This report summarizes the nursing experience of a patient with acute myocardial infarction complicated by cardiogenic shock and frequent electrical storms.The key nursing interventions are outlined as follows.Formation of a multidisciplinary management team:a collaborative treatment plan was developed by assembling a multidisciplinary team of healthcare professionals.Activation of the hospital emergency response system:the hospital's emergency response protocols were promptly activated to ensure efficient emergency nursing care.Dynamic hemodynamic monitoring:circulatory support strategy guided by hemodynamic monitoring.Establish-ment of a malignant arrhythmia warning system:a warning system for malignant arrhythmias was implemented to standardize the emergency procedures for electrical cardioversion and defibrillation,thereby maximizing the time available for life support.Sequential antiplatelet and anticoagulation management:a sequential approach to antiplatelet and anticoagulation therapy was employed to effectively prevent the risks of thrombosis and bleeding.Focus on psychological care and rehabilitation training:emphasis was placed on psychological support and rehabilitation exercises to enhance the patient's comfort and exercise tolerance.The patient was hospitalized for 33 days and was discharged in improved condition.This translation is structured to reflect the conventions of academic writing,making it suitable for inclusion in a clinical report or research paper.

This report summarizes the nursing experience of a patient with acute myocardial infarction complicated by cardiogenic shock and frequent electrical storms.The key nursing interventions are outlined as follows.Formation of a multidisciplinary management team:a collaborative treatment plan was developed by assembling a multidisciplinary team of healthcare professionals.Activation of the hospital emergency response system:the hospital's emergency response protocols were promptly activated to ensure efficient emergency nursing care.Dynamic hemodynamic monitoring:circulatory support strategy guided by hemodynamic monitoring.Establish-ment of a malignant arrhythmia warning system:a warning system for malignant arrhythmias was implemented to standardize the emergency procedures for electrical cardioversion and defibrillation,thereby maximizing the time available for life support.Sequential antiplatelet and anticoagulation management:a sequential approach to antiplatelet and anticoagulation therapy was employed to effectively prevent the risks of thrombosis and bleeding.Focus on psychological care and rehabilitation training:emphasis was placed on psychological support and rehabilitation exercises to enhance the patient's comfort and exercise tolerance.The patient was hospitalized for 33 days and was discharged in improved condition.This translation is structured to reflect the conventions of academic writing,making it suitable for inclusion in a clinical report or research paper.

Adiponectin is a plasma protein derived from fat cells that regulates a variety of metabolic processes. With the increasing research of adiponectin in nervous system diseases, it is gradually found that adiponectin plays a role in the control of key processes in brain physiology, including neuronal excitability and synaptic plasticity, neuroprotection, neurogenesis and regulation of glial cell activation. This article reviews the research progress of adiponectin in neurodegenerative diseases, convulsive diseases, ischemic brain injury and other neurological diseases.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.

Alkaloids are a class of naturally occurring bioactive compounds that are widely distributed in various food sources and Traditional Chinese Medicine. This study aimed to investigate the therapeutic effects and underlying mechanisms of alkaloid extract from Codonopsis Radix (ACR) in ameliorating hepatic lipid accumulation in a mouse model of non-alcoholic fatty liver disease (NAFLD) induced by a high-fat diet (HFD). The results revealed that ACR treatment effectively mitigated the abnormal weight gain and hepatic injury associated with HFD. Furthermore, ACR ameliorated the dysregulated lipid metabolism in NAFLD mice, as evidenced by reductions in serum triglyceride, total cholesterol, and low-density lipoprotein levels, accompanied by a concomitant increase in the high-density lipoprotein level. ACR treatment also demonstrated a profound anti-oxidative effect, effectively alleviating HFD-induced oxidative stress and promoting ATP production. These effects were achieved through the up-regulation of the activities of mitochondrial electron transfer chain complexes I, II, IV, and V, in addition to the activation of the AMPK/PGC-1α pathway, suggesting that ACR exhibits therapeutic potential in alleviating the HFD-induced dysregulation of mitochondrial energy metabolism. Moreover, ACR administration mitigated HFD-induced endoplasmic reticulum (ER) stress and suppressed the overexpression of ubiquitin-specific protease 14 (USP14) in NAFLD mice. In summary, the present study provides compelling evidence supporting the hepatoprotective role of ACR in alleviating lipid deposition in NAFLD by improving energy metabolism and reducing oxidative stress and ER stress. These findings warrant further investigation and merit the development of ACR as a potential therapeutic agent for NAFLD.
Mice ; Animals ; Non-alcoholic Fatty Liver Disease/metabolism* ; Codonopsis ; Liver ; Lipid Metabolism ; Antineoplastic Agents/pharmacology* ; Alkaloids/pharmacology* ; Endoplasmic Reticulum Stress ; Energy Metabolism ; Lipids ; Diet, High-Fat/adverse effects* ; Mice, Inbred C57BL

