Objective This review aims to investigate the application of eye tracking(ET)in patients with speech impairment in the ICU.The review summarizes the current status and prospects of ET technology applications.Methods Following the scoping reviews framework,a systematic search was conducted across Web of Science,PubMed,Cochrane Library,Embase,CINAHL,CNKI,Wanfang Data,Chinese Medical Database,and Chinese biomedical database.The search covered publications from the inception of each database to October 29th,2024.The included studies were comprehensively analyzed.Results A total of 12 pieces of the literature were included,including 4 prospective cohort studies,4 experimental studies,3 prospective observational studies,and 1 randomized controlled trial.The application population of ET in the ICU mainly includes patients on mechanical ventilation,those at high risk of delirium,patients with spinal cord injury,etc.The types of integrated ET system equipment are mainly head-mounted and fixed;the types of ET involve gaze,blinking,etc.;the functions include standardized scale assessment,free interaction,and eye-movement model recognition.The main outcome indicators of the research are feasibility,physical symptoms and social-psychological status.Conclusion ET is applicable to a specific group of ICU patients with aphasia,and has shown good feasibility and effectiveness in the expression of patients'basic needs,self-assessment of symptoms and improvement of psychosocial status.

Excessive fat accumulation,viral infections and sustained inflammatory responses caused by non-alcoholic and alcoholic factors can contribute to liver inflammation,fibrosis and carcinogenesis,promoting the development of chronic liver disease.Gaining an in-depth understanding of the etiologic factors and underlying mechanisms that lead to chronic liver disease can help identify potential therapeutic targets for targeted therapy.Lactate,as an important substance in hepatic metabolism,has been found to be involved in the process of chronic liver disease through various pathways,and this review will provide a useful reference for the prevention and treatment of chronic liver disease.

Objectives:To evaluate the effectiveness of functionalized decellularized extracellular matrix(F-dECM)prepared from porcine auricular cartilage or porcine rib cartilage in repairing xenogeneic articular osteochondral defects.Methods:The por-cine auricular cartilage and rib cartilage were crushed and decellularized.Heparin modification and multi-factor loading were a-chieved through amide bond reaction.The physical characteristics of the particles were characterized by SEM observation and mer-cury intrusion.The chemical characteristics of the particles were characterized by tissue section staining and kit detection.The rabbit knee joint full-thickness defect models were established and implanted by different particles respectively.After 6 weeks and 12 weeks of operation,the samples were taken for gross observation,CT scanning and tissue sectioning to comprehensively evaluate the repair effect.Results:After heparin modification,the glycosaminoglycan lost during the decellularization process was replen-ished.Both heparinized auricular cartilage and costal cartilage presented a highly developed porous structure.Among them,the porosity and pore diameter of costal cartilage were both lower than those of auricular cartilage(P＜0.05).During the observation periods of 6 weeks and 12 weeks,the porcine costal cartilage F-dECM implantation group was superior to other experimental groups in knee joint repair effects(P＜0.05).Conclusion:Costal-derived F-dECM is a joint osteochondral defect repair material with application potential.

Objective:To observe the efficacy of thrombectomy combined with ezetimibe and atorvastatin in patients with acute ischemic stroke (AIS) and the serum levels of absent in melanoma 2 (AIM2) and leukotriene B4 (LTB4).Methods:A prospective study method was used to select 60 patients with AIS thrombectomy treated in Marina Bay Central Hospital of Dongguan City from June 2021 to December 2022, and they were divided into two groups according to random number table method, with 30 cases in each group. The control group was given atorvastatin treatment, and the study group was combined with ezetimibe treatment on the basis of the control group treatment. Blood routine indexes, blood lipid indexes and serum levels of AIM2 and LTB4 were compared between the two groups at admission, discharge and follow-up for 3 months. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of neurological impairment of the patients, and the modified Rankin Scale (mRS) was used to assess the patients' ability to live independently. The occurrence of adverse reactions in the two groups was observed and compared.Results:The neutrophil to lymphocyte ratio (NLR) and neutrophil (N) in the study group were lower than those in the control group : 1.71 ± 0.05 vs. 2.04 ± 0.31, 0.261 ± 0.012 vs. 0.403 ± 0.021 at follow-up for 3 months, there were statistical differences ( P<0.05). The levels of low density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and triacylglycerol (TG) in the study group were lower than those in the control group at follow-up for 3 months:(1.59 ± 0.48) mmol/L vs. (2.09 ± 0.69) mmol/L, (2.92 ± 0.44) mmol/L vs. (3.57 ± 0.71) mmol/L, (1.19 ± 0.24) mmol/L vs. (1.37 ± 0.21) mmol/L, the level of high density lipoprotein cholesterol (HDL-C) was higher than that in the control group : (1.24 ± 0.19) mmol/L vs. (1.06 ± 0.21) mmol/L, there were statistical differences ( P<0.05). The levels of AIM2 and LTB4 in the study group were lower than those in the control group at discharge and follow-up for 3 months: (945.20 ± 123.60) ng/L vs. (1 094.40 ± 227.10) ng/L, (948.90 ± 135.80) ng/L vs. (1 236.90 ± 125.70) ng/L, (115.80 ± 20.60) ng/L vs. (129.70 ± 31.50) ng/L, (116.40 ± 21.10) ng/L vs. (130.30 ± 32.60) ng/L, there were statistical differences (P<0.05). The NHISS scores in the study group was lower than that in the control group at follow-up for 3 months: 2.00(1.00, 3.00) scores vs. 4.00(3.00, 5.00) scores, there was statistical difference ( P<0.05). After follow-up for 3 months, the mRS scores and incidence of adverse reactions between the two groups had no statistical differences ( P<0.05). Conclusions:The combination of atorvastatin and ezetimibe in the early stage of AIS thrombectomy can significantly reduce the levels of NLR, serum AIM2 and LTB4, improve blood lipid levels, reduce the degree of neurological impairment, and improve the ability of patients to carry out activities of daily living, with high safety.

