Arthroscopic inferior leaf meniscectomy of the involved anterior horn in the lateral meniscus horizontal tear via an accessary extreme far anteromedial portal.

BACKGROUND: An accessory extreme far anteromedial portal can improve visualisation and ease inferior leaf meniscectomy in patients with lateral meniscal anterior horn horizontal tears. However, the therapeutic outcomes of adding an accessory extreme far anteromedial portal remain unclear. This study aimed to evaluate the clinical efficacy of adding an accessory extreme far anteromedial portal for treating lateral meniscal horizontal tears involving the anterior horns. METHODS: This retrospective study included 101 patients with anterior horn involvement in lateral meniscal horizontal tears who underwent arthroscopic unstable inferior leaf meniscectomy between January 2016 and December 2020. The pathologies were diagnosed using physical examinations and magnetic resonance imaging. The anterior horn involved in the lateral meniscal horizontal tears was treated using inferior leaf meniscectomy. The primary endpoints were changes in the visual analogue scale, Lysholm, International Knee Documentation Committee, and Tegner scores at the final follow-up. The secondary endpoint was meniscal cure rate at 3 months postoperatively. The preoperative and postoperative functional scores were compared. The occurrence of complications was recorded. RESULTS: All patients were followed up for an average of 4.9 ± 1.2 years (range 2.3-7.5 years). After 4 months, none of the patients experienced pain, weakness, instability, or tenderness in the lateral joint line, achieving an imaging cure rate of 98%. At the final follow-up, significant postoperative improvements were observed in the average values of the visual analogue scale score (3.5 ± 0.7 vs. 0.7 ± 0.6), Lysholm score (62.7 ± 4.4 vs. 91.8 ± 3.1), International Knee Documentation Committee score (61.9 ± 3.7 vs. 91.7 ± 9.5), and Tegner score (2.0 ± 0.7 vs. 6.1 ± 0.7). Excellent Lysholm scores were obtained in 81 patients, and good outcomes were obtained in 18 patients, with an excellent-to-good rate of 98.0%. CONCLUSIONS: Inferior leaf resection via the accessory far anteromedial portal is a safe treatment option for the involved anterior horn in lateral meniscal horizontal tears. This approach enhances visibility and facilitates surgical procedures, with minimal complications.

Clinical outcomes following direct anterior approach during total hip arthroplasty without hip extension: a retrospective comparative study.

BACKGROUND: Traditional total hip arthroplasty (THA) using the direct anterior approach (DAA) requires a hip extension. This study aimed to compare the clinical outcomes of patients undergoing THA with DAA using either the no hip extension (NHE) or the traditional hip extension (THE) strategy. METHODS: A retrospective analysis of demographics, clinical and radiological outcomes, and occurrence of complications was performed using data from 123 patients treated between January 2020 and November 2021. The patients were categorised into two groups: NHE (84 patients) and THE (39 patients). RESULTS: The NHE group exhibited shorter operative time and had more male participants with higher ages. Comparable outcomes were observed in the visual analogue scale, Harris Hip, and Oxford Hip scores at the final follow-up. Furthermore, complications were observed in the NHE and THE groups, including two and one greater trochanteric fractures and three and one transfusions, respectively. CONCLUSIONS: Compared to the THE, employing the NHE strategy during THA with DAA in elderly and young female patients resulted in comparable clinical outcomes with several advantages, such as favourable surgical time. The NHE method also exhibited good safety and effectiveness. Therefore, the NHE strategy may be a favourable option for elderly and young female patients.

Which patients with coronary artery disease should include oral nitrates on their discharge medication list?

