Evaluafion of the efficacy of wall shear stress in carotid artery stenting.

Objective: To characterize the value of carotid wall shear stress (WSS) following carotid artery stenting (CAS) in patients with carotid stenosis. Methods: Twenty-eight patients with carotid stenosis treated with CAS between March 2021 to May 2022 in the eighth medical center of the PLA General Hospital were selected for our study. Carotid ultrasound was performed before the operation, one week post-operation, and six months post-operation. Carotid artery WSS was detected by blood flow vector imaging, and the changes in WSS before and after the operation were collected. Genetic testing of drugs was detected for patients with restenosis. Results: Pre-operative WSS of the proximal, narrowest region, and distal carotid arteries in patients with ischemic carotid artery stenosis was 7.88 ± 3.18Pa, 14.36 ± 6.66Pa, and 1.55 ± 1.15Pa, respectively. Comparatively, pre-operative WSS of the proximal, narrowest region and distal carotid arteries in patients without ischemic symptoms was 5.02 ± 1.99Pa, 9.68 ± 4.23Pa, and 1.10 ± 0.68Pa, respectively, with a significant difference between the two groups (p < 0.001). Overall WSS of the proximal, narrowest region, and distal carotid arteries in patients before CAS was 6.68 ± 3.0Pa, 12.47 ± 5.98Pa, and 1.39 ± 0. 96Pa. WSS of the proximal, narrowest region, and distal carotid was 4.15 ± 1.42Pa, 6.71 ± 2.64Pa, and1.86 ± 1.13Pa one week after CAS, compared to 4.44 ± 1.91Pa, 7.90 ± 4.38Pa, and 2. 36 ± 1.09Pa six months after CAS. WSS of the proximal and narrowest region of the carotid artery was reduced after carotid stenting, and the difference was statistically significant (p < 0.001). There was no statistically significant difference in WSS between one week and six months after stenting (P > 0.05). Conclusion: We employed early carotid WSS as a means of evaluating the efficacy of carotid artery stenting. Changes in carotid WSS are closely associated with carotid artery stenosis, providing valuable hemodynamic information for CAS treatment. This technique holds great application value in pre-operative evaluation and long-term follow-up.

Using a visual support package to facilitate independent leisure engagement and choice-making for individuals with moderate to severe autism in Taiwan.

LAY ABSTRACT: Self-determination encompasses various components, including decision-making and independence, making it a complex process. While the importance of self-determination for individuals with autism spectrum disorder has been explored in previous studies, there is limited research focusing on individuals with moderate to severe autism spectrum disorder. Evidence-based practices such as visual activity schedules and video modeling have shown effectiveness in promoting independence among individuals with autism spectrum disorder. To address the need for independence and choice-making among individuals with moderate to severe autism spectrum disorder, this study developed a visual support package incorporating visual activity schedules, video modeling, preference assessments, and prompt procedures. By investigating the intervention's effectiveness in three participants, this study contributes to the existing literature on the use of a visual activity schedule and video modeling in enhancing choice-making and independent leisure engagement. Following the intervention, all participants were able to select three leisure activities, develop their own visual schedules, and complete them. Notably, this study conducted preference assessments to determine participants' preferred leisure activities and did not provide additional reinforcement. Practical implications of this research include incorporating video prompting as needed and adjusting activity engagement time. Future research should explore the long-term effectiveness of the visual support package and its application in developing novel skills or vocational activities for individuals with moderate to severe autism spectrum disorder. This study fills a critical gap in the literature, providing important insights for practices and research in the field of autism spectrum disorder interventions.

EGR1 Regulates SHANK3 Transcription at Different Stages of Brain Development.

The expression levels of SHANK3 are associated with autism spectrum disorder (ASD). The dynamic changes in SHANK3 expression during different stages of brain development may impact the progression of ASD. However, no studies or detailed analyses exploring the upstream mechanisms that regulate SHANK3 expression have been reported. In this study, we employed immunofluorescence to examine the expression of SHANK3 in brain organoids at various stages. Our results revealed elevated levels of SHANK3 expression in brain-like organoids at Day 60. Additionally, we utilized bioinformatics software to predict and analyze the SHANK3 gene's transcription start site. Through the dual luciferase reporter gene technique, we identified core transcription elements within the SHANK3 promoter. Site-directed mutations were used to identify specific transcription sites of SHANK3. To determine the physical binding of potential transcription factors to the SHANK3 promoter, we employed electrophoretic mobility shift assay (EMSA) and chromatin immunoprecipitation (ChIP). Our findings demonstrated that the transcription factor EGR1 regulates SHANK3 expression by binding to the transcription site of the SHANK3 promoter. Although this study did not investigate the pathological phenotypes of human brain organoids or animal model brains with EGR1 deficiency, which could potentially substantiate the findings observed for SHANK3 mutants, our findings provide valuable insights into the relationship between the transcription factor, EGR1, and SHANK3. This study contributes to the molecular understanding of ASD and offers potential foundations for precise targeted therapy.

