Large DOF microscopic fringe projection profilometry with a coaxial light-field structure.

Fringe projection profilometry (FPP) has been widely researched for three-dimensional (3D) microscopic measurement during recent decades. Nevertheless, some disadvantages arising from the limited depth of field and occlusion still exist and need to be further addressed. In this paper, light field imaging is introduced for microscopic fringe projection profilometry (MFPP) to obtain a larger depth of field. Meanwhile, this system is built with a coaxial structure to reduce occlusion, where the principle of triangulation is no longer applicable. In this situation, the depth information is estimated based on the epipolar plane image (EPI) of light field. In order to make a quantitative measurement, a metric calibration method which establishes the mapping between the slope of the line feature in EPI and the depth information is proposed for this system. Finally, a group of experiments demonstrate that the proposed LF-MFPP system can work well for depth estimation with a large DOF and reduced occlusion.

Extraction and spatiotemporal changes of open-pit mines during 1985-2020 using Google Earth Engine: A case study of Qingzhou City, Shandong Province, China.

The global use of mineral resources has increased exponentially for decades and will continue to grow for the foreseeable future, resulting in increasingly negative impacts on the surrounding environment. However, to date, there are a lack of historical and current spatial extent datasets with high accuracy for mining areas in many parts of the world, which has hindered a more comprehensive understanding of the environmental impacts of mining. Using the Google Earth Engine cloud platform and the Landsat normalized difference vegetation index (NDVI) datasets, the spatial extent data of open-pit mining areas for eight years (1985, 1990, 1995, 2000, 2005, 2010, 2015, and 2020) was extracted by the Otsu algorithm. The limestone mining areas in Qingzhou, Shandong Province, China, was selected as a case study. The annual maximum NDVI was first derived from the Landsat NDVI datasets, and then the Otsu algorithm was used to segment the annual maximum NDVI images to obtain the extent of the mining areas. Finally, the spatiotemporal characteristics of the mining areas in the study region were analyzed in reference to previous survey data. The results showed that the mining areas were primarily located in Shaozhuang Town, Wangfu Street and the northern part of Miaozi Town, and the proportion of mining areas within these three administrative areas has increased annually from 88% in 1985 to more than 98% in 2010. Moreover, the open-pit mining areas in ​​Qingzhou gradually expanded from a scattered, point-like distribution to a large, contiguous distribution. From 1985 to 2020, the open-pit mining area expanded to more than 10 times its original size at a rate of 0.5 km2/year. In 2015, this area reached its maximum size of 19.7 km2 and slightly decreased in 2020. Furthermore, the expansion of the mining areas in Qingzhou went through three stages: a slow growth period before 1995, a rapid expansion period from 1995 to 2005, and a shutdown and remediation period after 2005. A quantitative accuracy assessment was performed by calculating the Intersection over Union (IoU) of the extraction results and the visual interpretation results from Gaofen-2 images with 1-m spatial resolution. The IoU reached 72%. The results showed that it was feasible to threshold the Landsat annual maximum NDVI data by the Otsu algorithm to extract the annual spatial extent of the open-pit mining areas. Our method will be easily transferable to other regions worldwide, enabling the monitoring of mine environments.

Effect of terbutaline combined with budesonide in treatment of bronchial asthma and rehabilitation nursing.

Terbutaline aerosol and budesonide suspension are commonly used in the treatment of bronchial asthma, and budesonide suspension has local high efficiency and anti-inflammatory effects. In this paper, we selected 240 patients with bronchial asthma and randomly divided them into two groups. The experimental group was treated with atomization inhalation of terbutaline, after 5 minutes interval, nebulized inhalation of budesonide was performed. The control group was treated with atomized inhalation of mixed liquid as terbutaline and budesonide. After treatment, the cough scores of the two groups decreased, and the dyspnea score improved significantly compared with that before treatment (P<0.05).After treatment, the levels of IL-6, BNP and CRP were decreased in the two groups. There was a significant difference between the two groups after treatment (P<0.05). The incidence of adverse drug reactions was low. There were 2 cases of panic disorder and 8 cases of pharyngeal discomfort in the experimental group. The results show that the interval medication of terbutaline and budesonide in the treatment of bronchial asthma can achieve better clinical efficacy and can provide reference for clinical treatment. In addition, this method can effectively reduce the level of inflammatory factors in acute asthma patients, thereby reducing the damage of inflammatory factors to the body.

