Aim To study the inhibitory effects of ex-tractive pericarpium trichosanthes ( EPT) on high glu-cose-induced apoptosis in human umbilical vein endo-thelial cells ( HUVECs ) and its underlining mecha-nisms. Methods HUVECs were cultured. Effects of EPT at different concentrations on the high-glucose-in-duced apoptosis in HUVECs were observed. The cell viability of HUVECs was determined by MTT colori-metric method. Cell apoptosis was identified by Ho-echst staining. The intracellular activity of Caspase-3 was detected with colorimetry. Protein expression and p65 nuclear translocation of NF-κB were detected by Western blot and immunofluorescence staining. Re-sults Treated with 30 mmol · L-1 glucose for 48 hours had a significantly decrease on cell viability com-pared with control, and the apoptotic rate and Caspase-3 activity were increased markedly, the protein expres-sion of NF-κB was upregulated and p65 nuclear trans-location in HUVECs increased; Pre-incubation with EPT(12. 5,25,50 mg·L-1 ) for 1 hour enhanced the cell viability, and decreased the apoptotic rate and Caspase-3 activity and downregulated the expression of NF-κB in a dose-dependent manner. Moreover, EPT could inhibit p65 translocation. Conclusion EPT can protect HUVECs against the apoptosis induced by high glucose in vitro,and its mechanism may be related with downregulation of NF-κB expression and inhibition of the intracellular activity of Caspase-3 .

Objective To evaluate the incidence and epidemiologic characteristics of Kawasaki disease (KD)in Nanjing.Methods We reviewed the medical records and reports of all patients admitted to Nanjing Chil-dren′Hospital with KD diagnosed during 3 -year periods from 2012 to 2014.Results We studied 1 446 inpatients diagnosed with KD from 2012 to 2014.There were 1 135 cases(78.5%)with complete KD.The ratio of male to female was 1.7241.The disease occurred in all of the seasons,but the peak was from spring to summer.Age at onset ranged from 1 month to 14 years old,and the peak age group was 1 year old.Fever(99.45%)was the most common clinical symptom,followed by conjunctive congestion(93.15%),rash(73.32%),oral changes(51.76%), extremities desquamate(75.08%)and lymphadenopathy(45.89%).There were 131(9.05%)patients with coronary aneurysm,the ratio of male to female was 3.02  1.14 patients (0.97%)developed recurrent KD.Conclusion Patients with KD has become more and more in Nanjing,and clinical doctors should improve the understanding of KD. Early diagnosis and treatment is very important to reduce the sequelae and reduce the mortality of KD.

OBJECTIVE: To observe the clinical effect of 5% D-fructose injectio on energy supply in surgery patients. METHODS: By setting 5% glucose injectio as control,the influence of 5% D- fructose injectio on blood sugar level,liver and kidney function indices was detected.RESULTS: 5% D-fructose injectio did not influence liver and kidney functions, serum uric acid and RESULTS: of routine examination of blood and urine.Compared with control group, the change of blood sugar level in experiment group was slighter.CONCLUSION: 5% D-fructose injectio is effective and safe for energy supply in surgery patients.

Objective To analyze the correlative differences in the cardiac surgery for patients with end-stage renal disease (ESRD) and non-nephropathy disease, and explore the cardiac perioperative nursing for patients with ESRD. Methods A single-center retrospective comparative analysis was conducted in patients with ESRD (ESRD group, 26 cases) and non-nephropathy disease (control group, 26 cases) treated with cardiac surgery from January 2004 to December 2016 in Peking University First Hospital. Postoperative laboratory indexes, the changes of indexes in the monitoring room and the blood transfusion were compared between two groups. Results At 0, 1 and 2 d after the surgery, hemoglobin levels of patients in ESRD group were significantly lower than those in the control group; creatinine and urea nitrogen levels in ESRD group were significantly higher than those in the control group (P< 0.01). Postoperative serum potassium levels in ESRD group were significantly higher than those in the control group (P<0.01). The amount of erythrocyte and platelet transfusion in ESRD group were higher than those of control group (P<0.01). There was no statistically significant difference between the ESRD group and the control group in the ventilator time, 24-hour pleural drainage and total thoracic drainage (P> 0.05). The duration of stay in ICU and postoperative hospital stay were (101.62±49.10) h and (28.23±20.44) d in the ESRD group, which were significantly longer than those in the control group [(71.35±33.10) h, (16.58±8.43) d]. Conclusions ESRD patients have a higher risk in the cardiac surgery when compared with patients with non-nephropathy disease. Therefore, nurses should pay attention to the perioperative electrolyte balance and infusion of blood products, as well as the prevention of postoperative complications and psychological nursing, to help patients with better prognosis.

