Objective To observe and analyze the application of ultrasonography to clinical treatment and diagnosis of patients with hemodialysis before and after artificial arteriovenous fistula. Methods A total of 72 cases with uremia hemodialysis treated in our hospital received ultrasonography before and after artificial arteriovenous fistula. The suit-able blood vessels were selected, and the functions of artificial arteriovenous fistula were evaluated and analyzed. Re-sults The ultrasound indicated that the success rate of fistulization with low blood flow was 25.00%, and that with nor-mal blood flow was 55.56%, and that with high blood flow was 19.44%. The success rate of the normal group was evi-dently higher than that of the high or low blood-flow group. The blood flow and blood velocity of patients 1 week, 2 weeks and 4 weeks after operation increased steadily. Conclusion Applying ultrasonography to diagnose and monitor the patients with hemodialysis of artificial arteriovenous fistula can improve the diagnostic level and treatment level for the disease, which can be promoted and applied in clinical practice.

Background Non-small cell lung cancer (NSCLC) is one of the most common malignant tumors.Despite the advances in therapy over the years,its mortality remains high.The aim of this study was to evaluate the expression of small ubiquitin-like modifier (SUMO) proteases 1 (SENP1) in NSCLC tissues and its role in the regulation of vascular endothelial growth factor (VEGF) expression.We also investigated the association between the expression level of SENP1 and the clinicopathological features and survival of the patients.Methods A SENP1 small interfering RNA (siRNA) was constructed and transfected into the NSCLC cells.VEGF gene expression was analyzed by real-time polymerase chain reaction (RT-PCR).Immunohistochemistry staining was used to assess the expression of SENP1 in 100 NSCLC patients and its association with the clinicopathological features and survival was analyzed.Results VEGF expression was significantly higher in NSCLC tissues than in normal lung tissues.Inhibition of SENP1 by siRNA was associated with decreased VEGF expression.SENP1 was over-expressed in 55 of the 100 NSCLC samples (55％) and was associated with a moderate and low histological tumor grade (3.6％,38.2％,and 58.2％ in high,moderate and low differentiated tumors,respectively,P=0.046),higher T stage (10.9％ in T1,and 89.1％ in T2 and T3 tumor samples,P ＜0.001)and TNM stage (10.9％ in stage Ⅰ,and 89.1％ in stages Ⅱ and Ⅲ tumor samples,P ＜0.001).The rate of lymph node metastasis was significantly higher in the SENP1 over-expression group (76.4％) than that in the SENP1 low expression group (33.3％,P ＜0.001).Sixty three patients received postoperative chemotherapy,including 34 with SENP1 over-expression and 29 with SENP1 low expression.Among the 34 patients with SENP1 over-expression,22 (64.7％) patients developed recurrence or metastasis,significantly higher than those in the low expression group 27.6％ (8/29) (P=0.005).Multivariate Cox regression analysis showed that lymph node metastasis (P=0.015),TNM stage (P=-0.001),and SENP1 expression level (P=0.002) were independent prognostic factors for the survival of NSCLC patients.Conclusions SENP1 may be a promising predictor of survival,a predictive factor of chemo-sensitivity for NSCLC patients,and potentially a desirable drug target for lung carcinoma target therapy.

A case of syphilis-related membranous proliferative glomerulonephritis is reported, presenting with fever, rash, generalized lymphadenopathy, and peripheral hypocytosis as the initial symptoms. The patient was admitted to the hospital and underwent various examinations to rule out lymphoma and other diseases. Subsequently, the patient developed edema with proteinuria. The toluidine red unheated serum test (TRUST) was 1∶4 (+) and the treponema pallidum particle agglutination (TPPA) test was >1∶160 (+). The pathological results of renal biopsy revealed membranous proliferative glomerulonephritis. The diagnosis of the patient was considered syphilitic nephropathy. Treatment with penicillin resulted in improvement of the condition. The coexistence of syphilitic nephropathy and membranous proliferative glomerulonephritis is rare and should be given careful attention in clinical practice. Antisyphilitic treatment improves the prognosis.

Based on the Pharmaceutical Comprehensive Knowledge and Skills Outline in the year of 2003, 2007, 2011 and 2015,the changes and the trend in the chapters and contents of Pharmaceutical Comprehensive Knowledge and Skills were analyzed and discussed,the meaning of versions was elaborated,and the shortcomings were discussed as well. The catalog of the chapters and contents conformed to the economic and social development in China,which is moving toward the direction of clinical pharmacy service.