Gastric acid secretion and gastrin release during continuous vagal neuromonitoring in thyroid surgery.

PURPOSE: The vagus nerve (VN) has essential regulatory roles in the gastric acid secretion and gastrin release. Continuous intraoperative neuromonitoring (CIONM) via VN stimulation is a promising technique in thyroid surgery because it potentially avoids injury to the recurrent laryngeal nerve. However, no studies have investigated changes in gastric acid secretion and gastrin release during CIONM. METHOD: This prospective study of 58 thyroid surgery patients compared gastric acid and serum gastrin at five time points: (1) before skin incision, (2) after baseline calibration of CIONM probe, (3) +20 min from baseline, (4) before probe removal, and (5) after extubation. Patients were excluded if they had any history of using tobacco, acid suppression medications, or drugs that affect gastric motility. Patients were also excluded if they had any history of gastroesophageal reflux symptoms, gastroesophageal reflux disease, peptic ulcer disease, helicobacter pylori infection, or chronic kidney disease. RESULTS: Non significant differences in mean gastric pH values were observed at all time points, i.e., (1) before skin incision (2.2 ± 0.2; p = 0.50), (2) after baseline calibration of CIONM probe (2.0 ± 0.8; p = 0.62), (3) +20 min from baseline (2.5 ± 0.5; p = 0.24), (4) before probe removal (2.9 ± 0.9; p = 0.52), and (5) after extubation (2.6 ± 1.0; p = 0.60). Comparisons of pH monitoring parameters revealed no significant differences in age, gender, side of CIONM (left vs. right), sequence of CIONM, or duration of CIONM. Gastrin values were normal in sequential determinations and did not significantly differ at any time points. CONCLUSIONS: CIONM performed via VN stimulation during total thyroidectomy in healthy patients does not influence gastrin secretion and gastric pH.

Continuous Intraoperative Neuromonitoring (C-IONM) Technique with the Automatic Periodic Stimulating (APS) Accessory for Conventional and Endoscopic Thyroid Surgery.

One of the most important trends in intraoperative neural monitoring (IONM) in thyroid surgery is currently the real-time monitoring of the vagus nerve (VN) in order to prevent recurrent laryngeal nerve (RLN) iatrogenic damages. Notably, continuous intraoperative neuromonitoring (C-IONM) seems to be superior to intermitted intraoperative neural monitoring (I-IONM) because it enhances standardization by permanent vagus nerve (VN) stimulation, and it provides entire and constant RLN function monitoring as the surgeon dissects and removes the thyroid gland. It also has to be highlighted that the surgical maneuvers for the automatic periodic stimulating (APS) placement must be accurate and standardized in order to avoid a potential iatrogenic morbidity on the VN function. We recommend the experienced surgeon be very careful in each step, with cautious dissection. With this review article we provide a comprehensive analyses of C-IONM technique with the APS accessory for conventional and endoscopic thyroid surgery.

Image-guided thyroid nodule ablation: technical notes and critical appraisal.

Image-guided thyroid nodule ablation is a relatively new technique for the management of thyroid disease. Notably, if there has been the correct patient selection and if they are performed in high volume centers and via a standardized technique, image-guided thyroid nodule ablation seems to be safe and effective and it can be used to treat thyroid goiters. However, there is still paucity of level 1 evidences and recommendation comparing ablation to surgical or to other non-surgical treatment modalities. Herein, some technical notes for the thyroid nodule ablation to achieve the critical view of safety are presented. Moreover, an additional remark and appraisal from a surgical point of view is described.

Evidence-based Analysis on The Clinical Impact of Intraoperative Neuromonitoring in Thyroid Surgery: State of the Art and Future Perspectives.

Laryngeal nerve injuries are one the most critical complications during thyroid and parathyroid surgery. Iatrogenic damages to the recurrent laryngeal nerve (RLN) are relevant in terms of clinical implications, economic costs, and for malpractice litigation. In order to minimize potential neural damages, a standardized surgical technique is mandatory. Intraoperatory neuromonitoring (IONM) of the RLN is an important adjunct to the traditional approach and is a reliable tool for neural mapping and in dissection and prognostication of postoperative neural function 4. Because of this, most of the iatrogenic damages are not related to direct transection, but they are visually undetectable. Notwithstanding the increasing use of IONM at this stage, there is still the need for prospective, randomized, well-powered, and well-designed trials in order to further validate (via evidence-based data) the role of IONM in thyroid surgery. The aim of this review is to provide a critical analysis of the scientific evidences on the clinical impact of IONM in thyroid surgery showing the unsolved problems and the future challenges.

