Objective To explore the pathogenesis, reason, diagnosis and treatment of cerebral salt wasting syndrome (CSWS) in the patients with serious cerebral injury. Methods The clinical data of 26 cases of CSWS after serious cerebral injury were analyzed retrospectively. Results The diagnosis of CSWS was confirmed by clinical symptoms of the patients and the results of laboratory examinations. After the effective treatment, the low plasma sodium level of 21 patients was corrected, and 5 patients died. Conclusion Hyponatremia,hypernatruria, hypovolemia, the increase of urinary amount and the elevation of plasma ANP and BNP level were main characteristics of CSWS.The supplement of water and salt was safe and effective in the treatment of CSWS.

Objective To study the correlation between the dynamic changes of sex hormones and the severity and prognosis of head injury,and to investigate the role of sex hormones in traumatic brain injury.Methods The dynamic changes of sex hormones were quantitatively dynamic measured in 100 patients with head injuries,while the relationships between glasgow coma score(GCS),glasgow outcome score(GOS) and the concentration of sex hormones were also studied.Results The estradioi,progesterone and testosterone levels in serum increased within 12 hours after trauma in all groups.Estradiol increased markedly continuously within 1,3 days in GCS≤12 group,testosterone levels in serum decreased within 3 days after trauma in GCS=3～8 group,with a significant differnce compared with others groups.The concentration of sex hormones correlated positively with GOS.Conclusions The measurement of sex hormones may be useful to judge the severity and prognosis of head injury in earlystage.The increases of estradiol in the early stage after traumatic brain injury may exert powerful protective effects on brain tissues.Decreases of sex hormones are important factors leading to death of patients of traumatic brain injury.

Objective To investigate the risk factors leading to complications in patients undergoing laparoscopic cholecystectomy (LC). Methods Clinical data of 11?974 patients undergoing LC from Mar. 1991 to June 2003 were collected and analyzed retrospectively. Fifteen clinical factors were recruited for the study in relation to surgical complications. Data were analyzed by ?2 test and Logistic regression. Results The overall operative complication rate was 1.896%. The procedure was shifted to open surgery in 2.389% of all cases, Logistic regression analysis revealed that Calot triangle adhesion, stage, expertise of the team, gallbladder wall thickness, gallbladder and vicinity adhesion were important risk factors for complications. Conclusion LC complications can be prevented by good training, strictly following protocol, and timely shifting to open surgery.

Objective:To systematically review the factors affecting adherence with exercise rehabilitation in patients with heart failure, so as to provide a theoretical basis for formulating intervention strategies.Methods:PubMed, Web of Science, Cochrane Library, JBI Library, Embase, CINAHL, Medline, PsycINFO, OVID, CENTRAL, Chinese Biomedical literature Database, China National Knowledge Infrastructure, Wanfang Database and VIP Database were searched for qualitative studies on the influencing factors of exercise rehabilitation adherence from the establishment of the databases to November 31, 2020. The evaluation was performed using the Australian JBI Evidence-Based Health Care Center (2016) qualitative research quality evaluation criteria, and the results were integrated using the Meta integration method.Results:A total of 10 studies were included, 22 research results were extracted, 5 new categories were summarized and 2 integrated results were obtained. The first was the patients' own factors, including physical health status, exercise behavior intention and exercise experience. The second was external factors, including the environment and resources.Conclusions:The adherence of exercise rehabilitation in patients with heart failure is affected by multi-dimensional factors. When formulating intervention strategies, medical staff should start from improving health status of patients, stimulating exercise behavior intention and guiding positive feedback experience, and at the same time provide necessary exercise environment and resource support to improve adherence with exercise rehabilitation in patients with heart failure.

Autophagy is a highly conserved intracellular catabolic process used to degrade cytoplasmic components. In recent years, it has attracted much attention because of its importance in the pathogenesis and targeted therapy of acute and chronic kidney disease. Autophagy plays an important role in maintaining renal homeostasis under physiological and pathological conditions. The study of conditional autophagy related gene knockout specific to various renal cells has gradually revealed the role of autophagy in renal diseases. Recent studies have found that autophagy deficiency may play a key role in different pathological states of the kidney. Activated autophagy shows cytoprotective function in both glomerulus and renal tubulointerstitium, suggesting that the up regulation of autophagy may become a potential therapeutic strategy. However, there is also contrary evidence that autophagy may be harmful, which poses a great challenge to the development of therapeutic strategies for up-regulated autophagy.

Objective:To conduct a scope review on the application of ICU diaries in critically ill patients, laying the foundation for further exploration and construction of ICU diary patterns and frameworks that were in line with the national conditions and tailored to different regions and cultural backgrounds.Methods:The Joanna Briggs Institute Reviewer′s Manual was used as the methodological framework, and a computer search was conducted in nine domestic and international databases, including China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, Cochrane Library, PubMed, and Embase, etc. The search period was from the inception of the databases until March 13, 2023. The included literature was screened, summarized, and analyzed.Results:A total of 19 articles were included. ICU diaries were commonly recorded using a combination of text and visuals, with the involvement of both healthcare professionals and family members. Most patients received ICU diaries approximately one month after their transfer from the ICU. Out of the 15 studies, ICU diaries were found to be effective, while 4 studies indicated no significant improvement in patients′ psychological issues. However, ICU diaries were still considered acceptable by patients and their families.Conclusions:The application of ICU diaries has shown positive significance in critically ill patients, but further research and exploration are needed to investigate its impact on issues such as post-traumatic stress disorder, anxiety, depression, and quality of life. In the future, a combination of multiple forms and high-quality research designs with large samples, long periods, and structured approaches should be employed to explore its application effects and long-term outcomes on psychological problems.

