Background: Data on the efficacy and incidence of adverse effects associated with dexmedetomidine (DEX) as a local anesthetic adjuvant for patient-controlled epidural analgesia (PCEA) are inconclusive. This meta-analysis assessed the efficacy and risks of DEX for PCEA using opioids as a reference. Methods: Two researchers independently searched PubMed, Embase, Cochrane Library, and China Biology Medicine for randomized controlled trials comparing DEX and opioids as local anesthetic adjuvants in PCEA. Results: In total, 636 patients from seven studies were included in this meta-analysis. Postoperative patients who received DEX had lower visual analog scale (VAS) scores than those who received opioids at 4–8 h (mean difference [MD]: 0.61, 95% CI [0.45, 0.76], P < 0.001, I2 = 0%), 12 h (MD: 0.85, 95% CI [0.61, 1.09], P < 0.001, I2 = 0%), 24 h (MD: 0.59, 95% CI [0.06, 1.12], P = 0.030, I2 = 82%), and 48 h (MD: 0.54, 95% CI [0.05, 1.02], P = 0.030, I2 = 91%). Additionally, patients who received DEX had a lower incidence of itching (odds ratio [OR]: 2.86, 95% CI [1.18, 6.95], P = 0.020, I2 = 0%) and nausea and vomiting (OR: 6.83, 95% CI [3.63, 12.84], P < 0.001, I2 = 24%). In labor analgesia, no significant differences in neonatal (pH and PaO2 of cord blood, fetal heart rate) or maternal outcomes (duration of labor stage, mode of delivery) were found between the DEX and opioid groups. Conclusions Compared with opioids, using DEX as a local anesthetic adjuvant in PCEA improved postoperative analgesia and reduced the incidence of itching and nausea and vomiting without increasing the incidence of adverse events.

Objective:To evaluate the diagnostic efficacy of FibroScan combined with various noninvasive diagnostic models for liver fibrosis in patients with chronic hepatitis B (CHB) complicated with nonalcoholic fatty liver disease (NAFLD), and to establish a new predictive model with common clinical indicators.Methods:From January 2016 to May 2024, the clinical data of 118 CHB patients complicated with NAFLD from the First Affiliated Hospital of Zhengzhou University, who underwent liver biopsy and FibroScan examination were respectively analyzed. According to the Scheuer scoring system, different diagnostic endpoints were set based on the degree of liver fibrosis (S0 to S1, ≥S2, ≥S3, and S4), fibrosis stage ≥S2 was designated as the criterion for significant liver fibrosis. Fibrosis-4 (FIB-4), γ-glutamyl transpeptidase (GGT) to platelet ratio (GPR), GGT-age-platelet-international normalized ratio (GAPI) model, S index, King index and Forns index were calculated according to the common clinical indicators. The independent t test or Mann-Whitney U test was used to compare the two groups. Spearman rank correlation was used to analyze the correlation between each noninvasive diagnostic method and the degree of liver fibrosis. Receiver operating characteristic curve (ROC) was plotted, and the DeLong test was performed to compare the area under the curve (AUC), and to evaluate the predictive value of FibroScan combined with various noninvasive diagnostic models for the diagnosis of liver fibrosis. The laboratory indicators were compared between patients with non-significant liver fibrosis and patients with significant liver fibrosis. And the indicators with statistically significant differences ( P<0.05) in the univariate analysis were further analyzed by multivariate logistic regression to establish a new predictive model for liver fibrosis. Hosmer-Lemeshow test was used to assess the model′s goodness of fit. Results:The results of Spearman rank correlation showed that FIB-4, GPR, FibroScan, GAPI model, S index, King index, and Forns index were positively correlated with the stage of liver fibrosis ( r=0.413, 0.458, 0.512, 0.473, 0.533, 0.380 and 0.478, all P<0.001). The results of ROC analysis indicated that among combination of FibroScan and other diagnostic models, the AUC values of FibroScan+ FIB-4, FibroScan+ Forns index were relatively high in ≥S2 and ≥S3, which were 0.804 and 0.907, respectively. The platelet count ((200.65±50.89)×10 9/L vs. (169.96±63.68)×10 9/L), total cholesterol ((4.69±0.77) mmol/L vs. (4.32±1.00) mmol/L), high-density lipoprotein (HDL) (1.28 (1.05, 1.46) mmol/L vs. 1.08 (0.92, 1.21) mmol/L), total protein (74.00 (70.63, 77.08) g/L vs. 68.80 (64.60, 73.55) g/L), albumin (47.06 (44.65, 48.81) g/L vs. 44.70 (41.55, 46.20) g/L), and globulin (26.80 (24.48, 29.70) g/L vs. 25.80 (23.05, 27.60) g/L) of the non-significant liver fibrosis group were higher than those of the significant liver fibrosis group, and the differences were statistically significant ( t=2.74, 2.09; Z=-3.30, -3.88, -3.95, -2.01; P=0.007, =0.040, =0.001, <0.001, <0.001, =0.044). GGT (27.50 (17.00, 41.75) U/L vs. 37.00 (22.50, 87.00) U/L), the liver stiffness measurement (LSM) in the non-significant hepatic fibrosis group was lower than the significant liver fibrosis group (6.85 (5.60, 9.26) kPa vs. 11.60 (7.08, 17.26) kPa), and the differences were statistically significant ( Z=-2.73, -4.39; P=0.006, <0.001). The result of multivariate logistic regression analysis revealed that globulin, albumin, HDL, and LSM were independent factors of liver fibrosis ( OR (95% confidence interval)=0.865 (0.759 to 0.985), 0.804 (0.691 to 0.935), 0.128 (0.023 to 0.711), and 1.251 (1.091 to 1.433), respectively; P=0.029, 0.025, 0.019, 0.001). A novel model, GLAH, was established with globulin, LSM, albumin, and HDL. The AUC for diagnosing liver fibrosis degree ≥S2, ≥S3, and S4 was 0.847, 0.938, and 0.909, respectively, which were higher than those of the above models. The positive predictive value for diagnosing liver fibrosis degree ≥S2 with GLAH>1.12 as the cutoff value was 95.8%. The negative predictive value for excluding fibrosis stage ≥S2 with GLAH<-1.41 was 92.3%. This approach could reduce the number of liver biopsies by 48.3% (57/118), with an accuracy of 94.7% (54/57). Conclusions:The clinical value of FibroScan combined with FIB-4 or Forns index is better in the diagnisis of fibrosis stage ≥S2 and ≥S3. The GLAH model has higher diagnostic value and can accurately predict the degree of liver fibrosis in CHB patients complicated with NAFLD, thus reducing the need for liver biopsy.

