Factores determinantes del éxito en la carrera de enfermeras actuantes en tecnología de reproducción asistida / Factors that affect career success of nurses who practice in assisted reproductive technology / Fatores que afetam o sucesso profissional de enfermeiros que atuam na área de tecnologia de reprodução assistida

Objetivo: examinar la relación entre éxito en la carrera y ambiente de trabajo con enfermeras actuantes en tecnología de reproducción asistida (TRA), e identificar factores que afectan su éxito en la carrera. Método: estudio transversal realizado en 53 centros de fertilidad de 26 provincias en la China Continental. Datos recolectados utilizando cuestionario de datos demográficos, un Cuestionario de Competencias de TRA para Enfermeras Especializadas, la Career-Success Scale (Escala de éxito profesional) y la Nursing Work Environment Scale (Escala del entorno de trabajo de enfermería). Se aplicó estadística inferencial y descriptiva. Resultados: 597 enfermeras actuantes en TRA participaron en nuestra encuesta, entregando 555 cuestionarios válidos. Los puntajes generales promedio de éxito en la carrera y ambiente de trabajo fueron 3,75 (desviación estándar, [DE]=1,01) y 3,42 (DE=0,77) respectivamente. Se observó fuerte correlación positiva entre éxito en la carrera y ambiente de trabajo (r=0,742; p<0,01). La regresión múltiple mostró que la concurrencia a conferencias académicas, atención psicológica, desarrollo profesional, apoyo y cuidado, salario y bienestar constituyeron factores significantes con influencia en el éxito en la carrera. Conclusión: la concurrencia a conferencias académicas, atención psicológica y ambiente de trabajo guardan relación positiva con el éxito en la carrera. Los gestores deberían considerar formas de abordar tales factores.

Objective: to examine the relationship between career success and work environment of nurses who practice in assisted reproductive technology and to identify factors that affect career success. Method: a cross-sectional study conducted in 53 fertility centres in 26 provinces in mainland China. Data were collected using a demographic data questionnaire, a specialised nursing competence questionnaire, the Career-Success Scale, and the Nursing Work Environment Scale. Descriptive and inferential statistics were applied. Results: 597 assisted reproductive technology nurses participated in our survey, and 555 valid questionnaires were collected. Theoverall mean scores for career success and work environment were 3.75 [standard deviation (SD) = 1.01] and 3.42 (SD = 0.77) respectively. There was a strong positive correlation between career success and work environment (r = 0.742, p < 0.01). Multiple regression showed that attending academic conferences, psychological care, professional development, support and care, salary, and welfare were significant factors that influence career success. Conclusion: attending academic conferences, psychological care, and work environment are positively related to career success. Administrators should consider ways to address these factors.

Objetivo: examinar a relação entre o sucesso profissional e o ambiente de trabalho de enfermeiros da área de tecnologia de reprodução assistida e identificar os fatores que afetaram tal sucesso. Método: estudo transversal conduzido em 53 centros de fertilidade em 26 províncias da China Continental. Os dados foram coletados por meio de um questionário demográfico, um questionário sobre competências de enfermagem especializada em tecnologias de reprodução assistida, da Career-Success Scale (Escala de Sucesso Profissional) e da Nursing Work Environment Scale (Escala do Ambiente de Trabalho na Enfermagem). Aplicaram-se análises de estatística descritiva e inferencial. Resultados: participaram do estudo 597 enfermeiros da área de tecnologia de reprodução assistida, e 555 questionários válidos foram coletados. As pontuações globais médias para o sucesso profissional e o ambiente de trabalho foram 3,75 [desvio padrão (DP) = 1,01] e 3,42 (DP = 0,77), respectivamente. Verificou-se forte correlação positiva entre o sucesso profissional e o ambiente de trabalho (r = 0,742; p < 0,01). A análise de regressão múltipla mostrou que a participação em eventos acadêmicos, a assistência psicológica, o desenvolvimento profissional, o apoio e os cuidados, e o salário e o bem-estar foram fatores que influenciaram significativamente o sucesso profissional. Conclusão: a participação em eventos acadêmicos, a assistência psicológica e o ambiente de trabalho mostraram correlação positiva com o sucesso profissional. Os gestores deveriam considerar formas de abordar esses fatores.

