Discussion on Ethical Value and Application Principle of Cryopreservation and Transplantation of Human Ovarian Tissue / 中国医学伦理学

In recent years, with the continuous progress of medical technology, the survival rate of cancer patients after treatment has been continuously improved, and more and more young cancer patients begin to pay attention to the fertility problem after survival. For prepubertal or adolescent cancer patients who require urgent chemoradiotherapy, and for reproductive female patients, ovarian tissue cryopreservation (OTC) follows by transplantation is the only option to preserve their fertility at present. Although the OTC technology has been carried out as a routine clinical project in a few medical institutions in China, it is still in the stage of clinical trial research in majority medical institutions. There are still many technical and ethical challenges in clinical practice of OTC technology. Therefore, this paper discussed the ethical principles that should be followed in clinical practice of human OTC and transplantation, and briefly analyzed the corresponding ethical issues. When implementing this technology, the indications should be followed strictly, the wishes of patients should be respected and true and full informed consent should be obtained while ensuring that the cancer treatment of patients is not delayed. Besides, it is significants to accumulate enough experience for minor patients to fully protect their rights and interests and promote the construction of relevant national laws and regulations.

Effect of high-frequency repetitive transcranial magnetic stimulation in M1 region combined with dorsolateral prefrontal cortex on electroencephalogram θ frequency band amplitude of patients with neuropathic pain after spinal cord injury / 中国康复理论与实践

ObjectiveTo explore the efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) in M1 region combined with dorsolateral prefrontal cortex (DLPFC) on electroencephalogram (EEG) θ frequency band amplitude of patients with neuropathic pain (NP) after spinal cord injury. MethodsFrom June, 2022 to June, 2023, 50 NP patients after SCI in Qingdao University Affiliated Hospital were included and divided into M1 region stimulation group (n = 25) and M1 region combined with DLPFC stimulation group (the combined stimulation group, n = 25). M1 region stimulation group received 10 Hz rTMS in the left M1 region, while the combined stimulation group received same stimulation in left M1 region combined with DLPFC, for three weeks. Before and after intervention, the pain was assessed with Short Form of McGill Pain Questionnaire (SF-MPQ), the depression and anxiety status were evaluated using Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA), and the EEG θ frequency band amplitude was recorded to detect the changes of brain electrophysiological activity. ResultsFour cases in M1 region stimulation group, and two cases in the combined stimulation group were dropped. After intervention, the total score of SF-MPQ and the scores of the subscales, the scores of HMMD and HAMA decreased in both groups (|t| > 2.523, P < 0.05). The EEG θ frequency band amplitude significantly reduced in the prefrontal and frontal regions in M1 region stimulation group (|t| > 5.243, P < 0.001), and it also significantly reduced in the prefrontal, frontal regions, central and parietal regions in the combined stimulation group (|t| > 4.630, P < 0.001). All the scores were lower (|t| > 2.270, Z = -1.973, P < 0.05), and the EEG θ frequency band amplitude in the prefrontal, frontal regions, central and parietal regions were lower (P < 0.05) in the combined stimulation group than in M1 region stimulation group. ConclusionHigh frequency rTMS is an effective analgesic method on NP after SCI, which can improve their depression and anxiety symptoms and reduce the EEG θ frequency band amplitude. Compared with M1 region rTMS stimulation, the combination of M1 region and DLPFC rTMS is more effective.

Advances in the Mechanism of Phage Resistance to Bacterial Biofilms and Strategies for Its Application / 现代检验医学杂志

Bacterial biofilms(BF)are complex microbial communities formed by bacteria on living or abiotic surfaces.Their formation significantly enhances bacterial virulence and drug resistance and is associated with a high proportion of chronic bacterial infections,posing a serious threat to human health.The ability of traditional antibiotics and commonly used disinfectants to clear biofilms is limited,and an effective new strategy to treat BF is urgently needed.Bacteriophage,as a kind of virus that can infect and lyse bacteria,has high safety and specificity,and is considered as a promising alternative method for the treatment of BF.In this paper,the mechanism of bacteriophage anti-bacterial biofilm and the application strategies based on bacteriophage and its derivatives in the prevention and control of bacteriophage biofilm formation were reviewed,which provided new ideas for the development of efficient bacteriophage anti-bacterial biofilm methods.

