Objective To observe the effect of hypoxia(HX)on autophagy and pyroptosis-related protein expression of interleukin(IL)-1β-induced chondrocytes,and explore its mechanism of cartilage protection.Methods The expression of Bcl2/adenovirus E1B interacting protein 3-like(BNIP3L/NIX)in normal and osteoarthritis chondrocytes was analyzed by bioinformatics method.The primary chondrocytes from the knee joints of C57BL/6J neonatal mice were extracted and assigned to control group,IL-1β group,HX group,or IL-1β+HX group.The cells were treated with 10 ng/mL IL-1β for 24 h to simulate osteoarthritis-like chondrocyte injury,and HX treatment was by incubation with 1%O2 for 24 h.The expression levels of collagen typeⅡ α1(COL2α1),matrix metalloproteinase 13(MMP13),a disintegrin and metalloproteinase with thrombospondin 5(ADAMTS5),nucleotide-binding oligomerization domain-like receptor 3(NLRP3),gasdermin D N-terminal domain(GSDMD-N),apoptosis-associated speck-like protein containing a CARD(ASC),IL-18,hypoxia induced factor 1α(HIF1α),NIX,Beclin1,microtubule-associated protein-light chain 3(LC3),and p62 proteins were detected by Western blotting in each group.Results Bioinformatics analysis showed that the expression of NIX was lower in osteoarthritis chondrocytes than in normal chondrocytes.Western blotting showed that compared to the control group,the IL-1β group showed significant decreases in COL2α1 and NIX protein expression(both P＜0.05)and significant increases in MMP13,ADAMTS5,NLRP3,GSDMD-N,ASC,IL-18 and HIF1α protein expression(all P＜0.01).Compared to the IL-1β group,the IL-1β+HX group showed significant increases in COL2α1,HIF1α,NIX,Beclin1,and LC3 Ⅱ/LC3Ⅰ(all P＜0.01)and significant decreases in MMP13,ADAMTS5,NLRP3,GSDMD-N,ASC,IL-18 and p62(all P＜0.01).Compared to the control group,the HX group exhibited significant increases in HIF1α,NIX,Beclin1,and LC3Ⅱ/LC3Ⅰ(all P＜0.01)and decreases in p62,NLRP3,GSDMD-N and IL-18(all P＜0.05).Conclusion Hypoxia may eliminate NLRP3 inflammasome and inhibit chondrocyte pyroptosis through HIF1α/NIX-mediated mitochondrial autophagy,thereby reducing IL-1β-induced chondrocyte injury.

Objective:To compare the application effects of different approaches (bilateral approach, traditional intermediate approach) in laparoscopic radical resection of rectal cancer with preservation of left colonic artery (LCA).Methods:The data of 120 patients undergoing laparoscopic radical resection of rectal cancer from January 2021 to December 2023 were retrospectively analyzed. Based on the different surgical approaches chosen for preserving LCA, 67 patients who underwent traditional intermediate approach to preserve LCA were included in the control group, while the remaining 53 patients who underwent bilateral approach to preserve LCA were included in the study group. The results of the main outcome indicators were recorded and the differences between the groups were compared, including perioperative indicators; lymph node dissection; gastrointestinal hormones (gastrin and motilin) before operation and 2 d after operation; postoperative complications such as anastomotic bleeding, anastomotic leakage, and urinary dysfunction.Results:Compared with the control group, the study group had longer surgical time and more intraoperative bleeding: (132.68 ± 11.24) min vs. (126.54 ± 10.45) min, (78.41 ± 5.35) ml vs. (75.22 ± 5.10) ml, the difference was statistically significant ( P = 0.003 and 0.001). However, there was no significant difference in exhaust time and hospitalization time between the two groups ( P>0.05). There was no significant difference in total lymph node clearance between the two groups ( P>0.05). The number of lymph node dissection in the 253 groups of the study group was higher than that in the control group: (5.18 ± 1.26) pieces vs. (4.35 ± 1.32) pieces, the difference was statistically significant ( P = 0.001). On the second day after surgery, the serum gastrin and motilin in both groups decreased compared to before surgery, but there was no significant difference between the two groups ( P>0.05). The incidence of postoperative urinary dysfunction in the study group was lower than that in the control group: 0 vs. 10.45% (7/67), the difference was statistically significant ( P = 0.015). Conclusions:Compared with the traditional intermediate approach for laparoscopic radical resection of rectal cancer with preserved LCA, the bilateral approach, although having a longer surgical time and slightly more intraoperative bleeding, can effectively clean 253 lymph nodes and reduce postoperative urinary dysfunction.

