Objective To observe the clinical effects and postoperative recurrence of endoscopic natural opening in the middle nasal meatus-maxillary sinus and prelacrimal recess approach in treating antrochoanal polyp(ACP).Methods Clinical data of 64 patients with ACP from March 2019 to March 2023 were analyzed retrospectively.According to different surgical approaches,the patients were divided into control group(n=32,endoscopic natural opening in the middle nasal meatus-maxillary sinus)and study group(n=32,endoscopic prelacrimal recess approach).Clinical efficacy,surgical indicators,preoperative and postoperative Lund-Mackay nasal endoscopy scores and sinus CT scores were compared between the two groups.Complications and recurrence that occurred within 5 months after surgery were recorded.Results The total clinical effective rate in the study group was 93.75%,higher than that in the control group 75.00%,the difference was statistically significant(P<0.05).Intraoperative blood loss of the study group less than that of control group,hospital stay of the study group shorter than that of the control group,the differences were statistically significant(P<0.05).Three months after surgery,Lund-Mackay nasal endoscopy scores and Lund-Mackay CT scores of both groups decreased,and the study group was lower than those of the control group,the differences were statistically significant(P<0.05).The recurrence rate in the study group was 3.13%,lower than that in the control group 18.75%,the difference was statistically significant(P<0.05),but there was no significant difference in the total incidence of postoperative complications between the groups(P>0.05).Conclusion Endoscopic prelacrimal recess approach is effective in the treatment of ACP.It can clean up the lesions,with little intraoperative blood loss and short hospital stay.Compared with endoscopic natural opening in the middle nasal meatus-maxillary sinus,the recurrence rate after endoscopic prelacrimal recess approach is lower.

In order to mine candidate vaccine antigens against ticks and to control ticks safely and effectively,the aim of this study was to immunize rabbits with purified aquaporins(AQPs)rD-mAQP1,rDmAQP2 and rDmAQP3 of Dermacentor marginatus.Blood collections for Western blot and ELISA tests were performed.The anti-tick challenge was conducted.The optimal expression conditions of rDmAQP1,rDmAQP2 and rDmAQP3 were screened by SDS-PAGE gel electrophore-sis.The three recombinant proteins were purified by HisSepNi-NTA6FF purification column.Rab-bits were divided into four groups of three rabbits each,including a control group and three immu-nized groups.The three purified recombinant proteins were separately immunized to three groups of rabbits,and the rabbits were immunized once on the 0th,14th and 21st day.Blood samples were collected every 7 days to prepare polyclonal antibodies.The reactivity was detected by Western blot and the antibody titer was detected by ELISA.Tick challenge test was carried out after the anti-body titer increased.The results showed that the optimal expression conditions for rDmAQP1 were induced for 8 h at IPTG concentration of 1.0 mmol/L and 37 ℃;the optimal expression conditions for rDmAQP2 were induced for 7 h at IPTG concentration of 1.0 mmol/L and 37 ℃;and the opti-mal expression conditions for rDmAQP3 were induced for 5 h at IPTG concentration of 1.0 mmol/L and 37 ℃.Western blot results showed that rDmAQP1,rDmAQP2 and rDmAQP3 all had certain reactivity.The ELISA results showed that the antibody titers of rabbits immunized with rD-mAQP1,rDmAQP2 and rDmAQP3 were as follows:the total anti-tick effect of rDmAQP1 protein was 79.74％,and the inhibition rates on average full-blooded tick weight,average egg weight and average egg hatching rate were 9.43％,25.17％and 63.81％,respectively.The total anti-tick effect of rDmAQP2 protein was 78.78％,and the inhibition rates of average full-blooded tick weight,av-erage egg weight and average egg hatching rate of Dermacentor marginatus were 8.30％,20.14％and 68.26％,respectively.The total anti-tick effect of rDmAQP3 protein was 87.91％,and the inhi-bition rates of average full-blooded tick weight,average egg weight and average egg hatching rate were 3.23％,22.47％and 80.5％,respectively.Through serological test and anti-tick test,it has been found that rDmAQP1,rDmAQP2 and rDmAQP3 all have the potential of candidate antigens against ticks,among which rDmAQP3 has the best immune effect,which lays a foundation for the study of the function of rDmAQP1,rDmAQP2 and rDmAQP3.

