Research progress on diabetes and human papilloma virus infection and vaccination / 公共卫生与预防医学

Diabetes is a common chronic non-infectious disease. Diabetic patients not only suffer from metabolic disorders, but are also prone to immune deficiencies and are at a higher risk of being infected with human papillomavirus (HPV). Many studies at home and abroad have shown that the HPV infection rate of patients with diabetes is higher than that of non-diabetic patients. Patients with diabetes can benefit from HPV vaccination, and the tolerance is good. HPV vaccination is recommended for diabetic patients. This article reviews the research on diabetes, HPV infection, and HPV vaccine, which will provide references for HPV vaccination in diabetic patients.

Correlation between DKK1 promoter methylation level and diabetic microangiopathopathy complicated with osteoporosis / 中华内分泌外科杂志

Objective:To investigate the correlation between the promoter methylation level of Dickkopf-related protein 1 (DKK1) gene and diabetic microangiopaopathy complicated with osteoporosis.Methods:Patients with type 2 diabetes mellitus (T2DM) microangiopathopathy who were admitted to our hospital from Jan. 2019 to Dec. 2022 were collected as research objects, and divided into observation group (44 cases) and control group (58 cases) according to whether they were complicated with osteoporosis. Bone mineral density (BMD) of lumbar spine (L1-4) was measured, and bone metabolism indexes, including serum calcium, serum phosphorus, 25-hydroxy vitamin D3[25-hydroxy vitamin D3, 25- (OH) D3], PTH, C-terminal telopeptide of typeI collagen (CTX), procollagen of aminoterminal propeptide (PINP) and tartrate resistant acid phosphatase (TRACP) levels were detected; The promoter methylation level of DKK1 gene was determined.Results:The methylation level of DKK1 gene promoter in the observation group was 5.17%±0.73%, which was significantly higher than that in the control group (3.81%±0.61%), with statistical significance ( t=5.22, P<0.001). The 25- (OH) D3 level, PTH and lumbar bone density in the observation group were significantly lower than those in the control group, while the CTX and TRACP levels were significantly higher than those in the control group ( t was 5.58, 4.35, 4.12, 4.05 and 4.17, respectively, P<0.001). In all patients, the promoter methylation level of DKK1 gene was significantly positively correlated with CTX and TRACP ( r was 0.41 and 0.39, P was 0.006 and 0.027, respectively), and significantly negatively correlated with PTH and lumbar bone density ( r was -0.38 and -0.43, respectively). P=0.015 and 0.003, respectively). ROC curve analysis showed that the area under the curve of DKK1 methylation level to distinguish type 2 diabetes microangionopathy with and without osteoporosis was 0.841 (0.762-0.921), and the sensitivity and specificity were 86.4% and 72.4%, respectively. Conclusion:The methylation level of DKK1 gene promoter is associated with osteoporosis and bone metabolism in T2DM patients with microangiopathia.

Effect of active music therapy on cognitive function for older adults with cognitive impairment: a systematic review based on ICD-11 and ICF / 中国康复理论与实践

ObjectiveTo conduct a systematic review of the effect of active music therapy on cognitive function for older adults with cognitive impairment based on International Classification of Diseases, the 11th Revision (ICD-11), and International Classification of Functioning, Disability and Health (ICF). MethodsA PICO framework was constructed. Thematic keyword searches were conducted in databases including PubMed, Web of Science, Embase, CNKI, VIP, and Wanfang data, for literature on the effect of active music therapy on cognitive function for older adults with cognitive impairment, published up to November 5th, 2023. Information on authors, countries, publication date, sample characteristics, study designs, intervention methods, measurement tools and outcomes were extracted. The methodological quality of the researches was evaluated using the Physiotherapy Evidence Database (PEDro) scale. ResultsEight researches from six countries were included, which were all randomized controlled trials involving 356 older adults with mild cognitive impairment and dementia. The articles were published from 2014 to 2020, with an average of 7.4 of the PEDro scale. Active music therapy was used by singing and playing instruments. Interventions took place in hospitals, nursing homes, and health centers. The intervention duration ranged from mostly 30 to 60 minutes a time, with a few 120 minutes a time. Interventions were implemented mostly one to three times a week, lasting from eight to twelve weeks. Health outcomes focused on cognitive function, including overall cognitive function, executive function, attention function and memory function. ConclusionA theoretical framework for the benefits of active music therapy on the cognitive function for older adults with cognitive impairment has been constructed based on ICD-11 and ICF. Active music therapy can improve overall cognitive function, executive function, attention function and memory function for older adults with cognitive impairment.

