Background and Objectives: SH3 and multiple ankyrin repeat domains 3 (Shank3) proteins play crucial roles as neuronal postsynaptic scaffolds. Alongside neuropsychiatric symptoms, individuals with SHANK3 mutations often exhibit symptoms related to dysfunctions in other organs, including the heart. However, detailed insights into the cardiac functions of Shank3 remain limited. This study aimed to characterize the cardiac phenotypes of Shank3-overexpressing transgenic mice and explore the underlying mechanisms. Methods: Cardiac histological analysis, electrocardiogram and echocardiogram recordings were conducted on Shank3-overexpressing transgenic mice. Electrophysiological properties, including action potentials and L-type Ca2+ channel (LTCC) currents, were measured in isolated cardiomyocytes. Ca2+ homeostasis was assessed by analyzing cytosolic Ca2+transients and sarcoplasmic reticulum Ca2+ contents. Depolarization-induced cell shortening was examined in cardiomyocytes. Immunoprecipitation followed by mass spectrometrybased identification was employed to identify proteins in the cardiac Shank3 interactome.Western blot and immunocytochemical analyses were conducted to identify changes in protein expression in Shank3-overexpressing transgenic cardiomyocytes. Results: The hearts of Shank3-overexpressing transgenic mice displayed reduced weight and increased fibrosis. In vivo, sudden cardiac death, arrhythmia, and contractility impairments were identified. Shank3-overexpressing transgenic cardiomyocytes showed prolonged action potential duration and increased LTCC current density. Cytosolic Ca2+ transients were increased with prolonged decay time, while sarcoplasmic reticulum Ca2+ contents remained normal. Cell shortening was augmented in Shank3-overexpressing transgenic cardiomyocytes. The cardiac Shank3 interactome comprised 78 proteins with various functions. Troponin I levels were down-regulated in Shank3-overexpressing transgenic cardiomyocytes. Conclusions This study revealed cardiac dysfunction in Shank3-overexpressing transgenic mice, potentially attributed to changes in Ca2+ homeostasis and contraction, with a notable reduction in troponin I.

Background and Objectives: SH3 and multiple ankyrin repeat domains 3 (Shank3) proteins play crucial roles as neuronal postsynaptic scaffolds. Alongside neuropsychiatric symptoms, individuals with SHANK3 mutations often exhibit symptoms related to dysfunctions in other organs, including the heart. However, detailed insights into the cardiac functions of Shank3 remain limited. This study aimed to characterize the cardiac phenotypes of Shank3-overexpressing transgenic mice and explore the underlying mechanisms. Methods: Cardiac histological analysis, electrocardiogram and echocardiogram recordings were conducted on Shank3-overexpressing transgenic mice. Electrophysiological properties, including action potentials and L-type Ca2+ channel (LTCC) currents, were measured in isolated cardiomyocytes. Ca2+ homeostasis was assessed by analyzing cytosolic Ca2+transients and sarcoplasmic reticulum Ca2+ contents. Depolarization-induced cell shortening was examined in cardiomyocytes. Immunoprecipitation followed by mass spectrometrybased identification was employed to identify proteins in the cardiac Shank3 interactome.Western blot and immunocytochemical analyses were conducted to identify changes in protein expression in Shank3-overexpressing transgenic cardiomyocytes. Results: The hearts of Shank3-overexpressing transgenic mice displayed reduced weight and increased fibrosis. In vivo, sudden cardiac death, arrhythmia, and contractility impairments were identified. Shank3-overexpressing transgenic cardiomyocytes showed prolonged action potential duration and increased LTCC current density. Cytosolic Ca2+ transients were increased with prolonged decay time, while sarcoplasmic reticulum Ca2+ contents remained normal. Cell shortening was augmented in Shank3-overexpressing transgenic cardiomyocytes. The cardiac Shank3 interactome comprised 78 proteins with various functions. Troponin I levels were down-regulated in Shank3-overexpressing transgenic cardiomyocytes. Conclusions This study revealed cardiac dysfunction in Shank3-overexpressing transgenic mice, potentially attributed to changes in Ca2+ homeostasis and contraction, with a notable reduction in troponin I.

