Evaluation of the clinical efficacy of nasointestinal ileus tube in the operation of extensive adhesive small bowel obstruction / 国际外科学杂志

Objective:To evaluate the feasibility and clinical effectiveness of placing a nasointestinal ileus tube (NTI) during extensive adhesive bowel obstruction (ABO) surgery.Methods:A retrospective analysis was performed for the clinical and follow-up data of 60 patients with extensive ABO admitted to the Department of General Surgery of Daxing District Hospital of Capital Medical University from April 2019 to April 2021, of which 30 patients underwent intraoperative NIT intraintestinal alignment (observation group) and 30 patients who did not undergo NIT intraintestinal alignment (control group) during the same period. There were 12 males and 18 females in the observation group. There were 16 males and 14 females in the control group. The operation time, gastrointestinal function recovery time, discharge time, total effective rate and postoperative complication rate were compared between the two groups, and the quantitative data of the recurrence rate of intestinal obstruction at 24 months after surgery were expressed as mean ± standard deviation ( ± s), and the t-test was used for comparison between groups. Numerological data were presented as cases (percentage) [ n (%)], and chi-square tests were used for comparison between groups. Results:All patients were successfully completed the surgery and discharged from the hospital. There was no statistically significant difference in total effective rate between the control group and the observation group( χ2=3.16, P=0.237). The surgical time in the observation group was slightly longer than that in the control group [(110.6±4.6) min vs (94.3±2.5) min, t=17.27, P=0.001]. The recovery time of gastrointestinal function and hospitalization time in the observation group were shorter than those in the control group[(8.13±1.00) d vs (8.70±0.70) d, t=2.53, P=0.014; (12.83±1.57) d vs (13.67±1.03) d, t=0.03, P=0.018]. The incidence of postoperative complications was lower than that in the control group (10% vs 30%, P=0.028), and the difference was statistically significant. Conclusion:Intraoperative application of NIT is safe and effective, and can significantly reduce the recurrence rate of postoperative intestinal obstruction.

Research progress of TCM functional exercises for the treatment of fatigue / 国际中医中药杂志

TCM functional exercises are the important means of TCM to prevent and cure diseases. By adjusting the bones and muscles externally, adjusting the heart and organs internally, promoting blood circulation, improving sleep disorders, enhancing metabolism and immune capacity, the aim of preventing and treating diseases, prolonging life span, and strengthening the body is achieved. TCM exercises have a significant effect on the treatment of various types of fatigue such as chronic fatigue syndrome, Exercise-induced fatigue, post-stroke fatigue, and cancer-related fatigue.

Midazolam alleviates neuronal damage induced by oxygen glucose deprivation/restoration in mice / 基础医学与临床

Objective To investigate the impact of midazolam on neuronal injury induced by oxygen glucose depri-vation/reoxygenation(OGD/R)in mice.Methods An injury model of neuronal cell line HT22 was established by OGD/R induction.HT22 cells were divided into OGD/R group,low-dose group,medium-dose group and high-dose group,midazolam+KG-501(CREB inhibitor)group and control group.ELISA was applied to detect TNF-α and IL-6 levels;Commercialy available reagent kits were applied to detect superoxide dismutase(SOD),catalase(CAT),and malondialdehyde(MDA)levels;MTT and Edu experiments were applied to detect cell prolifera-tion;flow cytometry was applied to detect cell apoptosis rate;RT-qPCR method was applied to detect the ex-pression levels of CREB mRNA and PGC-1α mRNA;Western blot was applied to detect the expression levels of Ki-67,Bcl-2,Bax,CREB,and PGC-1α proteins.Results Compared with the control group,the A490 value(24,48 hours),proliferation rate,SOD and CAT activity,CREB mRNA and PGC-1α mRNA expres-sion,Ki-67,Bcl-2,CREB,and PGC-1α protein level in the OGD/R group were all significantly reduced(P＜0.05);The apoptosis rate,TNF-α,IL-6,MDA,and Bax protein expression were significanty increased(P＜0.05).Compared with the OGD/R group,the A490 values(24,48 hours),proliferation rate,SOD,CAT activity,CREB mRNA and PGC-1α mRNA expression,and Ki-67,Bcl-2,CREB,and PGC-1α protein expression were significantly increased in low,medium,and high dose midazolam groups;The apoptosis rate,TNF-α,IL-6,MDA,and Bax protein expression were obviously reduced(P＜0.05).Compared with the high-dose midazolam group,A490 value(24,48 hours),proliferation rate,activity of SOD and CAT,CREB mRNA and PGC-1α mRNA expression as well as Ki-67,Bcl-2,CREB,and PGC-1α protein expression were all sig-nificantlu reduced in the high-dose midazolam+KG-501 group while the apoptosis rate,TNF-α,IL-6,MDA,and Bax protein expression were obviously increased(P＜0.05).Conclusions Midazolam might alleviate nerve cell injury potentially through the mechaninsms of promoting OGD/R-induced proliferation and reducing cell apoptosis in HT22 cells.

