Objective To analyze the clinical characteristics and prognosis of patients with spon-taneous coronary artery dissection(SCAD).Methods A retrospective analysis was conducted in 40 patients with acute myocardial infarction(AMI).All patients were diagnosed with SCAD during hos-pitalization through coronary angiography(CAG)or intravascular ultrasound(IVUS).The clinical characteristics,CAG or IVUS findings,and treatment regimens of the patients were analyzed,and their prognosis was assessed through follow-up.Results Among 40 SCAD patients,there were 11 males and 29 females,with a mean age of(53.04±9.15)years.Twelve patients had identified causative factors,and seven patients presented with chest pain as the initial symptom.CAG or IVUS results showed that a total of 69 SCAD lesions were detected in 40 patients,with 15 patients having a single lesion.The primary treatment approach for the patients was medical therapy.The median fol-low-up duration was 34 months(ranging 2 to 48 months),during which 5 major adverse cardiovascu-lar and cerebrovascular events(MACCE)occurred.The patients were divided into MACCE group(5 patients)and non-MACCE group(35 patients)based on occurrence of MACCE.The mean age and the incidence of regional wall motion abnormalities on echocardiography were higher in the MACCE group than in the non-MACCE group(P＜0.05).Conclusion SCAD has distinct imaging features on CAG,and IVUS can confirm the diagnosis.Most patients are treated with medical therapy and have a generally favorable prognosis.However,patients with older age or regional wall motion abnormali-ties on echocardiography have poorer prognosis.

Objective To analyze the medication rules and clinical experience of Qin Zujie in treating virtual labor based on data mining.Methods Outpatient medical records of Qin Zujie,diagnosed with deficiency syndrome at Ethnic Medicine Characteristic Diagnosis and Treatment Center,Guangxi International Zhuang Medical Hospital from January to December 2024 were selected.A standardized database was established and processed,yielding 148 clinical prescriptions containing 171 herbal ingredients.Frequency analysis,association rule analysis,and cluster analysis were employed to examine medication rules and clinical experience.Results The 20 Chinese herbal ingredients used more than 30 times each,with the first three being Zhigancao,Baizhu,Danggui.These herbs are primarily warm in nature,neutral in temperature,and slightly cold in effect,characterized by sweet,pungent,and bitter flavors.They mainly affect the spleen meridian and function to tonify deficiency,with Qi-tonifying herbs being the most common.Through association rule analysis,the most frequently combined pairs were Baizhu-Dangshen.Cluster analysis identified three core prescription clusters.Conclusion Qin Zujie's academic thought of treating virtual labor is to supplement deficiency as the main,detoxification as the auxiliary,and treat both the symptoms and the causes.

Objective:To evaluate and summarize the best evidence on nutritional management of children with inflammatory bowel disease (IBD) both domestically and internationally, so as to provide reference for clinical nursing practice.Methods:According to the "6S" evidence model, the literature on nutritional management of children with IBD was systematically searched in national and international computerized decision support systems, guideline websites, relevant professional association websites, and databases. The search period was from January 2014 to July 2024. The quality of the included literature was evaluated and the evidence was extracted, evaluated and integrated to form the best evidence.Results:A total of 15 papers were included, including three clinical decisions, five guidelines, two expert consensus, two position papers, and three systematic reviews. Thirty-four pieces of best evidence were extracted, focusing on six aspects of multidisciplinary team formation, nutritional assessment and monitoring, diet and nutrient management, nutritional support methods, exercise and obesity management, and follow-up and health education.Conclusions:This study summarizes the best evidence for nutritional management of children with IBD, which may provide a basis for clinical implementation of nutritional interventions. It is recommended that healthcare professionals screen for the best evidence, translate the evidence, and develop individualized nutritional management programs, taking into account the clinical context, professional opinion, and patient wishes.