Objectives:To screen out genes potentially involved in the dysregulation of immune microhomeostasis at the maternal-fetal interface of recurrent miscarriage (RM) patients, and to identify novel biomarkers of RM by bioinformatic analysis.Methods:The dataset GSE165004 of endometrial tissues from RM patients ( n=24) and normal women as the control ( n=24) was downloaded from the GEO database, and differentially expressed genes (DEGs) and immune-related modules were analyzed by using the R language's Limma package, along with CIBERSORT immune infiltration and Weighted Gene Co-expression Network Analysis (WGCNA). The functional associations of these core genes were evaluated through Gene Set Enrichment Analysis (GSEA) and Gene Set Variation Analysis (GSVA). Finally, we used the decidual tissue dataset GSE161969 to further validate the diagnostic value of these key genes. Results:Differential analysis identified 580 DEGs, and 3 271 immune-related modular genes were selected by WGCNA analysis. FGF2, ANO1, and LAPTM5 were subsequently identified as key genes through machine learning techniques. GSVA analysis further revealed critical roles of FGF2, ANO1 and LAPTM5 in immune infiltration and macrophage pathways. Conclusion:FGF2, ANO1 and LAPTM5 might participate in the immuno-related pathogenesis of RM, and present potential biomarkers for the early diagnosis and treatment of RM.

Objectives:To screen out genes potentially involved in the dysregulation of immune microhomeostasis at the maternal-fetal interface of recurrent miscarriage (RM) patients, and to identify novel biomarkers of RM by bioinformatic analysis.Methods:The dataset GSE165004 of endometrial tissues from RM patients ( n=24) and normal women as the control ( n=24) was downloaded from the GEO database, and differentially expressed genes (DEGs) and immune-related modules were analyzed by using the R language's Limma package, along with CIBERSORT immune infiltration and Weighted Gene Co-expression Network Analysis (WGCNA). The functional associations of these core genes were evaluated through Gene Set Enrichment Analysis (GSEA) and Gene Set Variation Analysis (GSVA). Finally, we used the decidual tissue dataset GSE161969 to further validate the diagnostic value of these key genes. Results:Differential analysis identified 580 DEGs, and 3 271 immune-related modular genes were selected by WGCNA analysis. FGF2, ANO1, and LAPTM5 were subsequently identified as key genes through machine learning techniques. GSVA analysis further revealed critical roles of FGF2, ANO1 and LAPTM5 in immune infiltration and macrophage pathways. Conclusion:FGF2, ANO1 and LAPTM5 might participate in the immuno-related pathogenesis of RM, and present potential biomarkers for the early diagnosis and treatment of RM.