Evaluation of analgesic effect of nalbuphine in patients with non-mechanical ventilation in intensive care unit: a multi-center randomized controlled trail / 中华急诊医学杂志

Objective:To analyze the efficacy and safety of nalbuphine for analgesia in patients with non-mechanical ventilation in intensive care unit (ICU).Methods:From December 2018 to August 2021, a multicenter randomized controlled clinical study was conducted to select non-mechanical ventilation patients with analgesic needs admitted to ICU of four hospitals in Henan Province and Guizhou Province. Patients were randomly assigned to nalbuphine group and fentanyl group. The nalbuphine group was given continuous infusion of nalbuphine [0.05~0.20 mg/(kg·h)], and the fentanyl group was given continuous infusion of fentanyl [0.5~2.0 μg/(kg·h)]. The analgesic target was critical-care pain observation tool (CPOT) score<2. The observation time was 48 hours. The primary endpoint was CPOT score, the secondary endpoints were Richmond agitation-sedation score (RASS), ICU length of stay, adverse events, and proportion of mechanical ventilation. The quantitative data of the two groups were compared by t test or Mann-Whitney U test. The enumeration data were compared by chi square test or Fisher exact probability method. The data at different time points between groups were compared by repeated measures analysis of variance. Results:A total of 210 patients were enrolled, including 105 patients in the nalbuphine group and 105 patients in the fentanyl group. There was no significant difference in baseline data between the two groups (all P>0.05). There was no significant difference in CPOT score between nalbuphine group and fentanyl group at each time point after medication ( P>0.05), the CPOT score of both groups at each time point after medication was significantly lower than that before medication, and the analgesic target could be achieved and maintained 2 hours after medication. There was no significant difference in RASS between the two groups at each time point after medication ( P>0.05), which was significantly lower than that before medication, and the target sedative effect was achieved 2 hours after medication. There was no significant difference in ICU length of stay between nalbuphine group and fentanyl group [5.0(4.0,7.5) d vs. 5.0(4.0,8.0) d, P=0.504]. The incidence of delirium, nausea and vomiting, abdominal distension, pruritus, vertigo and other adverse events in the nalbuphine group was lower than that in the fentanyl group (all P<0.05). There was no significant difference in the incidence of other adverse events such as deep sedation, hypotension and bradycardia between the two groups (all P>0.05). The incidence of respiratory depression in nalbuphine group was not significantly different from that in fentanyl group ( P>0.05), but the proportion of mechanical ventilation was significantly lower than that in the fentanyl group [1.9% (2/105) vs. 8.6%(9/105), P=0.030]. Conclusions:Nalbuphine could be used for analgesia in ICU patients with non-mechanical ventilation. The target analgesic effect could be achieved within 2 hours, and it had a certain sedative effect with a low incidence of adverse reactions.

Efficacy of mFOLFOX7 regimen systemic chemotherapy combined with camrelizumab and apatinib for hepatocellular carcinoma with Vp4 portal vain tumor thrombus / 中华消化外科杂志

