Objective:To explore the relevant factors affecting the accuracy of scanning glucose monitoring (FGM) technology in critically ill patients.Methods:A total of 53 patients who were admitted to the Intensive Care Unit (ICU) of the Second Affiliated Hospital of Soochow University and used FGM glucose monitoring from September 2022 to December 2023 were selected by means of a convenience sampling method. The paired data of arterial blood glucose and FGM glucose were analysed. The accuracy of FGM blood glucose measurement in critically ill patients was evaluated using Bland-Altman analysis. The blood glucose data were divided into two groups: the FGM monitoring accuracy group and the FGM monitoring non-accuracy group.. The t-test and χ2 test were used for the comparison of one-way analysis of arterial versus FGM accuracy among critically ill patients with different demographic characteristics. Logistic regression analysis was used to analyze the factors influencing the accuracy of FGM. Results:The results of Bland-Altman analysis of the 53 patients indicated that the mean bias value of FGM blood glucose was elevated at 1.215 mmol/L in comparison with arterial-blood gas analysis blood glucose values. An incidence of exceeding the upper and lower limits of the range was observed, amounting to 6.349%. The discrepancy between the studies was found to be statistically significant (95% CI:1.0394~1.3908, P<0.001). The effects of the changes in height ( OR=0.877, 95% CI:0.780~0.987, P=0.029), changes in leukocyte counts( OR=0.917, 95% CI:0.868~0.969, P=0.002), changes in C-reactive protein( OR=1.009, 95% CI:1.002~1.017, P=0.016), changes in albumin counts( OR=0.986, 95% CI:0.974~0.999, P=0.031), and whether or not sepsis ( OR=3.937, 95% CI:1.192~13.008, P=0.025) on the accuracy of FGM had a statistically significant. Conclusion:The mean bias value of the accuracy of FGM was relatively higher compared with that of arterial blood gas analysis blood glucose values, and the influencing factors involved height, white blood cells, C-reactive protein, albumin, and whether or not sepsis was present. With the development of science and technology, applying the FGM system to critically ill patients has an absolute advantage in determining the overall glycemic trend, and the application value of FGM technology deserves further study.

Objective To investigate the involvement of phosphofurin acidic cluster sorting protein-2(PACS-2)in mitochondrial function and apoptosis in N2a/APP695swe cells and further explore the role and significance of PACS-2 in the development of Alzheimer's disease(AD).Methods The CCK8 method was used to analyze the cell survival rate of N2a/APP695swe cells treated with different concentrations of tetrahydroxy stilbene glycoside(TSG)for 48h and to select the appropriate concentration of TSG for subsequent experiments.N2a/WT cells and N2a/APP695swe cells were routinely cultured in vitro,and the experimental cells were divided into 3 groups:blank control group(WT group):N2a/WT cells;model group(APP group):N2a/APP695swe cells;treatment group(TSG group):N2a/APP695swe cells with appropriate concentrations of TSG intervention.TUNEL method to observe apoptosis by fluorescence microscopy;JC-1 method for flow detection of cellular mitochondrial membrane potential;WB to detect protein expression of PACS-2;RT-qPCR to detect PACS-2 mRNA expression.Results CCK8 method was used to analyze the cell survival rate of different concentrations of TSG acting on cells after 48h:the protective effect of 100 μmol/L TSG was the most significant and the difference was statistically significant(P<0.01).The TUNEL method of fluorescence microscopy observed the apoptosis:compared with the WT group,the apoptosis rate of APP group was increased,compared with the APP group,the apoptosis rate of TSG group was decreased,and the differences were statistically significant(P<0.05).The JC-1 method was used to detect the mitochondrial membrane potential of cells:compared with the WT group,the membrane potential of APP group was decreased,compared with the APP group,the membrane potential of TSG group was increased,and the differences were statistically significant(P<0.05);Western blot(WB)detection of PACS-2 protein expression:compared with the WT group,PACS-2 expression was significantly higher in the APP group,and compared with the APP group,PACS-2 expression was significantly lower in the TSG group,with statistically significant differences(P<0.05);The RT-qPCR detected the mRNA expression of PACS-2:the expression of PACS-2 was elevated in the APP group compared with the WT group and decreased in the TSG group compared with the APP group,with statistically significant differences(P<0.05).Conclusion PACS-2 has an important role in the development of AD,and its upregulation may promote the development of AD.The cerebroprotective drug TSG may exert cytoprotective effects by downregulating PACS-2 to inhibit apoptosis and improve mitochondrial function in AD model cells.