The Nomogram model was established for the risk assessment of intestinal colonization with neonatal CRKP / 实用医学杂志

Objective To establish a Nomogram model for assessing the risk of intestinal colonization by Carbapenem-Resistant Klebsiella pneumoniae(CRKP)to determine the specific probability of colonization and adopt individualized prevention strategies for the purpose of reducing the occurrence of colonization and secondary infection of neonatal CRKP.Methods A total of 187 neonates hospitalized between January 2021 and October 2022 and diagnosed with CRKP colonization by rectal swab/fecal culture as well drug sensitivity identification 48 h after admission were assigned to the CRKP group.Another 187 neonates without non-CRKP colonization during the same period were set as the non-CRKP group.All the data of the two groups were used for a retrospective analysis.The caret package in R 4.2.1 was used to randomly divide the 374 cases into the model group and validation group at a ratio of 3∶1.Then the glmnet package in R 4.2.1 was used to conduct a LASSO regression analysis over the data from the model group to determine the predictive factors for modeling and the rms software package was used to build a Nomogram model.The pROC and rms packages in R 4.2.1 were used to examine the data,analyzing the consistency indexes(Cindex),receiver operating characteristic curves(ROC),and area under the curves(AUC)and performing the internal and external validation of the efficacy of the Nomogram model via the calibration curves.Results LASSO regression analysis determined eight predictors from the 35 factors probably affecting neonatal CRKP colonization:gender,cesarean section,breastfeeding,nasogastric tube,enema,carbapenems,probiotics,and hospital stay.The Nomogram model constructed using these eight predictors as variables could predict CRKP colonization to a moderate extent,with the area under the ROC curve of 0.835 and 0.800 in the model and validation group,respectively.The Hos-mer-Lemeshow test showed that the predicted probability was highly consistent with the actual probability(the modeling group:P = 0.678>0.05;the validation group:P = 0.208>0.05),presenting a higher degree of fitting.Conclusion The Nomogram model containing such variables as gender,cesarean section,breastfeeding,nasogastric tube,enema,carbapenems,probiotics,and hospital stay is more effective in predicting the risk of neonatal CRKP colonization.Therefore,preventive measures should be individualized based on the colonization probability predicted by the Nomogram model in order to keep neonates from CRKP colonization and reduce the incidence of secondary CRKP infections among them.

Repetitive magnetic stimulation of S3 nerve root and M1 area for treating urinary retention after spinal cord injury / 中国组织工程研究

BACKGROUND:Repetitive magnetic stimulation of either S3 nerve root or M1 area can improve the urination function of patients with urinary retention after spinal cord injury,but there are few reports on the repetitive magnetic stimulation of both sites in patients with urinary retention after spinal cord injury. OBJECTIVE:To observe the effect of repetitive magnetic stimulation of both S3 nerve root and M1 area on urinary retention after spinal cord injury. METHODS:Forty patients with urinary retention after spinal cord injury were enrolled and were randomly divided into two groups(n=20 per group):group A(repetitive magnetic stimulation in both S3 nerve root and M1 area)and group B(repetitive magnetic stimulation in the S3 nerve root and sham stimulation in the M1 area).Patients in both groups were given 4-week repetitive magnetic stimulation based on conventional bladder function intervention.The stimulation time and duration of treatment were same in both groups,with a treatment time of 21 minutes daily,5 days per week,for 4 weeks in total.The urination diary and urodynamics were compared between two groups. RESULTS AND CONCLUSION:Before treatment,there were no statistically significant differences in the average daily catheterization times,average daily catheterization volume,average single urinary volume,urinary storage period(maximum bladder volume,bladder pressure),and urinary voiding period(detrusor pressure,residual urine volume)between the two groups(P>0.05).After 4 weeks of treatment,the average daily catheterization times in group A were lower than before treatment(P<0.05),while the average single urination volume in group A was higher than that before treatment(P<0.05);and the average daily catheterization times in group B were lower than before treatment(P<0.05).After 4 weeks of treatment,the average daily catheterization times in group A were lower than those in group B,and the average single urination volume was higher than that in group B(P<0.05).After 4 weeks of treatment,the maximum bladder volume and detrusor pressure during urination were increased in both groups compared with before treatment(P<0.05),while the bladder pressure and residual urine volume at the maximum volume of the two groups were decreased compared with those before treatment(P<0.05).Compared with group B,the maximum bladder volume and detrusor pressure during urination were higher in group A,while the bladder pressure and residual urine volume at maximum volume were lower in group A(P<0.05).To conclude,two treatments can both improve the urination function of patients with urinary retention after spinal cord injury,and repetitive magnetic stimulation of both S3 nerve root and M1 area is superior to repetitive magnetic stimulation of S3 nerve root alone.Repetitive magnetic stimulation of both S3 nerve root and M1 area can effectively improve the urination function of patients with urinary retention after spinal cord injury.

