Objective:The clinicalpathological features of TAFRO syndrome were analyzed to clarify the similarities and differences between TAFRO syndrome and autoimmune diseases and to establish differential diagnosis.Methods:Six patients diagnosed with TAFRO syndrome in Shanxi Bethune Hospital from January 2014 to March 2022 were collected. The clinical, examination, pathology and treatment of TAFRO syndrome were analyzed and compared with autoimmune diseases, especially systemic lupus erythematosus and Sj?gren′s syndrome.Results:Among the 6 patients, 4 were males and 2 were females, with an average age of (57.5 ±9.8) years. All the 6 patients had fever, edema (including chest and abdominal effusion and systemic edema), thrombocytopenia (3 main criteria) and more than 2 secondary criteria.ESR and CRP were significantly elevated in 6 patients. There were 1 case of elevated IgA and IgG (IgA 4.10 g/L, IgG19.05 g/L), 1 case of elevated igg (IgG 19.33 g/L), 3 cases of normal and 1 case of undetected. Serum IgG4 was negative in 4 cases and undetected in 2 cases. Autoantibodies: 4 cases were ANA positive, including 1 case with anti-SSA/Ro52(+), anti-SSA/Ro60(+), anti-SSB (+), 1 case with anti-SSA /Ro60(+), and 2 untested. Bone marrow cytological examination was performed in 6 cases, all of which showed active hyperplasia, 2 cases showed elevated megakaryocytes, and 1 case was accompanied by interstitial fibrosis. Pathological examination of lymph nodes: 5 cases were consistent with Castleman′s disease, and 1 case was suggestive of reactive hyperplasia of lymph nodes. Conclusion:Although the diagnostic criteria of TAFRO syndrome should exclude autoimmune diseases, TAFRO syndrome and autoimmune diseases can coexist, and the connective tissue disease complicated with TAFRO syndrome has its specific clinical characteristics and treatment plan, which needs to be identified clinically.

Objective: To investigate the correlation of chemerin levels in the serum and intestinal mucosal with in- testinal mucosal inflammation in IBS-D mice . Methods: A total of 128 female C57BL/6J mice were randomly di- vided into IBS-D group and control group , with 64 mice in each group . Wire Restraint Stress method (WRS) was used to construct an animal model of IBS-D . Enzyme-linked immunosorbent assay was used to detect serum and co- lonic mucosal chemerin levels in mice . Hematoxylin-eosin (HE) staining was used to observe colonic mucosal in- flammation . Geboes value was used to evaluate the severity of colonic mucosal inflammation . Results: In the IBS- D group , the concentration of serum chemerin increased and reached the peak in the first week of the experiment ( t = 6. 538 , P < 0. 001) , and the concentration of colonic mucosa chemerin increased and reached the peak in the fourth week of the experiment ( t = 8 . 104 , P < 0. 001) ; in the first week of experiment , the colonic mucosa of IBS- D mice showed inflammatory reaction , which was the most significant in the fifth week (P < 0. 05) . Geboes score was ( 1 . 75 ±0. 50) vs (0. 55 ±0. 52) . Conclusion There is a temporal sequence between the elevation of serum and intestinal mucosal chemerin levels and the severity of intestinal mucosal inflammation , and it is hypothesized that the elevated serum and intestinal mucosal chemerin levels correlate with the onset and progression of intestinal mucosal inflammation .

Objective To establish a risk model of rivaroxaban-related bleeding events in elderly patients with non-valvular atrial fibrillation(NVAF)based on gene polymorphism.Methods A total of 268 elderly NVAF patients receiving rivaroxaban treatment in Department of General Practice of the First Affiliated Hospital of Shihezi University from January 2021 to July 2023 were enrolled in this study.According to whether bleeding events occurred in 12 months'follow-up,they were divided into a bleeding group(47 cases)and a non-bleeding group(221 cases).The clinical data and results of gene polymorphism were compared between the two groups.Multivari-ate logistic regression was adopted to construct a risk prediction model of bleeding events based on gene polymorphism,and the predictive performance was verified.Results Significantly ad-vanced age and lower creatinine level were observed in the bleeding group than the non-bleeding group(P＜0.01).The bleeding group had obviously lower GG genotype frequency at the rs1128503 locus and TT genotype frequency at the rs4148738 of ATP-binding cassette,sub-family B member 1(ABCB1),and lower AC genotype frequency at the rs1057910 locus of cytochrome P450 2C9(CYP2C9)than the non-bleeding group(P＜0.05).Multivariate logistic regression analy-sis showed that age(OR=1.136,95％CI:1.031-1.251),and AA genotype(OR=15.407,95％CI:4.259-55.741)and GA genotype(OR=6.990,95％CI:1.599-30.546)of ABCB1 rs1 128503 were risk factors for rivaroxaban-related bleeding events in elderly NVAF patients(P＜0.01).Creatinine(OR=0.943,95％CI:0.899-0.989),TT genotype at ABCB1 rs4148738(OR=0.048,95％CI:0.009-0.242)and AC genotype of CYP2C9 rs1057910(OR=0.092,95％CI:0.021-0.408)were protective factors for the risk(P＜0.05).ROC curve analysis indicated that the AUC value of the risk model based on gene polymorphism was 0.827(95％CI:0.776-0.870),the spe-cificity was 81.90％,and the sensitivity was 76.60％.Conclusion Our risk model of rivaroxaban-related bleeding events based on ABCB1 gene and CYP2C9 gene has high application value for elderly NVAF patients.

