Objective:To observe the effect of personalized airway clearance therapy on extubation of patients with trache-otomy in intensive rehabilitation care unit. Method:Totally 62 patients who met the inclusion criteria were divided into the control group and experimen-tal group,with 31 patients in each group.During the experimental period,one patient in the control group and experimental group dropped off.The control group was given the posture drainage combined with back tap-ping on the basis of routine rehabilitation,while the experimental group was given the personalized airway clearance therapy(including cough training,active cycles of breathing techriques,posture drainage,etc.)on the basis of routine rehabilitation.The observation period was 6 weeks,and the sputum volume,extubation time,extubation success rate and clinical pulmonary infection score were compared between the two groups. Result:After 6 weeks of training,the average sputum volume in the experimental group was significantly high-er than that in the control group(P＜0.05).At the first week of training,there was no significant difference in the average daily sputum volume between the two groups(P＞0.05),but at the second,fourth and sixth weeks,the average daily sputum volume in the experimental group was significantly lower than that in the control group(P＜0.05).Before training,there was no statistically significant difference in CPIS scores between the two groups(P＞0.05),but at the first,third and sixth weeks,CPIS scores in the experimental group were significantly lower than that in the control group(P＜0.05).The results of repeated measure ANOVA showed that the time effect,inter-group effect and interaction effect of daily expectoration volume and CPIS score in the two groups were statistically significant(P＜0.05).The extubation time in the experimental group was significantly shorter than that in the control group(P＜0.05),and the success rate of extubation in the ex-perimental group was 93.3％,which was significantly higher than 70.0％in the control group(P＜0.05). Conclusion:Personalized airway clearance technology can improve the pulmonary infection of patients with tra-cheotomy in ICU more effectively,shorten the time of tracheal tube removal,and improve the success rate of extubation.

Objective:To observe the effect of abdominal electrical stimulation combined with airway clearance on cough ability and success rate of extubation in patients with severe tracheotomy. Method:A randomized,double-blind,controlled trial was conducted.52 patients with tracheotomy who met the inclusion criteria were divided into a control group and an experimental group,with 26 cases in each group.The experimental group was treated with abdominal electrical stimulation on the basis of airway clear-ance technique.The observation period was 6 weeks.Before and after treatment,involuntary cough peak flow rate(ICPF),clinical pulmonary infection score(CPIS),tracheal tube extubation time and extubation success rate were used to compare the differences in clinical efficacy. Result:Before the training,there was no significant difference in ICPF between the two groups(P＞0.05),but at l,3 and 6 weeks,the ICPF score of the experimental group was significantly higher than that of the con-trol group(P＜0.05).Before training,there was no significant difference in CPIS score between the two groups(P＞0.05),but after 1,3 and 6 weeks,the CPIS score of the experimental group was significantly lower than that of the control group,and the difference was statistically significant(P＜0.05).Before training,there was no significant difference in abdominal muscle thickness between the two groups(P＞0.05).At the 3rd and 6th week,the abdominal muscle thickness of the experimental group was significantly higher than that of the control group,and the difference was statistically significant(P＜0.05).The extubation time of the experimental group was significantly shorter than that of the control group(P＜0.05).The success rate of extu-bation in the experimental group was 92％,which was significantly higher than that in the control group(76％),and the difference was statistically significant(P＜0.05). Conclusion:Abdominal electrical stimulation combined with airway clearance can significantly improve the cough ability of patients with severe tracheotomy,shorten the time of tracheal cannula removal,and improve the success rate of extubation.

Cancer stem cells(CSCs)are a small group of cells found in tumors that have same self-renewing properties as nor-mal stem cells.In recent years,with continuous development of science and technology in various aspects,people's research on tumor diseases has been deepened.CSCs has been defined as a key factor in promoting tumor development,especially participating in pro-moting tumor recurrence,metastasis,chemotherapy resistance,etc.Currently,CD133 has become one of popular CSCs markers,and can be highly expressed in a variety of CSCs.CD133 is closely related to diagnosis of cancer diseases,and plays an important role in dignosis and drug targeting for gastric cancer,lung cancer,brain tumor,liver cancer,ovarian cancer and colorectal cancer.This article reviews structure,function,immune mechanism escape of CD133,signal pathway of CD133 in tumorigenesis,and correlation of CD133 with various tumors as well.