Influencing factors for intestinal colonization and secondary infection of CRKP in neonates / 中国感染控制杂志

Objective To analyze the influencing factors for intestinal colonization and secondary infection of car-bapenem-resistant Klebsiella pneumoniae(CRKP)in neonates,and provide a basis for formulating prevention and control strategies for CRKP infection.Methods Neonates who were admitted to the neonatal ward of a hospital from January 2021 to October 2022 were selected as the study subjects,and the first screening of CRKP was con-ducted within 48 hours after admission.In addition,active anal swab screening for carbapenem-resistant Ente-robacterales(CRE)was performed weekly during hospitalization,and the infection status of CRKP strains was mo-nitored.Clinical data of neonates in the colonization group,non-colonization group,and infection group were ana-lyzed.Intestinal colonized strains and the non-repetitive CRKP strains isolated from clinical specimens of neonates with secondary infection after colonization were performed carbapenemase gene detection,multilocus sequence ty-ping(MLST)and pulsed-field gel electrophoresis(PFGE)analysis.Results A total of 1 438 neonates were active-ly screened for CRE,174 were CRKP positive,CRKP colonization rate was 12.1％.Among 174 neonates,35 were with secondary infection,with the incidence of 20.1％.The independent risk factors for neonatal CRKP intestinal colonization were cesarean section(OR=2.050,95％CI:1.200-3.504,P=0.009),use of cephalosporins(OR=1.889,95％CI:1.086-3.288,P=0.024),nasogastric tube feeding(OR=2.317,95％CI:1.155-4.647,P=0.018).Protective factors were breast-feeding(OR=0.506,95％CI:0.284-0.901,P=0.021),oral probiotics(OR=0.307,95％CI:0.147-0.643,P=0.002),and enema(OR=0.334,95％CI:0.171-0.656,P=0.001).Independent risk factors for secondary infection after intestinal colonization of neonatal CRKP were carbapenem anti-biotic use(OR=19.869,95％CI:1.778-222.029,P=0.015)and prolonged hospital stay(OR=1.118,95％CI:1.082-1.157,P＜0.001).The detection results of drug resistance genes showed that carbapenemase-producing genes of CRKP strains were all blaKPC-2,all belonged to type ST11.Homologous analysis showed that intestinal CRKP colonization was highly homologous with the secondary infection strains after colonization.Conclusion CRKP intestinal colonization during neonatal hospitalization may increase the risk of CRKP infection.Risk and pro-tective factors of neonatal intestinal colonization and secondary infections after colonization should be paid attention,and corresponding preventive and control measures should be taken,so as to reduce the occurrence and transmission CRKP healthcare-associated infection.

Correlation between expressions of serum COL1A1/2 and intracranial aneurysm rupture / 局解手术学杂志

