Objective:To determine the content of the released nickel ion through the 7 extraction media to extract the Ni-Ti wires and to plot the curve of the released nickel ion so as to identify a leaching medium that can be substituted for blood for in vitro Ni release evaluation. Methods:The release of Ni through microwave digestion/inductively coupled plasma mass spectrometry (ICP-MS) in the goat serum was determined. Because of the high content of Ni release, it could be determined by diluting the extraction medium, and other extraction media could be determined directly. Ni release standard curves were plotted by the release amount and different time point variables. Though the different extraction media Ni release curves confirm the specificity of extraction media instead of blood.Results:By analyzing the Ni release curves of seven leaching media, it was found that none of these seven extraction media was suitable for the evaluation of Ni release in in vitro leaching media. Considering the safety of the leaching medium and the simplicity of preparation, hydrochloric acid solution was chosen as the leaching medium, but the concentration needed to be diluted accordingly. Finally, a hydrochloric acid solution was created as an alternative to blood for the in vitro study of Ni release from Ni-Ti alloy cardiovascular products, with a volume fraction of 0.005%. Conclusions:The in vitro leaching medium that can replace blood was found to be hydrochloric acid for the time being, but its concentration was too high, resulting in too much Ni release as well, which deviated from the actual situation. Therefore, the hydrochloric acid solution was diluted step by step, and the Ni release curve was examined until it was close to the clinical release level, and the actual concentration was determined, thus laying a solid foundation for the subsequent evaluation of the safety and risk.

Objective:To systematically evaluate the qualitative researches on cardiac telerehabilitation experience of patients with cardiovascular disease (CVD), so as to provide reference for clinical development and improvement of cardiac telerehabilitation services.Methods:Qualitative studies on cardiac telerehabilitation experience of CVD patients in PubMed, Web of Science, Embase, CINAHL, Cochrane Library, Scopus, China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Database and VIP were searched by computer. The search period was from establishment of the databases to August 2023. The quality of the literature was evaluated according to the quality evaluation criteria of the Evidence-Based Health Care Center of the Joanna Briggs Institute in Australia, and the results were integrated by aggregative integration method.Results:A total of 13 articles were included, 52 research results were extracted and classified into 11 categories. Four integrated results were formed, including the benefits, promoting factors, obstacle, expectations and suggestions for cardiac telerehabilitation experience in CVD patients.Conclusions:CVD patients benefit significantly from participating in cardiac telerehabilitation. In the future, it is supposed to pay more attention to the factors that affect patients' participation in cardiac telerehabilitation, actively develop domestic cardiac telerehabilitation tools and optimize the cardiac telerehabilitation model according to the needs and suggestions of patients.

Rheumatoid arthritis(RA)is a common chronic autoimmune disease with synovitis as its pathological basis and erosive arthritis as its main symptom.Pathogenesis of RA is complex,combination of genetic factors,environmental factors,immune cells,cytokines and autoantibodies causes joint injury,bone destruction and multi-system disease of RA.However,the above mecha-nisms can not fully explain the poor prognosis,high disability rate and poor clinical treatment effect of RA.Therefore,exploring new pathogenesis and therapeutic targets of RA is the focus of RA research.In recent years,with the deepening of RA research,it has been found that there is a new form of cell death in pathological process of RA,namely ferroptosis.Ferroptosis is a type of cell death caused by inhibition of glutathione peroxidase activity and accumulation of lipid reactive oxygen species.Previous studies have con-firmed the close correlation between RA and ferroptosis,this paper mainly explores ferroptosis-related signal pathways that affect the change and development of RA disease from the perspective of regulating the main signal pathways of ferroptosis,so as to find new therapeutic targets for RA and new therapeutic ideas for research.

