Single-cell analysis revealing the metabolic landscape of prostate cancer.

Tumor metabolic reprogramming is a hallmark of cancer development, and targeting metabolic vulnerabilities has been proven to be an effective approach for castration-resistant prostate cancer (CRPC) treatment. Nevertheless, treatment failure inevitably occurs, largely due to cellular heterogeneity, which cannot be deciphered by traditional bulk sequencing techniques. By employing computational pipelines for single-cell RNA sequencing, we demonstrated that epithelial cells within the prostate are more metabolically active and plastic than stromal cells. Moreover, we identified that neuroendocrine (NE) cells tend to have high metabolic rates, which might explain the high demand for nutrients and energy exhibited by neuroendocrine prostate cancer (NEPC), one of the most lethal variants of prostate cancer (PCa). Additionally, we demonstrated through computational and experimental approaches that variation in mitochondrial activity is the greatest contributor to metabolic heterogeneity among both tumor cells and nontumor cells. These results establish a detailed metabolic landscape of PCa, highlight a potential mechanism of disease progression, and emphasize the importance of future studies on tumor heterogeneity and the tumor microenvironment from a metabolic perspective.

Understanding Variations in the Management of Displaced Distal Radius Fractures With Satisfactory Reduction.

BACKGROUND: The American Academy of Orthopaedic Surgeons has set forth Clinical Practice Guidelines (CPGs) to help guide management of closed, displaced distal radius fractures (DRFs). There still exists variation in practice regarding operative vs nonoperative decision-making. This study aims to identify which factors influence the decision to treat DRFs not indicated for surgery by the CPGs after initial closed reduction. METHODS: Fifteen sets of DRFs and clinical vignettes were distributed via email to over 75 orthopedic residency programs, Orthopaedic Trauma Association, and New York Society for Surgery of the Hand membership. A Qualtrics survey collected respondent demographics, choice of treatment, and rationale. RESULTS: Responses were received from 106 surgeons and resident trainees. The odds of selecting operative management for fractures with 5 or more radiographic instability signs versus 3 or 4 was 3.11 (P < .05). Age over 65, higher patient activity level, and dominant-hand injury were associated with greater odds of operative management (3.4, 30.28, and 2.54, respectively). In addition, surgeons with more years in practice and high-volume surgeons had greater odds of selecting operative management (2.43 and 2.11, respectively). CONCLUSIONS: Assessment of instability at the time of injury, patient age and activity level, as well as surgeon volume and time in practice independently affect the decision to manage well-reduced DRF with surgical or nonsurgical treatment. The source of heterogeneity in the treatment of these fractures is borne at least in part from a lack of formal direction on the importance of prereduction instability from the CPGs.

The role of glutamine metabolism in castration-resistant prostate cancer.

Reprogramming of metabolism is a hallmark of tumors, which has been explored for therapeutic purposes. Prostate cancer (PCa), particularly advanced and therapy-resistant PCa, displays unique metabolic properties. Targeting metabolic vulnerabilities in PCa may benefit patients who have exhausted currently available treatment options and improve clinical outcomes. Among the many nutrients, glutamine has been shown to play a central role in the metabolic reprogramming of advanced PCa. In addition to amino acid metabolism, glutamine is also widely involved in the synthesis of other macromolecules and biomasses. Targeting glutamine metabolic network by maximally inhibiting glutamine utilization in tumor cells may significantly add to treatment options for many patients. This review summarizes the metabolic landscape of PCa, with a particular focus on recent studies of how glutamine metabolism alterations affect therapeutic resistance and disease progression of PCa, and suggests novel therapeutic strategies.

