Enantioselective Self-Assembly of a Homochiral Tetrahedral Cage Comprising Only Achiral Precursors

How Nature synthesizes enantiomerically pure substances from achiral or racemic resources remains a mystery. In this study, we aimed to emulate this natural phenomenon by constructing chiral tetrahedral cages through self-assembly, achieved by condensing two achiral compounds-a trisamine and a trisaldehyde. The occurrence of intercomponent CH⋅⋅⋅π interactions among the phenyl building blocks within the cage frameworks results in twisted conformations, imparting planar chirality to the tetrahedrons. In instances where the trisaldehyde precursor features electron-withdrawing ester side chains, we observed that the intermolecular CH⋅⋅⋅π forces are strong enough to prevent racemization. To attain enantioselective self-assembly, a chiral amine was introduced during the imine formation process. The addition of three equivalents of chiral amino mediator to one equivalent of the achiral trisaldehyde precursor formed a trisimino intermediate. This chiral compound was subsequently combined with the achiral trisamino precursor, leading to an imine exchange reaction that releasing the chiral amino mediator and formation of the tetrahedral cage with an enantiomeric excess (ee) of up to 75 %, exclusively composed of achiral building blocks. This experimental observation aligns with theoretical calculations based on the free energies of related cage structures. Moreover, since the chiral amine was not consumed during the imine exchange cycle, it enabled the enantioselective self-assembly of the tetrahedral cage for multiple cycles when new batches of the achiral trisaldehyde and trisamino precursors were successively added.

Enhanced NO2 Sensitivity of Vertically Stacked van der Waals Heterostructure Gas Sensor and Its Remarkable Electric and Mechanical Tunability

Nanodevices based on van der Waals heterostructures have been predicted, and shown, to have unprecedented operational principles and functionalities that hold promise for highly sensitive and selective gas sensors with rapid response times and minimal power consumption. In this study, we fabricated gas sensors based on vertical MoS2/WS2 van der Waals heterostructures and investigated their gas sensing capabilities. Compared with individual MoS2 or WS2 gas sensors, the MoS2/WS2 van der Waals heterostructure gas sensors are shown to have enhanced sensitivity, faster response times, rapid recovery, and a notable selectivity, especially toward NO2. In combination with a theoretical model, we show that it is important to take into account created trapped states (flat bands) induced by the adsorption of gas molecules, which capture charges and alter the inherent built-in potential of van der Waals heterostructure gas sensors. Additionally, we note that the performance of these MoS2/WS2 heterostructure gas sensors could be further enhanced using electrical gating and mechanical strain. Our findings highlight the importance of understanding the effects of altered built-in potentials arising from gas molecule adsorption induced flat bands, thus offering a way to enhance the gas sensing performance of van der Waals heterostructure gas sensors.

RIPK1 activation in Mecp2-deficient microglia promotes inflammation and glutamate release in RTT

Rett syndrome (RTT) is a devastating neurodevelopmental disorder primarily caused by mutations in the methyl-CpG binding protein 2 (Mecp2) gene. Here, we found that inhibition of Receptor-Interacting Serine/Threonine-Protein Kinase 1 (RIPK1) kinase ameliorated progression of motor dysfunction after onset and prolonged the survival of Mecp2-null mice. Microglia were activated early in myeloid Mecp2-deficient mice, which was inhibited upon inactivation of RIPK1 kinase. RIPK1 inhibition in Mecp2-deficient microglia reduced oxidative stress, cytokines production and induction of SLC7A11, SLC38A1, and GLS, which mediate the release of glutamate. Mecp2-deficient microglia release high levels of glutamate to impair glutamate-mediated excitatory neurotransmission and promote increased levels of GluA1 and GluA2/3 proteins in vivo, which was reduced upon RIPK1 inhibition. Thus, activation of RIPK1 kinase in Mecp2-deficient microglia may be involved both in the onset and progression of RTT.

[Tracking evaluation on the implementation of Survey of oncomelanid snails (WS/T 563-2017) in Sichuan and Anhui provinces]

To evaluate the implementation of Survey of oncomelanid snails (WS/T 563-2017) in schistosomiasis-endemic foci, two schistosomiasis-endemic counties were selected from two provinces of Sichuan and Anhui. Professional staff working in province-, city-, county- and township-level disease control and prevention institutions, parasitic disease control institutions or medical institutions were recruited, and the understanding, use and implementation of Survey of oncomelanid snails (WS/T 563-2017) were investigated using questionnaires and interviews. The awareness, use, proportion of propagation and implementation and correct rate of answering questions pertaining to Survey of oncomelanid snails (WS/T 563-2017) were analyzed. A total of 270 questionnaires were allocated, and 269 were recovered, including 254 valid questionnaires. The overall awareness of Survey of oncomelanid snails (WS/T 563-2017) was 84.64% (215/254), and propagation and implementation of Survey of oncomelanid snails (WS/T 563-2017) was not performed in 23.28% (17/73) of the survey institutions following implementation of Survey of oncomelanid snails (WS/T 563-2017), with meeting training and allocation of propagation materials as the main type of propagation and implementation. Among 254 respondents, 77.16% (196/254) were familiar with the standard, 66.14% (168/254) understood the conditions for use of the standard during snail surveys, and 96.85% (246/254) had the approach for identifying snails. In addition, there were 41.73% (106/254), 50.78% (129/254) and 7.48% (19/254) of respondents that considered the operability of Survey of oncomelanid snails (WS/T 563-2017) was very good, good and general, respectively. The findings demonstrate that the issue and implementation of Survey of oncomelanid snails (WS/T 563-2017) has filled the gap for the standardization of snail control techniques, and which plays an importang guiding role in the national schistosomiasis control program.