Clinical observation of postoperative visual perceptual training in children with intermittent exotropia on the recovery of visual function at all levels / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the role of visual perception training on the recovery of visual function at all levels and the improvement of perceptual eye position in children with intermittent exotropia(IXT).METHODS: Prospective clinical study. A total of 74 patients with IXT who received corrective surgery for strabismus in the Ophthalmology Department of the First People's Hospital of Lanzhou City from January to June 2022 were collected and followed up for 3mo. The patients were randomly divided into 2 groups at 1d after surgery: 35 patients in the training group received binocular visual perception training, and 39 patients in the control group did not receive visual training. The changes of visual function and perceived eye position at all levels were observed at 1d and 3mo after operation.RESULTS: There were 24 patients(69%)with simultaneous perception in the training group at 1d after surgery and 34 patients(97%)with recovered visual function at 3mo after surgery, which was significantly higher than 1d after surgery(P=0.002). Furthermore, there were 22 cases(56%)of fusion function in the control group at 3mo after surgery, 13 cases(33%)of far stereopsis, 20 cases(51%)of dynamic stereopsis and 17 cases(44%)of static fine stereopsis. In the training group, there were 31 cases(89%)of fusion function, 25 cases(71%)of far stereopsis, 30 cases(86%)of dynamic stereopsis and 27 cases(77%)of static fine stereopsis, which were significantly higher than those in the control group(all P&#x003C;0.05). The degree of perceived eye displacement in the training group decreased more significantly than that in the control group(all P&#x003C;0.05).CONCLUSION: Postoperative visual perceptual training in children with IXT can promote recovery of visual function at all levels, improve perceptual eye position and enhance the control of eye position at the perceptual level of the brain.

Diagnosis and treatment of autoimmune hepatitis: The indispensable role of pathology / 临床肝胆病杂志

Autoimmune hepatitis has become the main type of non-infectious hepatitis in China. This article summarizes its characteristic manifestations and the current status of diagnosis and treatment and points out that pathological histology plays an indispensable role in the diagnosis and treatment of autoimmune hepatitis.

The Nucleus Accumbens CRH-CRHR1 System Mediates Early-Life Stress-Induced Sleep Disturbance and Dendritic Atrophy in the Adult Mouse / 神经科学通报·英文版

Adverse experiences in early life have long-lasting negative impacts on behavior and the brain in adulthood, one of which is sleep disturbance. As the corticotropin-releasing hormone (CRH)-corticotropin-releasing hormone receptor 1 (CRHR1) system and nucleus accumbens (NAc) play important roles in both stress responses and sleep-wake regulation, in this study we investigated whether the NAc CRH-CRHR1 system mediates early-life stress-induced abnormalities in sleep-wake behavior in adult mice. Using the limited nesting and bedding material paradigm from postnatal days 2 to 9, we found that early-life stress disrupted sleep-wake behaviors during adulthood, including increased wakefulness and decreased non-rapid eye movement (NREM) sleep time during the dark period and increased rapid eye movement (REM) sleep time during the light period. The stress-induced sleep disturbances were accompanied by dendritic atrophy in the NAc and both were largely reversed by daily systemic administration of the CRHR1 antagonist antalarmin during stress exposure. Importantly, Crh overexpression in the NAc reproduced the effects of early-life stress on sleep-wake behavior and NAc morphology, whereas NAc Crhr1 knockdown reversed these effects (including increased wakefulness and reduced NREM sleep in the dark period and NAc dendritic atrophy). Together, our findings demonstrate the negative influence of early-life stress on sleep architecture and the structural plasticity of the NAc, and highlight the critical role of the NAc CRH-CRHR1 system in modulating these negative outcomes evoked by early-life stress.

Effect of Lactate on Immune Cells in Tumor Microenvironment and Progress of Related Target Therapy / 肿瘤防治研究

The relationship between tumor metabolism and immunity is complex and diverse. To date, the role of tumor-specific metabolic reprogramming in shaping the specific tumor microenvironment in tumor immunotherapy remains unclear. Lactic acid is the main product of glycolysis, and the aerobic glycolysis of tumor cells causes lactic acid to accumulate in the microenvironment. Recent studies have shown that the accumulation of lactic acid in the tumor microenvironment hinders anti-tumor immunity, especially affects the function, differentiation, and metabolism of immune cells, and participates in tumor immune escape, thus promoting tumor. This article reviews the effects of lactate accumulation in the tumor microenvironment on dendritic cells, T cells, NK cells, tumor-associated macrophages, and myeloid-derived suppressor cells. Targeted intervention of lactate production and efflux by tumor cells is expected to become a new strategy for tumor immunotherapy.