Excessive fat accumulation,viral infections and sustained inflammatory responses caused by non-alcoholic and alcoholic factors can contribute to liver inflammation,fibrosis and carcinogenesis,promoting the development of chronic liver disease.Gaining an in-depth understanding of the etiologic factors and underlying mechanisms that lead to chronic liver disease can help identify potential therapeutic targets for targeted therapy.Lactate,as an important substance in hepatic metabolism,has been found to be involved in the process of chronic liver disease through various pathways,and this review will provide a useful reference for the prevention and treatment of chronic liver disease.

Objective This review aims to investigate the application of eye tracking(ET)in patients with speech impairment in the ICU.The review summarizes the current status and prospects of ET technology applications.Methods Following the scoping reviews framework,a systematic search was conducted across Web of Science,PubMed,Cochrane Library,Embase,CINAHL,CNKI,Wanfang Data,Chinese Medical Database,and Chinese biomedical database.The search covered publications from the inception of each database to October 29th,2024.The included studies were comprehensively analyzed.Results A total of 12 pieces of the literature were included,including 4 prospective cohort studies,4 experimental studies,3 prospective observational studies,and 1 randomized controlled trial.The application population of ET in the ICU mainly includes patients on mechanical ventilation,those at high risk of delirium,patients with spinal cord injury,etc.The types of integrated ET system equipment are mainly head-mounted and fixed;the types of ET involve gaze,blinking,etc.;the functions include standardized scale assessment,free interaction,and eye-movement model recognition.The main outcome indicators of the research are feasibility,physical symptoms and social-psychological status.Conclusion ET is applicable to a specific group of ICU patients with aphasia,and has shown good feasibility and effectiveness in the expression of patients'basic needs,self-assessment of symptoms and improvement of psychosocial status.

Objectives:To evaluate the effectiveness of functionalized decellularized extracellular matrix(F-dECM)prepared from porcine auricular cartilage or porcine rib cartilage in repairing xenogeneic articular osteochondral defects.Methods:The por-cine auricular cartilage and rib cartilage were crushed and decellularized.Heparin modification and multi-factor loading were a-chieved through amide bond reaction.The physical characteristics of the particles were characterized by SEM observation and mer-cury intrusion.The chemical characteristics of the particles were characterized by tissue section staining and kit detection.The rabbit knee joint full-thickness defect models were established and implanted by different particles respectively.After 6 weeks and 12 weeks of operation,the samples were taken for gross observation,CT scanning and tissue sectioning to comprehensively evaluate the repair effect.Results:After heparin modification,the glycosaminoglycan lost during the decellularization process was replen-ished.Both heparinized auricular cartilage and costal cartilage presented a highly developed porous structure.Among them,the porosity and pore diameter of costal cartilage were both lower than those of auricular cartilage(P＜0.05).During the observation periods of 6 weeks and 12 weeks,the porcine costal cartilage F-dECM implantation group was superior to other experimental groups in knee joint repair effects(P＜0.05).Conclusion:Costal-derived F-dECM is a joint osteochondral defect repair material with application potential.

