Brain organoid maturation and implantation integration based on electrical signals input.

INTRODUCTION: Brain organoids are believed to be able to regenerate impaired neural circuits and reinstate brain functionality. The neuronal activity of organoids is considered a crucial factor for restoring host function after implantation. However, the optimal stage of brain organoid post-transplantation has not yet been established. External electrical signal plays a crucial role in the physiology and development of a majority of human tissues. However, whether electrical input modulates the development of brain organoids, making them ideal transplant donors, is elusive. METHODS: Bioelectricity was input into cortical organoids by electrical stimulation (ES) with a multi-electrode array (MEA) to obtain a better-transplanted candidate with better viability and maturity, realizing structural-functional integration with the host brain. RESULTS: We found that electrical stimulation facilitated the differentiation and maturation of organoids, displaying well-defined cortical plates and robust functional electrophysiology, which was probably mediated via the pathway of calcium-calmodulin (CaM) dependent protein kinase II (CAMK II)-protein kinase A (PKA)-cyclic-AMP response binding protein (pCREB). The ES-pretreated D40 organoids displayed superior cell viability and higher cell maturity, and were selected to transplant into the damaged primary sensory cortex (S1) of host. The enhanced maturation was exhibited within grafts after transplantation, including synapses and complex functional activities. Moreover, structural-functional integration between grafts and host was observed, conducive to strengthening functional connectivity and restoring the function of the host injury. CONCLUSION: Our findings supported that electrical stimulation could promote the development of cortical organoids. ES-pretreated organoids were better-transplanted donors for strengthening connectivity between grafts and host. Our work presented a new physical approach to regulating organoids, potentially providing a novel translational strategy for functional recovery after brain injury. In the future, the development of 3D flexible electrodes is anticipated to overcome the drawbacks of 2D planar MEA, promisingly achieving multimodal stimulation and long-term recordings of brain organoids.

3D printing of interferon γ-preconditioned NSC-derived exosomes/collagen/chitosan biological scaffolds for neurological recovery after TBI.

The reconstruction of neural function and recovery of chronic damage following traumatic brain injury (TBI) remain significant clinical challenges. Exosomes derived from neural stem cells (NSCs) offer various benefits in TBI treatment. Numerous studies confirmed that appropriate preconditioning methods enhanced the targeted efficacy of exosome therapy. Interferon-gamma (IFN-γ) possesses immunomodulatory capabilities and is widely involved in neurological disorders. In this study, IFN-γ was employed for preconditioning NSCs to enhance the efficacy of exosome (IFN-Exo, IE) for TBI. miRNA sequencing revealed the potential of IFN-Exo in promoting neural differentiation and modulating inflammatory responses. Through low-temperature 3D printing, IFN-Exo was combined with collagen/chitosan (3D-CC-IE) to preserve the biological activity of the exosome. The delivery of exosomes via biomaterial scaffolds benefited the retention and therapeutic potential of exosomes, ensuring that they could exert long-term effects at the injury site. The 3D-CC-IE scaffold exhibited excellent biocompatibility and mechanical properties. Subsequently, 3D-CC-IE scaffold significantly improved impaired motor and cognitive functions after TBI in rat. Histological results showed that 3D-CC-IE scaffold markedly facilitated the reconstruction of damaged neural tissue and promoted endogenous neurogenesis. Further mechanistic validation suggested that IFN-Exo alleviated neuroinflammation by modulating the MAPK/mTOR signaling pathway. In summary, the results of this study indicated that 3D-CC-IE scaffold engaged in long-term pathophysiological processes, fostering neural function recovery after TBI, offering a promising regenerative therapy avenue.

Enantioselective Nickel-Electrocatalyzed Reductive Propargylic Carboxylation with CO2.

The exploitation of carbon dioxide (CO2) as a sustainable, plentiful, and harmless C1 source for the catalytic synthesis of enantioenriched carboxylic acids has long been acknowledged as a pivotal task in synthetic chemistry. Herein, we present a current-driven nickel-catalyzed reductive carboxylation reaction with CO2 fixation, facilitating the formation of C(sp3)-C(sp2) bonds by circumventing the handling of moisture-sensitive organometallic reagents. This electroreductive protocol serves as a practical platform, paving the way for the synthesis of enantioenriched propargylic carboxylic acids (up to 98% enantiomeric excess) from racemic propargylic carbonates and CO2. The efficacy of this transformation is exemplified by its successful utilization in the asymmetric total synthesis of (S)-arundic acid, (R)-PIA, (S)-chizhine D, (S)-cochlearin G, and (S,S)-alexidine, thereby underscoring the potential of asymmetric electrosynthesis to achieve complex molecular architectures sustainably.

