Objective To investigate the effect of nursing intervention based on Kano model on surgical outcomes and negative emotions in patients with diabetic retinopathy(DR).Methods A to-tal of 262 DR patients who underwent vitrectomy were randomly divided into control group(n=131)and observation group(n=131)using the random number table method.The control group received routine nursing intervention,while the observation group received nursing intervention based on the Kano model.The surgical outcomes[visual acuity level and improvement in visual function],nursing needs[Perioperative Nursing Needs Questionnaire for DR Surgical Patients],negative emotions[Self-Rat-ing Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)],and quality of life[Chinese Version of Low Vision Quality of Life Scale(CLVQOL)]were compared between the two groups.The incidence of complications during the intervention period was also recorded in both groups.Results After interven-tion,the visual acuity levels in both groups increased compared to those before intervention,and the rates of low vision decreased(P＜0.001).The visual acuity level in the observation group was high-er,and the rate of low vision was lower than that in the control group,with statistically significant differences(P＜0.001).After intervention,the scores for peripheral visual field,sensory adaptation,and limitations in daily activities decreased in both groups compared to those before intervention,and the scores in the observation group were lower than those in the control group(P＜0.05).After intervention,the SAS and SDS scores in both groups decreased compared to those before interven-tion,and the scores in the observation group were lower than those in the control group(P＜0.001).After intervention,the CLVQOL scores in both groups increased compared to those before the intervention,and the score in the observation group was higher than that in the control group(P＜0.001).The incidence of complications in the control group was higher than that in the obser-vation group(12.22％versus 4.58％,P＜0.05).Conclusion Nursing intervention based on the Kano model can improve visual acuity level,visual function,and negative emotions,enhance the quality of life,and further reduce the incidence of complications in DR patients undergoing vitrectomy.

Objective To investigate the risk factors for the occurrence of bronchiolitis obliterans (BO) in children with refractory Mycoplasma pneumoniae pneumonia (RMPP) and their predictive value of the factors. Methods A retrospective analysis was performed for the medical records of 156 children with RMPP who were admitted to the hospital from May 2020 to March 2024. According to the diagnostic criteria for BO,they were divided into a BO group (n=76) and a non-BO group (n=80). A logistic regression analysis was used to investigate risk factors for the occurrence of BO,and the receiver operating characteristic (ROC) curve was used to assess the value of the model established based on the risk factors in predicting BO. Results Compared with the non-BO group,the BO group had a significantly longer duration of fever,a significantly higher leukocyte count,and a significantly lower albumin level (P<0.05). Compared with the non-BO group,the BO group had a significantly lower proportion of children with initiation of macrolide antibiotic therapy within 5 days,initiation of glucocorticoid therapy within 2 weeks,or initiation of bronchoscopic therapy within<2 weeks (P<0.05). The ROC curve analysis showed that the logistic regression model established based on the above six indicators had an area under the curve of 0.901 (95％CI:0.849-0.953,P<0.001) in predicting the occurrence of BO,with a sensitivity of 0.893 and a specificity of 0.827 at the optimal cut-off value of 0.341. Conclusions The logistic regression model established based on duration of fever,leukocyte count,albumin,initiation of macrolide antibiotic therapy within 5 days,initiation of glucocorticoid therapy within 2 weeks,and initiation of bronchoscopic therapy within 2 weeks has relatively high sensitivity and specificity in predicting the occurrence of BO in children with RMPP.

CD200 and its receptor CD200R constitute an endogenous inhibitory signal. The binding of CD200 and CD200R can regulate the immune response to pathogenic stimuli, which has received much attention in recent years. It has been found that CD200-CD200R is involved in the regulation of many kinds of pathological inflammation, including autoimmune diseases, cardiac cerebrovascular disease, infection and tumor. This paper reviews the protein structure, distribution, expression, biological function of CD200-CD200R and the correlation with diseases, and analyses the current status and development ideas of CD200-CD200R as drug targets. It aims to provide theoretical support for new drug research and development based on this target.