Objective:To compare the application effects of different approaches (bilateral approach, traditional intermediate approach) in laparoscopic radical resection of rectal cancer with preservation of left colonic artery (LCA).Methods:The data of 120 patients undergoing laparoscopic radical resection of rectal cancer from January 2021 to December 2023 were retrospectively analyzed. Based on the different surgical approaches chosen for preserving LCA, 67 patients who underwent traditional intermediate approach to preserve LCA were included in the control group, while the remaining 53 patients who underwent bilateral approach to preserve LCA were included in the study group. The results of the main outcome indicators were recorded and the differences between the groups were compared, including perioperative indicators; lymph node dissection; gastrointestinal hormones (gastrin and motilin) before operation and 2 d after operation; postoperative complications such as anastomotic bleeding, anastomotic leakage, and urinary dysfunction.Results:Compared with the control group, the study group had longer surgical time and more intraoperative bleeding: (132.68 ± 11.24) min vs. (126.54 ± 10.45) min, (78.41 ± 5.35) ml vs. (75.22 ± 5.10) ml, the difference was statistically significant ( P = 0.003 and 0.001). However, there was no significant difference in exhaust time and hospitalization time between the two groups ( P>0.05). There was no significant difference in total lymph node clearance between the two groups ( P>0.05). The number of lymph node dissection in the 253 groups of the study group was higher than that in the control group: (5.18 ± 1.26) pieces vs. (4.35 ± 1.32) pieces, the difference was statistically significant ( P = 0.001). On the second day after surgery, the serum gastrin and motilin in both groups decreased compared to before surgery, but there was no significant difference between the two groups ( P>0.05). The incidence of postoperative urinary dysfunction in the study group was lower than that in the control group: 0 vs. 10.45% (7/67), the difference was statistically significant ( P = 0.015). Conclusions:Compared with the traditional intermediate approach for laparoscopic radical resection of rectal cancer with preserved LCA, the bilateral approach, although having a longer surgical time and slightly more intraoperative bleeding, can effectively clean 253 lymph nodes and reduce postoperative urinary dysfunction.

Objective To observe the value of 3.0T 3D fast imaging employing steady state acquisition(FIESTA)with small flip angle(FA)for detecting fetal spinal dysplasia.Methods Forty-three singletons who underwent spinal MR examination,including 2D single shot fast spin echo(2D SSFSE),2D FIESTA,2D susceptibility weighted imaging(SWI)and 3D FIESTA sequences due to suspected spinal dysplasia by prenatal ultrasound were retrospectively enrolled.Likert scale was performed to evaluate imaging quality of fetal cervical,thoracic and lumbosacral vertebrae,then signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated.The subjective scores and objective evaluations of imaging quality were compared among different sequences.Results Significant differences of subjective scores,SNR and CNR of fetal cervical,thoracic and lumbosacral vertebrae were found among different sequences(all P＜0.001).Subjective scores of fetal lumbosacral vertebrae were not significantly different between 2D SSFSE and 2D FIESTA nor 2D SWI and 3D FIESTA(both P＞0.05),while significant differences of subjective scores of fetal cervical,thoracic and lumbosacral vertebrae were found between each 2 other sequences(all P＜0.05).For 3D FIESTA,SNR of fetal cervical and thoracic vertebrae,as well as CNR of thoracic vertebrae were all higher than those of 2D SSFSE,2D FIESTA and 2D SWI(all P＜0.05),while CNR of cervical vertebrae was higher than that of 2D SSFSE and 2D FIESTA(both P＜0.05),SNR of lumbosacral vertebrae was higher than that of 2D SWI(P＜0.05),and CNR of lumbosacral vertebrae was higher than that of 2D SSFSE and 2D SWI(both P＜0.05).Conclusion 3.0T FIESTA with small FA was helpful for detecting fetal spinal dysplasia.

Objective To observe the value of 3.0T 3D fast imaging employing steady state acquisition(FIESTA)with small flip angle(FA)for detecting fetal spinal dysplasia.Methods Forty-three singletons who underwent spinal MR examination,including 2D single shot fast spin echo(2D SSFSE),2D FIESTA,2D susceptibility weighted imaging(SWI)and 3D FIESTA sequences due to suspected spinal dysplasia by prenatal ultrasound were retrospectively enrolled.Likert scale was performed to evaluate imaging quality of fetal cervical,thoracic and lumbosacral vertebrae,then signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated.The subjective scores and objective evaluations of imaging quality were compared among different sequences.Results Significant differences of subjective scores,SNR and CNR of fetal cervical,thoracic and lumbosacral vertebrae were found among different sequences(all P＜0.001).Subjective scores of fetal lumbosacral vertebrae were not significantly different between 2D SSFSE and 2D FIESTA nor 2D SWI and 3D FIESTA(both P＞0.05),while significant differences of subjective scores of fetal cervical,thoracic and lumbosacral vertebrae were found between each 2 other sequences(all P＜0.05).For 3D FIESTA,SNR of fetal cervical and thoracic vertebrae,as well as CNR of thoracic vertebrae were all higher than those of 2D SSFSE,2D FIESTA and 2D SWI(all P＜0.05),while CNR of cervical vertebrae was higher than that of 2D SSFSE and 2D FIESTA(both P＜0.05),SNR of lumbosacral vertebrae was higher than that of 2D SWI(P＜0.05),and CNR of lumbosacral vertebrae was higher than that of 2D SSFSE and 2D SWI(both P＜0.05).Conclusion 3.0T FIESTA with small FA was helpful for detecting fetal spinal dysplasia.

