A 6-year single-center prospective follow-up study of the efficacy of radiofrequency ablation for thyroid nodules.

Background: Radiofrequency ablation (RFA) is an alternative modality for thyroid nodules (TNs) and many studies have also confirmed its favorable efficacy and safety. The scope of RFA increases in clinical practice and the aim of our study was to evaluate the efficacy of RFA. Methods: We conducted a prospective study to evaluate the efficacy of RFA for thyroid nodules between January 2017 and December 2022 at our institution. We assessed the change in nodal volume, volume reduction ratio (VRR), technique effective (TE) rate, complete ablation (CA) rate, and nodal regrowth rate and time after RFA. Results: We performed RFA for 1703 patients with TNs between January 2017 and December 2022, of which a total of 970 eligible patients were enrolled in the study. The preoperative volume of TNs was 6.23 ± 8.11ml, with 821 benign and 149 malignant nodules. The post-RFA TE and adjusted TE rate were 80% and 88.8%, respectively. CA was achieved in 145 (14.9%) patients with a mean time of 18.32± 12.98 months; nodal regrowth occurred in 15 (1.5%) patients with a mean time of 29.80 ± 12.47 months. TNs volume and VRR changed significantly at years 1 and 2 after RFA and stabilized after 5 years. A serious postoperative adverse event occurred in one patient with cervical sympathetic chain injury resulting in Horner's syndrome. A transient or permanent damage of the recurrent laryngeal nerve could not be evaluated due to the lack of postoperative laryngoscopy, and this is a significant limitation of the study. Conclusion: The expanded RFA indications were also effective for TNs, with no significant change in long-term efficacy.

The Chinese version of the Ohkuma questionnaire: reliability analysis and diagnostic value.

BACKGROUND: While the Ohkuma questionnaire is a simple, reliable, and easy-to-use tool to assess dysphagia, none of its versions can be used by the Chinese population. OBJECTIVE: The purpose of this study was to evaluate the internal consistency, reliability and clinical validity of a newly made Chinese version of the Ohkuma questionnaire, and to provide some objective basis for its application in screening dysphagia. MATERIALS AND METHODS: From September 21 to June 2022, 96 patients with dysphagia and 89 asymptomatic subjects were recruited from three hospitals in China to form an observation and a control group, respectively. All subjects completed the Ohkuma questionnaire, Eating Assessment Tool-10, and a Video Fluoroscopy Study of Swallowing. RESULTS: The Cronbach's α coefficient measured in the questionnaire was 0.867, indicating acceptable internal reliability. The analysis of variance generated four main factors to be assessed, showing a good aggregation effectiveness of the questionnaire. The AVE square root values of three factors were greater than the maximum absolute value of the correlation coefficients between factors, indicating good differentiation effectiveness. The sensitivity and specificity scores, together with the positive and negative likelihood as well as diagnostic odds ratios indicate a good reactivity of the questionnaire. Lastly, after adjusting for age and sex, the results of the stepwise linear regression analysis showed that there was a significant positive correlation between the Ohkuma questionnaire and the penetration aspiration scale. CONCLUSIONS: The Chinese version of the Ohkuma questionnaire has good reliability and validity, and can be used as a rapid and effective screening tool for dysphagia.

Effect of transcutaneous electrical acupoint stimulation on postoperative sore throat in patients un-dergoing double-lumen endobronchial intubation / 临床麻醉学杂志

Objective To investigate the effect of transcutaneous electrical acupoint stimulation(TEAS)on postoperative sore throat(POST)in patients undergoing double-lumen bronchial intubation based on general anesthesia.Methods A total of 103 patients,45 males and 58 females,aged 18-64 years,BMI 18-28 kg/m2,ASA physical status Ⅰ-Ⅲ,who received selective operation of double-lumen bronchial intubation under general anesthesia were selected.The patients were divided into two groups using the random number table method:TEAS group(n = 51)and control group(n = 52).In the TEAS group,TEAS on Tiantu acupoint and bilateral Hegu acupoints started 30 minutes before anesthesia induction,and the stimulation lasted until the patients were sent to the recovery room.In the control group,electrodes were placed on the same acupoints without electrical stimulation.The Mallampati grade,number of tracheal intu-bation attempts,compression of cricoid cartilage,resistance during intubation,and double-lumen endobron-chial tube(DLT)retention time were recorded.The incidence and severity of POST,VAS pain scores of sore throat,and the incidence of hoarseness 1 hour,6,and 24 hours after extubation were recorded.Results Compared with the control group,the incidence of POST,the incidence of POST level 1,and VAS pain scores of sore throat were significantly decreased 1 hour,6,and 24 hours after extubation(P＜0.05),the incidence of POST level 2 was significantly decreased 6 hours after extubation in the TEAS group(P＜0.05).There were no significant differences in the situations related to tracheal intubation,and the inci-dence of hoarseness 1 hour,6,and 24 hours after extubation between the two groups.Conclusion The transcutaneous electrical acupoint stimulation on Tiantu acupoint and bilateral Hegu acupoints can signifi-cantly reduce the incidence and severity of postoperative sore throat,and VAS pain scores of sore throat in patients undergoing double-lumen bronchial intubation.