Objective To investigate the impact of an integrated online and offline(O+O)co-care model on blood glucose management and pregnancy outcomes in pregnant patients with hyperglycemia.Methods A total of 200 pregnant patients with hyperglycemia(HIP)admitted to the Department of Endocrinology,Second Hospital of Jilin University were enrolled in this study from January 2021 to March 2023.All the participants were divided into two groups according to their diagnosis and treatment approach:routine group(n=102)and nursing group(n=98).General data were collected from the initial visit until delivery for comparative analysis between the two groups,including FPG,2 hPG,HbA1c,body weight,BMI,and daily insulin doses.Logistic regression analysis was used to evaluate the influencing factors for adverse pregnancy outcome in patients with gestational hyperglycemia.Results The care group exhibited higher rates of family history of DM,polycystic ovary syndrome,primipara,gestational diabetes mellitus,and diabetes combined with pregnancy compared to the routine group(P<0.01).The first visit of FPG,2 hPG,HbA1c,△FPG,△2 hPG,△HbA1c,2 hPG compliance rate,HbA1c compliance rate were higher(P<0.01),while the excess rates of △weight,2 hPG at delivery,△BMI and overweight weight gain were lower incare group than in routine group(P<0.05 or P<0.01).FPG,2 hPG and HbA1c were lower at delivery than at first visit in both groups(P<0.01).The nursing group had a lower incidence of adverse pregnancy outcomes including macrosomia and NICU admissions compared to the conventional group(P<0.05 or P<0.01).Logistic regression analysis revealed that the co-care mode was an influential factor for adverse pregnancy outcomes.Conclusions The O+O co-care mode is beneficial for managing blood glucose levels during pregnancy as well as controlling weight gain and reducing the risk of adverse pregnancy outcomes in HIP patients.

Objectives:This study was aimed to investigate the risk factors for moderate and severe acute kidney injury(AKI),in-hospital mortality and dialysis dependence after acute Stanford type A aortic dissection(TAAD)surgery. Methods:Complete clinical data of 294 TAAD patients who underwent ascending aorta replacement,total aortic arch replacement combined with frozen elephant trunk between December 2014 and December 2016 with time between symptom onset and diagnosis<14 days were retrospectively and consecutively collected and analyzed.AKI was defined according to the SCr component of the Kidney Disease Improving Global Outcomes(KDIGO)2012 consensus criteria,and classified as moderate-severe AKI(AKI stage 2-3)or non-moderate-severe AKI(no AKI or AKI stage 1).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for moderate to severe AKI,in-hospital mortality or dialysis dependence after TAAD surgery. Results:AKI occurs in 232 out of 294 patients(79.3%),124(42.2%)with AKI stage 1,45(15.3%)with AKI stage 2,63(21.4%)with AKI stage 3,and 27(9.2%)requiring continuous renal replacement therapy(CRRT).The dialysis dependence rate at discharge was 3.1%(n=9),and overall in-hospital mortality rate was 3.7%(n=11).Univariate analysis revealed that patients who developed the moderate-severe AKI were more likely to present with hypertension,preoperative renal hypoperfusion,longer duration of cardiopulmonary bypass(CPB),longer duration of aortic cross-clamp and higher intraoperative ultrafiltration volume(all P<0.05).Multivariate logistic regression analysis showed that renal hypoperfusion(OR=4.95,95%CI:1.97-12.26,P<0.001),and prolonged CPB time(OR=1.01,95%CI:1.00-1.02,P=0.016)were independent risk factors for moderate-severe AKI after TAAD surgery.Further analysis revealed that prolonged CPB time(OR=1.02,95%Cl:1.01-1.03,P=0.007)and moderate-severe AKI(OR=10.49,95%Cl:1.22-90.62,P=0.033)were independent risk factors for in-hospital mortality or dialysis dependence after TAAD surgery. Conclusions:Preoperative renal hypoperfusion and prolonged CPB time are independent risk factors for moderate-severe AKI after TAAD surgery.Prolonged CPB time and occurrence of moderate to severe AKI significantly increase the risk of in-hospital mortality and dialysis dependence,indicating that close clinical follow-up of these patients is required.

