Objective To investigate the mechanism of Guiqiyiyuan Ointment (GO) for preventing and treating 12C6+ beam radiation induced lung and kidney bystander effect to provide a new strategy for prevention and treatment of clinical radiation injury. Methods Sixty healthy male Wistar rats were randomly and equally divided into 3 groups: NC group, SR group (simple radiation 2ml/kg), GO group(GO 2ml/kg intragastric administration for 7 days). The right side of the lung was modeled by 12C6+beam radiation. After modeling, the rats were killed at 48h. The left lung, left and right kidney tissues were taken from the rats. The DNA methylation rate was detected by ELISA assay, pathological changes were observed by HE staining, and the expressions of Dnmt1, Dnmt3a and Dnmt3b were detected by immunohistochemistry. Results Compared with the NC group, the level of DNA methylation was decreased significantly (P<0.01), the left lung showed inflammation, no abnormal finding was seen in the left and right kidneys, and the expressions of Dnmt1, Dnmt3a and Dnmt3b were significantly increased in the SR group (P<0.01). Compared with the SR group, the level of DNA methylation was increased significantly (P<0.01), the left lung inflammation became better, and the expressions of Dnmt1, Dnmt3a and Dnmt3b were significantly decreased in the GO group (P<0.01). Dnmt1, Dnmt3a and Dnmt3b proteins were expressed in the cytoplasms of bronchial and renal tubular epithelial cells in all the groups. The NC group presented as light brown-brown staining, showing a weak positive expression, the SR group as brown-brown staining, showing astrong positive expression, and the GO group as light brown-brown staining, showing a moderate positive expression. Conclusion The GO can reduce the bystander effect caused by 12C6+ beam radiation, and its mechanism is related to improving the level of DNA methylation.

OBJECTIVETo describe a hospital outbreak of severe acute respiratory syndrome (SARS) and summarize its clinical features and therapeutic approaches.

METHODSThe outbreak started with a SARS patient from the community, and a total of 96 people (76 women and 20 men, mean age (29.5 +/- 10.3) years, 93.8% of whom were health care workers) who had exposure to this source patient became infected in a short time. Clinical data in this cohort were collected prospectively as they were identified.

RESULTS(1) The incubation period ranged from 1 to 20 (mean: 5.9 +/- 3.5) days. The duration of hospitalization was (17.2 +/- 8.0) days. (2) The initial temperature was (38.3 +/- 0.6) degrees C, while the highest was (39.2 +/- 0.6) degrees C (P < 0.001), with fever duration of (9.0 +/- 4.2) days. (3) Other most common symptoms included fatigue (93.8%), cough (85.4%), mild sputum production (66.7%), chills (55.2%), headache (39.6%), general malaise (35.4%) and myalgia (21.9%). (4) The radiographic changes were predominantly bilateral in the middle or lower lung zones. The number of affected lung fields was 1.2 +/- 0.8 on presentation, which increased to 2.9 +/- 1.4 after admission (P < 0.001). The interval from the beginning of fever to the onset of abnormal chest radiographs was (3.5 +/- 2.3) days, which increased in size, extent, and severity to the maximum (6.7 +/- 3.5) days later. The time before the lung opacities were basically absorbed was (14.9 +/- 7.8) days. (5) Leukopenia was observed in 67.7% of this cohort. The time between the onset of fever and leukopenia was (4.4 +/- 2.3) days, with the lowest white blood cell count of (2.80 +/- 0.72) x 10(9)/L. (6) The lowest arterial oxygen saturation was (94.8 +/- 3.1)% with supplementary oxygen. (7) Antibiotical therapies included tetracyclines (91.0%), aminoglycosides (83.3%), quinolones (79.2%); 18.8% of the patients received a combination of tetracyclines and aminoglycosides, while 11.5% received a combination of tetracyclines and quinolones, and 63.5% received a combination of tetracyclines, aminoglycosides and quinolones. Vancomycin was used in 13.5% of the patients. (8) 68.8% of the patients were treated with methylprednisolones for a mean interval of (4.9 +/- 2.4) days. The initial dose was (67.3 +/- 28.2) mg/d and the maximal dose was (82.4 +/- 30.5) mg/d. (9) Human gamma-globulin, interferon-alpha, antiviral drugs (oral ribavirin or oseltamivir) were used respectively in 68.6%, 46.9% and 92.7% of the patients. (10) Ninety-five patients (99.0%) had a complete clinical recovery, and only 1 patient (1.0%) died.