Objective To conduct the evaluation and comparison on the application effects of the 5-D Pruritus Assessment Scale and the Multidimensional Uremic Pruritus Assessment Scale in the patients with maintenance hemodialysis.Methods A total of 154 maintenance hemodialysis patients with pruritus symptom in this hospital from February to June 2023 were selected as the study subjects.The 5-D Pruritus Assessment Scale and the Multidimensional Uremic Itch Assessment Scale were used to evaluate the dimensions such as the pruritus degree,duration and itching location.After standardization treatment by aiming at the evaluation results of the two kinds of scales,the Bland-AItman method was adopted to conduct the consistency compari-son.The Spearman correlation coefficient was adopted to test the correlation between the two kinds of scales. Results The consensus limit (LoA) confidence interval of the 5-D Pruritus Assessment Scale was-0.1578 to 0.1603,the Multidimensional Uremic Pruritus Assessment Scale was-0.1592 to 0.1592.The Spearman correlation results showed that the two scales had the positive correlation (r=0.472,P<0.001).In the 5-D Pruritus Assessment Scale,the area under the curve(AUC) of the fractal dimensions such as duration,degree,development direction,disability and distribution were 0.674 (95％CI:0.557-0.790),0.799 (95％CI:0.700-0.899),0.637 (95％CI:0.528-0.747),0.951 (95％CI:0.905-0.997) and 0.786(95％CI:0.701-0.872),respectively.In the Multidimensional Uremic Pruritus Assessment Scale,AUC of the fractal dimen-sions such as symptom and sign,psychological society and sleep were 0.989 (95％CI:0.978-1.000),0.931 (95％CI:0.878-0.985),and 0.951 (95％CI:0.909-0.994),respectively.Conclusion The consistency of the two scales is good,and both scales can be used to evaluate uremia skin pruritus.The Multidimensional Uremic Pruritus Assessment Scale is more targeted in the assessment of sleep dimension,which is more suitable for the evaluation of maintenance hemodialysis patients.

Objective? To explore the differences between communication demands of tracheal intubation patients and cognition nurses in intensive care unit (ICU). Methods? We selected 105 tracheal intubation patients after the cardiac surgery and 19 nurses provided nursing for them as subjects at Peking University First Hospital by convenience sampling. All of the patients and nurses were investigated with the communication demands scale of tracheal intubation patients, and the differences between them were compared. Results? The total score of demands of tracheal intubation patients was (99.96±24.93) lower than that (123.11±19.48) of cognition of nurses with a statistical difference (P＜0.05). The highest communication demand of patients was the item of "I want to know the time of tube drawing" with (3.33±1.09) for the score ranked fourth in cognition of nurses. The scores of items in demands of love and belonging as well as self-esteem of patients ranked more than the tenth. Conclusions? There are differences between communication demands of tracheal intubation patients and cognition of nurses in ICU especially in physiological needs, safety needs as well as the need of love and belonging. Encouraging patients to express intentions, understanding patients' intentions and avoiding forming the fixed thinking can carry out nursing service better so as to provide the best scientific basis for patients' disease recovery.

Objective:To explore the risk factors associated with tibia fractures in children with congenital anterolateral bowing of the tibia (ALBT).Methods:A retrospective analysis was conducted on data from 87 children diagnosed with ALBT at the Children's Hospital of Hunan Province from January 2012 to January 2020. The collected data included age at initial diagnosis, affected limb side, whether there was a concomitant type I neurofibromatosis, whether there was a concomitant fibular pseudoarthrosis, whether there was concomitant ankle joint deformity, whether there was bone cystic change in the region of tibial bowing deformity, location of the apex of the bowing deformity, diameter of the tibial bowing deformity on the affected side, diameter on the healthy side in the same plane as the tibial bowing deformity, angle of lateral bending deformity of the tibia, angle of anterior bending deformity of the tibia, occurrence of tibia fracture, history of trauma before fracture, location of fracture, and age at the time of fracture. The follow-up endpoint was January 2023. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff values for the angles of lateral and anterior bending deformity of the tibia and the ratio of cross-sectional areas. The correlation between the above factors and tibial fractures in children was analyzed by single factor survival analysis, and the indicators with statistical significance were included in multivariate Cox proportional risk regression analysis to determine the risk factors for tibial fractures in children with ALBT.Results:Of the 87 children diagnosed with ALBT, the median age at initial diagnosis was 14.0 months (range, 1-93 months), with 42 males and 45 females, 44 left-sided and 43 right-sided cases. The median follow-up time for non-fracture cases was 42.0 months (range, 1-124 months). At the last follow-up, 43 children had experienced fractures, while 44 had not. The average time to fracture-free survival was 70.3 months, the median fracture-free survival time was 55.0 months, and the median survival time without fractures was 42.0 months. The ROC curve results indicated a cutoff value of 25.55° for the lateral bending angle of the tibia and 32.63° for the anterior bending angle of the tibia, with no statistically significant significance for the cross-sectional area ratio [AUC=0.54, 95% CI (0.42, 0.66), P=0.530]. Single-factor analysis of fracture-free survival suggested that there were statistically significant differences in the intergroup fracture-free survival rates of four factors: lateral bending angle of the tibia (χ 2=7.06, P=0.008), anterior bending angle of the tibia (χ 2=8.96, P=0.003), history of trauma (χ 2=18.26, P<0.001), and tibial bone cystic change (χ 2=4.30, P=0.038). The results of the multivariate Cox proportional hazards regression analysis showed that a lateral bending angle of the tibia≥25.55° ( HR=2.73, P=0.007), tibial bone cystic change ( HR=2.35, P=0.018), and history of trauma ( HR=2.65, P=0.004) were all positively correlated with fractures. Conclusion:The main risk factors for tibia fractures in children with ALBT include trauma, tibial bowing deformity with concomitant bone cystic change, and lateral bending angle of the tibia≥25.55°.