3D hippocampal segmentation based on spatial and frequency domain features adaptive fusion and inter⁃class boundary region enhancement / 解剖学报

Objective Hippocampal atrophy is a clinically important marker for the diagnosis of many psychiatric disorders such as Alzheimer’s disease‚ so accurate segmentation of the hippocampus is an important scientific issue. With the development of deep learning‚ a large number of advanced automatic segmentation method have been proposed. However‚ 3D hippocampal segmentation is still challenging due to the effects of various noises in MRI and unclear boundaries between various classes of the hippocampus. Therefore‚ the aim of this paper is to propose new method to segment the hippocampal head‚ body‚ and tail more accurately. Methods To overcome these challenges‚ this paper proposed two strategies. One was the spatial and frequency domain features adaptive fusion strategy‚ which reduced the influence of noise on feature extraction by automatically selecting the appropriate frequency combination through fast Fourier transform and convolution. The other was an inter-class boundary region enhancement strategy‚ which allowed the network to focus on learning the boundary regions by weighting the loss function of the boundary regions between each class to achieve the goal of pinpointing the boundaries and regulating the size of the hippocampal head‚ body and tail. Results Experiments performed on a 50-case teenager brain MRI dataset show that our method achieves state-of-the-art hippocampal segmentation. Hippocampal head‚ body and tail had been improved compared to the existing method. Ablation experiments demonstrated the effectiveness of our two proposed strategies‚ and we also validated that the network had a strong generalization ability on a 260-case Task04_Hippocampus dataset. It was shown that the method proposed in this paper could be used in more hippocampal segmentation scenarios. Conclusion The method proposed in this paper can help clinicians to observe hippocampal atrophy more clearly and accomplish more accurate diagnosis and follow-up of the condition.

Epidemiological characteristics and clinical features of pertussis in Shandong Province from 2007 to 2022 / 中华预防医学杂志

Objective: To analyze the epidemiological characteristics and clinical features of pertussis cases reported in Shandong Province of China. Methods: Data on pertussis cases in Shandong Province from 2007 to 2022 were collected from China Information System for Disease Control and Prevention. At the same time, some case information was collected from the database of notifiable pertussis in Shandong Province from 2007 to 2022. The distribution characteristics and clinical features of pertussis were analyzed. A spatial distribution map of pertussis cases in Shandong Province was drawn. Results: A total of 26 122 pertussis cases were reported in Shandong Province during 2007-2022, with an annual incidence rate ranging from 0.11 to 5.77 cases per 100 000 people. Cases occurred throughout the whole year, with a seasonal peak occurring in spring and summer, especially in July and August. In recent years, reported cases were mainly distributed in the central and western regions of Shandong Province, with fewer cases in the eastern region. The hot spots of the disease shifted from Heze and Dezhou City in 2007-2013 to Jinan and Tai'an city in 2014-2022. The age range of onset was from 1 day to 93 years old. The proportion of cases with age≤1 year was the largest (41.81%, 10 922/26 122), and the proportion of cases aged 0-6 months decreased from 32.21% (67/208)-55.67% (157/282) within the period of 2007 to 2013 to 16.78% (883/5 263)-41.97% (444/1 058) within the period of 2014 to 2022, with a statistically significant trend (χ² trend=670.01, P<0.001). There were 13 682 male cases and 12 440 female cases, with a male-female ratio of 1.10∶1. The male-female ratio was 1.45∶1 (806∶556) from 2007 to 2013 and 1.08∶1 (12 876∶11 884) from 2014 to 2022. The proportion of women increased from 42.31% (88/208) in 2007 to 47.84% (2 518/5 263) in 2022, and with a significant trend (χ² trend=22.25, P<0.001). In pertussis cases, the proportions of scattered children, kindergarten children and students were 71.38% (18 645/26 122), 15.13% (3 951/26 122), and 11.60% (3 031/26 122), respectively. The top five clinical symptoms of pertussis cases were paroxysmal spasmodic cough (86.33%, 21 411 cases), flushing (39.61%, 9 824 cases), restless sleep (34.51%, 8 558 cases), fever (30.80%, 7 638 cases), and crowing (27.53%, 6 829 cases). Among 24 802 cases, there were 15 542 cases (62.66%) with a history of immunization against pertussis vaccine. Conclusion: From 2007 to 2022, the incidence rate of pertussis cases in Shandong Province shows an upward trend, with the majority being young children, and the clinical symptoms are relatively typical.