Objective To analyze the medication rules and clinical experience of Qin Zujie in treating virtual labor based on data mining.Methods Outpatient medical records of Qin Zujie,diagnosed with deficiency syndrome at Ethnic Medicine Characteristic Diagnosis and Treatment Center,Guangxi International Zhuang Medical Hospital from January to December 2024 were selected.A standardized database was established and processed,yielding 148 clinical prescriptions containing 171 herbal ingredients.Frequency analysis,association rule analysis,and cluster analysis were employed to examine medication rules and clinical experience.Results The 20 Chinese herbal ingredients used more than 30 times each,with the first three being Zhigancao,Baizhu,Danggui.These herbs are primarily warm in nature,neutral in temperature,and slightly cold in effect,characterized by sweet,pungent,and bitter flavors.They mainly affect the spleen meridian and function to tonify deficiency,with Qi-tonifying herbs being the most common.Through association rule analysis,the most frequently combined pairs were Baizhu-Dangshen.Cluster analysis identified three core prescription clusters.Conclusion Qin Zujie's academic thought of treating virtual labor is to supplement deficiency as the main,detoxification as the auxiliary,and treat both the symptoms and the causes.

Objective:To evaluate and summarize the best evidence on nutritional management of children with inflammatory bowel disease (IBD) both domestically and internationally, so as to provide reference for clinical nursing practice.Methods:According to the "6S" evidence model, the literature on nutritional management of children with IBD was systematically searched in national and international computerized decision support systems, guideline websites, relevant professional association websites, and databases. The search period was from January 2014 to July 2024. The quality of the included literature was evaluated and the evidence was extracted, evaluated and integrated to form the best evidence.Results:A total of 15 papers were included, including three clinical decisions, five guidelines, two expert consensus, two position papers, and three systematic reviews. Thirty-four pieces of best evidence were extracted, focusing on six aspects of multidisciplinary team formation, nutritional assessment and monitoring, diet and nutrient management, nutritional support methods, exercise and obesity management, and follow-up and health education.Conclusions:This study summarizes the best evidence for nutritional management of children with IBD, which may provide a basis for clinical implementation of nutritional interventions. It is recommended that healthcare professionals screen for the best evidence, translate the evidence, and develop individualized nutritional management programs, taking into account the clinical context, professional opinion, and patient wishes.

Objective:To evaluate and summarize the best evidence on fatigue management in children with tumors both domestically and internationally, providing reference for medical and nursing staff to improve fatigue symptoms in children.Methods:The evidence on fatigue management in children with tumors, including best practices, recommended practices, guidelines, systematic reviews, evidence summaries, and expert consensus, was systematically retrieved from clinical decision support systems, guideline websites, professional association websites, and databases both domestically and internationally. The search period was from database establishment to April 2023. Two researchers independently conducted literature quality evaluation and evidence extraction.Results:A total of 17 articles were included, including four guidelines and 13 systematic reviews. Thirty-two best pieces of evidence were extracted from six aspects of assessment and screening, identification of risk factors, health education, exercise intervention, medication intervention, and other interventions of fatigue in children with tumors.Conclusions:The best evidence for fatigue management in children with tumors is summarized, which can provide a basis for medical and nursing staff to improve their fatigue symptoms. It is recommended that medical and nursing staff combine clinical context, professional opinions, and patient wishes to screen the best evidence and develop personalized fatigue management programs.