Research advances in hemorrhage after endoscopic retrograde cholangiopancreatography / 临床肝胆病杂志

Although hemorrhage after endoscopic retrograde cholangiopancreatography （ERCP） is mostly mild and self－limited， sometimes blood transfusion and endoscopic hemostasis are still needed. However， rebleeding may occur after conventional endoscopic hemostasis and thus requires interventional vascular embolization or surgical intervention， which might significantly increase the risk of death associated with post－ERCP bleeding. This article discusses the risk factors for post－ERCP bleeding， including disease－specific factors， patient－related factors， and operation－related factors， and elaborates on different measures for the prevention and treatment of post－ERCP bleeding， so as to provide a reference for identifying the high－risk population for bleeding and developing precise surgical strategies in clinical practice.

Curative effects of levodopa and benserazide hydrochloride combined with pramipexole on Parkinson's disease in 30 patients / 中国基层医药

Objective:To investigate the efficacy of levodopa and benserazide hydrochloride combined with pramipexole in the treatment of Parkinson's disease in 30 patients and their effects on neurotransmitters and oxidative stress response.Methods:A total of 90 patients with Parkinson's disease admitted to Jinhua People's Hospital from January 2020 to February 2022 were included in this study. They were randomly assigned to undergo treatment with levodopa and benserazide hydrochloride (levodopa and benserazide hydrochloride group), pramipexole (pramipexole group), or their combination (combined therapy group), with 30 patients in each group. All patients were treated for 12 consecutive weeks. Clinical efficacy, levels of brain neurotransmitters (dopamine, 5-hydroxytryptamine, norepinephrine, and substance P), and oxidative stress response (superoxide dismutase, malondialdehyde, homocysteine levels) were compared among the three groups.Results:Total response rate in the combined therapy group was 96.67% (29/30), which was significantly higher than 66.67% (20/30) in the levodopa and benserazide hydrochloride group and 76.67% (23/30) in the pramipexole group ( χ2 = 8.65, P < 0.05). After treatment, dopamine, 5-hydroxytryptamine, norepinephrine, substance P, superoxide dismutase, malondialdehyde, and homocysteine levels in the combined therapy group were (9.05 ± 1.24) ng/mg, (89.49 ± 10.69) μg/L, (15.16 ± 1.36) ng/mg, (102.8 ± 15.36) μg/L, (88.40 ± 10.04) kU/L, (5.5 ± 2.31) μmol/L, and (9.20 ± 3.36) μmol/L, respectively, which were superior to (6.61 ± 1.02) ng/mg, (68.52 ± 9.52) μg/L, (12.33 ± 1.24) ng/mg, (151.64 ± 16.03) μg/L, (74.99 ± 7.28) kU/L, (9.27 ± 3.07) μmol/L, and (13.52 ± 3.64) μmol/L in the levodopa and benserazide hydrochloride group and (7.22 ± 1.09) ng/mg, (79.52 ± 10.20) μg/L, (13.92 ± 1.31) ng/mg, (131.30 ± 15.65) μg/L, (80.59 ± 8.24) kU/L, (7.53 ± 2.93) μmol/L, (11.35 ± 3.71) μmol/L in the pramipexole group ( F = 38.53, 32.05, 35.49, -73.42, 18.42, -22.65, -12.13, all P < 0.05). Conclusion:Levodopa and benserazide hydrochloride combined with pramipexole are highly effective on Parkinson's disease. The combined therapy can effectively improve brain neurotransmitters and regulate oxidative stress response.

Exploration of transcriptome SSR markers and its application in genetic diversity assessment of Asarum sieboldii / 中国中药杂志