Objective:To evaluate the diagnostic efficacy of FibroScan combined with various noninvasive diagnostic models for liver fibrosis in patients with chronic hepatitis B (CHB) complicated with nonalcoholic fatty liver disease (NAFLD), and to establish a new predictive model with common clinical indicators.Methods:From January 2016 to May 2024, the clinical data of 118 CHB patients complicated with NAFLD from the First Affiliated Hospital of Zhengzhou University, who underwent liver biopsy and FibroScan examination were respectively analyzed. According to the Scheuer scoring system, different diagnostic endpoints were set based on the degree of liver fibrosis (S0 to S1, ≥S2, ≥S3, and S4), fibrosis stage ≥S2 was designated as the criterion for significant liver fibrosis. Fibrosis-4 (FIB-4), γ-glutamyl transpeptidase (GGT) to platelet ratio (GPR), GGT-age-platelet-international normalized ratio (GAPI) model, S index, King index and Forns index were calculated according to the common clinical indicators. The independent t test or Mann-Whitney U test was used to compare the two groups. Spearman rank correlation was used to analyze the correlation between each noninvasive diagnostic method and the degree of liver fibrosis. Receiver operating characteristic curve (ROC) was plotted, and the DeLong test was performed to compare the area under the curve (AUC), and to evaluate the predictive value of FibroScan combined with various noninvasive diagnostic models for the diagnosis of liver fibrosis. The laboratory indicators were compared between patients with non-significant liver fibrosis and patients with significant liver fibrosis. And the indicators with statistically significant differences ( P<0.05) in the univariate analysis were further analyzed by multivariate logistic regression to establish a new predictive model for liver fibrosis. Hosmer-Lemeshow test was used to assess the model′s goodness of fit. Results:The results of Spearman rank correlation showed that FIB-4, GPR, FibroScan, GAPI model, S index, King index, and Forns index were positively correlated with the stage of liver fibrosis ( r=0.413, 0.458, 0.512, 0.473, 0.533, 0.380 and 0.478, all P<0.001). The results of ROC analysis indicated that among combination of FibroScan and other diagnostic models, the AUC values of FibroScan+ FIB-4, FibroScan+ Forns index were relatively high in ≥S2 and ≥S3, which were 0.804 and 0.907, respectively. The platelet count ((200.65±50.89)×10 9/L vs. (169.96±63.68)×10 9/L), total cholesterol ((4.69±0.77) mmol/L vs. (4.32±1.00) mmol/L), high-density lipoprotein (HDL) (1.28 (1.05, 1.46) mmol/L vs. 1.08 (0.92, 1.21) mmol/L), total protein (74.00 (70.63, 77.08) g/L vs. 68.80 (64.60, 73.55) g/L), albumin (47.06 (44.65, 48.81) g/L vs. 44.70 (41.55, 46.20) g/L), and globulin (26.80 (24.48, 29.70) g/L vs. 25.80 (23.05, 27.60) g/L) of the non-significant liver fibrosis group were higher than those of the significant liver fibrosis group, and the differences were statistically significant ( t=2.74, 2.09; Z=-3.30, -3.88, -3.95, -2.01; P=0.007, =0.040, =0.001, <0.001, <0.001, =0.044). GGT (27.50 (17.00, 41.75) U/L vs. 37.00 (22.50, 87.00) U/L), the liver stiffness measurement (LSM) in the non-significant hepatic fibrosis group was lower than the significant liver fibrosis group (6.85 (5.60, 9.26) kPa vs. 11.60 (7.08, 17.26) kPa), and the differences were statistically significant ( Z=-2.73, -4.39; P=0.006, <0.001). The result of multivariate logistic regression analysis revealed that globulin, albumin, HDL, and LSM were independent factors of liver fibrosis ( OR (95% confidence interval)=0.865 (0.759 to 0.985), 0.804 (0.691 to 0.935), 0.128 (0.023 to 0.711), and 1.251 (1.091 to 1.433), respectively; P=0.029, 0.025, 0.019, 0.001). A novel model, GLAH, was established with globulin, LSM, albumin, and HDL. The AUC for diagnosing liver fibrosis degree ≥S2, ≥S3, and S4 was 0.847, 0.938, and 0.909, respectively, which were higher than those of the above models. The positive predictive value for diagnosing liver fibrosis degree ≥S2 with GLAH>1.12 as the cutoff value was 95.8%. The negative predictive value for excluding fibrosis stage ≥S2 with GLAH<-1.41 was 92.3%. This approach could reduce the number of liver biopsies by 48.3% (57/118), with an accuracy of 94.7% (54/57). Conclusions:The clinical value of FibroScan combined with FIB-4 or Forns index is better in the diagnisis of fibrosis stage ≥S2 and ≥S3. The GLAH model has higher diagnostic value and can accurately predict the degree of liver fibrosis in CHB patients complicated with NAFLD, thus reducing the need for liver biopsy.