Objective To compare the effects of CalliSpheres drug-eluting beads transcatheter arterial chemoembolization(DEB-TACE)and conventional TACE(c-TACE)on liver fibrosis and liver function in the treatment of primary hepatocellular carcinoma(HCC).Methods A total of 40 patients diagnosed with HCC at Xuzhou Municipal Cancer Hospital of China between October 2020 and October 2022 were enrolled in this study.According to therapeutic scheme,the patients were divided into DEB-TACE group(n=20)and c-TACE group(n=20).The preoperative,and postoperative 5-day and one-month hyaluronidase(HA),type Ⅲ procollagen peptide(P Ⅲ NP),type Ⅳ collagen(CⅣ)and laminin(LN),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),albumin(Alb),and prothrombin time(PT)were compared between the two groups.Results The technical success rate was 100％in both groups,and tumor staining completely disappeared immediately after TACE in all patients.The postoperative 5-day levels of HA,LN,P Ⅲ NP,and CⅣ in both groups were remarkably higher than the preoperative ones(P＜0.05).One month after TACE,HA level in the DEB-TACE group was prominently higher than its preoperative value(P＜0.05);HA and LN levels in the c-TACE group were obviously higher than their preoperative values(P＜0.05);and the HA and LN levels in c-TACE group were significantly higher than those in DEB-TACE group(P＜0.05).Five days after TACE,in the DEB-TACE group the AST and PT levels were higher than their preoperative values while the Alb level was lower than its preoperative value(P＜0.05);in the c-TACE group the ALT,AST,TBiL and PT were higher than their preoperative values while the Alb level was lower than its preoperative value(P＜0.05);the ALT and AST levels in the c-TACE group were strikingly higher than those in the DEB-TACE group while Alb level was strikingly lower than that in the DEB-TACE group(P＜0.05).Conclusion Both CalliSpheres DEB-TACE and c-TACE can aggravate liver fibrosis and cause liver function damage.However,the degree of liver fibrosis and liver function damage caused by CalliSpheres DEB-TACE is less than that caused by c-TACE.(J Intervent Radiol,2024,33:259-263)

Objective:To analyze the electrocardiographic characteristics of patients with chronic pulmonary artery stenosis (PAS), and to explore their relationship with disease severity indicators.Methods:The study was a retrospective case-series analysis. Patients with chronic PAS admitted to Gansu Provincial Hospital from January 2018 to July 2021 were enrolled. The clinical data and the results of electrocardiography, transthoracic echocardiography, right cardiac catheterization, N-terminal B-type natriuretic peptide (NT-proBNP) measurement and 6-min walking distance test of patients were analyzed. The linear regression model or logistic regression model was used to analyze the relationship between electrocardiographic characteristics and the disease severity in patients with chronic PAS.Results:Sixty-three patients aged (62.1±9.7) years including 43 females (68.3%) were enrolled in the study. Among them, 62 patients (98.4%) had (R 1+S Ⅲ)-(S Ⅰ+R Ⅲ)<1.5 mV, and no patients had V 5lead R: S ratio to V 1 lead R: S<0.04 and V 6 lead R: S ratio<0.4. There were 55 patients (87.3%), with flat or inverted T-waves in V 1, and 10 patients (15.9%) with flat or inverted T-waves in all precordial leads (V 1-V 6). There were 18 patients (28.6%) with flat or inverted T-waves in inferior leads (Ⅱ, Ⅲ, aVF). Multiple liner regression analysis showed that Max R V1, 2+Max S I, aVL-S V1 combined with the number of flat or inverted T-waves in limb leads was independently correlated with atrial area ( R2=0.290, P=0.002); R V1+S V5 was independently correlated with right ventricular area ( R2=0.257, P=0.001); R peak V 1 combined with the number of flat or inverted T waves in precordial leads was independently correlated with tricuspid annular plane systolic excursion ( R2=0.407, P<0.001); (R 1+S Ⅲ)-(S Ⅰ+R Ⅲ) combined with the number of flat or inverted T waves in precordial leads was independently correlated with NT-proBNP ( R2=0.504, P<0.001); Max R V1, 2+Max S I, aVL-S V1 were independently correlated with right atrial pressure ( R2=0.803, P=0.036); (R 1+S Ⅲ)-(S Ⅰ+R Ⅲ) were independently correlated with mean pulmonary artery pressure ( R2=0.302, P<0.001); R aVRcombined with the number of flat or inverted T-waves in precordial leads was independently correlated with cardiac index ( R2=0.173, P=0.003); (R 1+S Ⅲ)-(S Ⅰ+R Ⅲ) was independently correlated with pulmonary vascular resistance ( R2=0.173, P=0.002); R peak V 1 combined with the number of flat or inverted T-waves in precordial leads was independently correlated with mixed vein oxygen saturation ( R2=0.302, P<0.001). Conclusion:The vast majority of patients with chronic PAS have (R 1+S Ⅲ)-(S Ⅰ+R Ⅲ)<1.5 mV and flat or inverted T-wave in V 1 lead, and some characteristic electrocardiographic manifestations are correlated with indicators of disease severity.