Epidemiological characteristics and clinical features of pertussis in Shandong Province from 2007 to 2022 / 中华预防医学杂志

Objective: To analyze the epidemiological characteristics and clinical features of pertussis cases reported in Shandong Province of China. Methods: Data on pertussis cases in Shandong Province from 2007 to 2022 were collected from China Information System for Disease Control and Prevention. At the same time, some case information was collected from the database of notifiable pertussis in Shandong Province from 2007 to 2022. The distribution characteristics and clinical features of pertussis were analyzed. A spatial distribution map of pertussis cases in Shandong Province was drawn. Results: A total of 26 122 pertussis cases were reported in Shandong Province during 2007-2022, with an annual incidence rate ranging from 0.11 to 5.77 cases per 100 000 people. Cases occurred throughout the whole year, with a seasonal peak occurring in spring and summer, especially in July and August. In recent years, reported cases were mainly distributed in the central and western regions of Shandong Province, with fewer cases in the eastern region. The hot spots of the disease shifted from Heze and Dezhou City in 2007-2013 to Jinan and Tai'an city in 2014-2022. The age range of onset was from 1 day to 93 years old. The proportion of cases with age≤1 year was the largest (41.81%, 10 922/26 122), and the proportion of cases aged 0-6 months decreased from 32.21% (67/208)-55.67% (157/282) within the period of 2007 to 2013 to 16.78% (883/5 263)-41.97% (444/1 058) within the period of 2014 to 2022, with a statistically significant trend (χ² trend=670.01, P<0.001). There were 13 682 male cases and 12 440 female cases, with a male-female ratio of 1.10∶1. The male-female ratio was 1.45∶1 (806∶556) from 2007 to 2013 and 1.08∶1 (12 876∶11 884) from 2014 to 2022. The proportion of women increased from 42.31% (88/208) in 2007 to 47.84% (2 518/5 263) in 2022, and with a significant trend (χ² trend=22.25, P<0.001). In pertussis cases, the proportions of scattered children, kindergarten children and students were 71.38% (18 645/26 122), 15.13% (3 951/26 122), and 11.60% (3 031/26 122), respectively. The top five clinical symptoms of pertussis cases were paroxysmal spasmodic cough (86.33%, 21 411 cases), flushing (39.61%, 9 824 cases), restless sleep (34.51%, 8 558 cases), fever (30.80%, 7 638 cases), and crowing (27.53%, 6 829 cases). Among 24 802 cases, there were 15 542 cases (62.66%) with a history of immunization against pertussis vaccine. Conclusion: From 2007 to 2022, the incidence rate of pertussis cases in Shandong Province shows an upward trend, with the majority being young children, and the clinical symptoms are relatively typical.

Immunogenicity and reactogenicity of heterologous immunization schedules with COVID-19 vaccines: a systematic review and network meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Data on the immunogenicity and safety of heterologous immunization schedules are inconsistent. This study aimed to evaluate the immunogenicity and safety of homologous and heterologous immunization schedules.@*METHODS@#Multiple databases with relevant studies were searched with an end date of October 31, 2021, and a website including a series of Coronavirus disease 2019 studies was examined for studies before March 31, 2022. Randomized controlled trials (RCTs) that compared different heterologous and homologous regimens among adults that reported immunogenicity and safety outcomes were reviewed. Primary outcomes included neutralizing antibodies against the original strain and serious adverse events (SAEs). A network meta-analysis (NMA) was conducted using a random-effects model.@*RESULTS@#In all, 11 RCTs were included in the systematic review, and nine were ultimately included in the NMA. Among participants who received two doses of CoronaVac, another dose of mRNA or a non-replicating viral vector vaccine resulted in a significantly higher level of neutralizing antibody than a third CoronaVac 600 sino unit (SU); a dose of BNT162b2 induced the highest geometric mean ratio (GMR) of 15.24, 95% confidence interval [CI]: 9.53-24.39. Following one dose of BNT162b2 vaccination, a dose of mRNA-1273 generated a significantly higher level of neutralizing antibody than BNT162b2 alone (GMR = 1.32; 95% CI: 1.06-1.64), NVX-CoV2373 (GMR = 1.60; 95% CI: 1.16-2.21), or ChAdOx1 (GMR = 1.80; 95% CI: 1.25-2.59). Following one dose of ChAdOx1, a dose of mRNA-1273 was also more effective for improving antibody levels than ChAdOx1 (GMR = 11.09; 95% CI: 8.36-14.71) or NVX-CoV2373 (GMR = 2.87; 95% CI: 1.08-3.91). No significant difference in the risk for SAEs was found in any comparisons.@*CONCLUSIONS@#Relative to vaccination with two doses of CoronaVac, a dose of BNT162b2 as a booster substantially enhances immunogenicity reactions and has a relatively acceptable risk for SAEs relative to other vaccines. For primary vaccination, schedules including mRNA vaccines induce a greater immune response. However, the comparatively higher risk for local and systemic adverse events introduced by mRNA vaccines should be noted.@*REGISTRATION@#PROSPERO; https://www.crd.york.ac.uk/PROSPERO/ ; No. CRD42021278149.