Correlation study between epicardial fat and coronary artery lumen stenosis in young adults / 实用放射学杂志

Objective To explore the correlation between epicardial fat volume(EFV),epicardial fat volume indexed(EFVi)and coronary artery lumen stenosis in young adults.Methods The data of 80 young patients who underwent both coronary computed tomography angiography(CCTA)and coronary angiography(CAG)within 2 weeks were analyzed retrospectively.The correlation between EFV,EFVi and coronary artery lumen stenosis in young adults was evaluated.Results A total of 80 patients were enrolled,taking CAG exomination results as the gold standard,58 cases were enrolled into the lesion group and the other 22 cases were enrolled into the control group.The incidence of coronary artery lumen stenosis was higher in young males than that in young females(t=4.309,P=0.038).EFV and EFVi in the lesion group were higher than those in the control group(t=3.023,P=0.001;t=2.785,P=0.001).The EFV in males was higher than that in females(t=2.558,P=0.012).There was no significant difference in EFVi between male and female groups.The differences between EFV and EFVi of males in lesion group and control group were statistically significant(t=4.083,P<0.01;t=4.429,P<0.01).The differences between EFV and EFVi of females in lesion group and control group showed no sta-tistical significance.EFV and EFVi were moderately positively correlated with coronary artery lumen stenosis(rs=0.437,P<0.01;rs=0.463,P<0.01).Receiver operating characteristic(ROC)curve analysis of EFV and EFVi showed that the area under the curve(AUC)of EFV was 0.784,the cut-off value was 107.24 cm3,the sensitivity was 0.776,and the specificity was 0.682.The AUC,cut-off value,sensitivity and specificity of EFVi was 0.793,53.68 cm3/m2,0.81,0.682,respectively.Conclusion EFV and EFVi are moderately positively correlated with coronary artery lumen stenosis in young adults,which is helpful to the diagnosis of coronary heart disease.However,the differences between EFV and EFVi of young females in lesion group and control group show no statistical significance.

Correlation between resilience,post-traumatic stress disorder and quality of life of front-line medical staff in public health emergencies / 沈阳医学院学报

Objective:To explore the correlation between post-traumatic stress disorder(PTSD),resilience and quality of life of front-line medical staff in public health emergencies.Methods:From Nov to Dec 2020,the medical staff of 4 COVID-19 designated hospitals in Wuhan were investigated with the general demographic questionnaire,10-item Connor-Davidson Resilience Scale,PTSD Checklist for DSM-5 and Simplify Qualify of Life Scale.Spearman correlation analysis and hierarchical regression analysis were used to investigate the correlation between PTSD,resilience and quality of life.Results:A total of 545 questionnaires were collected in this survey and the valid effective rate was 97.8% (533/545).The score of psychological resilience,PTSD and quality of life of medical staff were 26(20,30),17(8,25),and 20(18,23),respectively.And 13.1% (70/533)of medical staff had obvious PTSD symptoms.There were significant differences in the score of quality of life among medical staff with different genders,occupations and PTSD levels.Spearman correlation analysis results showed that the score of PTSD was negatively correlated with quality of life and psychological resilience(r=-0.488 and-0.464,P＜0.01).The score of psychological resilience was positively correlated with the score of quality of life(r =0.578,P＜0.01).Psychological resilience and PTSD were important predictors of quality of life,with an explanatory capacity of 37.0% .Conclusions:PTSD is a risk factor for quality of life,and psychological resilience is a protective factor for quality of life.In public health emergencies,improving psychological resilience,preventing and treating PTSD can improve the quality of life of medical staff.

