Patients with severe pneumonia caused by novel coronavirus infection are often complicated with acute respiratory distress syndrome (ARDS), which has a high mortality. ARDS is characterized by diffuse alveolar damage, pulmonary edema, and hypoxemia. Mitochondria are prone to morphological and functional abnormalities under hypoxia and viral infection, which can lead to cell apoptosis and damage, severely impacting the disease progression. Mitochondria maintain homeostasis through fission and fusion. In ARDS, hypoxia leads to the phosphorylation of dynamin-related protein 1 (Drp1), triggering excessive mitochondrial fission and damaging the alveolar epithelial barrier. Animal experiments have shown that inhibiting this process can alleviate lung injury, providing a potential direction for treatment. The pathology of novel coronavirus infection-related ARDS is similar to that of typical ARDS but more severe. Viral infection and hypoxia disrupt the mitochondrial balance, causing fission and autophagy abnormalities, promoting oxidative stress and mitochondrial DNA (mtDNA) release, activating inflammasomes, inducing the expression of hypoxia-inducible factor-1α (HIF-1α), exacerbating viral infection, inflammation, and coagulation reactions, and resulting in multiple organ damage. Mechanical ventilation and glucocorticoids are commonly used in the treatment of novel coronavirus infection-related ARDS. Mechanical ventilation is likely to cause lung and diaphragm injuries and changes in mitochondrial dynamics, while the lung protective ventilation strategy can reduce the adverse effects. Glucocorticoids can regulate mitochondrial function and immune response and improve the patient's condition through multiple pathways. The mitochondrial dynamics imbalance in novel coronavirus infection-related ARDS is caused by hypoxia and viral proteins, leading to lung and multiple organ injuries. To clarify the pathophysiological mechanism of mitochondrial dynamics imbalance in novel coronavirus infection-related ARDS and explore effective strategies for regulating mitochondrial dynamics balance to treat this disease, so as to provide new treatment targets and methods for patients with novel coronavirus infection-related ARDS. The existing treatments have limitations. Future research needs to deeply study the mechanism of mitochondrial dysfunction, develop new therapies and regulatory strategies, and improve the treatment effect.
Humans ; Respiratory Distress Syndrome/etiology* ; COVID-19 ; Mitochondrial Dynamics ; Mitochondria/metabolism* ; DNA, Mitochondrial ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism* ; Dynamins ; SARS-CoV-2

Objective: To explore the latent categories and general demographic characteristics of short form video addiction among college students, so as to provide empirical reference for prevention and intervention of short form video addiction among college students. Methods: Convenience sampling method was used to select 1 386 college students from a certain university in Anhui Province in June 2023. A questionnaire survey was conducted among college students by using the Short Video Addiction Scale. The latent profile analysis method of "individual center" was used to explore the categories of college students short form video addiction, and multiple Logistic regression was used to explore the influence of demographic variables on the latent classification of short form video addiction. Results: College students with short form video addiction were divided into three latent categories:non addiction group (22.15%, n =307), low addiction group (63.28%, n =877) and high addiction group (14.57%, n =202). The results of multiple Logistic regression analysis showed that gender, major type and family location were related with short form video addiction among college students:male students (low addiction group: OR =0.47; high addiction group: OR =0.41), cultural and historical majors (low addiction group: OR =0.66), and students from cities (high addiction group: OR =0.51) were less likely to be involved in short form video addiction ( P <0.05). Conclusions There is significant group heterogeneity in short form video addiction among college students. Families, schools and society should attach importance and pay attention to the phenomenon of short form video addiction among college students, actively take targeted intervention measures to prevent and reduce the occurrence of short form video addiction symptoms among college students.

