BackgroundPersistent cognitive impairment is prevalent among patients with stable schizophrenia. While serum total bile acid （TBA） level in acute-phase patients are known to be associated with cognitive dysfunction， the relationship between serum TBA and multi-dimensional cognitive functions in stable phase patients remains unclear. ObjectiveTo investigate the correlation between serum TBA level and cognitive function in patients with stable schizophrenia， and to evaluate its predictive value for cognitive impairment， thereby providing a serological biomarker for the timely identification and objective assessment of cognitive dysfunction. MethodsA cross-sectional study was conducted on 137 inpatients with stable schizophrenia at The Fourth People's Hospital of Yancheng from March to December 2024. All participants met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. Cognitive function was evaluated using the Chinese Brief Cognitive Test （C-BCT）， patients were categorized into four groups： normal cognition （n=28）， mild impairment （n=28）， moderate impairment （n=47）， and severe impairment （n=34）. Fasting venous blood samples were collected， and serum TBA level was quantified using an enzymatic cycle assay. Spearman correlation analysis was ultilized to determine the relationship between serum TBA level， overall cognitive function， and specific cognitive domains. Binary Logistic regression model was used （adjusting for covariates such as age， gender， and disease duration） to analyze the impact of serum TBA level on overall and individual cognitive functions. The predictive value of serum TBA level for overall cognitive impairment was evaluated using receiver operating characteristic （ROC） curve. ResultsSerum TBA levels differed significantly among the four groups （H=18.677， P<0.01）. Specifically， serum TBA levels in both the moderate and severe cognitive impairment groups were significantly higher than those in the normal cognitive group （adjusted P<0.01）. Serum TBA level was positively correlated with the severity grading of overall cognitive impairment （r_s=0.354， P<0.05）， and negatively correlated with T-scores on the trail making test （r_s=-0.328， P<0.05）， continuous performance test （r_s=-0.247， P<0.05）， digit span （r_s=-0.265， P<0.05）， and symbol coding （r_s=-0.221， P<0.05）. Binary Logistic regression analysis identified serum TBA level as an independent risk factor for overall cognitive impairment （OR=1.322， 95% CI： 1.021 - 1.713， P=0.034）， with a particularly robust predictive ability for impaired information processing speed （OR=1.325， 95% CI： 1.057 - 1.661， P=0.015）. The area under ROC curve （AUC） for serum TBA level in predicting overall cognitive impairment was 0.738， with a sensitivity of 60.61% and a specificity of 78.64%. ConclusionIn patients with stable schizophrenia， elevated serum TBA levels are associated with worse overall cognitive function， as well as deficits in information processing speed， attention， working memory， and executive function. Serum TBA serves as an independent risk factor and exhibits moderate predictive value for overall cognitive impairmen，particularly in the domain of information processing speed. ［Funded by Yancheng Municipal Health Commission Medical Research Project （number， YK2024141）］

Objective:To construct a risk nomogram model for cancer-related fatigue in non-small cell lung cancer patients undergoing chemotherapy, and to verify the application value of the model.Methods:From from January 2017 to December 2021, 520 non-small cell lung cancer patients undergoing chemotherapy admitted to Taizhou People's Hospital and the Second People's Hospital of Lianyungang were selected as the research objects using the convenient sampling method, 400 patients admitted from January 2017 to February 2020 were selected as the model group, and 120 patients admitted from April 2020 to December 2021 were selected as the verification group. Lasso analysis and Logistic regression analysis were used to explore the risk factors of cancer-related fatigue in non-small cell lung cancer patients undergoing chemotherapy. R 4.1.2 software was used to establish a risk nomogram model to predict the risk of cancer-related fatigue in non-small cell lung cancer patients undergoing chemotherapy, and to verify the application value of the model.Results:The incidence of cancer-related fatigue in the model group was 65.5% (262/400) . Logistic regression analysis showed that age≥60 years old, female, living alone, TNM stage (Ⅲ-Ⅳ stage) , poor sleep, depression, frequency of chemotherapy>2 times and percentage of forced expiratory volume in one second to the predicted value (FEV 1%) <70% were the risk factors of cancer-related fatigue in non-small cell lung cancer patients undergoing chemotherapy. The results of risk nomogram model showed that consistency index of the model group and the verification group were 0.846 (95% CI: 0.810-0.889) , 0.887 (95% CI: 0.857-0.917) respectively. The calibration curve showed that the actual and predict values of the model group and the validation group had a good fitting degree. The areas under receiver operating characteristic curve of the model group and the validation group were 0.845 and 0.866, respectively. The decision curve showed that the predictive graph of cancer-induced fatigue in non-small cell lung cancer patients undergoing chemotherapy had good clinical efficacy. Conclusions:Age≥60 years old, female, living alone, TNM stage (Ⅲ-Ⅳ) , poor sleep, depression, frequency of chemotherapy>2 times and FEV 1%<70% are the risk factors of cancer-related fatigue in non-small cell lung cancer patients undergoing chemotherapy, the risk nomogram model established based on the above risk factors is helpful to developing the screening and prevention measures of patients at high-risk of cancer-related fatigue.