Low-intensity ultrasound ameliorates brain organoid integration and rescues microcephaly deficits.

Human brain organoids represent a remarkable platform for modeling neurological disorders and a promising brain repair approach. However, the effects of physical stimulation on their development and integration remain unclear. Here, we report that low-intensity ultrasound significantly increases neural progenitor cell proliferation and neuronal maturation in cortical organoids. Histological assays and single-cell gene expression analyses reveal that low-intensity ultrasound improves the neural development in cortical organoids. Following organoid grafts transplantation into the injured somatosensory cortices of adult mice, longitudinal electrophysiological recordings and histological assays reveal that ultrasound-treated organoid grafts undergo advanced maturation. They also exhibit enhanced pain-related gamma-band activity and more disseminated projections into the host brain than the untreated groups. Finally, low-intensity ultrasound ameliorates neuropathological deficits in a microcephaly brain organoid model. Hence, low-intensity ultrasound stimulation advances the development and integration of brain organoids, providing a strategy for treating neurodevelopmental disorders and repairing cortical damage.

The Potential of FOXP3 in Predicting Survival and Treatment Response in Breast Cancer.

Background: Breast cancer (BC) continues to pose a substantial challenge to global health, necessitating an enhanced understanding of its fundamental mechanisms. Among its various pathological classifications, breast invasive carcinoma (BRCA) is the most prevalent. The role of the transcription factor forkhead box P3 (FOXP3), associated with regulatory T cells, in BRCA's diagnosis and prognosis remains insufficiently explored, despite its recognized importance. Methods: We examined the mRNA expression profile of FOXP3 in BRCA patients, assessing its correlation with disease detection, patient survival, immune checkpoint alterations, and response to anticancer drugs. Results: Our analysis revealed significantly elevated FOXP3 mRNA levels in BRCA patients, with a 95.7% accuracy for BRCA detection based on the area under the curve. High FOXP3 mRNA levels were positively correlated with overall survival and showed significant associations with CTLA4, CD274, PDCD1, TMB, and immune cell infiltration status. Furthermore, FOXP3 mRNA expression was linked to the efficacy of anticancer drugs and the tumor inflammation signature. Discussion: These findings suggest that FOXP3 serves as a promising biomarker for BRCA, offering valuable insights into its diagnosis and prognosis. The correlation between FOXP3 expression and immune checkpoint alterations, along with its predictive value for treatment response, underscores its potential in guiding therapeutic strategies. Conclusion: FOXP3 stands out as an influential factor in BRCA, highlighting its diagnostic accuracy and prognostic value. Its association with immune responses and treatment efficacy opens new avenues for research and clinical applications, positioning FOXP3 as a vital target for further investigation in BRCA management.

Atropisomeric Carboxylic Acids Synthesis via Nickel-Catalyzed Enantioconvergent Carboxylation of Aza-Biaryl Triflates with CO2.

Upgrading CO2 to value-added chiral molecules via catalytic asymmetric C-C bond formation is a highly important yet challenging task. Although great progress on the formation of centrally chiral carboxylic acids has been achieved, catalytic construction of axially chiral carboxylic acids with CO2 has never been reported to date. Herein, we report the first catalytic asymmetric synthesis of axially chiral carboxylic acids with CO2, which is enabled by nickel-catalyzed dynamic kinetic asymmetric reductive carboxylation of racemic aza-biaryl triflates. A variety of important axially chiral carboxylic acids, which are valuable but difficult to obtain via catalysis, are generated in an enantioconvergent version. This new methodology features good functional group tolerance, easy to scale-up, facile transformation and avoids cumbersome steps, handling organometallic reagents and using stoichiometric chiral materials. Mechanistic investigations indicate a dynamic kinetic asymmetric transformation process induced by chiral nickel catalysis.

Early warning indicators via latent stochastic dynamical systems.