Objective:To investigate the efficacy of acidified aliphatic ester in the treatment of atopic dermatitis (AD) in mouse models, and to preliminarily explore its mechanisms of action.Methods:Twenty female BALB/c mice aged 6 to 8 weeks were randomly divided into 2 groups: 5 mice in the blank control group were topically treated with absolute ethanol on both ears (14.3 μl per ear) every day, and 15 mice in the model group were topically treated with calcipotriol liniment (14.3 μl per ear) and 20 g/L ovalbumin (25 μl per ear) on both ears every day for 10 consecutive days to establish AD-like mouse models. From day 11, 15 mice in the model group were randomly divided into 3 groups (5 mice in each group), including AD model group, aliphatic ester group, and acidified aliphatic ester group; in the forenoon, all the 3 groups continued to be topically treated with calcipotriol liniment and ovalbumin to maintain AD-like models; in the afternoon, the aliphatic ester group and acidified aliphatic ester group were topically treated with aliphatic ester and acidified aliphatic ester respectively (10 μl per ear), and no treatment was given to the AD model group. Changes in body weight, ear thickness, ear skin lesion scores, and scratching frequency were observed. Ear skin swabs were obtained from the mice on days 10 and 14 for 16S rRNA gene - based microbial diversity tests. On day 14, mice were sacrificed after reflectance confocal microscopy examinations of the ear skin, ear tissues were resected for hematoxylin and eosin staining, mast cell staining, and real-time fluorescence-based quantitative PCR (RT-qPCR), and blood samples were collected for detection of serum IgE levels. One-way analysis of variance was used for analysis of data that met homogeneity of variance criteria, and least significant difference- t test for multiple comparisons. Results:On day 14, the severity of mouse ear lesions was the highest in the AD model group, followed in turn by the aliphatic ester group, acidified aliphatic ester group, and blank control group; compared with the AD model group, the acidified aliphatic ester group showed significantly decreased mouse ear thickness ( F = 897.50, P < 0.001), skin lesion scores ( F = 268.80, P < 0.001), scratching frequency ( F = 64.36, P < 0.001), and epidermal thickness ( F = 256.20, P < 0.001). In addition, RT-qPCR indicated that the expression of inflammatory factors such as interleukin (IL) -33, thymic stromal lymphopoietin, IL-4, and tumor necrosis factor-α in lesional areas, and the degree of mast-cell infiltration were all significantly lower in the acidified aliphatic ester group than in the AD model group ( F = 3.38, 8.70, 41.73, 44.30, 134.30, P = 0.049, = 0.001, < 0.001, < 0.001, <0.001, respectively). Microbial diversity tests showed that the acidified aliphatic ester treatment could inhibit the colonization of Staphylococcus spp. in the ears of AD-like mouse models, and the Shannon index and Simpson index significantly differed among the 4 groups ( F = 9.00, 7.92, P = 0.001, 0.002, respectively) . Conclusion:Acidified aliphatic ester could improve skin lesions of AD-like mouse models, possibly by regulating immunity, suppressing inflammation, and restoring skin microecological diversity.