Assessment of a portable monitoring device WatchPAT 200 in the diagnosis of obstructive sleep apnea.

We assessed the accuracy of a wrist-worn device WatchPAT 200 for the diagnosis of obstructive sleep apnea (OSA) and sleep and wakefulness indicators compared to standard polysomnography (PSG) using American Academy of Sleep Medicine (AASM) criteria. Twenty-eight adults with suspected OSA underwent a standard in-hospital PSG while wearing a WatchPAT 200. PSG events were manually scored using AASM criteria; WatchPAT 200 data were collected and analyzed by an automatic algorithm. The accuracy of WatchPAT 200 algorithm in apnea hypopnea index (AHI) and sleep-wake detection was compared to standard PSG methodology. The study population consisted of 21 males and 7 females, mean age of 47.45 ± 13.46 years, and mean body mass index of 29.99 ± 5.74 kg/m(2). For AHI, the mean PSG score for events per hour was 23.00 ± 21.55 compared to a mean score of 25.99 ± 19.09 for WatchPAT (r = 0.92, P < 0.001). The agreement of the sleep-wake assessment based on 30-s bins between the PSG and the WatchPAT was 89 ± 6 %. WatchPAT 200 detected OSA based on AHI with comparable accuracy, and provided a reasonably accurate estimation of sleep and wakefulness in patients with OSA on an epoch-by-epoch basis.

Chlorogenic acid regulates the proliferation and migration of high-grade serous ovarian cancer cells through modulating the miR199a5p/DDR1 axis.

This study aimed to demonstrate that chlorogenic acid (CGA) has anticancer effects against ovarian cancer. The MTT assay was used to assess the optimum concentrations of CGA on the ovarian cancer cell lines OVCA433 and SKOV3, followed by the rate of apoptosis using Annexin V-FITC/PI. The mitochondrial membrane potential of ovarian tumour cells treated with CGA was evaluated using mitochondrial staining kits followed by Western blot analysis, immunofluorescence, and RT-PCR assays. The Trans-well migration assay conducted the percentage of cell migration, followed by wound healing and colony formation assays. CGA induces activation of mitochondria-mediated intrinsic apoptotic pathways in ovarian cancer cells. The discovery that miR-199a-5p is inversely correlated to DDR1, a receptor tyrosine kinase involved in collagen synthesis, was the major consequence of examining the various mechanisms involved in the development of ovarian cancer. After treatment with CGA, cells derived from ovarian cancer cells were deregulated partially via the miR199a5p/DDR1 axis, significantly affecting tumour suppression. DDR1 has been identified as a direct target of miR199a5p in these ovarian cancer cells. We found that CGA-induced loss of DDR1 caused the inactivation of NF-κB signalling downstream in the MMP, migration, and EMT pathways. The study results showed that CGA is a promising drug candidate for treating ovarian cancer, particularly because it exhibits anti-invasive and migrastatic properties.

Effects of Slope Aspect and Rainfall on Belowground Deep Fine Root Traits and Aboveground Tree Height.

The vertical root distribution and rooting depth are the main belowground plant functional traits used to indicate drought resistance in arid and semiarid regions. The effects of the slope aspect on the aboveground traits are visible but not the belowground deep root traits. We aimed to investigate the fine root traits of the locust tree (Robinia pseudoacacia L.) planted on southerly and northerly aspects, and the variations in the rooting depth in regions with different rainfall, as well as assessing how deep rooting, might affect the response to drought in a loess region. We selected three study sites with different rainfall amounts, with six sampling plots at each site (three each with southerly and northerly aspects). Soil core samples were collected down to the depth where no roots were present. The locust trees tended to develop deeper fine roots rather than greater heights. The tree height and diameter were greater for locust trees on northerly aspects, whereas trees on southerly aspects had significantly deeper rooting depths. Fine root traits (root length, root area, and root dry weight density) were higher in the southerly aspect for both Changwu and Ansai, but lower in Suide. The ratio of the root front depth tree height ranged from 1.04 to 3.17, which was higher on southerly than northerly aspects, and it increased as the rainfall decreased. Locust tree growth traits (belowground fine root and aboveground tree height) were positively correlated with the mean annual rainfall. The soil moisture content of the topsoil decreased as the rainfall decreased, but the pattern varied in the deep layer. Our results suggest that the variations in the belowground rooting depth under different slope aspects may be related to plant survival strategies. The vertical extension of the rooting depth and tree height may be key functional traits that determine plant growth in drought-prone regions.