Nitrogen removal characteristics of heterotrophic nitrification-aerobic denitrification bacterium Acinetobacter ZQ-A1 and community characteristics analysis of its application in pig farm wastewater

A heterotrophic nitrifying aerobic denitrifying (HN-AD) strain ZQ-A1 with excellent denitrification performance, identified as Acinetobacter, was isolated from simultaneous nitrification and denitrification (SND) craft. ZQ-A1 was capable of removing NH4+, NO2-, and NO3-; the 21-hour removal rates were 84.84%, 87.13%, and 92.63%. ZQ-A1 has the ability to treat mixed nitrogen sources. In addition, ZQ-A1 can be well applied to actual sewage. According to the analysis of microbial community characteristics, the relative abundance of Acinetobacter in the experimental group increased from 0.06% to 2.38%, which is an important reason for the removal rate of NH4+ exceeding 99% within 30 days. The results of KEGG function prediction showed that with the addition of ZQ-A1, the relative abundance of pathways related to bacterial metabolism, such as tricarboxylic acid cycle metabolism, was higher. The research expanded the thinking of HN-AD bacteria in actual production and laid a foundation for its application in sewage treatment.

[Robotic-assisted laparoscopic modified ventral onlay lingual mucosal graft in complex ureteral stricture construction: experience of eight cases]

Objective: To examine the efficacy of robot-assisted laparoscopic modified ventral onlay lingual mucosal graft for complex ureteral stricture. Methods: The clinical data of 8 patients with ureteral stricture admitted to the Department of Urology, General Hospital of Southern Theater Command from May to October 2022 were retrospectively analyzed. There were 6 males and 2 females, aged (45.1±10.2) years (range: 34 to 64 years), body mass index (24.6±2.0) kg/m2 (range: 20.7 to 26.6 kg/m2). Five cases on the left side, 3 cases on the right side, the length of the ureteral structure was (3.1±0.7) cm (range: 2.2 to 4.5 cm). The value of preoperative serum creatinine was (113.8±22.3) μmol/L (range: 96 to 15 μmol/L). Before excising the structure segment, the titched anastomosed part of the dorsal wall of the ureter, and then the posteriorly augmented anastomotic, the remaining ventral side was augmented with a onlay lingual mucosa graft, then the omentum flap was used to wrap the reconstructed ureteral segment. The lingual mucosa graft with a length of 2.5 to 5.0 cm and a width of 1.0 to 1.5 cm was cut according to the actual structure. The surgery information of the patient, complications, and recent follow-up were recorded. Results: The operation under robot-assisted laparoscopy was performed successfully in the 8 patients without conversion to open surgery. The duration of the operation was (226.9±22.8) minutes (range: 210 to 255 minutes), estimated blood loss was (93.8±25.9) ml (range: 75 to 150 ml), the retention time of the postoperative drainage tube was (4.8±1.3) days (range: 3 to 7 days), and the duration of postoperative hospitalization was (11.1±3.6) days (range: 9 to 14 days). One week after the operation, the patient could pronounce correctly, enunciate clearly, and eat normally. Double J tubes were removed 4 to 8 weeks after the operation. The follow-up time in this group was 3 to 9 months, the follow-up patients underwent imaging and other examinations, which showed a significant improvement in hydronephrosis on the affected side, and the value of renal pelvic separation on the affected side was (1.4±0.8) cm (range: 0 to 2.3 cm). The serum creatinine value was (100.1±24.9) μmol/L (range: 76 to 155 μmol/L). Three months after the operation, the ureteroscopy showed that the ureter was smooth and the mucosa was normal. Conclusions: Robot-assisted laparoscopic ureteroplasty with a lingual mucosal graft is a safe and feasible operation for complex ureteral stricture without serious complications, which provides a surgical option for repairing ureteral stricture.

Small molecule activators of TAK1 promotes its activity-dependent ubiquitination and TRAIL-mediated tumor cell death

TAK1 is a key modulator of both NF-κB signaling and RIPK1. In TNF signaling pathway, activation of TAK1 directly mediates the phosphorylation of IKK complex and RIPK1. In a search for small molecule activators of RIPK1-mediated necroptosis, we found R406/R788, two small molecule analogs that could promote sustained activation of TAK1. Treatment with R406 sensitized cells to TNF-mediated necroptosis and RIPK1-dependent apoptosis by promoting sustained RIPK1 activation. Using click chemistry and multiple biochemical binding assays, we showed that treatment with R406 promotes the activation of TAK1 by directly binding to TAK1, independent of its original target Syk kinase. Treatment with R406 promoted the ubiquitination of TAK1 and the interaction of activated TAK1 with ubiquitinated RIPK1. Finally, we showed that R406/R788 could promote the cancer-killing activities of TRAIL in vitro and in mouse models. Our studies demonstrate the possibility of developing small molecule TAK1 activators to potentiate the effect of TRAIL as anticancer therapies.

Derivation and validation of a novel preoperative risk prediction model for surgical site infection in pancreaticoduodenectomy and comparison of preoperative antibiotics with different risk stratifications in retrospective cohort

BACKGROUND

Surgical site infections (SSIs) are common postoperative complications of pancreaticoduodenectomy.

AIM

To develop a model for preoperative identification of the risk of SSI that may improve outcomes and guide preoperative antibiotics.

METHODS

The prediction model was built by meta-analysis. After literature search and inclusion, data extraction, and quantitative synthesis, the prediction model was established based on the pooled odds ratio of predictors. A single-centre retrospective cohort was the validation cohort. Receiver operating characteristic curves and area under the curve were used to assess the model's ability. We also created a decision curve and a calibration plot to assess the nomogram. The effects of prophylactic antibiotics on SSI were compared between groups by multivariable logistic regression with different risk stratifications.

FINDINGS

Twenty-eight studies were included in the meta-analysis, 17 studies in the derivation cohort. Age, male gender, body mass index, pancreatic duct diameter, high-risk diagnosis, and preoperative biliary drainage were selected to build the prediction model. The model was validated in an external cohort. The cut-off value was 3.5 and area under the curve (AUC) was 0.76 in open pancreaticoduodenectomy (OPD). In laparoscopic pancreaticoduodenectomy, the cut-off value was 4.5 and AUC was 0.69. Decision curve and calibration plot showed good usability of the model, especially in OPD. Multivariable logistic regression did not indicate differences between broad- and narrow-spectrum antibiotics for SSI in different risk stratifications.

CONCLUSION

The model can identify patients with a high risk of SSI preoperatively. The choice of prophylactic antibiotics under different risk stratifications should be investigated further.

