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OBJECTIVE To systematically reevaluate （umbrella review） the systematic review/meta-analysis of Tripterygium glycosides （TG） in the treatment of diabetic kidney disease （DKD）， in order to provide a higher quality evidence-based reference for TG in the treatment of DKD. METHODS The systematic reviews/meta-analysis of TG in the treatment of DKD were searched from CNKI， Wanfang， VIP， CBM， PubMed， Cochrane Library and Embase. The PRISMA 2020 statement， the AMSTAR 2 scale and the GRADE tool were used to evaluate the quality of the report， the quality of the methodology， and the quality of the evidence， respectively. The quantitative results of the included systematic review/meta-analysis were analyzed comprehensively. RESULTS A total of 18 systematic reviews/meta-analyses were included. PRISMA 2020 stated that 3 reports were complete， 13 reports had partial information defects， and 2 reports had serious information defects. The results of the AMSTAR 2 scale evaluation showed that 4 literature had low methodological quality， and 14 literature had very low methodological quality. GRADE tool evaluation results showed that there were 106 outcome indicators， including 34 intermediate-quality evidence accounted for 32.1%， 51 poor-quality evidence accounted for 48.1%， 21 very poor-quality evidence accounted for 19.8%， and there was no high- quality evidence. Comprehensive analysis of quantitative results of various outcome indicators showed that TG had definite improvement effects on the total effective rate of DKD， 24-hour urinary protein quantity and serum albumin， and the adverse drug reactions were different in every study. CONCLUSIONS The efficacy of TG in the treatment of DKD is relatively accurate， safety still needs to be paid attention to， and future studies with larger sample size need to be verified.
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Connective tissue nevi (CTN) , a kind of benign skin hamartomas, can be classified into 3 types according to the excessive components predominating in skin lesions, including collagen type, elastin type and proteoglycan type, and each type of CTN includes various inherited and acquired diseases. Therefore, genetic, clinical, and histopathological features should be considered for the confirmation of diagnosis of CTN and its subtypes. According to the latest Chinese and international literature, this review elaborates clinical classification and histopathological characteristics of CTN, aiming to further strengthen the understanding of this disease.
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Objective:To evaluate the role of cold-inducible RNA-binding protein (CIRP) in acute renal injury in a mouse model of myocardial ischemia-reperfusion (I/R) and the relationship with nuclear factor kappa B (NF-κB) signaling pathway.Methods:Twenty-four SPF-grade healthy male C57BL/6 mice, aged 6-8 weeks, with body mass index of 24-28 g, were divided into 3 groups ( n=8 each) using a random number table method: sham operation group (Sham group), myocardial I/R group (I/R group) and myocardial I/R + CIRP-derived peptide C23 group (I/R+ C23 group). The model of myocardial I/R was developed by ligation of the left anterior descending coronary artery for 30 min followed by 120-min reperfusion in anesthetized animals. CIRP-derived peptide C23 8 mg/kg was intraperitoneally injected before myocardial ischemia and reperfusion in I/R+ C23 group, while Sham group was only threaded without ligation. Blood samples were collected from the right internal carotid artery at 120 min of reperfusion for determination of the serum creatine kinase isoenzymes (CK-MB), lactic dehydrogenase (LDH), creatinine (Cr) and blood urea nitrogen (BUN) concentrations. Renal tissues were obtained for examination of the pathological changes, and the tubular injury score was assessed. The expression of NF-κB, phosphorylated NF-κB (p-NF-κB), Nod-like receptor protein 3 (NLRP3), interleukin-1beta (IL-1β) and IL-18 in renal tissues was detected by Western blot. The expression of Toll-like receptor 4 (TLR4), NLRP3, IL-1β, TNF-α and IL-6 mRNA was determined by real-time polymerase chain reaction. Results:Compared with Sham group, the levels of serum CK-MB, LDH, Cr and BUN and renal tubule injury score were significantly increased, the expression of p-NF-κB, NLRP3, IL-1β and IL-18 was up-regulated, the expression of TLR4, NLRP3, IL-1β, TNF-α and IL-6 mRNA was up-regulated ( P<0.05), and the pathological injury to renal tissues was aggravated in I/R group. Compared with I/R group, the serum CK-MB, LDH, Cr, BUN and renal tubular injury score were significantly decreased, and the expression of p-NF-κB, NLRP3, IL-1β and and IL-18 was down-regulated, the expression of TLR4, NLRP3, IL-1β, TNF-α and IL-6 mRNA was down-regulated ( P<0.05), and the pathological injury to renal tissues was alleviated in I/R+ C23 group. Conclusions:CIRP is involved in the process of acute renal injury in a mouse model of myocardial I/R, which is associated with activation of NF-κB signaling pathway and promotion of inflammatory responses.
