Objective To investigate the intervention effect of cordycepin on DCM rats and its reg-ulative effect on of AKT/GSK3β signaling pathway.Methods A total of 80 male SD rats were randomly divided into model group,cordycepin group,AKT inhibitor group and cordycepin+AKT inhibitor group,with 20 rats in each group.After the establishment of DCM model,corre-sponding intervention was given to each group.Another 20 healthy rats served as control group.Cardiac function indicators(LVEF,LVFS,LVESD,LVEDD),levels of IL-6,IL-1β,TNF-α,SOD,GSH-Px and MAD,and expression of AKT/GSK3β signaling pathway related proteins were de-termined and compared among the groups blotting.Results The model group had significantly lower LVEF and LVFS,decreased myocardial SOD and GSH-Px contents,and declined p-AKT/AKT and p-GSK3β/GSK3β,but increased LVESD and LVEDD and myocardial IL-6,IL-1β,TNF-αand MAD expression levels when compared with the control group(P＜0.05).Cordycepin treat-ment obtained increased LVEF and LVFS and myocardial tissue SOD,GSH-Px,Bcl-2,p-AKT/AKT and p-GSK3β/GSK3β protein expressions,and decreased LVESD and LVEDD and myocar-dial expression of IL-6,IL-1β,TNF-α,MAD and Bax than the model group(P＜0.05),while AKT inhibitor reversed all the changes induced by modelling(P＜0.05).Combination of cordycepin+AKT inhibitor resulted in lower LVEF,LVFS and myocardial SOD,GSH-Px,Bcl-2,p-AKT/AKT,p-GSK3β/GSK3β protein levels,and increased LVESD,LVEDD and expressions of IL-6,IL-1β,TNF-α,MAD and Bax protein in myocardial tissue when compared with cordycepin group(P＜0.05).And the combination also resulted in increases in LVEF and LVFS[(61.29±5.61)％vs(39.28±4.12)％,(39.05±3.43)％vs(24.47±2.73)％,P＜0.05]and decreases in LVESD and LVEDD(4.36±0.48 mm vs 6.97±0.69 mm,6.07±0.61 mm vs 9.02±0.85mm,P＜0.05)when compared with AKT inhibitor group.Conclusion Cordycepin improves cardiac function,myocar-dial injury,inflammation and oxidative stress in DCM rats probably by activating AKT/GSK3βsignaling pathway,and inhibits the apoptosis of cardiomyocyte.

Objective:To explore the value of amide proton transfer weighted imaging (APTWI) combined with human epidermal growth factor receptor 2 (HER2) expression in predicting pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer.Methods:The study was a cross-sectional study. Clinicopathological [estrogen receptor (ER), progesterone receptor (PR), HER2, Ki-67 status, and molecular subtypes] and imaging data were retrospectively analyzed in 100 female patients who had invasive ductal carcinoma of the breast confirmed pathologically by preoperative puncture in the Henan Cancer Hospital from May 2023 to May 2024. All patients underwent MRI, including enhanced MRI, APTWI, and diffusion-weighted imaging (DWI) before NAC. The reference enhanced MRI images were segmented into lesions using the threshold extraction method, and the three-dimensional region of interest within the tumor was automatically outlined by the software and replicated in the amide proton transfer map generated by APTWI and the apparent diffuse coefficient (ADC) map generated by DWI. The magnetization transfer ratio asymmetry (MTRasym) value and the ADC value were measured, respectively. Tumor response to NAC was assessed using the Miller-Payne grading system, where Grade 5 indicated pCR and Grades 1-4 were classified as non-pCR. Independent sample t-tests and χ2 tests were used to compare clinical pathological and imaging parameters between pCR and non-pCR patients. Statistically significant variables were included in multivariate logistic regression to identify independent predictors of pCR. The diagnostic performance of individual and combined indicators for pCR was evaluated using receiver operating characteristic curves and the area under the curve (AUC). DeLong′s test was used to compare AUCs. Results:There were 39 pCR and 61 non-pCR patients. Significant differences were observed between the pCR and non-pCR patients in molecular subtypes, ER, PR, HER2, and Ki-67 statuses ( P<0.05). Pre-treatment MTRasym values were significantly higher in the pCR patients compared to the non-pCR patients ( P=0.005), whereas ADC values showed no statistical difference ( P=0.372). Multivariate logistic regression analysis showed HER2 positivity ( OR=5.87, 95% CI 1.99-17.30, P=0.001) and MTRasym values>2.61% (OR=4.39, 95% CI 1.37-14.08, P=0.013) was independent predictors of pCR after NAC. HER2 positivity combined with MTRasym value>2.61% predicted pCR after NAC in breast cancer with AUC of 0.819, which was superior to HER2 positivity and MTRasym value alone in predicting efficacy ( Z=3.91, P<0.001; Z=2.63, P=0.009). Conclusions:The MTRasym value of pre-treatment APTWI is valuable in predicting pCR after NAC in breast cancer. APTWI combined with HER2 expression status can further enhance the predictive efficacy.

