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OBJECTIVES: To investigate the mechanism of the effect of acupuncture and moxibustion on improving liver injury in cisplatin (DDP) induced liver injury model mice by observing the changes of inositol-requiring enzyme (IRE) -1 signaling pathway. METHODS: Forty KM mice were randomly divided into control, model, acupuncture and moxibustion groups, with 10 mice in each group. The liver injury model was replicated by intraperitoneal injection of DDP (10 mg/kg). In the acupuncture group and the moxibustion group, acupuncture and moxibustion were performed at "Dazhui"(GV14), and bilateral "Ganshu"(BL18), "Shenshu" (BL23), and "Zusanli"(ST36), respectively for 6 min, once per day for 7 d. The apoptosis of hepatocytes was detected by TUNEL staining. The expression of phosphorylation(p)-IRE-1α, glucose-regulated protein (Grp) 78 and cysteine aspartic protease (Caspase) -12 in liver tissue were detected by immunohistochemistry and Western blot, respectively. The expression levels of Grp78 and Caspase-12 mRNA in liver tissue were detected by quantitative real-time PCR. RESULTS: Compared with the control group, the apoptosis rate of hepatocytes was increased (P<0.05), the positive expression and protein expression of p-IRE-1α, Grp78, and Caspase-12 were increased (P<0.05), the expression levels of Grp78 and Caspase-12 mRNA were increased (P<0.05) in the model group. Compared with the model group, all these indicators showed opposite trends (P<0.05) in the acupuncture and moxibustion groups. CONCLUSIONS: Acupuncture and moxibustion can reduce liver injury due to DDP chemotherapy by modulating IRE-1 signaling pathway, inhibiting the excessive activation of endoplasmic reticulum stress, and reducing liver cell apoptosis.
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Acupuncture Therapy , Apoptosis , Cisplatin , Endoplasmic Reticulum Chaperone BiP , Liver , Moxibustion , Protein Serine-Threonine Kinases , Signal Transduction , Animals , Mice , Male , Humans , Liver/metabolism , Liver/injuries , Protein Serine-Threonine Kinases/metabolism , Protein Serine-Threonine Kinases/genetics , Endoribonucleases/metabolism , Endoribonucleases/genetics , Chemical and Drug Induced Liver Injury/therapy , Chemical and Drug Induced Liver Injury/metabolism , Chemical and Drug Induced Liver Injury/genetics , Acupuncture Points , Heat-Shock Proteins/metabolism , Heat-Shock Proteins/genetics , Caspase 12/metabolism , Caspase 12/genetics , Hepatocytes/metabolismABSTRACT
The diagnosis of leukemia is a serious matter that requires immediate and accurate attention. This research presents a revolutionary method for diagnosing leukemia using a Capsule Neural Network (CapsNet) with an optimized design. CapsNet is a cutting-edge neural network that effectively captures complex features and spatial relationships within images. To improve the CapsNet's performance, a Modified Version of Osprey Optimization Algorithm (MOA) has been utilized. Thesuggested approach has been tested on the ALL-IDB database, a widely recognized dataset for leukemia image classification. Comparative analysis with various machine learning techniques, including Combined combine MobilenetV2 and ResNet18 (MBV2/Res) network, Depth-wise convolution model, a hybrid model that combines a genetic algorithm with ResNet-50V2 (ResNet/GA), and SVM/JAYA demonstrated the superiority of our method in different terms. As a result, the proposed method is a robust and powerful tool for diagnosing leukemia from medical images.
