Objective To evaluate the effect of case management model on the stable patients with chronic obstructive pulmonary disease (COPD),containing health knowledge level,the number of acute exacerbation and the quality of life.Methods Fifty patients were divided into the experimental group and the control group with 25 cases each by random digits table method.The experimental group received the case management model for 3 months.The control group received routine care for 3 months.The COPD health Knowledge Questionnaire(CKQ) scores and St George's Respiratory Questionnaire(SGRQ) scores were measured for 4 times (the beginning of the intervention and 1 months,2 months,3 months later),and the numbers of acute exacerbation were measured at 3 months later.Results The CKQ scores at 1,2,3 months after intervention were (28.04±1.43),(28.20±1.00),(28.40±1.04) points in the experimental group,and (18.08±2.30),(18.50±1.87),(18.33±1.66) points in the control group,and there were significant differences (t=18.109,22.556,5.320,all P ＜ 0.01).The scores of SGRQ and symptom at 2 months and 3 months after intervention were (50.56±8.68),(49.40±8.05),(41.52±10.86),(37.16±8.90) points in the experimental group,and (57.42±10.22),(59.46±9.06),(54.50±8.67),(56.71 ±10.03) points in the control group,and there were significant differences (t=-7.222-2.536,P ＜ 0.05 or 0.01).The influence scores at 1,2,3 months after intervention were (46.28±8.74),(44.40±8.11),(42.04±8.22) points in the experimental group,and (51.50±7.77),(51.79±8.06),(54.08±6.96) points in the control group,and there were significant differences(t=-2.206,-3.197,-5.523,P ＜ 0.05 or 0.01).There was no statistically significant difference about activity scores between two groups before and after intervention (P ＞ 0.05).The numbers of acute exacerbation during 3 months with 3,22 cases in 1 and 0 time in the experimental group and 9,15 cases in the control group,and there was statistically difference between two groups(x2=4.306,P＜ 0.05).Conclusions The case management model can promote the stable COPD patients to know more disease-related health knowledge,and improve the health knowledge level.The case management model can reduce the symptoms of the stable COPD patients,reduce the frequency of acute exacerbation,reduce the influence of disease on daily life,prevent further decline in activity endurance,and improve the quality of life.

Objective To characterize the differential protein expression in the progeny of human liver ceils surviving from ionizing radiation by the proteomic analysis.Methods Two-dimensional electrophoresis gel coupled with mass spectrometry was used to explore the specific protein expression in the progeny of 7702 human liver cells surviving from ionizing radiation.Alterations in expression level of protein spots between the control and the progeny groups were statistically analyzed by ImageMaster 2D Platinum software and mass spectrometry was used to identify the protein spots with significantly altered expression-level.Results The progeny of irradiated ceils were derived from human liver cell line exposed to 0,2,4,6 Gy of 60Co γ-irradiatian.A total of 42 differentially expressed proteins between the control and the progeny of the irradiated cells groups were screened,of which 17 were identified by matrix assistant laser desorption ion-top off light-mass spectrometry(MALDI-TOF MS)analysis,including 4 up-regulated and 13 down-regnlated proteins.Conclusions The differentially expressed proteins profile could be significantly altered in the progeny of irradiated cells.The proteomics approach has the potential to detect the protein changes relevant to radiatian-induced genomic instability(RIGI).Further study of differentially expressed proteins would likely reveal the molecular mechanisms of gene expression in RIGI.

Objective To investigate the differential expression profile in the progeny of human liver cells surviving from ionizing radiation.Methods Complemental DNA gene chip was used to measure the transcriptional profile in progeny of HL-7702 cells exposed to 0, 2, 4, and 6 Gy of 60Co γ-rays, and the differentially expressed genes HAVCR2 and RAN were further identified by real-time PCR.Results The transcription level of 262 genes, 2746 genes and 3406 genes changed in the progeny of survival cells at 2, 4 and 6 Gy, respectively.A total of 71 common differentially expressed genes were screened, most of which were associated with transduction, cell cycle regulation, cellular immunity, cytoskeleton and movement, cell replication and repair mechanism.Conclusions Ionizing radiation could induce the expression changes of many genes, which might reveal the molecular mechanisms of gene expression in radiation induced genomic instability.