Objective This study aims to develop and validate a dynamic web-based nomogram for predicting kinetophobia in patients following percutaneous coronary intervention(PCI).Methods A prospective design was employed to selectively enroll 330 PCI patients admitted to a hospital in Hangzhou from December 2022 to July 2023.Single-factor analysis and Lasso regression were utilized to identify independent risk factors for kinesophobia post-PCI.Logistic regression was performed using R software,and a nomogram was constructed.The model was assessed through the area under the receiver operating characteristic curve(AUC)and Hosmer-Lemeshow tests.Results There were 206 cases of kinesiophobia in 330 patients after PCI,and the incidence was 62.4％.Logistic regression analysis identified combined heart failure,emergency surgery,NYHA cardiac function grade,ADL level,sedentary behavior,Chinese version of PROMIS Physical Function Summary Table score,and Chinese version of Perceptive Social Support Scale score as independent influencing factors for kinesophobia after PCI(P＜0.05).The AUC value of the model was 0.821,with a sensitivity of 70.4％and specificity of 82.0％.The Hosmer-Lemeshow fit test yielded a non-significant result(x2=9.350,P=0.314).Calibration and decision curves demonstrated the model's favorable calibration and clinical practicability.The C-index of the nomogram prediction model was 0.778,0.774,and 0.800,respectively,by 5-fold cross-validation,10-fold cross-validation,and the Bootstrap method.Conclusion The dynamic nomogram model developed in this study effectively predicts kinesophobia in patients after PCI.It provides valuable references and support for clinical staff in early identification of high-risk patients,enabling the formulation of individualized health education strategies and exercise rehabilitation plans.

Objective:To evaluate the effectiveness of oral-nasal oxygen supply mouth guard in painless gastroscopy for snoring patients.Methods:The snoring patients who underwent painless gastroscopy at two Endoscopy Centers of Shanghai East Hospital, Tongji University in July 2022 were randomly divided into the observation group (using oral-nasal oxygen supply mouth guard) and the control group (using ordinary nasal oxygen tube and mouth guard). Parameters such as the wearing time and the removal time of the mouth guard, lowest pulse oxygen saturation (SpO 2), incidence of hypoxemia, and the satisfaction of medical staff were compared between the two groups. Results:The wearing time of mouth guard was 11.63±0.84 seconds and the removal time was 5.33±0.76 seconds in the observation group ( n=40), which were lower than those in the control group ( n=47) (14.91±1.21 seconds, t=-14.463, P<0.001; 10.38±0.80 seconds, t=-30.095, P<0.001). The wearing satisfaction score was 9.80±0.61, the lowest SpO 2 was (96.70±3.42)%, the removal satisfaction score was 9.75±0.67, and the anesthesiologists' satisfaction score was 9.20±1.42 in the observation group, which were higher than those in the control group [7.70±0.93, t=12.209, P<0.001; (94.06±3.72)%, t=3.417, P=0.001; 7.96±0.98, t=9.803, P<0.001; 8.13±1.35, t=3.615, P=0.001] with significant difference. There was no significant difference in the incidence of hypoxemia [10.00% (4/40) VS 14.89% (7/47), χ2=0.130, P=0.718] and endoscopic physician satisfaction score (9.30±0.97 VS 9.02±1.31, t=1.112, P=0.269) between the two groups. Conclusion:The oral-nasal oxygen supply mouth guard is easy to wear and remove, effectively reducing SpO 2 fluctuations during painless gastroscopy for snoring patients. It can enhance medical staff satisfaction with high clinical value.