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Objective:To examine the clinicopathological and molecular pathological characteristics of patients with colorectal cancer(CRC)who have mutations in the POLE and POLD1 genes.Methods:In this study, we retrospectively collected data from 276 middle-aged and elderly patients aged 45 years and over who were diagnosed with colorectal cancer at Beijing Hospital between October 2020 and September 2022.We utilized next generation sequencing and bioinformatics analysis to screen for harmful germline and somatic mutations in the POLE and POLD1 genes.The study involved 276 patients, who were divided into three groups based on their genetic mutations.The deleterious mutation group had 6 cases, the mutation of unknown significance group had 18 cases, and the wild type group had 252 cases.We also collected clinical and pathological features of the patients and analyzed their correlation with other molecular pathological results such as tumor mutation burden(TMB), microsatellite instability(MSI), and gene co-mutation.Results:No germline mutations were detected in the POLE and POLD1 genes across all patients.Out of the 276 patients, 18(6.5%)were found to carry POLE mutations.Among these, 6(2.2%)were classified as deleterious mutations, 12(4.3%)were positive for POLE mutations of unknown significance, and the remaining patients had wild type POLE genes.Out of the 276 patients, POLD1 gene mutations of unknown significance were found in 10 patients(3.6%). Among the 276 patients, 5 cases(1.8%)carried two types of gene mutations.Patients in the deleterious mutation group showed earlier tumor stage( P<0.05)and a higher prevalence of low-grade tumor budding( P<0.05), with 6 patients being affected by this.Compared to the wild type group, colon cancer patients showed a higher frequency of deleterious mutations and variants of unknown significance in the poorly differentiated group( P<0.05). The median TMB in the deleterious mutation group was 257.76 muts/Mb, 74.4 muts/Mb in the mutation of unknown significance group, and 5.81 muts/Mb in the wild type group.The study found significant differences in TMB-H status among the three groups, with all P-values less than 0.01.MSI-H status was detected in 1 case(16.7%, 1/6), 14 cases(77.8%, 14/18), and 18 cases(7.1%, 18/276)in the deleterious mutation group, variant of undetermined significance group, and wild type group, respectively.Notably, patients with variants of undetermined significance had a higher MSI-H status than patients with wild type and POLE deleterious mutations, with all P-values less than 0.01.The frequencies of co-mutations in KRAS, NRAS, BRAF, and PIK3CA were higher in the deleterious mutation group compared to the mutation of undetermined significance group and wild type group(all P<0.05). Conclusions:Colorectal cancer(CRC)patients with harmful mutations and variants of undetermined significance exhibit unique clinicopathological features.Patients with variants of undetermined significance are more likely to develop colon cancer, show poor differentiation, and have higher frequencies of TMB-H(tumor mutational burden)and MSI-H(microsatellite instability-high).
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ObjectiveTo summarize the modeling elements， evaluation indicators， characteristics， and drawbacks of the animal models of diabetic nephropathy， and thus provide guidance for the standardized modeling and rational application of these models. MethodThe articles about the animal experiments of diabetic nephropathy published in the last decade were retrieved from China National Knowledge Infrastructure， Wanfang Data， and PubMed. The data of animal species， sex， modeling techniques， modeling criteria， and evaluation indicators were analyzed in Excel. ResultA total of 287 publications were included in this study. Male SD rats were mainly used for the modeling of diabetic nephropathy. The animal models of type 1 diabetes were mainly established by intraperitoneal injection of streptozotocin （STZ） at 60-69 mg·kg-1 once or 50 mg·kg-1 for 5 continuous days， and those of type 2 diabetes by intraperitoneal injection of STZ at 30-39 mg·kg-1 once or 30 mg·kg-1 for 2 continuous days combined with 4 weeks of high-fat and high-sugar diet. Blood glucose and 24-hour urine protein were mainly used to determine whether the modeling was successful. The evaluation indicators of the animal models mainly included basic indicators， glucose and lipid metabolism indicators， and renal function indicators. ConclusionAnimal models are commonly used in the research on diabetic nephropathy， while there is no unified standards for the preparation or evaluation of the animal models. Moreover， Chinese medicine is rarely considered in the modeling. Through literature review and data analysis， this paper summarizes the modeling elements and standards， key evaluation indicators， characteristics， and shortcomings， aiming to build the animal models of diabetic nephropathy with a high success rate and with the characteristics in line with the clinical pathogenesis and syndromes.