Association of Increased Remnant Cholesterol and the Risk of Coronary Artery Disease: A Retrospective Study.

Background and Aims: Low-density lipoprotein cholesterol (LDL-C) is the primary target of lipid-lowering therapy in coronary artery disease (CAD). But some patients with the normal levels of LDL-C still suffer from CAD progression and malignant outcomes (e.g., major adverse cardiovascular events [MACEs]), and the mechanism is unclear. The previous prospective studies demonstrated that the remnant cholesterol (RC) and non-high-density lipoprotein cholesterol (non-HDL-C) were capable to predict the risk of CAD. This study evaluated the association between RC and non-HDL-C with the risk of CAD. Methods: In our study, 12,563 patients were enrolled. We categorized patients into four concordance/discordance groups according to the median of RC, LDL-C, and non-HDL-C. Then, we performed a propensity score matching (PSM) strategy. The unadjusted and adjusted multivariate logistic regression models were used to evaluate the relationship between the lipid concentrations. Results: In this study, 8,658 (68.9%) patients were male with a median age of 61 (54 and 67) years. The multivariate logistic regression showed the odds ratio (OR) of RC was 1.952 (CI = 1.276-2.988, p = 0.002). The OR of the low RC/high LDL-C group was 0.626 (CI = 0.504-0.778, p < 0.001) and the OR of the low RC/high non-HDL-C group was 0.574 (CI = 0.462-0.714, p < 0.001). The p-values for interaction between the RC and hypertension, diabetes were both < 0.001. Conclusion: Our study showed a significant association between the RC and CAD. The level of RC was more capable to reflect the risk of CAD than LDL-C and non-HDL-C. There was an interaction relationship between RC and age, gender, hypertension, diabetes, in CAD. But we did not find whether there was a relationship between the non-HDL-C and CAD.

Detection of genomic structure variants associated with wrinkled skin in Xiang pig by next generation sequencing.

Wrinkling is prominent manifestation of aging skin. A mutant phenotype characterized by systemic wrinkles and thickened skin was discovered in Xiang pig populations with incidence about 1-3%. The feature in histological structure was epidermal hyperplasia and thickening, collagen fibers disorder. To uncover genetic mechanisms for the mutant phenotype of Xiang pigs with systemic wrinkle (WXP), a genome-wide of structural variations (SVs) in WXP was described by next generation resequencing, taking Xiang pigs (XP) and European pigs (EUP) as compares. Total of 32,308 SVs were detected from three pig groups and 965 SVs were identified specifically from WXP, involving 481 protein-coding genes. These genes were mainly enriched in nuclear structure, ECM components and immunomodulatory pathways. According to gene function and enrichment analysis, we found that 65 candidate SVs in 59 protein genes were probably related with the systemic wrinkle of WXP. Of these, several genes are reported to be associate with aging, such as EIF4G2, NOLC1, XYLT1, FUT8, MDM2 and so on. The insertion/deletion and duplication variations of SVs in these genes resulted in the loss of stop-codon or frameshift mutation, and aberrant alternative splicing of transcripts. These genes are involved in cell lamin filament, intermediate filament cytoskeleton, supramolecular complex, cell differentiation and regulation of macromolecule metabolic process etc. Our study suggested that the loss of function or aberrant expression of these genes lead to structural disorder of nuclear and the extracellular matrix (ECM) in skin cells, which probably was the genetic mechanisms for the mutant phenotype of systemic skin wrinkle of Xiang pig.

Association of an intronic variant of the heme oxygenase-1 gene with hypertension in northern Chinese Han population.

Heme oxygenase was regarded as a regulator of oxidative stress, which was believed to underlie the etiology of hypertension. To assess the effect of its encoded genes (HMOX1 and HMOX2) on hypertension, we designed a case-control study in 503 cases and 490 controls. The results indicated that the rs9607267 of the HMOX1 gene was significantly associated with essential hypertension (EH) and the Hap3(T-C-G) of the HMOX1 gene was also significantly associated with the risk of EH. No association was observed between the HMOX2 gene and EH. The multifactor-dimensionality reduction analyses results did not show any interaction between the HMOX1 and HMOX2 genes underlying the development of hypertension.