[How do young surgeons understand and grasp the new concepts, new techniques, and recent progress of hernia and abdominal wall surgery?]

With the development of modern surgery, the field of hernia and abdominal wall surgery is undergoing a transformative change, and new techniques, new concepts, and recent progress are being updated, which have motivated the high-quality development of the discipline. In the past two decades, the development of hernia and abdominal wall surgery in China has been recognized by international peers. Many young surgeons have gradually become the main force in the treatment of hernia and leaders in surgical technique. The innovation and development of discipline will never terminate; young surgeons as the main force should seriously think about how to improve their professional qualities. Young surgeons are interested in the innovation of surgical techniques and need to push for a traditional operation on the one hand and an innovative operation on the other. Updates to concepts and acquisition of new materials are more important, which can provide a solid foundation for technological innovation. Young surgeons should start with the basics and classics. Understanding the history and development of new techniques, new concepts and recent progress, and grasping indications of clinical application, is the important part of growing up for young surgeons, which can make surgical treatment more standardized, benefit patients, and promote the progress of Chinese specialized medical education.

Acute ACAT1/SOAT1 Blockade Increases MAM Cholesterol and Strengthens ER-Mitochondria Connectivity

Cholesterol is a key component of all mammalian cell membranes. Disruptions in cholesterol metabolism have been observed in the context of various diseases, including neurodegenerative disorders such as Alzheimer's disease (AD). The genetic and pharmacological blockade of acyl-CoA:cholesterol acyltransferase 1/sterol O-acyltransferase 1 (ACAT1/SOAT1), a cholesterol storage enzyme found on the endoplasmic reticulum (ER) and enriched at the mitochondria-associated ER membrane (MAM), has been shown to reduce amyloid pathology and rescue cognitive deficits in mouse models of AD. Additionally, blocking ACAT1/SOAT1 activity stimulates autophagy and lysosomal biogenesis; however, the exact molecular connection between the ACAT1/SOAT1 blockade and these observed benefits remain unknown. Here, using biochemical fractionation techniques, we observe cholesterol accumulation at the MAM which leads to ACAT1/SOAT1 enrichment in this domain. MAM proteomics data suggests that ACAT1/SOAT1 inhibition strengthens the ER-mitochondria connection. Confocal and electron microscopy confirms that ACAT1/SOAT1 inhibition increases the number of ER-mitochondria contact sites and strengthens this connection by shortening the distance between these two organelles. This work demonstrates how directly manipulating local cholesterol levels at the MAM can alter inter-organellar contact sites and suggests that cholesterol buildup at the MAM is the impetus behind the therapeutic benefits of ACAT1/SOAT1 inhibition.

FST estimates of 94 populations in China based on STR markers

The proper assessment of DNA evidence in cases of personal identification is a recurring theme in forensics. It is common practice to evaluate the strength of DNA evidence using the likelihood ratio (LR). The accurate use of population allele frequencies is a crucial problem in LR calculation. Allele frequency differences among different populations could be estimated by the F_ST values. Thus, F_ST would also affect LR values by correcting the allele frequencies. In this study, Chinese population allele frequency data were selected from population reports published in Chinese and English journals. The population-specific F_ST values of each population, the overall F_ST values of each province, each region, and the whole country, and the locus-specific F_ST values of different loci were calculated. The LRs using different allele frequencies and different F_ST values were compared based on the combination of simulated genotypes. As a result, the F_ST values of 94 populations, 19 provinces, 7 regions, and the whole country were obtained. The LR was overestimated using allele frequencies of the combined population containing multiple populations rather than using allele frequencies of a population, and the LRs after F_ST correction were lower than those without correction. Conclusively, the correction in conjunction with corresponding F_ST values can make the LRs more accurate and reasonable.

Prediction of Cavity Length Using an Interpretable Ensemble Learning Approach

The cavity length, which is a vital index in aeration and corrosion reduction engineering, is affected by many factors and is challenging to calculate. In this study, 10-fold cross-validation was performed to select the optimal input configuration. Additionally, the hyperparameters of three ensemble learning models-random forest (RF), gradient boosting decision tree (GBDT), and extreme gradient boosting tree (XGBOOST)-were fine-tuned by the Bayesian optimization (BO) algorithm to improve the prediction accuracy and compare the five empirical methods. The XGBOOST method was observed to present the highest prediction accuracy. Further interpretability analysis carried out using the Sobol method demonstrated its ability to reasonably capture the varying relative significance of different input features under different flow conditions. The Sobol sensitivity analysis also observed two patterns of extracting information from the input features in ML models: (1) the main effect of individual features in ensemble learning and (2) the interactive effect between each feature in SVR. From the results, the models obtaining individual information both predict the cavity length more accurately than that using interactive information. Subsequently, the XGBOOST captures more correct information from features, which leads to the varied Sobol index in accordance with outside phenomena; meanwhile, the predicted results fit the experimental points best.

[Goblet cell adenocarcinoma in the digestive system: a clinicopathological analysis of 22 cases]

Objective: To investigate the clinical features, morphological characteristics, immunophenotype, and differential diagnosis of goblet cell adenocarcinoma (GCA) in the digestive system. Methods: The clinicopathological data, morphological characteristics, immunophenotypes of 22 cases of GCA in the digestive system diagnosed from January 2010 to January 2021 were collected. Meanwhile, 25 cases of neuroendocrine neoplasm (NEN) and 24 cases of adenocarcinoma were used as controls. Relevant literature was also reviewed. Results: There were 16 males and 6 females, aged from 36 to 79 years with an average of 56 years. The anatomical sites of the 22 GCA were mostly appendix (17 cases) and occasionally extra-appendix (5 cases), including 3 cases in stomach, 1 case in duodenum and 1 case in anal. All 17 cases of appendiceal GCA were pure GCA. Among the 5 cases of extra-appendiceal GCA, One case of gastric GCA was pure, two cases of gastric GCA with NEN or adenocarcinoma, duodenal GCA with NEN and adenocarcinoma, anal GCA with NEN.Low-grade GCAs were composed of goblet, Paneth and neuroendocrine cells, which were arranged in intestinal crypt tubular or cluster structures and distributed in the wall of digestive system. The tubular and cluster structures lacked adhesion. Goblet cells were columnar, located in the base, with clear cytoplasm, small nuclei, inconspicuous atypia, and uncommon mitoses. Extracellular mucus and signet-ring cells with nuclear variations could be seen in some cases. Nerve fiber bundle invasion and tumor thrombus in vessels were often present. High-grade GCAs lacked tubular and cluster structures, and their histological structures were more complex. Tumor cells expressed mixed neuroendocrine and glandular epithelial markers. Similar to the expression patterns of synaptophysin and chromogranin A, CD200 and INSM1 were also dot-like or patch-positive in GCA. Conclusions: GCA is an infrequent tumor of the digestive system and shows the bi-directional differentiation characteristics of neuroendocrine and glandular epithelium. Accurate diagnosis and staging are related to its prognosis.