Objective:To investigate the efficacy and safety of acute stent implantation during endovascular treatment for patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis.Methods:A retrospective analysis was carried out on 46 patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis who received endovascular treatment at the Strategic Support Force Medical Center from January 2015 to August 2022. Twenty-seven patients underwent balloon angioplasty alone and 19 patients underwent acute stent implantation. The baseline characteristics, modified thrombolysis in cerebral infarction (mTICI) score of the responsible vessels, modified Rankin scale (mRS) score 90 days after operation, incidence of symptomatic intracranial hemorrhage and mortality of the two groups were evaluated.Results:The proportion of effective recanalization of the offending vessels (mTICI≥2b) in the acute stenting group was slightly higher than that in the balloon angioplasty group (16/19 vs. 81.5%), but the difference was not statistically significant ( P>0.05). Besides, there was no significant difference in the median of mRS between the acute stenting group [3.0(0, 4.0)] and the balloon angioplasty group [4.0(1.0, 5.0)] 90 days after operation ( P>0.05). In terms of safety, the incidence of symptomatic intracranial hemorrhage and mortality were comparable between the two groups ( P>0.05). Conclusions:The effect of acute stent implantation during endovascular treatment for patients with emergent large vessel occlusion due to intracranial atherosclerotic stenosis is not inferior to that of balloon angioplasty, and it does not increase the risk of intracranial bleeding complications.

ObjectiveTo investigate the prevalence of polycystic ovary syndrome （PCOS） among female college students at a university in Fuzhou City， Jiangxi Province， and to facilitate early detection and intervention of PCOS. MethodsUsing a stratified sampling method， a total of 450 female freshmen were randomly selected for PCOS screening. A self-designed questionnaire was used for data collection， covering menstrual status， high androgen signs， lifestyle， dietary habits， and awareness of PCOS. Sample t test and χ² test were used to compare the basic information and dietary habits between PCOS and non-PCOS cases. The correlation between various indicators and the prevalence of PCOS was analyzed by a logistic regression model. ResultsA total of 12 PCOS cases were identified， with a prevalence rate of 2.99%. PCOS cases exhibited statistically significant differences compared to non-PCOS cases in terms of waist-to-hip ratio， waist circumference， abdominal obesity， the proportion of overweight or obese individuals， and a preference for sweet food （all P<0.05）. Multivariate logistic regression analysis revealed a significant correlation between preference for sweet food and the occurrence of PCOS （OR=4.858， 95%CI=1.199‒19.675，P=0.027）， as well as a significant correlation with PCOS accompanied by abdominal obesity （OR=7.083， 95%CI=0.773‒64.937， P=0.048）. Among the female college students surveyed， 37.90% had never heard of PCOS， 51.62% were only familiar with the name of the disease， and 10.47% had attempted to search for PCOS-related information. ConclusionThe prevalence of PCOS among female college students should not be overlooked and unhealthy dietary habits may be a crucial factor contributing to the occurrence of PCOS during this period. Early screening for PCOS during puberty is crucial.

Objective To investigate the changes and clinical significance of serum 25-hydroxyvitamin D3[25(OH)D3],blood calcium and bone metabolism indexes in menopausal women with benign paroxysmal positional vertigo(BPPV).Methods A total of 103 menopausal BPPV patients from Hangzhou Ninth People's Hospital from August 2020 to August 2021 were enrolled into BPPV group.According to the one-year recurrence situation,they were divided into recurrence group(n=18)and non-recurrence group(n=85).A total of 50 healthy menopausal women during the same period were enrolled as control group.The clinical data,serum 25(OH)D3,calcium and bone metabolism indexes[procollagen typeⅠN-terminal propeptide(PINP),N-terminal midfragment of osteocalcin(N-MID),β-isomerised C-terminal telopeptide of collagen typeⅠ(β-CTX),bone alkaline phosphatase(BALP)]were collected.Logistic regression model was constructed to analyze the risk factors of BPPV in menopausal women.The predictive value of related indexes for BPPV recurrence was analyzed by receiver operating characteristic curves.Results The serum 25(OH)D3 level in BPPV group was significantly lower than that in control group(P<0.05),and the proportion of long-term irregular diet,PINP,N-MID and BALP levels were significantly higher than those in control group(P<0.05).Multivariate Logistic regression analysis showed that low 25(OH)D3,high PINP,high N-MID and high BALP were all risk factors for BPPV in menopausal women(P<0.05).The 25(OH)D3 level in recurrence group was significantly lower than that in non-recurrence group(P<0.05),and the PINP,N-MID and BALP levels were significantly higher than those in non-recurrence group(P<0.05).The area under the curve(AUC)of 25(OH)D3,PINP,N-MID,BALP and the four combined predictions for BPPV recurrence were 0.833,0.654,0.697,0.782 and 0.910,respectively,and the AUC of the four combined predictions was the largest.The sensitivity and specificity were 98.97%and 70.62%,respectively.Conclusion There is no significant change in level of serum calcium in menopausal women with BPPV.Decreased serum 25(OH)D3 and increased PINP,N-MID and BALP are risk factors of BPPV,which can be applied to predict BPPV recurrence.