Objective:To identify a two-component signaling system (TCSS) composed of β-lactam antibiotic resistance-associated intracellular CiaR and transmembrane serine/threonine kinase StkP of Streptococcus pneumoniae ( S. pneumoniae). Methods:The intracellular segment of stkP gene (IC- stkP) was amplified by PCR and the PCR product was sequenced after T-A cloning. A prokaryotic expression system for IC- stkP segment was established. SDS-PAGE was used to detect the expression of the target recombinant proteins (rIC-StkP and rCiaR) by the established prokaryotic expression system and a previously established prokaryotic expression system for ciaR gene. Ni-NTA affinity chromatography was used to purify the recombinant proteins. The rIC-StkP-captured target proteins of S. pneumoniae were identified by LC-MS/MS after Co-IP. The ability of rCiaR to bind to rIC-StkP was detected by surface plasmon resonance (SPR) and isothermal titration calorimetry (ITC). Results:The established prokaryotic expression system for IC- stkP segment could effectively express rIC-StkP. Both rIC-StkP and rCiaR after purification showed a single protein band on SDS-PAGE. CiaR could be specifically co-precipitated with rIC-StkP. Three extracted cleaved peptides were found in CiaR molecule with exactly matched sequences. SPR and ITC showed that rCiaR could strongly bind to rIC-StkP with high affinity and the KD values were 1.526×10 -9 mol/L and 1.980×10 -6 mol/L, respectively. Conclusions:S. pneumoniae CiaR could act as the downstream response regulatory protein of StkP kinase to compose StkP/CiaR TCSS.

Objective To observe the effects of buccal green tea ice on preventing and controlling radioactive oral mucositis caused by radiotherapy for nasopharyngeal carcinoma. Methods In this single-blind quasi-experiment, totally 160 patients diagnosed with nasopharyngeal carcinoma by histopathology or cytology and treated in the Department of Oncology, Taizhou People's Hospital from April 2014 to April 2018 were selected by convenient sampling and randomized into control (n=41), buccal ice (n=40), green tea mouthwash (n=40) and buccal green ice tea (n=39) groups. Since radiotherapy, patients in the control group received conventional nursing care; patients in the buccal ice group received buccal ice;patients in the green tea mouthwash group received green tea mouthwash; and patients in the buccal green tea ice group received buccal green tea ice. The incidence of oral mucosa response and pain grading were compared among the four groups. Results The incidence rates of oral mucosa response after radiotherapy were 85.37%, 97.50%, 92.50% and 79.49% in control, buccal ice, green tea mouthwash and buccal green ice tea groups. The incidence rates of oral mucosa response 1 week after radiotherapy were 100.00%, 72.50%, 77.50% and 66.67% in control, buccal ice, green tea mouthwash and buccal green ice tea groups and there was statistically significant difference between the four groups (P＜0.05). There was statistically significant difference in the pain levels 1 week after radiotherapy between the four groups (P＜0.05). Totally 41 cases (100.0%) in the control group, 35 (87.5%) in the ice group, 39 (97.5%) in the green tea group and 26 (66.7%) in the buccal green tea ice group suffered pain 1 week after radiotherapy. Conclusions Buccal green tea ice can effectively alleviate the severity of oral mucositis in patients undergoing radiotherapy for nasopharyngeal carcinoma, reduce their pain, ameliorate their clinical symptoms, and prevent radioactive oral mucositis caused by nasopharyngeal carcinoma.

