Objective To introduce the modeling method of pendulum-like modified rat abdominal heart heterotopic transplantation model and evaluate the quality of the model. Methods An operator without transplantation experience performed 15 consecutive models, recorded the time of each step, changes in body weight and modified Stanford scores, and calculated the surgical success rate, postoperative 1-week survival rate and technical success rate. Ultrasound examinations was performed in 1 week postoperatively. Results The times for donor heart acquisition, donor heart processing, recipient preparation and transplantation anastomosis were (14.3±1.4) min, (3.5±0.6) min, (13.6±2.1) min and (38.3±5.2) min respectively. The surgical success rate was 87% (13/15), and the survival rate 1 week after operative was 100% (13/13). The improved Stanford score indicated a technical success rate of 92% (12/13), and the postoperative 1-week ultrasound examination showed that grafts with Stanford scores ≥3 had detectable pulsation and blood flow signals. Conclusions The pendulum-like modified rat abdominal heart heterotopic transplantation improved model further optimizes the operational steps with a high success rate and stable quality, may be chosen as a modeling option for basic research in heart transplantation in the future.

Objective:To explore the influencing factors of hemodialysis (HD) initiation in non-diabetic kidney disease (NDKD) patients with predialysis arteriovenous fistula (AVF) creation.Methods:This was a single-center prospective cohort study. The NDKD patients undergoing predialysis AVF creation were enrolled at the First Affiliated Hospital of Xi'an Jiaotong University from 2015 to 2018. According to the estimated glomerular filtration rate (eGFR, the Chronic Kidney Disease Epidemiology Collaboration equation) and age, patients were divided into different subgroups, eGFR: group 1 [eGFR<10 ml·min -1·(1.73 m 2) -1], group 2 [ eGFR between 10 to 15 ml·min -1·(1.73 m 2) -1], and group 3 [eGFR > 15 ml·min -1·(1.73 m 2) -1]; age: age ≥65 years group and age <65 years group. The primary outcome was defined as the initiation of HD within 1 year after AVF surgery. The second outcome was the use of AVF access at the time of HD initiation. Cox proportional hazard regression was performed to identify which demographic and clinical factors were associated with the initiation of HD after AVF surgery. Logistic regression analysis was performed to investigate factors associated with AVF use at the initiation of HD. Results:A total of 220 patients were enrolled, with age of (48.1±16.2) years, of which 143(65.0%) were males. Overall, the clinical parameters of eGFR, cystatin C, serum albumin, 24h-Urine protein, serum phosphorus were as follows respectively, 7.7 (6.6,9.2) ml·min -1·(1.73 m 2) -1, (3.93±1.12) mg/L, (36.0±4.0) g/L, (2.22±1.36) g, (1.71±0.53) mmol/L. The proportion of patients initiating HD within 6 months ( Fisher=6.832, P=0.020) and the level of hemoglobin ( F=3.112, P=0.047) were higher in group 3 compared to the other two eGFR groups. While the median time interval between AVF creation and HD initiation ( H=6.295, P=0.043) was shorter in group 1. In age <65 years group, the level of serum albumin ( t=2.076, P=0.039), triglyceride ( t=1.995, P=0.048) were higher compared with age ≥65 years group; interestingly, the proportion of patients initiated HD within 3 months ( χ2=4.033, P=0.045) and 6 months ( χ2=5.012, P=0.025) were lower in age <65 years group. The median time interval between AVF creation and HD initiation among these patients was 84 (49,174) days. The patients initiating HD within 3 months, 6 months, and 1 year after AVF creation were 112 (50.9%), 152 (69.1%), and 202 (91.8%), respectively. Multivariate Cox regression analysis indicated that higher cystatin C level ( HR=1.283, 95% CI 1.121-1.469, P<0.001) was associated with earlier HD initiation within 1 year of AVF surgery in NDKD patients. AVF usage was accomplished in 64.3% of patients who initiated HD within 90 days, the ratio was 100.0% in those initiated HD between 91 to 180 days, and 88.0% in those ≥181 days after AVF surgery. No factor was independently associated with AVF use at HD initiation identified by multivariate logistic regression analyses in patients with NDKD. Conclusion:Serum cystatin C level is associated with HD initiation within 1 year of the predialysis AVF creation in NDKD patients.