Objective: To explore the clinical characteristics of various types of infected pancreatic necrosis(IPN) and the prognosis of different treatment methods in the imaging classification of IPN proposed. Methods: The clinical data of 126 patients with IPN admitted to the Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University from December 2018 to December 2021 were analyzed retrospectively. There were 70 males(55.6%) and 56 females(44.4%), with age(M(IQR)) of 44(17)years (range: 12 to 87 years). There were 67 cases(53.2%) of severe acute pancreatitis and 59 cases (46.8%) of moderately severe acute pancreatitis. All cases were based on the diagnostic criteria of IPN. All cases were divided into Type Ⅰ(central IPN)(n=21), Type Ⅱ(peripheral IPN)(n=23), Type Ⅲ(mixed IPN)(n=74) and Type Ⅳ(isolated IPN)(n=8) according to the different sites of infection and necrosis on CT.According to different treatment strategies,they were divided into Step-up group(n=109) and Step-jump group(n=17). The clinical indicators and prognosis of each group were observed and analyzed by ANOVA,t-test,χ² test or Fisher exact test,respectively. Results: There was no significant difference in mortality, complication rate and complication grade in each type of IPN(all P>0.05). Compared with other types of patients, the length of stay (69(40)days vs. 19(19)days) and hospitalization expenses(323 000(419 000)yuan vs. 60 000(78 000)yuan) were significantly increased in Type Ⅳ IPN(Z=-4.041, -3.972; both P<0.01). The incidence of postoperative residual infection of Type Ⅳ IPN was significantly higher than that of other types (χ²=16.350,P<0.01). There was no significant difference in the mortality of patients with different types of IPN between different treatment groups. The length of stay and hospitalization expenses of patients in the Step-up group were significantly less than those in the Step-jump group(19(20)days vs. 33(35)days, Z=-2.052, P=0.040;59 000(80 000)yuan vs. 122 000(109 000)yuan,Z=-2.317,P=0.020). Among the patients in Type Ⅳ IPN, the hospitalization expenses of Step-up group was significantly higher than that of Step-jump group(330 000(578 000)yuan vs. 141 000 yuan,Z=-2.000,P=0.046). The incidence of postoperative residual infection of Step-up group(17.4%(19/109)) was significantly lower than that of Step-jump group(10/17)(χ²=11.980, P=0.001). Conclusions: Type Ⅳ IPN is more serious than the other three types. It causes longer length of stay and more hospitalization expenses. The step-up approach is safe and effective in the treatment of IPN. However, for infected lesions which are deep in place,difficult to reach by conventional drainage methods, or mainly exhibit "dry necrosis", choosing the step-jump approach is a more positive choice.
Male ; Female ; Humans ; Retrospective Studies ; Pancreatitis, Acute Necrotizing/complications* ; Acute Disease ; Intraabdominal Infections/complications* ; Necrosis/complications* ; Treatment Outcome

OBJECTIVE: To explore whether casticin (CAS) suppresses stemness in cancer stem-like cells (CSLCs) obtained from human cervical cancer (CCSLCs) and the underlying mechanism. METHODS: Spheres from HeLa and CaSki cells were used as CCSLCs. DNA methyltransferase 1 (DNMT1) activity and mRNA levels, self-renewal capability (Nanog and Sox2), and cancer stem cell markers (CD133 and CD44), were detected by a colorimetric DNMT activity/inhibition assay kit, quantitative real-time reverse transcription-polymerase chain reaction, sphere and colony formation assays, and immunoblot, respectively. Knockdown and overexpression of DNMT1 by transfection with shRNA and cDNA, respectively, were performed to explore the mechanism for action of CAS (0, 10, 30, and 100 nmol/L). RESULTS: DNMT1 activity was increased in CCSLCs compared with HeLa and CaSki cells (P<0.05). In addition, HeLa-derived CCSLCs transfected with DNMT1 shRNA showed reduced sphere and colony formation abilities, and lower CD133, CD44, Nanog and Sox2 protein expressions (P<0.05). Conversely, overexpression of DNMT1 in HeLa cells exhibited the oppositive effects. Furthermore, CAS significantly reduced DNMT1 activity and transcription levels as well as stemness in HeLa-derived CCSLCs (P<0.05). Interestingly, DNMT1 knockdown enhanced the inhibitory effect of CAS on stemness. As expected, DNMT1 overexpression reversed the inhibitory effect of CAS on stemness in HeLa cells. CONCLUSION CAS effectively inhibits stemness in CCSLCs through suppression of DNMT1 activation, suggesting that CAS acts as a promising preventive and therapeutic candidate in cervical cancer.
Female ; Humans ; Cell Line, Tumor ; HeLa Cells ; Neoplastic Stem Cells/metabolism* ; RNA, Small Interfering/metabolism* ; Uterine Cervical Neoplasms/metabolism*