Objective:To investigate the effect of intraoperative ultrasound-guided nasal bone fracture repair on the clinical outcome of pediatric patients with nasal bone fracture. Methods:A total of 83 patients with nasal bone fracture who underwent prosthesis in our hospital from June 2022 to March 2024 were selected and assigned to control group （endoscopic nasal bone fracture repair） and experimental group （ultrasound-guided nasal bone fracture repair） using random number table method. Both groups were treated with the same nursing measures after surgery. There were 41 cases in the control group and 42 cases in the experimental group. The evaluation parameters of nasal bone fracture, nasal ventilation function, nasal appearance and olfactory function score, postoperative complications and satisfaction were compared between the two groups. Results:The operation time and hospital stay were significantly lower in the experimental group than in the control group （P<0.05）, and secondary repair case （n=0） in the experimental group was significantly less than in the control group （P<0.05）. Compared to preoperative status, the minimum nasal cross-sectional area, nasal volume and total nasal expiratory volume of the two groups increased three months post-operatively, and those in the experimental group were higher （P<0.05）, nasal expiratory and inspiratory resistance, nasal appearance and olfactory disorder scores decreased and those in the experimental group were lower （P<0.05）. The postoperative complications incidence in the experimental group was lower than in the control group （7.14% and 14.63%, respectively, P>0.05）. The overall satisfaction in the experimental group was higher than in the control group（90.48% and 82.93%, respectively, P>0.05）. Conclusion:Ultrasound-guided nasal fracture repair can effectively shorten the operation time, improve the success rate, and promote the postoperative recovery of nasal appearance and nasal function, reduce complications, and enhance the overall satisfaction of children and their families.
Humans ; Nasal Bone/surgery* ; Patient Satisfaction ; Child ; Female ; Male ; Postoperative Complications ; Treatment Outcome ; Postoperative Period ; Fractures, Bone/surgery* ; Ultrasonography