Investigation on biological subtypes of depression based on diffusion tensor imaging / 四川精神卫生

BackgroundBeing complex and highly heterogeneous with regard to the etiology and clinical manifestations of depression， neuroimaging studies make a breakthrough for exploring the biological subtypes of depression， while the current data-driven approach for the identification of subtyping depression using structural magnetic resonance imaging （MRI） data is insufficient. ObjectiveTo explore the biological subtypes of depression using diffusion tensor imaging （DTI） and machine learning methods. MethodsA total of 127 patients with depression who attended Beijing Anding Hospital from September 2017 to August 2021 and met the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） diagnostic criteria were included， and another 80 healthy individuals matched for gender and age were recruited through advertisements in surrounding communities during the same period. DTI findings， demographic characteristics and clinical data were collected from all participants. Tract-based spatial statistics （TBSS） and the Johns Hopkins University （JHU） white matter probability maps were used to extract fractional anisotropy （FA） values of white matter tracts. A semi-supervised machine learning technique was used to identify the subtypes， and the FA values for whole brain white matter of patients and controls were compared. ResultsPatients with depression were classified into two biological subtypes. FA values in multiple tracts including corpus callosum and corona radiata of subtype I patients were smaller than those of healthy controls （P<0.01， FDR corrected）， and FA values in middle cerebellar peduncle， left superior cerebellar peduncle and left cerebral peduncle of subtype II patients were larger than those of healthy controls （P<0.01， FDR-corrected）. Baseline Hamilton Depression Scale-17 item （HAMD-17） score yielded no statistical difference between subtype I and subtype II patients （P>0.05）， while subtype I patients scored lower on HAMD-17 than subtype II patients after 12 weeks of treatment （t=2.410， P<0.05）. ConclusionDepression patients exhibit two biological subtypes with distinct patterns of white matter damage. Furthermore， the subtypes respond differently to the medication treatment. ［Funded by the National Key Research and Development Program of China （number， 2016YFC1307200）， the Scientific Research and Cultivation Program of Beijing Municipal Hospitals （number，PX2023066）， Beijing Anding Hospital， Capital Medical University （number，YJ201904， YJ201911）； www.chictr.org.cn number： ChiCTR-OOC-17012566］

Observation on the teaching effect of mind mapping on interns in nephrology department / 中华医学教育探索杂志

Objective:To improve the critical thinking ability of interns in nephrology department based on electronic "Spot" mind mapping teaching method.Methods:In the control group, the traditional clinical teaching method was adopted. Each kidney disease unit was divided into 3 courses. ①The clinical practice teacher dictated or demonstrated his/her experience to the student in the first class. ②Students could exchange questions and answers in the second class. ③In the third class, according to the homework situation, the teacher presided over the discussion, guided the students to express their difficulties and help them solve the problems. The research group adopted the electronic "Spot" mind mapping teaching method: ①Grouping: the students were divided into groups, 6 to 8 people in each group, a total of 16 groups. ②Preparation: each group established a WeChat group, and teachers guided them download the Mindmanager software and learn its mapping method. ③In class: each kidney disease unit was divided into 3 sessions. In the first class, based on what the instructor taught, the students summarized the contents and drew a mind map, and then explain their understanding according to the map. In the second class, "Spot" in the group was conducted based on standards, reading each other in the group, actively discussing with each other, further improving and reconstructing the core knowledge points of the chapter, and encouraging each student to actively participate in enhancing their subjective initiative in learning. In the third class, teachers evaluated students according to their learning situation, and students filled in the gaps according to their opinions, perfected their mind maps, and finally posted to the WeChat group. ④Review: the final versions were sent to the WeChat groups as review materials, which was convenient for learning together. SPSS 24.0 was used for Chi-square test.Results:There was no significant difference between the two groups before study ( P>0.005). After the research, the scores of theory test ( t=2.52, P=0.015), clinical skill test ( t=2.22, P=0.034) and total score ( t=3.53, P=0.003) in the experimental group were significantly higher than those in the control group ( P<0.05). There was no significant difference in the scores of critical thinking ability between the two groups before research ( P>0.05). Six months after research, the total scores of critical thinking ability in the experimental group were significantly higher than those in the control group ( P<0.05). Conclusion:The introduction of electronic "Spot" mind mapping teaching method into clinical practice teaching can realize the cross-linking of related knowledge points and systematize the knowledge. At the same time, it is interesting and can stimulate students' learning interest, and is helpful to cultivate the clinical critical thinking ability of students.

