Tumor necrosis factor-like weak inducer of apoptosis ( TWEAK ) is a member of the superfamily .TWEAK binds to its receptor [ fibroblast growth factor-inducible 14 ( Fnl4 ) and the serum level of soluble CD 163 ( sCD163 ) ] and regulates many cellular activities via associated signal pathways ,including proliferation,migration,differentiation,apoptosis, angiogenesis and inflammation ,which play a significant role in the formation and development of cardiovascular diseases , such as atherosclerosis , heart failure , cardiomyopathy , and peripheral vascular disease .This review summarizes functions of TWEAK and its receptor in cardiovascular diseases .

Objective To study the clinic features and the mechanism of skin damage induced by high-dose methotrexate(HD-MTX).Method Children treated with HD-MTX were enrolled in a retrospective study in which the incidence and presentations of skin damage were concluded.Mechanism of the damage was studied base on skin pathology of an animal model.Result Skin damage presented in 3～9(median 5) days after HD-MTX and usually followed by bullation and exfoliation.Twelve cases,more severe than the others,accompanied with fever and symptoms of other organs especially the respiratory tract and the intestine.Skin damage was reduced when large dose rehydration used before,during and after HD-MTX.Conclusion HD-MTX may cause scald-like skin damage directly by its prolonged toxic effect on epidermal cells.Besides extended tetrahydrofolic acid rescue and supportive treatments,anti infection is the most important in dealing this condition.

To improve the usage rate and quality of emergency equipment in the hospital, the emergency equipment management was studied. The specialized management and common use of emergency equipment in a hospital was analysed with statistical methods. The usage rate, economic effectiveness and management quality of the equipment were evaluated. Based on the practical experience, the superiorities of the specialized management and common use of emergency equipment in hospitals were summarized, and the inferior positions and their improvement approaches were proposed. As a result, the hospital resource allocation was optimized and the equipment management level was improved by using the specialized management and common use of emergency equipment in the hospital.
Emergency Service, Hospital ; organization & administration ; Materials Management, Hospital ; organization & administration

Objective To investigate the relationship between serum uric acid and traditional risk factors of coronary artery disease. Basic information was obtained by using questionnaire and measured for blood pressure , height ,weight. Venous blood was collected for detecting fasting plasma glucose ,serum lipid and uric acid. All data were analyzed with SPSS 20.0. Correlation analysis was used to assess the association of serum uric acid and traditional risk factors of coronary artery disease in patients with coronary artery disease. Results The mean value of serum uric acid in coronary artery disease is 6.3 mg/dL. The level of serum uric acid was significantly higher in male than that in female. Serum uric acid and body mass index(r = 0.137,P < 0.001),systolic blood pressure (r = 0.053,P = 0.025)and triglycerides(r = 0.188,P < 0.001)had a positive correlation. Serum uric acid was negatively correlated with high density lipoprotein cholesterol(r =-0.146,P < 0.001)and estimated glomerular filtration rate(r=-0.340,P<0.001). Serum uric acid was higher in patients with men,smoking,drinking,and chronic CAD. The serum uric acid level was lower in patients with exercise time more than 30 minutes than no movement or movement time less than 30 minutes. Conclusion Elevated serum uric acid were associated with body mass index,systolic blood pressure,triglyceride,high density lipoprotein cholesterol,estimated glomerular filtration rate,male,smoking,and chronic CAD.