BACKGROUND: Which patients with coronary artery disease (CAD) should have oral nitrates on their discharge medication list after coronary angiography (CAG)? To assess the relationship between oral nitrates included in the discharge medication list and major adverse cardiovascular events (MACEs) among CAD patients, we designed this retrospective cohort study. METHODS: A total of 2979 CAD patients hospitalised in the Department of Cardiology, Affiliated Hospital of Jining Medical University from May 2013 to October 2015 were enrolled, grouped according to whether oral nitrates were included at discharge after CAG, and followed up for MACEs for a mean of 4.42 years after discharge. The primary endpoint was MACEs. Multivariate Cox proportional hazards models were used to analyses potential confounding factors. Stratified analysis was used to observe the relationship between oral nitrates and MACEs by different covariates. RESULTS: The median follow-up time was 4.61 years, and 296 (9.94%) patients experienced MACEs. Multivariate Cox proportional hazards model analysis showed no association between oral nitrates on the discharge medication list and the occurrence of MACEs among patients with CAD (p > 0.05) after adjusting for some covariates, such as SYNTAX score (hazard ratio (HR): 1.18, 95% confidence interval (CI): 0.90-1.55, p = 0.2420). Stratified analysis revealed a higher incidence of MACEs among hypertensive patients prescribed oral nitrates at discharge (HR: 1.67, 95% confidence CI: 1.13-2.46, p = 0.0046). However, prescribing nitrates at discharge for patients with low uric acid levels increased the incidence of MACEs, which showed a possible trend towards significance (HR: 1.44, 95% CI: 0.99-2.09, p = 0.0525). CONCLUSION: There was no association between oral nitrates included in the discharge medication list and the development of MACEs among patients with CAD after adjusting for some covariates, such as SYNTAX score. Oral nitrates after discharge for CAD patients combined with hypertension increased the occurrence of MACEs. Oral nitrates after discharge for CAD patients combined with low uric acid levels may increase theoccurrence of MACEs, and close monitoring for any adverse events is recommended.

A network Meta analysis of the effects of different exercise modalities on inhibitory control in children with attention deficit hyperactivity disorder / 中国学校卫生

Objective@#To compare the relative effectiveness of different exercise modalities on inhibitory control in children with attention deficit hyperactivity disorder (ADHD), so as to provide an evidence based basis for the development of effective exercise prescriptions.@*Methods@#The databases of China National Knowledge Internet (CNKI), Pubmed, Web of Science, Embase, and Cochrane were searched to screen the literature of randomized controlled trials of exercise interventions for inhibitory control in children with ADHD up to December 31, 2022. The Cochrane risk of bias assessment tool was used for methodological quality assessment, and Stata 17.0 software was used for network Meta analysis, standardized mean difference ( SMD ) and 95% CI were used as the effect indicators to compare the difference in effect between interventions and rank the effect.@*Results@#Twenty two papers with a total of 1 134 participants aged 6-14.5 years were finally included. Network Meta analysis showed that the impact effects of physical and mental exercises [ SMD (95% CI )=1.08(0.50-1.66)], cognition+exercise [ SMD (95% CI ) =0.81(0.13-1.48)], and ball games [ SMD (95% CI )= 1.54(0.99-2.09)] were significantly superior to that of control group, and the ball games had a significantly better effect than single aerobic exercise [ SMD (95% CI )=1.02(0.20-1.84)], and combined exercises [ SMD (95% CI )=1.08( 0.28 -1.88)]( P < 0.05 ). The results of surface under the cumulative ranking (SUCRA) showed that ball games might be the best means to improve inhibitory control in children with ADHD(SUCRA=95.3).@*Conclusion@#It is recommended to appropriately increase ball sports in sports activities to more effectively improve the inhibitory control of children with ADHD.

Advances in the characterization of gold nanoparticles and their application in biosensing systems / 国际检验医学杂志

Gold nanoparticles(AuNPs)present unique physicochemical characteristics,excellent biocom-patibility and ease of surface functionalization,which have become the research hotspots in the field of biosens-ing.This article reviews the synthesis methods,main properties and surface functionalization of AuNPs,as well as the research progress of application in various sensing platforms.

Effects of Aβ receptor PirB on mouse astrocyte proliferation and reactive astrogliosis / 解放军医学杂志