[The applications and challenges of liquid chromatography tandem mass spectrometry in maternal and child health]

Due to its ultra-high sensitivity, specificity and throughput, liquid chromatography tandem mass spectrometry (LC-MS/MS) has become an important analytical tool in clinical laboratories in quantifying various small molecules, such as vitamins, bile acids, steroids and other internal metabolites relevant to maternal diseases. As an effective means of screening and diagnosing diseases in preventive medicine, LC-MS/MS has been widely used in maternal and child health, contributing to the reduction of the incidence of maternal and child diseases and premature morbidity and mortality. At present, LC-MS/MS is an emerging and powerful platform in laboratory testing in China, facing both challenges and opportunities. In this article, the representative applications in the field of maternal and child health are summarized and discussed, along with the major hurdles of LC-MS/MS in clinical recognition and implementation.

Early life dynamics of ARG and MGE associated with intestinal virome in neonatal piglets

The pre- and post-weaning stages for piglets are critical periods for the maturation of intestinal functions and contamination with antibiotic resistant bacterial pathogens will threaten their intestinal health. The presence of bacteriophage can also alter bacterial populations in the intestine but whether transmission of antibiotic resistance genes (ARG) is affected by phage during maturation of the neonatal piglet intestine is not known. We therefore identified the intestinal virome along with ARGs and mobile genetic elements (MGE) from piglet fecal samples collected from 3 to 28 days representing the different growth stages. We found wide fluctuations for the intestinal virome of weaning piglets and most virus - related antibiotic resistance was derived from temperate phage suggesting a reservoir of multidrug resistance was present in the neonatal porcine gut. Our results provide a comprehensive understanding of ARGs associated with the intestinal virome that therefore represents a potential risk for horizontal ARG transfer to pathogenic bacteria.

Esophageal cancer-related gene 4 and solid tumors: a brief literature review

Esophageal cancer-related gene 4 (ECRG4) plays key roles in various malignancies, including lung cancer, prostate cancer, esophageal cancer, and breast cancer, and has potential applications in the early diagnosis, prevention, treatment, and prognosis of cancer. However, the mechanisms underlying the role of ECRG4 in cancer remain elusive. An association between ECRG4 and proliferation, migration, cell cycle, apoptosis, methylation, and ubiquitination in cancer has been found. Additionally, some studies have investigated the regulatory mechanism of the relationship between ECRG4 and long non-coding RNAs, co-factors, and resistance to chemotherapy. Drugs that demethylate ECRG4 are in clinical use. Thus, further investigation of the mechanisms by which ECRG4 influences tumorigenesis, and its clinical significance, are needed. The present study outlines the current understanding of the functions of ECRG4 in cancer and discusses its potential value in cancer therapy.

[Multimodality-based super-resolution reconstruction for routine brain magnetic resonance images]

OBJECTIVE

To propose a multi-modality-based super-resolution synthesis model for reconstruction of routine brain magnetic resonance images (MRI) with a low resolution and a high thickness into high-resolution images.

METHODS

Based on real paired low-high resolution MRI data (2D T1, 2D T2 FLAIR and 3D T1), a structure-constrained image mapping network was used to extract important features from the images with different modalities including the whole T1 and subcortical regions of T2 FLAIR to reconstruct T1 images with higher resolutions. The gray scale intensity and structural similarities between the super-resolution images and high-resolution images were used to enhance the reconstruction performance. We used the anatomical information acquired from segment maps of the super-resolution T1 image and the ground truth by a segmentation tool as a significant constraint for adaptive learning of the intrinsic tissue structure characteristics of the brain to improve the reconstruction performance of the model.

RESULTS

Our method showed the performance on the testing dataset than other methods with an average PSNR of 33.11 and SSIM of 0.996. The anatomical structure of the brain including the sulcus, gyrus, and subcortex were all reconstructed clearly using the proposed method, which also greatly enhanced the precision of MSCSR for brain volume measurement.

CONCLUSION

The proposed MSCSR model shows excellent performance for reconstructing super-resolution brain MR images based on the information of brain tissue structure and multimodality MR images.

[Pathological characteristics and clinical prognosis of nodular sclerosis grade 2 of classic Hodgkin's lymphoma]

Objective: To investigate the pathological characteristics and clinical prognosis of nodular sclerosis grade 2 of classic Hodgkin's lymphoma (cHL-NS2) in our cancer center. Methods: A retrospective collection of 23 cases of cHL-NS2 admitted in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from July 2008 to April 2019 was performed. Fifty-five cases of nodular sclerosis grade 1 of classical Hodgkin's lymphoma (cHL-NS1) during the same period were selected as control group. Survival curves were plotted using the Kaplan-Meier method, and Cox regression model was used to analyze the influencing factors for survival. Results: The median age of 23 cases of cHL-NS2 was 30 years old. Five cases had extra nodal invasion, and 19 cases were Ⅰ-Ⅱ stage based on Ann Arbor system. The pathological morphology of cHL-NS2 showed that the lymph node structure was completely destroyed and was divided into nodules by thick collagen. The tumor cells in the nodules were abundant and proliferated in sheets. The boundaries between the tumor cells were not clear. The incidence of tumor necrosis in cHL-NS2 was 43.5% (10/23), which was significantly higher than 18.2% (10/55) in cHL-NS1 (P=0.040). The 3-year progression-free survival (PFS) rate of patients in the cHL-NS2 group was 58.1%, which was significantly lower than 89.7% in the cHL-NS1 group (P=0.002). In all of 78 cases, the 3-year PFS rate of patients who did not obtain complete response (CR) was 67.1%, which was significantly lower than 92.2% in patients who achieved CR (P=0.030). Multivariate Cox regression analysis demonstrated that both cHL-NS2 and failure to obtain CR by first-line treatment were independent indicators for short PFS time (P<0.05). Conclusions: In cHL-NS2, the morphology of tumor cells are diverse, and tumor necrosis can be easily found. Under the current first-line treatments of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) or bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP), cHL-NS2 is an independent indicator for worse PFS.