Objective: To analyze the clinical characteristics of allergic reactions in patients with colorectal cancer after routine premed-ication with dexamethasone (5 mg) before chemotherapy with an oxaliplatin-containing regimen and to provide a reference for reduc-ing the risk of oxaliplatin allergy. Methods: Retrospective analysis of 242 patients with colorectal cancer who received chemotherapy with an oxaliplatin-containing regimen at the Changzhou Cancer Hospital of Soochow University from January 2014 to October 2017 was performed, and the incidence of allergic reactions was calculated. The associations between multiple factors and allergic reactions were then assessed using univariate analysis. The independent factors of allergic reactions were assessed using multivariate Logistic analysis, and the treatment outcome of oxaliplatin rechallenge in allergic patients was discussed. Results: A total of 242 patients were studied. They received routine premedication with dexamethasone (5 mg) before chemotherapy with an oxaliplatin-containing regi-men. Twelve (4.9%) patients had type I allergic reactions, with a median onset time of 6 (5.5-10.5) cycles and a median cumulative dose of 895 (716.5-1 075.0) mg. Multivariate analysis identified undergoing an oxaliplatin-free interval as an independent risk factor (P=0.04). Rechallenging patients with prophylactic agents was successful in 1 (33.3%) of 3 patients who completed their treatment. Conclusions: Routine low-dose dexamethasone premedication before oxaliplatin administration is safe and exhibited a lower inci-dence of hypersensitivity reactions than that reported in literature. An oxaliplatin-free interval may increase the risk of hypersensitivity reactions. Caution should be exercised while rechallenging allergic patients with oxaliplatin.

Objective:To identify the risk factors of cognitive dysfunction in patients with atrial fibrillation and to establish a risk prediction model.Methods:The convenience sampling method was used to evaluate 260 patients with atrial fibrillation who were hospitalized in the Department of Cardiology of the Affiliated Hospital of Jining Medical College from January to December 2020. The cognitive function of the patients was evaluated with the Montreal Cognitive Function Assessment Scale (MoCA). Univariate analysis was used to screen the independent variables that had influence on the occurrence of cognitive dysfunction, and the statistically significant variables were included in the multivariate Logistic regression model. According to the regression coefficients of statistically significant variables, a line map was drawn to construct the risk prediction model of cognitive dysfunction in patients with atrial fibrillation.Results:There were 209 cases with cognitive impairment and 51 cases without cognitive impairment. Univariate analysis showed that sex, age, smoking history, drinking history, education level, free thyroxine, hemoglobin, D-dimer and BMI ( χ2 values were 4.08-18.83, t values were -6.04-2.94, Z=-2.76) were significantly different between the patients with or without cognitive dysfunction. The results of multivariate Logistic regression analysis showed that age ( OR values were 1.13), education level ( OR=0.01-0.05), quit smoking history ( OR=0.36), drinking history ( OR=0.35) and free thyroxine( OR=1.14) had significantly statistical significance ( P<0.05). The area under ROC curve (AUC) = 0.878 and AUC>0.8, this model had good clinical prediction ability. Conclusions:The construction of cognitive dysfunction risk prediction model for patients with atrial fibrillation can prevent or intervene high risk factors in advance, facilitate clinical use, and provide data support for the improvement of cognitive function in patients with atrial fibrillation.

【Objective】 To explore the safety and efficacy of a novel endoscopic two-wire guided dilation in the creation of channels in percutaneous nephrolithotomy (PCNL). 【Methods】 Clinical records of 180 patients undergoing PCNL during Oct.2020 and Oct.2022 were retrospectively analyzed. The patients were divided into three groups, 60 in AMD group (fascial amplatz dilation), 60 in OSD group (one shot dilation) and 60 in END group (endoscopic dilation). Time to establish channels, operating time, failure of access, stone clearance rate, drop in hemoglobin, embolization rate, fever rate, blood transfusion rate and postoperative hospitalization were compared among the three groups. 【Results】 There were no significant differences in the general data among the three groups (P>0.05). Compared with AMD and OSD groups, END group needed significantly reduced time to establish the first channel [(5.6±0.8) min vs. (4.9±1.4) min vs. (4.2±0.5) min, (P<0.05)] . Compared with OSD group, END and AMD groups had significantly more hemoglobin drop [(14.0±17.6) g/L vs. (19.4±12.6) g/L vs. (10.2±6.8) g/L, (P<0.05)] . There were no significant differences in terms of failure of establishing channels, operating time, stone clearance rate, embolization rate, fever rate, blood transfusion rate and postoperative hospitality. Four patients needed selective renal artery embolization (1 case in AMD group and 3 in OSD group). No serious complications such as organ injuries, septic shock or death occurred. 【Conclusion】 Endoscopic two-wire guided dilation is simple, with few complications and good application value.