Objective To investigate the risk factors associated with prolonged hospitalization in patients diagnosed with diabetic foot ulcers(DFU),to develop a predictive model,and to conduct internal validation of the model.Methods The clinical data of DFU patients admitted to West China Hospital,Sichuan University between January 2012 and December 2022 were retrospectively collected.The subjects were randomly assigned to a training cohort and a validation cohort at a ratio of 7 to 3.Hospital stays longer than 75th percentile were defined as prolonged length-of-stay.A thorough analysis of the risk factors was conducted using the training cohort,which enabled the development of an accurate risk prediction model.To ensure robustness,the model was internally validated using the validation cohort.Results A total of 967 inpatients with DFU were included,among whom 245 patients were identified as having an extended length-of-stay.The training cohort consisted of 622 patients,while the validation cohort comprised 291 patients.Multivariate logistic regression analysis revealed that smoking history(odds ratio[OR]=1.67,95%confidence interval[CI],1.13 to 2.48,P=0.010),Wagner grade 3 or higher(OR=7.13,95%CI,3.68 to 13.83,P＜0.001),midfoot ulcers(OR=1.99,95%CI,1.07 to 3.72,P=0.030),posterior foot ulcers(OR=3.68,95%CI,1.83 to 7.41,P＜0.001),multisite ulcers(OR=2.91,95%CI,1.80 to 4.69,P＜0.001),wound size≥3 cm2(OR=2.00,95%CI,1.28-3.11,P=0.002),and white blood cell count(OR=1.11,95%CI,1.05 to 1.18,P＜0.001)were associated with an increased risk of prolonged length of stay.Additionally,a nomogram was constructed based on the identified risk factors.The areas under the receiver operating characteristic(ROC)curves for both the training cohort and the validation cohort were 0.782(95%CI,0.745 to 0.820)and 0.756(95%CI,0.694 to 0.818),respectively,indicating robust predictive performance.Furthermore,the calibration plot demonstrated optimal concordance between the predicted probabilities and the observed outcomes in both the training and the validation cohorts.Conclusion Smoking history,Wagner grade≥3,midfoot ulcers,posterior foot ulcers,multisite ulcers,ulcer area≥3 cm2,and elevated white blood cell count are identified as independent predictors of prolonged hospitalization.Therefore,it is imperative that clinicians conduct a comprehensive patient evaluation and implement appropriate diagnostic and therapeutic strategies to effectively shorten the length of stay for DFU patients.

Brain glucose metabolism disorder is one of the pathophysiological features of Alzheimer's disease (AD), in which aerobic glycolysis (Warburg effect) metabolic pathway abnormality is one of the causes of early cognitive impairment in AD, and improving brain energy metabolism has become an important strategy to prevent AD. AMP-activated protein kinase (AMPK) is a central hub regulating glucose metabolism, the most sensitive molecular compound for sensing fluctuations of energy levels in the body. Activation of AMPK can affect the Warburg effect and its key rate-limiting enzyme activity, regulate brain glucose metabolism involved in the pathogenesis of AD, to achieve the purpose of delaying AD progression and improving cognitive function in early clinical stage. In this review, we will discuss the pathogenesis of AD and targeting of AMPK from the perspective of Warburg effect in glucose metabolism.

Objective To explore the CT finding of inflammatory myofibroblastic tumor (IMT)in the rare abdominal or pelvic, and compare their pathologies,to improve the accuracy of diagnosis and understanding of the disease.Methods The imaging,clinical and pathological data of 1 7 cases with IMT in the rare abdominal or pelvic were analyzed retrospectively.1 1 cases were performed with plain and enhanced scan,3 cases had plain scan only,and 3 cases had enhanced scan only.Results Among the 1 7 cases,8 cases were male,9 cases were female;1 5 cases were single,2 cases were multiple;4 cases were located in the stomach,colon or bladder,3 cases located in spleen,1 case located in kidney or urachus.Among those,2 lesions located in the colon cavity presented as soft tissue, it was difficult to distinguish the lesion from the adjacent intestinal contents since the small intestinal hypotonic CT examination was not performed and the intestinal filling was poor,thus those lesions were missed diagnosed with CT plain scan.The remaining 15 cases presented as soft tissue density as well,among those,9 cases presented with clear border while 6 cases with blurred border;the peripheral fat space of 4 cases were blurred and presented as infection and exudation,5 cases were accompanied with lymph node enlargement around the lesion;the density of 10 cases were uneven,among those,1 IMT lesion in bladder presented with linear calcification,1 IMT lesion in gastric antrum presented with nodular ossification in the center,9 cases showed obvious necrosis and cystic degeneration;5 cases showed even.After contrast administration,the lesions were enhanced mildly,moderately or significantly.The enhancement type were various,presented as uniform or nonuniform delayed enhancement.Vessel shadow was observed in 10 cases during arterial phase.All of the 17 lesions were primary, and no recurrence was found during follow-up.Conclusion The feature of IMT in the abdominal or pelivic including the following:the peripheral area of the lesion presenting as infection or exudation,the lesion showing uniform or nonuniform delayed enhancement, and vessel shadow observed in the lesion during arterial phase;in addition,calcification of the edge or central of the lesion occasionally happens,while ossification of the lesion is quite rare.

Since the examination of doctor's qualifications came into effect, methods that are set by standard to judge whether one passes the examination or not were in dispute all the while. This article is going to introduce four kinds of methods (Angoff method、Modified Angoff method、Nedelsky method、Borderline group method) which are commonly used at home and abroad. Summarizing their advantages, disadvantages and the usage in the process of standards setting in various countries, we aim to provide reference for setting cutoff score of the examination of doctor's qualifications in China.