Background and Objectives: SH3 and multiple ankyrin repeat domains 3 (Shank3) proteins play crucial roles as neuronal postsynaptic scaffolds. Alongside neuropsychiatric symptoms, individuals with SHANK3 mutations often exhibit symptoms related to dysfunctions in other organs, including the heart. However, detailed insights into the cardiac functions of Shank3 remain limited. This study aimed to characterize the cardiac phenotypes of Shank3-overexpressing transgenic mice and explore the underlying mechanisms. Methods: Cardiac histological analysis, electrocardiogram and echocardiogram recordings were conducted on Shank3-overexpressing transgenic mice. Electrophysiological properties, including action potentials and L-type Ca2+ channel (LTCC) currents, were measured in isolated cardiomyocytes. Ca2+ homeostasis was assessed by analyzing cytosolic Ca2+transients and sarcoplasmic reticulum Ca2+ contents. Depolarization-induced cell shortening was examined in cardiomyocytes. Immunoprecipitation followed by mass spectrometrybased identification was employed to identify proteins in the cardiac Shank3 interactome.Western blot and immunocytochemical analyses were conducted to identify changes in protein expression in Shank3-overexpressing transgenic cardiomyocytes. Results: The hearts of Shank3-overexpressing transgenic mice displayed reduced weight and increased fibrosis. In vivo, sudden cardiac death, arrhythmia, and contractility impairments were identified. Shank3-overexpressing transgenic cardiomyocytes showed prolonged action potential duration and increased LTCC current density. Cytosolic Ca2+ transients were increased with prolonged decay time, while sarcoplasmic reticulum Ca2+ contents remained normal. Cell shortening was augmented in Shank3-overexpressing transgenic cardiomyocytes. The cardiac Shank3 interactome comprised 78 proteins with various functions. Troponin I levels were down-regulated in Shank3-overexpressing transgenic cardiomyocytes. Conclusions This study revealed cardiac dysfunction in Shank3-overexpressing transgenic mice, potentially attributed to changes in Ca2+ homeostasis and contraction, with a notable reduction in troponin I.

Background and Objectives: SH3 and multiple ankyrin repeat domains 3 (Shank3) proteins play crucial roles as neuronal postsynaptic scaffolds. Alongside neuropsychiatric symptoms, individuals with SHANK3 mutations often exhibit symptoms related to dysfunctions in other organs, including the heart. However, detailed insights into the cardiac functions of Shank3 remain limited. This study aimed to characterize the cardiac phenotypes of Shank3-overexpressing transgenic mice and explore the underlying mechanisms. Methods: Cardiac histological analysis, electrocardiogram and echocardiogram recordings were conducted on Shank3-overexpressing transgenic mice. Electrophysiological properties, including action potentials and L-type Ca2+ channel (LTCC) currents, were measured in isolated cardiomyocytes. Ca2+ homeostasis was assessed by analyzing cytosolic Ca2+transients and sarcoplasmic reticulum Ca2+ contents. Depolarization-induced cell shortening was examined in cardiomyocytes. Immunoprecipitation followed by mass spectrometrybased identification was employed to identify proteins in the cardiac Shank3 interactome.Western blot and immunocytochemical analyses were conducted to identify changes in protein expression in Shank3-overexpressing transgenic cardiomyocytes. Results: The hearts of Shank3-overexpressing transgenic mice displayed reduced weight and increased fibrosis. In vivo, sudden cardiac death, arrhythmia, and contractility impairments were identified. Shank3-overexpressing transgenic cardiomyocytes showed prolonged action potential duration and increased LTCC current density. Cytosolic Ca2+ transients were increased with prolonged decay time, while sarcoplasmic reticulum Ca2+ contents remained normal. Cell shortening was augmented in Shank3-overexpressing transgenic cardiomyocytes. The cardiac Shank3 interactome comprised 78 proteins with various functions. Troponin I levels were down-regulated in Shank3-overexpressing transgenic cardiomyocytes. Conclusions This study revealed cardiac dysfunction in Shank3-overexpressing transgenic mice, potentially attributed to changes in Ca2+ homeostasis and contraction, with a notable reduction in troponin I.