Toxoplasma gondii cathepsin C proteases (TgCPC1, 2, and 3) are important for the growth and survival of T. gondii. In the present study, B-cell and T-cell epitopes of TgCPC1 were predicted using DNAstar and the Immune Epitope Database. A TgCPC1 DNA vaccine was constructed, and its ability to induce protective immune responses against toxoplasmosis in BALB/c mice was evaluated in the presence or absence of the adjuvant α-GalCer. As results, TgCPC1 DNA vaccine with or without adjuvant α-GalCer showed higher levels of IgG and IgG2a in the serum, as well as IL-2 and IFN-γ in the spleen compared to controls (PBS, pEGFP-C1, and α-Galcer). Upon challenge infection with tachyzoites of T. gondii (RH), pCPC1/α-Galcer immunized mice showed the longest survival among all the groups. Mice vaccinated with DNA vaccine without adjuvant (pCPC1) showed better protective immunity compared to other controls (PBS, pEGFP-C1, and α-Galcer). These results indicate that a DNA vaccine encoding TgCPC1 is a potential vaccine candidate against toxoplasmosis.
Animals ; B-Lymphocytes ; Cathepsin C* ; Cathepsins* ; DNA* ; Epitopes, T-Lymphocyte ; Immunoglobulin G ; Interleukin-2 ; Mice* ; Peptide Hydrolases ; Spleen ; Toxoplasma* ; Toxoplasmosis* ; Vaccines, DNA*

Objective To explore a simple and precise method in predicting the preset length of PICC in order to improve the probability of reaching the best position in clinical practice .Methods The study investigated 419 patients who were eligible to receive PICC with IEGM guidance .The horizontal distance from the puncture point to the peak of the right collarbone sternoclavicular was reported as A length and the subsequent length into the vein was reported as B length .The P wave amplitude of lead Ⅱ began to rise and reached to 30%-50% of QRS wave, then 50%-80% of QRS wave.The two-way P wave was reported as P1, P2, P3, P4 wave and its corresponding catheter length was reported as B 1, B2, B3, B4.Observing the B length with different P waves and taking X-ray in an erect position at P3 wave.In addition, the A length increased extra 7cm for patients with no P3 wave.The position of the catheter tip and the corresponding B length were the main outcomes.Results Approximately 92.36% (387/419) of the participants had typical P1, P2, P3, P4 wave and the B length were 3 cm,5 cm,7 cm and 10 cm (H=1 527.290,P<0.01).Approximately 97.16%(376/387) of the patients′catheter tips were located in the third intercostal space .Approximately 7.64%(32/419) of the patients had no P3 wave and the X-ray demonstrated that 29 cases′catheter tip was vertical downward in the third intercostal space and behind the sternum .Conclusions The method of predicting the preset length of PICC not only is simple and precise but also has a high probability of reaching the best position in clinical practice .That is, the puncture side arm abducts until vertical to the body and the horizontal distance is 7cm from the puncture point to the peak of the right collarbone sternoclavicular .

OBJECTIVETo investigate the characteristics,diagnosis and therapy of post-biopsy renal artery pseudoaneurysm in children and to study the clinical value of arterial embolization for traumatic renal hemorrhage when conservative treatment failed.

METHODData were compiled from medical records of a child in whom renal artery pseudoaneurysm occurred after biopsy in the Provincial Hospital Affiliated to Shandong University , and the related literature was reviewed to analyze the diagnosis and treatment of such pseudoaneurysm.

