Microbiota characterization of the green mussel Perna viridis at the tissue scale and its relationship with the environment.

Research on the microbiota associated with marine invertebrates is important for understanding host physiology and the relationship between the host and the environment. In this study, the microbiota of the green mussel Perna viridis was characterized at the tissue scale using 16S rRNA gene high-throughput sequencing and compared with the microbiota of the surrounding environment. Different mussel tissues were sampled, along with two environmental samples (the mussel's attachment substratum and seawater). The results showed that the phyla Proteobacteria, Bacteroidetes, and Spirochaetae were dominant in mussel tissues. The bacterial community composition at the family level varied among the tissues of P. viridis. Although the microbiota of P. viridis clearly differed from that of the surrounding seawater, the composition and diversity of the microbial community of the foot and outer shell surface were similar to those of the substratum, indicating their close relationship with the substratum. KEGG prediction analysis indicated that the bacteria harbored by P. viridis were enriched in the degradation of aromatic compounds, osmoregulation, and carbohydrate oxidation and fermentation, processes that may be important in P. viridis physiology. Our study provides new insights into the tissue-scale characteristics of mussel microbiomes and the intricate connection between mussels and their environment.

Associations of cardiac biomarkers with stroke severity and short-term outcome in patients with acute ischemic stroke / 国际脑血管病杂志

Objective:To investigate associations between cardiac biomarkers with stroke severity and short-term outcome in patients with acute ischemic stroke (AIS).Methods:Patients with AIS admitted to the Affiliated Hospital of Qingdao University from June 2018 to February 2024 whose etiological classification was large artery atherosclerosis (LAA), small vessel occlusion (SVO) or cardioembolism (CE) were included retrospectively. According to the National Institutes of Health Stroke Scale score at admission, patients were divided into mild stroke group (≤8) and moderate to severe stroke group (>8). According to the modified Rankin Scale score at discharge, patients were divided into good outcome group (≤2) and poor outcome group (>2). Multivariate logistic regression analysis was used to determine the independent correlation between cardiac biomarkers and short-term outcome. The predictive value of cardiac biomarkers for poor outcome in patients with AIS and different stroke etiology subtypes were evaluated using receiver operating characteristic (ROC) curves. Results:A total of 2 151 patients with AIS were enrolled, including 1 256 males (58.4%), aged 67.40±11.34 years. 1 079 patents were LAA type (50.2%), 679 were SVO type (31.6%), and 393 were CE type (18.3%); 1 223 were mild stroke (56.86%) and 928 (43.14%) were moderate to severe stroke; 1 357 patients (63.09%) had good short-term outcome, and 794 (36.91%) had poor short-term outcome. Multivariate logistic regression analysis showed that N-terminal pro-B type natriuretic peptide (NT-proBNP), NT-proBNP/creatine kinase (CK) isoenzyme MB (CK-MB) ratio, and CK-MB/CK ratio were independent risk factors for poor short-term outcome. ROC curve analysis shows that the CK-MB/CK ratio had a higher predictive value for short-term poor outcome in patients with AIS (the area under the curve, 0.859, 95% confidence interval 0.839-0.879). Various cardiac biomarkers had a higher predictive value for short-term outcome of CE type and LAA type, but the predictive value for short-term outcome of SVO type was lower. Conclusions:Cardiac biomarkers are associated with the severity and poor outcome of AIS. NT-proBNP/CK-MB and CK-MB/CK ratios have higher predictive value for short-term poor outcome of AIS, especially in patients with CE type.

Research Progress in Tong Du Tiao Shen of Mental Disorders / 世界科学技术-中医药现代化

Mental disorders are characterized by disturbances in behavior,volition,emotion,and cognition and are considered emotional diseases in traditional Chinese medicine.Acupuncture is one of the most widely used complementary alternative therapies for the treatment of mental disorders.Recently,there has been growing interest in the use of the Tong Du Tiao Shen(Dredging Du meridian to regulate the spirit)as a primary treatment.However,a comprehensive summary of the establishment and related acupuncture methods of Tong Du Tiao Shen is lacking.This paper aims to address this gap by exploring the origin and development of Tong Du Tiao Shen,its application in treating mental disorders,and the modern biological mechanisms involved.Ultimately,this paper seeks to expand the clinical application of Tong Du Tiao Shen acupuncture and provide a scientific basis for future research in this field.