Application of melt electrowriting technology in tissue engineering / 中国组织工程研究

BACKGROUND:With computer-aided design,melt electrowriting technology can precisely construct 3D tissue engineering scaffolds with specific morphology,which has attracted increasing attention in tissue engineering. OBJECTIVE:To elaborate on the progress of melt electrowriting technology in tissue engineering in recent years. METHODS:PubMed and CNKI were used to retrieve articles about applications of melt electrowriting technology in tissue engineering.The search time was from March 2008 to February 2023.The search terms were"melt electrowriting,melt electrospinning,electrospinning,tissue engineering,scaffold,regeneration"in English and"melt electrowriting,electrospinning,tissue engineering"in Chinese.A preliminary screening of articles was performed by reading the titles and abstracts.Finally,69 articles were included for review. RESULTS AND CONCLUSION:(1)Melt electrowriting technology can achieve precise layer-by-layer deposition of fibers compared to traditional electrospinning technology,which better simulates the complex structure of natural tissues.Compared to other 3D printing technologies,smaller-diameter fibers can be prepared by melt electrowriting technology,resulting in highly ordered porous structures.(2)By combining with other scaffold preparation techniques or materials,such as fused deposition modeling,solution electrospinning technology,and hydrogel,melt electrowriting technology shows great potential in preparing complex tissue engineering scaffolds,which provides certain possibilities for achieving complex tissue regeneration.(3)The regeneration of complex tissues often involves blood vessels,nerves,and soft and hard tissues at the same time.The regeneration of blood vessels and nerves is of great significance to realize the physiological reconstruction of tissues.However,soft and hard tissues have certain difficulties to realize the coordinated regeneration of both due to their different biological and mechanical properties.Melt electrowriting technology has certain advantages in the field of bionic scaffolds due to its good biocompatibility,the ability to prepare multi-scale scaffolds and high porosity.

Semen cuscutae in the treatment of osteoarthritis:network pharmacology analysis and experimental validation / 中国组织工程研究

BACKGROUND:Semen cuscutae has the effect of tonifying the liver and kidney system and benefiting the essence.The main pathogenesis of osteoarthritis is deficiency of the liver and kidneys.Therefore,it is hypothesized that there is a link between semen cuscutae and osteoarthritis. OBJECTIVE:To explore the potential relationship between osteoarthritis and semen cuscutae and validate the mechanism of semen cuscutae based on the network pharmacology and molecular docking analysis. METHODS:First,the active ingredients and targets of semen cuscutae were screened in TCMSP,and the genes related to osteoarthritis were collected in the disease databases GeneCard's,OMIM and TTD.The intersected genes were taken and then subjected to a series of analyses and screened for hub genes.Through the enrichment analysis of hub genes,the pathway of semen cuscutae acting on osteoarthritis was selected.The role of hub genes was verified by molecular docking.Therefore,the appropriate active ingredients of semen cuscutae were selected for experimental verification. RESULTS AND CONCLUSION:There were 11 active ingredients of semen cuscutae,66 intersection target genes of semen cuscutae and osteoarthritis,and 12 hub genes,including tumor necrosis factor,interleukin 1B,TP53,RAC-alpha serine/threonine protein kinase(AKT1),vascular endothelial growth factor A,matrix metalloproteinase 9,prostaglandin peroxidase 2,cystatinase 3,epidermal growth factor,peroxisome proliferator-activated receptor gamma,interleukin 10,vascular cell adhesion factor 1.After the enrichment analysis of the hub genes,the classical inflammatory pathway,nuclear factor-κB signaling pathway,was selected for subsequent validation of semen cuscutae to alleviate osteoarthritic inflammation.Through the results obtained after molecular docking of each active ingredient and the hub gene of the pathway prostaglandin peroxidase 2,sesamin with the highest affinity was selected for subsequent cell experiments,and the experimental results confirmed that sesamin,the active ingredient of semen cuscutae,could reduce the expression of cyclooxygenase 2 by inhibiting the nuclear factor-κB signaling pathway induced by interleukin-1β.To conclude,sesamin,the active ingredient of semen cuscutae,reduces the expression of cyclooxygenase 2 by inhibiting the nuclear factor-κB signaling pathway induced by interleukin-1β,thereby improving inflammation in osteoarthritis and expanding the therapeutic effect of semen cuscutae in osteoarthritis.

Effect of recombinant bovine basic fibroblast growth factor gel combined with silver ion dressing on the donor site in patients with hand trauma undergoing skin grafting / 中国基层医药