Analysis on the current situation and countermeasures of job burnout among the trainees in the standardized residency training of pediatrics / 中华医学教育探索杂志

Objective:To investigate the current status of job burnout among trainees in the standardized residency training of pediatrics (short for "pediatric residents") in the hope of identifying the problems involved, and proposing corresponding countermeasures and suggestions based on these current situations and problems.Methods:This study conducted a questionnaire survey among the pediatric residents who received the standardized residency training in The Children's Hospital, Zhejiang University School of Medicine. The questionnaire consisted of two parts: general information survey and Maslach job burnout survey. The generated data were analyzed using IBM SPSS 26.0. Chi-square test was used to determine the equilibrium of the groupings for the basic situation of the data. If the normal distribution of the data in two groups was satisfactory, the t-test was used for inter-group comparison; otherwise, the Kruskal-Wallis H test was employed. For more than two groups, if the data met the normal distribution and the variance was homogeneous, one-way analysis of variance was used for inter-group comparison; otherwise, the Kruskal-Wallis H test was used. Multiple linear regression analysis was used for multivariate analysis. Results:A total of 138 pediatric residents participated in this survey. The detection rate of job burnout was 65.2% (90/138), of which 45 (32.6%), 29 (21.0%) and 16 (11.6%) were mild, moderate and severe, respectively. In univariate analysis, there was a statistically significant difference in job burnout among pediatric residents in different grades ( H=7.22, P=0.027), and the low achievement score (27.90±8.48) of the first-year pediatric residents was higher than that of the second-year pediatric residents (23.54±6.79), and the difference was statistically significant ( t=-2.25, P=0.025). Multiple linear regression analysis regression model showed no statistically significant difference. Conclusion:The level of job burnout among pediatric residents is high, and relevant departments should pay attention to the problem of job burnout of the pediatric residents, and take various measures to prevent the occurrence of job burnout.

Comparison of the therapeutic effects of different antibacterial drugs combined in the treatment of adult brucellosis patients / 中华地方病学杂志

Objective:To compare the efficacy of different antibacterial drugs combined in the treatment of adult brucellosis patients.Methods:Using a prospective design, 60 adult brucellosis patients admitted to the Affiliated Hospital of Jining Medical University from January 2018 to December 2021 were selected as the study subjects. They were randomly divided into an observation group ( n = 30) and a control group ( n = 30) using a random number table method. The observation group was treated with rifampicin combined with minocycline, and the control group was given rifampicin combined with doxycycline. The course of treatment in both groups was 6 weeks. The efficacy and clinical symptom disappearance time between the two groups, as well as the blood white blood cell count (WBC), alanine aminotransferase (ALT) levels, and serum interferon-γ (IFN-γ), interleukin-4 (IL-4) and interleukin-10 (IL-10) levels before and after treatment, and the occurrence of adverse reactions were compared. Results:The total effective rate of the observation group (96.67%, 29/30) was higher than that of the control group (73.33%, 22/30), with a statistically significant difference (χ 2 = 4.71, P = 0.030). The disappearance time of joint pain, hyperhidrosis, gastrointestinal reactions, and fever in the observation group were shorter than those in the control group, and the differences were statistically significant ( P < 0.05). After treatment, the blood WBC and ALT levels in both groups decreased compared to before treatment ( P < 0.05). After treatment, the blood WBC and ALT levels in the observation group were lower than those in the control group ( P < 0.001). The levels of serum IFN-γ and IL-10 were both decreased after treatment compared to before treatment in two groups, while IL-4 level increased compared to before treatment ( P < 0.05). The levels of serum IFN-γ and IL-10 in the observation group were lower than those of the control group, while IL-4 level was higher than that of the control group ( P < 0.001). The incidence of adverse reactions in the observation group (13.33%, 4/30) was lower than that in the control group (36.67%, 11/30), and the difference was statistically significant (χ 2 = 4.36, P = 0.037). Conclusion:The combination of rifampicin and minocycline in the treatment of adult brucellosis patients has good efficacy and can reduce serum IFN-γ and IL-10 levels and increase IL-4 level with few adverse reactions.

Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus disease 2019 (version 2023) / 中华创伤杂志

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.

Correlation of related indexes of blood lipid and insulin resistance with cognition scores in middle-aged and elderly people with mild cognitive impairment / 中华健康管理学杂志

