Objective To investigate the relationsheep between colonic H2 S‐producing enzyme cystathionine‐γ‐lyase(CSE) and colonic motility in a rat model of diabetes mellitus(DM) .Methods To obtained diabetic rat models ,all rats were injected intra‐peritoneally (ip) 1% streptozotocin (STZ ,65 mg/kg) ,type 1 diabetes model was established ,nornmol conditions were observed pe‐riodically .Ten days after treatment ,production of colonic longitudinal smooth muscle strips ,organ bath recordings were used to test the colonic motility ;immunofluorescence and double immunofluorescence lableling method were performed to detect the distribution of CSE;Western blot were performed on rat colonic samples devoid of mucosa and submucosa to detect the expression of CSE .Re‐sults DM rats decreased the colonic motility(P<0 .05);CSE was strongly expressed in the cytosols of the circular and longitudinal smooth muscle cells and the nucleus of the myenteric plexus neurons ;CSE distributed in myenteric neurons in the nucleus of rat ,but the proportion of MP had no difference (P>0 .05);DM rats increased the expression of CSE in the colon devoid of mucosa and sub‐mucosa(P<0 .05) .Conclusion The decrease of colonic motility in diabetic rat may be associated with the increased production of H2 S‐producing enzyme CSE .

Objective To study the quick triage assessment system for emergency nurse, establish evaluation model and method, select indicators and contents, guide triage nurses to be accurate, fast, convenient and practical, and also to optimize the use of emergency medical resources. Methods Screening the target population to conduct the research, collecting main indicators and features covered with main symptom and characteristics of severe critical emergency patients, selecting manifestation form of triage assessment system. Results The selected indicators and contents were demonstrated by a table-based form, and the quick triage assessment form for emergency nurse was established to instruct triage work. Conclusions This established quick triage assessment form is simple, intuitive and can improve the quality of emergency triage work. It possesses feasibility, practicality and achieves the optimal medical services with the limited emergency medical resources, which shows both social and economic effect.

Objective To discusses the value of combined CA125 and CT/MR/ in diagnosing the ovarian thecoma.Methods Forty cases of patients with ovarian thecoma were retrospectively analyzed.The results of CA125 and the appearance of CT and MRI were recorded,the value of CA125 changes and CT/MRI features was analysed in the diagnosis of ovarian thecoma.Results The value of CA125 elevated in 17 cases of ovarian thecoma,and showed statistical significance in the ratio((12/35 vs.5/5;x2=2.274,P=0.046) and the levels of the value of CA125 ((90.24 ± 18.56) U/ml vs.(243.35 ± 20.45) U/ml;t =7.780,P =0.002).Compared with 40 cases of control group,elevated CA125 level showed no obviously statistical significance (t =5.348,P=0.22).Forty patients in CT and MRI were all single lesion,30 cases were solid neoplasm,the rest were cystic-solidary lesions or priority of cystic component,75％ lesions were more than 5 cm,9 cases of lesions contains calcification.In pre-enhanced CT and MR/scan the lesions showed iso-density or signal-intensity,mildly enhanced;Twenty-two patients with ascites and 11 cases with symptoms in the elevating of estrogen.Combined the results of CA125 and the apperaance of CT and MR/,the accuracy of the diagnosis in ovarian thecoma was 85％.Conclusion CT and MR/imaging combining with CA125 can improve the diagnosis accuracy of ovarian thecoma.which should be given priorities.

BACKGROUND:Xenogeneic bone structure and biological characteristics are similar to human bone tissue, and the xenogeneic bone has a decreased antigenicity after physicochemical treatment, with a natural porous structure and rich source, and can be kept for a long time, which is considered to be an effective way to solve the shortage of the autogenous bone and al ograft bone.
OBJECTIVE:To compare the physical and chemical properties of xenogenic bone materials prepared by two different methods.
METHODS:Sheep cancellous bone treated with chemical method was placed into the muffle furnace at 1 000 ℃for 2 hours to prepare calcined bone. Another cancellous bone was placed into an 80 ℃ refrigerator for 4 weeks and then placed into a vacuum instrument to prepare freeze-dried bone. Cancellous bone rinsed with ultra-pure water served as controls.
RESULTS AND CONCLUSION: Three groups of samples retained three-dimensional porous structure which similar with human bone tissue under microscopic observation. The framework was stil intact, with a smal pore of 55-650μm and high porosity of 65%-80%. For the calcined bone, the toughness was decreased and the brittleness increased significantly, but the freeze-dried bone had a little changes in the mechanical properties. Through diffraction analysis, hydroxyapatite was the main composition of the three groups. However, there was a smal amount ofβ-tricalcium phosphate in the calcined bone. Spectrum analysis confirmed that calcium and phosphorus content in these three groups were al close to the human body. The results suggest the cancellous bone treated with these two methods is similar to human bone structure, and the major elements are close to the body. In addition, the cancellous bone after processing has enough smal pore and higher porosity. However, calcination process has a more influence on the mechanical property of scaffold materials, and the freeze-dried bone has a little change but the antigen cannot be completely removed that can reach the basic requirements.