Objective:To investigate the efficacy of combined repair therapy using recombinant bovine basic fibroblast growth factor (R-bFGF) gel and silver ion dressing on the donor site of patients with hand trauma undergoing skin grafting.Methods:Eighty patients with hand trauma who underwent skin grafting at Lishui Central Hospital between October 2020 and October 2021 were enrolled in this study. Using a simple random grouping method, the patients were randomly assigned to a control group and an observation group in a 1:1 ratio, with 40 patients in each group. The control group received conventional vaseline gauze treatment, while the observation group was treated with a combination of R-bFGF gel and silver ion dressing. After 2 weeks of treatment, the repair effects of both groups were evaluated. Before and after treatment, the Connor-Davidson Resilience Scale (CD-RISC) scores and Visual Analog Scale (VAS) scores were compared between the control and observation groups. Additionally, wound healing time, granulation tissue growth time, wound epithelium formation time, and dressing change times as well as total active motion of the fingers were evaluated and compared between the two groups.Results:The repair effect in the observation group was significantly superior to that in the control group ( Z = 4.92, P < 0.05). Furthermore, the recovery of hand function in the observation group was notably better than that in the control group ( Z = 4.31, P < 0.05). The CD-RISC score in the observation group was significantly higher than that in the control group [(77.54 ± 11.35) points vs. (70.61 ± 9.72) points, t = 2.93, P < 0.05]. Additionally, the VAS score, wound healing time, granulation tissue growth time, wound epithelium formation time, and dressing change times in the observation group were significantly lower or fewer than those in the control group [(4.95 ± 1.13) points vs. (5.52 ± 1.24) points, (10.43 ± 1.65) days vs. (15.54 ± 1.71) days, (7.42 ± 2.35) days vs. (11.56 ± 2.71) days, (10.25 ± 2.47) days vs. (12.82 ± 2.64) days, and (2.12 ± 0.63) times vs. (3.35 ± 0.86) times, t = -2.15, -13.60, -7.30, -4.50, -7.30, all P < 0.05]. Conclusion:The combined use of R-bFGF gel and silver ion dressing effectively enhances the repair outcomes of skin donor sites, thereby improving the psychological well-being and reducing pain perception in patients with hand trauma. This therapeutic approach markedly promotes the prognosis and functional recovery of these patients, offering valuable clinical reference for the treatment of hand injuries.

Effect of robotic training under position limitation on upper limbs in patients with shoulder subluxation after stroke / 中国康复理论与实践

Objective To explore the effect of robotic training under position limitation on upper limb of patients with shoulder sub-luxation after stroke. Methods From March to December,2023,sixty patients with shoulder subluxation after stroke in the First Affiliated Hospital of Bengbu Medical University were randomized into conventional group(n = 20),robot group(n = 20)and position-limited group(n = 20).All the groups accepted conventional rehabilitation,while the robot group underwent robot training and the position-limited group underwent robot training under position limitation,for four weeks.Before and after treatment,Fugl-Meyer Assessment-Upper Extremities(FMA-UE)and modified Bar-thel Index(MBI)were used for evaluation,surface electromyography(sEMG)was used to measure the average electromyography(AEMG)and root mean square(RMS)of posterior deltoid fasciculus and supraspinatus during contraction,and musculoskeletal ultrasonography was used to determine the distance of acromion-greater tuber-osity(AGT)of the affected side. Results After treatment,FMA-UE score,MBI score,AEMG,RMS and the distance of AGT improved in all the groups(|t|>10.850,P<0.001),and all the indexes were optimal in the position-limited group(F>42.031,P<0.001). Conclusion Robotic training for upper limb under postural limitation can further improve upper limb function and sub-luxation status,activities of daily living,and peri-shoulder muscle in patients with shoulder subluxation after stroke.

The evaluation value of serum PTX3 and CK-MB levels on volume load in patients with chronic decompensated heart failure / 中国医师杂志

Objective:To explore the evaluation value of serum levels of positive pentameric protein 3 (PTX3) and creatine kinase isoenzyme MB (CK-MB) on volume load in patients with chronic decompensated heart failure (CDHF).Methods:A total of 300 CDHF patients who visited the Xingtai Central Hospital from July 2019 to July 2022 were selected and divided into a capacity overload group ( n=182) and a non capacity overload group ( n=118) based on their capacity balance level. Two clinical data sets were compared and analyzed. The receiver operating characteristic (ROC) curve was used to analyze the evaluation value of serum PTX3 and CK-MB levels on the volume load of CDHF patients. The clinical disease characteristics of the two groups of patients were analyzed using univariate analysis, and the influencing factors of volume load of CDHF patients were analyzed using logistic regression. A column chart model was constructed and validated. Results:The body mass index (BMI), waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose (FBG), glycosylated hemoglobin (HbA 1c), C-reactive protein (CRP), uric acid (UA), homeostasis model assessment of insulin resistance (HOMA-IR) of patients in the capacity overload group were higher than those in the non-capacity overload group, and the differences were statistically significant (all P<0.05). The PTX3, CK-MB, pulmonary capillary wedge pressure (PCWP), and CVP levels of patients in the capacity overload group were higher than those in the non-capacity overload group, while albumin, hemoglobin, and hematocrit were lower than those in the non-capacity overload group, and the differences were statistically significant (all P<0.05). The ROC curve showed that the area under the curve (AUC) of PTX3 and CK-MB for predicting capacity overload in CDHF patients are 0.795 and 0.718, with sensitivity of 86.2% and 83.7%, specificity of 65.4% and 68.6%, respectively, indicating high predictive accuracy; The AUC of the two joint predictions is 0.817, the sensitivity was 92.5%, and the specificity was 70.6%. The prediction accuracy was higher than PTX3 ( Z=3.812, P<0.05) and CK-MB ( Z=3.365, P<0.05). PTX3, CK-MB, albumin, hemoglobin, hematocrit, PCWP, and central venous pressure (CVP) were all influencing factors of volume load status in CDHF patients (all P<0.05). The column chart risk prediction model established based on these factors had high accuracy and strong applicability in clinical treatment. Conclusions:Serum PTX3 and CK-MB levels are influencing factors for volume overload in CDHF patients. A column chart model constructed in combination with indicators such as albumin, hemoglobin, hematocrit, PCWP, and CVP has high predictive value for the volume overload status of CDHF.