Clinical study on early predictors of concurrent bile duct injury following TACE in patients with liver cancer / 中华肝脏病杂志

Objective: To explore the predictive factors of concurrent bile duct injury following transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods: A retrospective study was conducted on 483 HCC patients in relation to TACE postoperative complications. A total of 21 cases of bile duct injury were observed following the TACE procedure. Laboratory data, imaging data, and clinically relevant medical histories were recorded before and after one week following the TACE procedure and follow-up. The χ (2) test, or Fisher's exact probability method, was used for categorical variables. The mean of the two samples was compared using a paired t-test or Wilcoxon rank sum test. The comparison of multiple mean values was conducted using an analysis of variance. Results: Twenty-one cases with bile duct injury had intrahepatic bile duct dilatation, bile tumors, hilar biliary duct stenoses, and other manifestations. 14.3% (3/21) of patients showed linear high-density shadows along the bile duct on a plain CT scan, while 76.2% (16/21) of patients had ALP > 200 U/L one week following TACE procedure, and bile duct injury occurred in later follow-up. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and γ-glutamyl transferase (GGT) were significantly increased in all patients following TACE procedure (t = -2.721, P = 0.014; t = -2.674, P = 0.015; t = -3.079, P = 0.006; t = -3.377, P = 0.003, respectively). Conclusion: The deposition of iodized oil around the bile duct on plain CT scan presentation or the continuous increase of ALP (> 200 U/L) one week following TACE procedure has a certain predictive value for the later bile duct injury.

Application of pathological feature clustering in oral pathology teaching / 中华口腔医学杂志

To propose a new student-guided teaching method, in which students carried out the clustering of different diseases with the same pathological characteristics, and differentiated diagnosis of these diseases. This method was named pathological feature clustering (PFC). Seventy-seven undergraduates of School of Stomatology, Wuhan University were enrolled. Stratified random sampling method was adopted to divide the students into 4 groups with 18-20 students in each group. Each group of students selected a disease from the following four topics as the theme and summarize the histological characteristics of the disease: ①oral mucosal disease;②odontogenic tumors and tumor-like lesions, oral and maxillofacial cysts; ③salivary gland diseases;④epithelial-derived tumors and tumor-like lesions (referred to as topics 1, 2, 3, and 4, respectively). When discussing a specific type of disease, the group which select the topic was the summary group (SG), and the other groups were the non-summary group (NSG). After summarizing, students shared the summary results through PPTs, and teachers made comments and supplements. The teaching effect was evaluated by comparing the results of the pre-class test and the final examination. Students' acceptance of PFC teaching method was evaluated through a questionnaire, which included 8 objective questions and 1 subjective question. Likert-scale was used to design the questionnaire, with 1 to 5 points for each question. Students rated each question according to their own situation. Differences among groups were compared by Mann-Whitney U nonparametric test. The pre-class test results showed that the scores of students in SG group in subjects 1, 2, 3 [(5.6±0.8), 5.0(1.0) and (2.9±1.0) points for subjects 1, 2 and 3, respectively] were higher than those in NSG group [(5.1±1.0), 4.0(2.5) and 1.5(2.5) points] (U=402.50, P=0.047; U=392.00, P=0.026; U=295.00, P=0.003). The final examination results showed that there was no significant difference between the scores of the SG group and the NSG group in subjects 1, 2, 3 and 4 (P>0.05). These results showed that the differences between SG and NSG groups were reduced after the summarizing and share between groups, further demonstrating the effectiveness of the PFC teaching method. The results of questionnaire showed that 81.8%(63/77) students were completely satisfied with PFC teaching method, 13.0%(10/77) students were satisfied and 5.2%(4/77) students were basically satisfied. According to the feedback of Likert scale objective evaluation questionnaire, the mean score of each question ranged from 4.19 to 4.77, indicating that students believed that PFC teaching method had a positive impact on the learning of oral pathology. The PFC teaching method proposed in this study could improve the ability of pathological differential diagnosis of undergraduates.