Modulating Tankyrases (TNKS), interactions with USP25 to promote TNKS degradation, rather than inhibiting their enzymatic activities, is emerging as an alternative/specific approach to inhibit the Wnt/β-catenin pathway. Here, we identified UAT-B, a novel neoantimycin analog isolated from Streptomyces conglobatus, as a small-molecule inhibitor of TNKS-USP25 protein-protein interaction (PPI) to overcome multi-drug resistance in colorectal cancer (CRC). The disruption of TNKS-USP25 complex formation by UAT-B led to a significant decrease in TNKS levels, triggering cell apoptosis through modulation of the Wnt/β-catenin pathway. Importantly, UAT-B successfully inhibited the CRC cells growth that harbored high TNKS levels, as demonstrated in various in vitro and in vivo studies utilizing cell line-based and patient-derived xenografts, as well as APC^min/+ spontaneous CRC models. Collectively, these findings suggest that targeting the TNKS-USP25 PPI using a small-molecule inhibitor represents a compelling therapeutic strategy for CRC treatment, and UAT-B emerges as a promising candidate for further preclinical and clinical investigations.

ObjectiveTo observe the effectiveness and safety of the Chinese herbal medicine Mingshi Granules （明视方颗粒） for low myopia in children with heart yang insufficiency. MethodsA multicentre， prospective， double-blind randomised controlled study was conducted， in which 290 children with low myopia from 8 centres were randomly divided into 145 cases in the treatment group and 145 cases in the control group， and the treatment group was given education， dispensing glasses， and Chinese herbal medicine Mingshi Granules， while the control group was given education， dispensing glasses， and granules placebo. Both Mingshi Granules and placebo granules were taken orally， 1 bag each time， twice daily， 4 weeks of oral intake and 2 weeks of rest as 1 course of treatment， a total of 4 courses of treatment （24 weeks）. Equivalent spherical lenses， best naked-eye distance visual acuity， ocular axis， corneal curvature K1， adjustment amplitude， traditional Chinese medicine （TCM） symptom scores， calculate the amount of progression of equivalent spherical lenses， were observed at the 12th and the 24th week of treatment， at the 36th week and 48th week of follow-up， resectively， the control rate of myopia progression was evaluated at the 24th week， and safety indexes were observed before treatment. ResultsThe amount of progression of equivalent spherical lenses was lower in the treatment group than in the control group at the 48-week follow-up （P＜0.05）. The control rate of myopia progression at 24 weeks after treatment in the treatment group was higher （57.60%， 72/125） than that in the control group （44.63%， 54/121） （P＜0.05）. The best naked-eye distance visual acuity at 36-week follow-up in the treatment group was higher than that in the control group （P＜0.05）. Equivalent spherical lenses were significantly lower in both groups at all observation time points compared with pre-treatment （P＜0.05）， and were higher in the treatment group than in the control group at the 48-week follow-up （P＜0.05）. The ocular axes of both groups were significantly higher at each observation time point after treatment and at follow-up compared with before treatment （P＜0.05）. The amount of eye axis growth in the treatment group was lower than that in the control group at 24 weeks after treatment and at the 48-week follow-up （P＜0.05）. Corneal curvature K1 was significantly lower in the treatment group at the 24th week of treatment compared to pre-treatment （P＜0.05）. The magnitude of adjustment in the treatment group was significantly higher at the 36-week follow-up and at the 48-week follow-up than before treatment （P＜0.05）. The scores of white/dark complexion， white coating thin pulse， fatigue and total TCM symptom scores of children in both groups at the 12th， 24th， 36th and 48th weeks of follow-up were significantly lower than those before treatment （P＜0.05）； the scores of blurred vision at the 24th and 36th weeks of follow-up were significantly lower than those before treatment （P＜0.05）； and the scores of blurred vision in the treatment group at the 48th week of follow-up were signi-ficantly lower than those before treatment （P＜0.05）. In the treatment group， the score of fatigue was higher than that of the control group at the 36-week follow-up， and the score of blurred vision was lower than that of the control group at the 48-week follow-up （P＜0.05）. No adverse reactions or obvious abnormalities of the safety indexes were observed of the two groups during the treatment. ConclusionChinese herbal medicine Mingshi Granules showed the effect of controlling the progression of low myopia， improving the best naked eye distance visual acuity， slowing down the growth of the eye axis， improving some of the TCM symptoms， with good safety.