Objective: To investigate the effects of γ-tocotrienol (γ-T3) on the invasion and migration of human gastric cancer SGC-7901 cells as well as its possible molecular mechanism. Methods: The different concentrations (0, 15, 30, 45, 60, and 100 μmol/L) of γ-T3 were used to treat SGC-7901 cells. Then the proliferation, migration and invasion of SGC-7901 cells were detected by CCK-8 assay, cell scratch wound healing assay and Transwell invasion assay, respectively. Furthermore, the expressions of cyclooxygenase-2 (COX-2) and nuclear factor-kappa B (NF- κB) signal pathway proteins were detected by Western blotting. Results: After treatment with different concentrations (15-100 μmol/L ) of γ-T3 for 24, 48 and 72 h, the proliferation of SGC-7901cells was evidently inhibited in a time- and dose-dependent manner (all P<0.01). After treatment with γ-T3 (15-60 μmol/L) alone or combined with tumor necrosis factor-alpha (TNF-α) (10 ng/mL) for 24 h, the migration and invasion abilities of SGC-7901 cells were significantly inhibited (all P<0.01). The expressions of NF-κB, NF-κB p65 and COX-2 proteins were significantly down-regulated in SGC-7901 cells after γ-T3 (15-60 μmol/L) treatment for 24 h (all P<0.01). Conclusion: γ-T3 can inhibit the invasion and migration of human gastric cancer SGC-7901 cells. Its mechanism may be associated with blocking NF-κB signal pathway and reducing the expression of COX-2 protein.

Objective:To establish reference ranges for M-mode echocardiography in preterm infants within 7 days after birth based on different gestational age (GA) and birth weight.Methods:This retrospective study analyzed M-mode echocardiographic values of 489 premature infants, who were admitted to the neonatal intensive care unit of Department of Pediatrics, Peking University Third Hospital from March 2017 to February 2020. These infants were divided into four groups according to GA:<28 weeks, 28-31 +6weeks, 32-33 +6weeks and 34-36 +6weeks; and five groups according to birth weight:<1 000 g, 1 000-1 499 g, 1 500-1 999 g, 2 000-2 499 g and ≥2 500 g. The M-mode values among groups were compared by independent sample K-W test, and based on which, the 95% confidence interval ( CI) and the Z-value reference ranges were established. Results:The gestational age of these infants was 32.0 (24.0-36.7) weeks, and the birth weight was 1 700 (650-3 180) g. The interventricular septum end-diastolic thickness (IVSd), left ventricular posterior wall end-diastolic thickness (LVPWd), left atrial diameter (LAD), left ventricular end-diastolic diameter (LVED), left ventricular end-systolic diameter (LVES), right ventricular outflow tract (RVOT) and the right ventricular end-diastolic diameter (RVED), were all correlated with GA and birth weight ( r = 0.209, 0.216, 0.430, 0.608, 0.495, 0.464, 0.447; r= 0.275, 0.288, 0.445, 0.609, 0.496, 0.499, 0.464;all P<0.01). While the left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) had no correlation with GA or birth weight (all P<0.05). Within the first 7 days after birth, the greater the GA and birth weight, the greater the inner diameters of the heart chambers, and the thicker the ventricular wall. The LVEF and LVFS maintained a high and stable level within the first week of life (95% CI: 67%-69%, 34%-36%). Conclusions:According to different GA and birth weight, the reference ranges for chamber diameters, interventricular septal thickness and left ventricular wall thickness within 7 days were established. The 95% CI and Z score ranges for M-mode echocardiographic measurements established based on gestational age and birth weight can provide a reliable reference for preterm infants aged 0-7 days.