Analysis of Interaction Network Between Host Protein and M Protein of Swine Acute Diarrhea Syndrome Coronavirus

Swine acute diarrhea syndrome coronavirus (SADS-CoV) is an enterovirus that can cause acute diarrhea and death in piglets and cause serious economic losses to the pig industry. SADS-CoV membrane (M) protein mainly plays a key role in biological processes, such as virus assembly, budding, and host innate immune regulation. Understanding the interaction between M protein and host proteins is very important to define the molecular mechanism of cells at the protein level and to understand specific cellular physiological pathways. In this study, 289 host proteins interacting with M protein were identified by glutathione-S-transferase (GST) pull-down combined with liquid chromatography-mass spectrometry (LC-MS/MS), and the protein-protein interaction (PPI) network was established by Gene Ontology (GO) terms and Kyoto Encyclopedia of Gene and Genomes (KEGG) pathways analysis. Results showed that SADS-CoV M protein was mainly associated with the host metabolism, signal transduction, and innate immunity. The Co-Immunoprecipitation (CO-IP) validation results of six randomly selected proteins, namely, Rab11b, voltage-dependent anion-selective channel 1 (VDAC1), Ribosomal Protein L18 (RPL18), RALY, Ras Homolog Family Member A (RHOA), and Annexin A2 (ANXA2), were consistent with LC-MS results. In addition, overexpression of RPL18 and PHOA significantly promoted SADS-CoV replication, while overexpression of RALY antagonized viral replication. This work will help to clarify the function of SADS-CoV M protein in the life cycle of SADS-CoV.

Study of the intentional replantation procedure used to treat a tooth with a palatogingival groove: A case report

In order to clarify the prognosis of intentional replantation used for palatogingival groove treatment for long-term follow-up observation, the case of a patient with a maxillary lateral incisor with palatogingival groove was investigated. The intentional replantation was carried out to preserve the tooth. The periodontal pocket and the apical bone defect were almost completely repaired at 12-month follow-up. However, the infection was reoccurred after 25-month follow-up examinations. The infected tooth was extracted, of which the root was investigated by histological analysis. Therefore, the reason of the replant failure and the pathways of bacterial infection was investigated.

Key words:Palatogingival groove, intentional tooth replantation, bacterial infection, maxillary lateral incisor.

Ckip-1 Mediates P. gingivalis-Suppressed Cementoblast Mineralization

Porphyromonas gingivalis is responsible for the destruction of cementum in patients with periodontitis and periapical periodontitis. However, research about the effects of P. gingivalis on cementoblast mineralization and the underlying mechanism is still lacking. Casein kinase 2 interacting protein 1 (Ckip-1) is a scaffold protein that interacts with various proteins and signals to regulate different cell functions, such as cell morphology, apoptosis, and differentiation. In this study, we verified the suppressive effects of P. gingivalis and lipopolysaccharide (Pg-LPS) on OCCM-30 mineralization. We also showed that Ckip-1 gradually decreased during OCCM-30 mineralization but increased with the aggravation of Pg-induced inflammation. However, it remained unchanged when cells were stimulated with Pg-LPS, regardless of the concentration and incubation time. Then, more cellular cementum and enhanced Osterix expression were observed in Ckip-1 knockout mice when compared with the wild-type mice. Meanwhile, Ckip-1 silencing significantly enhanced cementoblast mineralization with or without P. gingivalis-associated inflammation. The trend was opposite when Ckip-1 was overexpressed. Finally, we found that the p38, Akt, and Wnt pathways were activated, while the Erk1/2 pathway was inhibited when Ckip-1 was silenced. The opposite results were also observed in the Ckip-1 overexpression group. Furthermore, we proved that cell mineralization was weakened when p38, Akt inhibitors were applied and strengthened when the Erk1/2 pathway was inhibited. In summary, Ckip-1 is upregulated underP. gingivalis-induced inflammation and negatively regulates cementoblast mineralization partially through mitogen-activated protein kinases and Akt signaling pathways, which may contribute to the restoration of cementum destroyed by P. gingivalis.

Molecular characterisation and function analysis of NOD1 gene from Yangzhou goose (Anser cygnoides domesticus)

1. NOD1 is a significant member of the NOD-like receptor (NLR) family. Its main role is to identify microorganisms that invade the body, transmit immune signals and regulate innate immune responses. However, the expression and role of the NOD1 in immune defence against infection in geese remain unknown.2. The RT-PCR method and rapid amplification of cDNA ends (RACE) was used to obtain the full-length goose NOD1 (gNOD1) cDNA series. The cDNA for gNOD1 contains 2856-bp nucleotides, i.e. 47-bp 5' UTR, 135-bp 3' UTR, and 1275-bp ORF region, and encodes a 951-amino-acids (AAs) polypeptide chain. The nucleotide sequence of gNOD1 was found more than 90% similar to its homologs from other avian organisms.3. The qRT-PCR results showed that gNOD1 mRNA was widely distributed in different tissues, but highly expressed in liver, spleen, lung and caecum tissues.4. Following stimulation of goose embryo fibroblasts (GEFs) with lipopolysaccharide (LPS) and polyriboinosinic polyribocytidylic acid (poly(I:C)), the expression of gNOD1 and cytokines, such as IL-1β, IL-6, IL-18, and TNF-α, changed with the response-efficacy correlation at 24 and 48 h post-infection (hpi).5. When the goslings were challenged with Salmonella entertidis (SE) and LPS, the expression of gNOD1 was up-regulated at 3 and 6 hpi in the spleen and caecum tissues, respectively. However, after SE infection, the expression level of gNOD1 fluctuated, while in the LPS group, gNOD1 mRNA increased immediately at a peak time of 6 hpi and then steadily declined. These results indicated that NOD1 was associated with the potency to resist bacterial and viral infections in the goose, both in vivo and in vitro.