OBJECTIVE: To explore the effectiveness of proximal femoral nail antirotation (PFNA) combined with minimally invasive clamp reduction technique by Kocher pincers in the treatment of irreducible intertrochanteric femoral fracture in the elderly. METHODS: The clinical data of 35 elderly patients with irreducible intertrochanteric femoral fractures who were treated with PFNA combined with minimally invasive clamp reduction technique by Kocher pincers between January 2016 and December 2022 were retrospectively analysed. There were 16 males and 19 females, aged from 63 to 95 years (mean, 75.2 years). The causes of injury included traffic accident in 3 cases and falling in 32 cases. The time from injury to operation was 2-11 days (mean, 3.6 days). According to AO/Orthopaedic Trauma Association (AO/OTA) classification system for intertrochanteric fractures, there were 14 cases of type A1, 18 cases of type A2, and 3 cases of type A3. According to the displacement of fracture by intraoperative fluoroscopy, there were 5 cases with only coronal displacement, 17 cases with only sagittal displacement, and 13 cases with both coronal and sagittal displacement. The operation time, intraoperative blood loss, rate of hemoglobin decline at 1 day after operation, length of hospital stay, and fracture healing time were recorded. The reduction quality of fracture during operation was evaluated according to reduction quality criteria proposed by Chang et al. The Harris scoring system was used to evaluate the hip joint function at last follow-up. RESULTS: The operation time was 45-105 minutes (mean, 54.4 minutes); the intraoperative blood loss was 80-300 mL (mean, 116.3 mL). The reduction quality of fracture during operation was good in 22 cases (62.9%) and acceptable in 13 cases (37.1%). The rate of hemoglobin decline at 1 day after operation ranged from 6.2% to 18.6% (mean, 10.2%); the length of hospital stay was 5-18 days (mean, 7.2 days). One case died of respiratory failure due to pulmonary infection, 2 cases were lost to follow-up, and the remaining 32 cases were followed up 6-24 months (mean, 10.6 months). All 32 patients achieved bony union and the healing time was 3-9 months (mean, 3.6 months). There was no complication such as incision infection, internal fixation failure, or coxa varus during follow-up. At last follow-up, the Harris score of hip joint was 67-96 (mean, 88.9); among them, 19 cases were excellent, 10 cases were good, 2 cases were fair, and 1 case was poor, with an excellent and good rate of 90.6%. CONCLUSION For the elderly patients with irreducible intertrochanteric femoral fracture, the application of PFNA combined with minimally invasive clamp reduction technique by Kocher pincers can achieve high-quality fracture reduction, which has the advantages of simple reduction operation, less trauma, and can avoid the radiation exposure of operators during maintenance reduction.
Humans ; Male ; Female ; Aged ; Minimally Invasive Surgical Procedures/methods* ; Hip Fractures/diagnostic imaging* ; Bone Nails ; Aged, 80 and over ; Retrospective Studies ; Fracture Fixation, Intramedullary/instrumentation* ; Middle Aged ; Treatment Outcome ; Fracture Fixation, Internal/instrumentation* ; Fracture Healing ; Femoral Fractures/surgery*

Objective:To observe the effects of muscle regions of meridians needling method combined with auricular point sticking on pain and lumbar range of motion in patients with chronic nonspecific low back pain. Methods:A total of 100 patients with chronic nonspecific low back pain were randomly divided into a control group and an observation group,with 50 patients in each group.Both groups received auricular point sticking treatment,while the control group received additional conventional acupuncture treatment,and the observation group received additional muscle regions of meridians needling method.The total effective rate of the two groups was compared after 4 weeks of treatment.Before treatment and after 1 week and 4 weeks of treatment,the visual analog scale(VAS)score was used to assess the degree of low back pain,and the modified-modified Schober(MMS)score was used to evaluate the lumbar range of motion. Results:There was statistical significance in comparing the total effective rate between the two groups(P<0.01).During the treatment process,as the number of treatments increased,the VAS score gradually decreased,and the MMS score gradually increased in both groups.After 1 week and 4 weeks of treatment,the VAS score in the observation group was lower than that in the control group(P<0.01),and the MMS score in the observation group was higher than that in the control group(P<0.01).During the treatment period,no serious adverse reactions occurred in either group. Conclusion:Based on auricular point sticking treatment,muscle regions of meridians needling method is more effective than conventional acupuncture in treating chronic nonspecific low back pain since it is able to significantly reduce the pain and improve the lumbar range of motion.