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Algorithms , Leukemia , Neural Networks, Computer , Humans , Leukemia/diagnostic imaging , Machine Learning , Image Processing, Computer-Assisted/methods , Databases, FactualABSTRACT
AIM: This study aimed to evaluate examinees' perceptions of the performance of student standardized patients (SPs) and to explore student SPs' experiences. BACKGROUND: Objective structured clinical examination (OSCE) is a standard approach to the task of evaluating students' clinical competency that relies on SPs. However, professional SPs are characterized by high costs and insufficient availability. Training students to serve as SPs can help address this lack of OSCE resources. However, only preliminary evidence regarding this process and its feasibility has been reported. DESIGN: We used a concurrent mixed-method study design that included quantitative surveys and qualitative group interviews. METHODS: Our sample consisted of two-year Bachelor of Nursing program students and trained student SPs who were recruited in May 2021. We used a 5-item performance evaluation tool to assess the SPs' performance. The reliability of this evaluation tool was indicated by a Cronbach's α coefficient of.95. Descriptive statistics were used to assess the examinees' satisfaction with the student SPs' performance using SPSS 28.0 software. We used a semi-structured interview guide during a group interview; the interview was transcribed verbatim and analyzed via thematic analysis with the assistance of Microsoft Word software. RESULTS: Eighty-two nursing school students responded to the survey and 10 student SPs were included in a group interview. Nursing school students rated SPs' performance favorably. The mean score assigned to the SPs on the performance scale was 4.41 out of 5. The student SPs described the challenges and benefits that they experienced regarding their role. The challenges they described included 1) staying true to my role, 2) overcoming a physically overwhelming role and 3) facing the threat of insecurity. However, the corresponding benefits included 1) gaining rewards, 2) advancing nursing competency and 3) experiencing a sense of accomplishment. CONCLUSION: After undergoing training, the SPs performed well. They experienced a variety of challenges and obtained certain benefits. In health care education, recruiting students to serve as SPs is feasible.
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With the recent rapid changes in the medical environment and technology, traditional teaching methods are no longer sufficient to meet current professional needs. There is an increasing demand for emerging technologies in higher education, necessitating more interactive and personalized educational approaches. Hence, educators are exploring innovative teaching interventions, including digital simulations and gamified learning, to enhance motivation and engagement in learning. In this article, the concept and core elements of gamified learning are introduced and related methods applicable to nursing education such as digital simulations, virtual reality, tabletop games, and escape rooms are described. In addition, gamification teaching techniques that enhance student learning motivation as well as improve learning outcomes in theory and practice are discussed. Gamified learning enables nursing students to practice in rich and diverse interactive simulated environments. Using appropriate teaching strategies, the gamified approach to learning can strengthen critical thinking, problem-solving abilities, and communication confidence in students. Designing game mechanisms and methods that align with educational objectives and mastering the key principles of gamified teaching is an effective approach to diversifying and enhancing the effectiveness of learning activities in the classroom.
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Education, Nursing , Learning , Humans , Education, Nursing/methods , Video GamesABSTRACT
BACKGROUND: Whole plant senescence represents the final stage in the life cycle of annual plants, characterized by the decomposition of aging organs and transfer of nutrients to seeds, thereby ensuring the survival of next generation. However, the transcriptomic profile of vegetative organs during this death process remains to be fully elucidated, especially regarding the distinctions between natural programmed death and artificial sudden death induced by herbicide. RESULTS: Differential genes expression analysis using RNA-seq in leaves and roots of Arabidopsis thaliana revealed that natural senescence commenced in leaves at 45-52 days after planting, followed by roots initiated at 52-60 days. Additionally, both organs exhibited similarities with artificially induced senescence by glyphosate. Transcription factors Rap2.6L and WKRY75 appeared to serve as central mediators of regulatory changes during natural senescence, as indicated by co-expression networks. Furthermore, the upregulation of RRTF1, exclusively observed during natural death, suggested its role as a regulator of jasmonic acid and reactive oxygen species (ROS) responses, potentially triggering nitrogen recycling in leaves, such as the glutamate dehydrogenase (GDH) shunt. Root senescence was characterized by the activation of AMT2;1 and GLN1;3, facilitating ammonium availability for root-to-shoot translocation, likely under the regulation of PDF2.1. CONCLUSIONS: Our study offers valuable insights into the transcriptomic interplay between phytohormones and ROS during whole plant senescence. We observed distinct regulatory networks governing nitrogen utilization in leaf and root senescence processes. Furthermore, the efficient allocation of energy from vegetative organs to seeds emerges as a critical determinant of population sustainability of annual Arabidopsis.
