Construction of a clinical prediction model for the impact of acupuncture on pregnancy outcomes in poor ovarian response (POR) patients based on a patient registry research platform / 中国针灸

OBJECTIVES@#To construct a clinical prediction model for the impact of acupuncture on pregnancy outcomes in poor ovarian response (POR) patients, providing insights and methods for predicting pregnancy outcomes in POR patients undergoing acupuncture treatment.@*METHODS@#Clinical data of 268 POR patients (2 cases were eliminated) primarily treated with "thirteen needle acupuncture for Tiaojing Cuyun (regulating menstruation and promoting pregnancy)" was collected from the international patient registry platform of acupuncture moxibustion (IPRPAM) from September 19, 2017 to April 30, 2023, involving 24 clinical centers including Acupuncture-Moxibustion Hospital of China Academy of Chinese Medical Sciences. LASSO and univariate Cox regression were used to screen factors influencing pregnancy outcomes, and a multivariate Cox regression model was established based on the screening results. The best model was selected using the Akaike information criterion (AIC), and a nomogram for clinical pregnancy prediction was constructed. The prediction model was evaluated using receiver operating characteristic (ROC) curves and calibration curves, and internal validation was performed using the Bootstrap method.@*RESULTS@#(1) Age, level of anti-Müllerian hormone (AMH), and total treatment numbers of acupuncture were independent predictors of pregnancy outcomes in POR patients receiving acupuncture (P<0.05). (2) The AIC value of the best subset-Cox multivariate model (560.6) was the smallest, indicating it as the optimal model. (3) The areas under curve (AUCs) of the clinical prediction model after 6, 12, 24, and 36 months treatment were 0.627, 0.719, 0.770, and 0.766, respectively, and in the validation group, they were 0.620, 0.704, 0.759, and 0.765, indicating good discrimination and repeatability of the prediction model. (4) The calibration curve showed that the prediction curve of the clinical prediction model was close to the ideal model's prediction curve, indicating good calibration of the prediction model.@*CONCLUSIONS@#The clinical prediction model for the impact of acupuncture on pregnancy outcomes in POR patients based on the IPRPAM platform has good clinical application value and provides insights into predicting pregnancy outcomes in POR patients undergoing acupuncture treatment.

Benefits and Harms of COVID-19 Vaccines in Cardiovascular Disease:A Comprehensive Review

Patients with a history of cardiovascular disease (CVD) who contract coronavirus disease 2019 (COVID-19) tend to have a worse prognosis and more severe cardiovascular side effects.COVID-19 vaccines, which are intended to prevent COVID-19, may also potentially reduce the severity and complications (including cardiovascular sequelae) of COVID-19, especially in patients with a history of CVD. However, there have also been reports of cardiovascular side effects from COVID-19 vaccines of various brands and types. The purpose of this study is to review the benefits and harms of COVID-19 vaccines in relation to CVD. In this thorough review of the most current evidence on the benefits and harms of COVID-19 vaccines, we present information about the characteristics of cardiovascular complications. Most of the evidence focuses on myocarditis or pericarditis, which are most strongly associated with mRNA vaccines and predominantly occur in young males within days of receiving the second dose. Meanwhile, post-vaccination myocardial infarction is more common in older males, and the first dose of adenoviral vector vaccines appears to play a greater role in this complication. This information may guide us in formulating alternative options and implementing targeted surveillance. Gaining more knowledge about the potential benefits and harms of COVID-19 vaccines will improve our ability to make informed decisions and judgments about the balance of these factors.

Research advances on the characteristics of fibroblast in keloid / 中华烧伤杂志

In re-cent 20 years, the development of cell biology technology has promoted the research of keloid. Keloid fibroblasts (KFbs) are the main effector cells in keloid, which are closely related to the occurrence and development of keloid. It is significantly different in terms of biological characteristics and gene expression between KFbs and normal fibroblasts. This articles reviews the characteristics of KFbs from multiple perspectives, describing its biological character- istics in details including microstructures, metabolic character- istics, and proliferation properties, and introducing the main characteristics of heterogeneity and genomics of KFbs. The further research on KFbs will help to elucidate the pathogenesis of keloids and provide valuable strategies for the prevention and treatment of keloids.