Objective To observe the effects of amyloid-β(Aβ)receptor PirB on mouse astrocyte proliferation and reactive astrogliosis in vitro.Methods Mouse primary astrocytes were cultured,and divided into control group,Aβ group,Aβ+0.2 μmol/L PEP group,Aβ+0.4 μmol/L PEP group,Aβ+Fluspirilene group,Aβ+GFP-LV group,and Aβ+mPirB-LV group.The mouse astrocytes were treated with soluble PirB extracellular peptide PEP or PirB inhibitor Fluspirilene,respectively,to inhibit endogenous PirB receptor,or overexpressed PirB gene via lentivirus transfection and then treated with Aβ1-42 oligomers.The proliferation of astrocytes was observed by RTCA and EdU methods,and the mRNA expression levels of S-100 calcium-binding protein B(S-100β),Vimentin,Nestin and amyloid precursor protein(APP)associated with reactive astrogliosis of astrocytes were observed by real-time PCR,and the expression level of glial fibrillary acid protein(GFAP)was detected by Western-blotting.Results The results of RTCA monitoring showed that normalized cell index(NCI)values of each group decreased sharply after treatment,and then increased gradually and tended to be stable.The results of EdU staining showed that the proliferative activity of astrocytes was significantly enhanced in the Aβ group(P<0.05)compared with control group;Compared with Aβ group,cell proliferation activity in Aβ + 0.2 μmol/L PEP group,Aβ+0.4 μmol/L PEP group and Aβ+Fluspirilene group were significantly decreased(P<0.01 or P<0.001).The results of real-time PCR showed that compared with control group,mRNA expressions of GFAP,S-100β,Vimentin,Nestin,APP and PirB in Aβ group were significantly increased(P<0.05);Compared with Aβ group,mRNA expressions of GFAP,S-100β,Vimentin,Nestin,APP and PirB in Aβ+0.4 μmol/L PEP group were significantly decreased(P<0.01);Compared with Aβ+GFP-LV group,mRNA expressions of GFAP,S-100β,Vimentin,Nestin,APP and PirB in Aβ +mPirB-LV group were significantly increased(P<0.05).The results of Western blotting showed that compared with control group,the expression of GFAP in Aβ group was significantly increased(P<0.05);Compared with Aβ group,the expression of GFAP in Aβ+0.4 μmol/L PEP group was significantly decreased(P<0.05).Conclusions PirB is an upstream molecule which could regulate astrocyte proliferation and reactive astrogliosis,and inhibiting PirB receptor in astrocytes may be a potential treatment for Alzheimer's disease.

Interleukin-7 enhances T helper 9 cell activity in patients with septic cardiomypathy / 中华急诊医学杂志

Objective:To investigate the levels of interleukin-7 (IL-7), T helper cell 9 (Th9), and cytotoxic T cell 9 (Tc9), and to assess the regulation of exogenous IL-7 to Th9 in septic cardiomypathy patients.Methods:A cross-sectional study was conducted. Septic cardiomypathy patients, septic patients, and controls were enrolled in the 7th People’s Hospital of Zhengzhou between June 2018 and January 2022. Plasma and peripheral blood mononuclear cells (PBMCs) were isolated. PBMCs were stimulated with recombinant IL-7. Plasma IL-7, IL-9, and soluble CD127 levels were measured by enzyme-linked immunosorbent assay. CD127 expression on T cells and Th9/Tc9 percentageswere measured by flow cytometry. mRNAexpressions of purine-rich nucleic acid binding protein 1 (PU.1) and forkhead box protein O1 (Foxo1) were semi-quantified by real-time PCR. IL-7-stimulated Th9 cells from septic cardiomypathy patients were co-cultured with autologous CD8 + T cells and human umbilical vein endothelial cells. Target cell death, cytotoxic molecules and cytokines secretions were investigated. Kruskal-Wallis test was used for comparison among groups, while Dunns multiple test was used for comparison between the two groups. Paired t test or Wilcoxon paired test was used for comparison before and after stimulation. Results:A total of 21 septic cardiomypathy patients, 56 septic patients, and 31 controls were enrolled. IL-7 level was lower in septic cardiomypathy patients compared with in septic patients and controls [75.71(42.28, 135.59) pg/mL vs. 118.47(60.18, 171.73) pg/mL vs. 168.42(105.41, 232.30) pg/mL, P<0.05]. Soluble CD127 level was higher in septic cardiomypathy patients and septic patients compared with in controls [96.70(56.76, 147.04) pg/mL vs. 69.75(43.19, 111.28) pg/mL vs. 29.13(19.33, 42.11) pg/mL, P<0.001]. There was no significant difference of CD127 +CD8 + percentage among three groups ( P=0.477). Th9 percentage and Foxo1 mRNA expression was lower in septic cardiomypathy patients compared with in septic patients and controls ( P<0.001). Tc9 percentage, PU.1 mRNA expression and IL-9 level was lower in septic cardiomypathy patients and septic patients compared with in controls ( P<0.001). Th9 percentage, PU.1/Foxo1 mRNA expression, and IL-9 secretion was up-regulated in response to IL-7 stimulation in PBMCs from septic cardiomypathy patients ( P<0.05). IL-7 stimulated Th9 cells from septic cardiomypathy patients promoted CD8 + T cell-mediated target cell death ( P<0.05). Perforin, granzyme B, and interferon-γ levels were also increased in the supernatants ( P<0.05). Conclusion:IL-7 could enhance Th9 cell activity in septic cardiomypathy patients.