Objective To establish a risk model of rivaroxaban-related bleeding events in elderly patients with non-valvular atrial fibrillation(NVAF)based on gene polymorphism.Methods A total of 268 elderly NVAF patients receiving rivaroxaban treatment in Department of General Practice of the First Affiliated Hospital of Shihezi University from January 2021 to July 2023 were enrolled in this study.According to whether bleeding events occurred in 12 months'follow-up,they were divided into a bleeding group(47 cases)and a non-bleeding group(221 cases).The clinical data and results of gene polymorphism were compared between the two groups.Multivari-ate logistic regression was adopted to construct a risk prediction model of bleeding events based on gene polymorphism,and the predictive performance was verified.Results Significantly ad-vanced age and lower creatinine level were observed in the bleeding group than the non-bleeding group(P＜0.01).The bleeding group had obviously lower GG genotype frequency at the rs1128503 locus and TT genotype frequency at the rs4148738 of ATP-binding cassette,sub-family B member 1(ABCB1),and lower AC genotype frequency at the rs1057910 locus of cytochrome P450 2C9(CYP2C9)than the non-bleeding group(P＜0.05).Multivariate logistic regression analy-sis showed that age(OR=1.136,95％CI:1.031-1.251),and AA genotype(OR=15.407,95％CI:4.259-55.741)and GA genotype(OR=6.990,95％CI:1.599-30.546)of ABCB1 rs1 128503 were risk factors for rivaroxaban-related bleeding events in elderly NVAF patients(P＜0.01).Creatinine(OR=0.943,95％CI:0.899-0.989),TT genotype at ABCB1 rs4148738(OR=0.048,95％CI:0.009-0.242)and AC genotype of CYP2C9 rs1057910(OR=0.092,95％CI:0.021-0.408)were protective factors for the risk(P＜0.05).ROC curve analysis indicated that the AUC value of the risk model based on gene polymorphism was 0.827(95％CI:0.776-0.870),the spe-cificity was 81.90％,and the sensitivity was 76.60％.Conclusion Our risk model of rivaroxaban-related bleeding events based on ABCB1 gene and CYP2C9 gene has high application value for elderly NVAF patients.

Objective:The clinicalpathological features of TAFRO syndrome were analyzed to clarify the similarities and differences between TAFRO syndrome and autoimmune diseases and to establish differential diagnosis.Methods:Six patients diagnosed with TAFRO syndrome in Shanxi Bethune Hospital from January 2014 to March 2022 were collected. The clinical, examination, pathology and treatment of TAFRO syndrome were analyzed and compared with autoimmune diseases, especially systemic lupus erythematosus and Sj?gren′s syndrome.Results:Among the 6 patients, 4 were males and 2 were females, with an average age of (57.5 ±9.8) years. All the 6 patients had fever, edema (including chest and abdominal effusion and systemic edema), thrombocytopenia (3 main criteria) and more than 2 secondary criteria.ESR and CRP were significantly elevated in 6 patients. There were 1 case of elevated IgA and IgG (IgA 4.10 g/L, IgG19.05 g/L), 1 case of elevated igg (IgG 19.33 g/L), 3 cases of normal and 1 case of undetected. Serum IgG4 was negative in 4 cases and undetected in 2 cases. Autoantibodies: 4 cases were ANA positive, including 1 case with anti-SSA/Ro52(+), anti-SSA/Ro60(+), anti-SSB (+), 1 case with anti-SSA /Ro60(+), and 2 untested. Bone marrow cytological examination was performed in 6 cases, all of which showed active hyperplasia, 2 cases showed elevated megakaryocytes, and 1 case was accompanied by interstitial fibrosis. Pathological examination of lymph nodes: 5 cases were consistent with Castleman′s disease, and 1 case was suggestive of reactive hyperplasia of lymph nodes. Conclusion:Although the diagnostic criteria of TAFRO syndrome should exclude autoimmune diseases, TAFRO syndrome and autoimmune diseases can coexist, and the connective tissue disease complicated with TAFRO syndrome has its specific clinical characteristics and treatment plan, which needs to be identified clinically.