Study on the Expression and Clinical Value of Serum ADAM17 and CXCL16 Levels in Patients with Chronic Atrophic Gastritis / 现代检验医学杂志

Objective To study the serum levels of adisintegrin and metalloproteases 17(ADAM17)and C-X-C chemokine ligand 16(CXCL16)in patients with chronic atrophic gastritis(CAG)and their clinical value.Methods A total of 174 patients admitted to Xidian Group Hospital Affiliated to Shaanxi University of Traditional Chinese Medicine from January 2018 to January 2020 due to abdominal discomfort and other symptoms were selected.Based on pathological biopsy results,they were divided into CAG group(n=94)and non CAG group(n=80).The CAG group was divided into mild group(n=27),moderate group(n=30),and severe group(n=37)based on the severity.Meanwhile,50 healthy examinees were used as the control group.Enzyme-linked immunosorbent assay was used to detect serum ADAM17 and CXCL16 levels.Multivariate logistic regression analysis was used to investigate the influencing factors of CAG occurrence,and the diagnostic values of serum ADAM17 and CXCL16 for CAG were analyzed using receiver operating characteristic curves.Results The serum levels of ADAM17(79.25±9.34ng/L)and CXCL16(4.66±0.58μg/L)in CAG group were higher than those in non-CAG group(73.94±8.26ng/L,4.03±0.55μg/L)and control group(53.04±7.20ng/L,1.02±0.35μg/L),and the differences were statistically significant(t=5.794,24.854;11.053,55.497,all P＜0.05).The serum levels of ADAM17(87.17±9.30ng/L)and CXCL16(5.14±0.51μg/L)in severe CAG patients were higher than those in mild CAG group(79.12±9.52ng/L,4.65±0.57μg/L)and moderate groups(68.54±7.89ng/L,4.02±0.63μg/L),and the differences were statistically significant(t=11.574,5.152;11.065,4.987,all P＜0.05).Serum ADAM17(OR=1.851,95%CI:1.350～2.522)and CXCL16(OR=1.682,95%CI:1.233～2.296)were independent risk factors for CAG.The area under the curve of serum ADAM17 and CXCL16 combined diagnosis of CAG was 0.912(95%CI:0.858～0.949),which was larger than the single indicator of 0.843(95%CI:0.801～0.907)and 0.785(95%CI:0.722～0.834),and the differences were statistically significant(Z= 9.357,12.894,all P＜0.05).Conclusion The serum levels of ADAM17 and CXCL16 were increased in CAG patients,indicating they may be related to the severity of CAG.The combined detection of ADAM17 and CXCL16 has a high predictive value for CAG.

The application of quantitative MRI in the diagnosis of early intervertebral disc degeneration / 实用放射学杂志

Objective To evaluate the potential clinical value of T2 mapping and mDixon Quant in the diagnosis of early interver-tebral disc degeneration.Methods A total of 79 volunteers who underwent lumbar MRI examination were enrolled.All subjects were examined for 3.0T MR with T2WI,T2 mapping,and mDixon Quant while recording the condition of low back pain.The differ-ences between T2 mapping(map)value and fat fraction(FF)values of the vertebral(V)and nucleus pulposus(NP)within the Pfir-rmann Ⅰ and Pfirrmann Ⅱ intervertebral disc(grade Ⅰ 76,grade Ⅱ 87)were statistically analyzed.Receiver operating characteristic(ROC)curve analyses were performed for meaningful parameters.Results V-FF showed a mild positive correlation with degenera-tive intervertebral disc lesions,and NP-FF and NP-map values showed a mild negative correlation with lesions.There were statistically significant differences between the two groups in V-FF(P＜0.001),NP-FF(P=0.005),and NP-map(P＜0.001).Some measure-ments had statistically significant differences when different intervertebral disc segments were compared.Conclusion V-FF,NP-FF,and NP-map are associated with intervertebral disc degeneration.T2 mapping and mDixon Quant are potentially valuable as diagnostic tools to quantitatively assess early intervertebral disc degeneration and help diagnose.

Study on the level of binary coping and its influencing factors in patients with perimenopausal syndrome / 中国实用护理杂志

Objective:To explore the current situation of binary coping in patients with perimenopausal syndrome and analyze its influencing factors, in order to provide a basis for improving the level of binary coping.Methods:Using convenience sampling method, a total of 210 patients with perimenopausal syndrome and their spouses from the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine were cross-sectional surveyed by a general data questionnaire, the Binary Coping Scale, and the Modified Kupperman Score Scale. The influencing factors of binary coping level in patients with perimenopausal syndrome were explored by univariate analysis and variance decomposition model analysis.Results:A total of 200 valid questionnaires were retrieved.The patients aged (50.52 ± 2.89) years old. The binary coping score was (79.64 ± 22.74) points. The variance decomposition model analysis showed that marriage age, type of medical insurance, number of children, education level, family monthly income, spouse′s education level, presence of major comorbidities in spouse, modified Kupperman score, presence of generalized anxiety in spouse were the main influencing factors of binary coping in patients with perimenopausal syndrome (all P<0.05). Conclusions:The binary coping scores of patients with perimenopausal syndrome are lower than normal, and considering the influence and involvement of patients' spouses, nursing staff should pay special attention to patients who are married relatively early, have more children, have lower education levels, and have lower family monthly incomes. Additionally, attention should be given to spouses who experience widespread anxiety, have a lower level of education, and suffer from major chronic diseases. By developing and implementing comprehensive intervention measures aimed at improving the Kupperman score and the level of binary coping, both parties can be encouraged to support each other more effectively, thereby improving the marital relationships of patients during the perimenopausal period.