Objective To investigate the intervention effect of cordycepin on DCM rats and its reg-ulative effect on of AKT/GSK3β signaling pathway.Methods A total of 80 male SD rats were randomly divided into model group,cordycepin group,AKT inhibitor group and cordycepin+AKT inhibitor group,with 20 rats in each group.After the establishment of DCM model,corre-sponding intervention was given to each group.Another 20 healthy rats served as control group.Cardiac function indicators(LVEF,LVFS,LVESD,LVEDD),levels of IL-6,IL-1β,TNF-α,SOD,GSH-Px and MAD,and expression of AKT/GSK3β signaling pathway related proteins were de-termined and compared among the groups blotting.Results The model group had significantly lower LVEF and LVFS,decreased myocardial SOD and GSH-Px contents,and declined p-AKT/AKT and p-GSK3β/GSK3β,but increased LVESD and LVEDD and myocardial IL-6,IL-1β,TNF-αand MAD expression levels when compared with the control group(P＜0.05).Cordycepin treat-ment obtained increased LVEF and LVFS and myocardial tissue SOD,GSH-Px,Bcl-2,p-AKT/AKT and p-GSK3β/GSK3β protein expressions,and decreased LVESD and LVEDD and myocar-dial expression of IL-6,IL-1β,TNF-α,MAD and Bax than the model group(P＜0.05),while AKT inhibitor reversed all the changes induced by modelling(P＜0.05).Combination of cordycepin+AKT inhibitor resulted in lower LVEF,LVFS and myocardial SOD,GSH-Px,Bcl-2,p-AKT/AKT,p-GSK3β/GSK3β protein levels,and increased LVESD,LVEDD and expressions of IL-6,IL-1β,TNF-α,MAD and Bax protein in myocardial tissue when compared with cordycepin group(P＜0.05).And the combination also resulted in increases in LVEF and LVFS[(61.29±5.61)％vs(39.28±4.12)％,(39.05±3.43)％vs(24.47±2.73)％,P＜0.05]and decreases in LVESD and LVEDD(4.36±0.48 mm vs 6.97±0.69 mm,6.07±0.61 mm vs 9.02±0.85mm,P＜0.05)when compared with AKT inhibitor group.Conclusion Cordycepin improves cardiac function,myocar-dial injury,inflammation and oxidative stress in DCM rats probably by activating AKT/GSK3βsignaling pathway,and inhibits the apoptosis of cardiomyocyte.

Objective:To explore the value of amide proton transfer weighted imaging (APTWI) combined with human epidermal growth factor receptor 2 (HER2) expression in predicting pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer.Methods:The study was a cross-sectional study. Clinicopathological [estrogen receptor (ER), progesterone receptor (PR), HER2, Ki-67 status, and molecular subtypes] and imaging data were retrospectively analyzed in 100 female patients who had invasive ductal carcinoma of the breast confirmed pathologically by preoperative puncture in the Henan Cancer Hospital from May 2023 to May 2024. All patients underwent MRI, including enhanced MRI, APTWI, and diffusion-weighted imaging (DWI) before NAC. The reference enhanced MRI images were segmented into lesions using the threshold extraction method, and the three-dimensional region of interest within the tumor was automatically outlined by the software and replicated in the amide proton transfer map generated by APTWI and the apparent diffuse coefficient (ADC) map generated by DWI. The magnetization transfer ratio asymmetry (MTRasym) value and the ADC value were measured, respectively. Tumor response to NAC was assessed using the Miller-Payne grading system, where Grade 5 indicated pCR and Grades 1-4 were classified as non-pCR. Independent sample t-tests and χ2 tests were used to compare clinical pathological and imaging parameters between pCR and non-pCR patients. Statistically significant variables were included in multivariate logistic regression to identify independent predictors of pCR. The diagnostic performance of individual and combined indicators for pCR was evaluated using receiver operating characteristic curves and the area under the curve (AUC). DeLong′s test was used to compare AUCs. Results:There were 39 pCR and 61 non-pCR patients. Significant differences were observed between the pCR and non-pCR patients in molecular subtypes, ER, PR, HER2, and Ki-67 statuses ( P<0.05). Pre-treatment MTRasym values were significantly higher in the pCR patients compared to the non-pCR patients ( P=0.005), whereas ADC values showed no statistical difference ( P=0.372). Multivariate logistic regression analysis showed HER2 positivity ( OR=5.87, 95% CI 1.99-17.30, P=0.001) and MTRasym values>2.61% (OR=4.39, 95% CI 1.37-14.08, P=0.013) was independent predictors of pCR after NAC. HER2 positivity combined with MTRasym value>2.61% predicted pCR after NAC in breast cancer with AUC of 0.819, which was superior to HER2 positivity and MTRasym value alone in predicting efficacy ( Z=3.91, P<0.001; Z=2.63, P=0.009). Conclusions:The MTRasym value of pre-treatment APTWI is valuable in predicting pCR after NAC in breast cancer. APTWI combined with HER2 expression status can further enhance the predictive efficacy.