Objective To detect the levels of serum collagen type Ⅰ alpha 1 chain(COL1A1)and collagen type Ⅰ alpha 2 chain(COL1A2)in patients with intracranial aneurysm(IA),and explore their correlations with aneurysm rupture.Methods A total of 110 IA patients admitted to our hospital were regarded as the IA group and another 100 volunteers who underwent physical examination in our hospital were regarded as the control group.The expression levels of serum COL1A1 and COL1A2 were detected by ELISA.The IA patients were divided into the ruptured group(n=66)and unruptured group(n=44)according to the presence or absence of aneurysm rupture,and the clinical data and expression levels of serum COL1A1 and COL1A2 were compared between the two groups.The expression levels of serum COL1A1 and COL1A2 in patients with different Hunt-Hess grades were compared.The risk factors of aneurysm rupture in patients with IA were analyzed by multivariate Logistic regression analysis.The predictive value of serum COL1A1 and COL1A2 for aneurysm rupture in patients with IA were evaluated by receiver operating characteristic(ROC)curve.The correlation of serum COL1A1 and COL1A2 with Hunt-Hess grade for patients in rupture group was analyzed by Spearman correlation analysis.Results The expression levels of serum COL1A1 and COL1A2 for patients in the IA group were significantly higher than those in the control group(P<0.05).The number of patients with hypertension,diabetes mellitus,hyperlipidemia,aneurysm diameter>10 mm,and the expression levels of serum COL1A1 and COL1A2 in the rupture group were significantly more/higher than those in the unruptured group(P<0.05).The expression levels of serum COL1A1 and COL1A2 in patients with Hunt-Hess grades from Ⅲ to Ⅳ were significantly higher than those in patients with grades from Ⅰ to Ⅱ(P<0.05).The expression levels of serum COL1A1 and COL1A2 for patients in the rupture group were positively correlated with Hunt-Hess grade(r=0.562,0.414,P<0.05).Multivariate Logistic regression analysis showed that hypertension,diabetes mellitus,aneurysm diameter>10 mm,and increased expression levels of COL1A1 and COL1A2 were risk factors for aneurysm rupture in IA patients(P<0.05).The area under the curve(AUC)of aneurysm rupture predicted by serum COL1A1 and COL1A2 together was significantly higher than that predicted by COL1A1 alone(Z=1.905,P=0.028)and COL1A2 alone(Z=1.754,P=0.040).Conclusion The increased expression levels of serum COL1A1 and COL1A2 are risk factors for aneurysm rupture in patients with IA,and their combined prediction of aneurysm rupture in IA patients has certain clinical value.

Optimal repair timing and predictors of death in patients with ventricular septal rupture post myocardial infarction / 中华胸心血管外科杂志

Objective:The main objective of this study was to analyze the optimal timing for repair of post-AMI ventricular septal rupture(VSR). Secondary endpoints were to determine which factors could influence in-hospital mortality in the patients with VSR.Methods:We designed an observational, retrospective study, selecting 100 patients with post-AMI VSR between January 1, 2019 and August 31, 2023, with inclusion and exclusion criteria. Analyzed the usefulness and appropriate timing of surgery in this patient cohort. Compared the background characteristics, treatment and laboratory data between survival and death group. The risk factors for in-hospital mortality were assessed using multivariate analysis with a logistic regression model. Results:The overall in-hospital mortality rate was 56%, the mortality rate of surgical patients was 34.9%, and the mortality rate of conservative patients was 91.9%. Patients operated on very early(0-3 days) had significantly poor results with a mortality rate of 63.6% while those operated within 2 weeks, had a mortality rate of 38.1%, and those operated later(>14 days) showed 22.6% mortality.There were statistically significant differences between the two groups in terms of heart rate, ratio of revascularization , size of VSR, shock stage and severity of coronary artery lesions( P<0.05), and the C-reactive protein, WBC count, BNP level, creatinine level and blood lactate level in the death group were higher than those in the survival group( P<0.05). Logistic regression analysis revealed that the level of white blood cell count, lactate and brain natriuretic peptide were independent risk factors for in-hospital mortality. Conclusion:In our study, we observed that surgery is the definitive therapy for the majority of patients.For patients who are hemodynamically stable and have compensated heart failure, there may be more benefit from delayed ventricular septal rupture repair. The risk factors for in-hospital mortality were the elevated lactate levels, BNP levels and WBC count.

Role of β-glucuronidase in the formation of primary intrahepatic stones / 临床肝胆病杂志

Primary intrahepatic stones （PIS） is a refractory disease with a high incidence rate in Southwest China， which greatly affects the life of patients. Metabolites， such as β-glucuronidase produced by chronic biliary tract infection， play an important role in the formation of pigmented stones. In addition to exogenous β-glucuronidase produced by bacteria， endogenous β-glucuronidase produced by intrahepatic bile duct cells also plays an important role in the formation of stones. This article analyzes the research advances in the role of β-glucuronidase in the pathogenesis of PIS， in order to provide a possible method for the prevention and treatment of PIS.