Research on harmless disposal method and equipment for medical waste in mobile hospital / 医疗卫生装备

Objective To explore harmless disposal method and equipment for the medical waste in the mobile hospital. Methods The characteristics and harmless disposal methods were analyzed,and then a pyrolysis scheme was proposed for the medical waste in the mobile hospital.The scheme took considerations on equipment miniaturization,vehicle mounting as well as gas cleaning. Results A medical waste pyrolysis vehicle was developed for the mobile hospital, which had the performances met the requirements of 300 persons/d casualty throughput,environment protection and etc.Conclusion The developed vehicle can be used for harmless disposal of the medical waste in the mobile hospital, and is worthy promoting practically.

Cloning,expression and biological activity of m6A binding protein YTHDF2 / 军事医学

Objective To construct the recombinant plasmid of YTH domain family 2(YTHDF2)and express it in E.coli in order to obtain YTHDF2 fusion protein that was capable of binding m 6A-modified RNA.Methods The coding region of YTHDF2 gene was amplified by RT-PCR.The recombinant plasmid pET-28a-YTHDF2 was constructed and expressed in E.coli.The fusion protein was purified by Ni2+-NTA resin affinity chromatography, while the fusion protein activity was analyzed by Ni2+-NTA magnetic spheres.Results and Conclusion The recombinant YTHDF2 protein was expressed in E.coli BL21(DE3)and purified.YTHDF2 fusion protein was capable of binding RNA with m 6A-modification. The preparation of YTHDF2 fusion protein provides an essential tool to study the biological function of RNA with m6A-modification.

The tyrosine kinase inhibitor nintedanib activates SHP-1 and induces apoptosis in triple-negative breast cancer cells

Triple-negative breast cancer (TNBC) remains difficult to treat and urgently needs new therapeutic options. Nintedanib, a multikinase inhibitor, has exhibited efficacy in early clinical trials for HER2-negative breast cancer. In this study, we examined a new molecular mechanism of nintedanib in TNBC. The results demonstrated that nintedanib enhanced TNBC cell apoptosis, which was accompanied by a reduction of p-STAT3 and its downstream proteins. STAT3 overexpression suppressed nintedanib-mediated apoptosis and further increased the activity of purified SHP-1 protein. Moreover, treatment with either a specific inhibitor of SHP-1 or SHP-1-targeted siRNA reduced the apoptotic effects of nintedanib, which validates the role of SHP-1 in nintedanib-mediated apoptosis. Furthermore, nintedanib-induced apoptosis was attenuated in TNBC cells expressing SHP-1 mutants with constantly open conformations, suggesting that the autoinhibitory mechanism of SHP-1 attenuated the effects of nintedanib. Importantly, nintedanib significantly inhibited tumor growth via the SHP-1/p-STAT3 pathway. Clinically, SHP-1 levels were downregulated, whereas p-STAT3 was upregulated in tumor tissues, and SHP-1 transcripts were associated with improved disease-free survival in TNBC patients. Our findings revealed that nintedanib induces TNBC apoptosis by acting as a SHP-1 agonist, suggesting that targeting STAT3 by enhancing SHP-1 expression could be a viable therapeutic strategy against TNBC.

Relationship between Placenta Location and Resolution of Second Trimester Placenta Previa / 华中科技大学学报（医学）（英德文版）