Objective To understand the changing trend of dementia disease burden attributed to high BMI in China from 1990-2019, and to provide a basis for the development of dementia prevention and control strategies. Methods Using data from the Global Burden of Disease Study 2019(GBD2019)，the changes in disease burden were analyzed using indicators such as deaths, disability adjusted life years (DALYs), years lived with disability (YLDs), years of life lost (YLLs) and their standardized rates. The differences between sexes and age groups were compared. Joinpoint regression model was used to analyze the trend of changes in the disease burden of dementia attributable to high BMI in China. Results From 1990 to 2019, the burden of dementia disease attributed to high BMI continued to increase, with 20,300 more deaths, 404,200 more DALYs, and more than a four-fold increase in both mortality and DALYs rates. The overall burden of disease was greater for women than for men, but the rate of increase in the burden of disease was higher for men than for women. The disease burden in the age group of 80 and over was significantly higher than in other age groups. Conclusion Attention should be paid to people with high BMI, especially for the prevention and control of dementia risk in older age groups with high BMI. Active countermeasures should be taken to control the occurrence of dementia.

Objective To observe the analgesic effects of mild moxibustion on primary dysmenorrhea(PD)rats with cold and dampness stagnation syndrome and its effect on BDNF/TrkB signaling pathway in hypothalamus;To explore its mechanism for the treatment of PD.Methods A total of 32 Wistar non-pregnant female rats were randomly divided into blank group,model group,Western medicine group and mild moxibustion group,with 8 rats in each group.Except for the blank group,the other groups received estradiol benzoate intraperitoneal injection combined with ice bath treatment + oxytocin intraperitoneal injection to establish PD with cold and dampness stagnation syndrome model.The mild moxibustion group received treatment at"Shenque"and"Guanyuan"from the eighth day of modeling for 10 min,and the Western medicine group was given ibuprofen solution intragastically for 4 days.The latency period of rats twisting was observed and the twisting score was calculated,Western blot and PCR were used to detect the expressions of c-fos,BDNF,TrkB protein and mRNA in hypothalamic tissue.Results Compared with the blank group,the model group showed a shortened latency period and an increased twisting score(P<0.01),the expressions of c-fos,BDNF,TrkB protein and mRNA in hypothalamic tissue increased(P<0.01,P<0.05).Compared with the model group,the mild moxibustion group had a longer latency period and lower twisting score(P<0.01),while the expressions of c-fos,BDNF,TrkB protein and mRNA in hypothalamic tissue increased(P<0.01,P<0.05).Conclusion Mild moxibustion may effectively improve the pain state of PD rats with cold and dampness stagnation syndrome.This mechanism may be related to downregulating c-fos expression,inhibiting BDNF/TrkB signaling pathway activation,thereby inhibiting pain signal transmission,regulating pain occurrence and maintenance.

Objective To analyze the values of peripheral blood red blood cell distribution width(RDW),neutrophil(NEU)to lymphocyte(LYM)ratio(NLR),fibrinogen(FIB)to albumin(ALB)ratio(FAR)and surfactant protein A(SP-A)in evaluating patient condition and risks of acute exacerbation of COPD.Methods A total of 200 patients with COPD admitted to Hebei University Affiliated Hospital from January 2021 to December 2023 were selected as study subjects.All the patients had follow-up visits in the outpatient department within the past three months.According to the presence or absence of acute exacerbation,they were divided into exacerbation group(n=96)and non-exacerbation group(n=104).Meanwhile,50 healthy volunteers were assigned to a control group.Peripheral blood RDW,NEU,LY,FIB,ALB and SP-A in the three groups were compared.NLR and FAR were cal-culated.The correlation of RDW,NLR,FAR,and SP-A with the severity of AECOPD was analyzed.ROC curves were used to analyze the values of RDW,NLR,FAR,and SP-A in evaluating the risks of acute exacerbation of COPD.Multivariate logistic regression analysis was conducted to identify the risk factors for AECOPD.The differences in RDW,NLR,FAR,and SP-A were compared among the patients with different prognoses.Results Peripheral blood RDW,NEU,NLR,FIB,FAR and SP-A were higher in the exacerbation group than in the non-exacerbation group,whereas LYM and ALB were lower(P<0.05).Levels of RDW,NLR,FAR and SP-A were higher in the patients with grade Ⅲ AECOPD than those with grade Ⅱ or grade Ⅰ AECOPD(P<0.05).RDW,NLR,FAR,SP-A,and grade of patient condition in patients with AECOPD were positively correlated in pairs(P<0.05).The sensitivity,specificity and area under the ROC curve of combined prediction of AECOPD using RDW,NLR,FAR and SP-A were 0.798 and 0.830(95%CI:0.738～0.922),all of which were superior to prediction using a single indicator.Multivariate analysis found that smoking,RDW>14.33%,NLR>2.80,FAR>0.08,and SP-A>2.21 ng/mL were risk factors for acute exacerbation of COPD(P<0.05).RDW,NLR,FAR,and SP-A in the readmission group within 30 days after discharge were higher than those in the non-readmission group(P<0.05).Conclusions RDW,NLR,FAR,and SP-A are closely related to the patient condition of COPD,and can help to predict the risk of acute exacerbation and prognosis.Therefore,they are worthy of monitoring in clinical practice.