To explore the genetic diversity of Asarum sieboldii this study developed SSR markers based on transcriptome sequencing results and five populations of A.sieboldii from different regions were used as samples for genetic diversity assessment using software such as GenALEx 6.5, NTSYS 2.1, and Structure 2.3.4. The results showed that 16 SSR markers with high polymorphism and good repeatability were selected from the A.sieboldii transcriptome. Primers designed based on the flanking sequences of these markers successfully amplified 56 polymorphic fragments from 150 individual samples of the five A.sieboldii populations. On average, each primer amplified 3.5 polymorphic fragments, ranging from 2 to 8. The mean values of expected heterozygosity(H_e), Shannon's diversity index(I), Nei's gene diversity index(H), and the polymorphic information content(PIC) were 0.172, 0.281, 0.429, and 0.382, respectively. The mean population differentiation coefficient(F_(ST)) was 0.588, consistent with the analysis of molecular variance(AMOVA) results, which indicated greater genetic variation among A.sieboldii populations(69%) than that within populations(31%). The percentage of polymorphic loci(PPL) ranged from highest to lowest as SNJ>LN>SY>SZ>TB. Principal coordinate analysis(PCoA) and UPGMA clustering analysis further revealed genetic clustering of A.sieboldii individuals based on their geographical distribution, consistent with the results of the structure clustering analysis. In summary, the SSR markers developed from the transcriptome effectively assessed the genetic differentiation and population structure of natural A.sieboldii populations, revealing a relatively low genetic diversity in A.sieboldii, with genetic variation primarily observed at the population level and a correlation between population differentiation and geographic distance.

The role of glutamine metabolism in castration-resistant prostate cancer / 亚洲男科学杂志(英文版)

Reprogramming of metabolism is a hallmark of tumors, which has been explored for therapeutic purposes. Prostate cancer (PCa), particularly advanced and therapy-resistant PCa, displays unique metabolic properties. Targeting metabolic vulnerabilities in PCa may benefit patients who have exhausted currently available treatment options and improve clinical outcomes. Among the many nutrients, glutamine has been shown to play a central role in the metabolic reprogramming of advanced PCa. In addition to amino acid metabolism, glutamine is also widely involved in the synthesis of other macromolecules and biomasses. Targeting glutamine metabolic network by maximally inhibiting glutamine utilization in tumor cells may significantly add to treatment options for many patients. This review summarizes the metabolic landscape of PCa, with a particular focus on recent studies of how glutamine metabolism alterations affect therapeutic resistance and disease progression of PCa, and suggests novel therapeutic strategies.

Short-Term Power Prediction of a Photovoltaic Power Station Based on the SSA-CEEMDAN-FCN Model.

Photovoltaic power generation is greatly affected by weather factors. To improve the prediction accuracy of photovoltaic power generation, complete ensemble empirical mode decomposition with an adaptive noise algorithm (CEEMDAN) is proposed to preprocess the power sequence. Then, the full convolutional network (FCN) model optimized based on the sparrow search algorithm (SSA) is used to predict the short-term photovoltaic power. SSA can more reasonably determine the parameters of FCN and improve the prediction performance of FCN. Therefore, the FCN model optimized by the SSA algorithm is used to establish prediction models for subsequences and predict each subsequence, respectively. Finally, the predicted value of each subsequence is superimposed. Taking the actual data of a photovoltaic power station in Jiangsu province of China as an example, by comparing some different common prediction models, it is proved that the proposed method is reasonable and feasible.

Is intravenous immunoglobulin a risk factor for necrotizing enterocolitis in neonates with haemolytic disease of the newborn? A retrospective cohort study.

BACKGROUND AND OBJECTIVES: To assess whether the use of intravenous immunoglobulin (IVIG) in late-preterm and term newborns with haemolytic disease of the newborn (HDN) is associated with an increased risk of necrotizing enterocolitis (NEC). MATERIALS AND METHODS: A retrospective cohort study was conducted in a tertiary centre. Infants with HDN during early neonatal period (<7 days) who were of ≥34 weeks' gestation and born between January 2019 and October 2021 were included. Propensity score, interaction as well as univariate and multiple logistic regression analyses were employed. RESULTS: One-thousand two-hundred and fifty-nine infants with HDN were enrolled, of whom 192 (15.3%) received IVIG. NEC was diagnosed in 29 (2.3%) patients with 5 (2.6%) in the IVIG group and 24 (2.2%) in the non-IVIG group. No significant association between IVIG administration and confirmed NEC was observed using univariate analysis (p > 0.05). The possible predictors of NEC, as assessed by multivariate analysis, were caesarean delivery, haemoglobin on admission <130 g/L and patent ductus arteriosus (PDA). There was no interactive effect of IVIG against NEC for prematurity, low birth weight, caesarean delivery, haemoglobin on admission <130 g/L and PDA. CONCLUSIONS: In late-preterm and term infants with HDN, there was no evidence that the early use of IVIG led to the development of NEC.