Establishment and application of activity determining methods for different subtypes of xanthine oxidoreductase / 药学学报

Xanthine oxidoreductase (XOR), the key enzyme catalyzing purine to produce uric acid, including two subtypes, xanthine dehydrogenase (XDH) and xanthine oxidase (XO), respectively, in vivo. Usually, XDH and XO can transform to each other. In this study, based on the principle that the subtype XO or XDH uses different electron acceptors, the methods for the measuring the activities of bovine milk XOR (pure enzyme) and its subtypes were established. The optimal concentrations of substrate xanthine (50 μmol·L-1) and electron acceptor NAD+ (50 μmol·L-1), pH value (7.80) were investigated. The ranges of the XOR, XO, XDH activity which could be determined were 0.97-17.5 U·L-1, 1-9 U·L-1, and 66-1 191 mU·L-1, respectively. Furthermore, the methods for determining the activities of XOR and its subtypes in mouse liver were established. The preparation of liver samples, the optimal concentrations of xanthine (100 μmol·L-1) and NAD+ (100 μmol·L-1) were researched. And the activity ranges of XOR, XO and XDH in mouse liver which could be determined were 0.67-3.98, 0.19-1.08, and 0.52-3.55 U·gprot-1, respectively. With the methods above, the effects of classic XOR inhibitor allopurinal (Allo) on XOR, XO and XDH from both milk and mouse liver were determined. All animal experiments have been approved by the Animal Experimental Center, Institute of Materia Medica, Chinese Academy of Medical Science and Peking Union Medical College (00003346). This study established new methods for the determination of XOR and its subtypes activity in pure enzyme system and in mouse liver, respectively, which were accurate and convenient. It laid the experimental foundation for exploring the different pathophysiological effects of XOR in the body and developing new XOR inhibitors.

The natural decline and death course of hepatic cystic echinococcsis / 中华消化外科杂志

Hepatic cystic echinococcosis (HCE) is a global public health problem. At present, the research of echinococcosis mainly focuses on etiology, epidemiology, immunology, imaging and treatment programs, while ignoring the systematic study of its natural decline and death course. The popularization of modern imaging examination methods enable researchers to obtain the clinical data of HCE in different stages, with different imaging features and pathological states. Based on CT imaging features and clinical practice, the authors discuss the natural decline and death course of HCE, in order to provide new ideas for its diagnosis and treatment.

Research update on the clinical application of the quantity and quality of high-density lipoprotein in atherosclerosis / 中华检验医学杂志

Recent research evidence challenges the hypothesis that high density lipoprotein (HDL) has a protective effect on atherosclerosis. Due to the heterogeneity of HDL particle composition and the diversity of HDL functions, the evaluation of HDL particle composition and the detection of HDL function might overcome the deficiency from the measurement of single high-density lipoprotein cholesterol (HDL-C) level. This review briefly introduced the detection method and clinical application for the "quantity" of HDL, and focused on the current status of clinical application and the future development trend of related detection method for the structure and function of HDL. It is postulated that the evaluation of the "quality" of HDL may become the routine method of HDL detection in the future.

Risk factors of occult lymph node metastasis of levels Ⅲ and Ⅳ in papillary thyroid carcinoma / 中华肿瘤杂志

Objective: To investigate the potential risk factors for occult lateral cervical lymph node metastasis (LNM) to levels Ⅲ and Ⅳ in patients with papillary thyroid carcinoma (PTC) and the necessity of super-selective lateral lymph node dissection for patients harboring these metastases. Methods: This prospective study included PTC patients who were operated by the same surgeon in the Department of Head and Neck Surgery of Cancer Hospital, Chinese Academy of Medical Sciences from October 2015 through October 2019. Preoperative ultrasound and enhanced Computer Tomography (CT) did not denote suspected enlarged lymph nodes in the lateral neck. All patients underwent lymph node dissection in levels Ⅲ and Ⅳ on the basis of original thyroid collar incision after LNM to level Ⅵ was confirmed by preoperative fine needlebiopsy or intraoperative frozen pathology. Results: Of all 143 patients, 74 (51.7%) had occult LNM in levels Ⅲ and Ⅳ confirmed by postoperative pathology. The average number of metastasized lymph nodes in levels Ⅲ and Ⅳ was 2.64±1.80, and that in level Ⅵ was 3.77±3.27. There was a significant linear positive correlation between the number of metastasized lymph nodes in level Ⅵ and that in levels Ⅲ and Ⅳ (r=0.341, P<0.001). That the metastasized lymph nodes in level Ⅵ equals three was the best predictor of occult lateral LNM to levels Ⅲ and Ⅳ. Univariate analysis showed that age <55 years, tumor size ≥2.0 cm, number of metastasized lymph nodes in level Ⅵ ≥3, and percentage of metastasized lymph nodes in the total number of dissected lymph nodes in level Ⅵ >50% were associated with occult LNM in levels Ⅲ and Ⅳ (P<0.05). Multivariate analysis showed that number of metastasized lymph nodes in level Ⅵ≥3 was an independent risk factor for occult LNM in levels Ⅲ and Ⅳ (P=0.006). Conclusions: Age, tumor size and LNM in level Ⅵ were associated with occult lateral LNM in PTC patients. Lymph node dissection in levels Ⅲ and Ⅳ could be considered for selective patients, since it will help to avoid secondary operation for residual tumor or recurrence resulted from insufficient treatment without increasing the incidence of complications or affecting patients' appearances.