Objective:In this study, the liver, spleen, and hepatic portal vein in the portal venous phase images of abdominal enhanced computed tomography (CT) are artificially segmented and annotated, and the radiomics features are extracted from them. A model for predicting portal pressure in patients with hepatitis B virus (HBV) related cirrhosis is constructed by combining radiomics features with clinical indicators.Methods:A total of 171 patients who had abdominal enhancement CT examination and trans-jugular hepatic venous pressure gradient (HVPG) measurement at the same time were enrolled from January 2016 to May 2020 in the Zhongshan Hospital Affiliated to Fudan University. The liver, spleen, and hepatic portal vein in the portal venous phase images of the CT were manually labeled by using ITK-SNAP 3.8 software. The radiomics features of these three sites were extracted using Python programming, and an HVPG prediction model was established.Results:A total of 171 patients was included in the study. The average age was (51.1±10.3)years, of which 134(78.4%) were males, and the average HVPG was 16.87±5.695. A total of 2 553 radiomics features were extracted from three sites of the portal venous phase images of abdominal enhanced CT in each patient. The 2 553 features extracted were screened using LASSO, and by combing with clinical features and radiomics features, the predictive model of HVPG was obtained: m_HVPG=31.622+ 0.028 8T×total bile acids-6.31(portal venous wavelet-LHH_glcm_ClusterShade)=0.253(portal venous wavelet-LHL_glszm_LargeAreaLowGrayLevelEmphasis)-20.9(spleen wavelet-LLH_glcm_Correlation)-0.000 127(liver original_shape_SurfaceArea)+ 2.79(liver wavelet-LLH_glcm_ClusterShade). The coefficient of determination R2 was 0.345. Conclusions:The study suggests that radiomics features of the liver, spleen, and portal venous combined with clinical features may be used as a non-invasive method to assess the portal pressure in patients with HBV-related cirrhosis.

Objectives:To observe the anatomical location and mechanism of axis ring fractures (ARF) using 3-D CT scans, and propose a new classification for such fractures.Methods:By reviewing prospectively maintained database collecting ARF from 7 medical centers in China, 202 patients were included in this study. According to anatomical location, ARFs were classified into axis arthrosis fracture (AAF) and axis bony damage (ABD). The axis ring was divided into anterior, middle, and posterior rings, based on the border of the pars interarticularis (or pedicle) of axis. According to the features of ARF and previous study, a new classification was proposed based on the anatomical features of different fracture patterns, which was divided into three types and six subtypes (A1, A2, B1, B2, C1 and C2). The incidence of AAF and ABD and their distribution in different location of axis ring and the new classification, were observed.Results:In 202 patients with ARF, 501 anatomical structures were involved. 288 AAFs were found in 178 patients (288/501, 57%), while 213 ABDs were found in 149 patients (213/501, 43%). In anterior ring, 304 structures (304/501, 61%) were involved in injury, with 225 AAF and 79 ABD. In middle ring, 99 structures (99/501, 20%) were involved in injury, and all of them were ABD. In posterior ring, 98 structures (98/501, 19%) were involved in injury, with 63 AAF and 35 ABD. The anterior ring injuries (61%) were more common than middle (20%) or posterior ring (19%). In anterior ring, AAF (84%) were morecommon than ABD (16%); In middle ring, all the injuries were ABD; In posterior ring, AAFs (64%) were more common than ABD (36%). Type A fractures were featured with pedicle fractures and were identified in 30 patients (30/202, 15%). Type A1 fractures were bilateral pedicle fracture lines symmetrically or asymmetrically and identified in 12 (6%) patients; Type A2 fractures were pedicle fracture lineson one side and inferior articular facet injuries or lamina fractures on the otherside and identified in 18 (9%) patients. Type B fractures were featured with superior articular facet injuries or posterior wall of C2 body fractures on one side and identified in 136 patients (67%). Type B1 fractures were superior articular facet injuries or posterior wall of C2 body fractures on one side and pedicle fracture on the other side and identified in 57 (28%) patients; Type B2 fractures were superior articular facet injuries or posterior wall of C2 body fractures on one side and inferior articular facet injuries or lamina fractures on the otherside and identified in 79 (39%) patients. Type C fractures were featured with bilateral superior articular facet injuries or posterior wall of C2 body fractures and identified in 36 patients (18%). Type C1 fractures were bilateral superior articular facet injuries or posterior wall of C2 body fractures symmetrically and identified in 22 (11%) patients; Type C2 fractures were bilateral superior articular facet injuries or posterior wall of C2 body fractures asymmetrically and identified in 14 (7%) patients.Conclusion:ARF could occur in different anatomical locations, and most of these fractures were caused by hyperextension and axial load on superior articular facet on one or two sides. The new CT classification of ARF with three types and six subtypes might provide all fracture patterns, which could be useful for the choice of proper diagnosis and treatment for such fractures.