Objective:To analyze the allocation of chief examining physicians in health examination (management) institutions in 2019.Methods:A current situation study. Using a census method, a questionnaire survey was conducted to collect basic information (such as institution name, address, nature, affiliation, category, and level) and the allocation of chief physicians (such as gender, year of birth, full-time or part-time, type of practice, level of professional title, and years of engagement in health examination and management work) of 5 428 health examination (management) institutions in 2019. The collected data were statistically analyzed using chi-square test.Results:In terms of the type of practice of chief physicians, the proportions of internal medicine physicians in public and privately-run institutions was 72.84% and 68.23%, respectively, with a statistically significant difference in distribution ( χ2=19.632, P<0.05); the proportions of surgeons was 27.16% and 31.77%, respectively. The proportions of internal medicine physicians in third-, second-, first-, and unclassified-level institutions was 75.76%, 69.14%, 68.60%, and 68.78%, respectively; the proportions of surgeons was 24.24%, 30.56%, 31.40%, and 31.22%, respectively; with a statistically significant difference in distribution ( χ2=47.682, P<0.05). In terms of the level of professional title of chief physicians, the proportions of associate senior physicians in public and privately-run institutions was 69.56% and 73.66%, respectively, and the proportions of senior physicians was 30.44% and 26.34%, respectively, with a statistically significant difference in distribution ( χ2=15.276, P<0.05); the proportions of associate senior physicians in third-, second-, first-, and unclassified-level institutions was 62.72%, 75.55%, 78.40%, and 74.51%, respectively, with the proportions of senior physicians being 37.28%, 24.45%, 21.60%, and 25.49%, respectively, with a statistically significant difference in distribution ( χ2=168.462, P<0.05). The average number of chief physicians per institution in China was 1.67, with the highest number in the North China (2.10) and the lowest number in the Southwest region (1.49). The compliance rate of chief physicians with qualifications was 33.37% nationwide, with only the North China (48.64%) and the East China (37.05%) surpassing the national average, and the lowest rate was in the Northeast region (24.01%). Conclusions:There are regional differences in the allocation of chief examining physicians in China, and the uneven and insufficient development of their skills and abilities remains a prominent contradiction.

Objective:To search, screen, and summarize the best evidence-based evidence for procedural pain management in adult patients in the Intensive Care Unit (ICU), so as to provide reference for clinical practice.Methods:Guidelines, clinical decisions, expert consensus, systematic reviews, and randomized controlled trial (RCT) on procedural pain management for adult patients in ICU were searched in domestic and foreign databases, guide websites, and professional association websites. The search time limit was from the establishment of the database to August 31, 2022.Results:A total of 14 articles were included, including six guidelines, three RCTs, three systematic reviews, and two clinical decisions. A total of 8 themes and 27 best evidence were extracted.Conclusions:It is recommended that clinical medical and nursing personnel provide personalized and multimodal procedural pain intervention measures for adult patients in ICU in a timely manner in accordance with the medication principles of procedural pain management, in order to improve the procedural pain experience of ICU patients and the quality of nursing.

Starch is the predominant compound in bulb scales, and previous studies have shown that bulblet development is closely associated with starch enrichment. However, how starch synthesis affects bulbification at the molecular level is unclear. In this study, we demonstrate that

In this study, HRP or FeCl3were used as the catalysts in MTT, TMB and Mino reaction system, the effects of carnosine on the oxidation reaction were evaluated respectively. Indeed, carnosine was a pro-oxidant in luminol reaction, however an anti-oxidant in MTT assay. Once TMB was its substrate, carnosine was neutral in oxi-dation. Thus, it is supposed that the oxidative property of carnosine depends on the substrates.

Objective:To further evaluate the long-term predictive value of HPV test in cervical cancer screening.Methods:To search PubMed and Web of Science databases by computer.The studies conducted HPV-based screening program and followed up for more than 3 years were included.After data extraction,the risk of cervical intraepithelial neoplasia(CIN) grade Ⅱ or worse(CIN Ⅱ +),CIN gradeⅢ or worse(CIN Ⅲ +),and cervical cancer was evaluated through the pooled cumulative incidence and odds ratio(OR) values among women with different baseline test results.Results:Finally,26 cohort studies were included.Compared to cytology negative,negative for HPV test was associated with significantly lower incidence of cervical diseases within 3 years (CIN Ⅱ +:OR =0.500,P ＜ 0.001;CIN Ⅲ+:OR =0.377,P ＜ 0.001;cervical cancer:OR =0.546,P ＜ 0.001).The 5-year pooled cumulative incidence of CIN Ⅱ +,CIN Ⅲ + and cervical cancer in HPV negative women was lower than 3-year detection rates in cytology negative women(CIN Ⅱ +:0.47％ vs 0.60％;CINⅢ +:0.15％ vs 0.20％;cervical cancer:0.016％ vs 0.020％),while the OR values had no significant difference.Conclusions:We recommend that HPV test using alone can be considered as an alternative strategy for cervical cancer screening with five-year screening interval.