[Expression of CD200 and INSM1 in gastrointestinal and pancreatic neuroendocrine neoplasms and its diagnostic values]

Objective: To investigate the expression and diagnostic values of CD200 and insulinoma associated protein 1 (INSM1) in gastrointestinal and pancreatic neuroendocrine neoplasm (GIP-NEN). Methods: The expression of CD200, INSM1, Syn and CgA was detected in 69 cases of GIP-NEN, 66 cases of gastrointestinal and pancreatic non-neuroendocrine neoplasm (GIP-nonNEN) and 16 cases of metastatic neuroendocrine neoplasm by immunohistochemistry, to compare the values of CD200, INSM1, Syn, CgA and their combinations in diagnosing GIP-NEN. Receiver operating characteristics (ROC) curve was used. Results: The immunoreactivity of CD200 was present in the cytoplasma and/or membrane of the neoplasms cells, the positive expression rates in GIP-NEN and GIP-nonNEN were significantly different (P<0.01). The sensitivity and specificity of CD200 for diagnosing GIP-NEN were 95.7% and 78.8%, respectively. There was significant difference of the positive rates of CD200 between neuroendocrine tumor and neuroendocrine carcinoma (P=0.05). The immunoreactivity of INSM1 was present in the nuclei of neoplasms cells. The positive expression rates in GIP-NEN and GIP-nonNEN were significantly different (P<0.01). The sensitivity and specificity of INSM1 for diagnosis of GIP-NEN were 85.5% and 95.5%, respectively. There were also significantly different positive rates of INSM1 between neuroendocrine tumor and neuroendocrine carcinoma, as well as between G1 and G3 neuroendocrine tumors (P<0.05). There was no difference in the area under ROC curve (AUC) of single stain of CD200, INSM1, Syn or CgA (0.857, 0.907, 0.890 and 0.833, respectively, P>0.05). The sensitivity of combined CD200+INSM1 stains for diagnosing GIP-NEN was significantly higher than that of Syn+CgA (85.5% vs. 63.8%, P<0.05). The AUC of two combinations were 0.962 and 0.925, respectively, which were not statistically different (P>0.05). Conclusions: CD200 and INSM1 are two novel markers of neuroendocrine neoplasm, which aid to diagnosis for GIP-NEN and exclude its mimickers. They are associated with tumor grades. Combining both as an immunohistochemical panel shows high sensitivity and specificity. Thus, the combined panel can be utilized as useful supplement for Syn and CgA.

Analysis of risk factors and prognosis of post-stroke pulmonary infection in integrated ICU

OBJECTIVE

The incidence of SAP (stroke-associated pneumonia) is high in integrated ICU (Intensive Care Unit), and it might result in sepsis, which exacerbates the clinical outcome and increases mortality. It is necessary to investigate the epidemiological features of post-stroke infection and sepsis, identify the risk factors and analyze the prognosis.

PATIENTS AND METHODS

We retrospectively analyzed the data of 329 patients with cerebral infarction or cerebral hemorrhage, from seven tertiary university hospitals in Suzhou, Jiangsu Province, between January 1, 2016, and December 31, 2016. Basic demographic and clinical data including common health evaluation, stroke severity, microbiological parameters, surgical interventions and treatments were recorded for the analysis. SAP was diagnosed according to the criteria and recommendation from American Heart Association (AHA).

RESULTS

188 (66.4%) patients suffered pneumonia, 124 patients were diagnosed as SAP. Compared with SAP, patients with non-SAP pulmonary infection had prolonged mechanical ventilation time, prolonged central venous catheter indwelling time, and higher incidence of sepsis (17.7% vs. 48.4%). 53 patients (18.7%) developed sepsis during hospitalization, whose mortality rate during hospitalization and the occurrence of neurologic dysfunction at 3 months were significantly increased (p<0.05). 130 positive results of sputum cultures were found. The detected pathogens were mainly gram-negative bacteria. The pathogenic detection rate of non-SAP patients with pulmonary infection was higher (78.1%). The in-hospital mortality was 16.3% and the related risk factors were higher NIHSS score at admission, lower GCS score at admission, pulmonary infection (especially non-SAP pulmonary infection) and sepsis during hospitalization.

CONCLUSIONS

The incidence of pulmonary infection after stroke in the integrated ICU is high, and it is easy to be complicated with sepsis, prolonging the mechanical ventilation time, central venous catheter indwelling time and hospitalization time, and the prognosis of long-term neurological function is relatively poor. The definition of stroke-associated pneumonia has implications for the classification of clinical infections, the prediction of possible pathogenic pathogens, and the guidance of anti-infective treatment.

Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run

We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.

Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run

We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.

Extended Very-High-Energy Gamma-Ray Emission Surrounding PSR J0622+3749 Observed by LHAASO-KM2A

We report the discovery of an extended very-high-energy (VHE) gamma-ray source around the location of the middle-aged (207.8 kyr) pulsar PSR J0622+3749 with the Large High-Altitude Air Shower Observatory (LHAASO). The source is detected with a significance of 8.2σ for E>25  TeV assuming a Gaussian template. The best-fit location is (right ascension, declination) =(95.47°±0.11°,37.92°±0.09°), and the extension is 0.40°±0.07°. The energy spectrum can be described by a power-law spectrum with an index of -2.92±0.17_{stat}±0.02_{sys}. No clear extended multiwavelength counterpart of the LHAASO source has been found from the radio to sub-TeV bands. The LHAASO observations are consistent with the scenario that VHE electrons escaped from the pulsar, diffused in the interstellar medium, and scattered the interstellar radiation field. If interpreted as the pulsar halo scenario, the diffusion coefficient, inferred for electrons with median energies of ∼160  TeV, is consistent with those obtained from the extended halos around Geminga and Monogem and much smaller than that derived from cosmic ray secondaries. The LHAASO discovery of this source thus likely enriches the class of so-called pulsar halos and confirms that high-energy particles generally diffuse very slowly in the disturbed medium around pulsars.