BACKGROUND:Many in vivo and in vitro experiments indicate that implantation of exogenous basic fibroblast growth factor can significantly promote the process of bone formation, but the in vivo degradation of exogenous basic fibroblast growth factor affects the therapeutic efficacy.
OBJECTIVE:To observe the effects of basic fibroblast growth factor-transfected mesenchymal stem cells which transfected using molecular biology techniques combined with al ogeneic bone in the repair of critical-size bone defects in sheep.
METHODS:Al ogeneic bone with basic fibroblast growth factor-transfected bone marrow mesenchymal stem cells, bone marrow mesenchymal stem cells combined with al ogeneic bone material stents, al ograft bone material,β-tricalcium calcium material were respectively implanted into critical-size bone defects in sheep. After 4, 8 and 12 weeks, histological and immunohistochemical staining was performed.
RESULTS AND CONCLUSION:At 12 weeks after implantation of al ogeneic bone with basic fibroblast growth factor-transfected bone marrow mesenchymal stem cells as tissue engineering bone, there were many cartilage-like structures in the operative binding region and a large amount of osteoblast-like cells in the center of operative region, and there was more material degradation in the entire operative area as compared with other groups;there were fibrous connective tissues ful of the pores, and osteoclast-like cells were commonly seen around the implant material;bone sialoprotein and col agen type Ⅰ expression were strongly positive. In the other three groups, although the cartilage-like structure appeared in the binding region, dead bone structure was found in the central area, and bone sialoprotein and type Ⅰ col agen expression was weak. These findings indicate that al ogeneic bone with basic fibroblast growth factor-transfected bone marrow mesenchymal stem cells can basical y repair critical-size bone defects in sheep.

Vibrio vulnificus infection has a high disability rate and fatality rate. This paper summarized the diagnosis and treatment of a case of Vibrio vulnificus sepsis to help clinicians in the early detection and optimization of treatment options for such infections, thereby providing a clinical reference for related research. In September 2022, a case of sepsis caused by Vibrio vulnificus infection was admitted to the Emergency Department of Hainan Hospital of Traditional Chinese Medicine. Clinical treatment was conducted, and the report was analyzed. Meanwhile, Vibrio vulnificus literature was reviewed to analyze and summarize the treatment methods of Vibrio vulnificus sepsis. The 61-year-old patient was treated in the Emergency Department from September 23 to October 8, 2022, during which bacteriological examination of pus and wound infection samples identified the infection as being caused by Vibrio vulnificus. Therefore, targeted treatment with meropenem injection plus levofloxacin injection was administered for the infection, and early CRRT (continuous renal replacement therapy) was implemented to control the inflammatory cytokine storm of sepsis, and surgical debridement treatment was performed. After the patient's condition stabilized, the patient was transferred to the vascular surgery department, where two debridement + left lower limb skin grafting procedures were performed on October 27 and November 19. Then a third debridement + left lower limb third skin grafting + toe amputation was performed on December 10, the patient was discharged with improved condition post-surgery. At present, the patient can live independently and can move the affected limb autonomously. In clinical diagnosis and treatment of sepsis caused by Vibrio vulnificus infection, attention should be paid to the inflammatory cascade reaction. CRRT can eliminate inflammatory factors in the early stage, sensitive antibiotics for anti-inflammatory, surgical debridement interventional treatment, and multi-disciplinary linkage can be initiated to treat patients with Vibrio vulnificus sepsis.

OBJECTIVE:To detect the blood drug level of digoxin in order to offer reference about clinical safety and utility and rational use of cardiac glycoside drugs. METHODS: The plama concentration of digoxin was determined by fluorescence polarization immunization, and the monitoring rssults were subjected to statistical analysis. RESULTS: Of the total 126 cases who treated with digoxin, the blood drug concentration in 32(25.4%) was above 2.0 ng?mL-1,and it was 0.8～2.0 ng?mL-1 in 83(65.9%) and less than 0.8 ng?mL-1 in 11(8.7%); Toxic symptoms were noted in 16 cases(12.7%). CONCLUSION: To ensure clinical efficacy and reduce incidence of toxic reactions, it is of great importance to monitior the blood drug level and formulate individual dosage regimen.