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Arabidopsis , Gene Expression Profiling , Gene Expression Regulation, Plant , Herbicides , Plant Senescence , Arabidopsis/genetics , Arabidopsis/growth & development , Arabidopsis/drug effects , Arabidopsis/metabolism , Herbicides/pharmacology , Herbicides/toxicity , Gene Expression Regulation, Plant/drug effects , Plant Senescence/genetics , Plant Leaves/drug effects , Plant Leaves/genetics , Plant Leaves/metabolism , Plant Leaves/growth & development , Plant Roots/growth & development , Plant Roots/drug effects , Plant Roots/metabolism , Plant Roots/genetics , Transcriptome , Arabidopsis Proteins/genetics , Arabidopsis Proteins/metabolism , Reactive Oxygen Species/metabolism , Transcription Factors/genetics , Transcription Factors/metabolismABSTRACT
PURPOSE: To evaluate the diagnostic performance of contrast-enhanced (CE) ultrasound using Sonazoid (SNZ-CEUS) by comparing with contrast-enhanced computed tomography (CE-CT) and contrast-enhanced magnetic resonance imaging (CE-MRI) for differentiating benign and malignant renal masses. MATERIALS AND METHODS: 306 consecutive patients (from 7 centers) with renal masses (40 benign tumors, 266 malignant tumors) diagnosed by both SNZ-CEUS, CE-CT or CE-MRI were enrolled between September 2020 and February 2021. The examinations were performed within 7 days, but the sequence was not fixed. Histologic results were available for 301 of 306 (98.37%) lesions and 5 lesions were considered benign after at least 2 year follow-up without change in size and image characteristics. The diagnostic performances were evaluated by sensitivity, specificity, positive predictive value, negative predictive value, and compared by McNemar's test. RESULTS: In the head-to-head comparison, SNZ-CEUS and CE-MRI had comparable sensitivity (95.60 vs. 94.51%, P = 0.997), specificity (65.22 vs. 73.91%, P = 0.752), positive predictive value (91.58 vs. 93.48%) and negative predictive value (78.95 vs. 77.27%); SNZ-CEUS and CE-CT showed similar sensitivity (97.31 vs. 96.24%, P = 0.724); however, SNZ-CEUS had relatively lower than specificity than CE-CT (59.09 vs. 68.18%, P = 0.683). For nodules > 4 cm, CE-MRI demonstrated higher specificity than SNZ-CEUS (90.91 vs. 72.73%, P = 0.617) without compromise the sensitivity. CONCLUSIONS: SNZ-CEUS, CE-CT, and CE-MRI demonstrate desirable and comparable sensitivity for the differentiation of renal mass. However, the specificity of all three imaging modalities is not satisfactory. SNZ-CEUS may be a suitable alternative modality for patients with renal dysfunction and those allergic to gadolinium or iodine-based agents.
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Contrast Media , Ferric Compounds , Iron , Kidney Neoplasms , Magnetic Resonance Imaging , Oxides , Tomography, X-Ray Computed , Ultrasonography , Humans , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/pathology , Male , Female , Middle Aged , Prospective Studies , Ultrasonography/methods , Tomography, X-Ray Computed/methods , Magnetic Resonance Imaging/methods , Aged , Diagnosis, Differential , Adult , Aged, 80 and overABSTRACT
Understanding how animals swim efficiently and generate high thrust in complex fluid environments is of considerable interest to researchers in various fields, including biology, physics, and engineering. However, the influence of often-overlooked perturbations on swimming fish remains largely unexplored. Here, we investigate the propulsion generated by oscillating tailbeats with superimposed rhythmic perturbations of high frequency and low amplitude. We reveal, using a combination of experiments in a biomimetic fish-like robotic platform, computational fluid dynamics simulations, and theoretical analysis, that rhythmic perturbations can significantly increase both swimming efficiency and thrust production. The introduction of perturbations increases pressure-induced thrust, while reduced phase lag between body motion and the subsequent fluid dynamics response improves swimming efficiency. Moreover, our findings suggest that beneficial perturbations are sensitive to kinematic parameters, resolving previous conflicts regarding the effects of such perturbations. Our results highlight the potential benefits of introducing perturbations in propulsion generators, providing potential hypotheses for living systems and inspiring the design of artificial flapping-based propulsion systems.