Detecting early warning indicators for abrupt dynamical transitions in complex systems or high-dimensional observation data are essential in many real-world applications, such as brain diseases, natural disasters, and engineering reliability. To this end, we develop a novel approach: the directed anisotropic diffusion map that captures the latent evolutionary dynamics in the low-dimensional manifold. Then three effective warning signals (Onsager-Machlup indicator, sample entropy indicator, and transition probability indicator) are derived through the latent coordinates and the latent stochastic dynamical systems. To validate our framework, we apply this methodology to authentic electroencephalogram data. We find that our early warning indicators are capable of detecting the tipping point during state transition. This framework not only bridges the latent dynamics with real-world data but also shows the potential ability for automatic labeling on complex high-dimensional time series.

Structural and functional changes of anterior cingulate cortex subregions in migraine without aura: relationships with pain sensation and pain emotion.

Migraine without aura is a multidimensional neurological disorder characterized by sensory, emotional, and cognitive symptoms linked to structural and functional abnormalities in the anterior cingulate cortex. Anterior cingulate cortex subregions play differential roles in the clinical symptoms of migraine without aura; however, the specific patterns and mechanisms remain unclear. In this study, voxel-based morphometry and seed-based functional connectivity were used to investigate structural and functional alterations in the anterior cingulate cortex subdivisions in 50 patients with migraine without aura and 50 matched healthy controls. Compared with healthy controls, patients exhibited (1) decreased gray matter volume in the subgenual anterior cingulate cortex, (2) increased functional connectivity between the bilateral subgenual anterior cingulate cortex and right middle frontal gyrus, and between the posterior part of anterior cingulate cortex and right middle frontal gyrus, orbital part, and (3) decreased functional connectivity between the anterior cingulate cortex and left anterior cingulate and paracingulate gyri. Notably, left subgenual anterior cingulate cortex was correlated with the duration of each attack, whereas the right subgenual anterior cingulate cortex was associated with migraine-specific quality-of-life questionnaire (emotion) and self-rating anxiety scale scores. Our findings provide new evidence supporting the hypothesis of abnormal anterior cingulate cortex subcircuitry, revealing structural and functional abnormalities in its subregions and emphasizing the potential involvement of the left subgenual anterior cingulate cortex-related pain sensation subcircuit and right subgenual anterior cingulate cortex -related pain emotion subcircuit in migraine.

Cu-Catalyzed Asymmetric Dicarboxylation of 1,3-Dienes with CO2.

Dicarboxylic acids and derivatives are important building blocks in organic synthesis, biochemistry, and the polymer industry. Although catalytic dicarboxylation with CO2 represents a straightforward and sustainable route to dicarboxylic acids, it is still highly challenging and limited to generation of achiral or racemic dicarboxylic acids. To date, catalytic asymmetric dicarboxylation with CO2 to give chiral dicarboxylic acids has not been reported. Herein, we report the first asymmetric dicarboxylation of 1,3-dienes with CO2 via Cu catalysis. This strategy provides an efficient and environmentally benign route to chiral dicarboxylic acids with high regio-, chemo-, and enantioselectivities. The copper self-relay catalysis, that is, Cu-catalyzed boracarboxylation of 1,3-dienes to give carboxylated allyl boronic ester intermediates and subsequent carboxylation of C-B bonds to give dicarboxylates, is key to the success of this dicarboxylation. Moreover, this protocol exhibits broad substrate scope, good functional group tolerance, easy product derivatizations, and facile synthesis of chiral liquid crystalline polyester and drug-like scaffolds.

Reverse design of a new type of low-profile lateral malleolus steel plate assisted by computer bioengineering technology / 中国组织工程研究

