Objective To analyze the 5-year survival rate,causes of death and prognostic indicators of systemic lupus erythematosus (SLE).Methods A retrospective analysis was performed on 243 newly diagnosed SLE patients who Were admitted into our hospital from 1998 to 2005.The clinical features and serologic data were studied.Survival rate of SLE patients over time was studied by the Kaplan-Meier method,and prognostic indicators of mortality were studied by Cox proportional hazards models.Results The 1-,3- and 5-yr survival rate was 96%,94% and 91%,respectively.Renal failure and infection were the main causes of death,followed by lupus encephalotmthy and pulmonary hypertension.Cox regression analysis revealed that lupus nephritis and lupus encephalopathy at the diagnosis were independent risk determinants for mortality.However,age,sex,low C3 level,positive anti-dsDNA antibody,hematological abnormalities,lupus lung involvement and heart damages at diagnosis and immunosuppressant treatment had no strong association with survival.Conclusion Early diagnosis,control of SLE organ damage and infection prevention are critical to improve survival of SLE patients.

Objective To explore the difference of gene expression profiling between normal basilar arteries and basilar arteries of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) in rabbits. Methods cDNA chip of normal basilar arteries and basilar arteries of CVS after SAH in rabbits were downloaded from GEO database. The chip was analyzed and screened by Bioconductor software, and function enrichment and pathway analysis of the differentially expressed genes were analyzed by Cytoscape software. Then 6 adult male Japanese rabbits were used, and randomly divided into normal control group (n=3) and SAH model group (n=3). Rabbit SAH models were established by cisterna secondary-blood-injection method. RNA data of normal basilar artery specimens on the 0 day and basilar artery specimens after SAH on the 5-day were used to validate the parts of differentially expressed genes by qRT-PCR. Results A total of 4356 differentially expressed genes were found in normal basilar arteries and basilar arteries of CVS after SAH in rabbits. Among them, 920 genes were considered to be significant with P-value<0.05, such as GRIK1, MYH13, ZNF45, SAA3, RLN1, MSR1 and others. Function enrichment analysis indicated that the differentially expressed genes were involved in regulation of Ca2+transmembrane transporter activity, negative regulation of ion transmembrane transport, regulation of potassium ion transport, positive regulation of JAK-STAT signaling cascades and other biological processes. Pathway analysis showed that calcium signaling pathway, cGMP-PKG signaling pathway, HIF-1 signaling pathway, PI3K-Akt signaling pathway and other signaling pathways maybe related with the differentially expressed genes. qRT-PCR verification showed that the expression of MSR1 in SAH model group was consistent with that of the chip result. Conclusion The gene expressions of basilar arteries of CVS after SAH in rabbits are significantly different, and MSR1 gene can be used as a potential target for studying the pathological mechanism of CVS.

Objective To study the feasibility of dose calculation using kilovoltage X-ray cone-beam CT (KVCBCT) imaging for head-and-neck radiation therapy.Methods 11 patients with nasopharyngeal carcinoma were scanned with KVCBCT to adjust position before treatment, and rescanning images with KVCBCT after correction were input a treatment-planning system.The dose was recalculated by applying the patients′ treatment plans based on planning CT to the KVCBCT images.The dose distributions and dose volume histograms (DVH) of the tumor and critical structures were compared with the original treatment plan.Results The DVH and dose distribution of the plan based on the KVCBCT are compared with that of the planning CT, and they shows a good consistency for the 11 cases.The doses calculated from the planning CT and KVCBCT were compared on the isocenter planes.Using γ analysis with a criterion of 3%/3 mm, 98.0%±1.33% of the points on the isocenter planes in the planning CT and KVCBCT.The difference of the dose to target volume was<1% and to normal structure was<2%.Conclusions This study indicated that CBCT images can be used to make a treatment plan with its individual hounsfield unit-electron density calibration curve.

Objective To investigate the clinical characteristics of systemic lupus erythematosus (SLE) and the situation of diagnosis after onset. Methods Three hundred outpatients diagnosed with SLE were investigated in the People's Hospital, the Third Hospital of Peking University, Xinjiang People's Hospital and the Affiliated Hospital from May to July 2008, including gender, age of onset, clinical manifestations and the site of first hospitalization. Results ① In the cross-sectional study, 300 SLE patients were investigated. The male-to-female ratio was 1:13. ② The most common manifestations at onset were arthritis (46.3%), rash (34.%) and fever (32.7%). Lupus nephritis was found to occur in a significantly higher frequency in male patients than female as the initial manifestation. 60.9% patients had lupus nephritis in the first year after onset. ③ 99.1% of the patients were correctly diagnosed after visiting rheumatologists. 23.7% of the SLE patients were not correctly diagnosed for more than one year after disease onset. Conclusion Arthritis, rash and fever are the most common initial clinical manifestations of SLE. Lupus nephritis is more commonly seen in male SLE patients than female at the disease onset. The diagnosis of lupus is delayed in certain proportion of patients.