Objective:To investigate the effects and mechanisms of copper transporter 1 (CTR1) in radiation induced intestinal injury in vitro. Methods:Human small intestinal epithelial cells (HIEC) were irradiated with 2, 4, 6, 8 Gy of X-rays and rat intestinal epithelial cells (IEC-6) were irradiated with 5, 10, 15, 20 Gy of X-rays. At 2, 4, 8, 24, and 48 h after irradiation, the expression of CTR1 was detected by Western blot assay. In some experiments, HIEC and IEC-6 cells were transfected with CTR1 shRNA and then exposed to X-rays. Copper levels were detected by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The radiosensitivity of cells was verified by colonogenic assay, the cellular reactive oxygen species (ROS) level and DNA damage were detected to further explore the related mechanism. In addition, Western blot was applied to detect the expressions of antioxidants and cuproptosis associated proteins in enterocytes after silencing CTR1 or irradiation.Results:The expression of CTR1 was increased by X-ray irradiation in a dose-dependent manner ( t=3.53, 3.45, 6.37, 11.11, 11.13, P<0.05). CTR1 expression was successfully diminished by CTR1 shRNA adenovirus vectors. According to the survival curves, the enhancement ratios of the radiosensitivity of HIEC and IEC-6 cells with CTR1 knocking-down were 1.146 and 1.201, respectively. Radiation-induced copper accumulation was alleviated after CTR1 silencing in IEC-6 cells ( t=3.10, P<0.05). At 0.5 h after irradiation, the ROS production in the CTR1 knockdown group was significantly lower than that in the control group ( t=5.23, 2.96, P<0.05). At 1 h after irradiation, the protein expression of γ-H2AX in the CTR1 knockdown group was obviously lower than that in the control group ( t=7.50, 4.29, P<0.05). The expressions of Nrf2 and HO-1 were increased after irradiation, which could be further increased after CTR1 silencing. In addition, cuproptosis associated protein DLAT, LIAS and FDX1 were reduced post-irradiation, which were recovered after CTR1 silencing. Conclusions:The radioresistance of HIEC and IEC-6 cells was enhanced after CTR1 silencing, possibly through the intracellular ROS and cuproptosis pathway.

Background: Clostridium difficile infection (CDI) is the most common cause of hospital-acquired diarrhea and an important cause of death in hospitalized patients with diarrhea. However, there are not sufficient clinical researches on the risk factors of CDI. Aims: To investigate the risk factors of CDI in hospitalized patients with diarrhea. Methods: A total of 230 hospitalized diarrhea patients who received Clostridium difficile test from January 2015 to January 2019 at the Second Hospital of Hebei Medical University were collected. The patients were divided into CDI group and non-CDI group. Logistic regression analysis was performed to investigate the risk factors of CDI. Results: Compared with non-CDI group, patients in CDI group had a longer hospital stay (P<0.05) and a higher proportion of surgery in the past 6 months (P<0.05). The number of comorbidities in CDI group was higher than that in non-CDI group (P<0.05), and the ratio of gastrointestinal disease, cardiovascular disease, blood/immune system disease, nervous system disease in CDI group were higher than those in non-CDI group (P<0.05). Multivariate analysis showed the number of comorbidities (OR=3.215, 95% CI: 1.576-4.743; P=0.003), gastrointestinal disease (OR=4.135, 95% CI: 3.048-11.416; P=0.000), surgical history (OR=6.734, 95% CI: 2.692-15.849; P=0.000) and antibiotic use (OR=5.996, 95% CI: 2.173-15.481; P=0.000) were risk factors of CDI, especially the use of quinolone antibiotics (OR=4.769, 95% CI: 2.138-14.757; P=0.000). Conclusions: CDI can prolong the hospital stay of patients with diarrhea. Number of comorbidities, underlying gastrointestinal disease, recent history of surgery and antibiotic use, especially the use of quinolone antibiotics are risk factors of CDI in hospitalized patients with diarrhea.