Sj?gren syndrome(SS)is an immune disease mainly characterized by lymphocytes infiltrate in salivary and lacrimal glands,leading to glandular secretion disorders and dryness in the mouth and eyes.In recent years,clinical application of ultrasound elastography(USE)increased widespread,providing a new imaging method for diagnosis of SS.The research progresses of USE in SS were reviewed in this article.

Objective:To develop an evidence-based nursing practice program based on the Stetler model to extend the lifespan of arteriovenous fistulas (AVF) in maintenance hemodialysis (MHD) patients and evaluate its effectiveness.Methods:An evidence-based nursing practice program was constructed based on the best evidence for extending AVF lifespan in MHD patients. Expert group discussions were held to determine review indicators. A baseline survey was conducted among 100 MHD patients and 42 nurses using covenience sompling at the Blood Purification Center of Wuxi People's Hospital from January to December 2023, to identify barriers and facilitators. In the following year, from January to December 2024, the evidence-based practice was implemented at the same hospital, and the AVF surgical intervention rate and AVF self-management levels of MHD patients were compared before and after the practice.Results:No statistically significant difference was found in the AVF surgery rates before and after the evidence-based practice ( P>0.05) . However, after implementing the evidence-based practice, MHD patients' scores on the AVF self-management scale significantly improved, and the difference was statistically significant ( P<0.01) . Conclusions:The evidence-based practice based on the Stetler model is beneficial for standardizing the clinical management of AVF, reducing the need for surgical interventions, and improving MHD patients' ability to self-manage their AVF.

Objective:To develop an evidence-based nursing practice program based on the Stetler model to extend the lifespan of arteriovenous fistulas (AVF) in maintenance hemodialysis (MHD) patients and evaluate its effectiveness.Methods:An evidence-based nursing practice program was constructed based on the best evidence for extending AVF lifespan in MHD patients. Expert group discussions were held to determine review indicators. A baseline survey was conducted among 100 MHD patients and 42 nurses using covenience sompling at the Blood Purification Center of Wuxi People's Hospital from January to December 2023, to identify barriers and facilitators. In the following year, from January to December 2024, the evidence-based practice was implemented at the same hospital, and the AVF surgical intervention rate and AVF self-management levels of MHD patients were compared before and after the practice.Results:No statistically significant difference was found in the AVF surgery rates before and after the evidence-based practice ( P>0.05) . However, after implementing the evidence-based practice, MHD patients' scores on the AVF self-management scale significantly improved, and the difference was statistically significant ( P<0.01) . Conclusions:The evidence-based practice based on the Stetler model is beneficial for standardizing the clinical management of AVF, reducing the need for surgical interventions, and improving MHD patients' ability to self-manage their AVF.

Sj?gren syndrome(SS)is an immune disease mainly characterized by lymphocytes infiltrate in salivary and lacrimal glands,leading to glandular secretion disorders and dryness in the mouth and eyes.In recent years,clinical application of ultrasound elastography(USE)increased widespread,providing a new imaging method for diagnosis of SS.The research progresses of USE in SS were reviewed in this article.