This prospective study was conducted to assess the rate of resolution of second trimester placenta previa in women with anterior placenta and posterior placenta,and that in women with and without previous cesarean section.In this study,placenta previa was defined as a placenta lying within 20 mm of the internal cervical os or overlapping it.We recruited 183 women diagnosed with previa between 20+0 weeks and 25+6 weeks.They were grouped according to their placenta location (anterior or posterior) and history of cesarean section.Comparative analysis was performed on demographic data,resolution rate of previa and pregnancy outcomes between anterior group and posterior group,and on those between cesarean section group and non-cesarean section group.Women with an anterior placenta tended to be advanced in parity (P=0.040) and have increased number of dilatation and curettage (P=0.044).The women in cesarean section group were significantly older (P=0.000) and had more parity (P=0.000),gravidity (P=0.000),and dilatation and curettage (P=0.048) than in non-cesarean section group.Resolution ofprevia at delivery occurred in 87.43％ women in this study.Women with a posterior placenta had a higher rate of resolution (P=0.030),while history of cesarean section made no difference.Gestational age at resolution was earlier in posterior group (P=0.002) and non-cesarean section group (P=0.008) than in anterior group and cesarean section group correspondingly.Placenta location and prior cesarean section did not influence obstetric outcomes and neonatal outcomes.This study indicates that it is more likely to have subsequent resolution of the previa when the placenta is posteriorly located for women who are diagnosed with placenta previa in the second trimester.

Numerical simulation of chemico-biological particles transportation inside human micropassage / 军事医学

Objective To investigate the transportation of chemico-biological particles(CBP) through the micropassage inside the human body in order to improve chemico-biological protection.Methods Dissipative particle dynamics (DPD) method was used to study CBP transportation through micropassages inside the human body.Results The Poiseuille flow could be ensured by imposing boundary conditions including pressure gradient and no-slip.The axial velocity between fluid particles and CBPs was well matched except the area close to the passage wall.However, CBPs tended to accumulate and the density of CBPs slightly increased, leading to the jam effect and producing particle accumulation.Conclusion The characteristic of CBP transportation is better understood,which can help develop some chemico-biological protection devices according to movement of CBPs and improve the performance of CBPs during chemico-biological protection.

Clinical features, electroneurophysiology, neuroimaging and gene analysis of one juvenile dentatorubral-pallidoluysian atrophy pedigree / 中华神经科杂志

Objective To explore the clinical features,electroneurophysiology,neuroimaging and gene characteristics of one juvenile dentatorubral-pallidoluysian atrophy (DRPLA) pedigree with an onset of epilepsy.Methods The clinical data of the elder sister and younger brother in a family with juvenile DRPLA were collected.Furthermore,their clinical manifestations,electroneurophysiology results,neuroimaging characteristics and atrophin-1 gene CAG repeat numbers were detected and analyzed in detail.Results There were four patients in this family in total.The probands were two siblings,and they both had the onset manifestation of epilepsy.The younger brother had frequently epileptic seizure,marked cerebellar ataxia,involuntary movement and mental retardation.Compared with her younger brother,the sister had light symptoms such as mild memory deterioration without ataxia and involuntary movement,and she could undertake some simple work.The spike wave and sharp wave complex can be detected in electroencephalogram (EEG) examination,the cortical center segment lesions pathological changes were revealed in somatosensory evoked potentials (EP),and the latency period of P300 was prolonged in the both siblings.Magnetic resonance imaging (MRI) showed that the younger brother had marked atrophies in the cerebral cortex,brainstem and cerebellum.Furthermore,MRI showed that the elder sister had only mild atrophies in the cerebral cortex,brainstem and cerebellum,and that on the contrary some abnormally high signals were observed in cerebral cortex but not white matter.DRPLA gene detection revealed that the numbers of CAG repeats were 15/68 (the younger brother) and 15/64 (the elder sister),respectively.Conclusions Epilepsy,especially the myoclonus,is a common clinical manifestation for juvenile DRPLA,and many other types of epileptic seizures may arise with the development of DRPLA.DRPLA has diverse clinical heterogeneity.EEG,EP and brain MRI examination are great for DRPLA diagnosis and differential diagnosis,and the specific gene detection can be helpful for a definitive diagnosis.