Effect of montelukast combined with budesonide in the treatment of children with intermittent asthma / 中国医师进修杂志

Objective:To analyze the effect of montelukast combined with budesonide in the treatment of children with intermittent asthma, and the impact on airway remodeling and T helper type 1 (Th1)/T helper type 2 (Th1/Th2) related cytokines.Methods:A prospective study was conducted among 120 children with intermittent asthma admitted to Huanghua Municipal People′s Hospital from December 2021 to February 2023. The children were randomly divided into the control group (60 children treated with budesonide atomizationinhalation) and the observation group (60 children treated with montelukast on the basis of the treatment of control group). Clinical efficacy, airway remodeling indicators [total area of airway (Ao), outer diameter of airway (D) and wall area to total airway cross-sectional area (WA%)], pulmonary function [peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV 1)/forced vital capacity (FVC) and the maximum expiratory flow at 25% of vital capacity (MEF25%)], Th1/Th2 related cytokines, inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), interleukin-6 (IL-6) and interferon-gamma (IFN-γ)], recurrence, and the incidence of adverse reactions were compared between the two groups. Results:The total effective rate in the observation group was higher than that in the control group: 90.00% (54/60) vs. 75.00% (45/60) ( P<0.05). After treatment, Ao, D and WA% in the observation group were lower than those in the control group: (17.58 ± 1.89) mm 2 vs. (19.22 ± 1.94) mm 2, (4.25 ± 0.48) mm vs. (4.48 ± 0.49) mm, (63.75 ± 6.49)% vs. (69.22 ± 7.14)% ( P<0.05). PEF, FEV 1/FVC and MEF25% in the observation group were higher than those in the control group: (3.13 ± 0.34) L/s vs. (2.86 ± 0.35) L/s, (87.45 ± 8.86) % vs. (83.59 ± 8.42) %, (87.63 ± 8.86)% vs. (82.15 ± 8.43)% ( P<0.05). The levels of Th1 and Th1/Th2 in the observation group were higher than those in the control group: (14.13 ± 1.46) % vs. (10.27 ± 1.25) %, 3.46 ± 0.39 vs. 1.88 ± 0.25, and the level of Th2 was lower than that in the control group: (3.96 ± 0.45)% vs. (5.48 ± 0.56)% ( P<0.05). After treatment, the levels of TNF-α and IFN-γ in the observation group were higher than those in the control group: (76.15 ± 7.78) ng/L vs. (66.38 ± 6.47) ng/L, (7.15 ± 0.74) ng/L vs. (6.14 ± 0.66) ng/L. The levels of IL-4 and IL-6 were lower than those in the control group: (77.85 ± 7.96) ng/L vs. (86.42 ± 8.74) ng/L, (37.25 ± 3.89) mg/L vs. (44.23 ± 4.57) mg/L ( P<0.05). The recurrence rate in the observation group was lower than that in the control group: 3.33% (2/60) vs. 15.00% (9/60) ( P<0.05). The incidence rates of adverse reactions in the two groups were without statistically significant difference between the groups ( P>0.05). Conclusions:Montelukast combined with budesonide can reduce airway remodeling in children with intermittent asthma, improve their pulmonary function, Th1/Th2 related cytokines and inflammatory response indicators, and reduce recurrence rate, with good safety.

Dosimetric analysis of radiation pneumonitis induced by 125I seed implantation for the treatment of malignant lung tumors / 中华放射医学与防护杂志