Porcine parvovirus(PPV)is a causative agent of porcine parvovirus infection(PPI),which significantly impacts the pig industry due to its association with reproductive dysfunction.The condition is characterized by stillbirth,mummified fetuses,fetal weakness,and abortion in pregnant sows.The pathogenic mechanism remains incompletely understood,with no effective therapeutic drugs available currently.Despite extensive research on the host's response to PPV in-fection and identification of various signaling pathway transduction mechanisms,a comprehensive understanding is still lacking.This review aims to summarize the current knowledge regarding al-terations in related signaling pathways following PPV infection,provide novel insights into the pathogenesis of PPV and facilitate the drug development.

This study aims to investigate the effects of Japanese encephalitis virus(JEV)on TLRs signaling pathway and its regulation of the secretion of inflammatory factors during the infection of testicular interstitial cells,In this study,the mRNA levels of TLR3,TLR7,TLR8,TRIF and MyD88 genes were detected by qPCR after 1 MOI dose of JEV was inoculated into testicular stro-mal cells at different time periods.Western blot assay was used to detect the expression levels of TLR3,TLR7,TRIF and MyD88 protein at 6 h after JEV infection,and ELISA was used to detect the expression levels of IL-1β,IL-6 and TNF-α at different time periods(6,12 and 24 h).The re-sults showed as follows:After 6 h of JEV infection,the mRNA levels of TLR3,TLR7,TRIF and MyD88 genes were significantly up-regulated(P＜0.05),and the mRNA levels of TLR8 genes were down-regulated(P＜0.05).Western blot results showed that the protein expressions of TLR3,TLR7,TRIF and MyD88 were significantly up-regulated when JEV infected testicular stromal cells for 6 h(P＜0.05),which was consistent with the corresponding mRNA transcription levels.There was no significant change in TLR8 protein expression.ELISA results showed that 6 h after JEV infection of testicular stromal cells,IL-6 was significantly increased(P＜0.01),and the expressions of IL-1β and TNF-α were not changed.TLR3,TLR7,TLR8,TRIF and MyD88 were si-lenced by siRNA,and the silenced cells were inoculated with JEV for 6 h,and IL-6 expression lev-els were detected by ELISA.The results showed that silenced TLR3,TLR7,TLR8,TRIF and MyD88 could significantly reduce the increase of IL-6 secretion induced by JEV infection(P＜0.05).These results indicated that JEV could induce the expression of inflammatory factor IL-6 by activating TLR3,TLR7 and TLR8 signaling pathway after infection of testicular stromal cells.This study provides a reference for further elucidating the mechanism of reproductive disorders caused by JEV infection.

To predict the distribution and habitat of Dermacentor nuttallii in Xinjiang and to under-stand its life cycle history.In this study,Maximum Entropy Modeling(MaxEnt)was used to pre-dict the geographical distribution and adaptation area of Dermacentor nuttallii in Xinjiang,and jackknife test and response curve of environmental variables were used to evaluate the environmen-tal factors affecting the distribution of Dermacentor nuttallii.Dermacentor samples were collected randomly based on predicted sites.The species of Dermacentor was identified by the combination of morphological characteristics and molecular biology.The New Zealand white rabbit was the only blood donor,and the life cycle and biological characteristics of the tick were observed and recorded by the method of earmuffs feeding under natural light in the laboratory.The jackknife test and SPSS analysis results showed that the main environmental variables affecting the distribution of suitable areas of Dermacentor nuttallii were average temperature(Bio1),average daily tempera-ture range(Bio2),seasonal temperature change(Bio4),driest month precipitation(Bio14),precip-itation variation coefficient(Bio15).The response curves of major environmental variables showed that Dermacentor nuttallii had the highest presence probability when Bio1 was 15.58 ℃,Bio2 was 6.19 ℃,Bio4 had a coefficient of variation of 1 500,Bio14 had a coefficient of variation of 20 mm,Bio15 had a coefficient of variation of 23.799 and Bio19 was 69 mm.The prediction results showed that the suitable areas of Dermacentor nuttallii in Xinjiang were Tianshan Mountain range in Junggar Basin,Turpan basin in Altai Mountain valley and some areas south of Tianshan Mountain range,accounting for 50.99％of the total area of Xinjiang.Dermacentor were collected from the predicted area according to MaxEnt model and identified as Dermacentor nuttallii by morphologi-cal and molecular biological methods.The full blood stage was 5.31 d,the degeneration stage was 8.19 d,and the degeneration rate reached 95.5％.If the full blood stage was 8.65 d and the degener-ation stage was 12.86 d,the degeneration rate reached 98％.The full blood stage of adult ticks was 6.75 d,the early egg stage of full blood females was 5.86 d,and the spawning stage of full blood fe-males was 12.5 d.The eggs hatched into young ticks after 25.92 d,and the hatching rate reached 90％.Dermacentor nuttallii took 62-107 d to complete a life history,with an average of 86.06 d.The constructed MaxEnt model has high prediction accuracy and accuracy.According to the varia-ble analysis of the main environmental factors,precipitation and temperature are the main environ-mental factors affecting Dermacentor nuttallii.The study of the whole life cycle of Dermacentor nuttallii in Xinjiang provides the basis for establishing the method of artificial breeding of pure species of Dermacentor nuttallii in Xinjiang.