BACKGROUND:Poor incision healing and infection often occur in elderly patients with lateral malleolar fractures after traditional lateral plate fixation.With the application of engineering software in medicine,a new type of plate placed posterolateral can be designed to solve the above-described problems. OBJECTIVE:To design a new type of posterior lateral low-profile steel plate with the aid of medical bioengineering software,based on the 3D CT data of the distance between the top of the lateral ankle fracture line to the anterior starting point(ACD),the distance between the top of the fracture line to the tip of the lateral ankle(CTD),the distance between the top of the fracture line to the posterior edge of the fracture line(PCD)and the angle between the anterior and posterior lateral sides of the distal fibula(CA). METHODS:Thirty cases of unstable lateral malleolar fracture and normal ankle were taken for CT scanning and three-dimensional reconstruction.The ACD,CTD,and PCD values in patients with lateral malleolar fracture were measured by 3-matic software,and the characteristics of lateral malleolar fracture line were plotted and described.The mimics software was used to measure the value of CA in the normal ankle joint.Based on the data measured above,3-matic software and solidworks software were used to design the low-profile steel plate and the thickness of the steel plate and the direction of the nail path were constructed.In Geomagic Studio software,fine surface,automatic surface,and fitting surface were used to generate the prototype of the low-profile steel plate,and then 3D printing was performed.After making a posterolateral incision of the lateral malleolus,the peroneus longus and brevis tendons were removed,and the prototype of the 3D-printed steel plate was placed behind the fibula to test its size and fit to the bone surface. RESULTS AND CONCLUSION:(1)The mean of ACD was(2.97±0.03)cm,and the variation was 5.23.The mean of PCD was(3.17±0.11)cm,and the variation was 17.60.The mean of CTD was(4.52±0.07)cm,and the variation was 8.60.(2)The fracture line of the lateral malleolus was drawn with an inverted"V"shape.The mean of CA between anterior and posterior lateral surfaces of the distal fibula was(103.20±1.94)°.At the midpoint section of the upper and lower vertices of the anterior edge of the distal fibula,the angle of the anterior and posterior lateral sides(CA)of the distal fibula was(78.50±1.78)°.(3)By using 3-matic,Solidworks,and Geomagic Studio software,a new type of posterior lateral low-profile steel could be successfully designed.Three to four holes were reserved for the screw holes at the proximal end of the plate with screw directions from back to front,and three screw holes were reserved on the inner and outer sides at the far end.The direction of the inner three holes could be from back to front,and the outer three screw holes needed to be biased towards the inner side,with an angle of 9.72°-13.28°.(4)It is indicated that the variability of the ACD position on the anterior lateral fracture line of the lateral malleolus is relatively small,while the variability of the posterior lateral PCD position is relatively large.The angle between the anterolateral and posterolateral sides of the lateral ankle fracture block shows a decreasing trend,with a smaller variation in the proximal angle and a larger variation in the distal angle.Based on three-dimensional CT reconstruction data of the external ankle,with the help of computer bioengineering software and the use of reverse design concept,a new type of low-profile lateral malleolus steel plate with a good fit can be quickly and conveniently designed to provide a valuable reference for the design of internal fixation devices.

Effects of blue light on the development of the dioptric system in guinea pigs / 眼科新进展

Objective To investigate the effect of blue light on the dioptric development of the eyes of lens-induced myopia(LIM)guinea pigs.Methods Three-week-old trichromatic guinea pigs were randomly divided into three groups:control group,white light LIM(WL)group,and blue light LIM(BL)group(420 nm LED light,with an illuminance of 700 lx);guinea pigs in the latter two groups wore-10.00 D lenses in their right eyes to induce myopia.All guinea pigs under-went a 12 h light/12 h dark treatment cycle.Before and 2,4 weeks after the intervention,the diopter,axial length,retinal thickness and choroidal thickness were measured in all groups.After 4 weeks of intervention,the corneal fluorescent stai-ning and retinal Hematoxylin and Eosin(HE)staining were conducted.Results Compared with the control group,from week 0 to week 2 of the intervention(changes in weeks 0-2),the eyes in the WL group drifted(-2.22±1.28)D towards myopia,the axial length lengthened by(0.40±0.05)mm,and the retinal and choroidal thicknesses reduced by(-7.42± 7.04)μm and(-6.29±4.66)μm,respectively;compared with the WL group,in the BL group,the eyes drifted toward hyperopia by(0.48±1.16)D,the axial length increased by(0.20±0.10)mm,and retinal and choroidal thicknesses in-creased by(1.36±7.46)μm and(8.05±8.08)μm,respectively(all P＜0.05).From week 2 to week 4(changes in weeks 2-4),compared with the control group,the diopter in the WL and BL groups progressed towards myopia,with changes of(-4.64±0.50)D and(-2.11±2.02)D,respectively(both P＜0.05);the axial length lengthened,and reti-nal and choroidal thicknesses reduced in the WL group,with changes of(0.44±0.06)mm,(-7.35±5.87)μm and(-4.84±2.61)μm,while the choroidal thickness and the retinal thickness decreased in the BL group,with changes of(-0.33±5.95)μm and(-4.78±4.96)μm,respectively.Observations of corneal fluorescence staining and retinal HE staining indicated that prolonged blue light exposure could lead to damage to corneal and retinal cells.Conclusion Blue light may influence the development of myopia through choroid-related mechanisms,but its inhibitory effect is not positive-ly correlated with time.Prolonged exposure to blue light can damage the cornea and retina,thereby reducing the inhibitory effect.