Objective:To investigate the efficacy of mFOLFOX7 regimen systemic chemo-therapy combined with camrelizumab and apatinib for hepatocellular carcinoma (HCC) with Vp4 portal vain tumor thrombus (PVTT).Methods:The single-arm, open, exploratory clinical study was conducted. The clinicopathological data of 15 HCC patients with Vp4 PVTT who were admitted to the Sun Yat-sen Memorial Hospital of Sun Yat-sen University from April 2021 to October 2023 were collected. There were 14 males and 1 female, aged 48(range, 33-67)years. All patients underwent treatment with mFOLFOX7 regimen combined with camrelizumab and apatinib. Observa-tion indicators: (1) clinical efficacy; (2) survival of patients. Measurement data with skewed distribution were represented as M(rang), and count data were described as absolute numbers or percentages. Results:(1) Clinical efficacy. All 15 patients underwent treatment with mFOLFOX7 regimen combined with camrelizumab and apatinib. According to the response evaluation criteria in solid tumors version 1.1, the ratio of objective response, ratio of complete response, ratio of partial response, ratio of disease control, median progression free survival time and median total survival time of the 15 patients were 10/15, 1/15, 9/15, 15/15, not reached and not reached. The median progression free survival time and median total survival time were both >9 months. According to the modified response evaluation criteria in solid tumors, the ratio of objective response, ratio of complete response, ratio of partial response, ratio of disease control, median progression free survival time and median total survival time of the 15 patients were 12/15, 6/15, 6/15, 15/15, not reached and not reached. The median progression free survival time and median total survival time were both >9 months. Of the 15 patients, 7 cases were successfully treated with conversion therapy with the surgical conversion rate as 7/15, and all of them achieved R 0 resection. The other 6 cases were failed in conversion therapy, and there were 2 cases still undergoing conversion therapy. Of the 7 patients with successful conver-sion therapy, 5 cases achieved complete pathological remission, 1 case achieved major pathological remission with 90% of tumor tissue necrosis, and 1 case achieved complete remission through imaging examination, but new liver lesions appeared in multiple locations during further observation which were surgically removed. Results of histopathology examination on the patient confirmed multiple liver metastases. The proportion of treatment-associated adverse reactions in 15 patients was 13/15, with 7/15 having ≥grade 3 adverse reactions, including diarrhea (3/15), neutropenia (2/15), thrombo-cytopenia (2/15), and elevated aspartate aminotransferase (2/15). One patient may experience ≥1 adverse reaction. All patients were improved after symptomatic treatment. (2) Survival of patients. All 15 patients were followed up for 13.0(range, 2.0-31.0)months. During the follow-up period, 3 patients died. One case died of upper gastrointestinal bleeding after achieving partial remission, with a survival time of 7.5 months. One case died of multiple liver metastases of tumor, with tumors accounting for over 70% volume of liver and a survival time of 9.5 months. One case with multiple liver tumors and bilateral lung metastasis died due to disease progression after achieving partial remission, with a survival time of 13.5 months. The postoperative follow-up time for 7 patients undergoing surgical treatment was 14.0(range, 2.0-25.0)months. Of the 7 patients, 1 case experien-ced tumor recurrence 20.0 months after surgery, and 6 cases had no recurrence at last time of the follow-up (3 cases completed treatment and entered follow-up observation). The longest survival time was 31.0 months. Conclusion:The mFOLFOX7 regimen systemic chemotherapy combined with camrelizumab and apatinib for HCC with Vp4 PVTT is safe and feasible.

Mangiferin Attenuates Prostatic Fibrosis in Benign Prostate Hyperplasia by Regulating miRNA-483-3p / 医药导报

Objective This study was to investigate the ameliorative effects of mangiferin on prostatic fibrosis in benign prostatic hyperplasia(BPH)and the mechanism of action of regulating microRNA(miRNA)-483-3p.Methods The male mice were randomly divided into five groups:normal control group,BPH model control group,finasteride group,mangiferin group,and mangiferin+miRNA-483-3p antagonist group.The mice model of BPH was induced by castration and subcutaneous injection of tes-tosterone propionate.After 30 days,the prostatic collagen deposition was observed by masson and sirius red stain,and the level of hydroxyproline was detected.Prostatic mRNA levels of transforming grouth factor-β1(TGF-β1),mitogen-activated protein kinase 2(MK2),and mitogen-activated protein kinase kinase 6(MKK6),as well as the level of miRNA-483-3p,were detected by quantita-tive real-time PCR.Prostatic protein levels of TGF-β1,MK2,phosphorylated MK2(p-MK2),MKK6,and p-MKK6 were detected by western blotting.Finally,the binding effect of miRNA-483-3p on MK2 was evaluated by luciferase assay.Results Compared to normal control group,the prostatic collagen deposition,mRNA levels of TGF-β1,MK2,and MKK6,as well as protein levels of TGF-β1,p-MK2,and p-MKK6 were significantly increased(P＜0.01),while the miRNA-483-3p level was significantly decreased in BPH model control group(P＜0.01).Compared with BPH model control group,the mangiferin group was able to up-regulate the level of miRNA-483-3p,reduce the mRNA levels of TGF-β1,MK2,and MKK6,as well as the protein levels of TGF-β1,p-MK2,and p-MKK6,and alleviate prostatic collagen deposition.When compared to the mangiferin group,mangiferin+miRNA-483-3p antagomir significantly decreased the miRNA-483-3p level,increased the prostatic collagen deposition,mRNA levels of TGF-β1,MK2,and MKK6,as well as protein levels of TGF-β1,p-MK2,and p-MKK6(P＜0.01).Luciferase assay showed that miRNA-483-3p could tar-get binding with MK2.Conclusion Mangiferin can attenuate prostatic fibrosis by regulating miRNA-483-3p and inhibiting MK2.