Investigation of CT numbers correction of kilo-voltage cone-beam CT images for accurate dose calculation / 中华放射肿瘤学杂志

Objective To study CT numbers correction of kilo?voltage cone?beam CT (KV?CBCT) images for dose calculation. Method Aligning the CBCT images with plan CT images, then obtain the background scatter by subtracting CT images from CBCT images. The background scatter is then processed by low?pass filter. The final CBCT images are acquired by subtracting the background scatter from the raw CBCT. KV?CBCT images of Catphan600 phantom and four patients with pelvic tumors were obtained with the linac?integrated CBCT system. The CBCT images were modified to correct the CT numbers. Finally, compare HU numbers between corrected CBCT and planning CT by paired T test. Evaluate the image quality and accuracy of dose calculation of the modified CBCT images. Results The proposed method reduces the artifacts of CBCT images significantly. The differences of CT numbers were 232 HU, 89 HU, 29 HU and 66 HU for air, fat, muscle and femoral head between CT and CBCT respectively (P= 0?? 39,0?? 66,0?? 59,1).The differences of CT numbers between CT and CBCT was reduced to within 5 HU. And the error of dose calculation with corrected CBCT images was within 2%. Conclusions The CT numbers of corrected CBCT are similar with plan CT images and dose calculations based on the modified CBCT show good agreement with plan CT.

Image registration of a three-dimensional dynamic phantom in four-dimensional cone-beam computed tomography and four-dimensional computed tomography / 中华放射肿瘤学杂志

Objective To evaluate the image quality and registration accuracy of a three?dimensional ( 3D ) dynamic phantom in four?dimensional computed tomography ( 4DCT ) and four?dimensional cone?beam computed tomography ( 4DCBCT) . Methods The Computerized Imaging Reference Systems Dynamic Thorax Phantom Model 008A was scanned to get 4DCT and 4DCBCT images. Two balls with different diameters ( ?= 1 cm and ?= 2 cm) were used to simulate tumors with different sizes. The motion mode of the balls was 3D sinusoidal motion at 0?25 Hz ( the amplitudes along the x, y, and z axes were ±1?0 cm, ±0?4 cm, and ±0?2 cm, respectively). Gross target volumes (GTVs) from 10?phase bins, internal gross target volumes (IGTV), and target volumes on maximum intensity projection (MIP) and mean intensity projection (MeanIP) images were contoured and calculated. Target volumes on 4DCT or 4DCBCT images were compared with the static and dynamic volumes of the balls ( VS and VD ) . The matching index ( MI) of target volumes between the 4DCT and 4DCBCT images was analyzed after rigid image registration. Results The GTV in each phase of the image was larger than VS . The difference between the average GTV derived from 10 phases of 4DCT or 4DCBCT images and Vs of the small ball was larger than that of the large ball ( 35?03% vs. 22?66%;32?62% vs. 17?00%) . All the IGTVs and target volumes on MIP images were slightly larger than VD , but target volumes on MeanIP images were smaller than VD . The average MI of 10?phase bins of the small ball was smaller than that of the large ball ( 66?76% vs. 82?21%) . Moreover, MIs of IGTV,MIP, and MeanIP of the small ball were also smaller than those of the large ball ( 77?39% vs. 90?29%;75?90% vs. 89?28%;74?47% vs. 82?74%) . Conclusions In the case of a relatively small tumor volume and a relatively large motion amplitude, 4DCT and 4DCBCT should be used with caution for comparison of image registration.