CONCLUSIONSSARS appears to be quickly infectious and potentially lethal among health care workers, characterized by acute onset and rapid progression, and mostly bilateral lung involvement on chest radiographs. Proper administration of glucocorticosteroids seems to be of some benefits. Antibiotics, human gamma-globulin, interferon-alpha, and antiviral drugs, although empirically, might be useful to shorten the clinical course.

Adult ; China ; epidemiology ; Cross Infection ; diagnosis ; epidemiology ; therapy ; Disease Outbreaks ; Female ; Humans ; Male ; Severe Acute Respiratory Syndrome ; diagnosis ; epidemiology ; therapy

Objective: To investigate the status and relationship between anxiety and family need among parents of infants admitted to NICU, and examine the moderating effect of perceived nurse support on its relationships. Methods: A convenience sample of 207 parents were selected from the Second Hospital of Harbin Medical University during December 2017 to October 2018. To adopt the measurement of socio-demographic, Self-rating Anxiety scale (SAS), NICU-Family Need Iventory, (NICU-FNI) and Nurse Parent Support Tool (NPST) assessed the general information, anxiety, family need and perceived nurse support respectively. Results: The score of SAS were (57.81±3.83). SAS was positively correlated with family need (r= 0.327, P< 0.01) and negatively correlated with perceived nurse support (r=-0.294, P<0.01). The multiple linear regression analysis showed that perceived nurse support could moderate the relationships between family need and anxiety (β=-0.154, △R²= 0.018, P=0.012). Conclusions Severity anxiety were occured in parents of infants admitted to NICU. The perceived nurse support could moderate the relationships between family need and anxiety. To reinforce perceived nurse support and enhance satisfaction of family need by intervention strategies could be an effective approach to improve psychological adjustment among parents of infants admitted to NICU.

Objective lo analyze the difference of peri-coronary tat attenuation index(pr Al)on different grades of hypertension(HT),and to explore the value of pFAI in evaluating the risk of HT patients.Methods Retrospective data on hospitalized patients who underwent coronary computed tomography angiography(CCTA)examination for chest pain were collected.A total of 415 clini-cally confirmed HT patients were selected as observation group(including 132 patients in grade 1 HT group,137 patients in grade 2 HT group,146 patients in grade 3 HT group),and 187 non-hypertension patients during the same period as control group.The differ-ence of fat attenuation index(FAI)in three main coronary arteries[left anterior descending artery(LAD),left circumflex artery(LCX),right coronary artery(RCA)]was compared,and the correlation between pF AI and HT patients was analyzed.Results RCA-FAI(-78.86 HU±7.66 HU)and LAD-FAI(-80.62 HU±7.50 HU)were higher in HT group than those in control group(-84.46 HU± 8.00 HU,-83.43 HU±7.51 HU,P＜0.05).pFAI value was higher in grade 3 HT group than that in grade 1 HT group and grade 2 HT group(P＜0.05),while there were no differences between grade 1 HT group and grade 2 HT group(P＞0.05).After adjusting the influence of traditional risk factors and coronaryartery disease,RCA-FAI had relatively closer relationship with HT grades(r=0.47,P＜0.001).Conclusion LAD-FAI,RCA-FAI in the HT group are higher than those in control group and RCA-FAI has relatively closer relationship with HT grades,suggesting that RCA-FAI may be an imaging indicator to evaluate the pro-gression of HT and predict the risk of HT.

Objective:To construct the evaluation system of Intensive Care Unit (ICU) practice base for master of nursing specialist.Methods:The evaluation indicators at all levels were initially formulated through literature review and semi-structured interviews. Using the sampling method, 25 experts were selected from August to October 2021 for correspondence. The evaluation system of ICU practice base for master of nursing specialist was finally determined by Delphi method and analytic hierarchy process.Results:A total of two rounds of consultation were conducted. The expert positive coefficients were 88% (22/25) and 91% (20/22), the expert authority coefficients were 0.953 and 0.948, and the Kendall's W were 0.211 and 0.210 respectively with statistical differences ( P<0.01). The final evaluation system of ICU practice base for master of nursing specialist included 4 first-level indicators, 15 second-level indicators and 103 third-level indicators and evaluation contents. Conclusions:The evaluation system of ICU practice base for master of nursing specialist is scientific, reliable and comprehensive, which can provide reference for formulating the evaluation criteria of clinical practice base for nursing graduate students.