A clinical study on the treatment of primary trigeminal neuralgia with a new type of laser localization assisted percutaneous puncture of trigeminal nerve microsphere capsule compression surgery / 中国医师杂志

Objective:To explore the clinical efficacy and safety analysis of a novel laser localization technology assisted percutaneous puncture of trigeminal nerve microsphere capsule compression surgery for the treatment of primary trigeminal neuralgia.Methods:A retrospective selection was conducted on 63 patients with primary trigeminal neuralgia who underwent percutaneous puncture of the trigeminal nerve microsphere capsule compression surgery at the First Hospital of Hunan University of Chinese Medicine from January 2020 to December 2021. According to different surgical methods, they were divided into a new laser localization assisted puncture group (observation group) of 32 cases and a traditional barehanded localization puncture group (control group) of 31 cases. An analysis was conducted on the surgical time, puncture time, puncture frequency, intraoperative exposure to radiation, number of cases of poor balloon formation, and clinical efficacy within 6 months after surgery for two groups of patients. The prognosis of the patients was followed up at 6 months after surgery.Results:The surgical time, puncture time, puncture frequency, and intraoperative exposure of the observation group were all less than those of the control group, and the differences were statistically significant (all P<0.05). There was no statistically significant difference ( P>0.05) in the number of cases of poor balloon angioplasty between the observation group and the control group, as well as the pain score grading of the Barlow Neurological Institute (BNI) on the first day after surgery. Within 6 months after surgery, there was no statistically significant difference in the incidence of facial numbness, diplopia, masseter weakness, perilabial herpes, and recurrent pain between the two groups of patients (all P>0.05). Conclusions:Laser positioning technology can assist in precise puncture of the foramen ovale and accurate placement of balloons based on surgical experience, which helps to improve surgical safety, reduce postoperative complications and intraoperative radiation dose, and achieve satisfactory short-term follow-up results.

Issues related to surgical procedures of controlled decompression in the treatment of severe traumatic brain injury / 中华创伤杂志

Severe traumatic brain injury (sTBI) has a high mortality and disability rate, making it a difficult issue and hot topic in neurosurgery. Controlled decompression is an important technique in the treatment of sTBI combined with intracranial hypertension, which can reduce the ischemia-reperfusion injury to the nervous tissue and intracranial vessel and can significantly lower the incidence of complications related to decompressive craniectomy. However, the effects of the controlled decompression technique have been affected by different understandings of the technique and nonstandard surgical procedures in clinical practice. For this purpose, the authors discussed the concept of controlled decompression technique, its indications and the key problems during operation so as to standardize the surgical procedures and improve the therapeutic effects of controlled decompression technique in the treatment of sTBI.

Epidemic trends and strategies of major infectious diseases in 2023 / 中华临床感染病杂志

In 2023，World Health Organization（WHO）announced that the pandemic of COVID-19 is over；while there was an epidemic of multi-pathogenic infections in the respiratory tract by the end of the year in China，indicating that high attention still need to be paid to infectious diseases. In the past one year，some breakthroughs for infectious diseases have been achieved.This article reviews the major events and research progress in the diagnosis，prevention and treatment of infectious diseases in 2023.

Physical performance evaluated by the timed up and go test and its correlation with sleep in the elderly in China / 中华老年医学杂志

Objective:To investigate the effect of sleep on physical performance and the correlation between sleep quality and physical performance in the elderly.Methods:In this prospective multicenter case-control study, 472 elderly people aged 60-80 years were recruited from three regions in China, Beijing, Tianjin, and Hainan Province.Basic information of study participants was collected through face-to-face interviews, and physical performance of study participants was assessed by the time up and go(TUG)test on site, with 106 cases(22.5%)in the normal physical performance group and 366 cases(77.5%)in the abnormal group.The Pittsburgh Sleep Quality Index(PSQI)and the Epworth Sleepiness Scale(ESS)were applied to assess sleep quality of study subjects.Correlation analysis was performed to examine factors affecting subjects' physical performance.Results:Age, history of alcohol consumption, BMI, past medical history, the ESS score, daytime sleepiness, and some components of PSQI, such as sleep quality, sleep efficiency, sleep disturbances, use of sleeping drugs and daytime dysfunction, were influencing factors of the TUG score.Two components of PSQI, sleep duration and habitual sleep efficiency, and the ESS score were positively correlated with physical performance.Logistic regression analysis showed that risk factors for decreased physical performance in the elderly included increased age( OR=1.125, 95% CI: 1.083-1.168, P<0.01), history of alcohol consumption( OR=0.482, 95% CI: 0.384-0.605, P<0.001), abnormally high body mass index( OR=1.663, 95% CI: 1.340-2.063, P<0.01), hyperlipemia( OR=0.156, 95% CI: 0.077-0.318, P<0.01), digestive system diseases( OR=0.154, 95% CI: 0.044-0.532, P<0.01), use of sleeping drugs( OR=0.415, 95% CI: 0.202-0.854, P<0.05), daytime sleepiness( OR=4.234, 95% CI: 2.800-6.403, P<0.01), a high habitual sleep efficiency score of PSQI( OR=1.425, 95% CI: 1.214-1.672, P<0.01)and a high sleep disturbances score in PSQI( OR=3.356, 95% CI: 2.337-4.819, P<0.01). Conclusions:The incidence of physical performance decline is high in the elderly.There is a correlation between physical performance and sleep quality.