Transcriptional mechanism of E2F1/TFAP2C/NRF1 in regulating KANK2 gene in nephrotic syndrome.

The mortality rate linked with nephrotic syndrome (NS) is quite high. The renal tubular injury influences the response of NS patients to steroid treatment. KN motif and ankyrin repeat domains 2 (KANK2) regulates actin polymerization, which is required for renal tubular cells to maintain their function. In this study, we found that the levels of KANK2 in patients with NS were considerably lower than those in healthy controls, especially in NS patients with acute kidney injury (AKI). To get a deeper understanding of the KANK2 transcriptional control mechanism, the core promoter region of the KANK2 gene was identified. KANK2 was further found to be positively regulated by E2F Transcription Factor 1 (E2F1), Transcription Factor AP-2 Gamma (TFAP2C), and Nuclear Respiratory Factor 1 (NRF1), both at mRNA and protein levels. Knocking down E2F1, TFAP2C, or NRF1 deformed the cytoskeleton of renal tubular cells and reduced F-actin content. EMSA and ChIP assays confirmed that all three transcription factors could bind to the upstream promoter transcription site of KANK2 to transactivate KANK2 in renal tubular epithelial cells. Our study suggests that E2F1, TFAP2C, and NRF1 play essential roles in regulating the KANK2 transcription, therefore shedding fresh light on the development of putative therapeutic options for the treatment of NS patients.

Chromatin binding protein HMGN1 promotes HBV cccDNA transcription and replication by regulating the phosphorylation of histone 3.

BACKGROUND AND AIMS: Direct elimination of cccDNA remains a formidable obstacle due to the persistent and stable presence of cccDNA in hepatocyte nuclei. The silencing of cccDNA transcription enduringly is one of alternative strategies in the treatment of hepatitis B. Protein binding to cccDNA plays an important role in its transcriptional regulation; thus, the identification of key factors involved in this process is of great importance. APPROACHES AND RESULTS: In the present study, high mobility group nucleosome binding domain 1 (HMGN1) was screened out based on our biotin-avidin enrichment system. First, chromatin immunoprecipitation and fluorescent in situ hybridization assays confirmed the binding of HMGN1 with cccDNA in the nucleus. Second, functional experiments in HBV-infected cells showed that the promoting effect of HMGN1 on HBV transcription and replication depended on the functional region of the nucleosomal binding domain, while transfection of the HMGN1 mutant showed no influence on HBV compared with the vector. Third, further mechanistic exploration revealed that the silencing of HMGN1 increased the level of phosphorylase CLK2 and promoted H3 phosphorylation causing the reduced accessibility of cccDNA. Moreover, silenced HMGN1 was mimicked in HBV (r) cccDNA mouse model of HBV infection in vivo. The results showed that silencing HMGN1 inhibited HBV replication in vivo. CONCLUSIONS: In summary, our study identified that a host protein can bind to cccDNA and promote its transcription, providing a candidate strategy for anti-HBV targeting to interfere with the transcriptional activity of cccDNA microchromosomes.

The effect of staged thematic painting therapy on children with emotional disorders: a quasi-experimental study / 中国实用护理杂志