Objective:To investigate the effects of Five-Element music intervention on anxiety, depression, and weaning successful rate in intensive care unit (ICU) patients with difficult weaning.Methods:A prospective randomized controlled trial was conducted. Eighty patients with difficulty in weaning accompanied by anxiety and depression disorders admitted to the respiratory intensive care unit (RICU) of Henan Provincial People's Hospital from January 2019 to January 2021 were enrolled as research subjects. They were divided into an observation group and a control group using a random number table method, 40 cases in each group. The patients in the control group received routine respiratory rehabilitation treatment, with daily assessments of weaning and gradual reduction of mechanical ventilation support until weaning was achieved. The patients in the observation group received additional Five-Element music therapy, in addition to routine respiratory rehabilitation treatment. Based on the clinical manifestations of the patients and applying traditional Chinese medicine theory for syndrome differentiation, music therapy was applied accordingly. The intervention used traditional Chinese Five-Element music (composed by Shi Feng, published by China Medical Electronic Audio and Visual Publishing House). Baseline data including the gender, age, etiology of acute respiratory distress syndrome (ARDS), and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score of patients were recorded. A twelve-lead synchronous Holter monitor continuously recorded the R-wave dominant electrocardiogram signal for 24 hours or more. Heart rate variability (HRV) indices [standard deviation of all normal sinus R-R intervals (SDNN), standard deviation of 5-minute average R-R intervals (SDANN), percentage of continuous normal R-R intervals with differences greater than 50 ms (PNN50), and the root mean square of successive differences in adjacent R-R intervals (RMSSD)] were calculated, as well as HRV frequency domain parameters [low-frequency band (LF, 0.05-0.15 Hz), high-frequency band (HF, 0.16-0.50 Hz), and LF/HF ratio]. Additionally, the incidence of delirium, weaning successful rate, reintubation rate within 7 days, length of ICU stay, and hospital mortality were documented.Results:There were 8 cases in the control group dropping out, and resulting in 32 were participated, and the 40 cases in the observation group were all enrolled the analysis. There were no statistically significant differences in terms of gender, age, ARDS etiology, and APACHEⅡ score between the two groups, indicating balanced baseline data for comparison. There were also no significant differences in HRV indices and frequency domain parameters before the intervention between the two groups. After the intervention, the observation group showed significant increases in HRV indices and frequency domain parameters as compared with the control group [SDNN (ms): 77.21±11.75 vs. 63.81±13.50, SDANN (ms): 83.51±19.45 vs. 50.40±14.55, PNN50: (10.75±3.42)% vs. (7.79±3.13)%, RMSSD (ms): 47.15±6.57 vs. 31.74±6.37, HF (ms 2/Hz): 568.50±144.48 vs. 496.94±151.56, LF (ms 2/Hz): 840.13±110.76 vs. 587.81±144.51, LF/HF ratio: 1.60±0.60 vs. 1.22±0.21, all P < 0.05]. Seventeen patients in the control group developed delirium, including 12 cases of hyperactive delirium, 3 cases of hypoactive delirium, and 2 cases of mixed-type delirium; whereas in the observation group, 9 patients developed delirium, including 7 cases of hyperactive delirium, 1 case of hypoactive delirium, and 1 case of mixed-type delirium. There was no significant difference in the types of delirium between the two groups ( P > 0.05); however, the incidence of delirium in the observation group was significantly lower than that in the control group (22.50% vs. 53.12%, P < 0.01). The weaning successful rate in the observation group was significantly higher than that in the control group [95.00% (38/40) vs. 78.12% (25/32), P < 0.05], the reintubation rate within 7 days and hospital mortality were slightly lower than those in the control group [reintubation rate within 7 days: 5.00% (2/40) vs. 15.62% (5/32), hospital mortality: 0% (0/40) vs. 3.12% (1/32), both P > 0.05], and the length of ICU stay was also slightly shorter than that in the control group [days: 18.00 (17.00, 25.75) vs. 22.50 (15.00, 34.50), P > 0.05]. Conclusion:Five-Element music therapy is beneficial in improving anxiety and depression disorders in ICU patients with difficult weaning, reducing the incidence of delirium, and increasing the weaning successful rate.