Objective To analyze the serum levels of soluble intercellular adhesion molecule-1(sICAM-1),toll like receptor 4(TLR4)and haptoglobin(HPT)in patients with severe cerebral infarction complicated by nosocomial infection and their clinical value.Methods A total of 80 patients with severe cerebral infarction who visited the hospital from September 2019 to December 2023 were selected as the study group,and were separated into an infection group(29 cases)and a non infection group(51 cases)based on whether the pa-tients had nosocomial infection.92 healthy individuals who underwent physical examination in the hospital were selected as the health group.Enzyme linked immunosorbent assay(ELISA)was applied to detect serum levels of sICAM-1,TLR4,and HPT in each group,and clinical data of infection group and non infection group were analyzed.Pearson method was applied to analyze the correlation between serum sICAM-1,TLR4,and HPT levels in patients with severe cerebral infarction complicated by nosocomial infection.Multivariate Logis-tic regression was applied to analyze the factors affecting the occurrence of nosocomial infection in patients with severe cerebral infarction.Receiver operating characteristic(ROC)curve was applied to evaluate the di-agnostic value of serum sICAM-1,TLR4,and HPT levels for the occurrence of nosocomial infection in patients with severe cerebral infarction.Results Compared with the health group,the serum levels of sICAM-1,TLR4,and HPT in the study group were all elevated,and the differences were statistically significant(P＜0.05).Compared with health group,serum sICAM-1,TLR4 and HPT levels in the non infection group and the infection group were increased,and the differences were statistically significant(P＜0.05).Compared with the non infection group,the serum levels of sICAM-1,TLR4,and HPT in the infection group were all elevated,and the differences were statistically significant(P＜0.05).The serum sICAM-1 was positively correlated with TLR4 and HPT levels,and TLR4 was positively correlated with HPT in patients with severe cerebral in-farction complicated by nosocomial infection(r=0.473,0.529,0.421,P＜0.001).There were significant differences between the infection group and the non infection group in the presence or absence of diabetes and smoking history(P＜0.05).Diabetes,smoking history,serum sICAM-1,TLR4,and HPT levels were the in-fluencing factors of nosocomial infection in patients with severe cerebral infarction(P＜0.05).The area under the curve(AUC)of combined diagnosis of serum sICAM-1,TLR4,and HPT for nosocomial infection in pa-tients with severe cerebral infarction was 0.991,with sensitivity of 96.55％,and specificity of 94.12％,which were superior to those of the individual diagnosis of sICAM-1,TLR4,and HPT(Z combined diagnosis-SICAM-1=1.972,P=0.049,Z combined diagnosis-TLR4=3.068,P=0.002,Z combined diagnosis-HPT=2.337,P=0.020).Conclusion The serum levels of sICAM-1,TLR4,and HPT are all elevated in patients with severe cerebral infarction complicated by nosocomial infection.The combined detection of the three has high clinical diagnostic value for the occurrence of nosocomial infection in patients with severe cerebral infarction.

Objective To determine the expression pattern of macrophage-inducible c-type lectin (MINCLE)on Macrophage(Mφ),myeloid dendritic cell (mDC)and plasmacytoid DC(pDC)in peripheral blood (PB)and synovial fluid(SF)in patients with rheumatoid arthritis (RA).Methods For mRNA expression of MINCLE,253 RA patients and 71 healthy control subjects were enrolled.The mRNA level of MINCLE was determined by real-time PCR.For protein expression of MINCLE,18 patients with RA,5 patients with osteoarthritis(OA)and 12 healthy control subjects were enrolled.The expression of MINCLE on Mφ,mDC and pDC were detected by flow cytometry.The differences of MINCLE expressions in PB between RA patients,OA patients and healthy controls,or differences between PB and SF in RA patients were analyzed using Mann-Whitney U test or paired-samples t test.Results ①Compared to the healthy controls,RA patients showed elevated mRNA expression level of MINCLE in PBMCs[(1.65±0.36)vs (0.37±0.06),U=6057,P=2.75×10-5].②At protein level,MINCLE was hardly detected in Mφ,mDC and pDC in PB of OA patients and healthy controls.In SF,MINCLE was highiy expressed on mDC in RA patients,compared with that in OA patients[(34.8±4.4)%,U=0,P=2.6×10-3].In RA patients,the expression level of MINCLE was remarkably elevated in Mφ,mDC and pDC in SF compared with that in PB[Mφ(2.01±0.53)%vs(0.273±0.51)%,t=4.879,P=2.23×10-6;mDC(34.8±4.4)%vs(22.7±5.5)%t=2.535.P=0.017].Conclusion MINCLE is selectively expressed on Mφ.mDC and pDC in SF in RA patients.MINCLE may serve as a potential important marker,or even target,for RA and possibly even for inflammation in general.