Objective:To investigate the incidence of radiation pneumonitis (RP) induced by 125I seed implantation for the treatment of malignant lung tumors and analyze related dosimetric parameters. Methods:A retrospective analysis was conducted on 31 cases of malignant lung tumors treated with 125I seed implantation from January 2017 to December 2022 at Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center. These cases consisted of eight patients with squamous cell carcinoma, 10 patients with adenocarcinoma, and 13 patients with metastatic cancer in other sites. At 1-6 months after treatment, these patients received postoperative chest CT scans, with the efficacy evaluated based on the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1), including the objective response rate (ORR) and the disease control rate (DCR). The efficacy of RP was evaluated using the Radiation Therapy Oncology Group (RTOG) criteria. Postoperative dosimetric parameters, including D90 (minimum peripheral dose received by 90% of the target volume), V8 (percentage of lung volume receiving 8 Gy), V32 (percentage of lung volume receiving 32 Gy), and Dmean (mean radiation dose) of the affected lung, were statistically analyzed. The relationships of the RP occurrence with postoperative D90, V8, V32, and Dmean were analyzed by comparison with relevant external radiotherapy data, to identify the parameters that are correlated closely with RP occurrence. Results:All the patients underwent successful surgeries. The postoperative efficacy evaluation after six months showed complete response (CR) in 11 cases, partial response (PR) in 11 cases, stable disease (SD) in eight cases, and progressive disease (PD) in one case, with an overall response rate (ORR) of 71.0%, and a disease control rate (DCR) of 96.8%. Three patients suffered RP, with an incidence rate of 9.7%. Postoperative V8, V32, and Dmean could not serve as predictive indicators for RP. Follow-up observation revealed that three RP cases (3/5) exhibited postoperative D90 exceeding 170 Gy and no RP cases (0/26) showed postoperative D90 below 170 Gy. Conclusions:In the treatment of malignant lung tumors with 125I seed implantation, there is a certain correlation between RP and postoperative D90, while there is no correlation between it and V8, V32, and Dmean.

Effect of Guizhi Gegentang on Hemodynamics and Vascular Endothelial Function in Cervical Vertigo / 中国实验方剂学杂志

ObjectiveTo evaluate the therapeutic effect of Guizhi Gegentang on cervical vertigo and its impact on hemodynamics and vascular endothelial function. MethodA total of 144 patients with cervical vertigo treated from April 2019 to June 2022 were included in the study and randomly divided into a control group and an observation group， with 72 patients in each group. During the study， three patients dropped out from the observation group and two patients from the control group. The control group received conventional treatment （oral betahistine mesylate tablets）， while the observation group received conventional treatment combined with Guizhi Gegentang. The clinical efficacy， changes in the frequency and duration of dizziness attacks per month before and after treatment， changes in symptoms and functional evaluation scores of cervical vertigo assessed by the European Scale for Cervical Vertigo （ESCV）， changes in the average blood flow velocity of the left vertebral artery， right vertebral artery， and basilar artery， changes in indicators such as endothelin-1 （ET-1）， neuropeptide Y （NPY）， calcitonin gene-related peptide （CGRP）， changes in the Neck Disability Index （NDI） score， changes in the Functional Assessment of Cancer Therapy-General （FACT-G） score， and adverse reactions were observed and compared between the two groups. ResultThe total effective rate in the observation group was 95.65% （66/69）， significantly higher than 84.29% （59/70） in the control group （χ2=4.957， P<0.05）. Before treatment， there were no significant differences in the frequency and duration of dizziness attacks per month， ESCV scores， average blood flow velocity of the left vertebral artery， right vertebral artery， and basilar artery， levels of ET-1， NPY， CGRP， NDI score， and FACT-G score between the two groups. After treatment， compared with the baseline within each group， there were improvements in the frequency and duration of dizziness attacks per month， ESCV scores， average blood flow velocity of the left vertebral artery， right vertebral artery， and basilar artery， levels of ET-1， NPY， CGRP， NDI score， and FACT-G score in both groups （P<0.05， P<0.01）. Compared with the control group， the observation group showed better improvements in the frequency and duration of dizziness attacks per month， ESCV score， average blood flow velocity of the left vertebral artery， right vertebral artery， and basilar artery， levels of ET-1， NPY， CGRP， NDI score， and FACT-G score （P<0.05， P<0.01）. During the study period， one case of nausea occurred in the control group， and one case of dizziness occurred in the observation group. There was no statistically significant difference in the incidence of adverse reactions between the two groups. ConclusionGuizhi Gegentang can improve the therapeutic effect of cervical vertigo， effectively improve patients' hemodynamics and vascular endothelial function， and enhance their quality of life with few adverse reactions. It is worth applying in clinical practice.