Benefits of running on cardiac protection and the culture of exercise health awareness / Benefícios da corrida para a proteção cardíaca e a cultura da consciência sanitária do exercício / Beneficios de la carrera para la protección cardíaca y el cultivo de la conciencia de la salud del ejercicio

ABSTRACT Introduction: Several programs to encourage physical activity has been encouraged to reduce the sedentary lifestyle in China. Running is among them because it has potentially positive effects on cardiovascular diseases, hypertension, diabetes mellitus, and hypercholesterolemia, in addition to the intrinsic psychological and social benefits of outdoor sports. Objective: Explore the protective effect of running on the cardiac system by analyzing strategies for cultivating exercise health awareness. Methods: A group of ten healthy volunteers, five women aged 25-35 years, underwent a 45-minute running program, performed four times a week for three weeks. Data collected by spirometry and cardiac monitoring were collected, treated, compared, and discussed. This paper introduced the concept of subjective exercise intensity to find the best analysis and judgment of Cardiac Function. Finally, a quantitative investigation involving the analysis of 315 questionnaires explored the current status of sports health awareness in running fans. Results: Heart rate amplitude during running remained in the range of 120-160, belonging to the normal heart rate range for the surveyed audience. In most cases, women's heart rate was higher than men's (P<0.05). The exercise intensity was fixed at a frequency below the value of 16, which is a slightly strenuous stage, and the relative exercise intensity was controlled between 50% and 71.5%. Conclusion: Running has a good cardiac protective effect, and its followers are highly aware of sports health. Due to the beneficial effect of sports practice, its dissemination is recommended as a form of physical and social therapeutic activity. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: Com o intuito de reduzir o índice de sedentarismo na China, diversos programas de incentivo à atividade física foram estimulados. A corrida está dentre eles pois tem potenciais efeitos positivos nas doenças cardiovasculares, hipertensão arterial, diabetes mellitus e hipercolesterolemia, além dos benefícios psicológicos e sociais intrínsecos na prática esportiva ao ar livre. Objetivo: Explorar o efeito protetor da corrida no sistema cardíaco analisando as estratégias para a cultura da consciência sanitária do exercício. Métodos: Um grupo de dez voluntários saudáveis, com cinco mulheres e idade entre 25 a 35 anos foram submetidos a um programa de corrida por 45 minutos, realizado quatro vezes por semana, durante três semanas. Dados coletados por espirometria e monitoramento cardíaco foram coletados, tratados, comparados e discutidos. Este artigo introduziu o conceito de intensidade de exercício subjetivo para encontrar a melhor análise e julgamento da Função Cardíaca. Por fim, uma investigação quantitativa envolvendo a análise de 315 questionários explorou a situação atual da conscientização em saúde esportiva em adeptos da corrida. Resultados: A amplitude de frequência cardíaca durante a corrida manteve-se na faixa de 120-160, pertencente à faixa normal de frequência cardíaca ao público pesquisado. A frequência cardíaca das mulheres foi maior do que a dos homens na maioria dos casos (P<0,05). A intensidade do exercício fixou-se numa frequência inferior ao valor de 16, que é um estágio ligeiramente extenuante, e a intensidade relativa do exercício ficou controlada entre 50% e 71,5%. Conclusão: A corrida apresenta um bom efeito protetor cardíaco, seus adeptos possuem elevada conscientização da saúde esportiva. Devido ao efeito salutar da prática esportiva, recomenda-se a sua divulgação como forma de atividade terapêutica física e social. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Con el fin de reducir el estilo de vida sedentario en China, se han estimulado varios programas para fomentar la actividad física. La carrera se encuentra entre ellos porque tiene potenciales efectos positivos sobre las enfermedades cardiovasculares, la hipertensión, la diabetes mellitus y la hipercolesterolemia, además de los beneficios psicológicos y sociales intrínsecos del deporte al aire libre. Objetivo: Explorar el efecto protector de correr sobre el sistema cardíaco analizando las estrategias para cultivar la conciencia de la salud del ejercicio. Métodos: Un grupo de diez voluntarios sanos, cinco mujeres, con edades comprendidas entre los 25 y los 35 años, fueron sometidos a un programa de carrera durante 45 minutos, realizado cuatro veces por semana durante tres semanas. Los datos recogidos por la espirometría y la monitorización cardíaca fueron recogidos, tratados, comparados y discutidos. Este trabajo introdujo el concepto de intensidad subjetiva del ejercicio para encontrar el mejor análisis y juicio de la Función Cardíaca. Por último, una investigación cuantitativa que incluyó el análisis de 315 cuestionarios exploró el estado actual de la conciencia de la salud deportiva en los aficionados a las carreras. Resultados: La amplitud de la frecuencia cardíaca durante la carrera se mantuvo en el rango de 120-160, perteneciendo al rango de frecuencia cardíaca normal para el público encuestado. La frecuencia cardíaca de las mujeres fue mayor que la de los hombres en la mayoría de los casos (P<0,05). La intensidad del ejercicio se fijó en una frecuencia inferior al valor de 16, que es una etapa ligeramente agotadora, y la intensidad relativa del ejercicio se controló entre el 50% y el 71,5%. Conclusión: La acción de correr presenta un buen efecto cardioprotector, sus adeptos poseen alta conciencia de la salud deportiva. Debido al efecto saludable de la práctica deportiva, se recomienda su difusión como forma de actividad terapéutica física y social. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Targeted bile acids metabolomics in cholesterol gallbladder polyps and gallstones:From analytical method development towards application to clinical samples / 药物分析学报

