasal endoscopic total maxillectomy could be performed for the treatment of the sinonasal adenoid cystic carcinoma with hard palatine invasion. Positive margin, local recurrence and distant metastasis were important predictors for patients' prognosis.
Humans ; Carcinoma, Adenoid Cystic/pathology* ; Paranasal Sinus Neoplasms/pathology* ; Retrospective Studies ; Neoplasm Recurrence, Local/pathology* ; Prognosis

ObjectiveTo clarify the therapeutic effect of Huashi Baidu prescription on pneumonia in mice caused by influenza A （H1N1） virus and explore its mechanism based on the transcriptome. MethodA mouse influenza viral pneumonia model was built by intranasal infection with influenza A virus， and mice were continuously administered the drug for five days， so as to investigate the general condition， lung index， viral load， pathological morphology of lung tissue， survival time， and prolongation rate of survival time of mice and clarify the therapeutic effect of Huashi Baidu prescription on influenza viral pneumonia. Transcriptome technology was used to detect the differentially expressed genes in the lung tissue of mice in the model group and the normal group， as well as the Huashi Baidu prescription group and the model group， and the potential core target of the Huashi Baidu prescription for the treatment of influenza viral pneumonia was screened. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to verify the effect of Huashi Baidu prescription on the mRNA expression level of core target genes. ResultCompared with the normal group， the lung index and viral load in the lung tissue of the model group were significantly increased （P<0.05， P<0.01）. Compared with the model group， the high-dose group of Huashi Baidu prescription significantly prolonged the survival time of mice infected with influenza A virus （P<0.05） and significantly reduced the lung index value of mice （P<0.05） and the viral load of lung tissue. The high-dose， medium-dose， and low-dose groups of Huashi Baidu prescription could significantly reduce lung tissue inflammation， blood stasis， swelling， and other pathological changes in mice （P<0.05， P<0.01）. Transcriptome analysis of lung tissue showed that core genes were mainly enriched in the nuclear transcription factor-κB （NF-κB） signaling pathway， interleukin-17 （IL-17） signaling pathway， cytokine-cytokine receptor interaction， and other pathways after the intervention of Huashi Baidu prescription. TRAF6， NFKBIA， CCL2， CCL7， and CXCL2 were the top five node genes with combined score values. Real-time PCR validation showed that Huashi Baidu prescription significantly downregulated the mRNA expression of key genes TRAF6 and NFKBIA in the NF-κB signaling pathway， as well as chemokines CCL2， CCL7， and CXCL2 （P<0.05， P<0.01）. ConclusionHuashi Baidu prescription has a therapeutic effect on influenza viral pneumonia， possibly by inhibiting the expression of key nodes TRAF6 and NFKBIA in the NF-κB signaling pathway and that of chemokines CCL2， CCL7， and CXCL2， reducing the recruitment of inflammatory cells and viral load， and exerting anti-influenza viral pneumonia effects.

Objective:To investigate the relationship between the expression level of circular RNA_0005414 and islet cell function in type 2 diabetes patients.Methods:A total of 110 patients with type 2 diabetes and 106 cases of normal glucose tolerance (control group) in Uygur populations, 64 cases of type 2 diabetes mellitus and 63 cases of normal glucose tolerance (control group) in Han populations were enrolled in the study. All subjects underwent oral glucose tolerance test chemistry panel. Homeostasis model assessment for insulin resistance (HOMA-IR) and β cell function (HOMA-β) were evaluated by homeostasis model as islet cell function indexes. The differentially expressed circular RNAs were screened using RNA sequencing from the peripheral blood monocytes of 5 Uygur patients with type 2 diabetes mellitus and matched controls. The expression level of a significantly up-regulated circular RNA_0005414 was detected and verified, and the relationship between the expression level of circular RNA_0005414 and islet cell function was analyzed.Results:Differential expression profiles of circular RNAs were found in Uygur type 2 diabetic patients . The expression level of circular RNA_0005414 in Uygur type 2 diabetic group was higher than that in Uygur control group ( P<0.01), the expression level of circular RNA_0005414 in Han type 2 diabetic group was higher than that in Han control group ( P<0.01), the expression level of circular RNA_0005414 in Uygur type 2 diabetes group was higher than that in Han type 2 diabetes group, but the difference was not statistically significant ( P>0.05). In the Uyghur and Han groups, Spearman correlation analysis showed that the expression level of circular RNA_0005414 was positively correlated with fasting blood glucose, 2 h plasma glucose after glucose loading, HbA 1C, total cholesterol, fasting insulin, HOMA-IR ( P<0.05) and negatively correlated with HOMA-β ( P<0.01). Partial correlation analysis showed that circular RNA_0005414 expression level was positively correlated with fasting blood glucose, HbA 1C, and HOMA-IR ( P<0.01). Multivariate linear regression analysis showed that circular RNA_0005414 was the only factor affecting HOMA-β in Uygur patients with type 2 diabetes. Conclusion:The expression level of circular RNA_0005414 was closely related to islet cell function in Uygur type 2 diabetes patients, the up-regulation of circular RNA_0005414 may be involved in the occurrence and development of type 2 diabetes in Uygur.