Anxiety disorders are characterized by high prevalence and recurrence rate.Selective serotonin reuptake inhibitors(SSRIs)and cognitive behavioral therapy(CBT)are recommended as first-line treatments for anxiety disorders,while some patients do not response to either of these treatments.Therefore,exploring the neurobiological mechanisms associated with treatment response and valuable prognostic marker is of great value in guiding clinical decision making.Previous studies have reported an altered electroencephalogram(EEG)pattern in patients with anxiety disorders after treatment,and revealed a correlation between baseline EEG and treatment response,suggesting that EEG is of great value in predicting the treatment response in anxiety disorders.The purpose of this article is to delineate findings from a systematic review of the literature investigating the EEG signal in prognostic prediction and exploration of neurobiological mechanisms,so as to provide electrophysiological evidence for individualized treatment of anxiety disorders.Results of this review show that patients responding more strongly to negative emotional stimuli before treatment are more likely to benefit from SSRIs and CBT.After the CBT,no statistical difference is found in the amplitude of error-related negativity(ERN)and P1 component between pre-and post-procedure measurements,suggesting that CBT may not reduce anxiety symptoms by improving attention bias and behavioral monitoring.EEG indicators related to emotion perception under negative emotional stimuli at baseline,such as late positive potential(LPP),may be promising markers for predicting response to treatment in anxiety disorders.

Objective:To explore the effects of infusion of irritant medications on the patients with midline catheter based on propensity score matching method and provide reference for medications infusion through midline catheter.Methods:Through a retrospective cohort study, the clinical data of 1 539 patients with midline catheter placement in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from March 2019 to October 2022 were retrospectively analyzed, and the patients were divided into irritant medications group ( n=1 120) and non-irritant medications group ( n=419) according to the characteristics of the medications they were infused with, and then compared the patients of the two groups with midline catheter-related complications and catheter indwelling time based on the propensity score matching. Results:Among 1 539 patients, there were 656 males and 883 females, aged 18-92 (59.30 ± 18.76) years old. Before propensity score matching, there were statistically significant differences in age: (58.09 ± 18.72) years old, (62.55 ± 18.50) years old; hypertension:496 cases, 210 cases; diabetes:266 cases, 129 cases; white blood cell count:7.50(5.50, 9.70) × 10 9/L, 7.00(5.10, 9.50) × 10 9/L between the irritant medications group and non-irritant medications group ( t=4.18, χ2=4.18, 7.92, Z=-1.98, all P<0.05). After propensity score matching, there were 412 patients in the irritant medications group and 412 patients in the non-irritant medications group, and there was no significant difference in the general data between the two groups (all P>0.05). After propensity score matching, the rates of oozing, bleeding, catheter occlusion, catheter-related thrombosis, catheter dislodgement and total catheter complications between the two groups showed no statistically significant difference (all P>0.05). The catheter indwelling time in the irritant medications group was 10.00 (5.25, 16.75) days, which was longer than that in the non-irritant medications group for 6.00 (4.00, 11.00) days, the difference was statistically significant ( Z=-7.25, P<0.05). Conclusions:Infusion of irritant medications has no effect on the outcome of midline catheter, but monitoring and catheter maintenance should be strengthened in order to reduce the occurrence of cutheter related complications.