Evaluation of the correlation between diabetic retinopathy and diabetic ne-phropathy by emission computed tomography and clinical testing data via convolutional neural network / 眼科新进展

Objective To evaluate the relationship between diabetic nephropathy(DN)and diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(T2DM)based on imaging and clinical testing data.Methods Totally 600 T2DM patients who visited the First People's Hospital of Ziyang from March 2021 to December 2022 were included.The fundus photography and fundus fluorescein angiography were performed on all these patients and their age,gender,T2DM duration,cardiovascular diseases,cerebrovascular disease,hypertension,smoking history,drinking history,body mass in-dex,systolic blood pressure,diastolic blood pressure and other clinical data were collected.The levels of fasting blood glu-cose(FPG),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipo-protein cholesterol(LDL-C),glycosylated hemoglobin(HbA1c),24 h urinary albumin(UAlb),urinary albumin to creati-nine ratio(ACR),serum creatinine(Scr)and blood urea nitrogen(BUN)were measured.Logistic regression was used to analyze the risk factors associated with DR.DR staging was performed according to fundus images,and the convolutional neural network(CNN)algorithm was used as an image analysis method to explore the correlation between DR and DN based on emission computed tomography(ECT)and clinical testing data.Results The average lesion area rates of DR and DN detected by the CNN in the non-DR,mild-non-proliferative DR(NPDR),moderate-NPDR,severe-NPDR and pro-liferative DR(PDR)groups were higher than those obtained by the traditional algorithm(TCM).As DR worsened,the Scr,BUN,24 h UAlb and ACR gradually increased.Besides,the incidence of DN in the non-DR,mild-NPDR,moderate-NPDR,severe-NPDR and PDR groups was 1.67％,8.83％,16.16％,22.16％and 30.83％,respectively.Logistic regression analysis showed that the duration of T2DM,smoking history,HbA1c,TC,TG,HDL-C,LDL-C,24 h UAlb,Scr,BUN,ACR and glomerular filtration rate(GFR)were independent risk factors for DR.Renal dynamic ECT analysis demonstrated that with the aggravation of DR,renal blood flow perfusion gradually decreased,resulting in diminished renal filtration.Conclusion The application of CCN in the early stage DR and DN image analysis of T2DM patients will improve the diag-nosis accuracy of DR and DN lesion area.The DN is worsening as the aggravation of DR.

Pathogenesis， diagnosis， and treatment of pancreatogenic diabetes / 临床肝胆病杂志

Pancreatogenic diabetes is a type of diabetes mellitus secondary to exocrine pancreatic disease， and it was officially proposed by the American Diabetes Association in 2014， with chronic pancreatitis as the most common etiology， followed by pancreatic cancer. At present， the misdiagnosis rate of this disease is extremely high， and patients with pancreatogenic diabetes have a higher risk of death and readmission than patients with type 2 diabetes. Therefore， it is of great significance to fully understand， correctly identify， and diagnose pancreatogenic diabetes in the early state， so as to reduce the disability rate and mortality rate of this disease. This article reviews the advances in the possible pathogenesis， diagnosis， treatment， and management of pancreatic diabetes secondary to pancreatitis and pancreatic cancer.