Objective:To explore the effects of a structured exercise intervention on the healthy physical fitness in patients with leukemia receiving umbilical cord blood transplantation.Methods:It was a randomized controlled trial, conducted from August 2022 to October 2023 at the Department of Hematology of the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital). Fifty leukemia patients undergoing umbilical cord blood transplantation were recruited and were randomly assigned to either the control group (24 cases) or the intervention group (26 cases) using a random number table method. The control group received routine nursing care, health education, and exercise guidance during hospitalization. The intervention group were given moderate-intensity structured exercise intervention, including aerobic, resistance exercises, and flexibility training, three times per week for 30 to 40 minutes per session, over a period of 6 to 8 weeks. During the study, 2 patients withdrew due to disease reasons, and finally, 22 patients in the control group and 26 patients in the intervention group were obtained. The paired t-test, Wilcoxon test, and covariance analysis were used to compare the indices of healthy physical fitness before and after the intervention between the two groups, aiming to explore the effects of a structured exercise intervention on the healthy physical fitness of leukemia patients undergoing umbilical cord blood transplantation. Results:Before the intervention, there was no significant differences in baseline characteristics, such as age, gender and disease status between the two groups (all P>0.05). During the hospitalization phase, the rate of exercise participation in the intervention group was 73.4%, the frequency of exercise was (2.20±0.41) sessions per week and the duration of each exercise session was (34.34±5.05) minutes, and the Borg′s rating of perceived exertion was (13.04±0.82) points. After intervention, the indicators including cardiovascular endurance, muscle fitness, and functional activity status in the two groups were all decreased, and the reduction degree of the indicators were all significantly lower in the intervention group when compared with those in the control group [6-minute walk distance (48.81±30.39) m vs (143.05±77.26) m, grip strength of left hand (2.57±1.30) kg vs (6.72±4.88) kg, grip strength of right hand (2.47±1.97) kg vs (6.34±5.70) kg, muscle strength of left upper limb (4.12±2.07) times vs (8.18±5.26) times, muscle strength of right upper limb (3.96±2.29) times vs (7.91±5.16) times, 30 second chair standing test (3.65±1.98) times vs (7.86±4.34) times, and timed-up-and-go test (0.65±0.53) s vs (2.35±1.79) s] (all P<0.05). The flexibility fitness was improved in the intervention group after the intervention [sit-and-reach 2.00(-4.75, 8.18) cm vs 0(-9.75, 6.43) cm] ( P=0.011), but no significant differences was found in the control group ( P>0.05). Conclusions:The structured exercise intervention has advantages in reducing the decline of healthy physical fitness in patients with leukemia receiving umbilical cord blood transplantation, and exerts a protective effect on healthy physical fitness.