Correlation between contrast-enhanced ultrasound parameters and Crohn's disease activity / 中华内科杂志

Objective: By investigating the correlation between quantitative parameters of contrast enhanced ultrasound (CEUS) and commonly used activity assessment indicators of Crohn's disease (CD), and comparing the predictive power of laboratory inflammatory indicators with CEUS on Crohn's disease (CD), the significance of CEUS was evaluated. Methods: A case-control study. From October 2019 to December 2021, the clinical data of 67 patients with CD who were diagnosed by endoscopy and underwent contrast-enhanced ultrasonography were retrospectively analyzed in the First Affiliated Hospital with Nanjing Medical University, and their routine ultrasound and CEUS parameters, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fecal calprotectin (FC), Crohn's disease activity index (CDAI) and simplified endoscopic score for Crohn's disease (SES-CD) were collected. Using SES-CD as the standard, the patients were divided into a remission group and an active group, and the correlation of laboratory inflammatory indexes and contrast-enhanced ultrasound parameters with CDAI and SES-CD were evaluated. Besides, the ROC curve was used to analyze the predictive efficacy of each index on CD endoscopic activity. Results: A total of 67 patients were included in this study. According to the SES-CD score, there were 17 patients in the remission group and 50 patients in the active group. Except for the coefficient of the enhancement wash in slope and time to peak (TTP), the peak intensity (PI), area under the angiography curve, and laboratory inflammatory indexes were significantly different between the two groups (P<0.05), which also showed a moderate positive correlation with CDAI and SES-CD (P<0.05). ROC analysis showed that among the non-invasive indicators, PI and area under the angiography curve had the highest AUCs for predicting CD endoscopic activity, which were 0.912 and 0.891, respectively; with SES-CD taking >3 as the cut-off value, the corresponding sensitivities were 78.0% and 72.0%, with specificities of 100.0% and 94.1%, respectively. Conclusion: CEUS can objectively and repeatedly evaluate the disease activity of CD patients, and has great clinical application value, which can be used as a reliable imaging method for diagnosis and follow-up of patients with Crohn's disease.

Safety and efficacy of the early administration of levosimendan in patients with acute non-ST-segment elevation myocardial infarction and elevated NT-proBNP levels: An Early Management Strategy of Acute Heart Failure (EMS-AHF) / 中华内科杂志

Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.

Epidemiological characteristics of injury deaths among children and adolescents in China, 2010-2020 / 中国学校卫生

Objective@#To explore the epidemic characteristics of injury related deaths in children and adolescents aged 1-24 years old in China from 2010 to 2020, so as to provide a basis for the formulation of policies and measures related to the control of injuries and deaths among children and adolescents.@*Methods@#The data were sourced from the China Death Cause Monitoring Dataset from 2010 to 2020. Annual percentage change (APC) and average annual percentage change (AAPC) of injury deaths in China in this age group during the period 2010 to 2020 were analyzed by Join point regression.@*Results@#From 2010 to 2020, the standardized death rate of injury showed a decreasing trend (AAPC=-6.90%, t =4.58, P <0.01). The standardized death rates of male and rural injuries showed an overall downward trend, with AAPC rates of -8.37% and -7.79%( t =11.87, 10.34, P <0.01). An increasing trend was observed in the 20-24 year-old age group during 2010-2018 (APC=18.11%, t =6.50, P <0.01). The death rate from injuries was higher in males than females, and higher in rural areas compared with urban areas ( χ 2=16 483.64, 3 268.65 , P <0.01). A downward trend was observed in accidental falls and suicide, the overall standardized mortality rate of traffic accidents, accidental poisoning, fire, drowning, homicide and other injuries (AAPC=-10.22%, -6.21%, -7.50%, -7.94%, -9.01% , -10.97%, t =16.23, 7.29, 2.53, 9.32, 7.88, 4.58, P <0.05). @*Conclusion@#From 2010 to 2020, the overall injury standardized mortality rate in the 1-24 year-old age group shows a decreasing trend, but it remains at a relatively high level. Prevention efforts should be continuously strengthened, especially for urban areas, and should focus on women and those aged 20-24 years old, as well as accidental falls and suicide prevention.