Objective To investigate the clinical features and maternal and fetal outcomes of acute pancreatitis in pregnancy(APIP)and the risk factors for disease aggravation,and to establish a predictive model.Methods A retrospective analysis was performed for 52 APIP patients who were admitted to Affiliated Hospital of Zunyi Medical University from January 2017 to December 2022,and according to disease severity,they were divided into mild acute pancreatitis(MAP)group with 32 patients,moderate-severe acute pancreatitis(MSAP)group with 8 patients,and severe acute pancreatitis(SAP)group with 12 patients.The logistic regression analysis was performed for the clinical data of each group,and the receiver operating characteristic(ROC)curves were plotted to assess the value of risk factors in predicting the severity of APIP.A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups,and the least significant difference t-test was used for further comparision between two groups.The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups,and the Wilcoxon rank-sum test was used for further comparision between two groups;the chi-square test was used for comparison of categorical data between groups.Results Of all patients in terms of etiology,26(50%)had hyperlipidemic pancreatitis,20(38.4%)had biliary pancreatitis,and 6(11.5%)had idiopathic pancreatitis.In terms of gestational week,1 patient(1.9%)was in early pregnancy,25(48.1%)were in mid-pregnancy,and 26(50.0%)were in late pregnancy.A total of 10 patients(19.2%)had acute respiratory distress syndrome(ARDS),among whom 9(90%)required respiratory support.There were significant differences between the patients with different severities of APIP in aspartate aminotransferase,alanine aminotransferase,blood urea nitrogen,blood glucose,C-reactive protein(CRP),international normalized ratio(INR),pneumonia,ARDS,sepsis,hepatic insufficiency,and coagulation dysfunction(all P<0.05).The univariate analysis showed that the severity of APIP was associated with blood glucose,blood urea nitrogen,CRP,and pneumonia(all P<0.05),and pneumonia was a risk factor for the aggravation of APIP(odds ratio=18.938,95%confidence interval:1.020—351.747,P=0.048).CRP,blood glucose,blood urea nitrogen,and INR used in combination had a larger area under the ROC curve than each index used alone(0.954 vs 0.778/0.796/0.721/0.801).Conclusion Pneumonia is a risk factor for the aggravation of APIP,and the combination of CRP,blood glucose,blood urea nitrogen,and INR can be used to predict the severity of APIP.

The management of hospital volunteers is one of the main tasks of medical social workers.In practical work,they are often in a dilemma due to ethical problems,which restricts the scientific development of hospital volunteer organizations.Based on the experience of frontline medical social workers in the"Guangji Boat"Volunteer Service Alliance of the Second Affiliated Hospital Zhejiang University School of Medicine,while investigating other public hospitals,this paper summarized and organized ethical issues,analyzed their causes,and proposed improvement strategies.The ethical dilemma of hospital volunteer service was mainly in the conflict between the dual relationship of human emotion and norm,the conflict between incentive mechanism and non-reward value,as well as the conflict between participation motivation and organizational goal.The ethical dilemma in the management of hospital volunteers was attributed to the lack of standardized practical operation systems.Based on the above ethical dilemmas,combined with the development experience of volunteer service in public hospitals,this paper proposed reasonable countermeasures to provide a reference for the management of hospital volunteers.

