Background Manganese is an essential trace element for the human body and maintains normal development of many organs including the brain. However, long-term exposure to a high manganese environment or excessive manganese intake will lead to manganese poisoning and result in neurological diseases, and currently no effective treatment plan is available. Objective To develop an animal model for subchronic manganese exposure and assess the impact of Dendrobium nobile Lindl. alkaloids (DNLA) on manganese associated behavioral and hippocampal effects in rats. Methods Fifty male SPF SD rats were randomly allocated into a control group (0.9% normal saline by intraperitoneal injection), two experimental groups [7.5 mg·kg⁻¹ (low) or 15 mg·kg⁻¹ (high) of MnCl₂·4H₂O by intraperitoneal injection], and two DNLA antagonistic groups [15 mg·kg⁻¹ MnCl₂·4H₂O by intraperitoneal injection then either 20 mg·kg⁻¹ (low) or 40 mg·kg⁻¹ (high) DNLA by oral administration]. All groups of rats were adminaistered 5 d per wek, once a day, for consecutive 13 weeks. Following modeling, neurobehavioral assessments were conducted using open field, Morris water maze, and Y maze. Inductively coupled plasma mass spectrometry (ICP-MS) was utilized to measure manganese levels in the blood and brain tissues of the rats, and hematoxylin-eosin (HE) staining was employed to examine neuronal morphological changes in the hippocampal tissues of the rats. Results The neurobehavioral tests revealed that the manganese-exposed rats exhibited decreased total movement distance, prolonged central zone dwelling time, and reduced motor activity in the open field test, indicating tendencies toward depression and anxiety (P<0.05). In the Y-maze test, the mean exploration distance in the novel arm, the number of entries into the novel arm, and the time spent in the novel arm of the managanses-exposed rats were all reduced, while the latency period increased, suggesting impaired spatial exploration and learning-memory functions (P<0.05). In the Morris water maze navigation test, the escape latency was significantly longer in the manganese-exposed rats compared to the control group, and the number of platform crossings decreased in the spatial probe test, indicating a significant decline in spatial learning and memory (P<0.05). The ICP-MS analysis showed elevated manganese concentrations in the blood and hippocampus of the exposed rats (P<0.05), and the histopathological observation revealed hippocampal damage. Following the DNLA intervention, the manganese-exposed rats showed increased total movement distance and reduced central zone dwelling time in the open field test (P<0.05). In the Y-maze test, the mean exploration distance in the novel arm, the number of entries into the novel arm, and the time spent in the novel arm increased, while the latency period decreased, suggesting alleviation of anxiety and improved exploratory behavior (P<0.05). In the Morris water maze test, the escape latency gradually shortened, and both the number of platform crossings and the percentage of time spent in the target quadrant increased, indicating improved spatial learning and memory (P<0.05). Additionally, the manganese levels in the blood and hippocampus decreased (P<0.05), and the hippocampal pathological changes were partially restored. Conclusion DNLA demonstrates the ability to counteract multiple neurotoxic effects following the elevation of manganese levels in the blood and hippocampal tissues of rats induced by subchronic manganese exposure. Specifically, DNLA is shown to ameliorate the behavioral alterations observed in rats after manganese exposure, and mitigate the hippocampal damage in manganese-exposed rats.