Objective:To establish an HPLC method for the determination of content and entrapment efficiency of HIV-1 virus in-fection factor Vif inhibitor VEC-5 liposomes. Methods:VEC-5 liposomes were prepared by a method of freeze-drying and reconstruc-tion. The separation of free drug from the liposomes was achieved by ultracentrifugation, and an HPLC method was used to determine the content and entrapment efficiency of VEC-5 liposomes. Results:The linear range of VEC-5 was 20-100 μg·ml-1(r=0. 999 0). The average recovery was 100. 25% and RSD was 0. 93%(n=9). The content of three batches of VEC-5 liposomes was 98. 63%, 100. 43% and 102. 65%, respectively within the range of 90%-110%, and the entrapment efficiency was 94. 89%, 93. 68% and 94. 56%, respectively, which was above 90%. Conclusion:The method is accurate and reliable, which can be used to determine the content and entrapment efficiency of VEC-5 liposomes.

Objective:To explore the hemodynamic changes in aged patients with essential hypertension (EH).
Methods: Our research included 2 groups, EH group, n=180 patients and Control group, n=100 subjects without cardiovascular diseases. The relevant indexes were recorded and compared by BioZ.com noninvasive hemodynamic monitor between 2 groups.
Results: With statistic processing, the cardiac output/index (CO/CI), cardiac index, thoracic lfuid content (TFC), systemic vascular resistance/index (SVR/SVRI) were signiifcantly different between EH group and Control group, all P<0.05.
Conclusion: The hemodynamic changes exist at certain degree indicating the potential injury of cardiac function in aged EH patients, such changes might be helpful for clinical diagnosis and treatment in EH patients.

Objective: To observe two methods of cardioplegia under intrograde and retrograde, using mixed hypothemic blood in 59 patients receiving coronary artery bypass graft (CABG). Method:During perioperation and postoperation 24 hours,hemodynamie parameters were recorded. Myocardial enzyme level,the changes of ECG on 12 leads in postoperation,the frequency of using inotrope,time of staying in ICU and automatical reovery heart beat rate after openning aortic clamp were tested. Result: Cardioplegia by mixed hypothemie blood had better protective effects to the heart function, all patients could left the ICU safely,without significant differences between the two methods of cardioplegia,but in the retrograde group,there was obvious reduce in the change of myocardial enzyme level and less change of ECG in postoperation compared with those in the intrograde group. Conclusion:Both methods of mixed hypothemic blood for cardioplegia in CABG can protect effetively myocardium, but retrograde eardiaoplegia has better effect.

0.05), but pretreatment with yohimbine 10 ug significantly reduced the antinociceptive effect of tramadol ( 10ug) at 35 min and 40 min and the nociception score increased by 56% and 41 % respectively ( P 0.05). Scatchard analysis of the saturation isotherms showed that H-yohimbine was bound to a single binding site with a Kd value of 1.79 nM. The competition curve of tramadol was sigmoidal with a Ki value of 34.14 uM and an IC50 value of 68.25 uM. Tramadol was 19 000-fold less potent for binding to a2-adrenoceptor of the spinal cord as compared to H-yahimbine. Conclusion Intrathecal tramadol produces time-dependent antinociception. Tramadol has very low affinity with a2-adrenoceptor of the spinal cord. A part of its intrathecal antinociceptive effect was related to indirect a2-adrenoceptor effect of the spinal cord.

Objective: To study the effect of the bolus propofol on myocardial ? adrenergic receptor. Method: Twenty-one,aging 4-6 weeks,male health SD rats,were divided randomly into three groups:low dose group (L)with propofol of 5mg/kg,high dose group(H)with 12mg/kg of propofol and control group(C) with NS alone. The drugs were administered through the rat's tail vein in conscious state. 3 minutes after administration,the raps heart were totally taken out to investigate rat's myocardial ? adrenergic receptors with radioligand binding assay. Result:Compared with those in control group,in L group there was a decrease in ? adrenergic receptor density(Bmax),but no change in the affinity of ? adrenergic receptor (KD); In H group,Bmax decreased,KD value increased. The Bmax and KD were significantly different between L and H group. Conclusion:Intravenous bolus doses of propofol may cause down-regulation on myocardial ? adrenergic receptor of rats in dose-related way.

Objective To investigate the peri operative changes and anesthetic management during orthotopic liver transplantation (OLT) Methods General anesthesia or general anesthesia combined with epidural anesthesia was applied During the anhepatic phase, extracorporeal veno venous bypass (EVVB) was established Hemodynamics, respiratory function, blood gas, biochemistry, blood coagulation function, body temperature, blood glucose, urinary output and bleeding output were monitored According to the different characteristics of the pre anheptic phase, anheptic phase and neoheptic phase during OLT, the corresponding anesthetic management was supplied Results Applying EVVB during the anheptic phase could keep hemodynamics stable, but in 15 min of the primary anheptic and neoheptic stages a transient circulatory instablity occurred,and the rapid blood volume expansion was required Through comprehensive management, there was no obvious acid base disturbance during the phases The hypocalcemia, hypokalemia and hyperglycemia occurred and thebody temperature changed greatly,to require timly corrective measures Certain coagulative disturbances occurred, to require the supplement of coagulation factors, proper hemostatic drugs and protamine for neutralizing heparin Intraoperatively, anti rejection drugs were required Peri operatively, the blood glucose levels were higher than normal Conclusions Utilizing EVVB during the anheptic phase can be helpful to maintain hemodynamics stable, prevent obvious acidosis and hyperkalemia The anesthetic management during the neoheptic phase should be required to correcte hypothermia, hypocalcemia, hypokalemia, hyperglycemia and disturbence of coagulation