OBJECTIVE To provide a reference for the early diagnosis， drug treatment and medication monitoring for patients with Lemierre’s syndrome. METHODS The doctors confirmed the diagnosis of the patient as having Lemierre’s syndrome based on the patient’s condition and the results of metagenomic next-generation sequencing （mNGS）， and the clinical pharmacists participated in the treatment process of the patient. During the treatment process， the clinical pharmacists suggested using piperacillin sodium and tazobactam sodium combined with metronidazole for anti-infective treatment against Fusobacterium necrophorum infection； clinical pharmacists recommend anticoagulant treatment with Enoxaparin sodium injection for left internal jugular vein thrombophlebitis. RESULTS The doctors accepted the suggestion of the clinical pharmacists， and the patient’s condition improved after treatment and was allowed to be discharged with medication. CONCLUSIONS By interpreting the results of mNGS， combined with the patient’s condition， the clinical pharmacists assist doctors in formulating individualized anti-infective and anticoagulant plans for the patient and provide medication monitoring， ensuring the safety and effectiveness of the patient’s medication.

In response to the issues of insufficient stability and accuracy in dry chemical detection using reflectance photometry,caused by the divergence and multiple internal reflections of the reflected light signal from the sample and the multilayer dry film test strip,a dry chemical reflectance photometry detection system based on an integrating sphere is designed.Firstly,an integrating sphere device is incorporated to reduce signal divergence and loss,ensuring even detection of the sample's reflected light signal and improving detection stability.Secondly,Light Tools optical simulation analysis is performed,and an integrating sphere detection model is established.Thirdly,the Williams-Clapper equation is employed to correct the error in reflectance density caused by multiple internal reflections,enhancing detection accuracy.Experimental validation demonstrates that the developed integrating sphere-based dry chemical reflectance photometry detection system improves the stability and accuracy of the detection system.

Objective To investigate the diagnostic value of photoplethysmography (PPG) in the detection of obstructive sleep apnea syndrome (OSAS) among critically ill patients with respiratory or cardiocerebrovascular diseases accompanied by snoring. Methods A total of 91 critically ill patients with respiratory or cardiocerebrovascular diseases accompanied by snoring, admitted to the internal medicine ward of Subei People's Hospital from January 2019 to October 2023 were enrolled. After informed consent, overnight polysomnography (PSG) and PPG were performed. The consistency of the sleep apnea parameters obtained of the two methods by sensitivity, specificity, positive predictive value, negative predictive value, and the area under the receiver operating characteristic (ROC) curve. Results There were no statistically significant differences in apnea-hypopnea index (AHI), total sleep time, lowest oxygen saturation, and time with oxygen saturation below 90% between PPG and PSG (P>0.05). When AHI≥ 5 times/h and AHI≥15 times/h, the diagnostic sensitivity of the patients in this group was 94.37% and 93.10%, respectively, with specificities of 73.68% and 90.91%, positive predictive values of 91.78% and 94.74%, and negative predictive values of 77.78% and 88.23%, and areas under the ROC curves were 0.961 and 0.982, respectively. For critically ill patients with respiratory diseases, the diagnostic sensitivity was 89.29% and 87.10%, respectively, with specificities of 84.62% and 80.00%, positive predictive values of 92.59% and 93.10%, and negative predictive values of 78.57% and 72.72%, and the areas under the ROC curves were 0.978 and 0.987, respectively. For critically ill patients with cardiocerebrovascular diseases, the diagnostic sensitivity was 87.18% and 90.32%, respectively, with specificities of 83.33% and 89.47%, positive predictive values of 91.89% and 99.63%, and negative predictive values of 78.57% and 85.56%, and the areas under the ROC curves were 0.942 and 0.986, respectively. Conclusion PPG monitoring results show high consistency with PSG in critically ill patients with respiratory and cardiocerebrovascular diseases combined with OSAS.