Research advances in exosomal proteins,mRNA and non-coding RNA regulation of Hepatocellular Carci-noma / 实用医学杂志

Exosomes are extracellular vesicles commonly detected in numerous body fluids and contain a variety of components such as proteins,nucleic acids,lipids,and metabolites.These components enable exosomes to mediate intercellular communication and impact diverse cellular processes.Recently,research has highlighted that exosomes have a significant regulatory role in numerous aspects of hepatocellular carcinoma(HCC)occur-rence,development,and drug resistance.Non-coding RANs,a crucial component of exosomes,can regulate the HCC tumour microenvironment with a direct impact on biological behaviours such as tumour growth,metastasis,angiogenesis,and immunomodulation.To this end,exosomes present an interesting avenue for further research in the field of HCC therapy.It is anticipated to become a novel diagnostic,prognostic marker,or therapeutic target for hepatocellular carcinoma(HCC).Our review of the role played by exosomal components in HCC progression over the last five years aims to furnish references and innovative perspectives for early diagnosis,prognosis,and treatment of HCC.

Effects of berberine hydrochloride tablets combined with compound glutamine on intestinal mucosal barrier function in patients with ulcerative colitis / 天津医药

Objective To investigate the effect of berberine hydrochloride tablets combined with compound glutamine in treating ulcerative colitis(UC).Methods One hundred and two patients with UC admitted to our hospital were collected and grouped into two groups according to the random number table.Fifty-one patients in the control group were given conventional treatment+compound glutamine,and 51 patients in the experimental group were given berberine hydrochloride tablets based on the control group.Both groups were treated for 8 weeks.The efficacy,modified Mayo score,intestinal mucosal barrier function,soluble late glycation end product receptor(sRAGE),interleukin-17(IL-17),IL-6 and incidence of untoward reactions were compared between the two groups.Results The total effective rate of the experimental group was higher than that of the control group(92.2%vs.76.5%,P＜0.05).After treatment,scores of defecation frequency,blood in stool,endoscopic findings,physician's overall evaluation,diamine oxidase(DAO),D-lactic acid,endotoxin,sRAGE,IL-17 and IL-6 were lower in both groups than those before treatment(P＜0.05),and the research group was lower than the control group(P＜0.05).There was no significant difference in the total incidence of untoward reactions between the experimental group and the control group(P＞0.05).Conclusion Berberine hydrochloride tablets combined with compound glutamine are effective in treating UC,which can reduce the activity of UC,improve the intestinal mucosal barrier function,regulate serum sRAGE,IL-17 and IL-6 levels,without increasing adverse reactions.

Gentianopsis paludosa xanthone combined with probiotics inhibits colon inflammation-tumor transformation in rats by regulating TGF-β1/Smads pathway and inflammatory factors / 天津医药

Objective To investigate the mechanism of Gentianopsis paludosa xanthone(GPX)combined with probiotics in the intervention of colon inflammation-tumor transformation in rats by regulating TGF-β1/Smads pathway and inflammatory factors.Methods Ninety rats were divided into the normal group,the model group[drinking sodium dextran sulfate(DSS)for 3 days]and the intervention group by random number table method.The model group was subdivided into the inflammatory stage group,the pre-inflammatory cancer group(DMH injection for 4 weeks),the intermediate inflammatory cancer group(DMH injection for 13 weeks)and the advanced inflammatory cancer group(DMH injection for 21 weeks).The administration group was subdivided into the groups(after the first day of drinking DSS,drugs for each group were given by gavage once a day for 8 weeks)on the basis of the advanced inflammatory cancer group,including the GPX group(GPX 69.3 mg/kg),the probiotic group,the combined group(GPX+probiotics 400 mg/kg)and the thalidomide group(thalidomide 13.5 mg/kg).The disease activity index(DAI),colon length and wet mass index were compared between all groups.Characteristics of colon tumors were observed,and pathological changes of colon were observed by HE staining.The expression levels of transforming growth factor(TGF)-β1,Smad4,Smad7,interleukin(IL)-6 and tumor necrosis factor(TNF)-α were detected by Western blot assay and enzyme-linked immunosorbent assay,respectively.Results Compared with the advanced inflammatory cancer group,the administration groups showed an increase in colon length,the expression levels of TGF-β1 and Smad4 protein,a decrease in colon wall thickness,wet mass index,maximum tumor diameter,the levels of Smad7,IL-6,TNF-α,and DAI score decreased in the GPX group and the combined group(P＜0.05).The structure and morphology of intestinal mucosa were improved in the GPX group,the probiotic group and the combination group,and the structure of colonic crypt and goblet cell number were increased.Compared with the probiotic group and the GPX group,the colon wall thickness,colon wet mass index and tumor number were decreased,the protein expression levels of TGF-β1 and Smad4 were increased,and levels of IL-6 and TNF-α were decreased in the combination group(P＜0.05).Conclusion GPX combined with probiotics could inhibit the transformation of colon inflammation-tumor,and the mechanism may be related to the regulation of TGF-β1/Smads pathway and the inhibition of pro-inflammatory factors of IL-6 and TNF-α.