[Establishment of naive Bayes classifier-based risk prediction model for chemotherapyinduced nausea and vomiting]

OBJECTIVE

To establish a risk prediction model of chemotherapy-induced nausea and vomiting based on naive Bayes classifier.

OBJECTIVE

We collected the basic information, treatment protocols and follow-up data from 300 patients receiving chemotherapy in the Oncology Department of Second Xiangya Hospital from July to September, 2020. Correlation analysis was carried out between the potential factors related to nausea and vomiting in the treatment plan and the individual characteristics of the patients. For the two characteristics with a correlation coefficient greater than 0.8, their contribution to the area under curve (AUC) was calculated, and the characteristic with a smaller contribution was removed. The naive Bayes classifier in the machine learning library scikit-learn was used as the prediction model of chemotherapy-induced nausea and vomiting, and 10-fold stratified-shuffled-split cross-validation was used to obtain the final result of the model. The machine learning model was trained using 70% of the samples, and 30% of the samples were used as the test set to assess the performance of the model.

OBJECTIVE

The sensitivity of the model for predicting the risk of nausea and vomiting due to acute chemotherapy was 0.83±0.04 (95%CI: 0.80-0.86) with a specificity of 0.45±0.03 (95%CI: 0.42-0.47) and an AUC of 0.72±0.04 (95% CI: 0.69-0.75). The sensitivity of the model for predicting the risk of delayed chemotherapy-induced nausea and vomiting was 0.84±0.01 (95%CI: 0.83-0.86) with a specificity of 0.48±0.03 (95%CI: 0.45-0.52) and an AUC of 0.74±0.02 (95%CI: 0.72-0.77).

OBJECTIVE

The naive Bayes classifier model has a good performance in predicting the risk of chemotherapy-induced nausea and vomiting in Chinese cancer patients.

Long noncoding RNA SNHG14 regulates ox-LDL-induced atherosclerosis cell proliferation and apoptosis by targeting miR-186-5p/WIPF2 axis

To investigate the role of small nucleolus RNA host gene 14 (SNHG14) in the progression of atherosclerosis (AS), bioinformatics analysis, and other relevant experiments (cell counting kit-8, flow cytometry, quantitative real-time polymerase chain reaction, luciferase reporter, RNA immunoprecipitation, RNA pull-down, and western blot assays) were done. The current study revealed that SNHG14 level was high in the serum of AS patients and oxidized low-density lipoprotein (ox-LDL)-induced AS cell lines. Besides, we found that SNHG14 accelerated cell proliferation while inhibited cell apoptosis in ox-LDL-induced AS cell lines. Next, SNHG14 was confirmed to be a sponge for miR-186-5p in AS cells, and it was validated that SNHG14 regulated AS cell proliferation and apoptosis by sponging miR-186-5p. Moreover, we uncovered that WAS-interacting protein family member 2 (WIPF2) was a downstream target of miR-186-5p in AS cells. Finally, it was demonstrated that miR-186-5p modulated AS cell proliferation and apoptosis via targeting WIPF2. To conclude, our research disclosed that SNHG14 affected ox-LDL-induced AS cell proliferation and apoptosis through miR-186-5p/WIPF2 axis, which may provide a theoretical basis for the treatment and diagnosis of AS.

Effects of the FABP4 gene on steroid hormone secretion in goose ovarian granulosa cells

1. To investigate the physiological role of FABP4 in the goose ovary, this study determined the effects of overexpressing and siRNA interfering FABP4 on progesterone (P₄) and oestradiol (E₂) production in granulosa cells. Measurements were made by ELISA, real-time qRT-PCR and western blotting. 2. The concentrations of P₄ and E₂ in the FABP4 overexpression granulosa cells were increased compared to the control group (P > 0.05 for P₄; P < 0.05 for E₂). Likewise, the mRNA and protein expression levels of CYP11A1 and CYP19A1 were significantly higher than in the control group (P < 0.05 or P < 0.001). Conversely, the concentrations of P₄ and E₂ in the FABP4 silencing granulosa cells were significantly decreased compared with the control group (P < 0.001). Likewise, the mRNA and protein expression levels of CYP11A1 and CYP19A1 were significantly lower than in the control group (P < 0.001, or P < 0.01). 3. The study indicated that the FABP4 gene may regulate steroid hormone secretion and the expression of the steroidogenic genes in geese ovarian granulosa cells. These results support the possibility that the FABP4 gene mediates ovarian steroid hormone biosynthesis function and reproduction in geese.

Physics-Guided Deep Learning for Drag Force Prediction in Dense Fluid-Particulate Systems

Physics-based simulations are often used to model and understand complex physical systems in domains such as fluid dynamics. Such simulations, although used frequently, often suffer from inaccurate or incomplete representations either due to their high computational costs or due to lack of complete physical knowledge of the system. In such situations, it is useful to employ machine learning (ML) to fill the gap by learning a model of the complex physical process directly from simulation data. However, as data generation through simulations is costly, we need to develop models being cognizant of data paucity issues. In such scenarios, it is helpful if the rich physical knowledge of the application domain is incorporated in the architectural design of ML models. We can also use information from physics-based simulations to guide the learning process using aggregate supervision to favorably constrain the learning process. In this article, we propose PhyNet, a deep learning model using physics-guided structural priors and physics-guided aggregate supervision for modeling the drag forces acting on each particle in a computational fluid dynamics-discrete element method. We conduct extensive experiments in the context of drag force prediction and showcase the usefulness of including physics knowledge in our deep learning formulation. PhyNet has been compared with several state-of-the-art models and achieves a significant performance improvement of 7.09% on average. The source code has been made available^*.

MicroRNA-338-3p inhibits the progression of bladder cancer through regulating ETS1 expression

OBJECTIVE

MicroRNA-338-3p (miR-338-3p) was reported to influence the metastasis and development of several human cancers. However, in bladder cancer (BC), the special function of miR-338-3p remains unknown. Here, we aimed at exploring the miR-338-3p function in the progression of BC.