Objective:To collect data on urinary flow rate in the elderly female population across the country and to analyze the range of reference values.Methods:This study enrolled 333 subjects from July 2020 to June 2022.The study implementation process was divided into two steps.In the first step, subjects completed an electronic questionnaire, which included basic information about the subject, a short form for urinary incontinence, and a scoring form for the symptoms of overactive bladder syndrome.In the second step, the staff introduced the use of a mobile uroflowmetric device and distributed the instrument and materials.Uroflow rate data were automatically uploaded to a cloud database via the mobile phone.Subsequently, two or more physicians specializing in urinary control performed Uroflow rate-qualifying screenings and conducted statistical analyses.Results:A total of 333 subjects were enrolled in the study, and the researchers collected 1375 qualified urine flow rate records using a mobile urine flow rate instrument.The age of the subjects ranged from 60 to 84 years, with a mean age of 69 years.The reference ranges for urinary flow rate were found to be 24.8-26.2 s, with a mean urinary flow rate of 12.2-12.9 ml/s, a maximum urinary flow rate of 22.2-23.4 ml/s, and a time to peak of 8.5-9.7 s. The study observed a tendency for both maximal and mean urinary flow rates to decrease in older women as their age increased(Pearson correlation coefficient: -0.1, P<0.001). Conclusions:The uroflow rate of older women decreases with aging.Specifically, the average uroflow rate of women over 80 years old is lower than that of other age groups.This study aims to establish normal uroflow parameters for uroflowmetry in healthy older women in China.

Objective:To compare the clinical effective of clavicular hook plate with extra suture hole and traditional hook plate in the treatment of acute acromioclavicular dislocation.Methods:This study retrospectively analyzed the clinical data of traumatic acromioclavicular dislocation patients who were treated by operation from March 2017 to September 2020. The patients were included in traditional hook plate (THP) group and triangle stabilization technique hook plate (TSTHP) group according fracture fixations. TSTHP group adopted clavicular hook plate with extra suture hole. There were 27 patients in THP group with 18 male patients and 9 female patients; average age with 37.56±8.94 years old; 16 patients injured left side and 11 patients injured right side; crush injuries of 10 patients, traffic injuries of 9 patients and sports injuries of 8 patients; Rockwood classification of type III (9 patients), type IV (10 patients) and type V (8 patients). There were 20 patients in TSTHP group with 15 male patients and 5 female patients; average age with 38.95±9.91 years old; 13 patients injured left side and 7 patients injured right side; crush injuries of 9 patients, traffic injuries of 8 patients and sports injuries of 3 patients; Rockwood classification of type III (5 patients), type IV (9 patients) and type V (6 patients). The operation time, intraoperative bleeding, postoperative coracoclavicular space, visual analogue scale (VAS) and shoulder joint Constant-Murley score were compared between the two groups.Results:The operation time and blood loss of THP group and TSTHP group were 51.07±11.27 min, 87.41±15.34 ml and 55.65±8.59 min, 90.50±14.32 ml, respectively. The difference was not statistically significant ( t=1.52, 0.70, all P>0.05). Patients in both groups were followed up for 12 to 14 months after operations, with an average of 12.28 months. Six months after surgery, the coracoclavicular spaces of THP group and TSTHP group were 12.16±0.90 mm and 11.26±0.70 mm, respectively. The difference was statistically significant ( t=3.70, P<0.001). Postoperative VAS scores (2 days, 3 months, 6 months and 12 months) of TSTHP group [1.8±0.77, 0.00(0.00, 1.00), 0.00 (0.00, 0.00), 0.00(0.00, 0.00)] were significantly better than THP group [4.22±1.25, 2.00 (1.00, 3.00), 1.00 (0.00, 1.00), 0.00 (0.00, 1.00)]. The difference was statistically significant ( t=7.65, P<0.001; Z=4.85, P<0.001; Z=3.44, P=0.001; Z=2.96, P=0.003). Postoperative Constant-Murley scores (3 months, 6 months and 12 months) of TSTHP group (87.00±5.18, 91.25±2.75, 92.30±2.74) were significantly better than THP group (76.96±5.21, 83.22±3.86, 85.22±3.49). The difference was statistically significant ( t=6.54, 7.93, 7.51; P<0.001). The postoperative complication rates of THP group were higher than TSTHP group [70.4% (19/27) vs. 5.0% (1/20)]. Conclusion:In the treatment of acute acromioclavicular dislocation, the clavicular hook plate with extra suture hole can obtain satisfactory clinical effect compared with the THP, and clavicular hook plate with extra suture hole is more conducive to early recovery of shoulder function and reduce postoperative complications.