Lignans from stems and leaves of Cephalotaxus fortunei (Ⅱ) / 中国中药杂志

The present study aimed to explore the chemical constituents from the stems and leaves of Cephalotaxus fortunei. Seven lignans were isolated from the 75% ethanol extract of C. fortunei by various chromatographic methods, including silica gel, ODS column chromatography, and HPLC. The structures of the isolated compounds were elucidated according to physicochemical properties and spectral data. Compound 1 is a new lignan named cephalignan A. The known compounds were identified as 8-hydroxy-conidendrine(2), isolariciresinol(3), leptolepisol D(4), diarctigenin(5), dihydrodehydrodiconiferyl alcohol 9'-O-β-D-glucopyranoside(6), and dihydrodehydrodiconiferyl alcohol 4-O-β-D-glucopyranoside(7). Compounds 2 and 5 were isolated from the Cephalotaxus plant for the first time.

Molecular mechanism of resveratrol combined with irinotecan in treatment of colorectal cancer / 中国中药杂志

This study aimed to investigate the mechanism of resveratrol(RES) combined with irinotecan(IRI) in the treatment of colorectal cancer(CRC). The targets of RES, IRI, and CRC were obtained from databases, and the targets of RES combined with IRI in the treatment of CRC were acquired by Venn diagram. The protein functional cluster analysis, GO and KEGG enrichment analyses were performed. In addition, the protein-protein interaction(PPI) network was constructed. The core target genes were screened out and the target-signaling pathway network was set up. IGEMDOCK was used to dock the core target gene molecules. Besides, the relationship between the expression level of key target genes and the prognosis and immune infiltration of CRC was analyzed. Based on the in vitro cell experiment, the molecular mechanism of RES combined with IRI in the treatment of CRC was explored and analyzed. According to the results, 63 potential targets of RES combined with IRI were obtained for CRC treatment. Furthermore, cluster analysis revealed that protein functions included 23% transmembrane signal receptors, 22% protein modifying enzymes, and 14% metabolite converting enzymes. GO analysis indicated that BPs were mainly concentrated in protein autophosphorylation, CCs in receptor complex and plasma membrane, and MFs in transmembrane receptor protein tyrosine kinase activity. Moreover, KEGG signaling pathways were mainly enriched in central carbon metabolism in cancer. The key targets of RES combined with IRI in the treatment of CRC were PIK3CA, EGFR, and IGF1R, all of which were significantly positively correlated with the immune infiltration of CRC. As shown by the molecular docking results, PIK3CA had the most stable binding with RES and IRI. Compared with the results in the control group, the proliferation ability and EGFR protein expression of CRC cells in the RES-treated group, the IRI-treated group, and the RES+IRI treated group significantly decreased. Moreover, the cell proliferation ability and EGFR protein expression level of CRC cells in the RES+IRI treated group were remarkably lower than those in the IRI-treated group. In conclusion, PIK3CA, EGFR, and IGF1R are the key targets of RES combined with IRI in CRC treatment. In addition, RES can inhibit the proliferation of CRC cells and improve IRI chemoresistance by downregulating the EGFR signaling pathway.

