The quality control of the surgical pathway for colorectal cancer is closely related to reducing the incidence of postoperative complications, recurrence and metastasis, prolonging survival, and preserving functions. This pathway involves multiple disciplines, stages, and contents: standardizing the diagnosis and treatment process for colorectal cancer is crucial to ensuring medical quality and safety. Strengthening perioperative management is an important essential step for accelerating postoperative recovery and improving patient prognosis. Establishing a standard training program and effective inspection system is guarantee for the quality of colorectal cancer surgery.

Objective:To investigate the effects and mechanisms of Nicorandil, an ATP-sensitive potassium channel (KATP) opener, on pyroptosis and inflammatory responses in microglia(BV2) induced by oxygen-glucose deprivation/reoxygenation (OGD/R).Methods:BV2 cells were divided into control group, OGD/R group, and OGD/R+ Nicorandil group.And the cells were subjected to oxygen-glucose deprivation for 3 hours and then reoxygenated for 24 hours to establish an OGD/R cell model. OGD/R+ Nicorandil group cells were incubated with 5 μg/mL Nicorandil culture medium for 24 hours after oxygen-glucose deprivation for 3 hours.The cell proliferation activity was detected by CCK8 assay.Calcein/propidium iodide (calcein/PI) assay kit was used to detect the membrane porosity rupture rate of cell in each group.Western blot analysis was performed to detect the protein expression levels of nuclear factor-κB (NF-κB), phosphorylated NF-κB (p-NF-κB), inhibitor of nuclear factor-κB α(IκB-α), phosphorylated IκB-α (p-IκB-α), absent in melanoma 2 (AIM2), cleaved-caspase-1, gasdermin D-N (GSDMD-N), interleukin-18 (IL-18), and interleukin-1β (IL-1β). Immunofluorescence was used to detect the protein expression levels of AIM2 and GSDMD-N in each group. Statistical analysis was performed by SPSS 26.0 software. One-way ANOVA was used for multiple group comparisons, and LSD test was used for pairwise comparisons.Results:(1) There were statistically significant differences in the membrane porosity rupture rates among the three groups ( F=615.882, P<0.05). The membrane porosity rupture rate in the Nicorandil group was lower than that in the OGD/R group ((41.50±3.04)%, (59.44±3.66)%, P<0.05). (2) Western blot results showed that the protein expression levels of p-NF-κB, NF-κB, p-IκB-α, and IκB-α were significantly different among the three groups ( F=10.000, 62.652, 67.121, 101.023, all P<0.05). The levels of p-NF-κB, NF-κB and p-IκB-α in the OGD/R+ Nicorandil group ((0.60±0.13), (0.87±0.06), (0.55±0.06), respectively) were lower than those in the OGD/R group ((1.02±0.09), (1.03±0.09), (0.86±0.04), respectively) (all P<0.05). The level of IκB-α in the OGD/R+ Nicorandil group ((0.63±0.05), (0.46±0.06)) was higher than that in the OGD/R group( P<0.05). (3) The protein expression levels of AIM2, cleaved-caspase-1, GSDMD-N, IL-18, and IL-1β were significantly different among the three groups ( F=65.926, 12.428, 66.447, 44.831, 52.960, all P<0.05). The levels of AIM2, cleaved-caspase-1, GSDMD-N, IL-18 and IL-1β in the OGD/R+ Nicorandil group ((0.78±0.04), (0.71±0.09), (0.54±0.04), (0.72±0.07), (0.50±0.08), respectively) were lower than those in the OGD/R group ((0.94±0.09), (0.89±0.09), (0.85±0.04), (0.90±0.07), (0.99±0.03), respectively) (all P<0.05). (4) Immunofluorescence results showed statistically significant differences in the fluorescence intensity of pyroptosis marker proteins AIM2 and GSDMD-N among the three groups ( F=36.353, 46.817, both P<0.05). The fluorescence intensities of AIM2 ((124.36±7.91), (140.19±5.63)) and GSDMD-N ((134.16±5.18), (147.45±5.63))in the OGD/R+ Nicorandil group were lower than those in the OGD/R group (both P<0.05). Conclusion:Nicorandil can mitigate BV2 cell damage following oxygen-glucose deprivation, inhibiting the release of pro-inflammatory factors. The mechanism may be related to the downregulation of the expression of NF-κB related proteins and inhibition of AIM2 inflammasome-mediated pyroptosis after OGD/R.