Objective:To analyze the correlation between related indexes of serum lipid and insulin resistance and cognitive impairment in middle-aged and elderly people with mild cognitive impairment (MCI).Methods:In this cross-sectional study, 262 middle-aged and elderly patients with a Montreal Cognitive Function Scale (MoCA) cognitive score greater than or equal to 18 points who underwent physical examination in the Health Management Center of Beijing Tiantan Hospital Affiliated to Capital Medical University from January 1 to July 31, 2021 were selected as subjects. According to the cognitive function and MoCA score, the patients were divided into MCI group (143 cases) and normal cognition group (119 cases). Basic data, fasting blood glucose, triglyceride (TG), total cholesterol, apolipoprotein E(ApoE) genotype and other clinical indicators were collected. Hypothesis test was used to compare the differences in basic data, related indicators of blood lipid and insulin resistance between the two groups. Spearman correlation analysis was used to analyze the correlation between related indicators of blood lipid and insulin resistance and MoCA score in the two groups.Results:The age and the proportion of patients with hypertension, coronary heart disease and diabetes in the MCI group were all significantly higher than those in normal cognition group [(54.83±8.29) vs (50.76±6.34) years, 37.76% vs 31.93%, 4.20% vs 0.84%, 16.08% vs 8.40%] (all P<0.05). The elevation of serum TG ( r=-0.50, 95% CI:-0.88--0.12), TG glucose product index (TyG) ( r=-0.75, 95% CI:-1.29--0.20) and TG to high-density lipoprotein cholesterol ratio (TG/HDL-C) ( r=-0.52, 95% CI:-0.91--0.13) were all negatively correlated with MoCA score (all P<0.05). After adjusting for age and gender, the elevation of TG ( r=-0.39, 95% CI:-0.75--0.31) and TG/HDL-C ( r=-0.43, 95% CI:-0.80--0.05) were both still negatively correlated with MoCA score (both P<0.05). There was no significant correlation between all indexes and MoCA scores in the normal cognition group (all P>0.05). The elevated TG was negatively correlated with MoCA score in the MCI group ( r=-0.70, 95% CI:-1.23-0.16, P=0.017). There was no significant correlation between elevated TG and MoCA score in patients carrying ApoE ε2 and ApoE ε3 genotypes in MCI group (all P>0.05). Conclusion:Elevated related indexes of blood lipids and insulin resistance are negatively correlated with cognitive scores in middle-aged and elderly people with MCI, and it′s more obvious in patients with ApoE ε4 genotype.

Role of Homer1a/mGluR5 signaling pathway in cognitive dysfunction induced by sleep deprivation in aged rats / 中华麻醉学杂志

Objective:To evaluate the role of Homer1a/metabotropic glutamate receptor 5 (mGluR5) signaling pathway in sleep deprivation-induced cognitive dysfunction in aged rats.Methods:One hundred and four SPF healthy male Sprague-Dawley rats, aged 22-24 months, weighing 320-360 g, were divided into 4 groups ( n=26 each) using a random number table method: normal control group (group Control), sleep deprivation+ vehicle group (group SD+ Vehicle), sleep deprivation+ mGluR5 forward allosteric agent CDPPB group (group SD+ CDPPB), and sleep deprivation+ mGluR5 antagonist MPEP group (group SD+ MPEP). A 48-h sleep deprivation model was developed by sleep-deprived rod method. At the beginning of developing the model and 24 h after developing the model, CDPPB 10 mg/kg, MPEP 10 mg/kg and the equal volume of 1% Tween 80 were intraperitoneally injected in group SD+ CDPPB, group SD+ MPEP and group SD+ Vehicle, respectively.Morris water maze and novel object recognition tests were conducted to evaluate cognitive function after development of the model. The expression of Homer1a and mGluR5 in the hippocampus was detected by Western blot, the dendritic spine density in the hippocampal CA1 region was detected by Golgi staining, and the field excitatory postsynaptic potential (fEPSP) slope in the hippocampal CA1 region was detected by isolated electrophysiology. Results:Compared with Control group, the number of crossing the original platform, time of staying at the target quadrant, and novel object recognition index at 1 and 24 h after training were significantly decreased, the expression of Homer1a in the hippocampus was up-regulated, the expression of mGluR5 in the hippocampus was down-regulated, and the density of dendritic spine and fEPSP slope in the hippocampal CA1 region were decreased in group SD+ Vehicle ( P<0.05). Compared with group SD+ Vehicle, the number of crossing the original platform, time of staying at target quadrant, and novel object recognition index at 1 and 24 h after training were significantly increased, the expression of mGluR5 in hippocampus was up-regulated, and the density of dendritic spines and fEPSP slope in the hippocampal CA1 region were increased in group SD+ MPEP( P<0.05), and no statistically significant change was found in the parameters mentioned above in group SD+ CDPPB ( P>0.05). Conclusions:Sleep deprivation impairs the synaptic plasticity of hippocampal neurons by regulating Homer1a/mGluR5 signaling pathway, and thus mediating the process of cognitive dysfunction in aged rats.

Progress of CD99 as a potential therapeutic target for leukemia / 白血病·淋巴瘤

CD99 gene encodes a transmembrane protein and participates in cell differentiation, adhesion, migration and protein transport. The expression of CD99 is generally low in most normal tissues and cells, and CD99 is differentially expressed in bone marrow and the surface of lymphatic hematopoietic cells. This article reviews the research progress of CD99 in hematological diseases, explores the role of CD99 in myeloid and lymphocytic leukemia, and the significance of CD99 as a therapeutic target for hematological malignancies.