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Type 2 diabetes mellitus (T2DM) therapy is facing the challenges of long-term medication and gradual destruction of pancreatic islet β-cells. Therefore, it is timely to develop oral prolonged action formulations to improve compliance, while restoring β-cells survival and function. Herein, we designed a simple nanoparticle with enhanced oral absorption and pancreas accumulation property, which combined apical sodium-dependent bile acid transporter-mediated intestinal uptake and lymphatic transportation. In this system, taurocholic acid (TCA) modified poly(lactic-co-glycolic acid) (PLGA) was employed to achieve pancreas location, hydroxychloroquine (HCQ) was loaded to execute therapeutic efficacy, and 1,2-dilauroyl-sn-glycero-3-phosphocholine (DLPC) was introduced as stabilizer together with synergist (PLGA-TCA/DLPC/HCQ). In vitro and in vivo results have proven that PLGA-TCA/DLPC/HCQ reversed the pancreatic islets damage and dysfunction, thus impeding hyperglycemia progression and restoring systemic glucose homeostasis via only once administration every day. In terms of mechanism PLGA-TCA/DLPC/HCQ ameliorated oxidative stress, remodeled the inflammatory pancreas microenvironment, and activated PI3K/AKT signaling pathway without obvious toxicity. This strategy not only provides an oral delivery platform for increasing absorption and pancreas targetability but also opens a new avenue for thorough T2DM treatment.
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【Objective】 To provide reference for fine management of blood donors by classifying and analyzing different types of blood donors from domestic blood stations. 【Methods】 The resident population of 15 regions in China from 2016 to 2019 were taken as the research object, among which the blood donors were divided into three categories: age-eligible citizens, registered donors and donated donors. The average value and proportion of the three categories were calculated and statistically analyzed. 【Results】 The resident population of the 15 regions varied greatly. The mean 95% CI of the proportion of age-eligible citizens to resident population from 2016 to 2019 was (60.16%, 67.84%); registered donors to age-eligible citizens and resident population was (2.21%, 2.86%) and (1.41%, 1.79%), respectively; donated donors to registered donors, age-eligible citizens and resident population was (84.63%, 91.68%), (1.93%, 2.55%) and(1.23%, 1.59%), respectively. 【Conclusion】 There were differences in the number and proportion of different types of blood donors in different regions. The fine management of blood donors can help blood stations carry out more effective recruitment and retention strategies.
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【Objective】 To explore the recruitment and retention strategy of blood donors by investigating the age composition of blood donors in some areas of China, so as to promote blood donation and enhance clinical blood supply. 【Methods】 Through the working platform of Practice Comparison Working Group of China’s Mainland Blood Collection and Supply Institutions, the average age and age composition of blood donors from 22 blood centers were collected, and statistical analysis was conducted after eliminating invalid data. 【Results】 The median average age of blood donors during the survey year was 30.02.The median age in 2.89% of the blood centers was lower than 25. The average age of different genders was statistically significant only in 2018(P<0.05). Fot first-time blood donors, the median constituent ratio of donors <25 and ≥25 years old was 54.53% and 44.28%, with median retention rate at 10.30% and 9.61%, respectively. The median overall participation rate of blood donors was 2.7%, with median participation rate of blood donors <25 years old at 5.1%. 【Conclusion】 The recruitment and retention of blood donor is crucial to enhance clinical blood supply. Blood donors <25 years old, with a longer period for future donation, should be the main target of blood donation recruitment. Meanwhile, the revision of upper age limit for blood donation is another important initiative to grow the blood donor pool.