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OBJECTIVES: Mastication can be influenced by intraoral perturbation (e.g., hard food). We developed the masticatory perturbation task (MPT) to assess the perturbation effect during mastication and quantify the degree of adaptation to masticatory perturbation in younger and older adults. DESIGN: Thirty-eight younger and 38 older participants completed the MPT, which consisted of three trials assessing masticatory performance (MP) without perturbation (i.e., the baseline condition) and three trials assessing MP with perturbation (i.e., the perturbation condition). Perturbation was implemented by concurrently chewing test food on the preferred side and a drinking straw on the nonpreferred side. We estimated the perturbation effect as the ΔMP between the baseline and perturbation conditions and the adaptation effect as the ΔMP between the third and the first trials for both age groups. RESULTS: We found a significant perturbation effect, i.e., a lower MP in the perturbation condition than in the baseline condition, and an adaptation effect, i.e., a higher MP in the third trial than the first trial, in both groups. Moreover, the older group showed a lower degree of adaptation than the younger group. CONCLUSION: The masticatory perturbation task revealed the perturbation effect during mastication and the adaptation to masticatory perturbation. The results revealed an association between age and masticatory adaptation.
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Food , Mastication , Humans , AgedABSTRACT
INTRODUCTION: Salidroside (SAL), extracted from Rhodiola rosea, has been widely used in coronary heart disease and myocardial ischemia for decades. Previous studies have demonstrated that SAL could reduce arteriosclerosis, and thus combat ischemic brain damage. However, the in-depth function of the salidroside in Cerebral Small Vascular Disease (CSVD) has not been discovered, and related molecular mechanism is still unclear. OBJECTIVES: The present study aims to explore the effects of salidroside in angiogenesis as well as repair of blood brain barrier (BBB) and its possible mechanisms. METHODS: We established a rat model of SHR via 2-vessel gradual occlusion (SHR-2VGO) to mimic the CSVD. Subsequently, the MRI, pathomorphism, as well as Morriss water maze test were conducted to determine CSVD-related indicators. 8 weeks post-surgery, animals were randomly administered SAL, DAPT, ATN161 or saline.The aim was to explore the protective effects of SAL in CSVD as well as its possible mechanism. RESULTS: Here we found that SAL could attenuate cerebral hypoperfusion-induced BBB disruption, promote the pro-angiogenesis through enhancing the cell budding. Further investigations demonstrated that SAL could significantly increase the expression of Notch1, Hes1, Hes5, and ITGB1. In addition, we confirmed that SAL could activate Notch signal path, and then up-regulate ITGB1 to promote pro-angiogenesis and thus protect BBB from disruption. CONCLUSION: The aforementioned findings demonstrated that SAL could protect BBB integrity through Notch-ITGB1 signaling path in CSVD, which indicated that SAL could be a potential medicine candidate for CSVD treatment.
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BACKGROUND: To evaluate the safety and efficacy of camrelizumab plus albumin paclitaxel and carboplatin in the neoadjuvant treatment of borderline resectable or unresectable locally advanced esophageal cancer. METHODS: A retrospective analysis was conducted on 27 patients with borderline resectable or unresectable locally advanced esophageal cancer who received neoadjuvant treatment with camrelizumab plus albumin paclitaxel and carboplatin at Shanxi Cancer Hospital from January 2020 to March 2022. Of these, 20 patients underwent thoracoscopic esophagectomy after neoadjuvant treatment. RESULTS: Overall, 88.9% (24/27) of patients completed neoadjuvant treatment. The objective response rate was 79.2% (19/24) according to the RECIST criteria. Of the 20 patients who underwent surgery, the R0 resection rate was 95%, and 35% (7/20) achieved pathological complete response (pCR). During neoadjuvant treatment, 30% (6/20) of patients experienced grade ≥3 treatment-related adverse events (TRAEs), and 20% (4/20) had grade ≥3 postoperative complications. There were no cases of reoperation or perioperative mortality. CONCLUSION: Camrelizumab plus albumin paclitaxel and carboplatin were found to be safe and effective in the neoadjuvant treatment of borderline resectable or unresectable locally advanced esophageal cancer. It was observed to improve the rate of curative resection without increasing perioperative complications.