Objective:To evaluate the relationship between the Geriatric Nutritional Risk Index (GNRI) and postoperative pulmonary complications (PPCs) in elderly patients undergoing thoracoscopic lung resection.Methods:Two hundred and ninety-one elderly patients of either sex, aged ≥60 yr, of American Society of Anesthesiologists Physical Status classificationⅠ-Ⅲ, undergoing elective thoracoscopic lung resection at Xuzhou Cancer Hospital from July 2022 to September 2023, were selected. Patients were divided into high GNRI group or low GNRI group based on the optimal cutoff value of GNRI (represented as a continuous variable) determined by the receiver operating characteristic curve to predict PPCs. The occurrence of PPCs was compared between the two groups within the first 7 postoperative days. The relationship between GNRI and PPCs was evaluated by the logistic regression analysis. The nonlinear correlation between GNRI score (expressed as a continuous variable) and PPCs was investigated by the restricted cubic spline. The accuracy of the GNRI, Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score, and combination of the two in predicting the occurrence of PPCs was evaluated by the areas under the ROC curve (95% confidence interval[ CI]). Results:A total of 269 patients were finally included, with 114 in high GNRI group (GNRI≥100.9) and 155 in low GNRI group (GNRI<100.9). Compared with high GNRI group, the incidence of PPCs was significantly increased compared with low GNRI group (42.6% vs 16.7%, P<0.001). The multivariate logistic regression analysis showed that low GNRI was a risk factor for PPCs, while elevated GNRI score was a protective factor for PPCS in elderly patients undergoing thoracoscopic lung resection ( P<0.05). The restricted cubic spline showed a linear correlation between GNRI score and PPCs ( P=0.947). The areas under the receiver operating characteristic curves of the GNRI, ARISCAT score, and combination of the two in predicting PPCs were 0.646 (95% CI 0.589-0.704), 0.619 (95% CI 0.564-0.674) and 0.708 (95% CI 0.647-0.769), respectively. Conclusions:Low GNRI is an independent risk factor for PPCs in elderly patients undergoing thoracoscopic lung resection, while elevated GNRI score is a protective factor. The combination of GNRI and ARISCAT score can predict the occurrence of PPCs.

Immune checkpoint inhibitors(ICIs)are an emerging tumor treatment approach following traditional surgery,chemoradiotherapy and targeted therapy.They have proven to be effective in a variety of cancers.However,they may induce immune-related adverse events(irAEs)during treatment,which may affect patients'quality of life and lead to treatment interruption or cessation.The key to preventing irAEs is early evaluation and identification of medical staff.Therefore,this article reviews the clinical manifestations and influencing factors of irAEs to help the early identification of high-risk groups and provide reference for clinical nursing work.

Objective:To investigate the effect of intraoperative protection of the supraclavicular nerve on the healing of clavicular 1/3 mid-shaft fracture.Methods:A retrospective study was conducted to analyze the 83 patients who had been treated for clavicular 1/3 mid-shaft fractures at Department of Orthopaedics, The First Central Hospital of Baoding from June 2021 to March 2022. There were 57 males and 26 females with an age of (48.1±12.8) years. The patients were divided into 2 groups according to whether the supraclavicular nerve was protected or not during operation. There were 39 cases in the observation group (the supraclavicular nerve was protected during operation) and 44 cases in the control group (the supraclavicular nerve was not protected during operation). The incision length, operation time, intraoperative blood loss, hospital stay, visual analogue scale (VAS) pain scores before operation and 3, 6 and 12 months after operation, fracture healing at 3, 6 and 12 months after operation, and postoperative complications were recorded and compared between the 2 groups. Additionally, the number of microvessels in the middle clavicle was recorded and compared between the affected and healthy sides in 8 patients in the observation group at 6 weeks after operation.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The operation time for the observation group [(72.2±5.4) min] was significantly longer than that for the control group [(61.1±4.7) min]. The VAS scores at postoperative 3 and 6 months for the observation group [2.7 (2.4, 3.1) and 2.1 (1.9, 2.6) points] were significantly lower than those for the control group [3.5 (3.2, 3.8) and 2.7 (2.4, 2.9) points] ( P<0.05). The fracture healing rates at postoperative 3 and 6 months in the observation group [97.4% (38/39) and 100% (39/39)] were significantly higher than those in the control group [81.8% (36/44) and 86.4% (38/44)] ( P<0.05), but there was no significant difference in the fracture healing between the 2 groups at 12 months after operation ( P>0.05). At 6 weeks after operation, the number of microvessels in the middle clavicle was respectively 85.3±0.7 and 87.1±0.8 in the 8 patients in the observation group, showing no significant difference ( P>0.05). After operation, delayed incision healing occurred in 3 cases in the observation group and in 4 cases in the control group, and abnormal sensation of the skin around the incision occurred in 9 cases in the observation group and in 26 cases in the control group, showing a significant difference between the 2 groups ( P<0.05). Conclusion:Intraoperative protection of the supra-clavicular nerve is beneficial for reduction of early postoperative pain and improvement of early fracture healing, and may have a positive effect on the postoperative reconstruction of microvascular network.