Bile acids(BAs)are synthesized by the liver from cholesterol through several complementary pathways and aberrant cholesterol metabolism plays pivotal roles in the pathogeneses of cholesterol gallbladder polyps(CGP)and cholesterol gallstones(CGS).To date,there is neither systematic study on BAs profile of CGP or CGS,nor the relationship between them.To explore the metabolomics profile of plasma BAs in healthy volunteers,CGP and CGS patients,an ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)method was developed and validated for simultaneous determination of 42 free and conjugated BAs in human plasma.The developed method was sensitive and reproducible to be applied for the quantification of BAs in the investigation of plasma samples.The results show that,compared to healthy volunteers,CGP and CGS were both characterized by the significant decrease in plasma BAs pool size,furthermore CGP and CGS shared aberrant BAs metabolic characteristics.Cheno-deoxycholic acid,glycochenodeoxycholic acid,λ-muricholic acid,deoxycholic acid,and 7-ketolithocholic acid were shared potential markers of these two cholesterol gallbladder diseases.Subsequent analysis showed that clinical characteristics including cysteine,ornithine and body mass index might be closely related to metabolisms of certain BA modules.This work provides metabolomic information for the study of gallbladder diseases and analytical methodologies for clinical target analysis and efficacy evaluation related to BAs in medical institutions.

Application of flipped classroom combined with problem-based learning in the teaching of diagnostic audiology / 中华医学教育探索杂志

Objective:To investigate the teaching effect of flipped classroom combined with problem-based learning (PBL) in the teaching of the Diagnostic Audiology course.Methods:A total of 72 undergraduate students majoring in audiology and speech rehabilitation in the classes of 2019 and 2020 in Chongqing Medical University were enrolled as subjects, and three chapters of the Diagnostic Audiology course were selected for teaching reform. The 34 students in the class of 2019 were enrolled as control group and received lecture-based learning (LBL), and the 38 students in the class of 2020 were enrolled as experimental group and received flipped classroom combined with PBL. The teaching effect was evaluated by comparing the two groups in terms of classroom test scores, classroom participation scores, degree of satisfaction with teaching effect, and overall satisfaction with teaching. SPSS 23.0 software was used to perform the t-test, the chi-square test, and the Mann-Whitney U test. Results:The experimental group had a significantly higher classroom test score than the control group (25.95±1.21 vs. 23.21±1.55, P<0.001). In terms of classroom participation scores, the experimental group had significantly higher scores of participation in class discussion, cooperative and collaborative abilities, and questioning skills than the control group (all P<0.001). In terms of the degree of satisfaction with teaching, compared with the control group, the experimental group had significantly higher degrees of satisfaction in the dimensions such as interest in learning, mastery of theoretical knowledge, teamwork and collaboration abilities, self-learning ability, and self-presentation ( P=0.005, 0.009, 0.001, 0.016, and 0.005). In addition, the experimental group had a significantly higher degree of overall satisfaction with teaching than the control group ( P=0.006). Conclusion:Flipped classroom combined with PBL has a good teaching effect in the Diagnostic Audiology course and thus holds promise for further application.

Prediction of Atrial Fibrillation:From Traditional Regression Analysis Towards Artificial Intelligence / 中国循环杂志

Atrial fibrillation,which is closely correlated with stroke and heart failure,is among the most common arrhythmias in clinical practice.The asymptomatic and paroxysmal nature of atrial fibrillation leads to a very high missed diagnosis rate,more than half of misdiagnosed patients are classified as intermediate to high risk population of ischemic stroke and heart failure.With the progress of population aging in China,the prevalence of atrial fibrillation will continue to increase.The prediction model of atrial fibrillation can help screen patients with high risk of atrial fibrillation.Subsequent preventive intervention and intensive monitoring for this population can reduce the incidence of stroke and heart failure.This paper summarizes the research progress of traditional regression model and artificial intelligence in atrial fibrillation prediction,and limitations of current research and future research directions.