Objective: To systematically evaluate the incidence and influencing factors of depression in family caregivers of Alzheimer's disease (AD) patients, so as to provide the basis for the prevention and treatment of depression among the family caregivers of AD patients. Methods: Publications pertaining to depression in family caregivers of AD patients were retrieved from CNKI, Wanfang Data, PubMed and other databases from the time of their establishment to June 15, 2023. The evaluation criteria recommended by the Agency for Healthcare Research and Quality (AHRQ) and the Newcastle-Ottawa Scale were used to assess the quality of cross-sectional and cohort studies, respectively. Stata 16.0 and Revman 5.4 softwares were used to conduct a meta-analysis on the incidence and influencing factors of depression in family caregivers of AD patients. Sensitivity analysis and publication bias assessment were also performed on the results. Results: A total of 2 324 articles were retrieved, and ultimately 14 articles were included, with a total sample size of 8 313 individuals. There were 6 high-quality articles and 8 moderate-quality articles. Meta-analysis showed that the incidence of depression in family caregivers of AD patients was 37.5% (95%CI: 30.2%-45.1%). Factors associated with depression included patients' high degree of dementia (OR=1.718, 95%CI: 1.059-2.789), patients' low scores on Activities of Daily Living Scale (OR=1.344, 95%CI: 1.059-1.706), patients' psychobehavioral abnormalities (OR=1.248, 95%CI: 1.155-1.348), long duration of caregiving (OR=1.998, 95%CI: 1.637-2.437), less involvement of other family members in caregiving (OR=1.597, 95%CI: 1.237-2.061), low educational level (OR=1.191, 95%CI: 1.044-1.359), poor caregiving skills (OR=3.060, 95%CI: 2.257-4.149), poor self-rated health (OR=2.536, 95%CI: 1.114-5.771) and social support (OR=0.424, 95%CI: 0.232-0.774). The results of depression incidence demonstrated good stability with no significant publication bias. However, publication bias was observed in the influencing factors for depression, which were patients' high degree of dementia and patients' low scores on Activities of Daily Living Scale. Conclusions The incidence of depression in family caregivers of AD patients ranges from 30.2% to 45.1%. It is primarily influenced by the severity of patients' symptoms and ability to perform daily activities, and caregivers' educational level, caregiving skills, health status, caregiving duration and social support.

Myopia is a significant global health issue,and its exact causes are still not fully understood,leaving a lack of effective and propaqable treatment options.The prevalence of myopia among children and adolescents in China remains high,posing challenges for prevention and control efforts.According to the"theory of imbalance of essence and tendon",an imbalance in the essential elements and tendons can impede the passage of eye essence and blood,resulting in delayed expansion and contraction of the eye meridians and tendons,leading to blurred vision.Modern research indicates that during the development of myopia,there are notable changes in the microstructure,activation range,and signaling of various brain regions,providing a biological basis for the"brain-eye"mechanism.Moreover,abnormal activity in the brain nucleus contributes to alterations in choroid blood flow and the impairment of eye muscle regulation,thereby accelerating the progression of myopia,this phenomenon represents the manifestation of the brain-eye imbalance.Consequently,strategies for myopia prevention and control should prioritize nourishing kidney essence,replenishing brain marrow,promoting liver and blood health,and softening the meridians.These measures aim to optimize the functioning of the brain and eyes,maintain the flexibility of eye tendons,enhance eye regulation,sustain the strength of eye tendons,and delay the advancement of eye axis growth and myopia.By enriching the scientific understanding of the appropriate application of traditional Chinese medicine techniques to prevent and control myopia through the brain,this research provides valuable insights for future explorations in this field.

Objective To evaluate the efficacy of superselective embolization of the supplying arteries of uterine fibroids under the guidance of 3D angiography in treating uterine fibroids.Methods The clinical data of 14 patients with uterine fibroids,who received interventional embolization therapy at the Third Affiliated Hospital of Zhengzhou University of China,were retrospectively analyzed.Of the 14 patients,5 received microcatheter superselective embolization of the supplying arteries of uterine fibroids after the origin and path of the supplying arteries were clarified by 3D uterine artery angiography(group A),and 9 received embolization of the bilateral uterine arteries up to their main trunks because the fibroids had complex blood supply(group B).The sums of the preoperative and postoperative one-year maximum diameter of uterine fibroids,and the reduction rate of fibroid were statistically analyzed.Results The mean sum of the preoperative and postoperative one-year maximum diameter of uterine fibroids in group A were(85.00±43.35)mm and(35.20±25.96)mm respectively,and the difference was statistically significant(P=0.006),which in group B were(65.00±12.68)mm and(49.44±24.83)mm respectively,and the difference was not statistically significant(P=0.052).There was no statistically significant differences in the mean sum of the preoperative maximum diameter of uterine fibroids and in the postoperative one-year maximum diameter of uterine fibroids between the two groups(P=0.366 and P=0.331).The median reduction rate of uterine fibroids in group A and group B was 62％and 25％respectively,and the difference was statistically significant(P=0.031).Conclusion For the treatment of uterine fibroids,3D angiography-guided superselective embolization of the supplying arteries of uterine fibroids is superior to the embolization of the bilateral uterine arteries in clinical curative efficacy.(J Intervent Radiol,2024,33:533-536)