Objective:To explore the effects of staged thematic painting therapy on positive emotions, alexithymia and self-efficacy in children with emotional disorders.Methods:This was a quasi-experimental study. By convenient sampling, 61 children with emotional disorders admitted from January 2022 to December 2022 to the Department of Child and Adolescent Psychology, Affiliated Psychological Hospital of Anhui Medical University were selected as the research objects, 31 patients admitted from January 2022 to June 2022 were listed as the control group and 30 patients admitted from July 2022 to December 2022 were listed as the observation group according to the time of admission.The control group was given routine psychiatric care, and the observation group was given staged thematic painting therapy on this basis. The intervention time was 6 weeks. The intervention effect was evaluated by Positive and Negative Affect Scale,Toronto Alexithymia Scale, and General Self-Efficacy Scale.Results:There were 15 males and 16 females in the control group, aged (14.19 ± 1.79) years old. There were 13 males and 17 females in the observation group, aged (14.47 ± 1.55) years old. The difference in baseline data between the two groups was not statistically significant ( P>0.05) and was comparable. There was no significant difference in the score of positive emotions, alexithymia and self-efficacy before intervention between the two groups (all P>0.05). After intervention, the scores of positive emotions and self-efficacy in the observation group were (43.20±7.41), (31.88 ± 5.42) points, which were higher than those in the control group (33.81 ± 6.92), (21.24 ± 5.41) points, the differences were statistically significant ( t=-6.19, -5.63, both P<0.05). After intervention, the scores of alexithymia in the observation group was (53.44 ± 4.68) points, which was lower than that in the control group (60.44 ± 5.52) points, the difference was statistically significant ( t=-8.72, P<0.05). Conclusions:Staged thematic painting therapy can effectively improve the positive emotions, self-efficacy and alexithymia level of children with emotional disorders, help the patients establish confidence to overcome the disease. It is valuable in clinical practice.

Effects of conditioned medium of acute myeloid leukemia on biology of mesenchymal stem cells / 中国组织工程研究

BACKGROUND:At present,the biological functions and molecular changes of bone marrow mesenchymal stem cells in the tumor microenvironment of acute myeloid leukemia are still unclear. OBJECTIVE:To explore the changes in the biological function of bone marrow mesenchymal stem cells in acute myeloid leukemia and the role of acute myeloid leukemia conditioned medium by bioinformatics and experiment. METHODS:Differential genes were screened from GEO data sets,and enrichment analysis was performed.The protein-protein interaction network was constructed and the Hub gene was obtained.Bone marrow mesenchymal stem cells from patients with acute myeloid leukemia and healthy donors were cultured.Bone marrow mesenchymal stem cells from healthy donors were treated with acute myeloid leukemia conditioned culture solution.Each group was subjected to the adipogenic differentiation,osteogenic differentiation,staining of β-galactosidase,detection of the cell cycle,and validation of Hub genes. RESULTS AND CONCLUSION:(1)Gene expression data of bone marrow mesenchymal stem cells from acute myeloid leukemia patients and healthy donors were obtained from GSE84881,and 184 up-regulated genes and 140 down-regulated genes were screened.(2)The biological functions of enrichment mainly include cell cycle,adipocyte differentiation,cell metabolism,and MYC pathway.According to the Degree algorithm,10 up-regulated Hub genes and 10 down-regulated Hub genes were selected.(3)The cell in vitro experiment found that:compared with the control group,the surface antigen of acute myeloid leukemia mesenchymal stem cells did not change,but it showed enhanced lipid differentiation ability,weakened osteogenic differentiation ability,increased β-galactosidase positive cell number,altered cell morphology,arrested cell cycle,increased LGALS3 expression,and decreased MYC expression.Mesenchymal stem cells from healthy donors showed similar changes after being cultured in acute myeloid leukemia conditioned medium.(4)The results show that biological function of mesenchymal stem cells is altered in the acute myeloid leukemia microenvironment,which provides new insights into the interaction between mesenchymal stem cells and tumor cells.

Effect of carbonic anhydrase 9 on hypoxia-induced proliferation of retinal microvascular endothelial cells in preterm fetus / 中国新生儿科杂志