Objective　To study the clinical and epidemiological characteristics of the monkeypox epidemic in Longgang District, Shenzhen, and conduct a comprehensive analysis and discussion to provide a reference for monkeypox epidemic prevention and control. Methods An epidemiological investigation was conducted on 16 monkeypox cases found in the medical institutions of Longgang District on June 2023. The distribution of cases, high-risk exposure characteristics (contact objects, methods, locations, etc.), incidence characteristics, and medical treatment situation were analyzed. Relevant discussions on epidemic prevention and control were further conducted in light of the actual situation and the problems encountered. Results The cases were all unmarried young men and men who have sex with men (MSM) population. The disease was transmitted from person to person through same-sex contact, with non-fixed sexual partners as the source of infection and exposure locations being relatively concealed, and the average incubation period was 8.42 days. Most cases were discovered through active seeking medical attention, accounting for 68.78% (11/16). Fever was the primary initial symptom accounting for 56.25% (9/16), with the main symptoms being a rash and fever, at 100% and 68.75% (11/16), respectively. Time from fever to rash onset was mainly 0-3 days, accounting for 90.91% (10/11). The eruption site involveed multiple different parts of the body, and there was no special order of eruption. The time interval from onset to seeking medical attention and from onset to discovery was similar, with 5.91 days and 5.94 days respectively. The majority of cases were HIV infected, accounting for 68.75% (11/16)。Conclusions The monkeypox epidemic is prevalent in MSM populations and is transmitted through male to male contact through human transmission. However, due to unstable sexual partners and concealed exposure locations, tracing the source is difficult, with an average incubation period of 8.42 days. The symptoms are mainly fever and rash, with a long time from onset to medical treatment. The initial manifestations are mild, leading to missed diagnoses on the first visit, resulting in difficulty in timely discovery and prevention of further cases. At the same time, investigating and handling the epidemic are challenging, making the prevention and control of the outbreak a difficult task.

Objective:To explore the risk factors for lymphoproliferative disorders (PTLD) in children with thalassemia major (TM) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:This was a retrospective case-control study.A total of 482 children with TM who underwent allo-HSCT at Shenzhen Children′s Hospital between January 2020 and December 2022 were selected and classified into the PTLD and non-PTLD groups according to the occurrence of PTLD.The risk factors for PTLD after allo-HSCT in children with TM were analyzed, and the diagnostic efficiency of relevant risk factors for PTLD was analyzed by receiver operating characteristic (ROC) curve.Results:A total of 25 out of 482 patients (5.2%, 25/482) developed PTLD about 114 (54-271) days after allo-HSCT.Among them, 12 cases (12/25, 48.0%) occurred within 100 days, and 22 cases (22/25, 88.0%) occurred within 1 year after allo-HSCT.Univariate analysis showed that there were significant differences in gender composition, type of transplant donor, number of natural killer cells and B lymphocytes in peripheral blood at 30 days after allo-HSCT, positive rate of plasma Epstein-Barr virus deoxyribonucleic acid (EBV-DNA) and incidence rate of acute graft-versus-host disease (aGVHD) between the 2 groups (all P<0.05).Multivariate Logistic regression analysis showed that female ( OR=3.196, 95% CI: 1.144-8.929), positive plasma EBV-DNA ( OR=17.523, 95% CI: 5.449-56.344) and aGVHD ( OR=3.156, 95% CI: 1.161-8.575) were independent risk factors for PTLD after allo-HSCT in TM children (all P<0.05).The ROC curve analysis showed that positive plasma EBV-DNA had an excellent accuracy in predicting the occurrence of PTLD after allo-HSCT (sensitivity was 0.796, specificity was 0.800, area under the curve was 0.803).If combined with aGVHD and gender, the area under the curve for the prediction of PTLD increased to 0.831. Conclusions:Female, positive plasma EBV-DNA and aGVHD are independent risk factors for PTLD after allo-HSCT in children with TM.It provides useful early warnings for the prediction and prevention of PTLD.