Clock genes regulate the browning of white fat in obese rats undergoing hypoxia exercise / 中国组织工程研究

BACKGROUND:Hypoxic exercise can promote the degradation of body fat,and changes in the external environment can affect the circadian rhythm of animals,but the mechanisms by which changes in circadian rhythm regulate adipose tissue browning and fat degradation are unclear. OBJECTIVE:To elucidate the mechanism of clock gene regulation on epididymal adipose tissue Browning in obese rats undergoing hypoxia exercise. METHODS:Forty obese rats were randomly selected and divided into four groups(n=10 per group):normoxic sedentary group,hypoxic sedentary group,normoxic exercise group,and hypoxic exercise group for 4 weeks of intervention.The rats in the sedentary groups were not intervened,while those in the hypoxic groups lived in a hypoxic chamber with an oxygen concentration of 13.6%for the whole day.In the exercise groups,adaptive training was performed in the 1st week,and the speed and length of training remained unchanged for the last 3 weeks.The body mass,body length and perirenal fat mass of obese rats were measured.Serum levels of triacylglycerol,total cholesterol,low-density lipoprotein cholesterol,and high-density lipoprotein cholesterol in obese rats were detected by a biochemical assay kit.Liver fat content was observed by oil red O staining.Hematoxylin-eosin staining was used to evaluate the browning of epididymal adipose tissue of rats in different groups.RNA sequencing combined with bioinformatics analysis was used to analyze transcriptome changes in adipose tissue.The mRNA expressions of PGC-1α,Beclin 1,KLF 2 and Perilipin 1 in epididymal adipose tissue were detected by RT-PCR. RESULTS AND CONCLUSION:Hypoxic exercise intervention significantly decreased body mass,body fat percentage,Lee's index,serum triacylglycerol,total cholesterol,and low-density lipoprotein cholesterol levels(P＜0.01),and significantly increased high-density lipoprotein cholesterol level(P＜0.01).Oil red O staining and hematoxylin-eosin staining results showed that hypoxic exercise was more effective in promoting fat mobilization in liver tissue and promoting the browning of parepididymal adipose tissue compared with normoxic sedentary group,hypoxic sedentary group,and normoxic exercise group.RNA-seq results showed that hypoxic exercise significantly upregulated the expression of clock genes Dbp,Nr1d1,Sik1 and adipose tissue browning gene Ppargc1a(PGC-1α)and downregulated the expression of Arntl(Bmal1),accompanied by the enhanced expression of genes related to substance metabolism.qRT-PCR indicated that hypoxic exercise significantly increased the mRNA expression levels of PGC-1α and Perilipin1(P＜0.01).Therefore,these findings indicate that clock genes play an important role in promoting adipose tissue browning during hypoxic exercise.

Strategy Analysis of Tiered Diagnosis and Treatment Based on Evolutionary Game / 中国医院管理

Objective To explore the tripartite dynamic game strategy involving the interest relationship between government,hospital and patients in the tiered diagnosis and treatment system,which is conducive to improving the theoretical paradigm and policy logic of tiered diagnosis and treatment system.Methods It built a tripartite evolu-tionary game model to analyse their strategy choices and evolutionary paths,and to solve for stable strategies in the three-way evolutionary game.MATLAB R2018b was used to simulate the model,and the evolution paths and the in-fluence of different strategy choices on the promotion of the tiered diagnosis and treatment system were further ana-lyzed.Results Government,hospitals,and patients will influence each other and eventually evolve to the ideal stable state(1,1,1).Increasing government subsidies will accelerate the convergence of the initial participation probability of hospitals and patients to 1,while excessive subsidies will gradually cause the government to deviate from the strategy of encouraging.Conclusions The government should restrict subsidies for high-quality medical resources to a reasonable range,attract hospital experts,and strengthen regulations.It is important for large hospitals and basic medical institutions to realize the free flow and rational distribution of the resources available to doctors.Patients need to change their inherent concept of medical treatment to achieve orderly medical treatment.