Objective To investigate the mechanism of icariin regulating the NLRP3 inflammasome in the treatment of cerebral ischemia-reperfusion injury in rats.Methods A rat model of focal cerebral ischemia-reperfusion was induced using the thread embolism method.At 24 hours post-operation,the rats were randomly allocated into a sham operation group,model group,butylphthalide group(70 mg/kg),ICA-low dose(20 mg/kg),ICA-middle dose(40 mg/kg),and ICA-high dose(80 mg/kg)groups.The corresponding drugs were administered by gavage at 10 mL/kg once a day for 13 consecutive days.One hour after the last administration,neurological function was scored.The cerebral cortex was observed by hematoxylin-eosin(HE)staining.Expression of interleukin(IL)-1β and IL-18 in the cerebral cortex was determined by immunohistochemistry.Expression of NLRP3,ASC,and Caspase-1 in the cerebral cortex was determined by Western Blot.Results In contrast to the sham operation group,there was a notable increase in neural function scores within the model group.The ischemic area around the visible cerebral cortex showed neuron necrosis at various level or glial cell proliferation,and the number of intact neurons was significantly reduced.IL-1β and IL-18 positive cells were significantly increased.Expression of NLRP3,ASC,and Caspase-1 was significantly increased(P＜0.01,P＜0.05).After treatment with icariin,the neural function score was decreased significantly.The degree of neuronal necrosis in the peri-ischemic area was significantly reduced,and the number of intact neurons was significantly increased.IL-1 β and IL-18-positive cells were decreased significantly.Expressions of NLRP3,ASC,and Caspase-1 were significantly decreased(P＜0.01,P＜0.05).Conclusions Treatment of cerebral ischemia-reperfusion injury by icariin may be related to regulation of the NLRP3 inflammasome.

Objective:To retrospectively summarize the clinical characteristics and treatment of 49 patients with hyperthyroid cardiopath and to explore the diagnosis and treatment methods of hyperthyroid cardiopathy.Methods:A total of 49 patients with hyperthyroid cardiopath(HC group) who were successfully treated and followed up in the Department of Endocrinology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, from January 2016 to December 2021 were collected, and 85 cases of Graves′ disease without heart disease were collected as the control group(GD group). The medical history, laboratory tests, and echocardiographic parameters of the two groups were compared. Differences in thyroid and cardiac indicators before and after treatment in the HC group were summarized, along with the dosage of β-receptor blockers used in treating different types of conditions(atrial fibrillation and heart failure.Results:Patients in the HC group were older and had a longer duration of hyperthyroidism than those in the GD group( P<0.001, P=0.002). There were no significant differences in thyroid hormone levels between the two groups except for reverse triiodothyronine(rT 3). Age and rT 3 were independent risk factors of hyperthyroid cardiopathy. rT 3 level was linearly positively correlated with brain natriuretic peptide, systolic pulmonary artery pressure, left artrium diamete (LAD) and left ventricular end-systolic diameter(LVDs; r=0.352, P<0.001; r=0.392, P=0.019; r=0.202, P=0.029; r=0.242, P=0.028). In patients of HC group, free triiodothyronine(FT 3) level returned to normal range after 2.87(1.63, 5.53) months of treatment with radioiodine(41/49) or antithyroid drugs(8/49), while brain natriuretic peptide, LAD, LVDs, and systolic pulmonary artery pressure declined after 5.00(1.25, 8.00) months of treatment. Non-selective β-receptor blockers were used for both hyperthyroid heart failure and atrial fibrillation, and there was no statistically significant difference in dosage[(86.52±47.83)mg vs(88.67±47.19)mg, P>0.05]. Conclusions:rT 3 may be a biomarker of hyperthyroid cardiopath and indicate the severity of hyperthyroidism. β-receptor blockers are crucial in treating patients with hyperthyroidism who develop atrial fibrillation and heart failure.

Neonates, especially extremely preterm infants or those who have suffered birth asphyxia, require placental transfusion to stabilize blood pressure and respiratory support to maintain pulmonary expansion after birth. In clinical practices, it is common to first perform delayed cord clamping, followed by respiratory support after the umbilical cord has been cut. Nevertheless, as the prolonged onset of respiratory support carries risks, recent clinical studies have been investigating the possibility of implementing concurrent placental transfusion and respiratory support. This review discusses the physiological principles of placental transfusion combined with respiratory support, different methods of implementation, and their effects on neonates.