Objective:To investigate the effectiveness of suicide prevention cognitive behavioral therapy for depression patients with suicide attempt.Methods:Eligible participants were recruited from the inpatient department of Beijing Huilongguan Hospital from September 2021 to August 2022. A total of 112 patients were randomly allocated into the intervention group (56 cases) and the control group (56 cases) by a random number table. Patients in the intervention group received 12 sessions of cognitive behavioral therapy for suicide prevention over 8 weeks,while participants in the control group received supportive psychotherapy. Patient Health Questionnaire Depression Scale (PHQ-9) and the Beck Scale for Suicide Ideation-Chinese Version (BSI-CV) were used to assess changes in depressive symptoms,suicidal ideation,and suicidal tendencies in both groups at baseline,4-week of treatment,the end of treatment,and at follow-up (weekends 4,8,12). General data and scale scores between the two groups were analyzed by t test,Mann-Whitney rank sum test,and χ 2 test; repeated measure ANOVA were used to assess the baseline and intervention effects. Results:The change of PHQ-9 at each time point of the 2 groups showed a downward trend,and the group x time interaction was significant ( F=2.75, P=0.047). Since the 8th week,the PHQ score in the intervention group was significantly lower than that in the control group ( t=7.03, P<0.05). Time and group effect were significant in the four time points of the total score of suicidal ideation in the last week in BSI-CV ( F=96.78,6.35,both P<0.05),but the interaction between group and time was not significant. At weeks 8 and 12,the scores of the intervention group were lower than those of the control group ( Z=-3.11,-3.30;both P<0.01). In BSI-CV,time effects in the total score of suicidal intention was significant at four time points ( F=11.83, P<0.05),but the interaction between group and time was not significant ( F=2.56, P=0.059). There was no significant difference in suicide tendency between the two groups at each time point ( F=0.001, P=0.975). The total scores of suicidality in 2 groups at 4,8 and 12 weeks were all lower than baseline ( P<0.05). Conclusions:Compared with the control group,the cognitive behavioral therapy for suicide prevention showed superior effects on suicidal ideation and depression,but the intervention effect on suicidal tendency was not significant. Further studies are needed to investigate the long-term effects of cognitive behavioral therapy for suicide prevention in patients with depression who have attempted suicide.

This article reports a case of congenital choanal atresia with additional nostril and nasal deformities admitted to Henan Children's Hospital. A 43-day-old female patient was admitted to the hospital because of wheezing with mouth opening breathing and restricted feeding after birth'. The patient was diagnosis as bilateral congenital posterior nostril membranous atresia, congenital extra nostril nasal deformity and nasal stenosis by fiberoptic nasopharyngoscopy, CT, gene detection, and physical examination results. Under general anesthesia, endoscopic bilateral posterior nostril plasty and left anterior nostril plasty were performed. The child recovered well after operation.
Humans ; Choanal Atresia/surgery* ; Female ; Nasal Cavity/abnormalities* ; Infant ; Nose/surgery* ; Endoscopy/methods*

Objective:To construct an inpatient-outpatient-home step swallowing rehabilitation training program for partial laryngectomy patients.Methods:From June 2022 to May 2023, a preliminary program for inpatient-outpatient-home step swallowing rehabilitation training for partial laryngectomy patients was developed through literature search and analysis. Delphi method was used for two rounds of expert inquiry on the inpatient-outpatient-home step swallowing rehabilitation training program for partial laryngectomy patients.Results:A total of 15 experts were included for two rounds of expert inquiry. The effective response rates of the questionnaires from the two rounds of expert inquiries were 100.0% (15/15). The expert authority coefficients for the two rounds of inquiry were 0.885 and 0.855, respectively, and the Kendall harmony coefficients were 0.217 and 0.230, respectively ( P<0.01). The final inpatient-outpatient-home step swallowing rehabilitation training program for partial laryngectomy patients included three primary items (swallowing training step, swallowing training methods, and feeding guidance methods), 21 secondary items, and 35 tertiary items. Conclusions:The inpatient-outpatient-home step swallowing rehabilitation training program for partial laryngectomy patients based on the Delphi method has certain scientific and feasibility and can provide a reference for medical and nursing staff.