Aim To construct a diabetic atherosclerosis mouse model and study the pathological characteristics of diabetic atherosclerosis.Methods Fifty 8-week-old male LDLR-/-mice were fed with standard diet for 2 weeks and then changed to high-fat diet,they were randomly divided into two groups.The diabetic atherosclerosis group was given intraperitoneal injection of low dose streptozotocin(STZ)for 5 days continuouly to establish the model,and the atheroscle-rosis group was given citrate buffer injection at the same time.The body mass,blood glucose and blood lipids of the mice in the two groups were detected for many times.At the age of 23 weeks,the mice were euthanized after glucose tolerance test.HE staining and oil red O staining were used to detect the gross and aortic root atherosclerosis,immunohistochemical staining was used to detect CD4,α-smooth muscle actin(α-SMA),EGF-like module-containing mucin-like hormone re-ceptor-like 1(EMR1),monocyte chemotactic protein-1(MCP-1),NOD-like receptor protein 3(NLRP3),vascular cell adhesion molecule-1(VCAM-1),matrix metalloproteinase-2(MMP-2)and tissue inhibitor of metalloproteinase-1(TIMP-1),Western blot was used to detect α-SMA,CD4,tumor necrosis factor-α(TNF-α),NLPR3,intercellular adhesion molecule-1(ICAM-1),and type Ⅰ and Ⅲ collagen.Results Compared with the atherosclerosis group,the body mass decreased,the levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDLC)increased,and the levels of high density lipoprotein cholesterol(HDLC)decreased(P＜0.05)in the diabetic atherosclerosis group.Compared with the atherosclerosis group,the distribution of atherosclerotic plaques was diffuse and the area was increased in the diabetic atherosclerosis group,and the contents of lipids,T cells,macrophages,smooth muscle cells,type Ⅰ and Ⅲ colla-gen were increased(P＜0.05);the protein levels of TNF-α,MCP-1,MMP-2,NLRP3,ICAM-1 and VCAM-1 in vascular tissues were increased,while the content of TIMP-1 were decreased and MMP2/TIMP-1 were increased(P＜0.05).Conclusions LDLR-mouse model of diabetic atherosclerosis can be successfully established by STZ induction combined with high-fat diet,which can reflect the plaque composition and inflammatory characteristics of diabetes promoting atheroscle-rosis.It can be used as a relatively ideal pathological model for the study of diabetic macroangiopathy.

Objective:To summarize the best evidence for weight management in patients with knee osteoarthritis.Methods:Clinical decisions, guidelines, expert consensus, and systematic reviews regarding the weight management in patients with knee osteoarthritis were searched in databases such as British Medical Journal (BMJ) Best Practice, UpToDate, Cochrane Library, CINAHL, PubMed, and Embase. The search period was from database establishment to March 31, 2023. Two researchers conducted quality evaluations, extracted evidence, and recommended evidence levels for the included literature.Results:A total of 13 articles were included, including five guidelines, three expert consensus, and five systematic reviews. Thirty pieces of evidence were summarized from five aspects, namely the principles of weight management, weight management goals, exercise management strategies, dietary management strategies, and health education.Conclusions:The best evidence for weight management in patients with knee osteoarthritis can provide a basis for medical staff.

Objective:To explore the effect of physical activity trajectories on cognitive function in middle-aged and older adults.Methods:Based on data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, 809 participants aged ≥45 were selected. General data, physical activity levels, and cognitive function were collected. The group-based trajectory model (GBTM) was used to establish the physical activity trajectory model, and multiple linear regression was applied to investigate factors affecting cognitive function in middle-aged and older adults and to analyze the relationship between physical activity trajectories and cognitive function.Results:The cognitive function score for the 809 middle-aged and older adults was (11.71±4.60), and the logarithmic metabolic equivalent of physical activity was (8.38±1.06). Based on GBTM, four physical activity trajectories were identified: stable group, slow-increase group, rapid-decrease group, and stable-decrease group. Multiple linear regression analysis showed that the stable and slow-increase activity trajectories, gender, age, marital status, and retirement status were significant factors influencing cognitive function in middle-aged and older adults ( P<0.01) . Conclusions:Physical activity trajectories are associated with cognitive function in middle-aged and older adults. Maintaining stable or slowly increasing physical activity is beneficial for cognitive health. Nurses should design targeted interventions based on factors influencing cognitive function.