Risk factors of occult lymph node metastasis of levels Ⅲ and Ⅳ in papillary thyroid carcinoma / 中华肿瘤杂志

Objective: To investigate the potential risk factors for occult lateral cervical lymph node metastasis (LNM) to levels Ⅲ and Ⅳ in patients with papillary thyroid carcinoma (PTC) and the necessity of super-selective lateral lymph node dissection for patients harboring these metastases. Methods: This prospective study included PTC patients who were operated by the same surgeon in the Department of Head and Neck Surgery of Cancer Hospital, Chinese Academy of Medical Sciences from October 2015 through October 2019. Preoperative ultrasound and enhanced Computer Tomography (CT) did not denote suspected enlarged lymph nodes in the lateral neck. All patients underwent lymph node dissection in levels Ⅲ and Ⅳ on the basis of original thyroid collar incision after LNM to level Ⅵ was confirmed by preoperative fine needlebiopsy or intraoperative frozen pathology. Results: Of all 143 patients, 74 (51.7%) had occult LNM in levels Ⅲ and Ⅳ confirmed by postoperative pathology. The average number of metastasized lymph nodes in levels Ⅲ and Ⅳ was 2.64±1.80, and that in level Ⅵ was 3.77±3.27. There was a significant linear positive correlation between the number of metastasized lymph nodes in level Ⅵ and that in levels Ⅲ and Ⅳ (r=0.341, P<0.001). That the metastasized lymph nodes in level Ⅵ equals three was the best predictor of occult lateral LNM to levels Ⅲ and Ⅳ. Univariate analysis showed that age <55 years, tumor size ≥2.0 cm, number of metastasized lymph nodes in level Ⅵ ≥3, and percentage of metastasized lymph nodes in the total number of dissected lymph nodes in level Ⅵ >50% were associated with occult LNM in levels Ⅲ and Ⅳ (P<0.05). Multivariate analysis showed that number of metastasized lymph nodes in level Ⅵ≥3 was an independent risk factor for occult LNM in levels Ⅲ and Ⅳ (P=0.006). Conclusions: Age, tumor size and LNM in level Ⅵ were associated with occult lateral LNM in PTC patients. Lymph node dissection in levels Ⅲ and Ⅳ could be considered for selective patients, since it will help to avoid secondary operation for residual tumor or recurrence resulted from insufficient treatment without increasing the incidence of complications or affecting patients' appearances.

Construction of following-up index system for ICU patients with acute kidney injury based on the Omaha nursing outcome classification system / 中国实用护理杂志

Objective:To construct follow-up index system of ICU patients with acute kidney injury based on the Omaha nursing outcome classification system, and to provide a reference for the clinical care quality and the follow-up work of ICU patients after discharge.Methods:Based on the Omaha nursing outcome classification system, the Delphi method was used to establish the content of the follow-up index system for ICU patients with acute kidney injury, and determine the weight of all levels of indicators.Results:After two rounds of expert consultation, questionnaire response rates were 95.00%and 100.00%, expert authority coefficients were 0.861 and 0.892 (both P<0.01), coordination coefficients ranged from 0.296 to 0.667 and 0.240 to 0.804, the difference were statistically significant ( χ2 values were 60.77-288.17, and P<0.01). The final index system consisted of 4 first-level indicators, 16 second-level indicators, and 52 third-level indicators. The analytic hierarchy process was used to determine the weights of all indexes, and the consistency test (consistency ratio<0.1) was performed. Conclusions:The follow-up index system of ICU patients with acute kidney injury was constructed to provide a reference for the clinical care quality and the follow-up work of ICU patients after discharge, and to provide a theoretical basis for the follow-up mode after ICU.