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Objective:To explore the value of prognostic model based on ferroptosis-related long non-coding RNA (lncRNA) in predicting the prognosis of patients with colon cancer.Methods:Ferroptosis-related genes were downloaded from FerrDb database, and the RNA sequencing gene data and clinical data of colon cancer patients from the establishment of the database to November 2021 were downloaded from the Cancer Genome Atlas (TCGA) database. Through R3.6.3 software, the colon cancer gene expression data obtained from TCGA database and ferroptosis-related genes obtained from FerreDb database were analyzed to obtain differentially expressed ferroptosis-related genes in colon cancer and normal tissues. The expression correlation between ferroptosis-related genes and lncRNA in colon cancer was calculated by using R3.6.3 software to determine ferroptosis-related lncRNA in colon cancer. The survival-related differentially expressed ferroptosis-related lncRNA was screened and included in the multivariate Cox proportional hazards model to construct a colon cancer prognosis model; and the risk score of colon cancer patients was calculated by the prognostic model according to the lncRNA expression. According to the median risk score, the clinical cases collected from TCGA database were divided into high-risk group and low-risk group with 223 cases in each group. Kaplan-Meier survival analysis was performed for the two groups. The receiver operating characteristic (ROC) curve was used to analyze the effect of prognostic model risk score and clinical characteristics on predicting the survival of all patients. GSEA 4.1.0 software was used for gene set enrichment analysis (GSEA) of lncRNA in high-risk and low-risk groups, and ggpubr package of R3.6.3 software was used for single sample GSEA (ssGSEA) of immune cells and immune function of differentially expressed lncRNA between high-risk and low-risk groups.Results:According to the intersection of ferroptosis-related genes and differentially expressed genes obtained from databases, 65 differentially expressed ferroptosis-related genes were obtained, and 24 lncRNA related to the prognosis of colon cancer were analyzed, and then prognostic model was constructed based on lncRNA. Kaplan-Meier survival analysis showed that the survival of low-risk group was better than that of high-risk group ( P < 0.001); ROC curve analysis showed that the area under the curve (AUC) of 1-, 2-, 3-year survival predicted by the prognostic model risk score was more than 0.75, and the AUC of 1-year survival predicted by the risk score for all patients was greater than age, gender, the National Comprehensive Cancer Network (NCCN), T staging, N staging and M staging. GSEA showed that differentially expressed lncRNA in high-risk and low-risk groups concentrated in tumor and immune-related pathways; ssGSEA showed that there were differences in T cells, macrophages, mast cells, neutrophils, immune stimulation, human leukocyte antigen, type Ⅰ and type Ⅱ interferon response between high-risk group and low-risk group (all P < 0.05), and the expression levels of CD200 and TNFRSF14 at the immune checkpoint were significantly different (both P < 0.01). Conclusions:Ferroptosis-related lncRNA may play an important role in tumor immunity of colon cancer, and it can be used for the prognosis analysis of patients with colon cancer.
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Alzheimer disease (AD) is a neurodegenerative disease in the elderly. Early intervention is the only reliable means to delay the progress of the disease. Referring to the diagnostic criteria of AD, this paper summarizes and analyzes the representative literatures of various AD biomarkers derived from cerebrospinal fluid in recent years, and reviews the efficacy of various cerebrospinal fluid biomarkers in the diagnosis and differential diagnosis of AD. Results show that CSF Aβ42, Aβ42/Aβ40, T-tau, p-tau, Aβ42/p-tau, growth-associated protein 43, synaptosomal-associated protein 25, neurogranin and visinin-like protein-1 are of great value in the diagnosis and differential diagnosis of AD. The above CSF biomarkers can be used in the diagnosis and differential diagnosis of AD. The laboratory should select appropriate AD CSF biomarkers according to its own conditions in daily laboratory works.