Scholars'consensus on the construction and development of chinese medical humanities:summary of"seminar on the construction of Chinese medical humanities"held in Harbin in August 2023 / 中国医学伦理学

On August 2-4,2023,the"Third Summit Forum on'Building a Community of Shared Future for Doctors and Patients'"was jointly organized by institutions such as the Chinese Medical Ethics,the Hospital Humanities Management and Talent Training Special Committee of the China Population and Culture Promotion Association,Center for Ethical Studies of Renmin University of China,the Newspaper for China's Physicians,the China Health Law Society,the China Anti-Cancer Association,and the China Association For Ethical Studies in Harbin.The conference arranged a sub-forum for the"Seminar on the Construction of Chinese Medical Humanities",with domestic medical humanities scholars attending the conference.After heated discussions at the seminar,the Scholars'Consensus on the Construction and Development of Chinese Medical Humanities was formed.It was proposed that in the new era,it is urgent to build the medical humanities discipline,as well as lead the academic integration and development of medical humanities under the core socialist values.At the same time,for the construction of the medical humanities discipline,it is necessary to optimize the organizational mechanism,prosper and develop the overall framework of the medical humanities discipline,accelerate the construction of a professional teaching team for the medical humanities discipline,promote the establishment of a new carrier medical humanities education and teaching in cultivating morality and nurturing talents,as well as focus on solving problems related to the cultivation of medical humanities graduate students.

Research on the current situation of the social application field of medical humanities in China / 中国医学伦理学

ObjectiveTo clarify the current situation and trend of the social application field of medical humanities in China， explore contributions and characteristics of interdisciplinary fields， and provide a reference for improving the disciplinary research system and forming disciplinary synergy. MethodsCiteSpace， a visual software， was used to cluster the keywords of the social application of medical humanities journals from 2010 to 2022， which were included in three major databases of CNKI， Wanfang Data， and VIP. The clusters were classified according to the functions of contemporary universities. This paper summarized the current social application fields of medical humanities in China and conducted a holistic analysis. ResultsThe current social application field of medical humanities in China included eight fields： education and teaching of medical humanities， construction of discipline professional， academic research on discipline ideology， application of medical scientific research work， medical health service and safety management， resolution of doctor-patient relationship and dispute， traditional Chinese medicine culture and humanistic spirit， and adaptation to the national strategic development concept respectively. ConclusionThere was an uneven tendency in the development of the social application field of medical humanities in China. The overall distribution of its social application fields showed a trend of “strong humanities education， strong academic research， strong medical safety， and weak cultural concepts”. Medical humanities education was the common focus of the social application of medical humanities in China.

Applications and advances of digital technology in spinal surgery: from 3d printing to large language model / 中华创伤骨科杂志

With advancement of science and technology and consequent increasing demands, digital technology has become more and more important in the field of spinal surgery. It provides spinal surgeons with more information, support and assistance to improve the diagnostic accuracy, surgical efficiency, surgical safety, and surgical quality. It also offers new possibilities and opportunities for education, communication, and doctor-patient interaction in medicine. This article reviews the applications and advances of digital technology in the field of spinal surgery, mainly covering 3D printing, surgical navigation, virtual reality and augmented reality, surgical robots, and artificial intelligence. It also analyzes the latest research progress at home and abroad, limitations and challenges, and the future development trends of digital technology.