Post-traumatic tetanus is the main type of non-neonatal tetanus.To reduce the incidence and mortality rateof tetanus and guide the primary medical institutions to prevent and control tetanus after trauma,the National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization,and the latest research progress both at home and abroad.The guidelines focus on the basic procedures for the prevention and treatment of post-traumatic tetanus,the application of tetanus vaccines and immune preparation,and pre-exposure immunization in high-risk populations of trauma.

Post-traumatic tetanus is the main type of non-neonatal tetanus. To reduce the incidence and mortality rate of tetanus and guide the primary medical institutions to prevent and control tetanus after trauma, National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization, the latest research progress from home and abroad. The guidelines focus on the basic procedures for the prevention and disposition of post-traumatic tetanus, the application of tetanus vaccines and immune preparation, and the pre-exposure immunization in high-risk populations of trauma.

Objective To explore the effect of group cognitive behavior therapy (GCBT) on symptom relief and cognitive function improvement of patients with obsessive-compulsive disorder (OCD).Methods Fourty-eight OCD patients who met the DSM-IV-TR diagnostic criteria were introduced into this study,and they were divided into GCBT combination therapy group (n＝24) and drug therapy group (n＝24).The GCBT combination therapy group was treated with 8 times of cognitive behavior therapy on the basis of drug therapy,and the drug therapy group was treated only with drug therapy.The Y-BOCS was used to evaluate the symptoms of obsessive-compulsive before and after the therapy.Neuropsychological tests (including Trail Making Test (TMT),Digit-Symbol Test (DST),Digit Span Test (DST),Category Fluency Test (CFT)) were used to evaluate the cognitive function before and after the treatment.Results Before the treatment,there was no significant difference between GCBT combination therapy group and drug therapy group on Y-BOCS and neuropsychological test results.After the treatment,the Y-BOCS score of GCBT combination therapy group was significantly lower than that of the drug therapy group (18.7:t:3.1 vs.20.7:t:1.8;t＝-2.75,P＜0.05).Meanwhile,there were significant differences between the GCBT combination therapy group and drug therapy group in the TMT (B time),Digit-Symbol Test,DST (Forward Digit Span),DST (Backward Digit Span),CFF(the correct number;t＝-2.93,3.47,2.06,2.54,7.22;P＜0.05 or P＜0.01).Conclusion GCBT show significant effect on relieving the severity of obsessive compulsive symptoms and improving the cognitive function of OCD patients.

Objective To explore the effect of group cognitive behavior therapy (GCBT) on symptom relief and cognitive function improvement of patients with obsessive-compulsive disorder (OCD).Methods Fourty-eight OCD patients who met the DSM-IV-TR diagnostic criteria were introduced into this study,and they were divided into GCBT combination therapy group (n＝24) and drug therapy group (n＝24).The GCBT combination therapy group was treated with 8 times of cognitive behavior therapy on the basis of drug therapy,and the drug therapy group was treated only with drug therapy.The Y-BOCS was used to evaluate the symptoms of obsessive-compulsive before and after the therapy.Neuropsychological tests (including Trail Making Test (TMT),Digit-Symbol Test (DST),Digit Span Test (DST),Category Fluency Test (CFT)) were used to evaluate the cognitive function before and after the treatment.Results Before the treatment,there was no significant difference between GCBT combination therapy group and drug therapy group on Y-BOCS and neuropsychological test results.After the treatment,the Y-BOCS score of GCBT combination therapy group was significantly lower than that of the drug therapy group (18.7:t:3.1 vs.20.7:t:1.8;t＝-2.75,P＜0.05).Meanwhile,there were significant differences between the GCBT combination therapy group and drug therapy group in the TMT (B time),Digit-Symbol Test,DST (Forward Digit Span),DST (Backward Digit Span),CFF(the correct number;t＝-2.93,3.47,2.06,2.54,7.22;P＜0.05 or P＜0.01).Conclusion GCBT show significant effect on relieving the severity of obsessive compulsive symptoms and improving the cognitive function of OCD patients.

Lateral flow chromatography is a new rapid detection and sensing technology,has the advantages of low cost,convenient to use and rapid detection.This method can better meet the requirements of quality and safety surveillance and on-site rapid screening by comparing with the physical and chemical detection methods which are expensive,complicated to operate and require high detection environment.In this paper,the lateral flow chromatography strips were introduced including the test methods,the classification of marking materials and their practical applications in various fields.The researches on the application of lateral flow chromatography strips in biological and food safety testing was reviewed including the advantages and the current research status.The existing bottlenecks and the future development direction were also analyzed.These can provide insight for the further application and in-depth research of strip rapid detection technologies.