Objective:We applied a hypoxia-induced model of human fetal retinal microvascular endothelial cell (RMEC) to study the effect of carbonic anhydrase 9 (CA9) on cell proliferation.Methods:The eyeballs of spontaneously aborted fetuses in Guangdong Women and Children's Hospital were obtained, and the retinas were isolated. RMEC was obtained by trypsin and collagenase two-step enzyme digestion, and endothelial cells were identified by CD34. The fetal RMEC and the purchased adult RMEC were cultured in normoxic and hypoxic incubators (1%O 2+5%CO 2+94%N 2), and the expression of CA9 was detected by qPCR and Western blot. After knocking down the CA9 by small interference RNA technique, the cell proliferation was detected by CCK-8 method, and the cell viability was detected by CCK-8 after adding CA9 inhibitor U-104. Results:The primary RMEC was extracted successfully. Immunofluorescence staining showed the percentage of CD34 positive cells in the third-generation cells was nearly 100%. The expression of CA9 mRNA in immature fetus and adult RMEC under hypoxia culture was higher than that under normoxic culture (fetal 1% O 2 group vs. fetal 21% O 2 group: 67.80±10.31 vs. 1.00±0.04, P<0.001; adult 1% O 2 group vs. adult 21% O 2 group: 1.72±0.22 vs. 1.00±0.02, P=0.014). Western blot analysis showed significantly increased expression of CA9 in the fetal RMEC exposed to hypoxia, which aligned with the expression of CA9 mRNA. When fetal RMEC was transfected with siCA9 20 nM, the knockdown rate of CA9 was 95% ( P<0.001). CCK-8 assay showed significantly lower proliferation of fetal RMEC cells in siCA9 group compared to siNC group (0.57±0.05 vs. 0.90±0.03, P<0.001), which was reflected by the OD value. With the addition of 100 μM CA9 inhibitor U-104, the viability of fetal RMEC in the treated groupwas significantly lower than that in the untreated group (99.16%±3.82% vs. 119.10% ±1.72%, P=0.002). Conclusions:The expression of CA9 differed between adult and preterm fetus in our hypoxia-induced RMEC model. Inhibiting CA9 can inhibit the proliferation of retinal microvascular endothelial cells of preterm fetus.

Ultrasonographic Findings of Xp11.2/TFE3 Translocation Renal Cell Carcinoma / 中国医学影像学杂志

Purpose To investigate the ultrasound imaging characteristics of Xp11.2 translocation/TFE3 gene fusion renal cell carcinoma(Xp11.2/TFE3-tRCC).Materials and Methods A retrospective analysis was conducted of 10 patients with pathologically confirmed Xp11.2/TFE3-tRCC who underwent surgery in West China Hospital of Sichuan University from April 2009 to February 2022.The ultrasonic images were collected and further analyzed,including tumor border,shape,internal echoes,Doppler findings,and contrast-enhanced ultrasonography findings.Results A total of 10 masses were finally included,4 of which underwent contrast-enhanced ultrasound.The ultrasonographic manifestations of Xp11.2/TFE3-tRCC showed diversity and variability,and the mass was most commonly located in the medulla(5 cases).Conventional ultrasound showed solid nodules with clear boundaries and regular shape similar to benign lesions in 6 cases,and color Doppler showed punctated blood flow signals in 5 cases.Contrast-enhanced ultrasound was more inclined to malignant tumors(3 cases),which showed uneven enhancement,mostly accompanied by peripheral uneven enhancement rings.Conclusion Xp11.2/TFE3-tRCC tends to be benign on conventional ultrasound,while contrast-enhanced ultrasound shows malignant lesions.Therefore,contrast enhanced ultrasound can serve as a potential diagnostic tool for suspected Xp11.2/TFE3-tRCC.

Prediction of the Potential Habitat of Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao in Gansu Province Based on the Maximum Entropy Model and Analysis on Its Ecological Characteristics / 中国中医药信息杂志

Objective To investigate the effects of climate change on the geographical distribution of Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao in Gansu Province,and predict its potential habitat;To provide a theoretical basis for resource conservation of cultivation of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao.Methods Based on the distribution data of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao from field surveys,the maximum entropy model and geographic information system were used to simulate its potential habitat in Gansu Province for the current(1970-2000)and future(2041-2060)periods,and the contribution of environmental factors and the results of the knife-cut test were integrated to assess the important factors governing the distribution of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao.Results The dominant environmental variables governing the geographical distribution of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao were precipitation in the wettest month,average temperature in the wettest season,and elevation.The potential suitable area of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao in Gansu Province under current climatic conditions was 65 902.66 km2,and the high suitable area was mainly concentrated in Dingxi District.In the future period,the suitable areas of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao under the scenarios of SSP126,SSP370 and SSP585 all showed a decreasing trend,especially the area of the high suitable areas decreased significantly.Conclusion Future climate change will lead to a significant reduction in the suitable habitat for A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao in Gansu Province.The suitable habitat will mainly move towards high-altitude mountainous areas,and the continuity of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao resources can be maintained by establishing ecological protection zones.