Effects of different doses of X-rays on cGAS-STING signaling pathway and tumor immune microenvironment / 中华放射医学与防护杂志

Objective:To study the effects of different doses of X-ray irradiation on the immune microenvironment and cGAS-STING signaling pathway of hepatocellular carcinoma cells.Methods:C57BL/C mice were subcutaneously injected with Hepa 1-6 hepatocellular carcinoma cells in the right axilla to establish a subcutaneous tumor-forming hepatocellular carcinoma model. The mice were randomly divided into 0, 4, 8, 12 Gy irradiation groups, with 10 mice in each group. The body weights and tumor volumes were monitored. Specimens were collected 28 d after irradiation. The ELLSA and Flow Cytometry method was used to compare the macrophage-associated cytokines tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-6 (IL-6), chemokine ligand 5 (CCL5), IL-10, IL-13, transforming growth factor-β (TGF-β), IL-4 and macrophage M1, M2 phenotype ratio (M1/M2). Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) and immunoblotting assay were used to detect the expression of genes and proteins related to the cGAS-STING signaling pathway in hepatoma cells.Results:With the increase of irradiation dose, the tumor volume was significantly reduced ( F=8.42, P<0.05), the proportion of cell necrosis increased ( F=3.89, P<0.05), the content of macrophage-associated cytokines other than IL-4 increased ( F=6.32-15.50, P<0.05), and the proportion of M1 and M2 types of macrophage in the immune microenvironment of hepatocellular carcinoma tumors was elevated ( F= 5.46, 5.14, P < 0.05).The gene expression and protein expression levels of cGAS-STING signaling pathway were elevated in hepatocellular carcinoma cells (mRNA expression of cGAS and STING: F=6.35, 16.10, P<0.05; protein expression of cGAS and STING: F=71.31, 37.15, P<0.05). Conclusions:X-ray irradiation activates the cGAS-STING signaling pathway in hepatocellular carcinoma cells and contributes to the remodeling of the tumor immune microenvironment.

Application of 18F-FDG PET metabolic parameters in evaluating histopathologic grading of soft tissue sarcoma / 中华核医学与分子影像杂志

Objective:To evaluate the value of 18F-FDG PET metabolic parameters in predicting histopathological grade of soft tissue sarcoma (STS). Methods:From December 2012 to December 2021, 51 patients (26 males, 25 females, age range: 32-84 years) who underwent 18F-FDG PET/CT imaging before treatment and confirmed STS pathologically in the First Affiliated Hospital of Dalian Medical University were retrospectively collected. 18F-FDG PET metabolic parameters SUV max, metabolic tumor volume (MTV), total lesion glycolysis (TLG) and intertumoral FDG uptake heterogeneity (IFH) were measured. Kruskal-Wallis rank sum test was used to analyze the differences in metabolic parameters among different groups and Spearman rank correlation analysis was used to analyze the correlation of each metabolic parameter and histological grade. Logistic regression was used to screen and construct the prediction model for high-grade STS. ROC curve was plotted and Delong test was used to analyze the differences among AUCs. Results:The metabolic parameters SUV max, MTV, TLG and IFH were significantly different among French Federation of Cancer Centers Sarcoma Group (FNCLCC)Ⅰ( n=8), Ⅱ( n=10) and Ⅲ ( n=33) grade groups ( H values: 16.24, 10.52, 19.29 and 16.99, all P<0.05), and each metabolic parameter was positively correlated with histological grade ( rs values: 0.58, 0.45, 0.52, and 0.62, all P<0.05). Multivariate logistic regression analysis showed that SUV max(odds ratio ( OR)=1.27, 95% CI: 1.06-1.51, P=0.009) and IFH ( OR=6.83, 95% CI: 1.44-32.27, P=0.015) were independent risk indicators for high-grade STS. The prediction model constructed by combining SUV max and IFH had better diagnostic efficacy for differentiating high-grade STS with the AUC of 0.93, and the sensitivity of 93.9%(31/33) and the specificity of 16/18, respectively. The AUC of prediction model was significant different from SUV max, MTV, TLG and IFH (AUCs: 0.81, 0.78, 0.86 and 0.85; z values: 2.69, 2.53, 1.94 and 1.97, all P<0.05). Conclusions:The metabolic parameters SUV max, MTV, TLG and IFH are valuable predictors for histological grade of STS. The combination of SUV max and IFH may be a more meaningful method than using each of the above metabolic parameters alone.