Combination of 1％ platelet-rich plasma and bone marrow mesenchymal stem cells improves the recovery of peripheral nerve injury / 中国组织工程研究

BACKGROUND:Platelet-rich plasma has been shown to enhance the viability and the pro-angiogenesis capacity of mesenchymal stem cells.Extracellular vesicles are one of the key mediators for mesenchymal stem cells to exert their effects,but currently,it is unclear whether platelet-rich plasma affects the functions of extracellular vesicles. OBJECTIVE:To investigate the effects of platelet-rich plasma on the function of extracellular vesicles from bone marrow mesenchymal stem cells,verify whether platelet-rich plasma can be used as an adjuvant to enhance the healing effects of bone marrow mesenchymal stem cells on repairing the peripheral nerve injury. METHODS:For in vitro study,bone marrow mesenchymal stem cells were cultured under normal conditions and with 1%platelet-rich plasma.The ultracentrifugation was used to extract the extracellular vesicles produced by bone marrow mesenchymal stem cells cultured under normal conditions(EVs-nor)or the condition supplemented with 1%platelet-rich plasma(EVs-prp).Extracellular vesicles were used to incubate with Schwann cells.The EdU assay,western blot assay,qPCR and light microscopy photography were performed to examine the effects of EVs-nor and EVs-prp on Schwann cell reprogramming,which was characterized by cell proliferation,c-Jun expression,reprogramming-associated gene expression and cell morphology.For in vivo study,the model of sciatic nerve injury in rats was established.Bone marrow mesenchymal stem cells were grafted with or without 1%platelet-rich plasma into the injured rat sciatic nerve using a chitin nerve conduit.Eight weeks after the surgery,the recovery was assessed by histological and functional indexes,including regenerated nerve fiber density,gastrocnemius wet weight ratio and sciatic function index. RESULTS AND CONCLUSION:(1)Compared with EVs-nor,EVs-prp was stronger in promoting Schwann cell proliferation.The gene expressions of c-Jun and GDNF were significantly upregulated in EVs-prp treated Schwann cells.The morphology of Schwann cells was significantly longer in EVs-prp group than that in EVs-nor group,indicating that EVs-prp had a stronger ability to stimulate Schwann cell reprogramming than EVs-nor.(2)Sciatic nerve injury animal experiment results revealed that grafting mesenchymal stem cells along with platelet-rich plasma into the injured sciatic nerve showed the best recovery compared with grafting mesenchymal stem cells or platelet-rich plasma alone,demonstrated by the significantly improved density of nerve fibers,gastrocnemius wet weight ratio,and sciatic function index.(3)These results suggested that platelet-rich plasma improved the function of bone marrow mesenchymal stem cell-derived extracellular vesicles and could be served as a practical and feasible preparation to synergize with bone marrow mesenchymal stem cells to improve peripheral nerve repair.

Licorice-saponin A3 is a broad-spectrum inhibitor for COVID-19 by targeting viral spike and anti-inflammation / 药物分析学报

Currently,human health due to corona virus disease 2019(COVID-19)pandemic has been seriously threatened.The coronavirus severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)spike(S)protein plays a crucial role in virus transmission and several S-based therapeutic approaches have been approved for the treatment of COVID-19.However,the efficacy is compromised by the SARS-CoV-2 evolvement and mutation.Here we report the SARS-CoV-2 S protein receptor-binding domain(RBD)inhibitor licorice-saponin A3(A3)could widely inhibit RBD of SARS-CoV-2 variants,including Beta,Delta,and Omicron BA.1,XBB and BQ1.1.Furthermore,A3 could potently inhibit SARS-CoV-2 Omicron virus in Vero E6 cells,with EC50 of 1.016 pM.The mechanism was related to binding with Y453 of RBD deter-mined by hydrogen-deuterium exchange mass spectrometry(HDX-MS)analysis combined with quan-tum mechanics/molecular mechanics(QM/MM)simulations.Interestingly,phosphoproteomics analysis and multi fluorescent immunohistochemistry(mIHC)respectively indicated that A3 also inhibits host inflammation by directly modulating the JNK and p38 mitogen-activated protein kinase(MAPK)path-ways and rebalancing the corresponding immune dysregulation.This work supports A3 as a promising broad-spectrum small molecule drug candidate for COVID-19.