Population pharmacokinetics of mycophenolic acid in pediatric patients with primary IgA nephropathy / 中国药房

OBJECTIVE To develop a population pharmacokinetic （PPK） model for mycophenolate mofetil active metabolite mycophenolic acid （MPA） in children with primary IgA nephropathy， explore the factors affecting the pharmacokinetic parameters of MPA， and provide a basis for clinical individualized therapy. METHODS Retrospective collection was conducted on 636 concentrations and clinical data from 47 pediatric patients with primary IgA nephropathy. PPK analysis was carried out by using the nonlinear mixed-effects model； the covariates were tested with a stepwise method. Goodness-of-fit plots， Bootstrap and visual predictive check were employed to evaluate the final model. RESULTS The pharmacokinetics of MPA in children with IgA nephropathy in vivo conformed to the first-order absorption and elimination two-compartment model （objective function value of 3 276.31）. Covariate analysis suggested that body weight and albumin （ALB） levels were significant influencing factors on apparent clearance rate and apparent distribution volume. The typical values of PPK parameters of MPA in the final model were as follows： the central room had a distributed volume of 5.79 L， the clearance rate was 4.06 L/h， the volume of peripheral ventricular distribution was 430.93 L， the clearance rate between compartments was 15.40 L/h， the oral absorption rate constant was 1.29 h－1. After verification， most of the predicted corrected observed concentration points were within the 90% confidence interval of the predicted corrected simulated concentration， indicating that the MPA final model had good predictive performance. CONCLUSIONS The PPK model of MPA in children with primary IgA nephropathy is established in this study， identifying body weight and ALB levels are significant factors affecting MPA metabolism.

Mechanism of amino acid metabolism in nonalcoholic fatty liver disease / 临床肝胆病杂志

Nonalcoholic fatty liver disease （NAFLD） is one of the most prevalent chronic liver diseases in the world， affecting about one quarter of the global population， and it is estimated that NAFLD will become the main indication for liver transplantation by 2030. NAFLD can lead to significant abnormalities in the levels of a variety of amino acids including branched-chain amino acids， thereby promoting the development and progression of NAFLD. These results suggest that in addition to glucose and lipid metabolism， amino acid metabolism also plays an important role in the progression of NAFLD. In order to systematically understand the role and mechanism of amino acid metabolism in NAFLD， this article reviews the research advances in amino acid metabolism in NAFLD. This article aims to explore the role and mechanism of amino acid metabolism in the progression of NAFLD， so as to provide ideas and a theoretical basis for clinical prevention and treatment.

Comparison of intravitreal injection of Ranibizumab versus Conbercept in the treatment of retinopathy of prematurity / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the efficacy of intravitreal injection of ranibizumab(IVR)and intravitreal injection of conbercept(IVC)in children with retinopathy of prematurity(ROP).METHODS: Retrospective study. A total of 1 100 eyes with ROP treated with intravitreal anti-VEGF at our hospital from January 2015 to June 2023 were included. According to the different therapeutic drugs, the children were divided into two groups: IVR group and IVC group. According to the degree of ROP, the patients were divided into three groups: aggressive ROP(A-ROP), Zone Ⅰ type 1 ROP and Zone Ⅱ type 1 ROP. The reactivation and retreatment between the two groups were compared after propensity score matching(PSM)analysis, and they were followed-up for at least 3 mo after surgery.RESULTS: In Zone Ⅱ type 1 ROP, there was a statistically significant difference in the rates of reactivation and retreatment between the IVR and IVC groups(P&#x003C;0.05); however, in A-ROP and Zone I type 1 ROP, there were no statistically significant differences in the rates of reactivation and retreatment between the two groups(P&#x003E;0.05). The risk of reactivation and retreatment of Zone I type 1 ROP was higher than the Zone II type 1 ROP. Furthermore, the use of drugs and corrected gestational age of first treatment were influencing factors of lesion recurrence and retreatment.CONCLUSION: There is a significant difference in the initial cure effect between the two drugs in Zone II type 1 ROP, with the reactivation and retreatment rates of the IVC group being much lower than those of the IVR group.