Risk factors of implantable venous access port-related bloodstream infections in cancer patients:a Meta-analysis / 中国实用护理杂志

Objective:To systematically evaluate the risk factors of implantable venous access port-related bloodstream infections and provide basis for prevention of catheter-related bloodstream infection in tumor patients.Methods:The Cochrane Library, PubMed, EMBASE, Web of science, CNKI, Wanfang database, VIP database, CBM, Chinese and English Clinical trials Registry (ChiCTR) were searched to collect the literature on risk factors for implantable venous access port-related bloodstream infections in tumor patients from the establishment of the database to April 2022. Two evaluators independently screened and extracted the obtained literature according to the inclusion and exclusion criteria, and used the Newcastle-Ottawa Scale for quality evaluation. Meta-analysis was conducted by RevMan 5.3 software and Stata SE/MP(14.0 version).Results:A total of 13 studies were included, including 23 related risk factors. Among them, prolonged use of catheters, palliative treatment, hematological tumors, neutropenia, hospitalized patients, and chemotherapy were risk factors for implantable venous access port-related bloodstream infections in tumor patients, with statistically significant differences ( OR values ranging from 0.26 to 8.77, all P<0.05). Conclusions:The long time of catheter use, palliative treatment, hematological tumor, neutropenia and chemotherapy were the risk factors of implantable venous access port-related bloodstream infection in patients with tumor, Medical personnel should make a good assessment and strengthen health education to minimize the chances of infection and effectively reduce the incidence of infection related to the infusion port.

Clinical Characteristics of Chronic Myeloid Leukemia Patients with Deletion and Non-deletion of ASS Gene on Derivative Chromosome 9 / 肿瘤防治研究

Objective To investigate the clinical characteristics of patients with chronic myeloid leukemia (CML) in chronic phase with deletion and non-deletion of the argininosuccinate synthesis gene (ASS gene) on the derivative chromosome 9. Methods The clinical data of patients with CML initially treated with imatinib and BCR/ABL1/ASS1 3-color fusion probe to detect ASS gene deletion were analyzed. The patients were divided into deletion group (n=27) and non-deletion group (n=92). Clinical characteristics, treatment effects, and prognosis were analyzed. Results The average age of 119 patients was 37.22±12.72 years old. The sokal score differed between the deletion and non-deletion groups (χ2=4.304, P=0.038). No statistically significant difference in other general characteristics was found (P > 0.05). The 3-month CCyR rate, 6-month CCyR rate, and BCR-ABLIS≤ 1% rate in the deletion group were lower than those in the non-deletion group (P < 0.05). The median follow-up of 119 patients was 35.0 (3.0-60.0) months. The PFS in the deletion group was lower than that in the non-deletion group (χ2=4.293, P=0.038). Overall survival was not significantly different between the two groups (χ2=0.008, P=0.931). Conclusion The deletion of the ASS gene in patients with chronic CML is related to the poor efficacy of imatinib treatment, poor prognosis, and high risk of disease progression.

Path analysis of medical narrative competence and profession quality of life on professional identity of nurses / 中国实用护理杂志

Objective:To explore the path relationship among medical narrative competence and profession quality of life on professional identity of nurses, so as to provide reference for improving nurses ′professional identity. Methods:This study was across-sectional survey. From October 2022 to February 2023, totally 619 nurses in Shandong Provincial Hospital Affiliated to Shandong First Medical University were investigated using Self-designed Demographic Questionnaire, Medical Narrative Competence Scale, Professional Quality of Life Scale and Professional Identity Scale.Results:The score of nurses ′s medical narrative competence was (144.13 ± 22.09) points, compassion satisfaction was (34.82 ± 6.96) points, job burnout was (24.03 ± 5.48) points, secondary traumatic stress was (23.91 ± 5.89) points, and the scores of nurses ′ professional identity was (112.68 ± 19.05) points. Nurses ′ medical narrative competence was positively correlated with compassion satisfaction and professional identity ( r=0.585, 0.697, both P<0.01); nurses ′ medical narrative competence was negatively correlated with job burnout and secondary traumatic stress ( r=-0.516, -0.214, both P<0.01). Regression analysis showed that nurses ′ medical narrative ability, compassion satisfaction and job burnout were the influencing factors of nurses ′professional identity ( t=13.26, 10.52, -2.32, all P<0.05). Structural equation model indicated that medical narrative ability of nurses had an intermediary effect on professional identity through the dimension of compassion satisfaction, and the intermediary effect was 0.269, and the intermediary effect accounted for 36.88% of the total effect. Conclusions:Medical narrative ability of nurses can have positive emotional experience on nurses ′ psychology, and thus have an impact on professional identity. Nursing managers should pay attention to the level of nurses ′ medical satisfaction, and give full play to the intermediary effect of compassion satisfaction in nurses ′ medical narrative ability and professional identity.