Construction and evaluation of an indicator system for nursing human resource efficiency in integrated medical and elderly care institutions using Data Envelopment Analysis / 中华健康管理学杂志

Objective:To construct an evaluation indicator system for the efficiency of nursing human resources in integrated medical and elderly care institutions using Data Envelopment Analysis (DEA) and subsequently evaluate its effectiveness.Methods:This cross-sectional survey utilized literature review and investigative methods to initially establish a library of evaluation indicators for nursing human resource efficiency. The Delphi method was employed in two rounds of consultations with 17 experts from various fields, including nursing management, elderly care institution management, integrated medical and elderly care institution management, health economics management, and public health. The reliability of the indicator system was assessed based on factors such as expert enthusiasm, authority, concentration of opinions, and coordination. Adjustments, modifications, and improvements were made to the indicators based on expert opinions to establish the final indicator system. From August to December 2022, the DEA model was applied to evaluate the efficiency of 12 integrated medical and elderly care institutions in Haikou city based on this indicator system.Results:The constructed evaluation indicator system comprised 68 items divided into three levels: 9 primary indicators, 19 secondary indicators, and 40 tertiary indicators. The positive coefficients of the two rounds of expert consultations were 100% and 94.1%, with authority coefficients of 0.88 and 0.92, Kendall harmony coefficients of 0.471 and 0.348, and mean coefficients of variation of 0.16 and 0.12 ( P<0.001). DEA evaluation results for the 12 integrated medical and elderly care institutions showed that 5 were DEA effective institutions with comprehensive efficiency (OE), technical efficiency (TE), and scale efficiency (SE) values all equal to 1.000, while 7 were non-DEA effective institutions, including 4 with SE <1.000 but TE=1.000 and 3 with both SE and TE<1.000. Conclusions:The constructed evaluation indicator system demonstrates high enthusiasm, authority coefficients, and coordination in expert consultations, indicating high acceptability and comprehensive content with distinct levels and strong specialty characteristics. The DEA model′s evaluation results objectively and effectively reflect the efficiency of nursing human resources in integrated medical and elderly care institutions, demonstrating practical utility.

Impact of the age-adjusted Charlson comorbidity index on in-hospital mortality in long-living people with community-acquired pneumonia and a predictive mortality model / 中华老年医学杂志

Objective:To investigate the relationship between the age-adjusted Charlson comorbidity index(aCCI)and the risk of in-hospital death for people aged ≥ 90 years with community-acquired pneumonia(CAP), and to construct a novel scoring model for predicting in-hospital mortality.Methods:Basic personal and medical data about sex, age, hospitalization days, hospitalization expenses, in-hospital outcomes and discharge/admitting diagnosis of CAP patients aged ≥ 90 years hospitalized in Peking University Third Hospital between 2010 and 2019 were collected retrospectively.Multivariate Logistic regression analysis was conducted to examine the association between aCCI or other complications and in-hospital death.The receiver operating characteristic curve(ROC)was used to assess the value of aCCI and a new scoring model in predicting in-hospital death of CAP in people aged ≥ 90 years.Results:A total of 274 CAP patients aged ≥ 90 years were included in this study, of whom 85 died in hospital.Multivariate Logistic regression analysis showed that malnutrition( OR=2.21, 95% CI: 1.05-4.67, P<0.05), respiratory failure( OR=18.91, 95% CI: 9.34-38.25, P<0.001)and aCCI( OR=1.51, 95% CI: 1.23-1.85, P<0.001)were prognostic factors for in-hospital death in CAP patients aged ≥ 90 years.Based on the above results, a novel scoring model, MRC(malnutrition, respiratory failure, aCCI)was established.The area under the ROC curve of the aCCI score for predicting the risk of in-hospital death in CAP patients aged ≥ 90 years was 0.743(95% CI: 0.684-0.802). The area under the ROC curve of the MRC score was 0.891(95% CI: 0.848-0.933), indicating a higher predictive value than that of the aCCI score alone( Z=6.337, P<0.001). Conclusions:The MRC score model can be used to evaluate and predict the risk of in-hospital death in long-living CAP patients.

Effects of Zishui Qinggan Decoction on the hippocampal protein expressions of ERK,GSK3β,CREB and BDNF in a mouse model of depression induced by chronic restraint stress / 中成药