Antiplatelet therapy for patients with acute coronary syndrome and chronic kidney disease after percutaneous coronary intervention / 中国介入心脏病学杂志

Aspirin combined with P2Y12 receptor inhibitors is the standard dual antiplatelet therapy for the prevention of stent thrombosis and systemic atherosclerotic thrombotic events after percutaneous coronary intervention in acute coronary syndrome(ACS).Patients with ACS combined with chronic kidney disease(CKD)have a higher risk of thrombosis and a higher incidence of bleeding.Therefore,it is important to determine the optimal antiplatelet therapy strategy for this population.Most clinical trials have excluded patients with advanced CKD,so clinicians lack evidence-based medical evidence for antiplatelet therapy strategies in these patients.This article reviews the research progress of antiplatelet therapy in ACS patients with CKD,in order to provide reference for clinicians to choose appropriate antiplatelet therapy strategies when facing such patients.

Analysis of online patient experiences in a large public hospital′s internet hospital / 中华医院管理杂志

Objective:To analyze the online patient experiences in a public hospital′s internet hospital, and explore the influencing factors, for references for improving the online patient experiences and promoting the high-quality development of internet hospitals.Methods:Gender, age, visiting department, patient experience score, and evaluation text of patients in a public hospital′s internet hospital in 2022 were obtained. The patient experience scores were adopted the Likert 5-level scoring method. Intergroup comparisons were conducted by chi-square test and F-test. Word segmentation processing and word frequency statistics were used to extract high-frequency words in the evaluation text of dissatisfied patient experiences, and semantic network analysis on these high-frequency words was performed. Results:A total of 4 273 patients were included in this study, with a patient experience score of (4.1±1.6) points. Among them, 74.9% (3 199 cases) rated 5 points (very satisfied), and 19.5% (835 cases) rated 1 point (very dissatisfied). There was no significant difference in online patient experience scores among patients of different genders ( P>0.05), while patients of different ages or departments had different patient experience scores ( P<0.05); The top 10 high-frequently words of dissatisfied evaluation were doctor, answer, examination, limited help, ignoring, waste, refunding, registration fee, perfunctory, and closing.In the high-frequency semantic network of dissatisfied evaluations, high-frequency words such as doctor, answer, waste, examination, limited help, and ignoring were strongly correlated with each other. Conclusions:Most patients in an internet hospital were very satisfied with the online patient experience, but nearly 1/5 of the patients were very dissatisfied. The age and department affected the online patient experiences. The dissatisfied evaluations were mainly related to the attitude and professional competence of physicians, as well as the convenience of internet hospital platform and its diagnosis and treatment services.

Clinical efficacy of fire needling combined with cupping therapy on herpes zoster of acute stage and the effect on Th17/Treg cellular immune balance / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between the combined therapy of fire needling and cupping, and western medication on herpes zoster of acute stage, as well as the effects on Th17 and Treg cells and inflammatory factors, i.e. IL-10 and IL-17 in the peripheral blood.@*METHODS@#Eighty patients with herpes zoster of acute stage were randomly divided into a combined therapy (fire needling plus cupping) group and a western medication group, 40 cases in each one. In the combined therapy group, the pricking and scattering techniques with fire needle were used at ashi points and Jiaji (EX-B 2) corresponding to the affected spinal segments; afterwards, cupping therapy was delivered. The combined treatment was given once daily. In the western medication group, valaciclovir hydrochloride tablet and vitamin B1 tablet were administered orally. The duration of treatment in each group was 10 days. Before each treatment from day 1 to day 10 and on day 11 , the score of symptoms and physical signs was observed in the two groups separately. Before each treatment from day 1 to day 10 and on day 11, 30, 60, the score of visual analogue scale (VAS) and skin lesion indexes were observed in the two groups. On day 60, the incidence of postherpetic neuralgia was recorded in the two groups. The levels of Th17 and Treg cells, Th17/Treg ratio in the peripheral blood, as well as serum levels of IL-10 and IL-17 were detected before and after treatment in the two groups. The clinical efficacy was compared between the two groups.@*RESULTS@#From day 6 to day 10 during treatment and on day 11, the scores of symptoms and physical signs in the combined therapy group were lower than those of the western medication group (P<0.05, P<0.01). On day 3, day 6 to day 10 during treatment and day 11, day 30, VAS scores in the combined therapy group were lower than those of the western medication group (P<0.05, P<0.01). On day 60, the incidence of postherpetic neuralgia in the combined therapy group was lower compared with that in the western medication group (P<0.05). The blister arresting time and scabbing time in the combined therapy group were shorter than those of the western medication group (P<0.05). After treatment, the level of Th17, and Th17/Treg ratio in the peripheral blood, as well as the serum levels of IL-10 and IL-17 were all lower in comparison with those in the western medication group (P<0.05). The curative and remarkably effective rate was 82.5% (33/40) in the combined therapy group, higher than 62.5% (25/40) in the western medication group (P<0.05).@*CONCLUSION@#The early application of fire needling combined with cupping therapy can effectively treat herpes zoster of acute stage, relieve pain, and reduce the incidence of postherpetic neuralgia, which may be related to reducing the levels of Th17 and Treg cells, and Th17/Treg ratio in the peripheral blood, as well as the serum levels of IL-10 and IL-17 so that the cellular immune balance is modulated.