Objective To establish a prediction model for in-hospital mortality risk in patients with sepsis-induced coagulopathy based on LASSO regression.Methods Patients with sepsis-induced coagulopathy ad-mitted to intensive care unit(ICU)at Beth Israel Deaconess Medical Center during 2008 to 2019 were selected from the Medical Information Market for Intensive Care(MIMIC)-Ⅳ database(version 2.1)for retrospective study.The study subjects were randomly divided into modeling group and verification group,and the feature variables were screened by LASSO regression.The feature variables were analyzed by multivariate Logistic re-gression to determine independent risk factors,and the nomogram prediction model was established at the same time.The model performance was evaluated by drawing calibration curve and receiver operating charac-teristic(ROC)curve,as well as decision curve analysis.Results A total of 4 994 patients with sepsis-induced coagulopathy admitted to ICU for the first time were enrolled in this study.They were randomly divided into a model group(n=3 495)and a validation group(n=1 499)at a ratio of 7:3.Multivariate Logistic regres-sion analysis showed that age,mean respiratory rate,mean corpuscular hemoglobin concentration,red blood cell count,platelet count,prothrombin time,anion gap,acute physiological score Ⅲ and acute kidney injury were independent risk factors for in-hospital mortality of patients with sepsis-induced coagulopathy.Based on the above independent risk factors,a nomographic prediction model was constructed.The area under the ROC curve and 95％confidence interval of the nomogram in the modeling group and validation group were 0.864(0.849-0.880)and 0.877(0.852-0.901),respectively.The sensitivity was 0.795 and 0.763,and the speci-ficity was 0.779 and 0.843,respectively.The calibration curve suggested that the predicted probability was ba-sically consistent with the actual probability,and the decision curve analysis showed that it had good clinical net benefits within a wide range of threshold.Conclusion The nomogram model based on MIMIC-Ⅳ database has good predictive value for predicting the in-hospital mortality of patients with sepsis-induced coagulopathy and can be used to guide clinical work.

Here, we report a previously unrecognized syndromic neurodevelopmental disorder associated with biallelic loss-of-function variants in the RBM42 gene. The patient is a 2-year-old female with severe central nervous system (CNS) abnormalities, hypotonia, hearing loss, congenital heart defects, and dysmorphic facial features. Familial whole-exome sequencing (WES) reveals that the patient has two compound heterozygous variants, c.304C>T (p.R102*) and c.1312G>A (p.A438T), in the RBM42 gene which encodes an integral component of splicing complex in the RNA-binding motif protein family. The p.A438T variant is in the RRM domain which impairs RBM42 protein stability in vivo. Additionally, p.A438T disrupts the interaction of RBM42 with hnRNP K, which is the causative gene for Au-Kline syndrome with overlapping disease characteristics seen in the index patient. The human R102* or A438T mutant protein failed to fully rescue the growth defects of RBM42 ortholog knockout ΔFgRbp1 in Fusarium while it was rescued by the wild-type (WT) human RBM42. A mouse model carrying Rbm42 compound heterozygous variants, c.280C>T (p.Q94*) and c.1306_1308delinsACA (p.A436T), demonstrated gross fetal developmental defects and most of the double mutant animals died by E13.5. RNA-seq data confirmed that Rbm42 was involved in neurological and myocardial functions with an essential role in alternative splicing (AS). Overall, we present clinical, genetic, and functional data to demonstrate that defects in RBM42 constitute the underlying etiology of a new neurodevelopmental disease which links the dysregulation of global AS to abnormal embryonic development.
Female ; Animals ; Mice ; Humans ; Child, Preschool ; Intellectual Disability/genetics* ; Heart Defects, Congenital/genetics* ; Facies ; Cleft Palate ; Muscle Hypotonia