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Objective:To analyze the association between the perioperative amplitude-integrated electroencephalogram(aEEG)of neonates with congenital heart disease(CHD) and their neurodevelopmental outcome at 2 years of age.Methods:Neonates with CHD ( n=32) who were admitted to the neonatal intensive care unit at our hospital were included.All patients had undergone cardiac surgery during the neonatal period and preoperative and postoperative aEEG monitoring.The background pattern, sleep-wake cycle(SWC) pattern and seizure activity (including electrographic seizure activity) were used to quantify cerebral activity related to brain function.Infants with CHD were enrolled prospectively to follow up at 2 years old.Participants were assessed at 2 years old via the Bayley Scale of Infant Development. Results:A total of 32 neonates were enrolled in the study.Compared with average of normal population, psychomotor development index(PDI) of participants decreased significantly ( P<0.05). The mental development index(MDI) of patients with abnormal behavior was significantly lower.The longer length of ICU, longer time of ventilation, and the older age of father were risk factors of lower PDI.The MDI (76.29±23.38) of cases with mild abnormal preoperative background pattern were significantly lower than that with normal background pattern (97.37±22.65)( P=0.039). The PDI (74.00±20.09) of cases with abnormal preoperative background pattern was significantly lower than that (92.12±20.42) with normal preoperative background pattern ( P=0.046). The PDI (85.04±20.384) of cases with immature preoperative SWC were significantly lower than that with the normal preoperative SWC(110.00±16.55) ( P=0.027). Conclusion:Abnormal perioperative background pattern and SWC are markers for neurodevelopment disorder.The perioperative aEEG is a useful bedside tool that helps predict outcomes in infants underwent heart surgery.
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A clear and well-accepted diagnostic criterion is a prerequisite to evaluate the prevention or treatment effects of bronchopulmonary dysplasia(BPD). With the survival of extremely premature infants, the improvement of neonatal intensive care, the diagnostic criteria of BPD updated for several times.To be familiar with the diagnosis of BPD and the evidence of transition in different periods is of great significance for the research of BPD.This review introduced the history and the clinical practicability of the changing of BPD diagnostic criteria, to help clinicians and health care managers better evaluate existing research findings and guide long-term management policies for extremely premature infants.
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Objective:To explore the characteristics of pyroptosis-related genes in colon cancer cells screened by bioinformatics, and to verify the constructed prognostic model of colon cancer based on differentially expressed pyroptosis-related genes.Methods:Genetic data of RNA sequencing and clinical data of colon cancer patients were downloaded from The Cancer Genome Atlas (TCGA) database. Fifty-two genes associated with pyroptosis were identified by searching the literature and compared with the RNA sequencing gene dataset of colon cancer and normal colon tissues obtained from TCGA database to obtain differentially expressed pyroptosis-related genes in clinical samples. The protein interaction network of differentially expressed pyroptosis-related genes was analyzed by using STRING website and R software. Based on the differential expression of pyroptosis-related genes in clinical samples of TCGA database, colon cancer patients in TCGA database were divided into pyroptosis and non-pyroptosis groups, and genes with significant differential expression between the two groups were screened at P < 0.05 according to gene expression; based on these differentially expressed genes, LASSO Cox regression was used to construct a prognostic model of colon cancer associated with pyroptosis. Patients collected from TCGA database were divided into high risk (≥ median value) and low risk (< median value) groups according to the median value of risk scores calculated by the model, and the overall survival of the two groups was analyzed by Kaplan-Meier survival function. The time ROC package of R software was used to analyze the efficacy of applying risk scores to predict the different survival time of colon cancer patients in TCGA database. Multivariate Cox regression was used to analyze the effects of clinicopathological factors and risk scores calculated by the model on the survival of patients in TCGA database. R software was used to analyze and obtain the differential genes between high and low risk groups of colon cancer patients in TCGA database. R software was used to conduct Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis and single sample gene set enrichment analysis of immune cells and immune function (ssGESA) for differentially expressed pyroptosis-related genes. Results:Thirty-eight differentially expressed pyroptosis-related genes between colon cancer tissues and normal tissues of clinical samples were obtained based on data of TCGA database. A prognostic model consisting of 13 pyroptosis-related genes was established by applying LASSO Cox regression, the risk score = 0.118×MID2+0.354×IL20RB+0.083×HOXC11+0.011×TMEM88+0.021×SYNGR3+0.246×UPK3B+0.030×EGFL7+0.109×TMPRSS11E+0.138×IFITM10+0.161×RNF207+0.097×LINGO1+0.202×HEYL+0.025×ROBO3. Survival analysis showed that TCGA database had worse overall survival in the high-risk group than in the low-risk group ( P < 0.001). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve of the prognostic model risk score in predicting the survival of colon cancer patients in TCGA database at 1, 3 and 5 years was all > 0.7. Multivariate Cox regression analysis showed that risk score was an independent influencing factor for survival of colon cancer patients in TCGA database (high risk vs. low risk HR = 3.988, 95% CI 2.865-5.551, P < 0.001). GO and KEGG enrichment analysis showed that the differentially expressed genes between high and low risk groups (SULF1, FBLN2, COL1A1, DES, SFRP2, FNDC1, MYH11, APOE, C3, SPP1, COL1A2, COL10A1, THBS2, AEBP1, CNN1, IGHG1, and SFRP4) were upregulated in the high risk group, which were mainly associated with cellular matrix structural components and extracellular matrix (ECM) receptor interactions. ssGSEA analysis showed that the level of immune cell infiltration was higher in high risk group, especially B cells, macrophages, mast cells, helper T cells, and tumor-infiltrating lymphocytes were higher than those in low risk group; for immune function, chemokine receptors, immune checkpoints, human leukocyte antigens, parainflammation, T cell suppression, T-cell stimulation, and type Ⅱ interferon response in high risk group were higher than those in low risk group. Conclusions:The constructed prognostic model of colon cancer based on pyroptosis-related genes is valuable for predicting the prognosis of colon cancer patients. Pyroptosis-related genes may play an important role in tumor immunity of colon cancer and can be used for prognostic analysis of colon cancer patients.