Objective:To establish reference ranges for Doppler echocardiography in preterm infants within 7 days after birth based on different gestational age (GA), birth weight (BW) and body surface area (BSA).Methods:This retrospective study analyzed Doppler echocardiographic measurements of 489 premature infants, who were admitted to the neonatal Intensive Care Unit of Department of Pediatrics, Peking University Third Hospital from March 2017 to February 2020. These infants were divided into four groups according to GA:<28 weeks, 28-31 +6 weeks, 32-33 +6 weeks and 34-36 +6 weeks; and five groups according to BW:<1 000 g, 1 000-1 499 g, 1 500-1 999 g, 2 000-2 499 g and ≥ 2 500 g;and 14 groups according to BSA from 0.07-0.20 m 2. The Doppler values among groups were compared by independent sample KW test, and based on which, the 95% CI were established as reference ranges. Results:Among the 489 preterm infants, males were 264 and females were 225. Their GA, BW and BSA were 32.0 (30.0,33.9) weeks, 1 700 (1 260,2 040) g and 0.13 (0.11,0.15)m 2, respectively. Measurements are presented charting as 95% CI with respect to GA,BW and BSA for preterm infants aged 0-7 days. Aortic valve(AV) flow rate, mitral valve E peak (MV-E), mitral valve E/A (MV-E/A) and tricuspid valve E peak (TV-E) were all correlated with GA, BW and BSA ( r = 0.263, 0.256, 0.324 and 0.114 for GA; 0.292, 0.261, 0.281 and 0.135 for BW; 0.287, 0.268, 0.312 and 0.140 for BSA, all P<0.05). Within the first 7 days after birth, the greater the GA, birth weight and BSA, the greater the AV, MV-E, MV-E/A and pulmonary valve flow rate(all P<0.05). According to the above grouping of GA, the 95% CI of AV were 48-54, 52-57, 58-63 and 60-65 cm/s, respectively; and the 95% CI of MV-E were 32-37, 33-36, 39-42 and 40-45 cm/s, respectively; and the 95% CI of MV-E/A were 0.66-0.73, 0.74-0.80, 0.81-0.90 and 0.92-1.06. And according to the above grouping of BW, the 95% CI of AV were 45-53, 49-53, 59-64, 60-66 and 56-65 cm/s, respectively; 95% CI of MV-E were 29-35, 32-36, 38-41, 40-44 and 38-46 cm/s, respectively; 95% CI of MV-E/A were 0.65-0.74, 0.74-0.81, 0.81-0.99, 0.86-0.99 and 0.84-1.07. Conclusion:The 95% CI of Doppler echocardiographic measurements established based on GA, BW and BSA could provide a reference for preterm infants aged 0-7 days.

Consensus and guidelines regarding point-of-care ultrasound (POCUS) carried out by neonatologists in neonatal intensive care unit (NICU) have been published in many countries. This review summarizes the development, advantages, limitations, and current issues of POCUS in NICU, aiming to promote the establishment of systematic training courses, accelerate the development of POCUS in NICU in China, and ensure the effectiveness and safety of POCUS implementation.