Objective:This study aims to explore the relationship between the single nucleotide polymorphism (SNPs) of Apo liporoteine E (ApoE), GTP cyclohydrolase 1 (GCH1), and J subfamily member of inward rectifier potassium channel-15 (KCNJ15) gene and cognitive dysfunction in Han nationality patients with schizophrenia in Yunan province.Methods:From September 2018 to August 2020, 182 patients with schizophrenia (patient group) and 176 healthy volunteers (control group) were recruited from the Department of Psychiatry and Physical Examination Center respectively, in the First Affiliated Hospital of Kunming Medical University. The Chinese versions of PANSS and the MATRICS Cognitive Battery (MCCB) were used to evaluate psychiatric symptoms and cognitive function respectively. The SNPs of four loci of GCH1 (rs72713460), KCNJ15 (rs928771), and APOE (rs7412 and rs429358) genes were measured by fluorescence in situ hybridization. The differences of genes and genotypes between the two groups were compared. Then multiple linear regression analyses were performed in the patient group. In the regression models, the T scores of each cognitive function test were entered as dependent variables one by one, while the demographic and clinical data and the four SNPs of ApoE, GCH1, and KCNJ15 as independent variables.Results:The T scores of seven cognitive domains of MCCB were lower in the patient group than in the control group ( t=-25.65 to -18.27, all P<0.001). The genotype frequencies of ApoEε3ε4 (55/182 (30.2%) vs. 22/176 (12.5%)) and allele frequencies of ApoEε4 (65/182 (17.9%) vs. 30/176 (8.5%)) were statistically significantly higher in the patient group than in the control group (χ 2=16.64 and 13.55 respectively, both P<0.001). The genotype and allele frequency of GCH1 in patient group were higher than those in control group (χ 2=8.01 to 21.50), and the difference was statistically significant ( P<0.001 or P<0.05). In the patient group, the T scores of 7 cognitive domains were lower in ApoEε4 allele carriers than in non-carriers ( t=4.99 to 17.69), the T scores of 6 cognitive domains were lower in GCH1-T allele carriers than in non-carriers ( t=5.75 to 13.36), and the T scores of 5 cognitive domains were higher in KCNJ15-G allele carriers than in non-carriers ( t=-2.99 to -2.48). In schizophrenia patients, multiple regression analyses showed that the cognitive domains of information processing speed and word learning were related to carrying ApoEε4 and GCH1-T allele. Conclusion:There is pervasive and significant cognitive dysfunction in Han nationality patients with schizophrenia in Yunan province. The polymorphism of ApoE and GCH1 genes may be related to the pathogenesis of cognitive dysfunction in schizophrenia.

Objective:This study aims to explore the relationship between the single nucleotide polymorphism (SNPs) of Apo liporoteine E (ApoE), GTP cyclohydrolase 1 (GCH1), and J subfamily member of inward rectifier potassium channel-15 (KCNJ15) gene and cognitive dysfunction in Han nationality patients with schizophrenia in Yunan province.Methods:From September 2018 to August 2020, 182 patients with schizophrenia (patient group) and 176 healthy volunteers (control group) were recruited from the Department of Psychiatry and Physical Examination Center respectively, in the First Affiliated Hospital of Kunming Medical University. The Chinese versions of PANSS and the MATRICS Cognitive Battery (MCCB) were used to evaluate psychiatric symptoms and cognitive function respectively. The SNPs of four loci of GCH1 (rs72713460), KCNJ15 (rs928771), and APOE (rs7412 and rs429358) genes were measured by fluorescence in situ hybridization. The differences of genes and genotypes between the two groups were compared. Then multiple linear regression analyses were performed in the patient group. In the regression models, the T scores of each cognitive function test were entered as dependent variables one by one, while the demographic and clinical data and the four SNPs of ApoE, GCH1, and KCNJ15 as independent variables.Results:The T scores of seven cognitive domains of MCCB were lower in the patient group than in the control group ( t=-25.65 to -18.27, all P<0.001). The genotype frequencies of ApoEε3ε4 (55/182 (30.2%) vs. 22/176 (12.5%)) and allele frequencies of ApoEε4 (65/182 (17.9%) vs. 30/176 (8.5%)) were statistically significantly higher in the patient group than in the control group (χ 2=16.64 and 13.55 respectively, both P<0.001). The genotype and allele frequency of GCH1 in patient group were higher than those in control group (χ 2=8.01 to 21.50), and the difference was statistically significant ( P<0.001 or P<0.05). In the patient group, the T scores of 7 cognitive domains were lower in ApoEε4 allele carriers than in non-carriers ( t=4.99 to 17.69), the T scores of 6 cognitive domains were lower in GCH1-T allele carriers than in non-carriers ( t=5.75 to 13.36), and the T scores of 5 cognitive domains were higher in KCNJ15-G allele carriers than in non-carriers ( t=-2.99 to -2.48). In schizophrenia patients, multiple regression analyses showed that the cognitive domains of information processing speed and word learning were related to carrying ApoEε4 and GCH1-T allele. Conclusion:There is pervasive and significant cognitive dysfunction in Han nationality patients with schizophrenia in Yunan province. The polymorphism of ApoE and GCH1 genes may be related to the pathogenesis of cognitive dysfunction in schizophrenia.