Application of thoracoscope assisted intercostal nerve block combined with nalbuphine for postoperative multimodal analgesia in lung segment resection surgery / 临床外科杂志

Objective To evaluate the effect of thoracoscope assisted intercostal nerve block combined with nalbuphine for postoperative multimodal analgesia after lung segment resection surgery.Methods From April 2022 to September 2022,60 patients scheduled for thoracoscopic lung segment resection surgery were selected and divided into two groups according to the random number table,with 30 patients in each group.The patients in the observation group received intercostal nerve block under thoracoscope before closing the chest,and the postoperative analgesia pump was Naborphine combined with sufentanil for patient-controlled intravenous analgesia;In the control group,the thoracic cavity was closed directly,and sufentanil was used for patient-controlled intravenous analgesia.The visual analog pain score(V AS),the number of PCI A effective pressing,the situation of rescue analgesia and the occurrence of related adverse reactions were recorded 2 h,4 h,8 h,24 h and 48 h after surgery.Results The VAS scores at rest of the observation group at2h,4h,8h,24h and 48 h after operation 1.8±0.8,1.9±0.8,2.1±0.9,2.3±0.9,2.1±0.8,compared with control group 3.3±1.1,3.5±1.0,2.8±0.9,2.7± 0.7,2.6±0.8 were all significantly lower(P＜0.05).The VAS scores during activity of the observation group at 2 h,4 h,and 8 h after operation 2.2±0.6,2.3±0.6,2.5±0.9,compared with control group 3.9±1.9、3.9±1.7、3.3±1.7 were significantly lower(P＜0.05).The effective press times of PCIA in the observation group within 24 hours and 48 hours after operation were 2.7±1.5 and 5.4±2.3 times,while those in the control group were 5.2±3.4 and 10.2±6.0 times.The difference between the two groups was statistically significant(P＜0.05).The number of patients in the observation group receiving postoperative analgesia was less than that in the control group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).The satisfaction rate of patients in the observation group was higher than that in the control group,with a statistically significant difference(P＜0.05).Conclusion Thoracoscope assisted intercostal nerve block combined with nalbuphine can be a good choice for postoperative multimodal analgesia in lung segment resection surgery.

Effect of Proactive and Reactive Therapeutic Drug Monitoring of Infliximab on Prognosis of Patients With Inflammatory Bowel Disease / 胃肠病学

Background:Therapeutic drug monitoring(TDM)has emerged as the important method for managing loss of response to infliximab.The effect of reactive and proactive TDM on clinical outcomes in inflammatory bowel disease(IBD)is uncertain.Aims:To evaluate the effect of proactive and reactive TDM of infliximab on the prognosis of patients with IBD.Methods:Clinical data of 99 IBD patients treated with IFX from January 2017 to October 2021 at the First Affiliated Hospital of Air Force Military Medical University were retrospectively analyzed,including 34 patients with proactive TDM and 65 patients with reactive TDM.The rate of treatment failure,IBD-related surgery or hospitalization were compared between the two groups.Logistic regression analysis was used to determine the independent risk factors of treatment failure.Results:The median follow-up of the patients was 21(13,32)months.The rate of treatment failure,IBD-related hospitalization rate of proactive TDM group were significantly lower than those of reactive TDM group(P<0.05),however,no significant difference in IBD-related surgery rate was found between two groups(P=0.081).Univariate analysis showed that ileocolonic resection before TDM,antibodies to infliximab(ATI)and reactive TDM might be correlated with treatment failure(P<0.05).Logistic regression analysis showed that reactive TDM(OR=5.829,95%CI:1.070-31.754,P=0.042)was the risk factor of treatment failure,and ileocolonic resection before TDM(OR=0.119,95%CI:0.019-0.736,P=0.022)was the protective factor of treatment failure.Conclusions:Compared with reactive TDM group,proactive TDM can significantly decrease the rate of treatment failure and IBD-related hospitalization rate.Reactive TDM is the risk factor of treatment failure,and ileocolonic resection before TDM is the protective factor of treatment failure.

New Horizons in Treatment of Celiac Disease / 胃肠病学

Celiac disease is a common immune-mediated disorder that may present with various heterogeneous symptoms following gluten ingestion.It accounts for 0.7%-1.4%of the global population.The prevalence of celiac disease in China was once considered extremely low.However,in recent years,several cases of celiac disease have been reported one after another,which has gradually attracted people's attention.A gluten-free diet is the only effective treatment for celiac disease,but it has limitations in certain patient groups and is difficult to maintain over time.This is why studying alternative treatment options for celiac disease is of great clinical importance.In recent years,the treatment of celiac disease has seen the emergence of several novel therapies that provide ideas and directions for clinical treatment in terms of removing or reducing the factors that cause abnormalities in immune tolerance,suppressing one's immune response to gluten,and re-establishing immune tolerance to gluten.This review focuses on the research progress of new therapies for celiac disease.