Objective:To explore the application of case-based learning (CBL) guided by the International Classification of Functioning, Disability and Health (ICF) in teaching internship of rehabilitation medicine undergraduates.Methods:According to the implementation time of ICF-guided CBL teaching (February 2023), 55 students who interned before February 2023 were included in the control group and received routine teaching, and 54 students who interned after February 2023 were enrolled in the observation group and received ICF-guided CBL teaching. The assessment score, professional identity score, learning adaptability score, communication ability score, and critical thinking score were evaluated before and after teaching. SPSS 23.0 was used for t-test and chi-square test. Results:After teaching, the assessment score, professional identity score, learning adaptability score, communication ability score, and critical thinking score of both groups of students significantly increased. Compared with the control group, the observation group showed significantly higher assessment score [(166.01±14.21) vs. (150.19±13.73)], professional identity score [(124.50±12.73) vs. (103.94±10.42)], learning adaptability score [(71.93±7.43) vs. (57.69±6.71)], communication ability score [(23.77±4.21) vs. (19.97±3.94)], and critical thinking score [(150.03±11.20) vs. (129.38±10.57)].Conclusions:ICF-guided CBL teaching can help to improve the professional identity and learning adaptability of rehabilitation medicine undergraduates, enhance their skill of communication with patients and critical thinking ability, and increase their professional theoretical knowledge and practical ability. Therefore, ICF-guided CBL is a beneficial exploration of teaching internship of rehabilitation medicine undergraduates.

Objective:To explore the effect of visual mind mapping based on Mini-CEX evaluation combined with case-based learning (CBL) on improving the learning ability and teaching satisfaction of nursing students in department of general surgery.Methods:A total of 120 nurses rotating in the Department of General Surgery, Panzhihua Central Hospital (Clinical Medical College of Panzhihua University) from September 2019 to July 2020 were selected as research objects, and randomly divided into a control group and a study group, with 60 nurses in each group. The control group used traditional teaching, and the study group used visual mind mapping based on Mini-CEX evaluation combined with CBL. After the training, the clinical comprehensive ability of the nurses was evaluated by theoretical and practical assessment, and the self-learning ability and teaching satisfaction of the nurses were analyzed through self-made questionnaire survey. SPSS 22.0 was used for t test and chi-square test. Results:The theoretical and practical assessment scores of nursing students in the study group were significantly higher than those in the control group[(95.01±3.52) vs. (83.26±4.05); (96.14±3.22) vs. (81.17±4.30)] ( P=0.001). Before the rotation training, there was no statistical difference between the study group and the control group in the scores of self-motivation beliefs, task analysis, self-monitoring and adjustment, and self-evaluation ( P>0.05). After the rotation training, the scores of above 4 aspects were significantly higher in study group than the control group ( P<0.05). The nurse trainees in the study group were significantly superior to those in control group in the following 7 aspects: reasonable arrangement of the teaching plan, novelty of the teaching mode, improvement of clinical nursing skills, improvement of the nurse-patient communication ability, improvement of the emergency response ability, and overall teaching satisfaction ( P=0.001). Conclusion:Visual mind mapping based on Mini-CEX evaluation combined with CBL applied to clinical teaching training of nursing students in the department of general surgery can effectively improve the effectiveness of nursing teaching and teaching satisfaction, improve the learning ability of nurses, and improve the nursing level of nursing students in the department of general surgery.