Purpose To investigate the clinical value of artificial intelligence(AI)quantitative parameters in predicting the invasion degree of lung adenocarcinoma with diameter≤2 cm of ground-glass density.Materials and Methods A total of 80 patients with lung adenocarcinoma with diameter≤2 cm ground-glass density confirmed by pathology from March 2019 to April 2022 were retrospectively analyzed.A total of 90 nodules were rerolled,including 8 adenocarcinomas in situ(AIS),34 minimally invasive adenocarcinomas(MIA)and 48 invasive adenocarcinomas(IAC).They were divided into the experimental group(IAC)and the control group(AIS and MIA).The differences of the AI quantitative parameters such as volume,three-dimensional length diameter,maximum area,maximum CT value,minimum CT value and average CT value were compared between two groups,and the predictive values of AI quantitative parameters for the invasion degree of lung adenocarcinoma was evaluated.Results There were statistically significant differences with age,volume,three-dimensional length diameter,maximum area,maximum CT value and average CT value between the two groups(all P<0.05),but no statistically significant differences in gender and minimum CT value(both P>0.05).Binary Logistic regression analysis showed that the three-dimensional length diameter(odd ratio=2.020,P=0.034)and the maximum CT value(odd ratio=1.008,P=0.013)were independent predictors for lung adenocarcinoma with diameter≤2 cm of ground-glass density.The regression model based on the three-dimensional length diameter and the maximum CT value had the best predictive performance,and its AUC was 0.901.When the critical value was 2.432,its sensitivity and specificity were 93.75%and 71.43%,respectively.Conclusion AI quantitative parameters have a high value in predicting the degree of invasion of lung adenocarcinoma with diameter≤2 cm of ground-glass density,and the combined model with three dimensional long diameter and maximum CT value has the highest diagnostic efficiency.

Objective To explore the application of management model based on risk prediction model in hospitalized schizophrenics.Methods 500 schizophrenics hospitalized in the Seventh People's Hospital of Wenzhou from August 2020 to August 2022 were selected and analyzed retrospectively.334 patients were selected,and according to the modified overt aggression scales(MOAS)score after discharge,they were divided into 105 cases of violence behavior group and 229 cases of non violence behavior group.The influencing factors were analyzed and multi-factor regression analysis was carried out to establish the risk prediction model and verify the clinical prediction value of 166 cases with violence behavior.Results The age,family economic status,parenting style,treatment status,intelligence,hospitalization mode,occupation,previous violence,delusion,mental symptoms and irritability of patients in violence behavior group were significantly worse than those in non-violence behavior group,and the difference was statistically significant(P<0.05);Cox multivariate analysis showed that treatment status,intelligence,hospitalization mode,previous violence behavior,delusion,mental symptoms and irritability were independent risk factors for violence behavior in patients with schizophrenia(P<0.05).The area under the receiver operating characteristic(ROC)curve of the risk prediction model for predicting violence behavior in hospitalized schizophrenic patients was 0.941(95%CI:0.051-0.142,P<0.05).When the positive rate of the critical value for predicting the occurrence of violence was≥93.98%,the specificity was 0.915 and the sensitivity was 0.964.Conclusion The risk prediction model based on the treatment status,intelligence,hospitalization style,previous violence behavior,delusion,mental symptoms and irritability can effectively predict the occurrence of violence in schizophrenic inpatients,and has high distinctiveness and sensitivity,which has important guiding significance for clinical intervention.