OBJECTIVE: To evaluate the impact of critical care warning platform (CWP) on clinical outcomes of patients transferred from internal medical ward to intensive care unit (ICU) based on real-world data. METHODS: A retrospective cohort study was conducted. The patients transferred from internal medical ward to ICU of Zhongda Hospital, Southeast University, between January 2022 and October 2024, were enrolled. They were divided into critical care warning group and conventional treatment group based on whether they were connected to the CWP. The patients in the critical care warning group were connected to the CWP, which collected real-time vital signs and treatment data. The platform automatically calculated severity scores, generated individualized risk assessments, and triggered warning alerts, allowing clinicians to adjust treatment plans accordingly. The patients in the conventional treatment group were not connected to the CWP and relied on conventional clinical judgment and nursing measures for treatment management. Baseline characteristics [gender, age, body mass index (BMI), admission type, severity score of illness, underlying diseases, and disease type at ICU admission], primary clinical outcome (in-hospital mortality), and secondary clinical outcomes [ICU mortality, length of ICU stay, total length of hospital stay, and mechanical ventilation and continuous renal replacement therapy (CRRT) status] were collected. Multivariate Logistic regression was used to analyze the impact of CWP on in-hospital death, and subgroup analyses were performed based on different patient characteristics. RESULTS: A total of 1 281 patients were enrolled, with 768 in the critical care warning group and 513 in the conventional treatment group. Compared with the conventional treatment group, the proportion of patients in the critical care warning group with underlying diseases of diabetes and malignancy and transferred to ICU due to sepsis was lowered, however, there were no statistically significant differences in other baseline characteristics between the two groups. Regarding the primary clinical outcome, the in-hospital mortality in the critical care warning group was significantly lower than that in the conventional treatment group [17.6% (135/768) vs. 25.7% (132/513), P < 0.01]. For secondary clinical outcomes, compared with the conventional treatment group, the patients in the critical care warning group had significantly fewer days of mechanical ventilation within 28 days [days: 2 (1, 6) vs. 2 (1, 8), P < 0.05], significantly shorter length of ICU stay [days: 3 (2, 8) vs. 4 (2, 10), P < 0.01], and significantly lower ICU mortality [15.1% (116/768) vs. 21.4% (110/513), P < 0.01]. Multivariate Logistic regression analysis showed that, after adjusting for age and underlying diseases, the use of CWP was significantly associated with a reduction of in-hospital mortality among patients transferred from internal medical ward to ICU [odds ratio (OR) = 0.670, 95% confidence interval (95%CI) was 0.502-0.894, P = 0.006]. Further subgroup analysis revealed that, among patients transferred to ICU due to sepsis, the use of CWP significantly reduced in-hospital mortality (OR = 0.514, 95%CI was 0.367-0.722, P < 0.001). In patients aged ≥ 70 years old (OR = 0.587, 95%CI was 0.415-0.831, P = 0.003) and those with underlying diseases of malignancy (OR = 0.124, 95%CI was 0.046-0.330, P < 0.001), CWP also showed significant protective effects on in-hospital prognosis. CONCLUSION The use of CWP is significantly associated with a reduction in in-hospital mortality among patients transferred from internal medical ward to ICU, demonstrating its potential in assessing the deterioration of hospitalized patients.
Humans ; Intensive Care Units ; Retrospective Studies ; Hospital Mortality ; Prognosis ; Critical Care ; Male ; Female ; Patient Transfer ; Middle Aged ; Aged ; Cohort Studies