Objective:To explore the expressions and clinical significances of tripartite motif-containing protein 28 (TRIM28), 3-phosphoinositide-dependent protein kinase-1 (PDK1), and N-cadherin in pancreatic carcinoma.Methods:A total of 72 patients diagnosed with pancreatic carcinoma underwent radical resection in the Department of Hepatobiliary Surgery, Binzhou People′s Hospital from January 2009 to November 2022 were selected, all of which were pathologically diagnosed as pancreatic ductal adenocarcinoma (PDAC). Immunohistochemistry was used to detect the expression of TRIM28, PDK1, and N-cadherin in 72 cases of pancreatic carcinoma and paracancerous tissues, to explore the correlation between the expression of them and the clinicopathological features of pancreatic carcinoma, and to analyze the influence of their expression and clinicopathological characteristics on the prognosis of patients. The count data were expressed as the number of cases and percentage, and the Chi-square test was used for comparison between groups. Spearman method was used for correlation analysis. Kaplan-Meier method was used for survival analysis, and Log-rank test was used to compare the survival rate, and univariate and multivariate Cox regression analysis were used to analyze the risk factors affecting prognosis.Results:The positive rates of TRIM28 (72.22%), PDK1 (65.28%) and N-cadherin (61.11%) in PDAC were significantly higher than those in para-cancerous tissues (26.39%, 33.33%, 34.72%). Moreover, the patients with high expression of the three had the characteristics of low differentiation, late stage, and lymph node metastasis ( P<0.05). TRIM28 was positively correlated with PDK1 and N-cadherin expression in PDAC ( r=0.720, P<0.001; r=0.714, P<0.001), N-cadherin and PDK1 expression in PDAC was also positively correlated ( r=0.854, P<0.001). Kaplan-Meier survival curve showed that the 2-year survival rate of patients with positive TRIM28, PDK1 and N-cadherin (13.46%, 14.89%, 13.64%) was significantly lower than that of patients with negative tumor (50.00%, 40.00%, 39.29%), the differences were statistically significant ( P<0.05). Univariate Cox regression analysis showed that patients with poor differentiation, nerve infiltration and lymph node metastasis, TNM stage Ⅲ+ Ⅳ, TRIM28 positive, PDK1 positive and N-cadherin positive had a significantly increased risk of death within 2 years after surgery ( P<0.05). Multivariate Cox regression analysis showed that poor differentiation, nerve infiltration, TNM stage Ⅲ+ Ⅳ and TRIM28 positive were independent risk factors for poor prognosis of patients with PDAC ( P<0.05). Conclusions:TRIM28, PDK1 and N-cadherin are highly expressed in PDAC, and the expression level is significantly correlated with the malignant degree of PDAC. TRIM28 is an independent risk factor for the prognosis of patients with PDAC.

Objective:To analyse the clinical significance of selective single embryo transfer by time-lapse mo-nitoring(TLM)or conventional morphology assessment(CMA)in vitro fertilization/intracytoplasmic sperm in-jection and embryo transfer(IVF/ICSI-ET),and to initially explore the predictive value of Raman spectral analy-sis of embryo culture medium for clinical pregnancy rate.Methods:The study is a prospective randomized con-trolled clinical trial.We assigned 139 patients treated with IVF/ICSI-ET in Reproductive and Genetics Center of Suzhou Municipal Hospital from April 2019 to July 2020,which were randomly assigned to either the CMA or the TLM group.We performed selective single-embryo transfer(fresh cycle and FET)after selecting the optimal em-bryos with TLM or CMA respectively.If the patient's first embryo transfer was unsuccessful,a second one would be performed to compare the differences in the cumulative live birth rate of embryo transfer and other pregnancy outcomes between the two groups.Meanwhile,we collected 15 μl of embryo culture medium at day 3 after IVF/ISCI fertilization for Raman spectroscopy analysis.Results:There were no differences in cumulative live birth,cu-mulative clinical pregnancy,cumulative premature birth,cumulative early spontaneous abortion,cumulative ectopic pregnancy and LGA or SGA between TLM and CMA groups(P＞0.05).The Neonatal sex ratio in the TLM group was lower than that in the CMA group,but the difference was not significant(P＞0.05).Raman spectros-copy analysis of embryo culture medium predicted the clinical pregnancy rate with 67.21％accuracy.Conclu-sions:In young women with a good ovarian reserve,the advantage of using TLM to evaluate embryos is not obvi-ous,so we should remain vigilant that embryo selection based on morphokinetic parameters may affect the sex ratio.Raman spectroscopic analysis of embryo culture medium is not yet able to effectively predict the planting ability of embryos.

OBJECTIVE: To explore the correlation between microRNA (miRNA) differential expression and quality of embryo. METHODS: The miRNA expression profiles of 8 blastocysts were detected by a TaqMan microRNA array, and miRNAs with a stable expression were selected. Additional blastocysts were selected, and the candidate miRNA was detected by real-time PCR. Meanwhile, chromosomal abnormalities of the embryos were detected by using next-generation sequencing, and the results were compared. RESULTS: The expression of mir-720, mir-372, mir-886-3p and mir-512-3p was higher than that of miR-145, which suggested that mir-720, mir-372, mir-886-3p and mir-512-3p are related to early embryo development. The expression of miR-145 and mir-886-3p were significantly lower in the normal chromosome group. With the threshold values of above 9 and 3 for the relative expression of miR-145 and mir-886-3p, respectively, there was no embryo without a chromosomal abnormality. CONCLUSION There is a correlation between the expression level of specific miRNA and chromosomal abnormalities of embryos, which may be used as a novel biomarker for embryo selection.