Objective:To explore the appropriate use of a self-developed scoliosis rehabilitation robot in treating adolescent idiopathic scoliosis (AIS), and also its safety and effectiveness.Methods:The scoliosis rehabilitation robot consists of a closed-loop pneumatic control system and multi-segment torso, pelvis and upper extremity fixation devices. It provides three-dimensional synchronous correction. Eighteen AIS subjects first received 30min of robot-assisted treatment using the maximum tolerable orthotic force. The angles of their spinal processes were evaluated using ultrasound before the treatment and after 30 seconds, 5 minutes and 30 minutes of treatment, then 5min later. In a second 30sec course of treatment the transverse orthotic force was 10%, 15%, 20%, 25%, and 30% of the patient′s body weight. Any adverse effects were observed and recorded.Results:The robot ran smoothly and could apply intelligent and precise correction. No severe adverse effects were reported. The mean correction of the spinal process angles showed a significant cumulative effect with treatment time, reaching 104% at 30min. The mean process angle correction increased with the applied force. Force at 25% of the patient′s weight produced an average correction of 104% in patients with mild AIS and 65% in those whose AIS was moderate.Conclusion:The scoliosis rehabilitation robot is safe and immediately effective. Setting the transverse force at 25% of a patient′s weight gives the best corrective effect with mild AIS. Moderate AIS requires more force.

OBJECTIVE：To ex plore the protective effects of Longbie capsule contained serum （called“LBJN”for short ）on the apoptosis of chondrocytes induced by YAP inhibitor verteporfin and its mechanism. METHODS ：Primary human knee osteoarthritis（OA）chondrocytes were extracted by two-step enzymatic digestion ，and then identif ied by toluidine blue staining and type Ⅱ collagen immunofluorescence staining. The effects of 2，5 μmol/L verteporfin alone or combined with 5％LBJN on cell apoptosis were detected by flow cytometry. Solvent control （0.1％ DMSO）and 5％ LBJN were set. Western blot assay was adopted to detect the expression of apoptosis related proteins （YAP，Bcl-2，cleaved-caspase-3） after treated with 0.1％DMSO（solvent control ），2 μmol/L verteporfin，2 μmol/L verteporfin+5％LBJN 和 0（blank control ），2.5％ LBJN and 5％ LBJN for 48 h. The expression of autophagy related proteins （mTOR，Beclin-1，LC3A/B） after treated with 0 （blank control ），2.5％，5％ LBJN for 48 h were det ected by Western blot assay. RESULTS ：The isolated cells accorded with the characteristics of chondrocytes. Compared with 0.1％DMSO， the apoptosis rates of cells were increased significantly after treated with 2，5 μmol/L verteporfin（P＜0.05），and the effects of the two concentrations were similar （P＞0.05）. Compared with verteporfin alone ，2，5 μmol/L verteporfin combined with 5％LBJN could significantly decrease the apoptotic rate of cells （P＜0.05）. Compared with 0.1％DMSO，the protein expression of YAP and Bcl-2 were decreased significantly after treated with 2 μ mol/L verteporfin （P＜0.05）， while the protein expression of cleaved-caspase-3 were increased significantly （P＜0.05）. Compared with 2 μmol/L verteporfin，protein expression of YAP and Bcl-2 were increased significantly after treated with 2 μmol/L verteporfin+5％LBJN（P＜0.05），while the protein expression of cleaved-caspase-3 were decreased significantly （P＜0.05）. Compared with blank control ，the protein expression of YAP ，Bcl-2 and Beclin-1 were increased significantly after treated with 2.5％，5％LBJN（P＜0.05），while protein expression of cleaved-caspase- 3 and mTOR were decreased significantly （P＜0.05）. CONCLUSIONS ：LBJN can block the apoptosis of chondrocytes induced by YAP inhibitor verteporfin ，and its mechanism may be related to regulating the expression of apoptosis related proteins and enhancing autophagy of chondrocytes.