Role and mechanism of protein kinase D in the replication of human coronavirus 229E / 中国人兽共患病学报

This study investigated the role of protein kinase D(PKD)in the replication of human coronavirus 229E(HCoV-229E)and its potential molecular mechanisms.Using MRC-5 cells as a model,we assessed the expression levels of PKD family genes and proteins through qPCR and western blotting.We knocked down Prkd3 with siRNA and inhibited PKD activity with CRT0066101 to examine the replication lev-els of HCoV-229E-infected cells.Cell viability was assessed with CCK8,viral titration was determined with the TCID50,and immunofluorescence staining was used to assess HCoV-229E expression and the structure of the trans-Golgi network(TGN).The level of phosphatidylinositol 4,5-bisphosphate(PI(4,5)P2)was measured to reflect phosphatidylinositol 4-kinaseⅢβ(PI4KⅢβ)activity.PI4KⅢβ activity was inhibited with a PI4KⅢβ inhibitor(BQR695)to observe changes in TGN struc-ture and HCoV-229E replication after cell infection.CRT0066101 was used to inhibit PKD activity in Vero-E6 cells,and HCoV-229E replication levels were examined post-infection.The expression levels of PKD family genes and proteins,including Prkd1,Prkd2 and Prkd3,significantly increased during HCoV-229E infection.Knockdown of PKD3 significantly inhibited HCoV-229E mRNA levels and titers with respect to those in the control group(t=8.999,P＜0.001;t=6.920,P＜0.001),whereas overexpression of PKD3 increased HCoV-229E mRNA levels and titers(t=6.630,P＜0.001;t=5.794,P＜0.001).CRT0066101 also significantly inhibited HCoV-229E mRNA levels and titers(t=6.931,P＜0.001;t=4.055,P＜0.01).Im-munofluorescence staining indicated that CRT0066101 inhibited TGN fission caused by HCoV-229E infection.Inhibition of PI4KⅢβ activity significantly decreased PI(4,5)P2 levels,and BQR695 rescued the elevated PI(4,5)P2 levels caused by PKD overexpression(t=6.671,P＜0.01).BQR695 decreased TGN fission in HCoV-229E-infected cells,and HCoV-229E mRNA levels and titers(t=5.151,P＜0.001;t=7.744,P＜0.001).CRT0066101 inhibited HCoV-229E mRNA levels and titers in Vero-E6 cells(t=7.480,P＜0.001;t=7.228,P＜0.01).This study revealed that PKD regulates TGN fission through modu-latingPI4KⅢβ and is involved in HCoV-229E replication.PKD inhibitors and PI4KⅢβ inhibitors significantly decreased HCoV-229E replication,thus providing important insights for future research onthe treatment of coronavirus infections.

Geniposide promotes skin ulcer wound healing in diabetic rats through the PI3K/Akt pathway / 中国比较医学杂志

Objective To investigate the protective effect of geniposide against diabetic rats with skin ulcer and the mechanism.Methods Rats were divided into a normal group,model group,and geniposide subgroups(Gen(L):200 mg/kg;Gen(H):500 mg/kg).Diabetic rats were treated with normal saline or geniposide by intragastric administration(n=6).Treatments were administered once a day,and the wound healing and inflammation of each group were recorded every day.After 7 days of treatment for diabetic skin ulcers,the wound area,tissue sections,TUNEL staining and Western blot were used to quantitatively analyze changes in wound healing,apoptosis,and related regulatory protein expression.Results Compared with the model group,the group receiving orally administered geniposide(200 and 500 mg/kg)showed significantly improved wound healing and increased contraction of the injured area.In terms of skin wound apoptosis in diabetic rats,TUNEL-positive cells were significantly reduced in geniposide subgroups(P<0.05).Geniposide significantly inhibited skin inflammation and promoted wound repair,which may be related to promotion of PI3K and Akt phosphorylation.Conclusions Geniposide promoted skin wound repair in diabetic rats by inhibiting inflammatory responses and apoptosis.