Objective To observe the changes of liver function,blood cell,and lung function of healthy young and middle-aged men before and after fast-advancing short-term high altitude exposure(FSHAE);and to explore the effects and possible mechanisms of FSHAE on the function of liver,blood cells,and lung tissues.Methods This study included 48 healthy young and middle-aged male volunteers,who collected physiological indicators,tested liver function indicators,blood cell indicators,and lung function-related indicators 1 day before entering the plateau(100m above sea level),and 15 days after FSHAE(3000m above sea level).Differences in the relevant parameters of each system were compared before and after FSHAE.Results Compared with those before entering the plateau,the physiological parameters of young and middle-aged men after 15 days of FSHAE heart rate increased significantly,respiratory rate increased,systolic blood pressure increased,mean arterial blood pressure increased,oxygen saturation decreased(P＜0.01),and diastolic blood pressure increased(P＜0.05),all of which were statistically significant;and the indicators of liver function:glutamic oxaloacetic aminotransferase,glutamic alanine aminotransferase increased(P＜0.01),glutamylamine aminotransferase,glutamate aminotransferase,glutaminase,and pulmonary function were increased(P＜0.01),glutamyl transpeptidase,alkaline phosphatase,and total bile acids were elevated,and total protein decreased(P＜0.05),and the differences were statistically significant.Hemocyte-related indexes:erythrocyte count,erythrocyte pressure volume,mean erythrocyte volume,mean hemoglobin volume,mean hemoglobin concentration,and hemoglobin were elevated,and platelet count decreased(P＜0.01),and the differences were statistically significant.although there was an elevation of leukocyte count(P＞0.05);Lung function-related indexes:decreased exertion lung volume(P＜0.05).There were decreased exertion expiratory volume in the first second,increased one-second rate(P＞0.05).Conclusion FSHAE can lead to oxidative stress in the organism,and acute hypoxic multisystemic injury will occur,with the simultaneous emergence of hypoxic adaptive regulation of various systems,self-compensatory repair of various organs of the organism,and there may be the possibility of interactions between various systems.

Rheumatoid arthritis(RA)is an autoimmune disease with the basic pathological manifestation of synovial inflammation.Symmetric poly-articular pain and swelling are the main symptoms in clinical practice,and even extra-articular manifestations and comorbidities such as interstitial fibrosis and coronary artery disease are triggered,which seriously affect the quality of life of patients.Traditional Chinese medicine(TCM)has achieved good clinical efficacy in the prevention and treatment of RA with the advantages of multi-pathway,multi-target,multi-component,and less toxic side effects,and plays an important role in the treatment of RA.Recently,many studies have demonstrated that Chinese medicine monomers and Chinese herbal compound can control inflammation,reduce angiogenesis,induce apoptosis of synovial fibroblasts,and inhibit their proliferation,invasion and migration by regulating the PI3K/Akt signaling pathway,so as to play a key role in the treatment of RA.For this reason,the article summarizes current knowledge regarding the PI3K/Akt signaling pathway and its role in RA,as well as summarizes the current research progress of TCM in the treatment of RA by regulating the PI3K/Akt signaling pathway.The aim of this review is to provide theoretical bases for the prevention and treatment of RA and the development of new drugs.

Ankylosing spondylitis(AS)is a chronic inflammatory autoimmune disease characterized by inflammatory back pain.Its pathological features mainly include inflammation,bone destruction,and pathologic new bone formation.The etiology of AS is complex,and it may be related to genetics,infections,the environment,and intestinal flora.Its pathogenesis has not yet been clarified.In recent years,osteoimmunology,as a new theme in the study of inflammatory arthritis,plays an important role in the pathogenesis and development of AS,which was embodied in the inflammatory response and imbalance of bone metabolism.Traditional Chinese medicine(TCM)has the characteristics of multiple pathways,multiple components,multiple targets and multiple levels.TCM can improve the inflammatory response and bone metabolism imbalance of AS by regulating the osteoblasts of the skeletal system and the related factors of the immune system,thus to prevent and control AS.For this reason,the paper summarizes the role of bone immunology in the pathogenesis of AS,and reviews the current status of research on the intervention of TCM in bone immunology for the treatment of AS,with a view to providing certain references for the future clinical application of TCM in the prevention and treatment of AS.