Clinical analysis of helicobacter pylori biopsy in gastric antrum / 中国内镜杂志

Objective To analyze the detection of helicobacter pylori(Hp)in different parts of gastric antrum,and to provide clinical guidance for finding the best biopsy site for Hp.Methods Patients who underwent 13C urea breath test and electronic gastroscopy from January 2020 to December 2022 were retrospectively analyzed and divided into 13C urea breath test positive group[delta over baseline(DOB)≥4]and 13C urea breath test negative group(DOB<4)according to DOB value.Gastroscopy reports and pathological data of patients were collected.According to different biopsy sites in gastric antrum,patients were divided into conventional biopsy site group,elevated erosive site group and flat erosive site group,and the detection rate of Hp in different biopsy sites was compared.13C urea breath test positive group was divided into group A(4<DOB≤16),group B(16<DOB≤35)and group C(DOB>35)according to DOB value,and the gastric antral biopsy and pathology of each group were classified and analyzed.Combined with endoscopic reports and pathological data,patients were divided into atrophic gastritis group and non-atrophic gastritis group.Results In the 13C urea breath test positive group,the detection rate of Hp in the elevated erosive site group(96.4%)was higher than that in the conventional biopsy site group(92.7%)and the flat erosive site group(93.9%),and the difference was statistically significant(P = 0.036).In DOB group A,the detection rate of Hp was the highest at the site of elevated erosive and the lowest at the site of conventional biopsy,and the detection rate of Hp at the three biopsy sites was compared,the difference was statistically significant(P = 0.016);There was no significant difference in the detection rate of Hp at three biopsy sites between group B and group C(P = 0.622;P = 0.721);the non-atrophic gastritis group,the detection rate of Hp at the elevated erosive site(96.5%)was higher than that at the conventional biopsy site(91.2%)and the flat erosive site(92.0%),and the difference was statistically significant(P = 0.043).There was no significant difference in the detection rate of Hp at three biopsy sites in the atrophic gastritis group(P = 0.614).13C urea breath test negative group:There was no significant difference in Hp detection rate among the three biopsy sites(P = 0.255).Conclusion For patients with positive 13C urea breath test but low DOB value,the positive rate of Hp in the elevated erosive site is higher.For non-atrophic gastritis patients,the detection rate of Hp was higher in the elevated erosive sites than in the conventional biopsy sites.But for patients with atrophic gastritis,there was little difference in the detection rate of Hp in different parts of antrum.For patients with negative 13C urea breath test,there was no significant difference in Hp detection rate among the three biopsy sites.In future clinical work,for similar patients,precise biopsy can be performed to improve the detection rate of Hp.

Polyene phosphatidylcholine injection in the treatment of alcoholic liver disease:a systematic review and Meta-analysis / 中国药师

Objective To evaluate the efficacy and safety of polyene phosphatidylcholine injection in the treatment of liver disease.Methods Pubmed,Embase,The Cochrane Library,ClinicalTrial.gov,CNKI,SinoMed,VIP,and WanFang Data were electronically searched to collect randomized controlled trials(RCTs)of polyene phosphatidylcholine injection in the treatment of liver disease from inception to December 31st,2022.Two researchers independently screened literature,extracted data and assessed the risk of bias of the included studies.The Meta-analysis was performed using Stata 17.0 software.Results A total of 10 RCTs were included,including 809 patients.Meta-analysis showed that the effective rate in the polyene phosphatidylcholine injection group was higher than that in the control group(RR=1.12,95％CI 1.04 to 1.20,P=0.003 8).Compared with the control group,polyene phosphatidylcholine injection could decrease ALT level(MD=-18.92 U/L,95％CI-27.75 to-10.09,P＜0.001),AST level(MD=-31.19 U/L,95％CI-46.27 to-16.11,P=0.000 1),TBiL level(MD=-7.31 μmol/L,95％CI-10.75 to-3.88,P＜0.001),and GGT levels(MD=-48.93 U/L,95％CI-54.64 to-43.21,P＜0.001).Only one study reported mild adverse events,and six studies reported no severe adverse events in patients.Conclusion Current evidence shows that polyene phosphatidylcholine injection in the treatment of alcoholic liver disease can increase the effective rate,improve the levels of liver function indicators(ALT,AST,TBiL,and GGT),and has less adverse events.Due to the limited number and quality of included studies,the above conclusions need to be verified by more high-quality studies.