Analysis of Clinical Data and Construction of A Diagnostic Prediction Model for Metabolic Syndrome after Single-Center Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

UNLABELLED@#AbstractObjective: To analysis the clinical data of patients after single-center hematopoietic stem cell transplantation (HSCT) and construct a predictive model for metabolic syndrome (MS) diagnosis.@*METHODS@#Ninety-three hematology patients who underwent HSCT at the First Hospital of Lanzhou University from July 2015 to September 2022 were selected to collect basic data, transplantation status and postoperative data, the clinical characteristics of patients with and without MS after transplantation were compared and analyzed. Logistic regression model was used to analyze the influence fators of MS after transplantation, and a predictive model of HSCT-MS diagnosis was constructed under the influence of independent influence factors. The model was evaluated using the ceceiver operating characteristic curve (ROC curve).@*RESULTS@#Metabolic syndrome occurred in 36 of 93 HSCT patients and did not occur in 57. Compared with non-HSCT-MS group, HSCT-MS had significantly higher fasting blood glucose (FBG) levels before transplantation, shorter course before transplantation, and higher bilirubin levels after transplantation (P<0.05). The statistically significant clinical indicators were subjected to multi-factor logistic regression analysis, and the results showed that pre-transplant high FBG, pre-transplant short disease course and post-transplant high bilirubin were independent influence factors for HSCT-MS. The standard error of predicting the occurrence of HSCT-MS based on the clinical model was 0.048, the area under the curve AUC=0.776, 95% CI :0.683-0.869, the optimal threshold was 0.58 based on the Jorden index at maximum, the sensitivity was 0.694, and the specificity was 0.772, which has certain accuracy.@*CONCLUSION@#A clinical prediction model for HSCT-MS based on logistic regression analysis is constructed through the analysis of clinical data, which has certain clinical value.

Prevalence and trends of anemia among pregnant women in eight provinces of China from 2016 to 2020 / 中华预防医学杂志

This study analyzed the anemia status and change trend of 219 835 pregnant women in eight provinces from 2016 to 2020 in the Maternal and Newborn Health Monitoring Program(MNHMP). The results showed that from 2016 to 2020, the anemia rate of pregnant women in eight provinces was 41.27%, and the rates of mild, moderate and severe anemia were 28.56%, 12.59% and 0.12% respectively; the anemia rates in eastern, central and western regions were 41.87%, 36.09% and 44.63% respectively, and the anemia rates in urban and rural areas were 39.87% and 42.23%. From 2016 to 2020, the anemia rate of pregnant women decreased from 44.93% to 38.22%, with an average annual decline of 3.86% (95%CI:-5.84%, -1.85%). The anemia rate among pregnant women of the eastern region (AAPC=-6.16%, 95%CI:-9.79%, -2.38%) fell faster than that among pregnant women of the central region (AAPC=0.71%, 95%CI:-6.59%, 8.57%) and western region (AAPC=-1.53%, 95%CI:-5.19%, 2.28%). From 2016 to 2020, the moderate anemia rate in pregnant women decreased from 14.98% to 10.74%, with an average annual decline of 8.72% (95%CI:-12.90%, -4.34%), with a statistically significant difference (P<0.05); AAPC for mild and severe anemia in pregnant women was 1.56% (95%CI: 3.44%, 0.36%) and 18.86% (95%CI: 39.88%, 9.52%), respectively, without statistically significant difference (P>0.05).