Objective: To explore the effects of different concentrations of glucose solution on the survival of Aedes albopictus and Culex pipiens pallens larvae, the attraction to mosquitoes and egg-laying behaviors, so as to provide the reference for developing mosquito control technology based on sugar bait. Methods: White porcelain bowls were filled with 100 mL of 3%, 5%, 8%, 10% and 15% glucose solutions. Ten of fourth instar larvae of Aedes albopictus or Culex pipiens pallens were added to each bowl, and the survival of larvae was recorded after 2, 4, 6, 24, 48 and 72 hours. Egg-laying cups containing 5%, 8% and 15% glucose solution were put in mosquito cages containing fully blooded female mosquitoes of Aedes albopictus and Culex pipiens pallens (50 mosquitoes each), and the total number of eggs laid in 72 hours was observed. The analogous site room was filled with fully blooded and starved female mosquitoes of Aedes albopictus and Culex pipiens pallens (100 mosquitoes each), and simple mosquito control buckets containing 5% and 8% glucose solution and black sticky insect plates. The number of mosquitoes and eggs was observed after 6 days. All the above experiments were repeated 3 times using dechlorinated water as the control. Results: The 72 hour corrected mortality rates of Aedes albopictus and Culex pipiens pallens larvae gradually increased with the increase of glucose concentration. The glucose solution with 5% and higher concentrations was not suitable for mosquito larvae to survive. The attraction of egg-laying behaviors to Aedes albopictus and Culex pipiens pallens gradually decreased with the increase of glucose concentration. The effects were similar between 5% and 8% glucose solution, with the averages of 686.67 and 682.33 eggs for Aedes albopictus, and 3.00 and 2.33 egg rafts for Culex pipiens pallens. In analogous site room, there were 93.33, 105.00 and 130.33 adult mosquitoes captured on average in the control group, 5% and 8% glucose solution groups, respectively, with 8% glucose solution group more attractive to adult mosquitoes than the control group (F=3.283, P=0.030); there were 70.33, 55.33 and 63.00 Aedes albopictus eggs (eggs counts+larvae counts) on average, respectively, with statistically significant differences among the three groups (H=6.761, P=0.034). Conclusion Glucose solution with concentration of 5% or higher can effectively inhibit the survival of Aedes albopictus and Culex pipiens pallens larvae, and attractive to adult mosquitoes and egg-laying behavoirs.

In vitro diagnostic technology is an important aid for disease prevention,treatment,and prognostic monitoring.The de-velopment of its new technologies,methods and products is of great significance for improving medical quality and protecting public health.On the basis of exploring the mechanism of health impact of in vitro diagnostic technology,it takes dry chemical method and wet chemical method as an example,and compares the economy of the two diagnostic technologies for hyperkalemia diagnosis from the perspective of health system,with a view to draw references for the practical application and evaluation of new in vitro diagnostic techniques,methods and products in the future.

Objective Pertussis cases have increased markedly since 2018 in Guangxi.The aim of this study was to evaluate antibody levels and the infection status of pertussis in the resident population. Method A total of 10,215 serum samples from residents were collected from August-November 2018 and tested for anti-pertussis IgG and toxin IgG using the enzyme-linked immunosorbent assay(ELISA). Results Of the collected samples,1,833(17.94%)tested positive for anti-pertussis IgG,with the median concentration of 16.06 IU/mL.Antibody level<10 IU/mL accounted for more than 60%in children under 4 years of age,but declined with age,whereas the percentages of the other three levels(10-40,40-50,and≥50 IU/mL)increased almost with age(P<0.001).Moreover,7,924 samples were selected for anti-pertussis toxin IgG,of which 653(8.24%)tested positive(≥40 IU/mL)with the median concentration of 5.89 IU/mL,and 204 participants(2.56%)had recent pertussis infection(≥100 IU/mL).Among the different age groups,the highest rates of positivity and recent infection were observed at 11-20 years of age,the lowest positivity rate at 5 years of age,and the lowest recent infection rate at 4 years of age(P<0.001,P=0.005,respectively). Conclusion The survey results showed that all age groups in Guangxi lacked immunity against pertussis,which was one of the main factors contributing to the resurgence of pertussis in 2018.In addition,the prevalence of pertussis is relatively high in Guangxi,and its incidence is seriously underestimated,especially in adolescents and adults.