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Antibodies, Monoclonal, Humanized , Esophageal Neoplasms , Esophageal Squamous Cell Carcinoma , Humans , Carboplatin/therapeutic use , Esophageal Squamous Cell Carcinoma/drug therapy , Esophageal Squamous Cell Carcinoma/surgery , Esophageal Neoplasms/drug therapy , Esophageal Neoplasms/surgery , Esophageal Neoplasms/pathology , Paclitaxel/pharmacology , Paclitaxel/therapeutic use , Retrospective Studies , Induction Chemotherapy , Neoadjuvant Therapy , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Albumins/therapeutic useABSTRACT
Currently, the health benefits of ruminant trans fatty acids (R-TFA) are still controversial. Our previous investigations indicated that R-TFA at higher dosages (1.3% and 4% E) caused disordered lipid metabolism in mice; however, through collecting R-TFA intake data in 9 provinces of China, it was suggested that, in 2021, the range of R-TFA intake for Chinese residents was about 0.053-0.307 g d-1. Based on the 2022 Nutritional Dietary Guidelines for Chinese Residents, the recommended daily energy supply from R-TFA was about 0.11%-0.15% E. However, the health effects of R-TFA at a lower dosage are still unknown; therefore, our current research aims to further explore the effects of R-TFA on health. Through in vivo experiments, it was shown that R-TFA (0.15% E) decreased body weight gain and serum cholesterol levels in C57BL/6J mice fed a high-fat diet, while it had no significant effect on mice fed a low-fat diet. Besides, hepatic histopathology analysis suggested that R-TFA (0.15% E) ameliorated the degree of hepatic steatosis and reduced intrahepatocyte lipid droplet accumulation in C57BL/6J mice fed a high-fat diet. Through lipidomics analysis, we further screened 8 potential lipid metabolites that participate in regulating the dysregulation of lipid metabolism. Finally, it was suggested that R-TFA (0.15% E) down-regulated the expression of genes related to inflammation and cholesterol synthesis while up-regulated the expression of genes related to cholesterol clearance, which might partially explain the salutary effect of R-TFA (0.15% E) in ameliorating the hepatic steatosis and improving disordered lipid metabolism in mice fed a high-fat diet. Our current research will provide a reference for the intake of R-TFA and, furthermore, give some insights into understanding the health effects of R-TFA.
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Fatty Liver , Lipid Metabolism Disorders , Trans Fatty Acids , Animals , Mice , Diet, High-Fat/adverse effects , Dietary Fats , Trans Fatty Acids/metabolism , Trans Fatty Acids/pharmacology , Lipid Metabolism , Mice, Inbred C57BL , Liver/metabolism , Fatty Liver/metabolism , Cholesterol , Lipid Metabolism Disorders/metabolism , Ruminants/metabolismABSTRACT
Objective To investigate the role of triggering receptor expressed on myeloid cells-1(TREM-1)in ath-erosclerosis induced by chronic intermittent hypoxia(CIH).Methods ApoE-/-mice were randomly divided into blank group,model group and experimental group.The mice in the model group and the experimental group were kept in a hypoxic environment and fed with a high-fat diet.After 4 weeks of high-fat feeding,mice in the experi-mental group were intraperitoneally injected with TREM-1 inhibitor LR12(5 mg/kg)for 8 weeks.After 12 weeks of feeding,the level of serum total cholesterol(TC),low density lipoprotein(LDL),triglyceride(TG),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and interleukin-10(IL-10)were detected.Histological analysis of aortic TREM-1 expression,plaque area and macrophage level were examined.Results Compared with blank group,the expression of TREM-1 in the aorta of the model group significantly increased(P<0.05).Com-pared with model group,the aortic plaque,the level of lipids in serum(TC,LDL,TG)and inflammatory factors(TNF-α,IL-1β,IL-10),aortic plaque,the expression of TREM-1 and infiltrating macrophages in aortic plaque of the experimental group were all significantly reduced(P<0.05).Conclusions TREM-1 is involved in the develop-ment of CIH-induced AS.Inhibition of TREM-1 can alleviate CIH-induced AS and its mechanism is related to the inhibition of macrophage activation.