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Objective:To explore the role of denervation on kidney tubulointerstitial fibrosis(TIF)induced by ischemia reperfusion injury(IRI)via NF-E2-related factor-2 (Nrf2)/transforming growth factor-β(TGF-β)pathway in mice.Methods:C57BL/6 mice were randomized into four groups(n=12 each)of sham, kidney ischemia reperfusion(IR), RDN and RDN+ IR(DIR). At Days 1 and 7 post-reperfusion, kidney histology and fibrotic injury are observed after hematoxylin-eosin(HE)and Masson staining.α-SMA protein is detected by immunohistochemistry.The serum levels of blood urea nitrogen(BUN), creatinine(Cr)and neutrophil gelatinase-associated lipocalin(NGAL)are measured.And the contents of superoxide dismutase(SOD), malondialdehyde(MDA), interleukin 4(IL-4), interleukin 10(IL-10)and interleukin 13(IL-13)in kidney tissues are detected.Western blot is utilized for observing the expression levels of Nrf2, TGF-β and phospho-Smad3 protein in kidney tissues.Results:Compared with sham group, kidney histologic score, serum levels of BUN, Cr and NGAL and contents of MDA, IL-4, IL-10 and IL-13 in kidney tissues spiked while activity of SOD declined.Protein expressions of Nrf2, TGF-β and phospho-Smad3 rise in IR-1 and DIR-1 groups( P<0.05). Compared with IR-7 group, degree of fibrosis and levels of α-SMA, IL-4, IL-10 and IL-13 drop in DIR-7 group, Nrf2 protein expression increased and protein expressions of TGF-β and phospho-Smad3 decreased( P<0.05). Conclusions:Acute oxidative stress injury induced by IRI becomes aggravated after kidney denervation and initiates TIF.The long-term expression of TGF-β and phosphorylation of Smad3 are suppressed due to a continuous activation of Nrf2 pathway, thereby blunting the long-term TIF degree of kidney.
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Objective:To investigate clinical and histopathological features of mucinous nevi.Methods:Clinical and pathological data were collected from 10 patients with clinically and histopathologically confirmed mucinous nevi in Hospital of Dermatology, Chinese Academy of Medical Sciences from January 2014 to December 2019, and retrospectively analyzed.Results:All cases developed mucinous nevi in childhood, with an average age of onset being 6.5 years. Of the 10 patients, 7 had lesions on the trunk, among whom 4 had lesions on the back; the remaining 2 had lesions on the limbs, and 1 had generalized lesions on the trunk and limbs. The skin lesions were locally arranged in lines, bands or clusters, and skin-colored, reddish or yellow in color, with the texture varying from soft to hard. Histopathological examination showed that 10 patients presented with disordered arrangement of collagen fiber bundles in the dermis and mucin deposition at varying locations and to different degrees among them, 6 with thickened and red-stained collagen fibers in the deposition area, and the remaining 4 with sparse and decreased collagen; focal liquefaction degeneration of the basal layer was observed in 2 cases, and different amounts of mature adipose tissue in the dermis were seen in 3 cases.Conclusions:Mucinous nevus pathologically manifests as mucin deposition of varying degrees among disorderedly arrangd collagen fiber bundles in the dermis, which is similar to some other diseases, and is easily misdiagnosed. Close combination of clinical and pathological features facilitates confirmed diagnosis.