Objective:In order to provide the precise prevention and control strategy of drug resistance TB in Gansu province, we analyzed the status and risk factors of new drug resistance pulmonary tuberculosis patients.Methods:New pulmonary tuberculosis patients were enrolled from 30 tuberculosis-specialized medical institutions (drug resistance monitoring stations) in Gansu province between first September 2014 to 31 th August 2017, and filled in the survey questionnaire. The isolated Mycobacterium tuberculosis (MTB) strains were implemented 10 drugs drug- susceptibility tes, including isoniazid (INH), rifampicin (RFP), ethambutol (EMB), streptomycin (Sm), kanamycin (Km), amikacin (Am), ofloxacin (Ofx), capreomycin (Cm), propithio-iso-nicotinamide (Pto).The risk factors were analyzed by logistic regression model. Results:One patient was corresponding one clinical isolates among 1 815 patients. The rate (95% CI) of total drug-resistance, single drugresistance, multiple drug- resistance, multidrug-resistance and extensively drug-resistant were 25.45% (23.45%-27.46%), 11.40% (9.94%-12.87%),6.23% (5.11%-7.34%), 7.82% (6.59%-9.06%) and 0.28% (0.03%-0.52%) respectively. Among 142 multidrug-resistant TB patients, the farmers, young adults aged 20-59 and low-income group were 90.85%, 62.68% and 31.69%, respectively. The results of univariate and multivariate analysis showed that the male, non-Han, treatment less than 1 month group and treatment less than 1 month and withdrawal less than 2 month group were risk factors of new multidrug-resistant pulmonary TB. Conclusions:Compared with the Chinese national baseline level of TB resistance, the total drug resistance rate of new TB patients in Gansu province was low, but the multidrug-resistance rate was high. The health assistance for rural low-income TB patients was still an important strategy to prevent and control multidrug-resistant in Gansu province. And measures must implement to stop irregular treatment and poor compliance, as the risk factors of multidrug-resistance in new PTB patients.

Objective To explore the value of real-time three-dimensional echocardiography (RT-3DE) in evaluating right ventricular structure and hemodynamic parameters of patients with pulmonary hypertension (PH).Methods A total of 89 PH patients in Subei People′s Hospital from July 2014 to December 2016 were selected as PH group, and 49 subjects with health examination were designed as control group. According to pulmonary arterial systolic pressure (PASP), the 89 patients with PH were divided into mild PH group (n=29), moderate PH group (n=32) and severe PH group (n=28). The indexes of right heart structure such as right ventricular diameter (RVTD), left ventricular diameter (LVTD), right ventricular end diastolic volume (EDV), end systolic volume (ESV), stroke volume (SV) and right ventricular ejection fraction (RVEF) as well as hemodynamic parameters such as pulmonary systolic pressure (SPAP), pulmonary artery diastolic pressure (DPAP), mean pulmonary artery pressure (MPAP) and right ventricular output (RCO) were detected by RT-3DE in all the subjects. The indexes of right heart structure and hemodynamic parameters were compared by independent-samplet test between PH group and control group, and indexes of right heart structure and hemodynamic parameters were compared by variance analysis among different PH groups. The SNK-q test was used for the further comparison between any two groups.Results The RVTD, EDV and ESV in the PH group were significantly higher than those in the control group, while LVTD, SV and RVEF were significantly lower than those in the control group (t=-2.73,P=0.003;t=-4.37,P=0.001;t=-4.57,P=0.002;t=-3.49,P=0.039;t=-2.01,P=0.043;t=6.36,P=0.001). The RVTD, EDV and ESV in moderate PH group and severe PH group were significantly higher than those in the mild PH group, while the LVTD, SV and RVEF were significantly lower than those in the mild PH group (q=4.318, 4.713, 3.873, 3.921, 5.127, 5.347, 5.618, 5.903, 4.318, 4.501, 5.327, 5.981, allP<0.05). The LVTD, EDV, ESV, SV, RVEF in the severe PH group were significantly lower than those in the moderate PH group, while the RVTD was significantly higher than the moderate PH group (q=3.708, 3.249, 4.807, 3.953, 3.197, 3.764, allP<0.05). The SPAP, DPAP and MPAP in PH group were significantly higher than those in control group, while RCO was significantly lower than that that in the control group (t=0.637,P=0.001;t=0.875,P=0.001;t=0.783, P=0.001;t=0.691,P=0.035). The SPAP, DPAP and MPAP in moderate PH group and severe PH group were significantly higher than those in the mild PH group, and the SPAP in the severe PH group was significantly higher than that in the moderate PH group (q=4.349,P=0.041;q=5.871,P=0.039;q=4.201,P=0.042;q=4.869,P=0.043;q=3.981,P=0.034;q=3.991,P=0.035;q=0.421,P=0.039). There were no significant differences in DPAP and MPAP between the moderate PH group and the severe PH group. The RCO decreased gradually in the mild PH group, the moderate PH group and the severe PH group, and there were significant differences between any two groups (q=3.541,P=0.033;q=3.204,P=0.030;q=0.391,P=0.043). Conclusion In PH patients, the right ventricular function declined, and RT-3DE can accurately evaluate the right ventricular function in patients with different degrees of pulmonary hypertension.