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Objective To analyze the correlation between irritable bowel syndrome(IBS)as well as its subtypes and gallbladder stone.Methods Collected the clinical data of 556 patients who were treated in Department of Gastroenterology of the Sixth Medical Center of Chinese PLA General Hospital from January 2019 to March 2023.The patients were divided into IBS group(n=161)and non-IBS group(n=395).The subjects were investigated by questionnaire,physical examination and blood examination,and the data of gender,age,height,weight,blood pressure and blood biochemical indexes were obtained and compared between two groups.The relation between gallbladder stone and IBS were evaluated by logistic regression analysis.Results There were 90 cases of gallbladder stone in the total population,accounting for 16.2%,including 37 cases of gallbladder stone in IBS group(23.0%)and 53 cases in non-IBS group(13.4%).The prevalence rate of gallbladder stone in IBS group was significantly higher than that in non-IBS group(P<0.05).There were 6 cases of gallbladder muddy stones(3.7%)in IBS group and 3 cases(0.8%)in non-IBS group.And the prevalence rate of gallbladder muddy stones in IBS group was also significantly higher than that in non-IBS group(P<0.05).Logistic regression analysis showed that the age,BMI,total bile acids(TBA),total cholesterol(TC)and combined IBS were independently related to the occurrence of gallbladder stone(P<0.05).In the 161 IBS patients,there were 114 cases of diarrhea-predominant IBS(IBS-D group),including 26 cases(22.8%)of gallbladder stone in IBS-diarrhea(IBS-D,n=114)group and 47 cases of constipation-predominant IBS(IBS-C group),including 11 cases(23.4%)of gallbladder stone.And there were 53 cases(13.4%)of gallbladder stone in the non-IBS group(n=395).Further analysis showed that the prevalence rate of gallbladder stone in IBS-D group was significantly higher than that in non-IBS group(P<0.05).There was no significant difference in gallbladder stone prevalence rate between IBS-C group and non-IBS group(P>0.05).Conclusions There is a correlation between IBS and gallbladder stones.In addition,among the two subtypes of IBS,IBS-D patients may have an increased risk of gallbladder stone compared with non-IBS patients.
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BACKGROUND:Wnt signaling pathway is overexpressed in degenerative intervertebral discs,and inhibition of its expression can delay the process of intervertebral disc degeneration.Therefore,Wnt signaling pathway is closely related to intervertebral disc degeneration. OBJECTIVE:To summarize the relationship between Wnt signaling pathway and intervertebral disc,especially the specific role and influence of Wnt signaling pathway in intervertebral disc degeneration. METHODS:The first author took"intervertebral disc,Wnt,cell proliferation,cell senescence,cell apoptosis,extracellular matrix"as the English search terms.PubMed,Web of science and OVID LWWSpringerlink were searched for articles published from 2000 to January 2023,and articles related to Wnt signaling pathway and disc degeneration were consulted.Totally 54 articles were reviewed by reading,collating and preserving. RESULTS AND CONCLUSION:(1)During intervertebral disc formation in embryos,Wnt signaling pathway is overexpressed,which is involved in intervertebral disc formation and promotes posterior extension of notochord.(2)During intervertebral disc degeneration,Wnt signaling pathway can inhibit cell proliferation by stagnating cell cycle,increase the expression of age-related proteins and promote cell aging by participating in oxidative stress,and participate in cell apoptosis by regulation of long non-coding RNA.(3)Wnt signaling pathway can also decrease extracellular matrix related protein synthesis,promote extracellular matrix degradation and accelerate intervertebral disc degeneration.(4)Wnt signaling pathway can promote cell regeneration by activating as early intervertebral disc formation signal and participate in inducing stem cells to differentiate into intervertebral disc cells to repair damaged intervertebral disc.For example,Wnt signaling pathway can induce stem cells from cartilage endplate cells to migrate and transform to intervertebral disc.