Objective:To construct a training course system for online appointment nurses based on post competence,and to provide references for the training and development of online appointment nurses in China.Methods:From January 2021 to May 2022, based on the theory of post competence, literature review, policy research, questionnaire survey and and expert consultation were used to establish the training course system of online appointment nurses.Results:The effective recovery rates of the two rounds of expert consultation questionnaires were 18/18 and 17/18, respectively; the expert authority coefficient was 0.928 and 0.938, respectively; and the Kendall harmony coefficient was 0.185 and 0.284, respectively, the differences were statistically significant (all P<0.001). The final content of the training course system for online appointment nurses included 4 first-level indicators,which were professional knowledge, professional skills, professional abilities and traits, 19 second-level indicators and 58 third-level indicators. Conclusions:The training course system of online appointment nurses based on post competency is scientific, reasonable and prominent,which can provide reference for training of online appointment nurses in China.

The incidence of perioperative arrhythmias is 4%～20%in noncardiac surgery and 10%～30%in cardiothoracic surgery,with the incidence of perioperative arrhythmias in cardiac surgery patients as high as 90%.Perioperative arrhythmias can prolong hospitalization and increase morbidity and mortality during hospitalization.Studies have shown that aberrantly expressed microRNAs in cardiovascular diseases can participate in cardiac auto-maticity,excitability and conductivity by regulating ion channels,gap junction proteins,and intracellular Ca2+ handling proteins,thereby regulating cardiac electrophysiological homeostasis and arrhythmias.In this article,we will review the research progress of microRNAs and arrhythmias mainly from the perspective of cardiac electrophysi-ological imbalance.

Mesenchymal-epithelial transition factor (MET) amplification is an important driver of resistance in epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC), and the combination of MET proto-oncogene (MET) and EGFR-tyrosine kinase inhibitors (TKIs) has shown promise in overcoming this molecularly defined acquired resistance. Emerging data also demonstrate MET amplification as a resistance driver to TKIs-treated anaplastic lymphoma kinase (ALK)-, RET-, and ROS1-fusion NSCLC. Here, we review the literature on recent research progress of MET amplification as a resistance driver to targeted therapy in oncogene-driven NSCLC and summarize the progress of clinical strategies to overcome the resistance mechanism.
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Carcinoma, Non-Small-Cell Lung/genetics* ; Drug Resistance, Neoplasm/genetics* ; ErbB Receptors/genetics* ; Humans ; Lung Neoplasms/pathology* ; Mutation ; Protein Kinase Inhibitors/therapeutic use* ; Protein-Tyrosine Kinases ; Proto-Oncogene Proteins/genetics* ; Proto-Oncogene Proteins c-met/genetics*

With the rapid development and wide application of next generation sequencing (NGS) technology, a series of researches have revealed that concurrent genetic alterations play an important role in the response and resistance of epidermal growth factor receptor (EGFR)-mutant NSCLC to EGFR-tyrosine kinase inhibitor (TKI). Besides, TP53 mutation is the most common co-mutation gene in EGFR-mutant NSCLC, which has been proved to confer a worse prognosis in EGFR-mutated patients treated with first, second and third generation of EGFR-TKIs. Currently, it is still being explored how to select the best treatment strategies for patients with concomitant presence of TP53 mutation in EGFR-mutant NSCLC. Here, we review the literature on recent research progress of TP53 concurrent mutation in EGFR-mutant advanced NSCLC.
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Carcinoma, Non-Small-Cell Lung/genetics* ; ErbB Receptors/genetics* ; Humans ; Lung Neoplasms/genetics* ; Mutation ; Protein Kinase Inhibitors/therapeutic use* ; Tumor Suppressor Protein p53/genetics*