Diagnostic Efficacy of Blood Inicators in the Diagnosis and Treatment of Gram-positive Cocci and Gram-negative Bacilli Infection / 昆明医科大学学报

Objective To explore the differences in the effectiveness of using different blood indicators individually,in combination,and for dynamic monitoring in the diagnosis,differential diagnosis,and prognosis of bacterial infections.Methods 1843 cases with infectious symptoms or signs from January 2015 to September 2022 at the People's Hospital of Yuxi City were selected as the case group,and 2298 uninfected individuals during the same period were selected as the control group.Blood indicators of the two groups were collected.Variables were grouped according to gender,age group,specimen type,etc.SPSS 24.0 and Medcalc 20.0 were used for statistical analysis.Results The individual diagnostic efficacy of various blood indicators for detecting infection ranges from 0.656 to 0.937.When used together,the efficacy ranges from 0.907 to 0.987.The efficacy of distinguishing between G+c and G-b in different specimens is as follows:when PCT is used alone in blood,the AUC is 0.875 for males and 0.769 for females.However,the individual diagnostic efficacy in male mucous secretions,sterile body fluids,and non-adult male sputum is all≤0.7.Yet,when used together,the efficacy is AUC(0.789,0.737,0.86)respectively.The dynamic monitoring of PCT,IL-6,CRP,WBC,and LAC in adult patients at 24 h,48 h,and 72 h after admission shows statistically significant differences in prognostic efficacy for G+c and G-b(P<0.05).Conclusions Blood indicators have a certain diagnostic value for determining whether there is a bacterial infection,and there are gender differences.The combined use of these indicators is more effective.The diagnostic value of using blood indicators alone or in combination for distinguishing between G+c and G-b in different types of specimens varies.The use of PCT alone in blood specimens is the most effective.For adult males,the combined use of body surface mucous secretions and sterile body fluids is most effective,while for underage males,the combined use of sputum is most effective.The combined use for females is not effective.Dynamic monitoring of PCT,CRP,IL-6,LAC,and WBC has a high value for evaluating the prognosis and therapeutic effect of infections.The evaluation of G+c infection is most effective at 24 hours for IL-6,and for G-b infection,it is most effective at 72 hours for PCT.

Correlation between methylation and expression of RUNX2 gene in peripheral blood and sensitivity to neoadjuvant chemotherapy in breast cancer / 中华内分泌外科杂志

Objective:To investigate the correlation between the methylation and expression of Runt associated transcription factor 2 (RUNX2) gene in peripheral blood and sensitivity to neoadjuvant chemotherapy in breast cancer.Methods:90 female breast cancer patients who received full-course neoadjuvant chemotherapy and surgical resection for the first time in our hospital from Jan. 2021 to Jun. 2022 were included as the study objects, and 90 healthy women who underwent physical examination in our hospital during the same period were included as the control group. The methylation level of RUNX2 gene in peripheral blood of all subjects was detected by sulfite conversion method, and the mRNA expression level of RUNX2 gene in peripheral blood was detected by fluorescence quantitative PCR. The effects of neoadjuvant chemotherapy in breast cancer patients were divided into sensitive and insensitive groups.Results:The positive rate of RUNX2 gene methylation in peripheral blood of breast cancer patients was 41.11% (37/90) , significantly lower than that of the control group (64.44% (58/90) , the difference was statistically significant ( χ2=9.830, P=0.002) . The mRNA expression level of RUNX2 gene in peripheral blood of breast cancer patients was 1.73±0.24, which was significantly higher than that of the control group (1.19±0.18) , and the difference was statistically significant ( t=5.221, P<0.001) . The mRNA expression level of RUNX2 methylation-positive patients in peripheral blood of breast cancer patients was 1.26±0.20, significantly lower than that of RUNX2 methylation-negative patients (1.84±0.26) , and the difference was statistically significant ( t=4.981, P<0.001) . The positive rate of RUNX2 gene methylation was 49.28% (34/69) in patients with sensitivity to neoadjuvant chemotherapy, significantly higher than 14.29% (3/21) in patients with insensitive chemotherapy, and the difference was statistically significant ( χ2=8.142, P=0.004) . The mRNA expression level of RUNX2 gene in peripheral blood of neoadjuvant chemotherapy sensitive patients was 1.62±0.17, which was significantly lower than that of insensitive patients (2.09±0.22) , and the difference was statistically significant ( t=5.283, P<0.001) . The ROC curve showed that the sensitivity and specificity of RUNX2 mRNA expression in peripheral blood to predict the effect of neoadjuvant chemotherapy were 85.7% and 85.5%, respectively. Conclusion:The methylation and expression level of RUNX2 gene in peripheral blood are related to the sensitivity of neoadjuvant chemotherapy in breast cancer, and can be used as a marker to predict the efficacy of neoadjuvant chemotherapy in breast cancer.