Relationship between homocysteine metabolizing enzyme gene polymorphism and prognosis of multiple myeloma in Han nationality / 中国医师进修杂志

Objective:To investigate the clinical relationship between homocysteine (Hcy) metabolizing enzyme gene polymorphism and poor prognosis of multiple myeloma (MM) in Han nationality.Methods:One hundred and twenty-eight MM patients of Han nationality admitted to the First Affiliated Hospital of Hebei North University from February 2018 to March 2020 were selected as the disease group, and 120 healthy volunteers of Han nationality were recruited as the control group at the same time. Blood samples were taken to detect plasma Hcy level and Hcy metabolizing enzyme gene polymorphism, including methylenetetrahydrofolate reductase(MTHFR) C677T, MTHFRA1298C, methionine synthase reductase(MTRR) A66G, cystathionine beta-synthase(CBS) 844ins68 and methionine synthase (MS) A2756G. The patients in the disease group were treated with conventional methods , followed up for 1 year after treatment, and the incidence of poor prognosis was counted. Plasma Hcy level, genotype distribution and allele frequency of Hcy metabolic enzymes were compared between the two groups. Logistic multiple regression analysis was used to analyze the association of Hcy metabolizing enzyme gene polymorphism with MM poor prognosis in Han nationality.Results:The plasma Hcy level in the disease group was higher than that in the control group: (15.01 ± 2.98) μmol/L vs. (8.45 ± 1.69) μmol/L, there was statistical difference ( P<0.05). The frequency of TT genotype and T allele of MTHFRC677T locus in the disease group were higher than those in the control group : 26.56% vs. 6.67% , 29.30 vs. 16.25%; while the frequency of CT genotype in the disease group was lower than that in the control group: 5.47% vs. 19.17% , there were statistical differences ( P<0.05). There were no significant differences in genotype distribution and allele frequency of other gene loci between the two groups ( P>0.05). The incidence of poor prognosis in the disease group was 49.22%(63/128). Age, platelet count, serum β 2 microglobulin level, serum κ light chain level, plasma Hcy level and TT genotype of MTHFRC677T locus were the influencing factors of poor prognosis in the disease group ( OR = 7.286, 0.545, 6.841, 6.284, 8.117 and 8.440; P<0.05). Conclusions:The plasma Hcy level, TT genotype and T allele frequency of MTHFRC677T locus in MM patients of Han nationality are higher than those in healthy people, while the CT genotype frequency is lower than that in healthy people. The poor prognosis of MM in Han nationality is related to plasma Hcy level and TT genotype of MTHFRC 677T locus.

Efficacy and Safety of Helicobacter pylori Eradication in the Elderly: A Propensity Score Matching Analysis / 胃肠病学

Background: The benefits and risks of eradicating Helicobacter pylori (Hp) should be balanced in aged people. Aims: To investigate the efficacy, safety and antibiotic resistance status of Hp eradication treatment in the elderly. Methods: Four cohorts of subjects who received Hp eradication treatment in randomized controlled trials conducted in Chongqing Daping Hospital were reviewed; the demographic and clinical data were extracted and recorded. Propensity score matching was performed to select comparable elderly group (≥60 years old) and non-elderly group (0.05). Furthermore, there were no significant differences in the Hp eradication rates in terms of gender, cigarette smoking, alcohol consumption, comorbidities (hypertension, diabetes, surgical history, and inflammation), compliance, etc. in the elderly group (all P> 0.05). But in retreated elderly subjects, the resistance rate of clarithromycin was higher than that in naïve elderly subjects (P<0.05). Smoking and poor compliance were identified as independent risk factors for Hp eradication by multivariate Logistic regression analysis. Conclusions: Hp eradication in the elderly demonstrates comparable efficacy and safety with non-elderly subjects. Clarithromycin-containing regimens are not recommended for empirical retreatment in aged people.