Objective To investigate the prevalence and severity of symptoms and to construct symptom networks in head and neck cancer patients during treatment to identify core symptoms and symptom clusters.Methods 366 patients who were hospitalized in 3 tertiary hospitals in Changsha were selected using convenience sampling from March to October 2022 and asked to complete the M.D.Anderson Symptom Inventory-Head & Neck.Exploratory factors analysis was used to extract the symptom clusters,and R packages were used to construct the symptom severity network and symptom clusters network.The centrality indexes of the networks,including strength,closeness,and betweenness,were analyzed to identify core symptoms and core symptom cluster.Results The most common symptoms in head and neck cancer patients during treatment were dry mouth(93.44％),fatigue(89.07％),loss of appetite(86.34％),and difficulty swallowing or chewing(85.79％),and the most severe symptoms were dry mouth,loss of appetite,oral or pharyngeal mucus,and difficulty swallowing or chewing.4 symptom clusters were extracted,namely oral-pharyngeal,gastrointestinal,emotional-sleep,and sickness-sensing behavioral,which could explain 67.415％of the total variance.In the symptom severity network,oral or pharyngeal mucus(rs=9.60)was a symptom with the highest strength.In the symptom clusters network,oral or pharyngeal mucus(rs=1.20),nausea(rs=1.00),fatigue(rs=1.10),and drowsiness(rs=0.97)were the symptoms with the highest strength across 4 symptom clusters.Conclusion Oral or pharyngeal mucus,nausea,fatigue,and drowsiness are the core symptoms of symptom clusters in head and neck cancer patients during treatment.Oral-pharyngeal symptom cluster is the core symptom cluster.It is recommended that clinical staff should develop interventions based on the core symptoms and symptom cluster to implement precise symptom management and improve symptom management efficiency.

Objective To investigate the effects of cyclic stretch on migration of MC3T3-E1 cells and its related mechanism. Methods The strain loading system was used to stretch MC3T3-E1 cells cultured in vitro with 15% amplitude, to simulate the mechanical condition in vivo. The wound healing assay was used to detect the migration of MC3T3-E1 cells. Western blotting was used to test Runx2 expression. RNA interfering was used to decrease Runx2 expression. Results Cyclic mechanical stretch with 15% amplitude, 1.25 Hz frequency and lasting for 24 hours could promote the migration of MC3T3-E1 cells and increase the expression level of Runx2. Runx2 interference inhibited the migration of MC3T3-E1 cells in static culture condition. Interference with Runx2 expression in MC3T3-E1 cells could partially reduce the positive effect of cyclic mechanical stretch on cell migration. Conclusions Cyclic stretch can promote the migration of MC3T3-E1 cells, and Runx2 may play an important role in this process. This study provides experimental basis for finding innovative clinical treatment method to promote fracture healing.

OBJECTIVE To investigate the predictive value of prognostic nutritional index(PNI) and lymphocyte-monocyte ratio(LMR) in severe radiotherapy-induced oral mucositis(RIOM) during treatment of patients with head and neck cancer,and to construct a risk prediction model and test the prediction effect. METHODS A total of 502 patients with head and neck cancer who underwent radiotherapy were recruited from September 2021 to October 2023 in Xiangya Hospital Central South University. The participants were randomly divided into training group and validation group at a ratio of 7:3. According to whether severe RIOM occurred,they were divided into severe RIOM group and non-severe RIOM group. Univariate analysis and logistic regression analysis were used to screen the risk factors of severe RIOM. The receiver operating characteristic(ROC) curve was used to evaluate its prediction effect and R4.3.2 software was used to draw nomograms and decision curve. RESULTS The risk prediction model for patients with head and neck cancer during treatment had five factors,including the number of comorbidities(OR=2.221,95％CI=1.185-4.165),surgical history(OR=2.938,95％CI=1.393-6.198),the degree of tumor differentiation(OR=1.511,95％CI=1.090-2.094),PNI(OR=0.892,95％CI=0.852-0.934),LMR(OR=0.512,95％CI=0.254-1.030). Model formula:Y=2.102+0.413×degree of differentiation+0.798×number of comorbidities+1.078×surgical history-0.114×PNI-0.669×LMR. The validation results of the prediction model showed that the area under the ROC curve of the training group was 0.847(P<0.001),the area under the curve of the validation group was 0.808(P<0.001),and the P values of the Hosmer-Lemeshow test of the modeling group and the validation group were both greater than 0.05. The decision curve was above the reference line within most of the high-risk thresholds. CONCLUSION The risk prediction model constructed in this study has good effect,which can predict the risk of severe RIOM during radiotherapy in patients with head and neck cancer,providing the reference for taking preventive intervention measures for high-risk patients.

