With the reform of the national medical and health system entering a new stage of high-quality development of public hospitals,the large-scale implementation of day surgery in hospitals is imminent in the face of increasing patient demand.In this paper,the medical administration management and medical insurance policies related to day surgery in China and their im-pacts were sorted out,and the example of large-scale implementation of day surgery by a specialized ophthalmic medical institu-tion through pre-hospitalization mode was used to illustrate how to use management tools to break through the bottleneck in the promotion process of day surgery,and the positive effect of large-scale development of day surgery on both doctors and patients was expounded.

AIM:To analyze the expression profiles of long non-coding RNAs(lncRNAs)in the aortas of ath-erosclerotic mice,and explore the role and mechanism of lncRNA AI662270 in regulating macrophage inflammation and lipid phagocytosis.METHODS:Twenty 8-week-old male apolipoprotein E gene knockout(ApoE-/-)mice were randomly divided into experimental and control groups,with 10 mice in each group.The experimental group was fed a high-fat diet for 12 weeks to induce atherosclerosis,while the control group received a normal diet.Body weight and blood lipid levels were measured,and atherosclerotic lesions were detected using Oil Red O staining.High-throughput RNA sequencing(RNA-seq)was used to analyze the lncRNA expression profiles in mouse aortas,and differentially expressed lncRNAs were validated by RT-qPCR.Antisense oligonucleotides(ASO)were used to knock down the expression of lncRNA AI662270 in mouse macrophage RAW264.7 cells.Six treatment groups were established:blank(no treatment)group,ox-idized low-density lipoprotein(oxLDL)group(80 mg/L oxLDL),negative control ASO(ASO-NC)group(transfected with ASO-NC),oxLDL+ASO-NC group(transfected with ASO-NC and treated with 80 mg/L oxLDL),ASO-AI662270 group(transfected with ASO-AI662270),and oxLDL+ASO-AI662270 group(transfected with ASO-AI662270 and treated with 80 mg/L oxLDL).Tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels were measured using Enzyme-linked immunosorbent assay(ELISA).NF-κB p65,pNF-κB p65,IκBα and pIκBα levels were detected by Western blot,and NF-κB p65 in the cell nucleus was examined using fluorescent probes.RESULTS:The atherosclerosis mouse model showed significant differences in body weight,serum lipids,and aortic plaque area compared to the control group(P<0.01).A total of 29 differentially expressed lncRNAs were identified involved in metabolic pathways,autophagosome for-mation,and cell adhesion molecule expression(P<0.05).LncRNA AI662270 was significantly upregulated in lesions and oxLDL-stimulated macrophages(P<0.05).Knockdown of AI662270 significantly reduced TNF-α and IL-6 expression in oxLDL-induced RAW264.7 cells(P<0.01),suppressed lipid phagocytosis,and inhibited pNF-κB p65 and pIκBα ex-pression(P<0.05).Additionally,the knockdown of AI662270 reduced the nuclear content of NF-κB p65.CONCLU-SION:The lncRNA expression profiles in the aortas of atherosclerotic mice were significantly altered.LncRNA AI662270 is crucial in modulating inflammation and lipid phagocytosis in mouse macrophages through the NF-κB signaling pathway.

Bamboo leaf flavonoids(BLF)are compounds extracted from bamboo leaves,possessing properties including antioxidant,antimicrobial and anti-inflammatory properties.This study aimed to investigate the effects of BLF on liver damage,antioxidant function,and related gene expression in rats induced by diquat(DQ).Thirty-two 5-week-old male Sprague-Dawley(SD)rats were randomly divided into four experimental groups:the control group(Con),1 000 mg/kg BLF group(BLF),DQ stress group(DQ),and 1 000 mg/kg BLF+DQ stress group(BLF-DQ).The results showed that compared to the Con,the DQ group exhibited significantly decreased serum AST lev-els(P＜0.05),as well as decreased levels of T-AOC,GPX,SOD,and CAT in the liver(P＜0.05),and increased MDA levels in rats(P＜0.05).Additionally,the gene expression levels of HO-1,GPX,CAT,SOD1,and Nrf2 in the liver were significantly reduced(P＜0.05).In contrast,1 000 mg/kg BLF significantly decreased serum AST and ALT levels(P＜0.05),increased levels of T-AOC,GPX,CAT,and SOD in liver(P＜0.05),and significantly increased gene expression of HO-1,GPX,CAT,SOD1,Nrf2,and NQO1(P＜0.05).Compared to the DQ group,BLF-DQ significant-ly decreased liver index(P＜0.05),reduced serum AST and ALT levels(P＜0.05),increased lev-els of CAT,GPX,and T-AOC in liver(P＜0.05),decreased MDA levels(P＜0.05),and signifi-cantly upregulated gene expression levels of HO-1,GPX,CAT,SOD1,and Nrf2(P＜0.05).These findings indicated that BLF alleviate liver damage caused by DQ stress in rats,improve liver an-tioxidant function inhibition,activate the Nrf2 signaling pathway and PINK/Parkin mitophagy-re-lated gene expression.