ObjectiveTo explore the clinical efficacy and safety of Fuzheng Huaji Longbi decoction in treating benign prostatic hyperplasia （BPH） in the patients with the syndrome of healthy Qi deficiency and blood stasis. MethodA total of 94 BPH patients were randomized into control and observation groups， with 47 patients in each group. The control group was treated with doxazosin mesylate sustained-release tablets， and the observation group with Fuzheng Huaji Longbi decoction on the basis of the therapy in the control group. After eight weeks， the international prostate symptom score （IPSS）， quality of life （QOL） score， residual urine volume （RUV）， maximum urinary flow rate （Q_max）， TCM syndrome score， TCM symptom score， electrocardiogram， and liver and kidney function were determined to evaluate the clinical efficacy and safety of the two groups. ResultAfter 8 weeks of treatment， the total response rate in the control group was 63.64% （28/44）， which was lower than that （84.44%， 38/45） in the observation group （χ²=5.026， P<0.05）. The clinical efficacy in the observation group was higher than that in the control group （Z=-2.17， P=0.030）. The treatment in both groups decreased the IPSS， QOL score， RUV， and TCM syndrome scores and increased the Q_max （P<0.05）. Moreover， the observation group had lower IPSS， QOL score， RUV， and TCM syndrome score （P<0.05） and higher Q_max than the control group after treatment （P<0.05）. The treatment in the observation group decreased all the TCM symptom scores （P<0.05）， while that in the control group only decreased the frequency of urination at night and the scores of dysuria， weak urine stream， and post-urinary drainage （P<0.05）. After treatment， the observation group had lower frequency of urination at night and lower scores of mental fatigue， cold limbs， lower abdominal discomfort， and loose stool than the control group （P<0.05）. No adverse events associated with the administration of Fuzheng Huaji Longbi decoction were observed during the treatment period. ConclusionFuzheng Huaji Longbi decoction is effective in treating BPH in the patients with the syndrome of healthy qi deficiency and blood stasis. It can relieve the clinical symptoms and improve the quality of life， being a safe and reliable choice for clinical application.

【Objective】 To understand the current situation of social emotional competence of infants and toddlers, and analyze its relationship with home rearing environment, in order to provide the basis for improving the level of infant social emotional development. 【Method】 A study was conducted on 390 individuals from a child health institution in Hubei and Henan provinces.The "Infant and Toddler Social-Emotional Assessment Scale" and "1 - 3 Years Child Home Rearing Environment Scale" were used to investigate the social emotions ability and home rearing environment of infants and toddlers. 【Results】 A total of 390 valid questionnaires were collected in this survey, of which 199 were boys (51.0%) and 191 girls (49.0%). The average age of infants was (27.13±6.86)months.The age distribution is mainly among infants and young children aged 24 to 36 months, with a total of 305 people (78.2%). The caregiver′s registered residence (Z=-3.570), father′s education level (H=17.106), mother′s education level (H=7.980), per capita monthly income of the family (H=13.986), and the home rearing environment (Z=-8.881) had statistical significance on the social emotional competence of infants(P<0.05 or <0.01).There was a significant positive correlation between family rearing environment and infants′ social emotion (r=0.582, P<0.01).Multiple regression analysis showed that the social adaptation/self-care(β=0.30, 95%CI: 0.18 - 0.52, P<0.01)and language cognition dimensions(β=0.22, 95%CI: 0.07 - 0.59, P<0.05) in the home rearing environment had a statistically significant impact on the social emotional ability of infants and toddlers. 【Conclusion】 The home rearing environment is closely related to the social emotional development of infants and young children.Improve the parenting knowledge and skills of the main caregivers of infants and young children, build a good family rearing environment for infants and young children, which is beneficial to promote the development of children′s social emotions.

The quality control of the surgical pathway for colorectal cancer is closely related to reducing the incidence of postoperative complications, recurrence and metastasis, prolonging survival, and preserving functions. This pathway involves multiple disciplines, stages, and contents: standardizing the diagnosis and treatment process for colorectal cancer is crucial to ensuring medical quality and safety. Strengthening perioperative management is an important essential step for accelerating postoperative recovery and improving patient prognosis. Establishing a standard training program and effective inspection system is guarantee for the quality of colorectal cancer surgery.