Association of agression and angry expression category perception under social exclusion among male students in reform school / 中国学校卫生

Objective@#To explore the relationship between aggression and category perception of angry expression in reform school students under social exclusion, so as to provide reference for the reform school students mental health promotion.@*Methods@#In May 2023, 144 students were randomly selected from a reform school in Guizhou Province, and were divided into high and low aggression groups(77 and 67 students) by Aggression Questionnaire. Cyberball game was used to induce social exclusion and acceptance, subjects were divided into high aggressive exclusion group ( n =42), high aggressive acceptance group ( n =35), low aggressive exclusion group ( n =37) and low aggressive acceptance group ( n =30). All the participants completed the discrimination and identification tasks of category perception paradigm, and the relationship between aggression and category perception of angry expression of reform school students under social exclusion was analyzed by using category turning point, identification curve and analysis of variance.@*Results@#The total score of aggression(97.34±8.00) and four dimensions (physical aggression: 29.75± 4.61, verbal aggression:17.19±2.58, anger:22.29±3.66, hostility:28.10±3.54) in the high aggression group were higher than those in the low aggression group(74.10±9.02，21.09±4.98，14.30±2.66，17.16±3.83，21.55±3.88), and the differences were statistically significant ( t =16.38, 10.85, 6.62, 8.20, 10.59, P <0.01). For identifying the turning point of the fear anger continuum, the social exclusion group（2.58±0.07）was significantly smaller than the social acceptance group（2.79±0.07）( F =4.85, η 2=0.07, P < 0.05 ）, and the social exclusion group had a tendency to shift the category boundary to the fear side. For identifying the slope at the angry happiness continuum category boundary curve, the high aggression group (0.63±0.03) was significantly higher than the low aggression group (0.53±0.03)( F =5.38, η 2=0.08, P <0.05). In the fear anger continuum,the high aggression group[(694.86± 78.29 )ms] reacted more quickly than the low aggression group[(660.70±79.86)ms]( F =5.08, η 2=0.05， P <0.05) In the angry happiness continuum, there was no statistical significance of social exclusion and aggression( P >0.05).@*Conclusions@#The suggests that social exclusion can lead to hostility attribution bias in individuals, while aggression can make individuals more sensitive to angry expression. The mechanisms by which social exclusion and aggression affect expression category perception are independent rather than interactive. The society should give tolerance and acceptance to reform school students, reduce exclusion and discrimination, and the reform education department should correct the aggressive behavior of reform school students and promote their mental health.

SARS-CoV-2 antibody level one month after COVID-19 infection in healthcare workers in Pudong New Area of Shanghai / 上海预防医学

ObjectiveTo investigate the levels of serum antibodies against novel coronavirus （SARS-CoV-2） in healthcare workers after one month of natural infection， to explore the influencing factors and their correlations with the levels of antibodies， and to provide reference for strengthening the protection of healthcare workers and preventive intervention in Pudong New Area in Shanghai. MethodsVenous blood samples were collected from 1 102 medical staff in Pudong hospitals one month after infection. The serum levels of new coronavirus specific antibodies IgM， IgG and neutralizing antibodies were detected by chemiluminescent immunoassay. The information of gender， age， position， infection severity， vaccination， basic diseases and use of immunosuppressants were obtained by questionnaire to explore the influencing factors and their correlation with the antibody level. ResultsOne month after natural infection， 99.00% （1 091/1 102） of the subjects were found to be positive for IgG antibody against the new coronavirus， 17.79% （196/1 102） of the subjects were IgM antibody positive， and 99.00% （1 091/1 102） of the samples were positive for the neutralizing antibody. The level of antibody might be influenced by the severity of infection， the time of the last dose of vaccination， and the long-term use of immunosuppressants. The more severe the disease， the stronger the neutralizing antibody response. The antibody level in the people who received the final dose of vaccine within 6 months was higher than that of the people who received the vaccine 6 months ago， and the difference was statistically significant. The antibody levels were low in the subjects who received long-term immunosuppressants. ConclusionThe specific IgM， IgG and neutralizing antibody were found， one month after infection， in the medical workers in Pudong New Area， Shanghai， and the antibody titers were high， which had a good protective effect. The antibody level of the people who were vaccinated within 6 months was higher， it is recommended that people who receive the last vacination more than 6 months should be re-vaccinated with the booster vaccine， to improve the autoimmunity against the novel coronavirus.