Uridine is one of the essential nutrients in organisms. To maintain normal cell growth and intracellular metabolism, the uridine must be maintained at certain concentration. Recent studies have shown that uridine can reduce inflammatory response in organisms, participate in glycolysis, and regulate intracellular protein modification, such as glycosylation and acetylation. Furthermore, it can protect cells from hypoxic injury by reducing intracellular oxidative stress, promoting high-energy compounds synthesis. Previous studies have shown that the protective effects of uridine are closely related to its effect on mitochondria. This review summarizes the effect of uridine on mitochondrial function.
Uridine/metabolism* ; Mitochondria/metabolism*

Objective:To investigate the effect of the completion time of initial 30 mL/kg fluid resuscitation on the prognosis of patients with septic shock.Methods:An observational study was conducted. The inpatients with septic shock admitted to intensive care unit (ICU) of Northern Jiangsu People's Hospital, Affiliated Hospital of Yangzhou University and Jiangdu People's Hospital from October 1st, 2018 to September 30th, 2020 were enrolled. The general data including gender, age, body mass index (BMI), patient source, site of infection, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score and arterial blood lactic acid (Lac) at ICU admission, fluid resuscitation dose, completion time of initial 30 mL/kg fluid resuscitation, mechanical ventilation, incidence of acute kidney injury (AKI), continuous renal replacement therapy (CRRT), length of ICU stay and 28-day mortality. The relationship between the completion time of initial 30 mL/kg fluid resuscitation and ΔSOFA score (the difference between SOFA score 3 hours of fluid resuscitation and initial SOFA score) was analyzed. In addition, according to the completion time (T) of initial 30 mL/kg fluid resuscitation, the patients were divided into T ≤ 1 hour group, 1 hour < T≤2 hours group, 2 hours < T≤3 hours group and T > 3 hours group, and the observation parameters among the groups were compared.Results:① A total of 131 patients were enrolled, including 94 males and 37 females with an average age of (68.3±15.0) years old. The median APACHE Ⅱ score was 27 (21, 34), the median of initial SOFA score was 12 (10, 14), the median of initial Lac was 5.0 (3.4, 7.1) mmol/L, and the most common source of infection was lung, with a total of 87 patients (66.41%). The completion time of initial 30 mL/kg fluid resuscitation and ΔSOFA score fitted the Logistic curve ( Y = -1.062 6 X2+4.407 9 X+0.961 8), which suggested that the early or late completion time of initial fluid resuscitation had adverse effects on the prognosis of patients with septic shock.② There was no significant difference in infection site, initial APACHE Ⅱ score, initial Lac, and initial SOFA score among different completion time of initial 30 mL/kg fluid resuscitation groups. The respiratory support rate, the incidence of AKI and the ratio of CRRT in the T ≤1 hour group were significantly higher than those in the 1 hour < T≤2 hours group, 2 hours < T≤3 hours group and T > 3 hours group (respiratory support rate: 78.57% vs. 75.51%, 42.86%, 75.00%; incidence of AKI: 57.14% vs. 20.41%, 21.43%, 50.00%; ratio of CRRT: 35.71% vs. 0%, 7.14%, 16.67%), the differences among the groups were statistically significant (all P < 0.05). The 28-day mortality was the highest in the T ≤ 1 hour group (64.29%), and the lowest in the 1 hour < T ≤2 hours group (22.45%), 35.71% in the 2 hours < T ≤ 3 hours group, 33.33% in the T > 3 hours, and the difference among the groups was statistically significant ( P < 0.01). Conclusions:Completion of initial 30 mL/kg fluid resuscitation in 1-2 hours after septic shock may reduce the 28-day mortality and improve organ dysfunction, and initial fluid resuscitation prematurely or too late may increase 28-day mortality. But further research and verification are needed.

Septic shock is a serious stage of sepsis with a hospital mortality rate of more than 40%. The pathophysiology of septic shock is vasodilation and increased permeability. Fluid resuscitation, vasopressor drugs are usually used to maintain the perfusion pressure of the main organs. However, infectious patients usually have the irresponsive vessel to catecholamines and may lead to obvious side effects using high doses of norepinephrine or dopamine. Recent studies have shown that vasopressin (AVP) improves hemodynamics, increases tissue perfusion, and synergizes with norepinephrine in patients with septic shock, showing extent application prospects in the treatment of septic shock. The practice of AVP in septic shock is reviewed in this article in order to provide a reference for clinicians.