Effect of continuous blood purification on immunity and endothelial cell function in patients with sepsis / 中华危重病急救医学

Objective:To explore the effect of continuous blood purification (CBP) on the immunity and endothelial cell function of patients with sepsis.Methods:A prospective study was conducted. The patients aged ≥18 years old and meeting the diagnostic criteria of sepsis admitted to the department of critical care medicine of Binzhou Medical University Hospital from March 2019 to October 2020 were selected as the research subjects, and the patients were divided into standard treatment group and CBP treatment group according to random number table method. Both groups were given standard treatment including initial fluid resuscitation, infection source control and antibiotics according to the 2016 international guidelines for the management of sepsis and septic shock. CBP treatment group was additionally given continuous veno-venous hemofiltration (CVVH) at a dose of 25-30 mL·kg -1·h -1 and blood flow rate of 150-200 mL/min for more than 20 hours a day for 3 days. The clinical data of patients including blood lactic acid (Lac), procalcitonin (PCT), lymphocyte count (LYM), acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, sequential organ failure assessment (SOFA) score were recorded before treatment and 1 day and 3 days after treatment. At the same time, the venous blood was collected, and the immune function related indexes [interleukins (IL-4, IL-7), programmed death receptor-1 (PD-1), programmed death ligand-1 (PD-L1), interferon-γ (IFN-γ)] and endothelial cell injury related markers [soluble thrombomodulin (sTM), angiopoietin-2 (Ang-2), von Willebrand factor (vWF), heparan sulfate (HS), syndecan-1 (SDC-1)] levels in serum were determined by enzyme-linked immunosorbent assay (ELISA). The length of intensive care unit (ICU) stay of patients in the two groups was recorded, and the outcomes of patients in the two groups were followed up for 28 days. Results:Finally, 20 patients were enrolled in the standard treatment group, and 19 patients were enrolled in the CBP treatment group. There were no significant differences in gender, age and infection site between the two groups. The length of ICU stay in the standard treatment group was (10±5) days, and 5 patients died and 15 patients survived after 28 days. The length of ICU stay in the CBP treatment group was (9±4) days, and 8 patients died and 11 patients survived after 28 days. There were no significant differences in the length of ICU stay and number of patients who died within 28 days between the two groups (both P > 0.05). There were no significant differences in the Lac, PCT, LYM, APACHEⅡ score, SOFA score and immune function and endothelial cell injury related indexes before treatment and 1 day after treatment between the two groups. After 3 days of treatment, the Lac, PCT, APACHEⅡ score and SOFA score of the CBP treatment group were significantly lower than those before treatment, and pro-inflammatory and anti-inflammatory cytokines such as IFN-γ and IL-4, apoptosis-related indicators such as PD-1 and IL-7, and endothelial injury related factors such as sTM, SDC-1 and HS were significantly improved compared with the pre-treatment, the improvement degree of the above indicators was more obvious than that of the standard treatment group, and LYM was significantly higher than that of the standard treatment group (×10 9/L: 1.3±0.3 vs. 0.9±0.4, P < 0.05), IL-4, IFN-γ, IFN-γ/IL-4 ratio, IL-7, PD-1, sTM, SDC-1, HS, and Ang-2 were significantly lower than those of the standard treatment group [IL-4 (ng/L): 2.8 (1.5, 3.2) vs. 3.3 (2.7, 5.2), IFN-γ (ng/L): 6.3 (5.4, 106.5) vs. 217.9 (71.4, 517.1), IFN-γ/IL-4 ratio: 3.7 (1.8, 70.3) vs. 59.1 (18.3, 124.9), IL-7 (ng/L): 4.6 (3.2, 5.1) vs. 6.3 (5.2, 8.0), PD-1 (μg/L): 0.04 (0.03, 0.06) vs. 0.08 (0.05, 0.12), sTM (μg/L): 4.9 (4.3, 7.4) vs. 8.7 (6.0, 10.8), SDC-1 (μg/L): 0.6 (0.3, 1.1) vs. 0.9 (0.8, 2.5), HS (ng/L): 434.8 (256.2, 805.0) vs. 887.9 (620.1, 957.3), Ang-2 (ng/L): 934.0 (673.3, 1 502.1) vs. 2 233.9 (1 472.5, 3 808.4)], the differences were statistically significant (all P < 0.05). Conclusion:CBP treatment can eliminate the patient's immunosuppressive state, reduce a variety of endothelial injury markers and the degradation of glycocalyx, but cannot decrease the 28-day death risk or shorten the length of ICU stay.