Effect of Gandouling Decoction Combined with Cognitive Behavioral Therapy on Impulse Control Disorders in Wilson's Disease with Syndrome of Combined Phlegm and Stasis / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy of Gandouling decoction combined with cognitive behavioral therapy （CBT） in the treatment of impulse control disorders in patients with Wilson's disease （WD， syndrome of combined phlegm and stasis）. MethodA prospective study was conducted on 90 WD patients with the syndrome of combined phlegm and stasis and impulse control disorders （ICD） treated in the Department of Encephalopathy of the First Affiliated Hospital of Anhui University of Chinese Medicine from August 2018 to February 2023. They were randomized into a control group， a CBT group， and a treatment group， with 30 patients in each group. The control group received routine Western medicine treatment （basic copper removal）. The CBT group received cognitive behavioral therapy in addition to the therapy in the control group， and the treatment group received Gandouling decoction in addition to the therapy in the CBT group. Each course of treatment was 8 days， and the patients were treated for 4 courses. Before and after treatment， the 24-hour urine copper （24 h U-Cu）， non-ceruloplasmin-bound copper （NCC）， traditional Chinese medicine （TCM） syndrome score， unified WD rating scale part Ⅲ （UWDRS Ⅲ） score， Barratt Impulse Scale Version 11 （BIS-11） score， Buss-Perry aggression questionnaire （BPAQ） score， modified overt aggression scale （MOAS） score， and treatment emergent symptom scale （TESS） score of three groups of patients were determined and statistically analyzed. ResultBefore treatment， there was no statistically significant difference in the level of 24 h U-Cu or NCC among the three groups. After treatment， all the three groups showed an increase in 24 h U-Cu （P<0.01） and a decrease in the NCC level （P<0.05， P<0.01）. There was no significant difference in the 24 h U-Cu level among the three groups after treatment. After treatment， the NCC level showed no significant difference between the control group and the CBT group， while the NCC level in the treatment group was lower than that in the control group and CBT group （P<0.05）. Before treatment， there was no statistically significant difference in the TCM syndrome score among the three groups. After treatment， the TCM syndrome scores of all the three groups decreased （P<0.01）. Moreover， the treatment group had lower TCM syndrome score than the control group and CBT group （P<0.05）. Before treatment， the UWDRS Ⅲ， BIS-11， BPAQ， and MOAS scores had no statistically significant differences among the three groups. After treatment， the UWDRS Ⅲ， BIS-11， BPAQ， and MOAS in all the three groups declined （P<0.05）. Moreover， the CBT group and treatment group had lower UWDRS Ⅲ， BIS-11， BPAQ， and MOAS scores than the control group （P<0.05）， and the treatment group had lower BIS-11 and BPAQ scores than the CBT group （P<0.05）. ConclusionThe combination of Gandouling decoction and CBT can ameliorate impulse control disorders in the WD patients with combined phlegm and stasis.

Aspiration risk of preventive placement of nasal jejunum nutrition tube in advanced esophageal cancer patients receiving radiotherapy and the influencing factors / 肿瘤研究与临床

Objective:To investigate the aspiration risk of preventive placement of nasal jejunum nutrition tube in advanced esophageal cancer patients receiving radiotherapy and the influencing factors.Methods:The clinical data of 220 patients with advanced esophageal cancer who received radiotherapy and preventive placement of nasal jejunum nutrition tube feeding from November 2020 to November 2021 in Cancer Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed. The level of aspiration risk was measured according to the standard swallowing function assessment scale (SSA). The questionnaire collected the following data: (1) the general data including gender, age, educational level, history of smoking, history of alcoholism, knowledge of aspiration; (2) the disease factors including tumor staging, tumor site, swallowing function, abdominal distention; (3) the nosocomial factors including history of esophageal cancer surgery, sedation and analgesia treatment, combination of chemotherapy or not, cumulative radiotherapy dose, grade of radiation esophagitis, the position, time and tube feeding method of enteral nutrition. The standard swallowing function of patients was measured and repeated saliva swallowing test (RSST) was used to screen the patients with the difficulty in the esophageal function swallowing. Multiple linear regression was used to analyze the factors affecting aspiration risk.Results:A total of 220 patients with advanced esophageal cancer were enrolled in the investigation. Finally, 70 patients (31.8%) had grade 0 aspiration risk, and SSA score was 19; 23 patients (10.5%) had grade I aspiration risk, and SSA score was (23.4±1.3); 103 patients (46.8%) had grade Ⅱ aspiration risk, and SSA score was (27.5±1.1); 24 patients (10.9%) had grade Ⅲ aspiration risk, and SSA score was (33.2±1.5); 136 patients (61.8%) in total had aspiration risk. There were 32.7% (72/220) patients knowing the knowledge of aspiration. Multifactor analysis showed that esophageal tumor site ( t = -2.869, P = 0.005), cumulative radiotherapy dose ( t = 5.558, P < 0.001), grade of radiation esophagitis ( t = 11.405, P < 0.001), the duration time of enteral nutrition ( t = 4.050, P < 0.001) were independent factors affecting the aspiration risk. Conclusions:The aspiration risk of preventive placement of nasal jejunum nutrition tube in advanced esophageal cancer patients receiving radiotherapy is high, which is related to esophageal tumor site, grade of radiation esophagitis, cumulative radiotherapy dose and the duration time of enteral nutrition.