Objective:To observe the efficacy of thrombectomy combined with ezetimibe and atorvastatin in patients with acute ischemic stroke (AIS) and the serum levels of absent in melanoma 2 (AIM2) and leukotriene B4 (LTB4).Methods:A prospective study method was used to select 60 patients with AIS thrombectomy treated in Marina Bay Central Hospital of Dongguan City from June 2021 to December 2022, and they were divided into two groups according to random number table method, with 30 cases in each group. The control group was given atorvastatin treatment, and the study group was combined with ezetimibe treatment on the basis of the control group treatment. Blood routine indexes, blood lipid indexes and serum levels of AIM2 and LTB4 were compared between the two groups at admission, discharge and follow-up for 3 months. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of neurological impairment of the patients, and the modified Rankin Scale (mRS) was used to assess the patients' ability to live independently. The occurrence of adverse reactions in the two groups was observed and compared.Results:The neutrophil to lymphocyte ratio (NLR) and neutrophil (N) in the study group were lower than those in the control group : 1.71 ± 0.05 vs. 2.04 ± 0.31, 0.261 ± 0.012 vs. 0.403 ± 0.021 at follow-up for 3 months, there were statistical differences ( P<0.05). The levels of low density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and triacylglycerol (TG) in the study group were lower than those in the control group at follow-up for 3 months:(1.59 ± 0.48) mmol/L vs. (2.09 ± 0.69) mmol/L, (2.92 ± 0.44) mmol/L vs. (3.57 ± 0.71) mmol/L, (1.19 ± 0.24) mmol/L vs. (1.37 ± 0.21) mmol/L, the level of high density lipoprotein cholesterol (HDL-C) was higher than that in the control group : (1.24 ± 0.19) mmol/L vs. (1.06 ± 0.21) mmol/L, there were statistical differences ( P<0.05). The levels of AIM2 and LTB4 in the study group were lower than those in the control group at discharge and follow-up for 3 months: (945.20 ± 123.60) ng/L vs. (1 094.40 ± 227.10) ng/L, (948.90 ± 135.80) ng/L vs. (1 236.90 ± 125.70) ng/L, (115.80 ± 20.60) ng/L vs. (129.70 ± 31.50) ng/L, (116.40 ± 21.10) ng/L vs. (130.30 ± 32.60) ng/L, there were statistical differences (P<0.05). The NHISS scores in the study group was lower than that in the control group at follow-up for 3 months: 2.00(1.00, 3.00) scores vs. 4.00(3.00, 5.00) scores, there was statistical difference ( P<0.05). After follow-up for 3 months, the mRS scores and incidence of adverse reactions between the two groups had no statistical differences ( P<0.05). Conclusions:The combination of atorvastatin and ezetimibe in the early stage of AIS thrombectomy can significantly reduce the levels of NLR, serum AIM2 and LTB4, improve blood lipid levels, reduce the degree of neurological impairment, and improve the ability of patients to carry out activities of daily living, with high safety.

OBJECTIVE To evaluate the efficacy,safety and economics of the centrally procured generic versus original esomeprazole in the treatment of acute non-variceal upper gastrointestinal bleeding(ANVUGIB).METHODS A retrospective collection of real-world clinical data was conducted for ANVUGIB patients who received treatment at Shenzhen People's Hospital and University of Hong Kong-Shenzhen Hospital from January 2018 to March 2024.Patients were divided into imported original drug group(original drug group,221 cases)and centrally procured generic drug group(generic drug group,75 cases)according to the types of drug used.Propensity score matching(PSM)was performed at a ratio of 3∶1 to compare the clinical efficacy,safety and economics between the two groups.RESULTS Totally 241 patients were included after PSM,with 170 in the original drug group and 71 in the generic drug group.There were no significant differences between the two groups in terms of rebleeding rate,rate of second endoscopic intervention,blood transfusion rate,length of hospital stay,mortality due to gastrointestinal bleeding,30-day readmission due to rebleeding,and overall survival rate(P＞0.05).The incidence of adverse events among all patients in both groups also showed no statistically significant difference(P＞0.05);furthermore,the adverse events reported by the respective hospitals to the National Center for ADR Monitoring were comparable between the two groups.After PSM,the median total drug cost and high-dose esomeprazole cost in the generic drug group were significantly lower than those in the original drug group,while the median nursing fee and bed fee were significantly higher than those in the original drug group(P＜0.05).There was no statistically significant difference between the two groups in terms of median total hospitalization expenses,total treatment costs,laboratory fees,examination fees,material costs,or consultation fees(P＞0.05).CONCLUSIONS The clinical efficacy and safety of centrally procured generic esomeprazole in the treatment of ANVUGIB are comparable to those of the original drug,and it is more economical.

Rapid turnover of the intestinal epithelium is a critical strategy to balance the uptake of nutrients and defend against environmental insults, whereas inappropriate death promotes the spread of inflammation. PPARα is highly expressed in the small intestine and regulates the absorption of dietary lipids. However, as a key mediator of inflammation, the impact of intestinal PPARα signaling on cell death pathways is unknown. Here, we show that Pparα deficiency of intestinal epithelium up-regulates necroptosis signals, disrupts the gut vascular barrier, and promotes LPS translocation into the liver. Intestinal Pparα deficiency drives age-related hepatic steatosis and aggravates hepatic fibrosis induced by a high-fat plus high-sucrose diet (HFHS). PPARα levels correlate with TRIM38 and MLKL in the human ileum. Inhibition of PPARα up-regulates necroptosis signals in the intestinal organoids triggered by TNF-α and LPS stimuli via TRIM38/TRIF and CREB3L3/MLKL pathways. Butyric acid ameliorates hepatic steatosis induced by intestinal Pparα deficiency through the inhibition of necroptosis. Our data suggest that intestinal PPARα is essential for the maintenance of microenvironmental homeostasis and the spread of inflammation via the gut-liver axis.