Study of subject services in hospital libraries based on the institutional repository to assist high quality development of nursing research / 中华医学科研管理杂志

Objective:This study aims to investigate how hospital libraries can leverage their institutional repositories to enhance the quality of nursing research by providing tailored subject services.Methods:We analyzed the various modules and functionalities of institutional repositories, drawing insights from practical experiences. From this, we developed a model that enables hospital libraries to offer precise subject services to nursing management departments and nursing researchers.Results:Utilizing the institutional repository, libraries were able to provide detailed profiles of nursing research activities to research management departments for more refined management. We established precise, tiered subject services, including the collection of nursing research literature, targeted training, and additional research support services. These measures significantly enhanced the research capabilities of nursing staff.Conclusions:Adapting to the needs of our readers, the application of the institutional repository has broadened the scope of subject services, bolstered their effectiveness, and contributed to the high-quality progression of nursing research management in hospitals.

Impact of Target Lesion Calcification Evaluated by Coronary Angiography on Immediate Procedure Success Rate and Long-term Prognosis in Patients Underwent Percutaneous Coronary Intervention / 中国循环杂志

Objectives:To analyze the impact of target lesion calcification evaluated by coronary angiography on immediate procedure success rate and long-term clinical outcome in patients underwent percutaneous coronary intervention(PCI). Methods:Consecutive patients received angiographic calcification evaluation and underwent PCI in Fuwai Hospital,Chinese Academy of Medical Sciences from January 2017 to December 2018 were prospectively enrolled in this study.Patients are divided into 4 groups,including non-calcification group(n=14 387),mild calcification group(n=8 231),moderate calcification group(n=3 208)and severe calcification group(n=886).The primary endpoint was immediate post-PCI procedure success rate,which was defined as residual stenosis<50%without major operational complications(including coronary artery perforation,coronary artery dissection,intraoperative stent thrombosis)and failure to cross the lesion.The long-term clinical endpoint was the 3-year major adverse cardiovascular events(MACE),which included composite endpoint events such as all cause death,myocardial infarction(MI),and revascularization. Results:The severe calcification group had a lower success rate of interventional therapy(80.59%vs.94.23%vs.94.29%vs.91.49%),a higher incidence of residual stenosis≥50%(17.72%vs.5.03%vs.4.84%vs.7.29%),a higher incidence of coronary artery dissection(1.81%vs.0.66%vs.0.78%vs.1.25%),and a higher incidence of coronary artery perforation(2.14%vs.0.51%vs.0.38%vs.0.69%),and a higher incidence of failure to cross the lesion(0.23%vs.0.12%vs.0.04%vs.0.16%)compared to the non-calcification group,mild calcification group,and moderate calcification group(all P<0.05).Multivariate Cox regression analysis showed that patients with severe calcification had a higher risk of MACE(12.98%vs.9.35%,HR=1.21,95%CI:1.00-1.47,P=0.046),all-cause mortality(4.29%vs.1.80%,HR=1.55,95%CI:1.10-2.18,P=0.013),and MI(2.14%vs.0.97%,HR=1.97,95%CI:1.21-3.20,P=0.006)compared to patients without calcification. Conclusions:Patients with angiographic-detected severe calcification after PCI treatment face higher risk of PCI procedure failure,MACE,all-cause death,and MI compared to patients without,with mild,and moderate calcification.

A NIR fluorescent probe for Vanin-1 and its applications in imaging, kidney injury diagnosis, and the development of inhibitor

Vanin-1 is an amidohydrolase that catalyses the conversion of pantetheine into the amino-thiol cysteamine and pantothenic acid (coenzyme A precursor), which plays a vital role in multiple physiological and pathological processes. In this study, an enzyme-activated near-infrared (NIR) fluorescent probe (DDAV) has been constructed for sensitively detecting Vanin-1 activity in complicated biosamples on the basis of its catalytic characteristics. DDAV exhibited a high selectivity and sensitivity toward Vanin-1 and was successfully applied to the early diagnosis of kidney injury in cisplatin-induced kidney injury model. In addition, DDAV could serve as a visual tool for in situ imaging endogenous Vanin-1 in vivo. More importantly, Enterococcus faecalis 20247 which possessed high expression of Vanin-1 was screened out from intestinal bacteria using DDAV, provided useful guidance for the rational use of NSAIDs in clinic. Finally, oleuropein as a potent natural inhibitor for Vanin-1 was discovered from herbal medicines library using a high-throughput screening method using DDAV, which held great promise for clinical therapy of inflammatory bowel disease.