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In 2023,the National Health Commission and the National Administration of Traditional Chinese Medicine jointly issued the"Plan for Improving Medical Experience and Enhancing Patient Satisfaction(2023-2025)".The document puts forward a series of key tasks to guide medical institutions to embrace a"patient-centered"approach,aiming at enhancing the comfort,intelligence,and digitization of medical services.To comprehensively enhance patients'medical experience and satis-faction,an outpatient department of oncology hospital in Tianjin has explored and implemented various strategies from a holistic health perspective,including the establishment of an outpatient service system,innovation in chronic disease diagnosis and treat-ment models,improvement of humanistic aspects,environmental enhancements,and development of a smart outpatient system.These efforts have further advanced the implementation of a scientific,continuous,efficient,high-quality,and comfortable medi-cal service model in outpatient settings,promoting the standardization,regulation,and quality of outpatient services.
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Objective To investigate the characteristics,clinical indicators and risk factors of levofloxacin-induced arrhythmias in large hospitalized populations.Methods Using the"Adverse Event Active Monitoring and Intelligent Assessment Alert System-Ⅱ"(ADE-ASAS-Ⅱ),the electronic medical record of inpatients using levofloxacin in 2019 was monitored to obtain relevant data for patients with arrhythmias.Patients without arrhythmia were selected by propensity score matching,and the risk factors of levofloxacin-induced arrhythmias were analyzed by univariate and multivariate conditional logistic regression.Results The incidence of levofloxacin-induced arrhythmias was 1.64%in 12 879 people who used levofloxacin.The incidence in people over 65 years was 3.22%.The main manifestations of levofloxacin-induced arrhythmias were extrasystole(0.84%),tachycardia(0.63%),QT interval prolongation(0.44%),and no severe arrhythmias such as torsades de pointes and ventricular fibrillation.Multivariate Logistic regression analysis showed that the course of administration(OR=1.030,95%CI 1.009 to 1.050,P=0.004)and intravenous administration(OR=2.392,95%CI 1.478 to 3.870,P<0.001)independent risk factors for levofloxacin-induced arrhythmias.Conclusion Arrhythmias caused by levofloxacin are common and have various types,among which the occurrence of QT interval prolongation is occasional.We should pay more attention to elderly patients who receive intravenous levofloxacin and try to avoid long courses of medication.
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Objective:To investigate the expression of KCTD8 gene in breast ductal carcinoma and its correlation with clinical factors and prognosis.Methods:Immunohistochemistry technology(IHC)were employed to detect protein expression levels of KCTD8 in 27 pairs of breast ductal carci-noma and its paired adjacent tissues.Analyzing the correlation between changes in KCTD8 expres-sion of protein and clinical factors using statistical techniques.RNA expression and methylation data of breast cancer(including intraductal cancer)were analysed from TCGA database.Result:The pro-tein expression of KCTD8 gene in 27 pairs of breast ductal carcinoma tissues showed a decreasing trend compared to adjacent tissues(P<0.05),and the decreased expression level of protein was cor-related with the tumor size of patients(P<0.05).The analysis results of the TCGA database indicate that the expression and hypemethylation of KCTD 8 gene in breast cancer(including intraductal can-cer)tissues affected the prognosis of patients.Conclusion:The reduced protein expression level of KCTD8 gene in breast ductal carcinoma may be involved in the development and affect the prog-nosis of patients.