OBJECTIVE: To explore clinical effect of arthroscopy-assisted rotator cuff tendon transfer in treating irreparable rotator cuff tears (IRCT). METHODS: From May 2015 to May 2018, 23 patients with unrepairable rotator cuff tears were treated with arthroscopy-assisted rotator cuff tendon transfer, and 21 patients were followed up finally, including 8 males and 13 females, aged from 48 to 82 years old with an average of(64.3±9.1) years old;the courses of disease ranged from 6 to 36 months with an average of (14.0±6.4) months. American Rotator and Elbow Surgeons Score(ASES) and Constant-Murley score were used to evaluate clinical efficacy before surgery and at the latest follow-up. RESULTS: All 21 patients were followed up for 36 to 54 months with an average of (39.4±4.4) months. Axillary incision of 1 patient was redness, swelling and exudation after surgery, which healed after 3 weeks of dressing change, and exudate culture was negative. At the latest follow-up, MRI showed partial tearing of the metastatic tendon in 2 patients, but pain and movement of the affected shoulder were still better than before surgery. ASES increased from preoperative (41.0±9.6) scores to the latest follow-up (75.6±14.0) scores, and had statistical difference (t=10.50, P<0.01). Constant-Murley score increased from (49.8±7.1) scores before operation to (67.5±11.6) scores at the latest follow-up (t=11.27, P<0.01). CONCLUSION Arthroscopic assisted latissimus dorsalis tendon transposition restores physiological and anatomical structure of glenohumeral joint by reconstructing balance of horizontal and vertical couples of shoulder joint, thus achieving the stability of the shoulder joint, relieving shoulder pain and improving shoulder joint function.
Male ; Female ; Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Rotator Cuff Injuries/surgery* ; Superficial Back Muscles ; Rotator Cuff ; Treatment Outcome ; Shoulder Joint/surgery* ; Tendon Transfer ; Arthroscopy ; Range of Motion, Articular/physiology*

Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.
Male ; Female ; Humans ; Aged ; Natriuretic Peptide, Brain ; Simendan/therapeutic use* ; Non-ST Elevated Myocardial Infarction ; Heart Failure/drug therapy* ; Peptide Fragments ; Arrhythmias, Cardiac ; Biomarkers ; Prognosis

Objective:To explore the difference of the vessel and plaque characteristics, myocardial perfusion and cardiac function between patients with ischemia with non-obstructive coronary artery disease (INOCA) and obstructive coronary artery disease (CAD).Methods:From July 2021 to June 2022, 101 patients with angina were referred to dynamic computed tomography myocardial perfusion (CTP) and coronary computed tomography angiography (CCTA) and retrospectively included in our hospital. Based on the results of CTP and CCTA, patients were divided into INOCA (27 cases), moderate obstructive CAD (26 cases) and severe obstructive CAD (48 cases). The anatomical coronary artery stenosis, plaque characteristics and myocardial perfusion features of all patients were analyzed. Furthermore, left ventricular global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained on full-phase reconstruction CCTA image by using Medis Suite 3.2 postprocessing software. Multigroup analysis used one way ANOVA or Kruskal Wallis H test. Results:Patients with INOCA were younger than patients with moderate and severe obstructive CAD ( P<0.001). INOCA patients (7.4%, 2/27) had lower rate of positive remodeling than both moderate (57.7%, 15/26, P<0.001) and severe obstructive CAD patients (33.3%, 16/48, P=0.017). The percentage of ischemic myocardium volume in patients with INOCA were similar with those in patients with severe CAD (all P>0.05), but significantly higher than those in patients with moderate CAD (all P<0.05). No significant difference in terms of GLS was detected between patients with INOCA [-17.4% (-21.6%, -11.6%)] and severe CAD [-17.6% (-21.9%, -14.8%), P=0.536], however, patients both with INOCA and severe CAD also had higher GLS than patients with moderate obstructive CAD [-22.3% (-29.8%, -19.0%), all P<0.05]. Conclusions:Based on"one-stop-shop"CTP combined with CCTA imaging, early cardiac functional changes including abnormal myocardial perfusion and myocardial strain in INOCA patients were similar to those in patients with severe obstructive CAD and more severe than those in patients with moderate obstructive CAD.