OBJECTIVE: To observe the clinical efficacy of auricular point sticking therapy combined with antibiotics for pediatric bacterial pneumonia of wind-heat accumulating in lung. METHODS: Ninety-four children with bacterial pneumonia were divided into an observation group (47 cases, 3 cases dropped out) and a control group (47 cases, with 4 cases terminated). The patients in the control group were treated with intravenous drip of latamoxef sodium injection, twice daily for 7 days. The patients in the observation group were treated with auricular point sticking therapy in addition to the treatment given to the control group. Acupoints selected included Fei (CO₁₄), Qiguan (CO₁₆), Jiaogan (AH_6a), Shenshangxian (TG_2P), and Shenmen (TF₄), with treatment applied once daily, alternating ears, for 7 days. The TCM syndrome scores, Canadian acute respiratory illness and flu scale (CARIFS) scores, and levels of white blood cell count (WBC), C-reactive protein (CRP), and procalcitonin (PCT) were compared before and after treatment between the two groups, along with clinical efficacy. RESULTS: Compared before treatment, both groups showed a reduction in TCM syndrome scores, CARIFS scores, and levels of WBC, CRP, and PCT after treatment (P<0.05). Compared with the control group, the observation group had lower TCM syndrome scores in fever, cough, expectoration, lung auscultation, sneezing, runny nose, sleep, and bowel symptoms, as well as lower CARIFS scores in fever, cough, nasal congestion and runny nose, and irritability (P<0.05). The curative and remarkably effective rate was 70.5% (31/44) in the observation group, which was higher than 44.2% (19/43) in the control group (P<0.05). CONCLUSION Auricular point sticking therapy combined with antibiotics is more effective in improving symptoms such as fever, cough, and runny nose in children with bacterial pneumonia of wind-heat accumulating in lung.
Humans ; Male ; Female ; Acupuncture Points ; Child, Preschool ; Child ; Pneumonia, Bacterial/drug therapy* ; Acupuncture, Ear ; Infant ; Treatment Outcome ; Anti-Bacterial Agents/administration & dosage* ; Combined Modality Therapy

Objective:To analyze the risk factors of clinically significant bleeding in patients with severe acute pancreatitis (SAP).Methods:The clinical data of SAP patients who were managed at Changhai Hospital affiliated to Naval Medical University from January 1, 2014 to October 31, 2022 were retrospectively analyzed. Twenty-nine SAP patients with clinically significant bleeding were classified to form the bleeding group. There were 23 males and 6 females, aged (56.25±14.01) years old. Another 116 SAP patients with similar general data but with no clinically significant bleeding during the same hospitalization period were included to form the non-bleeding group based on a ratio of 1∶4. There were 94 males and 22 females, aged (56.14±13.96) years old in this non-bleeding group. The general data, modified CT severity index (MCTSI), bedside index for severity of acute pancreatitis (BISAP) and other clinical data of the two groups were collected to determine the risk factors of bleeding in SAP patients.Results:Of the 29 patients with bleeding, 6 had gastrointestinal bleeding, 14 had intra-abdominal bleeding, and 9 had mixed bleeding sites, 15 were cured and discharged, and 14 died. All the 29 SAP patients with bleeding received treatment using drugs. In addition, 8 patients underwent successful hemostasis using digital subtraction angiography, 3 underwent successful endoscopic hemostasis, 2 underwent successful surgical hemostasis, and 2 underwent successful conservative drug hemostasis. Multivariate logistic regression analysis showed that SAP patients with higher MCTSI ( OR=1.824, 95% CI: 1.187-2.802), longer prothrombin time (PT) ( OR=3.431, 95% CI: 1.470-8.007) and higher BISAP ( OR=2.286, 95% CI: 1.054-4.957) had an increased risk of bleeding (all P<0.05). Conclusion:The prognosis of SAP patients was compromised with bleeding. High MCTSI, prolonged PT, and high BISAP were independent risk factors for bleeding in SAP patients.

Objective:To analyze the research hotspots and trends in the field of pressure injury support surfaces both domestically and abroad and to provide references for future studies in this domain.Methods:Relevant literature on pressure injury support surfaces indexed in the Web of Science Core Collection, CNKI, Wanfang, and VIP database were retrieved, with the search spanning from January 1, 2010, to February 28, 2023. CiteSpace was utilized to perform a visualization analysis of the amassed data.Results:A total of 307 Chinese articles and 434 English articles were included in the analysis. The United States emerged as the country with the highest number of publications. The General Hospital of Eastern Military Command topped the list in China in terms of the number of publications. Chinese Journal of Modern Nursing and Journal of Tissue Viability were the journals with the highest publication frequencies in China and abroad, respectively. Jiang Qixia was the author with the highest number of publications in China, while Gefen secured this position internationally. The Chinese literature formed 12 clusters and the English literature formed 17, culminating in the identification of 8 meaningful categories (population, location, research type, risk factors, static support surfaces, dynamic support surfaces, intelligent monitoring, and effectiveness evaluation), among which intelligent monitoring was seen as a future research trend. Conclusions:Pressure injury support surfaces have been a research hotspot in recent years both domestically and internationally. It is recommended to promote the development of domestic research on pressure injury preventive care through strategies such as expanding the range of research populations, developing intelligent support surface devices conducive to promotion in collaboration with computer and artificial intelligence disciplines, and carrying out large-scale high-quality original research and corresponding quality improvement projects.