RESULTA 13-year-old boy had gross hematuria, aggravated dysuria and decreased hemoglobin 10 days after percutaneous renal biopsy. Hb decreased from 110 g/L on the first day after admission to 92 g/L on the 4th day, 83 g/L on the 7th day and the minimum to 74 g/L at the 8th day after admission. Ultrasound showed solid echogenic mass in the right renal pelvis as well as the bladder. Color Doppler ultrasound shows the red and blue rotation of blood flow in the polar capsule under the right kidney. Contrast-enhanced CT in the arterial phase showed a 0.5 cm sized renal mass with a strongly enhanced dot in the lower pole of the right kidney, suggesting a renal artery pseudoaneurysm. Haemostatic, supplement of red blood cells and blood volume and other integrative treatment of hematuria were applied for seven days, but his gross hematuria continued to be worsened. He was diagnosed as pseudoaneurysm by digital subtraction angiography (DSA) on the 19th day after renal biopsy. Superselective renal artery embolization using micro-coils and gelatin sponge particles was performed, and the blood clots were cleaned under cystoscope. Macro-haematuria and dysuria disappeared after the interventional treatment. Retrieval of reports on post-biopsy renal artery pseudoaneurysm in children by using "pseudoaneurysm, child" as the search term showed report of one case from the Chinese CNKI database and 3 cases from the PubMed database. The underlying disease was Henoch-Schonlein purpura nephritis in 3 cases and Sneedon syndrome in 1 case; clinical manifestation of gross haematuria was present in 4 cases, lumbago or pain at the site of the puncture in 2 cases, dysuria in 1 case, and fever in 2 cases.

CONCLUSIONThe post-biopsy renal artery pseudoaneurysm in children is often manifested as gross hematuria, lumbago, pain at the site of the puncture, fever and dysuria, DSA can be used for definite diagnosis and the interventional treatment is effective.

Adolescent ; Aneurysm, False ; therapy ; Angiography, Digital Subtraction ; Biopsy ; Embolization, Therapeutic ; Hematuria ; Hemorrhage ; Humans ; Kidney ; blood supply ; pathology ; Kidney Diseases ; diagnosis ; Male ; Nephritis ; Renal Artery ; pathology

OBJECTIVETo investigate the safety of different level of tween 80 by comparing the degree of pseudoanaphylactoid reactions (PR) induced by medicinal tween 80 and injectable tween 80.

METHODThe analysis of vascular permeability of the mice ears: ICR mouse were divided into different test groups, the mice were intravenously injected with solutions of medicinal tween 80 and injectable tween 80 with 0.2%, 1% and 5% concentration, positive control Compound 48/80 and 5% glucose injection. All test substances were mixed with 0.4% Evans blue. The reaction and vascular permeability of the ears were observed and measured 30 min after injection. The analysis of vascular permeability of the rat's skin: the rats were intravenous injected with 0. 6% Evans blue normal saline solution first, 10 minutes later, the same substances were intradermal administrated into the back of rats. The rats were sacrificed and the diameter of locus ceruleus and the content of Evans blue leak out were measured 20 min after injection.

RESULTMedicinal tween 80 and injectable tween 80 with 5% concentration caused obvious vascular hyper permeability in ICR mice, but the degree of vascular hyperpermeability caused by injectable tween 80 was lighter than by medicinal tween 80. Other tween 80 didn't cause obvious vascular hyper permeability in the ears of mouse. The solution of different concentration of tween 80 caused obvious locus ceruleus reaction in rat's back. As for the content Evans blue leak out, there was no statistical significance between each group except positive control Compound 48/80 group.

CONCLUSIONTween 80 can cause obvious vascular hyper permeability and the effect is dose dependent, which indicated that tween 80 can cause PR. On the other hand, injectable tween 80 is more security than medicinal tween 80, the dosage of tween 80 should be still controlled strictly so that to decrease the incidence of PR.

Anaphylaxis ; chemically induced ; Animals ; Injections ; methods ; Male ; Mice ; Mice, Inbred ICR ; Polysorbates ; toxicity ; Rats ; Rats, Wistar