Objective To explore the blood lead level and its relationship with behavior in school?age children from rural areas of Chongqing. Methods A total of 697 students from grades 3 to 6 in the fall semester of 2014 from 14 rural townships in one district of Chongqing was selected by using the random cluster sampling method. Blood were sampled to analyze the lead level. Neurobehavioral tests were performed to determine their personal cognitive and memory ability. Questionnaires and physical examinations were administered to obtain the information of confounding factors. All students were divided into Q1-Q4 groups according to the quartile of their blood lead level. The relationship between the blood lead level and behavior was analyzed by multivariate logistic regression model and restricted spline regression model. Results The mean age of 697 students was (10.07±1.36) years old, and the median (interquartile range) of their blood lead level was 44.31 (35.42) μg/L. Multivariate logistic regression model showed that after adjusting for age, gender, body mass index and maternal culture level, compared with Q1 group, the OR (95%CI ) values of high digit symbol substitution test (DSST) scores and high overall memory quotient (MQ) scores in Q 3 group were 1.65 (1.01-2.70) and 2.10 (1.21-3.62), and the OR (95%CI ) value of high long term memory (LTM) scores in Q4 group was 0.53 (0.31-0.92). The results of the restricted spline regression model showed that the dose?response curves between the blood lead level and MQ/LTM test scores were both parabolic (P<0.05). Conclusion The blood lead level of school?age children from rural areas of Chongqing is the same as that from other areas of China, but slightly higher than that from other areas of Chongqing. Children with higher blood lead level have poor long?term memory ability.

Objective To explore the blood lead level and its relationship with behavior in school?age children from rural areas of Chongqing. Methods A total of 697 students from grades 3 to 6 in the fall semester of 2014 from 14 rural townships in one district of Chongqing was selected by using the random cluster sampling method. Blood were sampled to analyze the lead level. Neurobehavioral tests were performed to determine their personal cognitive and memory ability. Questionnaires and physical examinations were administered to obtain the information of confounding factors. All students were divided into Q1-Q4 groups according to the quartile of their blood lead level. The relationship between the blood lead level and behavior was analyzed by multivariate logistic regression model and restricted spline regression model. Results The mean age of 697 students was (10.07±1.36) years old, and the median (interquartile range) of their blood lead level was 44.31 (35.42) μg/L. Multivariate logistic regression model showed that after adjusting for age, gender, body mass index and maternal culture level, compared with Q1 group, the OR (95%CI ) values of high digit symbol substitution test (DSST) scores and high overall memory quotient (MQ) scores in Q 3 group were 1.65 (1.01-2.70) and 2.10 (1.21-3.62), and the OR (95%CI ) value of high long term memory (LTM) scores in Q4 group was 0.53 (0.31-0.92). The results of the restricted spline regression model showed that the dose?response curves between the blood lead level and MQ/LTM test scores were both parabolic (P<0.05). Conclusion The blood lead level of school?age children from rural areas of Chongqing is the same as that from other areas of China, but slightly higher than that from other areas of Chongqing. Children with higher blood lead level have poor long?term memory ability.

Objective:To search for evidence of capacity management in patients undergoing extracorporeal membrane oxygenation support therapy, and summarize the evidence to provide evidence-based basis for medical staff to evaluate and manage the capacity of such patients.Methods:This study was an evidence-based nursing study. Based on the 6S evidence model, relevant evidence on patient volume management in extracorporeal membrane oxygenation support therapy was systematically searched for relevant evidence on patient volume management in extracorporeal membrane oxygenation support therapy from top to bottom, including UpToDate, the National Guidelines Library of the United States, the Scottish Interhospital Guidelines Network, the Medical Guidelines Network, the Extracorporeal Life Support Organization website, Cochrane Library, PubMed, CINAHL, Wanfang, China National Knowledge Infrastructure, and the Chinese Biomedical Literature Database. Based on the inclusion criteria, clinical guidelines, expert consensus, clinical decision-making, evidence summary, and systematic evaluation were selected for literature quality evaluation to extract the best evidence. The search period was from April 10, 2017 to April 10, 2022.Results:A total of 11 articles were included and 20 pieces of evidence were extracted, which were categorized into four categories: extracorporeal membrane oxygenation team composition and personnel qualifications, evaluation and monitoring, capacity management objectives, and capacity management measures.Conclusions:Based on a large amount of evidence of extracorporeal membrane oxygenation support for patient capacity management, this study can provide a reference basis for clinical workers to develop extracorporeal membrane oxygenation support treatment capacity management plans.