PATIENTS AND METHODS

miR-338-3p and ETS1 expressions were examined by quantitative Real-time polymerase chain reaction (qRT-PCR) in BC samples. Following that, transwell assays for cell migration and invasion were performed. And MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay for cell proliferation was conducted as well. Western blot was employed to examine the epithelial-mesenchymal transition (EMT) marker expressions. Finally, the relationship between miR-338-3p and E26 transformation specific-1 (ETS1) was verified by luciferase reporter assay.

RESULTS

The decreased miR-338-3p expression was examined in BC cells. Moreover, miR-338-3p upregulation repressed cell proliferation ability in BC. Next, miR-338-3p upregulation also depressed cell metastasis and EMT in BC cells. Furthermore, ETS1 was a direct target of miR-338-3p and inversely associated with its expression. And upregulation of ETS1 partially rescued the suppression of miR-338-3p for cell proliferation and metastasis in BC.

CONCLUSIONS

Upregulation of miR-338-3p inhibited the proliferation, metastasis and EMT in BC by suppressing ETS, showing that miR-338-3p might block the development of BC through regulating ETS1 expression.

[Effect of silencing hepatocyte growth factor receptor c-Met expression on biological characteristics of colon cancer cells]

Objective: To investigate the effect of silencing hepatocyte growth factor receptor (c-Met) expression on the biological characteristics of HCT116 colon cancer cells. Methods: Cellular model of c-Met transient transfection was established by using small interfering RNA (siRNA), the expression of c-Met in colon cancer cells was detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) and western blot. The apoptosis assay, cell invasion assay, cell migration and other experiments were conducted to observe the effects of silencing c-Met on the biological characteristics of colon cancer cells. Results: RT-qPCR results showed that the relative expression levels of c-Met mRNA in siRNA-Met group, blank control group and siRNA negative control (siRNA-NC) group were 0.32±0.26, 1.01±0.03 and 1.05±0.23, respectively, and the difference was statistically significant (P<0.05). Western blot analysis showed that the expression level of c-Met protein in the siRNA-Met group was 0.24±0.03, significantly lower than 1.23±0.06 in the blank control group and 1.18±0.11 in the siRNA-NC group (P<0.05). The cell counting kit-8 (CCK8) results showed that the 72-hour absorbance (A) values of the siRNA-Met group, blank control group and the siRNA-NC group were 1.13±0.05, 1.48±0.08 and 1.53±0.07, respectively, and the difference was statistically significant (P<0.01). Cell cycle results showed that the proportion of cells in G(2)/M phase was (14.65±1.41)% in siRNA-Met group , (5.07±0.70)% in blank control group and (5.63±0.71)% in siRNA-NC group, and the difference was statistically significant (P<0.05). The expression levels of cell cycle regulatory proteins Cdc25c and cyclin B1 in siRNA-Met group were significantly decreased. The apoptotic rate in siRNA-Met group was (5.85±0.35)%, significantly higher than (1.00±0.17)% in blank control group and (0.91±1.14)% in siRNA-NC group (P<0.05). The expression level of apoptosis-related protein Bcl-2 in the siRNA-Met group was significantly decreased while Bcl-2 associated X protein (BAX) expression level was significantly increased. The cell scratching result showed that the cell migration abilities of the siRNA-Met group, blank control group and the siRNA-NC group were (51.33±8.62)%, (100.00±3.72)% and (102.33±6.43)%, respectively, and the difference was statistically significant (P<0.05). The number of cell penetrating into the basement membrane of the siRNA-Met group, blank control group and the siRNA-NC group were 47.50±10.60, 100.00±5.33 and 102.50±10.61, respectively, and the difference was statistically significant (P<0.05). The expressions of invasion related proteins including MMP-2 and MMP-9 in siRNA-Met group were decreased significantly. Conclusions: c-Met plays an important role in maintaining the biological characteristics of colon cancer cells. Inhibition of c-Met may have important values in the treatment of colon cancer.

Retrospective analysis of defect reconstruction after abdominal wall tumor resection in 30 patients

PURPOSE

It is difficult to manage the full-thickness defect that is created by radical resection of an abdominal wall tumor. This report aimed to review our institutional experience with immediate reconstruction using mesh reinforcement after abdominal wall tumor resection.

METHODS

We retrospectively examined patients who underwent abdominal wall tumor resection with immediate mesh-reinforced reconstruction between April 2014 and November 2018. The patients' records were reviewed to collect data regarding their demographic characteristics, surgical procedures, and complications.

RESULTS

We identified 30 eligible patients, including 5 who underwent simultaneous resection of affected intra-abdominal organs or tissues. The median size of the resulting abdominal wall defect was 60 cm² (interquartile range: 32-127.5 cm²) and the median mesh size was 150 cm² (interquartile range: 150-225 cm²). The median operative time was 85 min (interquartile range: 60-133.8 min), the mean hospital stay was 19.4 ± 9.0 days, and the mean follow-up period was 28.6 ± 16.0 months. The complications included seroma (n = 4), infection (n = 2), massive hematoma (n = 1), and abnormal sensation (n = 3). Tumor recurrence was observed in two patients, and three patients died because of cancer progression. No patient developed a ventral hernia or abdominal bulging.

CONCLUSION

Immediate mesh-reinforced reconstruction is feasible and effective for patients who require abdominal wall tumor resection.

Forensic Significance of Skin Injury and Fracture Caused by Child Abuse

Abstract

In recent years, cases of child abuse that result in injuries and death have occurred from time to time in China, and there may be more undetected child abuse cases. However, many pediatricians and forensic doctors lack professional knowledge and formal training in detecting child abuse, which leads to the missed diagnosis, misdiagnosis and misidentification of many cases of child abuse. This paper reviews a large number of relevant domestic and foreign literatures, combined with practical work experience and China's national conditions, preliminarily summarizes the main points of clinical diagnosis and forensic identification of child abuse cases, in order to provide some help for early detection, accurate identification of child abuse cases and timely and effective treatment and protection for abused children.