Honokiol inhibits IL-1 induced angiogenesis in human lung cancer cell H460 through NF-kB signaling pathway / 中国药理学通报

Aim To investigate the effect of honokiol(HNK)on the angiogenesis of lung cancer cells H460 induced by the tumor inflammatory microenvironment and its possible mechanism.Methods CCK-8 was used to detect the effect of HNK on the proliferation of H460 cells and human umbilical vein endothelial cells(HUVECs); RT-PCR, Western blot, immunofluorescence were used to detect the expression of vascular endothelial growth factor(VEGF); Western blot was used to detect the signaling pathway protein p-IκBα, p-IKKα and NF-κB p65 protein expression.The wound healing test, transwell and tube formation tests were used to detect the inhibition ability of HNK on the migration and angiogenesis of HUVECs.Results HNK treated H460 cells for 24, 48, 72 h respectively, and inhibited the proliferation of H460 cells in a concentration-and time-dependent manner.HNK inhibited the survival of HUVEC cells in a concentration-dependent manner.HNK also reduced the protein and mRNA expression levels of VEGF in H460 cells.Subsequently, HNK concentration-dependently inhibited the phosphorylation of IκBα, NF-κB and IKKα in the NF-κB signaling pathway.Wound healing test, Transwell cell migration test and tube formation test showed that H460 conditioned medium treated with HNK had the ability to inhibit the migration and angiogenesis of HUVECs.Conclusions HNK reduces the viability and angiogenesis of human lung cancer cells by down-regulation of VEGF via the NF-κB pathway.

Application of flipped classroom combined with case workshop in general surgical practice teaching of undergraduate nursing students / 中华医学教育探索杂志

Objective:To explore the application of flipped classroom combined with case workshop in general surgical practice teaching of undergraduate nursing students.Methods:The subjects of this study were nursing undergraduates practicing in general surgery department of a "three A" hospital. The experimental group included 44 interns from July 2019 to January 2020 who were taught by the flipped classroom combined with case workshop teaching mode. The control group included 45 interns from July 2018 to January 2019 who were given the traditional teaching mode. The two groups of students were evaluated for their clinical ability before and after the internship, and their out-department theoretical and operational performances were assessed and the survey of internship satisfaction was conducted. SPSS 19.0 was used for t test and chi-square test. Results:Before the internship, there was no statistical significance in the scores of clinical ability between the two groups ( P > 0.05). After the internship, the overall evaluation scores of clinical ability of the experimental group were (7.11±0.54) points, which were significantly higher than that of the control group (6.42±0.58) points ( t=-5.81, P < 0.001); the total satisfaction scores of the experimental group were (3.46±0.25) points, which were significantly higher than that of the control group (3.09±0.32) points ( t=-6.04, P < 0.001). The operation scores of the experimental group were (90.22±4.70) points, which were significantly higher than that of the control group (86.99±7.39) points ( t=-2.46, P=0.024). Conclusion:The teaching mode of flipped classroom combined with case workshop in nursing undergraduate general surgery practice can improve students' clinical ability and internship satisfaction, and improve the teaching effect of internship effectively.