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Objective:The study seeks to explore the factors influencing the psychological status and sleep quality of medical workers amid the ongoing COVID-19 pandemic, in order to provide data sources and theoretical basis for the development of relevant psychological intervention programs.Methods:Employing the convenience sampling method, general information questionnaire (age, gender, marital status, educational background, job status, etc.), Generalized Anxiety Disorder-7 and Patient Health Questionnaire, epidemic stress index scale, and sleep quality questionnaire were distributed to medical staff between February 18 and April 3, 2020, using the PEM mental health care platform of by ZhongShengKaiXin for medical staff issued. Descriptive, single factor, and correlation analyses, as well as multiple linear regression analysis were used to analyze the data.Results:Overall, 24, 845 questionnaires were collected from 23 provinces, of which 24, 687 were valid, with a recovery rate of 99.36%. The findings showed that the proportion of medical personnel with symptoms of anxiety and depression was 50.58% and 51.37%, respectively; 16.11% had poor or very poor anti-stress ability; and 71.78% reported poor or very poor sleep quality. There was a positive correlation between anxiety, depression, anti-stress ability, and sleep quality ( P<0.05). Anxiety was positively correlated with depression, stress tolerance, and sleep quality( r=0.787, 0.667, and 0.486, all P<0.001); depression was positively correlated with stress tolerance and sleep quality ( r=0.709 and 0.586, both P<0.001); and stress tolerance was positively correlated with sleep quality ( r=0.452, P<0.001). Multiple linear regression analysis results showed that age, gender, marital status, educational background, professional title, job status, and participation influenced the anxiety levels of medical personnel in the backdrop of the pandemic ( P<0.001). Depression levels of medical staff were influenced by gender, educational background, job position, and participation ( P<0.001), while gender, marital status, educational background, job position, and participation influenced the stress tolerance levels ( P<0.001). The sleep quality of medical workers was influenced by age, gender, job position, participation in the fight against the pandemic, and professional title ( P<0.001). Conclusions:Amid the ongoing COVID-19 pandemic, medical staff reported poor mental health status and sleep quality, which can be attributed to diverse factors. The research findings can be useful for assisting medical staff to strengthen their self-cognition, while also providing certain psychological counseling data and theoretical basis for management departments.
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Objective:To investigate the safety of inter-hospital referral and the prognosis of neonatal with critical congenital heart disease.Methods:The criticality score, transit distance and time, and the prognosis of 237 newborns with critical congenital heart disease in Guangdong Provincial People′s Hospital from July 2016 to July 2018 were retrospectively analyzed.Results:A total of 237 children were included (162 male and 75 female) with the median age of 6 days and the median body weight of 2.98 kg.The median transit distance was 90 km.The average value of neonatal critical illness score (NCIS) was (86.54±9.05) scores before transport; 136 cases were greater than 90 scores, 84 cases between 70 and 90 scores, 17 cases less than 70 scores; while the average NCIS was (87.05±8.19) scores when arrived at neonatal intensive care unit (NICU), 138 cases were greater than 90 scores, 82 cases between 70 and 90 scores, 17 cases less than 70 scores.There were no significant differences in the scores of critical cases before and after transfer according to the transfer time and distance ( t=0.346, P>0.05). There was no one death occurred during the transfer process.All over, 222 cases were cured and discharged from the hospital after surgery and or medical interventional treatments, 15 cases died after giving up treatment or losing the opportunity for surgery. Conclusions:It is safe and effective of the inter-hospital transport for the rescue of infants with critical congenital heart disease when followed the principles and transport rules and regulations, with trained workers and special equipments.