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Objective:To investigate the clinical efficacy and safety of deep hyperthermia combined with sintilimab and nab-PC (albumin-bound paclitaxel + carboplatin) regimen in the treatment of advanced squamous non-small cell lung cancer (NSCLC) with driver gene negative and programmed death-1 receptor ligand 1 (PD-L1) expression positive.Methods:A prospective case-control study was performed. A total of 84 advanced squamous NSCLC patients with driver gene negative and PD-L1 expression positive in Hebei Seventh People's Hospital from January 2020 to December 2022 were collected, and all patients were divided into the observation group and the control group according to the random number table method, with 42 cases in each group. The control group was given the treatment of sintilimab combined with nab-PC regimen, and the observation group was given deep hyperthermia on the basis of the control group. After 4 consecutive cycles of treatment, the short-term efficacy of the two groups was compared. The levels of serum tumor markers [carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCCA), cytokeratin fragment 19 (CYFR21-1)], and the positive expression rates of immunohistochemistry markers [p40, p63, and cytokeratin 5/6 (CK5/6)] before and after treatment were compared between two groups. Functional Assessment of Cancer Therapy-Lung cancer module (FACT-L) scores, the adverse reactions and the long-term survival of the two groups were compared.Results:There were 26 males and 16 females in the observation group, and the age was (59±11) years; there were 22 males and 15 females in the control group, and the age was (58±11) years. The objective remission rate and the disease control rate were 71.43% (30/42), 90.48% (38/42), respectively in the observation group, and 50.00% (21/42), 80.95% (34/42), respectively in the control group; the objective remission rate in the observation group was higher than that in the control group, and the difference was statistically significant ( χ2 = 4.04, P = 0.044); and there was no statistically significant difference in the disease control rate of both groups ( χ2 = 1.56, P = 0.212). The levels of serum CEA, SCCA and CYFRA21-1, and the positive expression rates of p40, p63, and CK5/6 in the two groups after treatment were lower than those before treatment (all P < 0.05); and the scores of physiological status, functional status, additional concern in FACT-L scores and the total score of the scale after treatment were higher than those before treatment (all P < 0.05). There were no statistically significant differences in the incidence of adverse reactions including thrombocytopenia, neutropenia, leukopenia, anemia, fever of the two groups (all P > 0.05). The median progression-free survival (PFS) time was 6.5 months (95% CI: 3.82-12.75), 5.1 months (95% CI: 3.14-12.26),respectively in the observation group and the control group, and the difference in the median PFS time was statistically significantly of both groups ( χ2 = 4.21, P = 0.040). The median overall survival (OS) time was 12.9 months (95% CI: 6.25-15.46), 9.7 months (95% CI: 4.74-13.02), respectively in the observation group and the control group, and the difference in the median OS time was statistically significantly of both groups ( χ2 = 4.43, P = 0.035). Conclusions:Deep hyperthermia combined with sintilimab and nab-PC regimen in the treatment of advanced squamous NSCLC with driver gene negative and PD-L1 expression positive can effectively reduce the serum tumor markers levels and positive expression rate of immunohistochemical markers, improve the quality of life of patients, and increase the short-term and long-term efficacy.
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OBJECTIVE To provide a reference for drug treatment and pharmaceutical care in AIDS patients with tumor. METHODS For a case of AIDS complicated with pulmonary adenocarcinoma, interstitial lung disease occurred repeatedly in the course of targeted therapy, and bacterial and fungal infections could not be ruled out. Clinical pharmacists provided pharmaceutical care such as medication monitoring, drug reconciliation, and adverse reaction monitoring for the patient. RESULTS The patient’s use of Amivantamab is “highly likely related” to adverse reactions such as interstitial lung disease, and it is recommended by the clinical pharmacist that the targeted therapy drugs should be suspended, and hormone medication monitoring plans should be formulated. For the possible pathogens of AIDS opportunistic infection, it was recommended to stop ertapenem and foscarnet sodium, monitor voriconazole concentration in blood and follow up on the safety and antifungal course of voriconazole. According to the drug-drug interaction and the patient’s condition, the anti-AIDS drug was adjusted to bictegravir sodium, emtricitabine and tenofovir alafenamide. For the possibility of Pneumocystis carinii pneumonia, thrombosis and gastric mucosal injury, preventive drugs such as Compound sulfamethoxazole, nadroparin calcium and esomeprazole were recommended. Physicians followed the advice of the clinical pharmacists. The patient made a good outcome after drug treatment without any significant adverse reactions or drug-drug interactions, and was discharged smoothly. CONCLUSIONS AIDS patients with tumor have complex disease condition and use many therapeutic drugs. Clinical pharmacists should conduct drug treatment management as drug reconciliation and medication monitoring and provide individual pharmaceutical care for these patients to guarantee the safety of drug use.