Effect of stroke volume variation-guided fluid therapy on renal function in older pa-tients / 中国肿瘤临床

Objective:To examine the renoprotective benefits of stroke volume variation(SVV)-guided fluid therapy in older patients under-going laparoscopic colorectal cancer resection with combined administration of epidural and general anesthesia.Methods:A total of 100 older patients underwent laparoscopic colorectal cancer resection with combined administration of epidural and general anesthesia at The Affiliated Hospital of Inner Mongolia Medical University.Participants were randomly allocated into the control(group C)and experimental groups(group S).Each group consisted of an equal distribution of 50 patients.Group C received routine rehydration,while group S under-went SVV-guided fluid rehydration.To compare the two groups,the levels of serum creatinine(Scr),blood urea nitrogen(BUN),neutrophil gelatinase-associated lipocalin protein(NGAL),and kidney injury molecule-1(KIM-1)were analyzed before and after surgery.Results:NGAL concentrations were significantly reduced in group S compared with those in group C at 2 and 24h after surgery(P=0.033,P=0.014).KIM-1 levels were significantly lower in group S than in group C 24h after surgery(P=0.012).Furthermore,Scr levels were significantly lower in group S than in group C 1 day after surgery(P=0.049).The incidence of postoperative acute kidney injury(AKI)was significantly higher in group C than in group S(P=0.027).Conclusions:In older patients undergoing laparoscopic radical resection of colorectal cancer,the imple-mentation of SVV-guided fluid therapy can improve postoperative plasma markers of renal injury and reduce the incidence of postoperative AKI,thereby protecting renal function.

The role and mechanism of MMP13 and LRP1 in abnormal autophagy function of articular chondrocytes in patients with Kashin-Beck disease / 中华地方病学杂志

Objective:To investigate the impact of matrix metalloproteinase 13 (MMP13) and low-density lipoprotein receptor-related protein 1 (LRP1) on autophagy of articular chondrocytes in patients with Kashin-Beck disease (KBD).Methods:Human articular cartilage samples obtained from 4 KBD patients and 4 control subjects were collected from Shaanxi Institute for Endemic Disease Prevention and Control, and the expression levels of MMP13 and LRP1 in cartilage tissue were determined using immunohistochemistry (IHC). Chondrocytes were extracted and cultured in vitro, the mRNA and protein expression levels of LRP1 and the autophagy related genes [Beclin 1 (BECN1), microtubule associated protein 1 light chain 3 (LC3)], cartilage injury related genes [MMP13, caspase-3 (CASP3)], chondrocyte differentiation related genes [collagen type Ⅱ alpha 1 chain (COL2A1), and SRY-box transcription factor 9 (SOX9)] were detected by real-time fluorescence quantitative PCR (qRT-PCR) and Western blot (WB), respectively. Chondrocytes from 3 KBD patients were extracted, and MMP13 gene silencing experiment was performed by RNA interference (RNAi) technology, the mRNA and protein expression levels of the above genes were detected by qRT-PCR and WB, respectively. In addition, the antagonist receptor associated protein (RAP) of LRP1 was used to block the LRP1 of human normal chondrocytes (C28/I2 cells), and qRT-PCR and WB were used to detect the mRNA and protein expression levels of LRP1, chondrocyte autophagy, differentiation and cartilage injury related genes, respectively. Results:The IHC results showed that the expression levels of MMP13 (1.67 ± 0.21, 0.59 ± 0.15, 0.51 ± 0.12) in the surface, middle, and deep layers of cartilage tissue of KBD patients were significantly higher than those of control subjects (0.25 ± 0.03, 0.26 ± 0.04, 0.06 ± 0.01), and the differences were statistically significant ( t = - 11.38, P < 0.001; t = - 3.82, - 6.26, P = 0.019, 0.003). The expression levels of LRP1 (0.10 ± 0.02, 0.03 ± 0.01, 0.17 ± 0.03) were significantly lower than those of control subjects (1.63 ± 0.40, 0.44 ± 0.12, 0.34 ± 0.08), and the differences were statistically significant ( t = 6.61, 5.61, 3.64, P = 0.003, 0.005, 0.022). The mRNA and protein expression levels of MMP13, CASP3, SOX9 in chondrocytes of KBD patients were significantly higher than those of control subjects, and the differences were statistically significant ( P < 0.05). The mRNA expression levels of LRP1, LC3, COL2A1 were significantly lower than those of control subjects, and the differences were statistically significant ( P < 0.05). After silencing the MMP13 gene in chondrocytes of KBD patients, there were no significant differences in the mRNA and protein expression levels of LRP1, BECN1, LC3, CASP3, COL2A1, and SOX9 ( P > 0.05). After blocking LRP1 with RAP, the protein expression levels of LRP1, BECN1, LC3, MMP13, COL2A1 and SOX9 in chondrocytes were significantly lower than those in control group ( P < 0.05). Conclusions:There is no direct correlation between MMP13 and abnormal autophagy of articular chondrocytes in KBD patients. After blocking LRP1, the expression of the autophagy related genes BECN1 and LC3 in chondrocytes is decreased.