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OBJECTIVE：To investigate t he effects of Baihe gujin decoction combined with Shenmai injection on therapeutic efficacy and related indexes in elderly patients with ventilator-associated pneumonia. METHODS ：A total of 75 elderly patients with ventilator-associated pneumonia who were admitted to the Intensive Care Unit （ICU）of Zhuji Hospital of TCM from Apr. 2018 to Oct. 2019 were included. They were randomly divided into control group ，Shenmai group ，Baihe gujin decoction+Shenmai group ， with 25 cases in each group. Control group was given conventional treatments as Piperacillin sodium tazobactam sodium injection 4.5 g，ivgtt，q8 h for anti-infective treatment+ Ambroxol hydrochloride injection 4 mL，iv，bid for expectorant+ Doxofylline injection 20 mL，qd for relieving spasm and asthma+maintaining water ，electrolyte and acid-base balance. Shenmai group was given Shenmai injection 100 mL，ivgtt，qd，on the basis of control group. Baihe gujin decoction+Shenmai group was given Baihe A101） gujin decoction 200 mL nasally ， morning and evening ，on m the basis of Shenmai group. Each group took 7 days as a course of treatment ，and the treatment was continued for 2 courses. Acute physiology and chronic health status （APACHE）Ⅱ score，C-reactive protein （CRP）in peripheral blood ，procalcitonin（PCT），bronchial CD 68 count were observed in 3 groups before and after treatment while the mechanical ventilation time ，hospitalization time in the ICU and ADR recorded. RESULTS：Before treatment ，there was no statistically significant difference in APACHE Ⅱ score，the levels of CRP and PCT ， bronchial CD 68 count among 3 groups（P＞0.05）. After 14 days of treatment ，APACHE Ⅱ score，CRP and PCT levels of all 3 groups were significantly lower than before treatment ；bronchial CD 68 count was significantly higher before treatment ，the order of bronchial CD 68 cell count was Baihe gujin decoction+Shenmai group ＞Shenmai group ＞control group （P＜0.05 or P＜0.01）；after 7 days of treatment ，the order of CRP and PCT levels was Baihe gujin decoction+Shenmai group ＜Shenmai group ＜control group （P＜0.05）；after 14 days of treatment ，there was no staistically significant difference in APACHE Ⅱ score，CRP and PCT levels among 3 groups（P＞0.05）. After treatment ，the order of mechanical ventilation time and ICU hospitalization time was Baihe gujin decoction + Shenmai group ＜Shenmai group ＜control group （P＜0.05 or P＜0.01）. There was no significant difference in the incidence of ADR among 3 groups（P＞0.05）. CONCLUSIONS ：Based on routine treatment ，Baihe gujin decoction combined with Shenmai injection can improve the immune function of lung macrophages in the elderly patients with ventilator-associated pneumonia，inhibite pulmonary inflammation progress ，reduce mechanical ventilation time ，shorten the length of hospital stay with good safety.
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In order to meet the requirements in the cooperation and competition experiments for an individual patient in clinical application, two human interactive behavior key-press models based on hidden Markov model (HMM) were proposed. To validate the cooperative and competitive models, a verification experimental task was designed and the data were collected. The correlation of the score and subjects' participation level has been used to analyze the reasonability verification. Behavior verification was conducted by comparing the statistical difference in response time for subjects between human-human and human-computer experiment. In order to verify the physiological validity of the models, we have utilized the coherence analysis to analyze the deep information of prefrontal brain area. Reasonability verification shows that the correlation coefficient for the training data and the testing data is 0.883 1 and 0.578 6 respectively based on cooperation model, and 0.813 1 and 0.617 8 respectively based on the competition model. The behavioral verification result shows that the cooperation and competition models have an accuracy of 71.43% respectively. The results of physiological validity show that the deep information of prefrontal brain area could been extracted based on the cooperation and competition models, and reveal the consistency of coherence between the double key-press cooperative and competitive experiments, respectively. Above all, the high consistency is obtained between the cooperatio/competition model and the double key-press experiment by the behavioral and physiological evaluation results. Consequently, the cooperation and competition models could be applied to clinical trials.
ABSTRACT
Lung cancer leads to the highest cancer-related morbidity and mortality worldwide. With the development of multi-slice spiral computed tomography technology and the implement of lung cancer screening, more and more lung nodules have been discovered, many of which are multiple pulmonary nodules. These pulmonary nodules are usually diagnosed as multiple primary lung adenocarcinomas from a pathological perspective. For multiple nodules with different imaging features, the preferred treatment methods are different, and the treatment of each lung nodule is still controversial. In recent years, the interactions between multiple lesions and the evolution of the lesions as well as the inter-tumoral and intratumoral homogeneity and heterogeneity of the genomics also arouse attention. Our review gathered the research progress in multiple pulmonary nodules from the points of histopathology, genomics and surgical management. .