Laparoscopic ultrasound combined with CT three-dimensional reconstruction for guiding laparoscopic hepatectomy / 中国医学影像技术

Objective To observe the value of laparoscopic ultrasound(LUS)combined with CT three-dimensional reconstruction for guiding laparoscopic hepatectomy(LH).Methods Data of 78 hepatocellular carcinoma(HCC)patients who underwent LH were retrospectively analyzed.The patients were divided into observation group(n=46)or control group(n=32)based on whether underwent preoperative CT three-dimensional reconstruction and LUS.Clinical data,perioperative data and prognosis were compared between groups.Results No significant difference of clinical data was found(all P＞0.05),whereas significant differences of tumor body mainly location,resection method,tumor resection margin,surgical operation time,intraoperative blood loss,postoperative hospital stay,postoperative complication grading and incidence were found between groups(all P＜0.05).During follow-up period,15 patients died in observation group and 14 died in control group.Significant difference of disease-free survival rate was detected between groups(x2=4.210,P=0.040).Conclusion LUS combined with CT three-dimensional reconstruction for guiding LH could reduce intraoperative injury and complication incidence,improving disease-free survival rate of HCC patients.

Transesophageal echocardiography for guiding left atrial appendage closure with LAmbre occluder / 中国医学影像技术

Objective To observe the value of transesophageal echocardiography(TEE)for guiding left atrial appendage closure(LAAC)with LAmbre occluder.Methods Data of 40 non-valvular atrial fibrillation(NVAF)patients who underwent LA AC with LAmbre occluder were retrospectively analyzed.CT angiography(CTA)before treatment,TEE and digital subtraction angiography(DSA)findings during LAAC were comparatively observed,and the correlations of the anchor area diameter and left atrial appendage opening diameter measured with the above three as well as occluder size were analyzed,and TEE and DSA for evaluating peri-device leak(PDL)were compared.Results LAAC were successfully performed with LAmbre occlude in all 40 cases.The diameter of the fixed umbrella was positively correlated with anchor area diameter measured with CTA,TEE and DSA(r=0.79,0.82,0.91,all P＜0.01),of occlusion umbrella was positively correlated with left atrial appendage opening diameter measured with CTA,TEE and DSA(r=0.56,0.89,0.86,all P＜0.01).Immediately after the release of occluder in LAAC,PDL occurred in 16 cases and were detected with both TEE and DSA,while in the rest 24 cases no PDL was found with neither TEE nor DSA.Conclusion TEE had comparable value to DSA for guiding LAAC using LAmbre occluder.

Establishment of a Predictive Model for the Diagnosis of Benign and Malignant Thyroid Nodules via Multimodal Ultrasound Combined with Thyroid Hormone / 中国医学影像学杂志

Purpose To construct a benign and malignant prediction model of thyroid nodules based on ultrasound image features and clinical features,and to evaluate its diagnostic efficacy.Materials and Methods The data of 121 patients diagnosed with thyroid nodules admitted to the General Hospital of Northern Theater Command from September 2020 to March 2022 were retrospectively analyzed.Taken surgical pathology as the gold standard,there were 70 benign nodules and 51 malignant nodules.Logistic regression was used to analyze the ultrasound image characteristics and clinical data of thyroid nodules,and the characteristic indexes with statistical differences were obtained and a comprehensive prediction model was established.Results There were significant differences in the maximum diameter,morphology,calcification,capsule continuity,blood flow grade,elastography score and contrast-enhanced ultrasound characteristics between benign and malignant thyroid nodules(χ2=11.709,17.707,6.901,12.785,16.984,57.095,98.854,all P<0.05).There were significant differences in age,free thyroxine/free thyroxine ratio,and free thyroxine between the two groups(χ2/t=5.944,2.519,-2.468,all P<0.05).The sensitivity,specificity and accuracy of the clinical model,ultrasonic characteristic model and ultrasonic-clinical combined model were 55.7%,98.6%and 97.0%;72.5%,94.1%and 96.1%;and 61.9%,95.1%and 95.9%,respectively.The area under the curve of the three models were 0.619,0.991 and 0.994,respectively.The diagnostic efficiency of the ultrasonic characteristic model and the combined model was superior to the clinical model,and the difference was statistically significant(Z=-1.75,-2.25,P=0.039,0.012).The area under the curve of the combined model was greater than that of the multi-modal ultrasound model,however,the difference was not statistically significant(Z=-1.60,P=0.054).Conclusion Both the multimodal ultrasound model and the clinical model have certain diagnostic value in predicting benign and malignant thyroid nodules.The diagnostic efficiency of the multimodal ultrasound model is higher than that of the clinical model,and the combined prediction model of the two can improve the diagnostic value.