Objective:To explore the barriers and facilitators of exercise rehabilitation in patients with atrial fibrillation (AF) after radiofrequency ablation.Methods:From March to August 2022, 285 patients with atrial fibrillation who underwent radiofrequency ablation within three months were recruited from the "Cloud Ward" of the Department of Cardiovascular of the First Affiliated Hospital with Nanjing Medical University by convenience sampling. The Cardiac Rehabilitation Barriers Scale (CRBS) and the Self-efficacy for Exercise Scale (SEE) were used to evaluate the barriers and self-efficacy of patients participating in exercise rehabilitation, respectively. Among them, 22 patients were subjected to semi-structured interviews to extract themes.Results:Among 285 patients with atrial fibrillation, 202 (70.88%) participated in exercise rehabilitation programs. Work/time conflicts, lack of cardiac rehabilitation knowledge, and health/physical function limitations affected the participation of patients in exercise rehabilitation ( P<0.05). Qualitative research extracted three themes that affected the patient's exercise rehabilitation, including capability, opportunity, and motivation. Conclusions:The participation of atrial fibrillation patients in exercise rehabilitation is influenced by multiple factors such as family responsibility, capability, motivation, and opportunity. Medical and nursing staff should comprehensively consider the above factors, develop targeted interventions from all aspects and multiple angles, so as to effectively improve the participation of patients in exercise rehabilitation.

Objective:Using the model of young rats with intermittent hypoxia, to study the expression of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) in liver, and to provide objective evidence for the possible existence of growth retardation in children with OSAHS. Method:Divided 24 rats randomly into three groups, as control group and the mild and severe hypoxia group. Normally fed control group, without treatment, the other two groups were kept in the cabin has been simulated mild and severe intermittent hypoxia conditions of OSAHS in children. 8-hour day cycle of intermittent hypoxia, a total of 35 days. To the last day, animals were sacrificed and fresh liver tissues were fixed in liquid nitrogen, stored in the -80°C refrigerator, then took the molecular biology experiment of IGF-1 and IGFBP-3 in the liver. Result:The expression of IGF-1 mRNA in liver, semi-quantitative analysis showed that the difference of mRNA expression of IGF-1 among the three groups was statistically significant (P<0.05), pairwise comparison, mild hypoxia group was higher than control and severe group, there were significant differences (P<0.05), the control group and severe hypoxia had no significant difference (P>0.05). The expression of IGFBP-3 mRNA in liver showed that, differences between the three groups was not significant (P>0.05). IGF-1 expression in liver tissue analysis showed that, differences between the three groups was statistically significant (P<0.05), pairwise comparisons, its expression in the control group was lower than mild hypoxia group and severe group, there were significant differences (P<0.05), mild hypoxia and severe hypoxia group had no significant difference (P>0.05). IGFBP-3 expression in liver tissue analysis showed that, differences between the three groups was statistically significant (P<0.05), pairwise comparisons, the control group was higher than mild and severe hypoxic group, there were significant differences (P<0.05), mild hypoxia and severe hypoxia group had no significant difference (P>0.05). Conclusion:IGF-1 and IGFBP-3 in the liver of mild hypoxia group, severe hypoxic group and control group showed that their transcription levels and the severity of hypoxia had no significant correlation.

【Objective】 To study the expressions of BMAL1 and CerbB-2 genes in nasopharyngeal carcinoma (NPC) and their related mechanisms. 【Methods】 Plasmid transfection, MTT, RT-PCR and Western blotting were used to detect the proliferation of NPC cells, the expressions of BMAL1 and CerbB-2 genes and proteins, and the expression of NF-κB signaling pathway. 【Results】 The MTT results showed that BMAL1 and CerbB-2 could affect the proliferation of NPC cells. RT-PCR results showed that BMAL1 gene was significantly down-regulated in NPC (CK: 2.24±0.22, NPC: 0.63±0.11, P<0.01), while CerbB-2 gene expression was significantly up-regulated (CK: 0.89±0.13, NPC: 2.65±0.25, P<0.01). The p50 and p65 genes in the NF-κB signaling pathway were up-regulated in NPC cells (p50, CK: 0.48±0.12, NPC: 1.45±0.25; p65, CK: 0.52±0.12, NPC: 2.33±0.35, P<0.01). The results of Western blotting were consistent with gene expression, which further confirmed the reliability of the results. 【Conclusion】 This study reveals that BMAL1 and CerbB-2 regulate the invasion and metastasis of NPC cells through the inflammatory pathway NF-κB, providing further theoretical support for the treatment and prevention of NPC.