Compliance and correctness of hand hygiene of health care workers in intensive care units of a tertiary first-class hospital / 中国感染控制杂志

Objective To study the compliance and correctness of hand hygiene(HH)of staff in intensive care units(ICUs)of a tertiary first-class hospital,and provide theoretical basis for HH intervention.Methods In April 2023,staff in 17 ICUs of this hospital were performed on-site survey by infection control staff,and monitoring forms about HH compliance and correctness were filled out.Results A total of 874 HH opportunities were ob-served with the concealed observation method,501 HH opportunities were implemented,the compliance rate was 57.32％,273 HH opportunities were correctly implemented,with an correct rate of 54.49％.The compliance and correct rate of HH among staff in different ICUs varied significantly.Compliance and correct rates of HH among staff with different jobs were statistically different:HH compliance rate of cleaners(31.97％)was lower than that of nurses(63.83％),doctors(58.77％)and other personnel(58.14％);HH correct rate of cleaners(30.77％)was lower than that of nurses(58.17％).The causes for not implementing HH among staff with different jobs and at different HH opportunities were statistically different:the rate of not implementing any HH measures after con-tact with patients(84.75％)was higher than before contact with patients(41.27％),before clean and sterile ma-nipulation(30.00％),as well as after contact with blood and body fluid(45.45％).The rate of not implementing any HH measures after contact with the patient's surrounding environment(66.67％)was higher than before con-tact with patient as well as before clean and sterile manipulation.The rates of incomplete HH steps and insufficient HH time among staff with different jobs were statistically different:The rates of incomplete HH steps of other per-sonnel(82.35％)was higher than that of doctors(52.63％).The rates of insufficient HH time of doctors(82.46％)and nurses(78.18％)were higher than that of cleaners(51.85％).Conclusion The implementation of HH among different occupational groups and at different HH implementation opportunities in ICU is significantly different,which should be intervened based on their characteristics.

Analysis of the Impact of Different Low-density Lipoprotein Cholesterol Levels on the Progression of Intermediate Coronary Stenosis Based on Quantitative Flow Ratio Quantification / 中国循环杂志

Objectives:This study aims to investigate the impact of different Low-Density Lipoprotein cholesterol(LDL-C)levels on progression of intermediate coronary stenosis,and the associated risk factors leading to the progression of such lesions. Methods:Data were collected on 219 consecutive patients admitted at the Fuwai Central China Vascular Hospital from January 2020 to February 2021,underwent angiographic examinations and diagnosed with intermediate coronary stenosis,with at least one follow-up angiography after 11 months.Offline quantitative flow ratio(QFR)analysis was performed on these cases.Patients were divided into two groups:LDL-C controlled group(LDL-C<1.8 mmol/L,148 patients with 191 vessels)and LDL-C uncontrolled group(LDL-C≥1.8 mmol/L,71 patients with 98 vessels).Coronary artery QFR and anatomical indicators such as minimal lumen diameter,minimal lumen area,percentage diameter stenosis,percentage area stenosis were compared within and between the groups.Further analysis was performed to identify influencing factors leading to changes in coronary physiological parameters derived from QFR. Results:Within the LDL-C controlled group,there was no significant difference in the QFR values of the vessels compared to baseline(P>0.05),whereas in the LDL-C uncontrolled group(P<0.05),a notable decline in QFR was observed.Patients in the LDL-C controlled group had lower rates of maximum diameter and area stenosis and higher minimum lumen diameter and area(all P<0.05).Through multifactorial Logistic regression analysis,it was found that a body mass index＞28 kg/m2,LDL-C≥1.8 mmol/L,and a history of myocardial infarction were independent risk factors leading to the decline in QFR(all P<0.05). Conclusions:It was found that patients in the LDL-C controlled group had higher coronary artery QFR,minimum lumen diameter and area,lower rates of maximum diameter and area stenosis.

Progress of Multi-Parameter Magnetic Resonance Imaging in Evaluating the Efficacy of Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer / 中国医学影像学杂志

Neoadjuvant chemoradiotherapy is a part of the current standard treatment mode for locally advanced rectal cancer,which enables a certain proportion of patients to achieve complete tumor response,improving the surgical resection rate and anal retention rate,and then prolonging the disease-free survival period of patients.MRI is the preferred imaging examination to evaluate the efficacy of neoadjuvant therapy.With the development of functional MRI,quantitative parameters derived from different imaging principles can provide more biological information about tumors,improving the clinical application value of MRI.Multi-parameter MRI combining conventional MRI sequences and functional sequences can more comprehensively evaluate the efficacy of neoadjuvant therapy,which is conducive to developing individualized treatment plans for patients in clinical practice and realize precision medicine.