Objective To observe the change of oxidalive stress indexes in the patients with diabetic perineuropathy (DPN), and investigate the protection role of glutathione (GSH) on neuroprotective effect. Methods The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) and sensory nerve conduction velocity (SCV) were detected in 54 cases with DPN (DPN group) and 30 cases of health examination (control group). Fifty-four cases with DPN were divided into GSH group (given basic treatment and GSH 1.8 g/d) and CON group(given basic treatment and B vitamin) with 27 cases each by random-digits table. After treatment of 2 weeks, the levels of SOD, MDA and SCV were compared. Results The levels of MDA in DPN group were significantly higher than those in control group, while the activity of SOD was significantly lower than that in control group [(7.23 ±2.31) μmol/L vs. (4.87 ± 1.17) μmol/L, (59.72 ± 13.58) kU/L vs. (76.19 ± 7.55 ) kU/L](P＜ 0.01). After treatment, the level of MDA was decreased and the activity of SOD was increased in GSH group and CON group (P ＜0.05),but there was no significant difference between the two groups(P＞ 0.05). After treatment, the level of SCV was significantly increased in GSH group,while there was no significant difference in CON group (P ＞0.05). Conclusions Oxidative stress exists in DPN patients. The antioxidant treatment with GSH can improve impaired nerve and has a better effect of nerve protection than classical nerve nutrition therapy.

Objective:To explore and compare the value of radiomic features based on 18F-fluorodeoxyglucose (FDG) PET and CT in distinguishing epidermal growth factor receptor (EGFR) mutation status in patients with lung adenocarcinoma. Methods:Pretreatment 18F-FDG PET/CT images and EGFR gene status of 114 patients (64 males and 50 females, aged range: 35-84 (average age: 61) years) with primary lung adenocarcinoma between January 2017 and December 2017 were retrospectively collected. The volume of interest was drawn manually slice by slice, then the features were extracted by the LIFEx software. The parameters were screened by least absolute shrinkage and selection operator (LASSO) method for 200 times, and ten-fold cross-validation was used to select the best tuning parameter λ. Three models, namely M PET, M CT, M PET+ CT, were constructed by binary logistic stepwise regression. The receiver operating characteristic (ROC) curve was generated and the corresponding area under the curve (AUC), sensitivity, specificity and accuracy were calculated. The AUCs of three models were compared by Delong test. Results:Totally, 53.51%(61/114) patients were with wild type EGFR and 46.49%(53/114) patients had EGFR mutation. There were 3, 3, 7 parameters selected to form M PET, M CT, M PET+ CT, respectively. The AUCs for M PET, M CT, M PET+ CT were 0.730, 0.752 and 0.866 respectively. When the cut-off values were 0.427, 0.522, 0.378 for M PET, M CT and M PET+ CT, the Youden index were up to the maximum as 0.420, 0.405, 0.630, with sensitivities of 83.0%(44/53), 58.5%(31/53), 92.5%(49/53), specificities of 59.0%(36/61), 82.0%(50/61), 70.5%(43/61) and accuracies of 70.2%(80/114), 71.1%(81/114), 80.7%(92/114), respectively. There was no significant difference between AUC of M PET and M CT ( z=-0.320, P>0.05). The differences of AUCs between M PET+ CT and M PET, M PET+ CT and M CT were statistically significant ( z values: 2.963, 2.523, both P<0.05). Conclusions:PET, CT and PET+ CT radiomic features are all associated with EGFR gene expression in lung adenocarcinoma. M PET+ CT has the highest predictive efficiency.

Aim To look for cold-protective drugs treating cryogenic freezing that may bring great damage to animal physiological system.Methods The protective effect of curcumin on frozen damage and the changes of thyroid function in mice were studied in this study.Quantitative analysis of the changes in survival time and metabolic indexes in mice disposed at(-20±1)℃ was conducted.Mouse serum free triiodothyronine(FT3) and free thyroxine(FT4) contents were detected by ELISA kit.HE staining was used to observe thyroid tissue morphological items.The expression of genes related to thyroid function was assessed via real-time quantitative PCR.Results The intraperitoneal injection of curcumin(12.5~50 mg·kg-1) could remarkably prolong the survival time of mice when exposed to cryogenic freezing.HE staining results displayed a recovered thyroid injury in morphology in the curcumin group, further with a notably improved metabolic indexes and evidently increase in serum FT3 and FT4 levels.The real-time quantitative PCR results indicated that the expressions of sodium iodide symporter(Nis), thyroglobulin(Tg) and thyroid peroxidase(Tpo) were up-regulated, and the expression of thyroid-stimulating hormone receptor(Tshr) was down-regulated.Sodium levothyroxine collabrated with the promoting thyroid effects of curcumin, while propylthiouracil inhibited the effects.Conclusion Curcumin can prolong the survival time of the cryogenic freezing mice, which is closely related to its ability to promote thyroid function.