Objective To evaluate the effectiveness and safety of ultrasound-guided microwave ablation technique in the treatment of benign thyroid nodules.Methods A total of 3985 nodules in 2913 patients with pathologically confirmed benign thyroid nodules during 2016-2023 were analyzed retrospectively.The one-time ablation success rate,incidence rate of postoperative complications and side effects were evaluated.For 1890 ablation nodules in 1449 patients with a median follow-up period of 12 months,the nodule volume re-duction rate (VRR),recurrence rate,re-ablation rate and technical effective ablation rate were evaluated in postoperative 1,3,6,12,24 months and more.Results The success rate of one-time ablation in all patients was 99.7％ (3972/3985),the technical effective ablation rate was 88.6％ (535/604),the recurrence rate was 3.1％ (59/1890) and the re-ablation rate was 0.7％ (13/1890).In the follow-up nodules,VRR in postopera-tive 1,3,6,12,24 months and more was (-17±430)％ (n=727),(48±152)％ (n=643),(72±38)％ (n=573),(83±20)％ (n=604),(88±18)％ (n=279),respectively.In all patients,the incidence rate of major complications was 2.57％,the incidence rate of minor complications was 2.06％,and the incidence of side effects was 3.09％.Conclusion Ultrasound-guided microwave ablation of thyroid nodules is an effective and safe method for the treatment of benign thyroid nodules.

Objective To investigate the effect of sigma-1 receptor(sig-1R)inhibition on apoptosis in the dorsal root ganglion(DRG)of rats with sciatic nerve chronic constriction injury(CCI)-mediated neuropathic pain.Methods Rats undergoing intrathecal intubation were randomly divided into three groups with 12 in each:sham group,model group(CCI modeling one week after intrathecal intubation)and sig-1R inhibitor group(BD1047 group)that was injected intrathecally on the fourth,fifth,and sixth days after the CCI operation.The mechanical withdrawal threshold(MWT)of rats was detected on the day before surgery and then first,third,fifth and sev-enth days after surgery.The expression of sig-1R,Bcl-2 and Bax was detected by Western blot and immunofluo-rescence in DRG cell;TUNEL staining microscopy was used to observe the apoptosis of DRG cells.The changes of endoplasmic reticulum and mitochondria were observed by transmission electron microscopy of DRG cells.Results Compared with the sham group,the model group showed a decreased MWT at all time points after surgery,up-regulation of DRG cell apoptosis,up-regulation of sig-1R and Bax,down-regulation of Bcl-2,swelling of en-doplasmic reticulum,disruption of mitochondrial membrane and reduction of mitochondrial cristae in the DRG cell endoplasmic reticulum after surgery(P＜0.05).BD1047 group showed elevated MWT at the fifth and seventh postoperative days,down-regulation of DRG cell apoptosis,down-regulated expression of sig-1R and Box,up-regulated expression of Bcl-2 and slightly damaged endoplasmic reticulum as well as mitochondria of DRG cells compared with model group(P＜0.05).Conclusions Inhibition of sig-1R up-regulates mechanical withdrawal threshold and reduces DRG cell apoptosis in CCI rats.

Twelve DEK-NUP214 fusion gene-positive patients with acute myeloid leukemia and on allo-HSCT treatment at the Hematology Hospital of the Chinese Academy of Medical Sciences from November 2016 to August 2022 were included in the study, and their clinical data were retrospectively analyzed. The patients comprised five men and seven women with a median age of 34 (16-52) years. At the time of diagnosis, all the patients were positive for the DEK-NUP214 fusion gene. Chromosome karyotyping analysis showed t (6;9) (p23;q34) translocation in 10 patients (two patients did not undergo chromosome karyotyping analysis), FLT3-ITD mutation was detected in 11 patients, and high expression of WT1 was observed in 11 patients. Nine patients had their primary disease in the first complete remission state before transplantation, one patient had no disease remission, and two patients were in a recurrent state. All patients received myeloablative pretreatment, five patients received sibling allogeneic hematopoietic stem cell transplantation, and seven patients received haploid hematopoietic stem cell transplantation. The median number of mononuclear cells in the transplant was 10.87 (7.09-17.89) ×10 8/kg, and the number of CD34 + cells was 3.29 (2.53-6.10) ×10 6/kg. All patients achieved blood reconstruction, with a median time of 14 (10-20) days for neutrophil implantation and 15 (9-27) days for platelet implantation. The 1 year transplant-related mortality rate after transplantation was 21.2%. The cumulative recurrence rates 1 and 3 years after transplantation were 25.0% and 50.0%, respectively. The leukemia free survival rates were (65.6±14.0) % and (65.6±14.0) %, respectively. The overall survival rates were (72.2±13.8) % and (72.2±13.8) %, respectively.