Predictive value of D-dimer for futile recanalization after mechanical thrombectomy in patients with acute ischemic stroke / 中华全科医师杂志

Objective:To investigate the predictive value of preoperative D-dimer level for futile recanalization (FR) after mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS).Methods:It was a nested case-control study. A total of 116 patients with large vessel occlusion (LVO) stroke, who underwent successful recanalization (modified Thrombolysis in Cerebral Infarction, mTICI≥2b) after MT at the Stroke Unit of Beijing Hospital from August 2018 to January 2022,were consecutively enrolled, including 72 males (62.1%) with the age of (72.8±13.1) years. According to the 3-month modified Rankin Scale (mRS) score after MT, patients were divided into the meaningful recanalization group (mRS 0-2, n=41) and the futile recanalization group (mRS 3-6, n=75). The baseline clinical data of enrolled patients was collected. Logistic regression analysis was used to identify the independent risk factors for FR after MT in patients with AIS. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of D-dimer for FR. Results:Multivariate logistic regression analysis showed that high baseline systolic blood pressure (SBP) ( OR=1.038, 95% CI: 1.012-1.065, P=0.004), baseline National Institutes of Health Stroke Scale (NIHSS) score≥12 ( OR=10.157, 95% CI: 3.624-28.470, P<0.001) and high preoperative D-dimer level ( OR=4.536, 95% CI: 1.379-14.922, P=0.013) were independent predictors of FR after MT in AIS patients with LVO. ROC curve analysis indicated a good predictive value of preoperative D-dimer for the occurrence of FR ( AUC=0.733, 95% CI: 0.638-0.829, P<0.05), the optimal cut-off value of D-dimer was 2.65 μg/L(Lg), with the Youden index, sensitivity, specificity and accuracy of 0.435, 53.3%, 90.2% and 66.4%, respectively. Conclusion:High preoperative D-dimer level is an independent predictor of futile recanalization after MT in AIS patients with LVO, which shows good predictive ability for futile recanalization.

Application of Global Leadership Initiative on Malnutrition criteria in patients with liver cirrhosis / 中华医学杂志(英文版)

BACKGROUND@#The Global Leadership Initiative on Malnutrition (GLIM) criteria were published to build a global consensus on nutritional diagnosis. Reduced muscle mass is a phenotypic criterion with strong evidence to support its inclusion in the GLIM consensus criteria. However, there is no consensus regarding how to accurately measure and define reduced muscle mass in clinical settings. This study aimed to investigate the optimal reference values of skeletal muscle mass index for diagnosing sarcopenia and GLIM-defined malnutrition, as well as the prevalence of GLIM-defined malnutrition in hospitalized cirrhotic patients.@*METHODS@#This retrospective study was conducted on 1002 adult patients with liver cirrhosis between January 1, 2018, and February 28, 2022, at Beijing You-An Hospital, Capital Medical University. Adult patients with a clinical diagnosis of liver cirrhosis and who underwent an abdominal computed tomography (CT) examination during hospitalization were included in the study. These patients were randomly divided into a modeling group (cohort 1, 667 patients) and a validation group (cohort 2, 335 patients). In cohort 1, optimal cut-off values of skeletal muscle index at the third lumbar skeletal muscle index (L3-SMI) were determined using receiver operating characteristic analyses against in-hospital mortality in different gender groups. Next, patients in cohort 2 were screened for nutritional risk using the Nutritional Risk Screening 2002 (NRS-2002), and malnutrition was diagnosed by GLIM criteria. Additionally, the reference values of reduced muscle mass in GLIM criteria were derived from the L3-SMI values from cohort 1. Multivariate logistic regression analysis was used to analyze the association between GLIM-defined malnutrition and clinical outcomes.@*RESULTS@#The optimal cut-off values of L3-SMI were 39.50 cm 2 /m 2 for male patients and 33.06 cm 2 /m 2 for female patients. Based on the cut-off values, 31.63% (68/215) of the male patients and 23.3% (28/120) of the female patients had CT-determined sarcopenia in cohort 2. The prevalence of GLIM-defined malnutrition in cirrhotic patients was 34.3% (115/335) and GLIM-defined malnutrition was an independent risk factor for in-hospital mortality in patients with liver cirrhosis ( Wald = 6.347, P  = 0.012).@*CONCLUSIONS@#This study provided reference values for skeletal muscle mass index and the prevalence of GLIM-defined malnutrition in hospitalized patients with liver cirrhosis. These reference values will contribute to applying the GLIM criteria in cirrhotic patients.