The clinical data of 372 patients with septic shock admitted in departments of critical care medicine of three Grade A tertiary hospitals from January 2013 to December 2015 were retrospectively reviewed,including 211 survival cases and 161 fatal cases.According to septic shock early goal-directed therapy implementation,117 patients received bundle therapy (bundle group),including 30 cases with bundle goal-fully achieved,and 87 cases with bundle goal-partly achieved;and 255 cases received conventional treatment (non-bundle group).Muhiple logistic regression analysis showed that the multiple organ dysfunction syndrome score,length of ICU stay and first time using of antibiotics were independent risk factors for prognosis of septic shock (P ＜ 0.05).There was no significant difference in case fatality rate between bundle group and non-bundle group (46.2％ vs.42.0％,P ＞ 0.05),while the fatality in bundle goal-fully achieved group(20.0％)was significantly lower than that of goal-partly achieved group (55.2％) and non-bundle group (42.0％) (P ＜ 0.05).Survival curve analysis showed that the medial survival time in bundle goal-fully achieved group was significantly higher than that in non-bundle group (19.4 vs.10.5 days,P ＜0.05) and that in control group plus goal-partly achieved group(19.4 vs.12.9 days,P ＜0.05).Multiple Logistic regression analysis showed that central venous oxygen saturation and antibiotics using within one hour were protective factors for prognosis of septic shock (P ＜ 0.05).The results indicate that antibiotic bundle treatment of all indicators up to standards could significantly reduce the mortality of septic patients and early antibiotics is important in bundle treatment.

Objective To discuss the feasibility and reproducibility of left ventricular volume and function of patients with left atrial remodeling and left ventricular remodeling by 3-dimensional echocardiography HeartModel (3D-HM).Methods Three-dimensional images of 156 subjects were collected under HMACQ imaging mode.They were assigned into three groups:① control group (group A,n =70);② group of left ventricular remodeling after,acute myocardial infarction (group B,n =17);③group of hypertension left atrial remodeling (group C,n =69).3D-HM method was used for quantifying left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV),left atrial end-systolic volume (LAESV) and left ventricular ejection fraction (LVEF),and the results were compared with conventional 3D-manual results.The reproducibility of the 3D-HM method within one group and among different groups was evaluated.Results There was a significant difference in all the parameters measured with the 3D-HM method in different groups(P ＜0.05).LVEDV,LVESV,and LAESV in group B were higher than those in group A and group C(P ＜0.05),and LVEF was lower than that in group A and group C(P ＜0.05),LAESV of group C was higher than that of group A(P ＜0.05).The difference in the measurements of LVEDV and LVESV between the two methods was greatest in group B compared with group C and group A(P ＜0.05).In group C,the measured value difference of LAESV between two methods was greater than that of group A (P =0.03).There was closer correlation among LVEDV,LVESV,LAESV and LVEF measured values of 3D-HM method as well as measured values of the 3D-manual method (r =0.94,0.97,0.91 and 0.90).The data post-processing time of 3D-HM was significantly shorter than that of 3D-manual (P ＜0.05).The inter-observer and intra-observer difference of measured values of 3D-HM method had no statistical significance (P ＞0.05).Conclusions 3D-HM is a fast and feasible technique with high reproducibility for quantifying the left ventricular volume and function in patients with left atrial remodeling and left ventricular remodeling.

Objective To investigate the effect of different pore sized hydroxyapatite for promoting bone vascularization in tissue engineering.Methods Male Wistar rats were randomly divided into three groups,named group A,B and C,which were im-planted hydroxyapatite bioceramics compositing 4 μg bone morphogenetic protein with different aperture of 200 -300,350 -450, 500-600 μm in the back subcutaneously.The size of each block was 5 mm×5 mm×1 mm in a weight about of 40.0 mg.After im-plantation,the animals were killed and the implants and the surrounding tissue were taken out at the first,second,third and forth week respectively.HE staining of histological analysis was used to detect the situation of local neovascularization.Results There was significant difference between second and third week in group A.Comparing the area of vascularization at different time points in group B and group C,there were significant difference in the comparison of intragroup (P <0.05 ).During the first week after surgery,there was only group C that had the area of vascularization.During the second and forth week after operation,the area of vascularization in group B and group C were significant higher than group A (P <0.05).The C group showed a great deal of new-born blood vessels and clear formation of bone trabeculae.Conclusion The hydroxyapatite bioceramics of 500-600 μm could better promote vascalarization of tissue engineering in bone.

Objective To evaluate blood flow structure and quantify the variation of the flow within left ventricle,assess the impact of chronic heart failure(CHF) by vector flow mapping(VFM).Methods Twenty-seven patients with chronic heart failure and thirty controls were involved.The flow vector images on the section plane of the flow within the left ventricle were acquired by VFM.Time-flow(T-F) curve and all other peak systolic and diastolic flow curve include normal velocity profile,parallel velocity profile,vector profile,flow profile were analyzed by DSA-RS1 program.Results Ventricular ejection peak S,rapid ventricular filling peak E and atrial systole peak A were relatively lower at basal and middle segments in CHF group than normal control group.Normal velocity profile,velocity profile,flow profile at peak S and E were lower at basal and middle segments in CHF group than normal control group.Conclusions VFM technology could provide quantitative and intuitive information to demonstrate the flow structure of the ventricle and evaluate the cardiac function in patients with CHF.