Objective:To explore the application effects of case nursing review based on training transfer theory in specialized nurses training, and to provide reference for promoting the knowledge and skills transformation of specialized nurses.Methods:A total of 64 specialized nurses from Longgang District Maternity & Child Healthcare Hospital of Shenzhen City were selected as subjects by convenient sampling from June 10 to July 20, 2022 and divided into control group and observation group by random number table method. The control group received routine core competence training, while the observation group received case nursing review based on training transfer theory. The training duration of both groups was 12 months. Within 1 month after the training, the training satisfaction, nursing case report quality score, core competence of specialized nurses, patient satisfaction and training transfer outcomes of the two groups were compared.Results:Finally, 62 specialist nurses were included, with 31 nurses in control group and observation group, 2 males and 29 females in each group, aged (34.10 ± 3.93) years in control group and (33.35 ± 3.06) years in observation group. Before training, there were no significant differences in nursing case report quality score, total score of core competence of specialized nurses and patient satisfaction between the two groups (all P> 0.05). After training, the nursing case quality score, total score of core competence and patient satisfaction in the observation group were 73.00(68.00, 78.00), 179.00(175.00, 183.00), 96.00(94.00, 99.00) points, which were higher than 85.00(80.00, 89.00), 163.00(162.00, 166.00), 88.00(85.00, 92.00) points in the control group, and the differences were statistically significant ( Z = 5.81, 6.73, 13.31, all P<0.05). The total training satisfaction of nurses, awards in professional competitions and the number of technological innovations in the observation group were 21.00(20.00, 22.00) points, 15 awards, 8 innovations, which were higher than 15.00(14.00, 16.00) points, 5 awards, 2 innovations in the control group, and the differences were statistically significant ( Z = 6.74, χ2 = 7.38, 4.29, all P<0.05). Conclusions:The application of case nursing review based on training transfer theory can improve the training satisfaction of specialist nurses, stimulate their motivation to transfer training, and improve their ability and effectiveness in training transfer.

Objective To explore the pathogenic roles of miR-21, estrogen (E2), and estrogen receptor (ER) in adenomyosis. Methods We examined the expression levels of miR-21 in specimens of adenomyotic tissue and benign cervical lesions using qRT-PCR. In primary cultures of cells isolated from the adenomyosis lesions, the effect of ICI82780 (an ER inhibitor) on miR-21 expression levels prior to E2 activation or after E2 deprivation were examined with qRT-PCR. We further assessed the effects of a miR-21 mimic or an inhibitor on proliferation, apoptosis, migration and autophagy of the cells. Results The expression level of miR-21 was significantly higher in adenomyosis tissues than in normal myometrium (P<0.05). In the cells isolated from adenomyosis lesions, miR-21 expression level was significantly higher in E2 activation group than in ER inhibition+E2 activation group and the control group (P<0.05);miR-21 expression level was significantly lower in cells in E2 deprivation+ER inhibition group than in E2 deprivation group and the control group (P<0.05). The adenomyosis cells transfected with miR-21 inhibitor showed inhibited proliferation and migration, expansion of mitochondrial endoplasmic reticulum, increased lysosomes, presence of autophagosomes, and increased cell apoptosis, while transfection of the cells with the miR-21 mimic produced the opposite effects. Conclusion MiR-21 plays an important role in promoting proliferation, migration, and anti-apoptosis in adenomyosis cells by altering the cell ultrastructure, which may contribute to early pathogenesis of the disease. In addition to binding with E2, ER can also regulate miR-21 through other pathways to participate in the pathogenesis of adenomyosis, thus having a stronger regulatory effect on miR-21 than E2.