Quality control of linac in daily volumetric-modulated arc therapy / 中华放射肿瘤学杂志

Objective To verify the daily delivery accuracy of volumetric-modulated arc therapy (VMAT) and achieve the process quality control (PQC) of linac using statistical process control (SPC)technology.Methods The log files of all treatments were taken out from the linac system.An in-house software which created by Matlab 7.14 was used to analyze the daily parameters accuracy and the mechanism and dose delivery accuracy of the linac for each VMAT,and an daily evaluation report was automatically created for the linac.The stability of the linac and the deviation of the delivery accuracy for various cancer sites were also analyzed.To achieve the process quality control of hnac using SPC technology,the control limit of each parameter was calculated by Johnson alternation and the single value control charts were drawn.Results 76 patients mainly with nasopharyngeal carcinoma,cervical carcinoma,rectal cancer and laryngeal cancer,got the treatment daily with VMAT technology,and a total of 2 446 arcs were delivered by the linac in continuous 16 days.The gantry angle error,y and x collimator position error,MLC leaf position error and dose delivery error were 0.49°,0.09 mm,0.38 mm,0.31 mm,0.05 MU,respectively.Compare to the nasopharynx,uteri,rectal and larynx cancer,it can be seen that the variation factors of dose delivery and gantry angle errors for various cancer sites were higher,which was 8.10％ and 4.54％,respectively.Through the process quality control of the linac,it was found that all the parameters were in control.While some abnormal points arose (the error was greater than UCL),and the ratio of the gantry angle which was out of control (0.45％) was the highest in all parameters.Conclusions linac delivery accuracy could be monitored and verified during the whole VMAT treatment for each patient,and the daily running condition of linac could be monitored.Through the introduction of SPC technology and the control charts,the process quality control of linac in VMAT could be achieved.It is a financial and valid method for the daily quality assurance of linac.

Cloning and expression of recombinant rat long-chain 2-hydroxy acid oxidase / 中国药学杂志

OBJECTIVE: To clone and express rat long-chain 2-hydroxy acid oxidase. METHODS: Rat long-chain 2-hydroxy acid oxidase gene was amplified from rat kidney cDNA, and was cloned into pET-28a(+) vector as pET28a-rHao2 recombinant plas-mid, which was then transformed into Excherichia coil strain Rosetta (DE3). The expression of recombinant protein was induced by IPTG, and was purified by Ni-NTA purification system. The kinetic parameters of classic substrates were determined by measuring the change of DCIP in A(605) to identify the enzyme activities. RESULTS: The pET28a-rHao2( β2) and pET28a-rHao2 (β2) recombinant plasmids were successfully constructed, and the rat long-chain 2-hydroxy acid oxidase isozymes β1 and β2 were successfully induced and expressed. The Km values of 2-hydroxyoctanoic acid were (25.1±1.9) and (24.6±1.2) μmol · L for the rat long-chain 2-hydroxy acid oxidase isozymes β1 and β2 respectively. The Kn values of (S)-(-)-2-hydroxyisocaproic acid were (24.6±2.3) and (22.4±1.6) μmol · L respectively. CONCLUSION: Rat long-chain 2-hydroxy acid oxidase isozymes β1 and B2 were successfully cloned and expressed with high purity and good enzyme activities. It can be used as a model to screen the substrates and inhibitors of 2-hydroxy acid oxidase in vitro.

Evaluation of visualized area percentage assessment of cleansing score and computed assessment of cleansing score for capsule endoscopy

The purpose of this study was to evaluate the clinical significance of visualized area percentage assessment of cleansing score [AAC] and computed assessment of cleansing score [CAC] of these two small bowel cleanliness scores systems for capsule endoscopy [CE]. The reliability and consistency of the AAC and CAC scores were evaluated by comparing the scores by two examiners [one expert, one without any training in CE]. Reliability was determined using the intraclass correlation coefficient [ICC] and consistency was determined using the kappa statistic. The inter-observer agreement was excellent for both the AAC and CAC scores. For AAC, the ICC was 0.791 [95% confidence interval: 0.677-0.868], and for CAC the ICC was 1.000. Using 1.5 as the cutoff, there was no significant difference between AAC and CAC results by the expert examiner [kappa 0.756, P 0.000] or the non-expert examiner [kappa 0.831, P 0.000]. Evaluation of small bowel cleanliness using AAC took 15-30 min, and evaluation using CAC took about 2-3 min. The overall adequacy assessment [OAA] using the AAC was not significantly different between the two examiners [chi[2] 0.586, P 0.444]. There were also no significant differences between the OAA using the AAC and the OAA using the CAC by the expert examiner [chi[2] 1.730, P 0.188] or the non-expert examiner [chi[2] 1.124, P 0.289]. Both of these scores for assessment of small bowel cleanliness can be useful in clinical practice, but the CAC is simpler to use

Research progress of graphene-based materials in the application to biomedicine / 药学学报

Graphene is a kind of atomic crystal with two-dimensional polycyclic aromatic hydrocarbons planes, which is of great concern in various fields. This paper reviews the latest development of graphene-based materials in biomedical research fields in the recent years, including in vitro and in vivo toxicity, drug loading, targeting controlled release, as well as photodynamic therapy. These researches validate that the graphene-based materials indicate promising prospects in the application to biomedicine.