Objective To explore the assisted reproductive strategy and influencing factors for patients undergoing frozen-thawed cycle blastocyst transfer after hysteroscopic adhesiolysis for intrauterine adhesions.Methods A total of 275 patients who underwent frozen-thawed cycle blastocyst transfer after hysteroscopic adhesiolysis for infertility reasons at the Reproductive Genetics Center of the First Affiliated Hospital of University of Science and Technology of China from January 2018 to December 2022 were included in the study.They were divided into a single blastocyst transfer group(n=182)and a double blastocyst transfer group(n=93).The clinical outcomes were analyzed and compared retrospectively between the group.Results The two groups showed no statis-tically significant differences in terms of age,day of endometrial thickness conversion,endometrial preparation method,clinical pregnancy rate,miscarriage rate,preterm birth rate,gestational week at delivery,and mode of delivery(P>0.05).The single blastocyst transfer group had significantly lower infertility duration(years)(2.43±1.64 vs.3.03±2.13,P<0.05),significantly lower AFS prognosis score(5.13±2.25 vs.5.72±2.19,P<0.05),and significantly lower multiple pregnancy rate(1.33%vs.28.57%,P<0.05),but significantly higher quality embryo rate(90.66%vs.46.24%,P<0.05),implantation rate(50.00%vs.34.41%,P<0.05),and live infant mass(g)(3236.84±565.35 vs.2976.44±692.79,P<0.05)compared to the double blastocyst transfer group.Binary logistic regression analysis showed that the number of high-quality embryos transferred and AFS score were independent influencing factors for clinical pregnancy(P<0.05).Conclusions The number of high-quality embryos transferred and the AFS score are independent influencing factors for clinical pregnancy in patients undergoing frozen-thawed cycle blastocyst transfer after hysteroscopic adhesiolysis for intrauterine adhesions.Single high-quality blastocyst transfer is a preferred treatment for patients after hysteroscopic adhesiolysis,and double blastocyst transfer is favor-able for patients with a poor prognosis to achieve better pregnancy outcomes.

Deinagkistrodon acutus(also known as the five-paced viper and the traditional Chinese medicine ingredient is called Agkistrodon) venom is a viscous liquid from the venom glands of the Deinagkistrodon acutus. It contains a variety of protein and peptide components such as phospholipase A2, serine protease, metalloproteinase, C-type lectin, L-amino acid oxidase, and has a variety of biological activities, playing an important role in anti-tumour, anti-thrombotic, anti-inflammatory and anti-bacterial activities. In recent years, snake venom research has become increasingly widespread, but there is still a lack of comprehensive and systematic studies on snake venom from Deinagkistrodon acutus. In this paper, the source, identification, active ingredients, toxicity studies and quality researches of Deinagkistrodon acutus venom are summarized and analysed by searching the related research progress, in order to provide reference for further development and utilization of Deinagkistrodon acutus venom.

Sofosbuvir has ushered in a new era of hepatitis C treatment with its strong inhibition on the replication of hepatitis C virus, favorable safety profile and less interactions with other drugs. Sofosbuvir-based regimens have been included as the first-line therapies for the treatment of adults with chronic hepatitis C (CHC) in international guidelines. Available clinical trial data show that sofosbuvir with ribavirin and ledipasvir/sofosbuvir are highly efficacious and safe in CHC patients aged 3-17 years old; therefore, they can meet the unmet medical needs of adolescents and children with CHC in China. Furthermore, the pan-genotypic sofosbuvir/velpatasvir is being investigated in adolescents and children with CHC, which is expected to make the treatment in such patients more convenient upon approval.