Network Meta-analysis of the impact of different non-pharmacological interventions on blood glucose management in children and adolescents with type 1 diabetes / 中国实用护理杂志

Objective:To evaluate and rank the effects of different non-pharmaceutical interventions on the management of blood glucose in children and adolescents with type 1 diabetes by Bayesian network Meta-analysis.Methods:Computer search for PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China Biomedical Literature Database, China Knowledge Network, Wangfang Data and VIP Database, China and the United States Clinical Registration Center, the search time limit is from the establishment of each database to December 2020. Use WinBUGS, GeMTC, Stata software for blood glucose management data analysis.Results:Finally, 37 articles were included, with a total of 4 188 cases, involving 14 non-pharmaceutical intervention programs. The results of the network Meta-analysis showed that when different non-pharmacological interventions were used, the effectiveness of blood glucose management in children and adolescents with type 1 diabetes was ranked as follows: peer support education first, cognitive behavioral therapy second, advanced diabetes education third, family support intervention fourth, self guided intervention (GSD-Y) fifth, case training sixth, positive psychological intervention seventh, mobile phone based remote intervention eighth, diabetes education ninth, supportive consultation tenth, network based remote intervention eleventh position, multi-system therapy multi system therapy twelfth, conventional nursing thirteenth, motivational interview fourteenth.Conclusions:The available evidence shows that peer support education and cognitive behavioral therapy show certain advantages in blood glucose management in children and adolescents with type 1 diabetes, while motivational interviews perform the worst. Future research will further consider other potential benefits of non-pharmacological interventions, such as emotional health and diabetes self-management behavior.

Correlation between Serum Homocysteine Level, MTHFR Gene Polymorphism and Patients with Hematological Diseases Complicated with Coronary Heart Disease / 中国实验血液学杂志

OBJECTIVE@#To observe the expression level of serum homocysteine (Hcy) and methylenetetrahydrofolate reductase (MTHFR) gene polymorphism in patients with hematological diseases complicated with coronary heart disease, and analyze the relationship between serum Hcy level, MTHFR gene polymorphism and coronary heart disease.@*METHODS@#The medical records of 80 patients with coronary heart disease who completed treatment of hematological diseases during the period from March 2018 to March 2020 were selected as observation group. In addition, the medical records of 92 patients with hematological diseases who completed treatment in our hospital during the same period were selected as control group. Venous blood samples of the two groups were collected to detect serum Hcy level and MTHFR gene polymorphism. The serum Hcy levels of the two groups with different MTHFR genotypes were compared, and the effects of the above indicators on hematological diseases complicated with coronary heart disease were analyzed.@*RESULTS@#The detection rates of MTHFR gene TT and TC in the observation group were higher than those in the control group, while the distribution frequency of MTHFR genotype CC was lower (P<0.05). The serum Hcy levels of the patients with MTHFR genotype TT and TC in the observation group was higher than the control group (P<0.05). Binary logistic regression analysis showed that MTHFR gene TC/CC genotype serum Hcy overexpression may be influencing factor which induced coronary heart disease in patients with hematological diseases (OR=2.107/OR=1.634, P<0.05). ROC curves showed that the AUC of serum Hcy level of MTHFR gene TC/CC genotype and hematological disease complicated with coronary heart disease were both > 0.8. When MTHFR gene TC reaching the optimal threshold of 22.165 μmol/L, the sensitivity was 0.950 and the specificity was 0.837, While MTHFR gene CC reached the optimal threshold of 19.630 μmol/L, the sensitivity was 0.938 and the specificity was 0.826, the best predictive value could be obtained.@*CONCLUSION@#The changes of serum Hcy and MTHFR gene polymorphisms may be involved in the pathological process in patients with hematological diseases complicated with coronary heart disease. In the future, early detection of serum Hcy levels and MTHFR gene polymorphisms in patients with hematological diseases can be used to predict the risk of coronary heart disease.