Objective:To propose the application of recognizing bone species by touching blindly (ARBTB) and verify its application effect in human anatomy experimental courses.Methods:The study included experiment 1 and experiment 2, and the research objects were 60 students majoring in clinical medicine in Batch 2019 and 60 students majoring in preventive medicine in Batch 2018, respectively. The research objects in each experiment were randomized into mainstream teaching method group and ARBTB group, with 30 students in each group. In experiment 1, after students studying for the same hours, both of two groups carried out the same test, and then the average scores of the two groups were compared. In experiment 2, the average time spent by the two groups of students in osteology learning was compared.Results:In experiment 1, ARBTB group's average score of the test was significantly higher than that of the mainstream teaching group ( P<0.001). In experiment 2, the ARBTB group took much less time in osteology learning than the mainstream teaching group ( P<0.001). Conclusion:Compared with the mainstream teaching method, ARBTB is more effective in osteology learning, which is worth popularizing.

OBJECTIVE: To investigate the regulatory effect of iridoid glycoside of radix scrophulariae (IGRS) on endoplasmic reticulum stress induced by oxygen-glucose deprivation and reperfusion METHODS: Rat pheochromocytoma PC12 cells were pretreated with IGRS (50, 100, 200 μg/mL) for 24h, and the RESULTS: The damage caused by OGD/R to PC12 cells was significantly reduced by IGRS, with significant effect on increasing survival rate and reducing LDH release (all CONCLUSIONS IGRS has neuroprotective effect, which may alleviate cerebral ischemia-reperfusion injury by regulating SERCA2, maintaining calcium balance, and inhibiting endoplasmic reticulum stress-mediated apoptosis.
Animals ; Cell Survival/drug effects* ; Down-Regulation/drug effects* ; Endoplasmic Reticulum Stress/drug effects* ; Glucose ; In Vitro Techniques ; Iridoid Glycosides/pharmacology* ; Oxygen ; PC12 Cells ; Rats ; Reperfusion ; Reperfusion Injury/prevention & control* ; Snails/chemistry*

Objective To evaluate the effects of dexmedetomidine on NLRP3 inflammasome during acute lung injury ( ALI ) induced by blunt chest trauma and hemorrhagic shock-resuscitation in rats. Methods Forty-five SPF healthy male Sprague-Dawley rats, weighing 200-220 g, were divided into 3 groups (n=15 each) using a random number table method: sham operation group (Sham group), ALI group and dexmedetomidine group ( Dex group) . A rat model of ALI was established by blunt chest trauma and hemorrhagic shock-resuscitation. Dexmedetomidine 5 μg·kg-1 ·h-1 was infused into the femoral vein after blunt chest trauma in Dex group. Blood samples were collected from the femoral artery at 6 h after blunt chest trauma for measurement of arterial oxygen partial pressure and concentrations of pro-inflammatory cytokines interleukin-1beta ( IL-1β) and IL-18 in serum ( by enzyme-linked immunosorbent assay ) . The oxygenation index was calculated. The rats were sacrificed and lungs were removed for examination of the pathological changes which were scored and for determination of the expression of NLRP3, caspase-1 and apoptosis-associated speck-like protein containing CARD ( ASC) in lung tissues ( by Western blot) and ac-tivities of lactic dehydrogenase ( LDH) and myeloperoxidase ( MPO) in lung tissues ( by colorimetry) . Re-sults Compared with Sham group, PaO2 and oxygenation index were significantly decreased, the expres-sion of NLRP3, caspase-1 and ASC was up-regulated, the activities of LDH and MPO were increased, and the concentrations of IL-1β and IL-18 in serum were increased in ALI group ( P＜0. 05 ) . Compared with ALI group, PaO2 and oxygenation index were significantly decreased, the expression of NLRP3, caspase-1 and ASC was down-regulated, the activities of LDH and MPO were decreased, and the concentrations of IL-1β and IL-18 in serum were decreased in ALI group ( P＜0. 05) . Conclusion Dexmedetomidine can al-leviate blunt chest trauma and hemorrhagic shock-resuscitation induced ALI in rats, and the mechanism is related to inhibition of NLRP3 inflammasome activation and reduction of inflammatory response.