Objective To investigate the relationships of serum levels of human fractalkine (CX3CL1) and chitinase-3-like protein 1 (YKL-40) with early cognitive impairment in elderly patients with Alzheimer's disease (AD). Methods A total of 110 AD patients in the Second Affiliated Hospital of Xinxiang Medical University from February 2021 to December 2023 were selected as AD group, and 50 healthy individuals with physical examination during the same period were selected as control group. Clinical materials and serum levels of CX3CL1 and YKL-40 were compared between the two groups, and multivariate Logistic regression models were used to analyze the influencing factors of cognitive impairment in AD patients. Based on the Mini-Mental State Examination (MMSE) score, the 110 AD patients were divided into mild cognitive impairment group (n=47), moderate cognitive impairment group (n=36), and severe cognitive impairment group (n=27). Spearman correlation analysis was performed to explore the relationships of serum CX3CL1 and YKL-40 with MMSE score, Addenbrooke's Cognitive Examination-Ⅲ (ACE-Ⅲ) score, and Montreal Cognitive Assessment (MoCA) score. Results The AD group had higher proportions of patients aged over 80 years, with an education level of primary school or below, smoking history, alcohol consumption history, diabetes mellitus, hypertension, AD family history, and living alone as well as higher serum levels of CX3CL1 and YKL-40 compared to the control group; conversely, the AD group had a lower proportion of patients engaging in no physical exercise/labor, and lower MMSE, ACE-Ⅲ, and MoCA scores, with significant between-group differences (P < 0.05). Advanced age, diabetes mellitus, and high serum levels of CX3CL1 and YKL-40 were independent risk factors for cognitive impairment in AD patients (P < 0.05), while an education level of college or above was a protective factor (P < 0.05). Compared with the mild cognitive impairment group, the moderate and severe cognitive impairment groups had higher serum levels of CX3CL1 and YKL-40, and the severe cognitive impairment group had higher serum levels of CX3CL1 and YKL-40 than the moderate group, with significant between-group differences (P < 0.05). Spearman correlation analysis revealed that serum CX3CL1 and YKL-40 were negatively correlated with MMSE, ACE-Ⅲ, and MoCA scores (P < 0.05). Conclusion Serum CX3CL1 and YKL-40 are highly expressed in elderly AD patients, and are closely related to early cognitive impairment in elderly AD patients.

Objective:To explore the effect of Internet + technical liaison service mode on the postoperative continuing nursing of elderly patients with osteoporotic hip fractures.Methods:A total of 92 elderly patients with osteoporotic hip fractures who were admitted into in Orthopaedics Department of the First Affiliated Hospital of Soochow University from July 2018 to December 2019 were selected, and randomly divided into intervention group and control group by random number table method, with 46 cases in each group. The control group was given routine follow-up outside hospital, while the intervention group was given the continuing nursing led by the orthopedic specialist nurses based on the Internet + Technology home orthopedic care platform. All patients were followed up to 6 months after operation, and the differences of Harris Hip Score (Harris), Numeric Rating Scales (NRS), Barthel Index, Short Form 36-item Health Survey (SF-36) between the two groups were compared.Results:The Harris scores were 49.74 ± 4.28, 76.59 ± 4.33 and 90.78 ± 2.61 in the intervention group, and 46.17 ± 3.85, 74.26 ± 4.24 and 88.65 ± 2.17 in the control group in 1, 3 and 6 months after operation, respectively. The differences were statistically significant ( t=-4.20, -2.60, -4.26, all P<0.05). The NRS scores in the intervention group were 1.33 ± 0.47, 0.83 ± 0.38 and 0.76±0.43 in 1, 3 and 6 months after operation respectively, while the NRS scores in the control group were 1.61 ± 0.54, 0.96 ± 0.42 and 0.84 ± 0.38, respectively. The difference in pain scores between the two groups was statistically significant only at 1 month after operation ( t=2.68, P<0.05). The Barthel Index in the intervention group were 61.74 ± 8.90, 93.80 ± 5.29 and 98.26 ± 2.83 in 1, 3 and 6 months after operation respectively, while those of the control group were 60.33 ± 5.81, 91.09 ± 7.52 and 97.83 ± 3.10, respectively. The difference in Barthel Index between the two groups was statistically significant only in 3 months after operation ( t=-2.00, P<0.05). The scores of SF-36 in the intervention group were 93.73 ± 3.89, 100.26 ± 3.77 and 107.50 ± 3.56 at 1, 3 and 6 months after operation respectively, while those of the control group were 92.67±3.42, 97.71±2.67 and 103.68±2.83, respectively. The difference in SF-36 scores between the two groups was statistically significant only at 3 and 6 months after operation ( t=-3.74, -5.71, P<0.05). Conclusions:The continuing nursing based on multi-disciplinary team cooperation in hospital + Internet + Technology home orthopaedic nursing platform led by orthopaedic specialist nurses can improve joint function, relieve pain and improve quality of life of elderly patients with osteoporotic hip fractures after operation.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.