Objective:To explore the clinicopathological characteristics and the related influencing factors of efficacy and prognosis of elderly patients with malignant mesothelioma(MM)in Chinese population.Methods:We retrospectively analyzed the clinical data of 115 patients aged 65 years and above who were diagnosed with MM in Beijing Hospital, Peking University Cancer Hospital, and Cancer Hospital of Chinese Academy of Medical Sciences between November 2007 and July 2024, and the patients were grouped according to age(≥75 years in the older group and <75 years in the younger group), histological types and therapy regimens.Kaplan-Meier curve and Log-rank test were performed.Cox regression was used in prognostic analysis.Results:The positive expression rate of Calretinin in the Chinese elderly population with MM was consistent with previous reports, while the positive rates of Cytokeratin 5/6(CK5/6), WT-1, and D2-40 were much lower.The overall response ratio(ORR)for first-line treatment was 17.3%(9/52), and the disease control rate(DCR)was 92.3%(48/52).The ORR for second-line treatment was 7.7%(1/13)and the DCR was 76.9%(10/13).The ORR and DCR were higher in the first-line immunotherapy group than in the chemotherapy group, 50.0% vs.14.6%( P=0.134)and 100.0% vs.91.6%( P=1.000), respectively.The ORR in the second-line immunotherapy group was higher than that in the chemotherapy group, 25.0% vs.0, respectively, and the DCR were both 75.0% in two groups.The median progression free survival(mPFS)was 9.2 months and median overall survival(mOS)was 19.0 months for patients receiving first-line treatment, and the mPFS was 3.3 months and mOS was 11.0 months for second-line therapy.The first-line immunotherapy provided more shorter mPFS(1.6 months vs.9.2 months, P=0.081)and longer mOS(not reached vs.18.1 months, P=0.147)than the chemotherapy group.The younger group had prolonged mPFS(9.7 months vs.7.2 months, P=0.305)while shorter mOS(18.1 months vs.23.9 months, P=0.289)compared with the older group, and none of them reached statistical differences.Both mPFS and mOS were prolonged in the epithelioid subtype compared with the non-epithelioid subtypes, 10.4 months vs.1.6 months( P<0.001)and 20.3 months vs.4.6 months( P=0.803), respectively.Both mPFS(7.1 months vs.4.7 months, P=0.583)and mOS(18.3 months vs.6.3 months, P=0.134)were prolonged in the second-line chemotherapy group compared with the immunotherapy group.The Cox regression analysis showed that gender, Eastern Cooperative Oncology Group, Performance Status(ECOG PS)and positive CK5/6 were both the independent predictors for the first-line PFS.Histological type was an independent prognostic factor for the first-line OS. Conclusions:MM in the Chinese elderly population exhibits unique clinicopathologic characteristics.The immunotherapy improves ORR, DCR and prolongs mOS in first-line use, and improves ORR in second-line.First-line treatment improves mPFS in the younger group compared with the older group.Multivariate Cox regression demonstrates that gender, ECOG PS and CK5/6 expression are both predictors of efficacy, and histological type is an independent prognostic factor for survival of the Chinese elderly population with MM.

Electrocardiogram (ECG) signal is an important basis for the diagnosis of arrhythmia and myocardial infarction. In order to further improve the classification effect of arrhythmia and myocardial infarction, an ECG classification algorithm based on Convolutional vision Transformer (CvT) and multimodal image fusion was proposed. Through Gramian summation angular field (GASF), Gramian difference angular field (GADF) and recurrence plot (RP), the one-dimensional ECG signal was converted into three different modes of two-dimensional images, and fused into a multimodal fusion image containing more features. The CvT-13 model could take into account local and global information when processing the fused image, thus effectively improving the classification performance. On the MIT-BIH arrhythmia dataset and the PTB myocardial infarction dataset, the algorithm achieved a combined accuracy of 99.9% for the classification of five arrhythmias and 99.8% for the classification of myocardial infarction. The experiments show that the high-precision computer-assisted intelligent classification method is superior and can effectively improve the diagnostic efficiency of arrhythmia as well as myocardial infarction and other cardiac diseases.
Humans ; Electrocardiography ; Heart Diseases ; Myocardial Infarction/diagnostic imaging* ; Algorithms ; Electric Power Supplies