Objective To translate English version of the Questionnaire evaluating the Disability of Upper Extremities in daily activities among patients undergoing maintenance Hemo-Dialysis (QDUE-HD) and test the reliability and validity of QDUE-HD. Methods After translation, back translation, 2 rounds of Delphi expert advice and pre-investigation, the initial questionnaire was formed. Two hundred and eleven patients undergoing hemo-dialysis from 4 hospitals located in Suzhou, Wuxi, Shanghai and Zhejiang were investigated using the initial questionnaire. And reliability and validity of QDUE-HD were evaluated. Results Two common factors containing 10 items and 2 dimensions(i.e. gripping and upper and lower arm movements) were extracted by exploratory factor analysis. The rate of cumulative contribution was 69.473％. In addition, the content validity index, Cronbach α coefficients, half-fold coefficient and test-retest reliability coefficient of whole scale were 0.850, 0.906, 0.929 and 0.983, respectively. Conclusions The reliability and validity of QDUE-HD (Chinese version) are reliable and effective. This questionnaire is simple and convenient to use in clinic.

Objective: To explore sarcoplasmic reticulum ryanodine receptor2 (RyR 2) expression and calcium releasing function in chronic heart failure (CHF) rabbits and to study the impact of long term valsartan treatment in relevant animals. Methods: HF model was established by volume overloading with pressure overloading in experimental rabbits. 27 rabbits were divided into 3 groups: Sham group, HF group and HF+valsartan group. n=9 in each group and the animals were treated for 7 weeks. Left ventricular structure, hemodynamic parameters, expression and functional changes of myocardiocyte sarcoplasmic reticulum RyR 2 were observed and compared among different groups. Results: Compared with Sham group, HF group had increased left ventricular mess index (LVMI), left ventricular end diastolic pressure (LVEDP) and decreased left ventricular shortening fraction, LVEF, all P<0.05. Compared with HF group, HF+valsartan group showed decreased LVMI, LVEDP and increased left ventricular shortening fraction, LVEF, all P<0.05. Sarcoplasmic reticulum RyR 2 expression and calcium releasing function were lower in HF group than Sham group, P<0.05; while they were both higher in HF+valsartan group than HF group, P<0.05. Conclusion: Long term application of valsartan could improve the cardiac function which might be related to increased myocardial sarcoplasmic reticulum RyR 2 expression and calcium releasing function in experimental CHF rabbits.

Objective To investigate the effect of exogenous interleukin-10 (IL-10) on STAT3 protein activation in rats with allergic rhinitis (AR).Methods60 SD rats were randomLy divided into AR model group, IL-10 group and control group, with 20 in each group.AR group and IL-10 group were treated with conventional ovalbumin (OVA) combined with aluminum hydroxide sensitization method.The negative control group was treated with saline instead of 48 h after the last challenge.The levels of IL-6, TGF-β and P-STAT3 in nasal mucosa and serum IgE were measured by ELISA kit.The expression of IL-6, TGF-β and P-STAT3 in nasal mucosa was detected by Western-blot Detection.ResultsAR group exhibited severe clinical manifestations of AR, such as friction around, tears flowing, the signs of which in IL-10 group were significantly lower than that in the control group (P<0.05).Compared with the control group, the levels of serum IgE and IL-6, TGF-β and P-STAT3 in the nasal mucosa were significantly higher than those in the control group (P<0.05).After treatment with IL-10, the levels of TGF-β and P-STAT3 were significantly increased (P<0.05).Western-blot showed that compared with the control group IL-6, TGF-β and P-STAT3 in nasal tissues of AR group and IL-10 group were significantly increased, while the expression level of IL-10 group was lower than that of AR group.ConclusionTreatment of AR with exogenous IL-10 can significantly relieve the clinical manifestation of AR, inhibit STAT3 activation immune response, and achieve the purpose of treatment of AR in some extent.