Neutrophil-lymphocyte and platelet-lymphocyte ratios for assessing disease activity in patients with rheumatoid arthritis receiving tofacitinib treatment / 南方医科大学学报

OBJECTIVE@#To evaluate the value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for assessing disease activity in patients with rheumatoid arthritis (RA) treated with tofacitinib.@*METHODS@#This retrospective study was conducted among 98 RA patients in active stage treated with tofacitinib in Third Xiangya Hospital and 100 healthy control subjects from the Health Management Center of the hospital from 2019 to 2021. We collected blood samples from all the participants for measurement of erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and other blood parameters 1 month before and 6 months after tofacitinib treatment. We further evaluated PLR and NLR before and after tofacitinib treatment in the RA patients, and analyzed their correlations with RA disease activity.@*RESULTS@#PLR and NLR increased significantly in RA patients as compared with the healthy controls. In the RA patients, PLR and NLR were positively correlated with the levels of hs- CRP, ESR, IL- 6, Disease Activity Score of 28 joints-ESR (DAS28-ESR), anti-cyclic citrullinated peptide (CCP), and rheumatoid factor (RF) before and after tofacitinib treatment. Tofacitinib treatment for 6 months significantly decreased hs-CRP, ESR, IL-6, CCP, RF and DAS28-ESR levels in the RA patients.@*CONCLUSION@#NLR and PLR can be useful biomarkers for assessing disease activity in RA patients treated with tofacitinib.

Establishment of a nomogram prediction model for the etiological type of large vessel occlusive stroke based on clinical and imaging parameters / 国际脑血管病杂志

Objective:To develop a nomogram model based on clinical and imaging parameters to predict the etiological type of acute ischemic stroke (AIS).Methods:Patients with AIS received endovascular treatment in Beijing Hospital from March 2016 to December 2021 were retrospectively included. According to the etiological type, they were divided into large artery atherosclerosis (LAA) and cardioembolism (CE). The clinical and imaging parameters mostly relevant to the etiological type were selected by LASSO regression, and a nomogram model for predicting the etiological type of AIS was established by multifactorial logistic regression to investigate the predictive value of relevant clinical imaging parameters. In addition, the diagnostic efficacy of the prediction model was assessed by receiver operator characteristic (ROC) curves, calibration curves, and clinical decision curves. Results:A total of 136 AIS patients with anterior circulation large vessel occlusion received endovascular treatment were included, including 62 patients with CE (45.6%) and 74 with LAA (54.4%). Variables with P<0.10 in the univariate analysis were included in LASSO regression to screen for relevant variables. The gender, baseline National Institute of Health Stroke Scale (NIHSS) score, penumbra to ischemic core ratio, brain natriuretic peptide (BNP), and platelet (PLT) count were included into the multivariate logistic regression model. The results revealed that gender (odds ratio [ OR] 2.632, 95% confidence interval [ CI] 1.048-6.607; P=0.039), baseline NIHSS score ( OR 1.078, 95% CI 1.002-1.160; P=0.043), BNP ( OR 1.004, 95% CI 1.002-1.007. P<0.001), PLT ( OR 0.991, 95% CI 0.982-0.999; P=0.031) as the predictors to distinguish LAA from CE. In addition, the penumbra to infarct core ratio ( OR 0.886, 95% CI 0.785-1.000; P=0.050) also played an important role in predicting the model. The diagnostic efficacy of this predictive model was analyzed by the ROC curves, with an area under the curve of 0.881 (95% CI 0.815-0.930, P<0.001). Bootstrap internal validation showed that the good compliance with a mean absolute error of 0.027 for true versus predicted value compliance. Calibration curves, clinical decision curves, and Hosmer-Lemeshow test ( P=0.562) showed good agreement between the predicted and actual values of the model. Conclusion:Patients with CE are more common in women, have higher NIHSS scores and BNP, and have lower PLT and penumbra to ischemic core ratio. The nomogram model combining the above indicators can better identify LAA and CE, and maybe helpful in clinical decision making.

Potential profile analysis of self-efficacy in the management of stress injury in operating room nurses / 中国实用护理杂志