Preliminary study on the block-based charging model for neonatal medication in pharmacy intravenous admixture service / 中华医院管理杂志

Objective:To explore the block-based charging method for centralized dispensing of neonatal drugs in pharmacy intravenous admixture service (PIVAS), analyze its effect on drug savings and inpatient drug cost, so as to provide the reference for the appropriate charging method of neonatal drugs.Methods:According to the balance quantity and amount of neonatal intravenous drugs that were centrally allocated by the PIVAS of our hospital, refer to the doctor′s orders, the dosage per dose as well as the number of patients per dose were analyzed, then the drug types and plans for block-based charging were formulated. Before and after the implementation of the plan, the monthly average drug balance quantity and amount, the average number of drug charges for the neonates, the average daily drug cost, and the adverse events of related drugs were used as the indicators to be investigated to clarify the implementation effect of the block-based charging mothod.Results:Fourteen medicines were charged by block-based, including 4 antibiotics, 2 ordinary infusion preparations, and 8 parenteral nutrition solution preparations. The monthly average drug balance quantity was reduced from 5 047±541 to 1 856±225, and the monthly average balance amount was reduced from 65 811±10 265 yuan to 20 659±6 002 yuan. The average drug dosage for children in the trial drug was significantly reduced with a decrease range of 39.2% to 90.1%. Both the inpatient daily drug cost of neonatus and the daily average antibacterial drug cost was decreased. During the centralized dispensing of neonatal drugs, no related adverse drug events occurred.Conclusions:The block-based charging method of centralized drug distribution can improve the utilization rate of drugs, reduce drug waste, reduce the cost of inpatient medicines the financial burden on children′s families, which is worthy of further promotion and implementation.

Role of innate immune cells in host immune responses against Aspergillus fumigatus / 中华微生物学和免疫学杂志

Aspergillus fumigatus ( A. fumigatus) is an environmental filamentous fungus and an opportunistic pathogen that can cause chronic and invasive aspergillosis. The development of aspergillosis is the result of the interaction between the host and the pathogen, and the symptoms of A. fumigatus infection varied in patients with different immune status. The host innate immune response to inhaled fungal spores is a key determinant of the development of aspergillosis. This review focused on the role of innate immune cells including macrophages, neutrophils, natural killer cells, natural killer T cells and mast cells in host defense against A. fumigatus, aiming to provide reference for further research on the pathogenesis, clinical prevention and treatment of aspergillosis.

Osteoprotective effect of denosumab on patients with chronic kidney disease / 中华肾脏病杂志

Osteoporosis is a comorbidity or complication of chronic kidney disease (CKD). Low bone mineral density, osteoporosis, and fractures are risk factors of poor prognosis in patients with CKD. Active prevention and treatment of osteoporosis is essential for patients with CKD. Denosumab is a fully human monoclonal antibody that targets receptor activator of nuclear factor-κB ligand (RANKL) and is not metabolized or excreted by the kidney. Clinical studies have shown that the use of denosumab in CKD (including dialysis and renal transplantation) patients with osteoporosis, can increase bone mineral density and reduce the incidence of fractures with acceptable safety. As hypocalcemia has been observed in patients with CKD, close monitoring and early supplementation of calcium and vitamin D are required before denosumab initiation, and serum calcium levels need to be monitored during treatment. The review summarized the published literature of denosumab in bone protection of CKD.

Long-term survival influencing and risk factors in peritoneal dialysis patients: a single center study in Southwest China / 中华肾脏病杂志