Objective:To evaluate the clinical efficacy and safety of using the F4.8 Visual Puncture Micro-percutaneous nephrolithotomy to treat the female distal calculi associated with stricture.Methods:From June 2017 to December 2019, 32 female patients with distal ureteric calculi associated with stricture, aged(35.0±10.3) years ( range from 16 to 75 years)old, were enrolled into this retrospective study. They were diagnosed by colour doppler ultrasound, IVU(intravenous Urography), or CT, et al. The average stone size was (13.0±3.6)mm in diameter(range from 3 to 20 mm), and the stone obstruction duration was from 2 to 35 days, with average of(5±17) days. Twenty-seven cases were on the unilateral ureter and 5 cases were on the bilateral ureters. There were 17 cases undergoing ESWL 2 weeks before. Six cases of stone diameter less than 6 mm were administered medical therapy for more than 7 days. All the 32 case underwent ureteroscopic lithotripsy but failed because of the ureter stricture. They all suffered from hydronephrosis, with the diameter of renal collecting system from 15 to 45 mm, with(23±15)mm on average. The lithotomy position was taken, and the F4.8 Visual Micro-percutaneous nephrolithotomy using 0.9% Sodium chloride was applied to enter into ureter through urethra. There were 21 cases of ureter orifice stricture, including 8 cases associated with avulsion or perforation, 9 cases associated with intramural ureter abnormality and stricture, the zebra guidewire being failed to enter. The F4.8 Visual Micro-percutaneous nephrolithotomy cooperated with water pressure modulation was used to flush and open the ureter orifice and intramural ureter for entering. Holmium lase was used for lithotripsy. Two cases stone were infective and obstructed seriously. F4.8 Visual Micro-percutaneous nephrolithotriptor entered the ureter and destroyed the stones, and the stone fragments were discharged. Stone migrated upward and escaped occurred in 1 case, then the zebra guidewire was indwelled and ureteroscope was used for lithotripsy successfully. All cases were indewelled F4.7 doubld-J tube and urethral catheter after operation.Result:All the 32 patients underwent lithotripsy successful by one-stage. The operation time was 15-43 min [averaged (35.0±8.7)min]. All patients were recovered and discharged 4-7(averaged 5.3) days after operation. Three patients occured fever, T>38.5℃, and they recovered by using sensitive antibiotics according to the blood and urine culture. No severe complications occurred, such as ureteral perforation or extravasation. All patients were reviewed by ultrasound and KUB 3 days after operation, finding 24 cases with stone free, and 8 cases of a little residual stone, with the stone free rate of 75%. One month later, ultrasound and IVU was performed, and no residual stone was detected, with the stone free rate of 100%. The hydronephrosis alleviated by varying degrees. The diameter of the renal collecting system was from 0 to 35 mm, with(12±9)mm on average. The IVU showed the ureter was unobstructed. Conclusions:The F4.8 Visual Micro-percutaneous nephrolithotomy is safe and effective for the female distal calculi associated with stricture, when routine ureteroscopic lithotripsy failed.

Objective To explore the teaching effects of Lecture Based Learning (LBL) incorporated with Case Based Learning (CBL) and Problem Based Learning (PBL) methods in the teach-ing of anatomy.Methods 740 students of Grades 2012 and 2013 from clinical medical major were chosen as the subjects,randomly divided into experimental and control groups.LBL was conducted in the control group of 644 students,while LBL+PBL+CBL method was applied in the experimental group of 96 students.After completion of the course,all students were surveyed with the questionnaire and tested with specimen and theoretical examinations.The data was collected and analyzed with SPSS 17.0 and two sample U tests.Results The students' time of learning anatomy in the control group outside classroom teaching was (105 ± 25) minutes per week,while the students' time of learning anatomy in the experimental group was (190 ± 25) minutes per week.The difference was statistically significant (t=31.08,P=0.000).The difference of after-class total learn-ing time was also statistically significant between two groups(t=27.42,P=0.000).Percentages of satisfaction with teaching methods for control group were 87.5％ and 87％,while for the experimental group 98％ and 100％.Kruskal-Wallis test showed there were significant differences in experimental groups of grades 2012(x2=31.19,P=0.000) and 2013 (x2=40.35,P=0.000) compared with control group.Comparison of both groups' results of the examinations was statistically significant concerning multiple choices,essays and case analysis questions (P＜0.05).Conclusion Teaching method of LBL incorporated with PBL and CBL was significantly effective than that of the sole traditional LBL method,which indicated its practice value.