Objective:To investigate the relationship between the single nucleotide polymorphism（SNP）of function genes and effective components of Salvia miltiorrhiza and the molecular mechanism of specific quality formation of S. miltiorrhiza. Method:The fingerprints of components in S. miltiorrhiza from eight different habitats and varieties were obtained by high-performance liquid chromatography （HPLC）. The full-length cDNA of three functional genes acetyl-CoA C-acetyltransferase（SmAACT），4-diphosphocytidyl-2-C-methyl-D-erythritol kinase（SmCMK） and isopentenyl diphosphate isomerase（SmIPPI） in tanshinone metabolic pathway were amplified by polymerase chain reaction（PCR），cloned， and sequenced，followed by bioinformatics analysis. Result:The full-length cDNA sequences of three functional genes SmAACT，SmCMK， and SmIPPI in tanshinone metabolic pathway were obtained from 23 strains of S. miltiorrhiza from eight different habitats and varieties. As revealed by the analysis of SNP and amino acid polymorphisms of three functional genes，18，16， and 14 SNP sites were found respectively. HPLC results showed the samples from Beijing，Hubei，Shandong （No. SDB），Shanxi，Henan， and Shandong （No. SDZ） were clustered into one branch，and those from Hebei and Inner Mongolia were clustered into another branch， which suggested that the variation trend of S. miltiorrhiza components had little correlation with geographical distance，but the variety was a critical factor for the quality. Conclusion:There was an obvious genetic differentiation trend in S. miltiorrhiza from different habitats，and different origin-specific genotypes were formed. The molecular mechanism of the formation of the specific quality of S. miltiorrhiza from different habitats was discussed，which laid a foundation for the stability and effectiveness of clinical medication，and guided the breeding of excellent varieties of S. miltiorrhiza.

Objective:The effects of Atractylodes lancea， A. coreana， A. japonica， A. chinensis and Atractylodis Macrocephalae Rhizoma on spleen-Qi deficiency rats were compared. Method:A model of spleen-Qi deficiency was induced in rats by diet and overwork.The rats are given different suspensions of A.japonica， A.chinesis， A.coreana， A.lancea and Atractylodis Macrocephalae Rhizoma To test the indicators of the digestive system， immune system and antioxidant enzyme system related to spleen deficiency.Compare the similarities and differences between Atractylodis Macrocephalae Rhizoma and Atractylodis Rhizoma from four different sources. Result:All the drug-administered groups can increase the levels of γ interferon （IFN-γ）， gastric secrete element（GAS），serum amylase （AMS） and catalase（CAT） in rats with spleen-deficiency syndrome，in addition to the CAT index， the other indicators of the A. coreana， A.japonica， and A.lancea were significantly increased（P<0.05）. The MTL content of the A.chinesis， A.lancea， A.coreana and A.japonica increased and was significant（P<0.05）. The SDH content of A.japonica.and A.chinesis increased， and the difference was not significant.The increase of GSH-Px in the A.chinesis is significant（P<0.05）. All the drug-administered groups can reduce the content of IgG， TNF-α and MDA in rats with spleen deficiency and deficiency syndrome. Among them， the IgG content of the A.chinesis. and the A.lancea was significantly decreased（P<0.05）. The content of TNF-α in A.japonica group was significantly decreased（P<0.05）. The content of MDA in the A.chinesis， the A.lancea， the A.coreana，the A.japonica and the Atractylodis Macrocephalae Rhizoma were significantly decreased（P<0.05）.The decrease of IL-6 in the A.lancea was significant（P<0.05）. Conclusion:Four different sources of Atractylodes Rhizome and A.macrocephala have certain therapeutic effects on spleen-deficiency rats with deficiency syndrome.The therapeutic effect of A.lancea and A.japonica is basically the same，regulating the absorption，secretion and elimination of inflammation in the digestive system of rats with spleen deficiency A.coreana， A.chinesis， and Atractylodis Macrocephalae Rhizoma have certain regulatory effects in the digestive system， digestive tract inflammation， and antioxidant enzymes.