Objective:To understand the potential categories of self-efficacy in stress injury management of nurses in operating room and analyze the characteristics of different categories of nurses.Methods:A cross-sectional survey was conducted from June to August 2022. A total of 469 operating room nurses from 12 Grade A hospitals in Guangxi, Sichuan, Guizhou, Yunnan, Shanxi, Xinjiang and Chongqing were selected by convenient sampling method as subjects. General data questionnaire, proactive personality Inventory, Caring behavior Inventory, transformational leadership inventory, nursing clinical Decision scale and nurses stress injury management self-efficacy scale were used to investigate. Potential profile was used to analyze nurses' self-efficacy in stress injury management, and multiple Logistic regression was used to analyze different potential factors.Results:The self-efficacy of nurses in the management of stress injury in operating room could be divided into three potential profiles: poor self-efficacy group (23.9%, 112/469), medium self-efficacy group (33.0%, 155/469) and good self-efficacy group (43.1%, 202/469). Proactive personality, caring behavior, transformational leadership, nursing clinical decision-making and educational background were the factors influencing self-efficacy of operating room nurses in stress injury management (all P<0.05). Conclusions:There are three potential profiles of self-efficacy in the management of stress injury in operating room nurses. Nursing managers can give targeted intervention strategies according to different characteristics of nurses to improve their self-efficacy.

Application of Forward Projected Model-Based Iterative Reconstruction Solution in Improving Image Quality of Head and Neck CT Angiography / 中国医学影像学杂志

Purpose To explore the application value of forward projected model-based iterative reconstruction solution(FIRST)algorithm improving image quality of 100 kV low-dose head and neck CT angiography(CTA).Materials and Methods A total of 32 patients who underwent head and neck CTA examinations in the Beijing Hospital from September to October 2021 were retrospectively recruited.All patients were divided into three groups based on different reconstruction,including the filtered back projection(FBP)group,the adaptive iterative dose reduction 3D(AIDR 3D)group,and the FIRST group.The average CT value,image noise,signal-to-noise ratio,contrast to noise ratio and other objective indicators of the main blood vessels images(including common carotid artery,vertebral artery,internal carotid artery C1,C4,middle cerebral artery M1,M3 and anterior cerebral artery A1,A3)and background(including muscle,brain tissue)in the head and neck of the three groups were recorded and analyzed,respectively.The subjective imaging evaluation was scored and analyzed.Digital subtraction angiography(DSA)was used as the gold standard to evaluate the detection of vascular stenosis in the head and neck by each reconstruction algorithm.Results Compared with the AIDR 3D group and the FBP group,the FIRST group significantly reduced the image noise of the blood vessels and the background(muscle,brain tissue)(t=-13.19--7.28,all P<0.001).The signal-to-noise ratio and contrast to noise ratio of the FIRST group were significantly higher than those of the FBP group,AIDR 3D group(t=2.17-9.67,all P<0.001).The CT values of FIRST group were significantly higher than those of AIDR 3D group in the common carotid artery,internal carotid artery C1 and C4,middle cerebral artery M1,and anterior cerebral artery A1 segment(t=1.28-3.60,all P<0.05).The CT value of background(muscle,brain tissue)in FIRST group was significantly lower than those in the FBP group and the AIDR 3D group,with statistically significant difference(t=-7.63--4.03,all P<0.001).The images of FIRST group and AIDR 3D group met the diagnostic requirements,and the subjective scores of the two groups were significantly higher than those of the FBP group images(all P<0.05).The imaging scores of FIRST group were significantly higher than those of AIDR 3D group(P<0.05).Compared with DSA,FBP was ineffective for mild and moderate stenosis;FIRST and AIDR 3D algorithms were consistent with DSA.Conclusion Compared with traditional FBP and AIDR 3D reconstruction algorithms,FIRST algorithm can effectively improve the image quality of low-dose head and neck CTA and obtain better image quality and meet the diagnostic performance of head and neck vascular diseases.

Exploring Technology Frontiers for Neuroblastoma Treatment from Perspective of Patent Citation Network / 肿瘤防治研究

Objective To explore the technology frontiers for neuroblastoma treatment from the perspective of patent citation network. Methods Through patent analysis for neuroblastoma treatment, highly cited patents and highly cited papers in the citation network were taken as the research objects. The title and abstract of the citing patents were analyzed by text clustering to identify the technology frontiers. Through social network analysis, the core patents were identified from the indices of degree centrality, betweenness centrality, closeness centrality, and eigenvector centrality. Results A total of 6240 patent applications for neuroblastoma treatment were found, including 71304 patent citations and 88698 journal-article citations. Four technology frontiers were identified based on patent citation network, namely, drug target, drug design, tumor-indication expansion, and gene-expression regulation. Three technology frontiers were identified based on journal-article citation network. They were drug target, drug design, and tumor-indication expansion. Conclusion The development of technology for neuroblastoma treatment continues to be active. Drug target and drug design are the most important technology frontiers. This study could provide certain reference for neuroblastoma treatment from the perspective of information science.