Intra-abdominal aortic balloon occlusion in the management of placenta percreta / 中华医学杂志(英文版)

BACKGROUND@#Massive bleeding is the main concern for the management of placenta percreta (PP). Intra-abdominal aortic balloon occlusion (IABO) is one method for pelvic devascularization, but the efficacy of IABO is uncertain. This study aims to investigate the outcomes of IABO in PP patients.@*METHODS@#We retrospectively reviewed the clinical data of PP cases from six tertiary centers in China between January 2011 and December 2015. PP cases with/without the use of IABO were analyzed. Propensity score matching analysis was performed to reduce the effect of selection bias. Postpartum hemorrhage (PPH) and the rate of hysterectomy, as well as neonatal outcomes, were analyzed.@*RESULTS@#One hundred and thirty-two matched pairs of patients were included in the final analysis. Compared with the control group, maternal outcomes, including PPH (68.9% vs. 87.9%, χ2 = 13.984, P < 0.001), hysterectomy (8.3% vs. 65.2%, χ2 = 91.672, P < 0.001), and repeated surgery (1.5% vs. 12.1%, χ2 = 11.686, P = 0.001) were significantly reduced in the IABO group. For neonatal outcomes, Apgar scores at 1 minute (8.67 ± 1.79 vs. 8.53 ± 1.68, t = -0.638, P = 0.947) and 5 minutes (9.43 ± 1.55 vs. 9.53 ± 1.26, t = 0.566, P = 0.293) were not significantly different between the two groups.@*CONCLUSIONS@#IABO can significantly reduce blood loss, hysterectomies, and repeated surgeries. This procedure has not shown harmful effects on neonatal outcomes.

Systematic review of efficacy and safety of fondaparinux in the treatment of non-ST-elevation acute coronary syndrome in China / 中国药房

OBJECTIVE To systematically evaluate the efficacy and safety of fondaparinux versus low molecular weight heparin（nadroparin，enoxaparin）in the treatment of non-ST-elevation acute coronary syndrome （NSTE-ACS）. METHODS The computer searched PubMed ，Medline，Embase，EBSCO，CNKI，Wanfang medical network ，VIP Chinese Journal Full-text Database and relevant clinical trial registration network for the clinical retrospective cohort study （RCS）of fondaparinux （as trial group）and low molecular weight heparin （natroparin，enoxaparin）（as control group ）in the treatment of NSTE-ACS. The retrieval time limit was from the establishment of the database to August 2021. Newcastle Ottawa scale （NOS）was used to evaluate the quality of literature. Outcome indicators included primary efficacy indicators （incidence of acute myocardial infarction and recurrent angina pectoris during hospitalization ），secondary efficacy indicators [revascularization of target vessels during 话：0835-2862024。E-mail：xiexingxing07@163.com hospitalization， prothrombin time （PT）， activated partial thromboplastin time （APTT）]，safety indicators （incidence of serious cardiovascular events ，severe bleeding ，slight bleeding and severe puncture site co mplications during hospitalization ），combined endpoint indicators （30 and 180 days combined endpoint）. RevMan 5.3 software was used for Meta-analysis of each effect index. RESULTS Finally，17 RCS articles were included，involving 4 946 patients with NSTE-ACS ，including 2 507 in the trial group and 2 439 in the control group.The results of NOS literature quality evaluation showed that there were 8 high-quality studies ，accounting for 47.06％ . The results of Meta-analysis showed that there was no significant difference in the incidence of acute myocardial infarction ，recurrent angina pectoris，revascularization of target vessels ，PT and serious cardiovascular events between 2 groups （P＞0.05）；there was significant difference in the APTT （MD＝1.34，95％CI of 0.22-2.45，P＜0.05），the incidence of severe bleeding （RR＝0.47， 95％CI of 0.30-0.74，P＜0.05），the incidence of slight bleeding （RR＝0.48，95％CI of 0.32-0.71，P＜0.05），the incidence of severe puncture site complications （RR＝0.48，95％CI of 0.25-0.95，P＜0.05），30 day combined endpoint （RR＝0.57，95％CI of 0.46-0.72，P＜0.05），180 days combined endpoint （RR＝0.73，95％CI of 0.54-0.98，P＜0.05）. CONCLUSIONS Fondaparinux in the treatment of NSTE-ACS in China has the same efficacy as low molecular weight heparin （nadroparin，enoxaparin），and has more obvious advantages in drug safety such as bleeding ，severe puncture site complications.