Objective To systematically evaluate the efficacy and safety of ciprofol for sedation and anesthesia outside the operating room.Methods Databases such as PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang Data,CBM,and VIP were searched for randomized controlled trials(RCTs)related to the efficacy and safety of ciprofol for sedation and anesthesia outside the operating room.The search covered all publications up to June 2023.Statistical analysis was performed using RevMan 5.4 software and Stata 15.0.Results Twelve RCTs were included,involving 2 192 patients,of which 1 154 were in the ciprofol group and 1 038 in the propofol group.Compared with the propofol group,the anesthesia induction time(MD=0.28 min,95％CI 0.08-0.47 min,P=0.006)and recovery time(MD=1.16 min,95％CI 0.44-1.87 min,P=0.001)were significantly longer in the ciprofol group,and the inci-dences of injection pain(OR=0.04,95％CI 0.02-0.06,P＜0.001),hypotension(OR=0.64,95％CI 0.49-0.83,P=0.0008),hypoxemia(OR=0.44,95％CI 0.21-0.91,P=0.03),and respirato-ry depression(OR=0.19,95％CI 0.11-0.32,P＜0.001)were significantly lower.There were no sta-tistically significant differences between the two groups in terms of sedation success rate,physician satisfac-tion,the difference in heart rate before and after anesthesia induction,incidence of body movement,brady-cardia,nausea and vomiting,and dizziness.Conclusion The anesthetic effect of cyclopofol and propofol is similar when used for anesthesia outside the operating room.Compared to propofol,ciprofol offers comparable anesthetic effects for sedation and anesthesia outside the operating room,with a lesser impact on respiratory function and more stable hemodynamics.Ciprofol also significantly lowers the incidence of adverse reactions such as injection pain,hypotension,hypoxemia,and respiratory depression.

Long noncoding RNAs (lncRNAs) play a critical role in the regulation of atherosclerosis. Here, we investigated the role of the lncRNA growth arrest-specific 5 (lncR-GAS5) in atherogenesis. We found that the enforced expression of lncR-GAS5 contributed to the development of atherosclerosis, which presented as increased plaque size and reduced collagen content. Moreover, impaired autophagy was observed, as shown by a decreased LC3II/LC3I protein ratio and an elevated P62 level in lncR-GAS5-overexpressing human aortic endothelial cells. By contrast, lncR-GAS5 knockdown promoted autophagy. Moreover, serine/arginine-rich splicing factor 10 (SRSF10) knockdown increased the LC3II/LC3I ratio and decreased the P62 level, thus enhancing the formation of autophagic vacuoles, autolysosomes, and autophagosomes. Mechanistically, lncR-GAS5 regulated the downstream splicing factor SRSF10 to impair autophagy in the endothelium, which was reversed by the knockdown of SRSF10. Further results revealed that overexpression of the lncR-GAS5-targeted gene miR-193-5p promoted autophagy and autophagic vacuole accumulation by repressing its direct target gene, SRSF10. Notably, miR-193-5p overexpression decreased plaque size and increased collagen content. Altogether, these findings demonstrate that lncR-GAS5 partially contributes to atherogenesis and plaque instability by impairing endothelial autophagy. In conclusion, lncR-GAS5 overexpression arrested endothelial autophagy through the miR-193-5p/SRSF10 signaling pathway. Thus, miR-193-5p/SRSF10 may serve as a novel treatment target for atherosclerosis.
Humans ; Atherosclerosis/genetics* ; Autophagy/genetics* ; Cell Cycle Proteins/metabolism* ; Endothelial Cells/metabolism* ; Endothelium/metabolism* ; MicroRNAs/metabolism* ; Repressor Proteins/metabolism* ; RNA Splicing Factors ; Serine-Arginine Splicing Factors/genetics* ; RNA, Long Noncoding/metabolism*