Objective:To evaluate the efficacy and safety of mild hypothermia for patients with severe traumatic brain injury (sTBI).Methods:PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine Disc, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and VIP Database were searched for prospective randomized controlled researches on mild hypothermia and normothermia for patients with sTBI. The search time was from the establishment of the databases to February 2023. RevMan 5.3 software was used for Meta-analysis. The evaluation indicators included literature search results, basic characteristics and quality of the literature, poor prognosis rate and mortality at 6 and 12 months after treatment, incidence of pulmonary infection, arrhythmia, thrombocytopenia, intracranial infection, renal insufficiency, gastrointestinal ulcer/bleeding and electrolyte disorder during the treatment, and publication bias.Results:A total of 16 papers involving 2 640 patients were included, comprising 1 381 patients in the mild hypothermia group and 1 259 patients in the normothermia group. The poor prognosis rate in the mild hypothermia group was significantly lower than that in the normothermia group at 6 and 12 months after treatment ( RR=0.81, 95% CI 0.69, 0.95, P<0.01; RR=0.65, 95% CI 0.51, 0.84, P<0.01). There was no significant difference in the mortality between the two groups at 6 and 12 months after treatment ( RR=0.81, 95% CI 0.61, 1.08, P>0.05; RR=0.69, 95% CI 0.47, 1.03, P>0.05). In contrast with the the normothermia group, in the mild hypothermia group the incidence of pulmonary infection was significantly different ( RR=1.18, 95% CI 1.04, 1.34, P<0.01); the incidence of arrhythmia was not significantly different ( RR=1.35, 95% CI 0.73, 2.49, P>0.05); the incidence of thrombocytopenia was significantly different ( RR=1.78, 95% CI 1.34, 2.37, P<0.01); the incidence of intracranial infection was not significantly different ( RR=1.32, 95% CI 0.54, 3.23, P>0.05); the incidence of renal insufficiency was not significantly different ( RR=1.22, 95% CI 0.71, 2.09, P>0.05); the incidence of gastrointestinal ulcer/bleeding was not significantly different ( RR=0.98, 95% CI 0.73, 1.31, P>0.05); the incidence of electrolyte disorders was not significantly different ( RR=1.39, 95% CI 1.00, 1.94, P>0.05). The funnel plot was approximately symmetrical and the scattered points were concentrated in the narrow area in the upper part of the funnel plot, suggesting no publication bias. Conclusions:In comparison with normothermia for sTBI, mild hypothermia can not reduce the mortality at 6 and 12 months after treatment, but it can reduce the incidence of poor prognosis at 6 and 12 months after treatment. Moreover, mild hypothermia has no obvious effect on the incidence of arrhythmia, intracranial infection, renal insufficiency, gastrointestinal ulcer/bleeding, and electrolyte disorder, but it can increase the incidence of pulmonary infection and thrombocytopenia.

Objective:To explore the efficacy and safety of the modified VIALE-A regimen in the treatment of elderly (>75 years old) patients with intermediate or high risk myelodysplastic syndromes (MDS).Methods:A retrospective case series analysis was conducted. Clinical data were collected from 7 MDS patients aged >75 years who were continuously treated with the modified VIALE-A regimen (azacytidine 75 mg/m 2 per day from day 1 to day 7 + venetoclax 200 mg per day from day 8 to day 28) from May 2021 to August 2023, and the patients were diagnosed according to the World Health Organization 2016 staging criteria and were determined to be at intermediate or high risk according to the revised International Prognostic Scoring System. The patients' efficacy and common adverse reactions were analyzed, and the Kaplan-Meier method was used for survival analysis. Results:Of the 7 patients, 5 were female and 2 were male; the median age [ M ( Q1, Q3)] was 84 years old (80 years old, 90 years old). One patient failed the initial treatment, and the remaining 6 achieved complete remission or complete remission in bone marrow after induction therapy with the modified VIALE-A regimen in 1-2 courses. By the follow-up cut-off date of December 31st, 2023, the median follow-up was 10 months (5 months, 18 months) and the median overall survival time was 18 months (95% CI: 0-39 months). Grade 3-4 myelosuppression occurred in all 7 patients during the induction phase, with granulocytopenia lasting 7-10 d; Of the 64 courses of maintenance treatment, 54 (84%) had grade 1-3 myelosuppression; non-hematologic adverse reactions were mild; no treatment interruptions occurred in the cumulative 73 courses. Conclusions:The modified VIALE-A regimen is moderately efficacious in elderly patients with intermediate or high risk MDS, with controllable adverse reactions.