Patients who initiated peritoneal dialysis (PD) in Sichuan Provincial People's Hospital from January 1, 2001 to December 31, 2013 were enrolled in the single center and retrospective study. Clinical and laboratory data were collected to analyze the long-term survival rates, technique survival rates and associated influencing factors. Patients were followed up until December 31, 2021 or endpoints occurred (death or stopping PD treatment). Kaplan-Meier survival curves were used to estimate survival rates and technique survival rates. Cox proportional hazards regression model was used to analyze the risk factors of death and technique failure in PD patients. A total of 373 patients were enrolled in the study, with age of (52.1±15.8) years old and 199 (53.4%) males. During the follow-up, 154 (41.3%) patients died, 72 (19.3%) patients transferred to hemodialysis, and 40 (10.7%) patients received kidney transplant. Kaplan-Meier survival curves revealed that overall survival rates of PD patients at 1, 3, 5, 7, and 10 years were 92.2%, 76.6%, 66.0%, 52.4% and 38.6%, respectively. Technique survival rates were 93.5%, 84.8%, 74.2%, 62.8% and 44.5% at 1, 3, 5, 7, and 10 years, respectively. Multivariate Cox regression model results showed that age ( HR=1.055, 95% CI 1.039-1.073, P<0.001), transfer from hemodialysis ( HR=2.212, 95% CI 1.514-3.231, P<0.001), episodes of peritonitis ( HR=2.141, 95% CI 1.194-3.837, P=0.011), Charlson comorbidity index ( HR=1.525, 95% CI 1.305-1.783, P<0.001), and baseline albumin ( HR=0.951, 95% CI 0.925-0.978, P<0.001) were independent influencing factors of survival in PD patients. Episodes of peritonitis ( HR=2.327, 95% CI 1.274-4.250, P=0.006) and Charlson comorbidity index ( HR=1.244, 95% CI 1.035-1.496, P=0.020) were independent influencing factors of technique survival in PD patients. PD patients have good early survival rates and technical survival rates, but long-term outcomes need to be further improved. Peritonitis is a major risk factor for low long-term survival rates and technical survival rates in PD patients.

Research progress on the role and mechanism of ferroptosis in renal fibrosis / 中华肾脏病杂志

Ferroptosis is a recently identified type of non-apoptotic cell death, mainly caused by disruption of cellular metabolic pathways such as iron metabolism and reactive oxygen species metabolism, characterized by intracellular iron overload and reactive oxygen species accumulation leading to lipid peroxidation. Ferroptosis is closely related to renal diseases. The role of ferroptosis in diseases such as acute kidney injury and renal cell carcinoma has been extensively studied, and new discoveries and advances have been made in its relationship with renal fibrosis. The paper systematically reviews the relationship between ferroptosis and renal fibrosis in terms of the latest regulatory mechanisms of ferroptosis and its role in renal fibrosis, and explores the potential clinical application of targeted inhibition of ferroptosis to prevent renal fibrosis.

Legius syndrome combined with central precocious puberty: a case report and literature review / 中华神经科杂志

Objective:To investigate the clinical phenotype and genotypic characteristics of Legius syndrome.Methods:The clinical data of a child with precocious puberty and scattered café-au-lait macules admitted to Department of Neurology of the Children′s Hospital Affiliated to Zhengzhou University in July 2021 were retrospectively analyzed. Trio-whole exome sequencing (trio-WES) was used for genetic analysis to confirm the molecular diagnosis of the family. The relevant literature was reviewed to summarize the clinical characteristics of the disease.Results:The proband was a 10-year and 9-month-old girl, presenting with more than 5 café-au-lait macules with diameter>5 mm on the face and trunk, freckles in the axillary, without Lisch tubercles of iris and tumor signs of neurofibromatosis type 1, diagnosed as central precocious puberty at the age of 8. trio-WES results of the family revealed a spontaneous heterozygous nonsense mutation c.751(exon7) C>T in SPRED1 gene, causing a nonsense mutation in the amino acid sequence p.Arg251Ter (p. Ter251 *). Literature review showed a total of 88 pathogenic mutations were reported in SPRED1 gene, including frameshift mutations (41/88), nonsense mutations (31/88), splice mutations (7/88), missense mutations (6/88), and others (3/88), and no mutational hotspots were found. Clinical phenotype was as follows:>5 café-au-lait macules accounted for 92.8% (168/181), armpit and inguinal freckles 43.5% (73/168), macrocephaly 21.4% (31/145), learning disability 18.0% (30/166), psychomotor retardation 13.8% (22/159), lipoma (adult) 13.7% (21/153), Noonan facial sign 12.1% (21/173), and tumor phenotype of neurofibromatosis type 1 was not reported. Conclusions:The central precocious puberty phenotype of Legius syndrome was not reported in China. The clinical phenotype of Legius syndrome was mild, with a large variation, but without neurofibromatosis type 1 tumor phenotype. Genetic testing can be beneficial for early diagnosis of Legius syndrome.