An evaluation of carrier detection for Spinal muscular atrophy using digital PCR assay / 中华医学遗传学杂志

OBJECTIVE@#To assess the effectiveness and feasibility of carrier detection for Spinal muscular atrophy (SMA) by using digital PCR assay.@*METHODS@#Peripheral blood samples were collected from 214 pregnant women who were routinely screened for SMA carriers, of which 204 were randomly selected samples and 10 were samples with known copy numbers of SMN1 exons 7 and 8. Samples with known copy numbers of SMN1 exons 7 and 8 were randomly mixed into the experiment to validate the performance of the digital PCR assay.@*RESULTS@#The copy numbers of SMN1 exons 7 and 8 and SMN2 exons 7 and 8 in peripheral blood samples were detected by digital PCR assay. The results of SMN1 exons 7 and 8 were compared with those of the quantitative PCR method to assess the reliability and clinical performance of the digital PCR assay. Among the 204 random samples, digital PCR has detected five samples with simultaneous heterozygous deletion of SMN1 exons 7 and 8, three samples with heterozygous deletion of SMN1 exon 8 only, and 196 samples with no deletion of SMN1 exons 7 and 8. Ten samples with known SMN1 exons 7 and 8 copy numbers were detected with the expected values. The digital PCR test results were fully consistent with that of the quantitative PCR.@*CONCLUSION@#The results of digital PCR for the detection of copy number variation of SMN1 exons 7 and 8 were consistent with qPCR. Digital PCR assay was able to clearly distinguish the copy number of the target genes, therefore can be used for SMA carrier screening. Moreover, it can also detect copy number of SMN2 exons 7 and 8, which can provide more information for genetic counseling.

Clinical Effect of Tinglu Yixin Prescription on Heart Failure with Preserved Ejection Fraction with Diabetes： From Taste-based Compatibility and Descending Adverse Qi with Bitter and Pungent Medicinals / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy and safety of Tinglu Yixin prescription in the treatment of patients with heart failure with preserved ejection fraction （HFpEF） combined with diabetes （syndromes of Qi and Yin deficiency and water retention and blood stasis） from taste-based compatibility and descending adverse Qi with bitter and pungent medicinals. MethodA total of 108 HFpEF patients with diabetes （syndromes of Qi and Yin deficiency and water retention and blood stasis） treated in the Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from May 2022 to March 2023 were enrolled in this study and randomized into an observation group （54 patients） and a control group （54 patients）. Both groups received conventional Western medicine treatment according to the guide recommendations for chronic heart failure and diabetes， and the observation group additionally received Tinglu Yixin prescription. The treatment course for both groups was 12 weeks. The New York Heart Association （NYHA） grading of cardiac function， left ventricular end diastolic diameter （LVEDD）， left atrium diameter （LAD）， the ratio of early diastolic maximum mitral flow velocity （E） to early diastolic mitral annular motion velocity （e'） （E/e'）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， hemoglobin A1c （HbA1c）， 6-minute walking test （6MWT）， Minnesota Living with Heart Failure Questionnaire， traditional Chinese medicine （TCM） syndrome scores， and safety indicators were determined before and after treatment. ResultFinally， 104 patients were included for analysis， including 52 patients in the observation group and 52 patients in the control group. After treatment， 35 and 47 patients in the control and observation groups showed improved cardiac function， which indicated the total response rates of 67.3% and 90.4%， respectively. The total response rate regarding the cardiac function in the observation group was higher than that in the control group （χ2=2.754， P<0.05）. The observation group outperformed the control group in reducing LVEDD and LAD （P<0.05）， decreasing the E/e' ratio （P<0.05）， lowering the NT-proBNP and HbA1c levels （P<0.05）， and recovering the 6MWT and Minnesota quality of life score TCM syndrome scores （P<0.05）. None of the safety indicators in the two groups showed abnormal values before and after treatment， and no serious adverse reaction was observed. ConclusionTinglu Yixin prescription can improve the heart function， exercise tolerance， and quality of life， lower the HbA1c level， and alleviate the TCM syndrome in the patients with HFpEF combined with diabetes （syndrome of qi and yin deficiency and water stagnation and blood stasis）.