Ferroptosis and Parkinson′s disease / 中国医师杂志

Parkinson′s disease is a neurodegenerative disease caused by the loss of dopaminergic neurons in the substantia nigra. Research has confirmed that Fe deposition in the substantia nigra is an important factor in the degeneration of dopaminergic neurons. Ferroptosis is a new form of Fe dependent cell death first reported in 2012, and there is currently little research on iron death in Parkinson′s disease. This article introduces the formation process and pathological changes of ferroptosis from several aspects such as iron homeostasis, ferroptosis, and lipid peroxidation, as well as the relationship between ferroptosis and Parkinson′s disease.

Value of pubo-femoral distance in the diagnosis of infants with developmental dysplasia of the hip / 中华超声影像学杂志

Objective:To discuss the value of pubo-femoral distance(PFD) in the diagnosis of infants with developmental dysplasia of the hip(DDH).Methods:Nine hundred and thirty-one infants with DDH and normal infants diagnosed by clinical examination and ultrasonography were involved from February 2022 to June 2023 in Beijing Jishuitan Hospital. The ultrasonographic examination included Graf method and pubo-femoral distance measurement. Statistical analysis was made on the measurements of PFD of different types of hips.Results:Among all the hips, 1 359 hips were Graf type Ⅰ, 274 hips were Graf type Ⅱa, 166 hips were Graf type Ⅱb, 31 hips were Graf type Ⅱc, 7 hips were Graf type D, 13 hips were Graf type Ⅲ, and 12 hips were Graf type Ⅳ. The PFD of these hips were (0.34±0.07)cm, (0.35±0.08)cm, (0.35±0.08)cm, (0.51±0.11)cm, (0.67±0.09)cm, (0.95±0.26)cm, (1.27±0.30)cm, respectively. There was no significant difference in PFD between hips of Graf Ⅰ, Graf Ⅱa and Graf Ⅱb ( P>0.05), but there was significant difference in PFD between hips of the other Graf types ( P<0.05). The area under curve(AUC) of the PFD for the diagnosis of stability of the hips in infants was 0.959 with the cut-off value of 0.435 cm, the sensitivity and specificity were 88.9% and 90.4%, respectively. Conclusions:The PFD has great value in the evaluation of the stability of hip joint, and the cut-off value is 0.435 cm.

Hyperoxia caused intestinal metabolism disorder in mice / 中华危重病急救医学

OBJECTIVE@#To investigate the effect of hyperoxia on intestinal metabolomics in mice.@*METHODS@#Sixteen 8-week-old male C57BL/6 mice were randomly divided into hyperoxia group and control group, with 8 mice in each group. The hyperoxia group was exposed to 80% oxygen for 14 days. Mice were anesthetized and euthanized, and cecal contents were collected for untargeted metabolomics analysis by liquid chromatography-mass spectrometry (LC-MS) combined detection. Orthogonal partial least square discriminant analysis (OPLS-DA), volcano plot analysis, heat map analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to analyze the effects of hyperoxia on metabolism.@*RESULTS@#(1) OPLS-DA analysis showed that R2Y was 0.967 and Q2 was 0.796, indicating that the model was reliable. (2) Volcano plot and heat map analysis showed significant statistical differences in the expression levels of metabolites between the two groups, with 541 up-regulated metabolites, 64 down-regulated metabolites, and 907 no differences, while the elevated 5-hydroxy-L-lysine was the most significant differential metabolite induced by high oxygen. (3) KEGG pathway enrichment analysis showed that porphyrin and chlorophyll metabolism (P = 0.005), lysine degradation (P = 0.047), and aromatic compound degradation (P = 0.024) were the targets affected by hyperoxia. (4) Differential analysis of metabolic products through KEGG enrichment pathway showed that hyperoxia had a significant impact on the metabolism of porphyrin and chlorophyll, lysine, and aromatic compounds such as benzene and o-cresol.@*CONCLUSIONS@#Hyperoxia significantly induces intestinal metabolic disorders. Hyperoxia enhances the metabolism of porphyrins and chlorophyll, inhibits the degradation of lysine, and delays the degradation of aromatic compounds such as benzene and o-cresol.