A study on the correlation among clinical ability, professional commitment, and academic self-efficacy of nursing undergraduate interns / 中华医学教育探索杂志

Objective:To understand the current situation of clinical ability, professional commitment, and academic self-efficacy of undergraduate nursing interns, explore the correlation among them, and provide theoretical basis for improving the clinical competence of undergraduate nursing students.Methods:The method of convenient sampling was adopted to select 325 nursing undergraduates who had internships in a three-A hospital from July 2018 to July 2020 as the research objects. General data questionnaire, nursing mini-clinical exercise assessment scale, college student professional commitment survey scale and academic self-efficacy scale were used to investigate and evaluate the students at the end of their practice. SPSS 19.0 was used to conduct Pearson correlation analysis and multiple stepwise regression analysis.Results:The total scores of clinical ability, professional commitment and self-efficacy were (51.46±7.64) points, (88.11±5.02) points and (74.20±7.95) points respectively. The results of correlation analysis showed that the clinical ability of nursing undergraduates was significantly positively correlated with professional commitment and academic self-efficacy ( P<0.05). The multiple stepwise regression analysis further showed that the latter two factors had a positive predictive effect on clinical ability, and professional commitment was the strongest factor. Conclusion:Clinical practice teaching should pay attention to the cultivation of the professional commitment and academic self-efficacy of nursing undergraduates and thus promote the development of their clinical ability.

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Soil genesis is important for ecological restoration of red mud disposal area. Soil genesis of red mud and the microbial mechanism were studied by analyzing the change of physicochemical and biochemical characteristics of red mud. We analyzed the microbial community structure in a red mud disposal area without any human-induced restoration through a space for time substitution approach. The results showed that, with the increases of storage time, the physical parameters of porosity, water-stable aggregates content, and mean weight diameter increased, but the bulk density decreased. The chemical parameters, including pH, electrical conductivity, acid neutralizing capacity, and exchangeable sodium percentage, decreased with increasing storage time. The bio-chemical parameters of total organic carbon, total nitrogen, available phosphorus, microbial biomass carbon and basal respiration increased, but the metabolic quotient decreased. The Shannon diversity index increased, and the dominant microflora in red mud changed from the oxygenic photosynthetic bacteria Cyanobacteria and thanaerobic anoxygenic phototrophic bacteria Chlorobi and Chloroflexi to Proteobacteria, Actinobacteria and Firmicutes. The ratio between eutrophic and oligotrophic bacteria substantially increased. The micromorphology results showed that the microorga-nism-red mud aggregates were formed through adsorption, linkage, intertwinement and package between red mud particles, microbial cells and their metabolites. The red mud biotope changed spontaneously from extreme and oligotrophic into soil-like under natural stockpiling. The soil genesis process was mediated by microbes through increasing nutrient level, decreasing alkalinity and sali-nity, and improving soil structure.

Identifying the role of apolipoprotein A-I in prostate cancer.

Although localized prostate cancer (PCa) can be cured by prostatectomy and radiotherapy, the development of effective therapeutic approaches for advanced prostate cancer, including castration-resistant PCa (CRPC) and neuroendocrine PCa (NEPC), is lagging far behind. Identifying a novel prognostic and diagnostic biomarker for early diagnosis and intervention is an urgent clinical need. Here, we report that apolipoprotein A-I (ApoA-I), the major component of high-density lipoprotein (HDL), is upregulated in PCa based on both bioinformatics and experimental evidence. The fact that advanced PCa shows strong ApoA-I expression reflects its potential role in driving therapeutic resistance and disease progression by reprogramming the lipid metabolic network of tumor cells. Molecularly, ApoA-I is regulated by MYC, a frequently amplified oncogene in late-stage PCa. Altogether, our findings have revealed a novel indicator to predict prognosis and recurrence, which would benefit patients who are prone to progress to metastasis or even NEPC, which is the lethal subtype of PCa.