Objective: To investigate the effect of space glucose control (SGC) on the quality of blood glucose management in ICU patients with stress hyperglycemia. Methods: A prospective, cross-controlled, quasi-trial was conducted to observe patients with ICU-induced stress hyperglycemia between January 2018 and January 2019. Patients with conventional blood glucose management served as the control group, and SGC blood glucose management was used as the intervention group. The enrolled patients were interchanged between the two groups every 24 h, and the end point was 96 h. The differences in blood glucose management quality indicators between the two groups were compared, including the average blood glucose level, the highest and lowest blood glucose level, the average blood glucose monitoring interval, and the accumulated insulin dosage. SPSS 23.0 was used to analyze the data. The paired t test was used for the normal distributed data. Otherwise, two nonparametric correlation sample tests was used. A P<0.05 was considered statistically significant. Results: A total of 41 patients enrolled in this study during the study period. The average blood glucose value in the intervention group was significantly lower than that in the control group [(8.60 ±1.42)mmol/L vs (10.02 ±1.49)mmol/L, P< 0.01]. The frequency of hyperglycemia was lower than that of the control group (16.59 ±8.56 vs 18.73 ±7.91, P=0.023). The frequency of blood glucose value in the target blood glucose range was significantly higher than that of the control group (53.07±19.11 vs 29.44±19.60, P< 0.01). However, the frequency of hypoglycemia, the frequency of blood glucose monitoring and the accumulated insulin dosage in the intervention group were higher than those in the control group [1 (0, 5) vs 0 (0, 2), P< 0 01; 1 36 ±0 23 vs 1 89 ±0 28, P< 0.01; and (139.61 ±77.06)U vs (107.49 ±64.41)U, P<0.01]. Conclusions SGC can optimize the control of blood glucose in the target blood glucose range, but it can easily lead to mild hypoglycemia, and to a certain extent increases the workload of medical staff.

Objective:To explore the effect of red blood cell distribution width (RDW) on long-term follow-up study in patients with acute pulmonary thromboembolism (APE).
Methods:A total of 214 consecutive patients with the first episode of APE admitted in our hospital from 2009-01 to 2012-12 were enrolled. The patients were divided into 2 groups:RDW≤15%group, n=202 and RDW>15%group, n=12. Baseline RDW was measured at admission, the follow-up study was conducted at 3, 6, 12 months thereafter, and then at once per year. The major primary end point was chronic thromboembolic pulmonary hypertension (CTEPH). The independent predictor for CTEPH occurrence was studied by uni-and multivariate logistic regression analysis and the predictive capability of RDWwas evaluated by ROC curve.
Results: All patients ifnished the follow-up study at the mean of (31±17) months. The overall occurrence rate of CTEPH was 7.5% (16/214), which was higher in RDW>15% group than that in RDW≤15% group (33.3% vs 5.9%, P=0.002). Multivariate logistic regression analysis indicated that with adjusted clinical data and other predictors, RDW>15%was still the strong predictor for CTEPH occurrence (OR=7.916, 95%CI 1.474-42.500, P=0.016). Adding RDW to the evaluating model, the predictive capability could be signiifcantly improved by ROC curve (AUC increased from 0.856 to 0.901, P<0.01).
Conclusion: Elevated RDW is the independent predictor for CTEPH occurrence in APE patients, which is helpful to estimate the prognosis and treatment strategy in APE patients.

Objective To investigate the influence of ropivacaine with isodosage on heart rate variability (HRV ) following interscalene brachial plexus block under ultrasound guidance. Methods Forty-five ASA grade Ⅰ patients (28 males,1 7 females,aged 18-50 years)scheduled for upper limb fracture internal fixation removal were randomized into group R1 (0.375% ropivacaine 40ml),group R2(0.5% ropivacaine 30ml)and group R3 (0.75% ropivacaine 20 ml),1 5 in each group.Changes in HRV,such as LF,HF,LF/HF,SDNN,RMSSD,PNN50% were evaluated with dynamic electrocardiogram.The degree and duration of sensory and motor block were recorded 30 min after drug injection.Results The anesthetic effect and maintaining time had no significant difference among the groups.The incidence rate of Horner syndrome had no significant difference among groups,group R1 was 26.7%,group R2 20% and group R3 20%.LF(30 min after drug injection)in both group R2 and group R3 were significantly decreased compared with that before drug injection, and the decreased degree of LF had significant difference among the three groups.SDNN(30 min after drug injection)in group R2 and PNN50% in group R3 were significantly decreased compared with that before drug injection.The time required for LF,the most obvious changeable HRV parameter, returning to the pre injection level was (876.2 +43.7)min for group R1,(798.8 + 61.5 )min for group R2, group R3 (712.2 + 45.7 ) min, the difference between the three groups was not statistically significant.Conclusion ISBPB can affect the stability of the cardiovascular autonomic ac-tivities by reducing the cardiac sympathetic nerve function and increasing parasympathetic nerve func-tion,possibly through blockade of stellate ganglion or branches of vagus nerve.Along with the in-crease of the dose of anesthetic,the influence on HRV is greater.