Clinical treatment and observation of the endophthalmitis caused by Bacillus cereus / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the clinical characteristics and antibiotic sensitivity of traumatic endophthalmitis caused by Bacillus cereus and discuss the early diagnosis and treatment measures.METHODS: The data of 15 patients(15 eyes)with Bacillus cereus endophthalmitis admitted to the Eye Trauma Center of Shaanxi Provincial Eye Hospital from January 2019 to December 2021 were collected. The injury time, injury condition, preoperative visual acuity, corrected visual acuity in the last follow-up, operation method, bacterial culture and drug sensitivity test results were recorded.RESULTS: Among the 15 patients(15 eyes), 5 eyes with simple corneal perforating wound were treated with wound debridement and suture combined with intraocular antibiotic injection. And another 10 eyes with penetrating injuries combined with traumatic cataract and intraocular foreign bodies were treated with debridement, cataract extraction, removal of intraocular foreign bodies, vitrectomy combined with silicone oil tamponade and intraocular antibiotic injection. Among the 15 patients, 11 patients(73%)were treated effectively and the eyeball was preserved, and 4 patients(27%)were treated ineffectively and ocular evisceration was performed. Among the 11 patients with eyeball retention, 1(9%)had decreased vision, 1(9%)had unchanged vision, 4(36%)had improved vision by 1 level, and 5(45%)had improved vision by 2 levels, and the postoperative visual acuity was significantly improved. Correlation analysis showed that the course of disease was negatively correlated with corrected visual acuity(rs=-0.762, P=0.001). The cultures of vitreous humor and aqueous humor samples of patients were all grown in Bacillus cereus, and susceptibility tests were sensitive to vancomycin.CONCLUSIONS: Vancomycin is an effective drug for the treatment of Bacillus cereus endophthalmitis. Vitrectomy combined with silicone oil tamponade and intravitreal injection of vancomycin are effective method for the treatment of Bacillus cereus endophthalmitis.

Mechanism of Fructus Lycii against dry eye: an analysis based on network pharmacology and experimental verification / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the mechanism of fructus lycii in treating dry eye based on network pharmacology and experimental verification.METHODS: Taking “fructus lycii” as key words, the active ingredients and target of fructus lycii were searched by using Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP). Gene targets related to dry eye(DE)were searched by GeneCards and OMIM databases. The target genes of fructus lycii and DE were imported into Venn software to obtain the intersection target map of them. After that, the data were imported into the String database to obtain the PPI protein-protein interaction network diagram. Using Cytoscape3.7.2 software, the PPI protein-protein interaction network diagram was constructed for active ingredients, target sites and related diseases of fructus lycii. The Bioconductor platform and R language were used for gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis. And the key targets in the pathogenesis of DE were verified by experiments.RESULTS: Through TCMSP, 45 types of effective chemical components of fructus lycii, 174 target genes corresponding to active components and 131 common target genes with DE were screenedout. In accordance with the network topology of “drug-composition-disease-target”, 27 main effective components of fructus lycii were found in the treatment of DE. The PPI network was analyzed according to the high degree value, which is the key targets of fructus lycii for DE treatment, mainly including AKT1, VEGFA, CASP3, IL1B, JUN, PTGS2, CXCL8, etc. According to GO enrichment analysis, 166 biological functions and processes of fructus lycii for DE treatment were obtained. KEGG enrichment analysis showed that 31 signaling pathways were involved. Additionally, experimental verification displayed that the protein expressions of AKT1, interleukin-6(IL-6), tumor necrosis factor(TNF-α)and IL-17 in conjunctiva tissue of the DE model group were significantly increased.CONCLUSIONS: Through network pharmacology, this study confirmed that the treatment of DE by fructus lycii is a complex process involving multi-components, multi-targets and multi-pathways, and that the treatment of DE by fructus lycii is mainly regulated by anti-inflammatory and apoptosis-related molecules.

Proposal and thoughts on establishing and improving multi-level dental insurance in China / 中华口腔医学杂志

Oral diseases are highly prevalent in China, while oral health services are generally underutilized and public health resources are wasted. Lacking oral insurance may be one of the leading causes. The basic medical insurance of China does not cover dental care in most cities, which is worthy to further discuss. To better understand the experience of dental insurance from international dental care practice, the dental coverage scope, content, co-pay ratio, and effects of oral insurance on oral health improvement from the abroad countries with typical health insurance systems were summarized by using scoping review. Then, we discussed the coverage scope for dental health of basic medical insurance and private insurance in China. We also analyzed the current issues of dental care coverage and cost-share. At last, we proposed thoughts and suggestions to establish and improve a multi-level oral health insurance system with Chinese characteristics under the basic medical insurance frame. In particular, we gave suggestions on increasing the coverage for high dental care xpenditure by ebasic medical insurance, supplying children and teenagers with preventive dental care, and encouraging private insurance companies to cover dental care expenditure.