AIM To explore the effects of Zishui Qinggan Decoction on the mouse model of depression induced by chronic restraint stress(CRS)via ERK/GSK3β/CREB/BDNF signaling pathway.METHODS Except for those of the blank group,the mice of other groups were induced into depression models by CRS,and divided into the model group,the fluoxetine hydrochloride group(10 mg/kg)and the low,medium and high dose Zishui Qinggan Decoction groups(8.835,17.670 and 35.340 g/kg)for the corresponding drug intervention and simultanous CRS treatment.The mice had their sugar water preference experiment and behavior experiment on the 7th and 14th day after administration;the observation of the hippocampal morphological changes by HE staining,the detection of the superoxide dismutase(SOD)activity and malondialdehyde(MDA)level in serum by kits,the detection of levels of serum 5-hydroxytryptamine(5-HT),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)by ELISA,the detection of the hippocampal mRNA expressions of BDNF,TNF-α and IL-1β by RT-qPCR method,and the detection of the hippocampal protein expressions of ERK1/2,p-ERK1/2,GSK3β,p-GSK3β,CREB and BDNF by Western blot method 14 days after administration.RESULTS Compared with the model group,after 14 days of administration,both fluoxetine hydrochloride group and medium-dose Zishui Qinggan Decoction group displayed increased preference rate of sugar water(P<0.01),shortened immobility time of tail suspension and forced swimming(P<0.01),improved hippocampal damage of nerve cells,decreased levels of serum MDA,TNF-α and IL-1β(P<0.05,P<0.01),increased SOD activity and 5-HT level(P<0.05,P<0.01),decreased hippocampal mRNA expressions of TNF-α and IL-1β(P<0.01),and decreased expressions of BDNF mRNA and p-ERK1/2,p-GSK3β,CREB and BDNF proteins(P<0.05,P<0.01).CONCLUSION Zishui Qinggan Decoction can improve the depression-like behaviors in mice exposed to CRS,and its mechanism may be related to the regulation of hippocampal ERK/GSK3β/CREB/BDNF signaling pathway.

Dynamic changes of platelet-related indicators in infants with cow′s milk protein allergy / 中国儿童保健杂志

【Objective】 To dynamically monitor and analyze the changes of platelets and related indicators in infants with cow′s milk protein allergy (CMPA) during clinical treatment, in order to provide clues for further diagnosis and treatment of CMPA. 【Methods】 From August to November in 2022, 59 children aged from 1 month to 3 years old with CMPA in the pediatric outpatient clinic were selected as the CMPA group, and 29 healthy children who took physical examination were selected as the control group. The differences in platelet related indicators from a routine blood test were compared between the two groups, and their diagnostic value for CMPA was analyzed by receiver operating characteristic (ROC) curves. 【Results】 The mean platelet count (PLT) and plateletcrit (PCT) at baseline in the CMPA group were (374.68±113.21)×109/L and 0.37±0.10, significantly higher than those in control group[(271.07±40.32)×109/L, 0.26±0.05] (t=6.27, 6.43, P<0.001). In the CMPA group, after treatment, the mean PLT level was (316.39±94.68)×109/L, and the mean PCT level was 0.31±0.10, indicating a statistically significant decrease in PLT and PCT levels after treatment compared to baseline (t=4.32,4.75,P<0.05). The diagnostic performance, indicated by the area under the curve (AUC), for PLT and PCT in diagnosing CMPA was 0.811 and 0.823, respectively. The cutoff values for PLT and PCT were determined to be 304.5×109/L and 0.305, respectively. 【Conclusion】 The PLT and PCT levels in children with CMPA are found to be higher than those in healthy controls, suggesting their potential diagnostic value in the diagnosis of CMPA.

Factors influencing cardiopulmonary resuscitation competency among community medical staff in Beijing and countermeasures / 中华医学教育探索杂志

Objective:To investigate the status of the knowledge of cardiopulmonary resuscitation (CPR) in community medical staff, and analyze the factors influencing their levels of CPR knowledge and skills, and to provide a basis for improving community CPR training programs.Methods:From January to March 2022, we conducted a survey for the knowledge of CPR among community medical staff in Beijing through WeChat using a self-made questionnaire based on the 2016 National Consensus on Cardiopulmonary Resuscitation in China and the 2020 American Heart Association CPR guidelines. The questionnaire mainly focused on the basic information and CPR knowledge (full score, 17 points) and practice of medical workers. R4.0.3 software was used to perform multiple linear regression analysis.Results:A total of 990 medical personnel from 51 communities effectively responded to the survey. The mean CPR knowledge score was (10.27±2.87) points. The regression analysis showed that the CPR score was significantly lower in groups of male, non-31-40-year-olds, technical degrees, only 0-1 trainings in two years, not ever practicing CPR, and not ever using an automated external defibrillator (AED), suggesting that sex, age, educational attainment, training frequency, whether having the experience of CPR and AED practice or not were independent factors influencing the CPR score of community medical staff.Conclusions:The CPR competency of community medical staff needs to be improved, especially for those with technical degrees and non-31-40-year-olds. The training frequency should be increased based on the Ebbinghaus' forgetting curve, and stratified training is recommended for different populations. Those without practical experience should receive more CPR training with real-time feedback devices and high-fidelity simulation to improve their CPR skills.