Objective To discuss the clinical characteristics and treatment methods of lumbar disc herniation in adolescent and to in-crease the awareness of lumbar disc herniation among orthopedists.Methods Retrospectively reviewed the clinical data of 201 adolescent pa-tients(aged 20 years or less)with lumbar disc herniation who were admitted in General Hospital of Shenyang Military Area Command from January 2001 to December 2010.Analyzed the clinical characteristics and treatment methods,and compared the VAS score and ODI score be-fore operation,one week after operation and at the last follow up.Meanwhile,the complications were observed and compared.Results Among the 201 patients,187 patients(93.0%)presented with low back pain with or without radiating pain,20 patients(10.0%)presented with leg pain for the first symptom.There were only 97 patients(48.3%)were diagnosed with lumbar disc herniation for their first diagnosis in other hospital.Totally 70 patients(34.8%)had a history of trauma before the onset.The most common segments were L4 /L5 (101 cases,50.2%) and L5 /S1 (70 cases,34.8%).There were 140 patients treated by microendoscopy discectomy(MED),25 patients treated by percutaneous endoscopic lumbar discectomy(PELD),and 36 patients treated by open lumbar discectomy(OLD).All the patients were followed up for more than 12 months with averagely followed up for(22.9 ±11.7)months.There was significant improvement one week after operation and at the last follow up compared with the preoperative VAS score and ODI score,and the differences were statistically significant(P <0.05).The rate of postoperative complications was 3.6%,4.0%,8.3% in patients with MED,PELD and OLD respectively.Conclusion Diagnosis of LDH in adolescent is usually delayed.Increase the awareness of lumbar disc herniation could help orthopedists to get a exact medical history,per-form a directed physical examination,and order appropriate imaging studies.Minimally invasive surgery is an effective method to treat lumbar disc herniation in adolescent.

Objective:To study the expression of MMP-9 in nasal NK/T cell lymphoma, HIF-1a and its relationship with the clinical and pathologic characteristics. Methods:46 cases ( case group) of paraffin block specimens from patients with pathologically confirmed nasal NK/T cell lymphoma were collected from the Affiliated Hospital of Youjiang Medical College For Nationalities,the same period endoscopy turbinate mucosa were confirmed by pathology in 20 cases of chronic inflammation of mucosa specimens ( control group) , respectively HE staining and immunohistochemistry handle two specimens, observation of the expression differences of two groups of specimens of pathological morphology, MMP-9 and HIF-1a, and to analyze its relationship with the clinical and pathological features of the patients. Results: Case group HIF-1a expression rate 67. 39% (31/46), expression was 6. 52% (3/20) in control group. , the HIF-1a case group were significantly higher than control group (P<0. 05). Case group MMP-9 expression rate 71. 74%(33/46), in the control group expression was 6. 52% (3/20), MMP-9 expression in the case group was significantly higher than control group (P<0. 05). HIF-1a and MMP-9 in positive expression in Ann Arbor staging (Ⅲ-Ⅳ), lymph node metastasis, vascular invasion in patients with nasal NK/T cell lymphoma tissue appeared a high expression ( P< 0. 05 ) . Conclusion: Nasal NK/T cell lymphoma tissue of patients with HIF-1a, MMP-9 presented high expression, and there was a certain relationship between Arbor Ann stage (Ⅲ-Ⅳ) , lymph node metastasis and vascular invasion.