The Potential Mechanism of Hippo Signaling Pathway and Its Related miRNA Intervention in Alzheimer’s Disease and Parkinson’s Disease / 生物化学与生物物理进展

The main characteristics of neurodegenerative diseases represented by Alzheimer’s disease (AD) and Parkinson’s disease (PD) is the progressive irreversible loss of neurons, leading to varying degrees of pathological changes and loss of cognitive function. There is still no effective treatment. With the acceleration of global aging society, the incidence of neurodegenerative diseases is rapidly increasing, becoming a serious global public health concern that urgently requires the development of effective therapeutic strategies. The Hippo signaling pathway, a highly evolutionarily conserved pathway, consists of the core components MST1/2, LATS1/2, and downstream effectors, transcriptional co-activators YAP and TAZ. It plays a crucial role in the regulation of various biological processes such as cell proliferation, differentiation, development, and apoptosis. Dysregulation of the Hippo pathway contributes to the development of many diseases, including cancer, cardiovascular diseases, immune disorders, etc. Therefore, targeting the dysregulated components of the Hippo pathway may be an effective strategy for treating various diseases. Increasing evidence indicates that the Hippo pathway is excessively activated in the development of neurodegenerative diseases, manifested by increased expression of MST1 and downregulation of YAP. Stabilizing the Hippo pathway levels has shown improvements in AD and PD. However, most studies on the Hippo pathway in AD and PD focus on changes in the expression levels of Hippo pathway components, and research in other neurodegenerative diseases is still lacking. Therefore, further investigation is needed to fully understand the mechanistic role of the Hippo pathway in neurodegenerative diseases. Meanwhile, miRNA, similarly dysregulated in neurodegenerative diseases and serving as biomarkers, is a primary target for miRNA therapy in neurodegenerative diseases, including AD and PD. Activating or inhibiting dysregulated miRNAs is the main strategy of miRNA therapy during the neurodegenerative disease development. Evidence suggests that the interaction between the Hippo pathway and miRNA can result in widespread biological effects and crosstalk in the occurrence of different types of diseases. However, studies on the interplay between the Hippo pathway and miRNA in neurodegenerative diseases are relatively scarce. In this paper, we predicted the miRNAs related to Hippo pathway through bioinformatics database, and further screened the miRNAs with crosstalk relationship with Hippo signaling pathway through experiments in combination with PubMed. Then, the mechanism of action of Hippo signaling pathway related miRNAs in AD and PD is further elucidated. It is reported that the Hippo pathway and its related miRNA may exert neuroprotective effects by reducing oxidative stress, improving neuroinflammation, stabilizing autophagy levels, maintaining neuronal mitochondrial function, and ameliorating blood-brain barrier dysfunction, thereby delaying the progression of AD and PD. However, research on miRNA directly regulating the Hippo pathway to improve AD and PD is limited, and observations of the Hippo pathway and its related miRNA in other neurodegenerative diseases are scarce. However, considering the regulatory relationship between the Hippo pathway and miRNA in multiple diseases and their respective roles in key mechanisms of neurodegenerative diseases, such as oxidative stress and neuroinflammation, the crosstalk between miRNA and the Hippo pathway holds a crucial regulatory role in the development of neurodegenerative diseases. Thus, the interaction pathways of the Hippo pathway and its related miRNA may be a pivotal avenue for exploring effective therapeutic strategies for neurodegenerative diseases in the future.

Kidney transplantation from donors with Marfan syndrome: report of 2 cases and literature review / 器官移植

Objective To investigate the feasibility and clinical experience of kidney transplantation from donors with Marfan syndrome (MFS). Methods Clinical data of 2 recipients undergoing kidney transplantation from the same MFS patient were retrospectively analyzed and literature review of 2 cases was conducted. Characteristics and clinical diagnosis and treatment of kidney transplantation from MFS patients were summarized. Results The Remuzzi scores of the left and right donor kidneys of the MFS patient during time-zero biopsy were 1 and 2. No significant difference was observed in the renal arteriole wall compared with other donors of brain death and cardiac death. Two recipients who received kidney transplantation from the MFS patient suffered from postoperative delayed graft function. After short-term hemodialysis, the graft function of the recipients received the left and right kidney began to gradually recover at postoperative 10 d and 20 d. After discharge, serum creatinine level of the recipient received the left kidney was ranged from 80 to 90 μmol/L, whereas that of the recipient received the right kidney kept declining, and the lowest serum creatinine level was 232 μmol/L before the submission date (at postoperative 43 d). Through literature review, two cases successfully undergoing kidney transplantation from the same MFS donor were reported. Both two recipients experienced delayed graft function, and then renal function was restored to normal. Until the publication date, 1 recipient has survived for 6 years, and the other recipient died of de novo cerebrovascular disease at postoperative 2 years. Conclusions MFS patients may serve as an acceptable source of kidney donors. However, the willingness and general conditions of the recipients should be carefully evaluated before kidney transplantation. Intraoperatively, potential risk of tear of renal arterial media should be properly treated. Extensive attention should be paid to the incidence of postoperative complications.