MR imaging features of adrenal rest tumor / 中华放射学杂志

Objective To investigate the imaging features of adrenal rest tumor.Methods Twelve patients of adrenal rest tumor proved by surgery or clinical diagnosis were retrospectively analyzed.Among these 12 patients,12 were examined with ultrasound,11 with MR and 1 with CT. MR and CT were performed without and with intravenous injection of contrast material.The imaging features of adrenal rest tumor were retrospectively summarized and the relevant literatures reviewed. Results The adrenal rest tumors were found in testis in 10 of the 12 patients,and in ovaries and broad ligament in the remaining two.The imaging features of the testicular adrenal rest tumor were summarized as following:all patients had bilateral testicular masses without change of the testicular contour. On ultrasonography,the lesions were hypoechoic, with some hyperechoic areas and appeared highly vascularized on Colour Doppler ultrasonography.The masses showed iso-density on plain CT,and avid enhancement on post-contrast CT images.The masses ranging in size from0.7 cm×1.0 cm×2.2 cm to 2.3 cm ×2.7 cm ×2.9 cm with uniform signal intensity,lobulated margin on MRI.They exhibited iso- or slight hyperintensity on T1 WI and hypointensity on T2WI relative to normal testicular parenchyma.The tumors showed intense enhancement on post-contrast MR images. No abnormality was detected with Colour Doppler uhrasonography and MR in 2 patients of adrenal rest tumor in ovaries and broad ligament. Conclusion Combining imaging features with the typical clinical history,the diagnosis of adrenal rest tumor could be suggested pre-operatively.

Establishment of a off-pump leukocyte depletion method in canines / 中华麻醉学杂志

Objective To establish a off-pump leukocyte depletion method in canines.Methods Twenty-one healthy adult mongrel dogs of both sexes, weighing 10-12 kg, were randomized into 2 groups: control group (group C, n = 9) and leukocyte depletion group (group LD, n = 12) . An extracorporeal leukocyte filtration end was constructed by aseptic puncture of the bilateral external jugular veins via a blood transfusion line and the leukocyte filter for extracorporeal leukocyte depletion. In group LD, blood was filtered with a MP-300 blood line and a SQ40S leucocyte depletion filter one end placed in the right external jugular vein (artery end) and the other end placed in the left external jugular vein (venous end). After heparin anticoagulation, a MP-300 blood line pump was used as the power. Blood was filtered at a rate of 75 ml/min and it was maintained for 60 min. The artery end was then closed, normal saline injected into the closed circuit, the remaining blood pumped into the body, and then the venous end closed. In group C, aseptic puncture of the bilateral external jugular veins was performed. Arterial blood samples were taken immediately before leukodepletion (baseline, T_0 ) , at 10, 20, 30, 40, 50 and 60 min of leukodepletion (T_(1-6) , depletion period), and at 10, 20, 30, 40, 50, 60, 120, 180 and 270 min after leukodepletion (T_(7-15) , recovery period) for determination of blood routine. MAP, HR, RBC.Plt and body temperature were recorded at T_0 , T_6 , T_(12) and T_(15) . Results There were no significant difference in MAP and RBC between the two groups ( P > 0.05 ) . HR, body temperature, and Plt were significantly lower in group LD than in group C (P < 0.05) .The leukocyte concentration was lower during depletion period in group LD than in group C ( P < 0.05) , while there was no significant difference in leukocyte concentration during recovery period between the two groups (P > 0.05 ). Conclusion The off-pump leukocyte depletion method is successfully established and has exact efficacy with less adverse effects in this study.