Objective:To investigate the predictive value of platelet-to-neutrophil ratio (PNR) on hemorrhagic transformation (HT) and poor outcomes at 90 d after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received IVT in Hefei Second People's Hospital from July 2019 to June 2021 were retrospectively enrolled. HT was defined as intracerebral hemorrhage found by CT reexamination within 24 h after IVT, and the poor outcome was defined as the modified Rankin Scale score ≥3 at 90 d after onset. Multivariate logistic regression analysis was used to determine the independent predictors of HT and poor outcomes at 90 d, and the predictive value of PNR on HT and poor outcomes at 90 d was analyzed by receiver operating characteristic (ROC) curve. Results:A total of 202 patients with AIS treated with IVT were included, of which 32 had HT and 50 had poor outcomes at 90 d after onset. Multivariate logistic regression analysis showed that PNR at 24 h after IVT was significantly and independently negatively correlated with the poor outcomes (odds ratio [ OR] 0.959, 95% confidence interval [ CI] 0.928-0.991; P=0.012); PNR at admission ( OR 0.886, 95% CI 0.827-0.948; P<0.001) and PNR at 24 h after IVT ( OR 0.923, 95% CI 0.879-0.969; P=0.001) were significantly independently and negatively correlated with HT. ROC curve analysis showed that the area under the curve of PNR at 24 h after IVT for predicting poor outcomes was 0.733 (95% CI 0.659-0.807; P=0.012), the best cutoff value was 35.03, and the predictive sensitivity and specificity were 70.4% and 74%, respectively. The area under the curve of PNR at admission for predicting HT was 0.830 (95% CI 0.774-0.886; P<0.001), the best cutoff value was 34.81, and the predictive sensitivity and specificity were 70% and 93.7%, respectively. The area under the curve of PNR at 24 h after IVT for predicting HT was 0.770 (95% CI 0.702-0.839; P=0.001), the best cutoff value was 41.73, and the predictive sensitivity and specificity were 53.5% and 96.9%, respectively. Conclusion:For patients with AIS treated with IVT, lower PNR at 24 h after IVT is an independent predictor of the poor outcomes at 90 d, while PNR at admission and 24 h after IVT are the independent predictors of HT.

Objective:To study the correlation between umbilical artery blood gas (UABG) and Apgar score of neonates and the risk factors of low base excess (BE) in UABG.Methods:From March 2017 to September 2020, newborns without congenital malformation born in three hospitals were prospectively enrolled and received UABG analysis. According to their Apgar score, the infants were assigned into low Apgar score group and normal Apgar score group. According to BE of UABG, they were assigned into BE<-12 mmol/L group and BE≥-12 mmol/L group. The UABG indexes including abnormal pH and BE between the low Apgar score group and the normal Apgar score group were compared. The risk factors of low BE in UABG were analyzed.Results:A total of 1 351 qualified samples were included including 208 cases in low Apgar score group and 1 143 cases in normal Apgar score group. 115 cases were in BE <-12 mmol/L group and 1 236 cases in BE ≥-12 mmol/L group. The incidences of abnormal pH and BE values in the low Apgar score group were higher than the normal Apgar score group [50.0% (104/208) vs. 13.8% (158/1 143), 34.6% (72/208) vs. 3.8% (43/1 143)]. The pH and BE values of UABG were positively correlated with 1 min Apgar score ( r=0.402, 0.398, P<0.001). Multivariate logistic regression analysis indicated that the risk factors for BE<-12 mmol/L were Ⅲ° contaminated amniotic fluid ( OR= 3.155, 95% CI 1.972~5.025, P<0.001) and placental abruption ( OR = 3.968, 95% CI 1.992~7.874, P <0.001). Conclusions:The pH and BE values of neonatal UABG are positively correlated with 1 min Apgar score. Ⅲ° contaminated amniotic fluid and placental abruption are risk factors of low BE in UABG.