Advances in SARS-CoV-2 S protein-induced inflammatory response of respiratory epithelial cells / 中国感染控制杂志

Pneumonia caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection poses a threat to human life and health,resulting in great socio-economic losses.The structural protein spike protein(S protein)of viruses has always been considered to primarily mediate virus invasion into host cells.S protein can act independently of viruses and cause inflammatory reactions on a variety of cells,therefore,understanding the impact of S protein on the respiratory tract can provide a new perspective for the prevention and treatment of COVID-19.This article reviews the advances in the possible mechanisms and clinical manifestations of SARS-CoV-2 structural protein S protein-induced inflammatory response in respiratory epithelial cells,aiming to provide reference for the prevention and treatment of diseases.

Environmental contamination related to the first patient with carbapenem-resistant Acinetobacter baumannii infection and the infection status of pa-tients in the intensive care unit in Tibetan areas / 中国感染控制杂志

Objective To investigate the environmental contamination related to first patient with carbapenem-re-sistant Acinetobacter baumannii(CRAB)infection and the infection status of relevant patients in a newly established intensive care unit(ICU)of a hospital in Tibetan area,and analyze the transmission risk.Methods From the ad-mission in ICU of a patients who was first detected CRAB on November 15,2021 to the 60th day of hospitalization,all patients who stayed in ICU for＞48 hours were performed active screening on CRAB.On the 30th day and 60th day of the admission to the ICU of the first CRAB-infected patient,environment specimens were taken respectively 2 hours after high-frequency diagnostic and therapeutic activities but before disinfection,and after disinfection but before medical activities.CRAB was cultured with chromogenic culture medium.Results Among the 13 patients who were actively screened,1 case was CRAB positive,he was transferred from the ICU of a tertiary hospital to the ICU of this hospital on November 19th.On the 40th day of admission to the ICU,he had fever,increased frequency for sputum suction,and CRAB was detected.The drug sensitivity spectrum was similar to that of the first case,and he also stayed in the adjacent bed of the first case.64 environmental specimens were taken,and 9 were positive for CRAB,with a positive rate of 14.06％,8 sampling points such as the washbasin,door handle and bed rail were positive for CRAB after high-frequency diagnostic and therapeutic activities.After routine disinfection,CRAB was detected from the sink of the washbasin.Conclusion For the prevention and control of CRAB in the basic-level ICU in ethnic areas,it is feasible to conduct risk assessment on admitted patients and adopt bundled prevention and con-trol measures for high-risk patients upon admission.Attention should be paid to the contaminated areas(such as washbasin,door handle,and bed rail)as well as the effectiveness of disinfection of sink of washbasin.

Relationship between serum miR-410-3p expression and knee soft tissue lesions in patients with rheumatoid arthritis / 局解手术学杂志

Objective To explore the expression of serum miR-410-3p in patients with rheumatoid arthritis(RA)and its relationship with knee soft tissue lesions.Methods A total of 89 RA patients admitted to our hospital were selected and divided into the active group(42 cases)and the remission group(47 cases)according to disease activity score in 28 joints(DAS28).In addition,52 healthy volunteers underwent physical examination during the same period in our hospital were selected as the healthy group.The expression level of serum miR-410-3p was detected by RT-PCR,the lesions of knee soft tissue was examined by ultrasound,and the relationship between the expression of serum miR-410-3p and knee soft tissue lesions was analyzed by Pearson.Results The expression levels of serum miR-410-3p of patients in the active group and the remission group were lower than that in the healthy group(P<0.05),and the expression level of serum miR-410-3p of patients in the active group was lower than that in the remission group(P<0.05).The cartilage thicknesses of medial and lateral ankle of patients in the active group and the remission group were smaller than those in the healthy group(P<0.05),and the above indexes in the active group were smaller than those in the remission group(P<0.05).The depths of suprapatellar bursa fluid and synovial thicknesses of patients in the active group and the remission group were greater than those in the healthy group(P<0.05),and the depth of suprapatellar bursa fluid and synovial thickness of patients in the active group were greater than those in the remission group(P<0.05).The level of serum miR-410-3p in RA patients was positively correlated with the depth of suprapatellar bursa fluid and synovial thickness(P<0.05),and negatively correlated with the cartilage thicknesses of medial and lateral ankle(P<0.05).Conclusion Serum miR-410-3p expression level in RA patients is decreased,which was closely related to knee soft tissue lesions,detecting the changes of serum miR-410-3p level may provide a reference for the evaluation of knee soft tissue lesions.