Objective To observe the thickness and histologic changes of cartilage -perichondrium complex (CP) and vascular density changes in perichondrium after repairing perforated eardrum .Methods Forty -five male guinea pigs were randomly divided into three groups ,and were used to create left TM perforation .The left cavum conchae cartilage-perichondrium was immediately used to repair the perforation .The observation time for group A was two weeks ,group B was six weeks and group C was twelve weeks .The thickness of the composite was meas-ured before and after the implantation .The histologic changes of implants and the vascular change in perichondri were observed .Results The healing time for the left ear was 3 .8 ± 0 .84 ,and the right ear 7 .2 ± 0 .84 .The thick-ness of the composite for group A increased by 14 .4% (P<0 .05) .There was no significant change in the thickness of group B after implantation(P>0 .05) .Group C decrease by 14 .2% (P<0 .05) .After implantation ,the thickness of cartilage in group C was decreased by 34 .2% compared to that in group A (P<0 .05) .At the 2nd week in post -implantation ,the number of vessels within the unit area of fiber -perichondrium was up to 13 .28 ± 2 .49 ,while the above number reached to 7 .71 ± 2 .49 at the 6th week after implantation .The final histological structure of recon-structed tympanic membrane at the 2nd week and 6th week was composed of squamous epithelial layer ,fibrous -perichondrium layer ,cartilaginous layer and mucous layer .The above histological structure at 12th week was com-posed of squamous epithelial layer ,cartilaginous layer and mucous layer .Conclusion The healing time of the recon-structed tympanic membrane is shorter than the time spent on healing on its own .The thickness of the composite in post-implantation in three groups first increased and then decreased compared to that in pre -implantation .The number of blood vessels of fiber -perichondrium in the reconstructed tympanic membrane first increased and then re-duced .The layers of final histological structure of reconstructed tympanic membrane are similar to those of normal tympanic membrane .From the perspective of histology ,the cartilage-perichondrium composite is the suitable ma-terial for repairing tympanic membrane .

Objective To explore the labeling method of rat adipose-derived stromal cells,and observe the stem cell characteristics and the activities of EGFP-positive adipose-derived stromal cells (EGFP-ADSCs) in vitro and in vivo.Methods ADSCs were transfected for 12 h with enhanced green fluorescent protein gene (EGFP) carried by lentivirus(Lv-EGFP) vector at different value of MOI (0,5,10,25,50,100,respectively).The rate of EGFP expression and fluorescence intensity were evaluated by flow cytometric analysis and fluorescence microscopy,and cell viability was detected by MTT-test after transfection.Secondly,cells were exposed either to adipogenic medium or osteogenic medium,then stained with Oil Red O and Alizarin Red S.Cell growth was investigated on frozen longitudinal sections when EGFP-ADSCs were injected into acellular nerves to build tissue-engineered peripheral nerves repairing sciatic nerve defects in rats for 1 week in vivo.Results EGFP-positive rate and fluorescence intensity peak at 4 days after transfection.The rate of EGFP expression was 0.13％,31.09％,75.33％,92.66％,96.70％,98.38％ for MOI =0,1,5,25,50,100,respectively.The positive rate between the experimental group and control (MOI =0) existed significantly difference (P ＜ 0.05) ; the difference between MOI =1,5 groups and MOI =25,50,100 groups were also observed (P ＜ 0.05).There was no statistical difference in EGFP-positive rate and cell proliferation activity among MOI =25,50,100 groups (P ＞ 0.05).MOI =25 was chosen as best scheme to transfect ADSCs for subsequent experiments.Osteogenic and adipogenic differentiation for 20 days,orange calcium deposits,orange-red lipid droplets were seen in EGFP-ADSCs after Alizarin red and oil red O staining.At 1 week in vivo,EGFP-ADSCs evenly distributed and became fusiform on frozen longitudinal sections.Conclusion Lv-EGFP transfection does not affect the ADSCs activity and their osteogenic and adipogenic differentiation,so could be as a tracing method for ADSCs-tissue-engineered peripheral nerves repairing nerve defects.

Objective To investigate the status of research and research utilization in practice among nurses of hospital of Traditional Chinese Medicine.Methods Two hundred and sixty nurses of hospital of Traditional Chinese Medicine were selected to fill out the questionnaire.Results The rates of involvement of research activities and research utilization among nurses of hospital of Traditional Chinese Medicine were low.The score of every factor ranged from the higher to the lower were communication,organization,research and nurse.Conclusions Involvements of research activities and research utilization among nurses of hospital of Traditional Chinese Medicine are insufficient.Most factors associated with nurses' low extent of research utilization are objective factors.It is pivotal for nursing managers to construct supportive professional environment,improve nurses' research and information skills and the capacity of the research utilization.