Objective:To compare the efficacy and safety of Rotarex mechanical thrombectomy (Rotarex) combined with drug-coated balloon (DCB) versus percutaneous transluminal angioplasty (PTA) combined with DCB in the treatment of femoropopliteal artery in-stent restenosis (ISR).Methods:A multicenter, prospective, randomized controlled trial was conducted. 46 patients with femoropopliteal artery ISR admitted to five hospitals (Beijing Friendship Hospital, Capital Medical University; Beijing Chaoyang Hospital, Capital Medical University; Beijing Jishuitan Hospital, Capital Medical University; Xuanwu Hospital, Capital Medical University; Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University) from July 2020 to June 2024 were enrolled. Patients were randomly divided into the Rotarex+ DCB group ( n=24) and the PTA+ DCB group ( n=22) using a random number table. The clinical data of the two groups were collected, including clinical characteristics, Fontaine classification, stent placement location, stent duration, and lesion length. The primary endpoint was the target blood vessel patency rate at 6 and 12 months postoperatively; the secondary endpoints included improvement in clinical symptoms (Fontaine classification), rate of reintervention, and safety indicators. Measurement data were expressed as mean±standard deviation ( ± s), and the t-test was used for comparison between groups; count data were expressed as the number of cases and percentages, and intergroup comparisons were performed using the Chi-test or Fisher exact probability method. Results:At 12 months postoperatively, the target blood vessel patency rate in the Rotarex+ DCB group was significantly higher than that in the PTA+ DCB group (81.8% vs 45.5%, P=0.012), and the proportion of patients in Fontaine classification stage I was also higher (86.4% vs 45.5%, P=0.004). The results at the 6-month follow-up were consistent (target blood vessel patency rate: 87.0% vs 59.1%, P=0.035). In terms of safety, no severe complications such as arterial rupture, amputation, or procedure-related death occurred during the perioperative period in either group. During the postoperative follow-up, no amputation or procedure-related deaths occurred in either group. Conclusion:For the treatment of femoropopliteal artery ISR, Rotarex mechanical thrombectomy combined with DCB is significantly superior to PTA+ DCB in terms of 12-month target blood vessel patency rate and improvement of clinical symptoms, with comparable safety.

Objective To develop a novel solid-phase extraction(SPE)method based on a functionalized nanofiber membrane for the efficient co-extraction of structurally diverse antibiotics with markedly different physico-chemical properties from source water,and to establish a high-throughput analysis method by coupling this technique with ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS).Methods A polydopamine and zirconium(Ⅳ)fumarate metal-organic frameworks(MOF-801)co-modified polyacrylonitrile nanofiber membrane(PDA@PAN/MOF-801 NFMs)was prepared as the SPE adsorbent through hybrid electrospinning and dopamine self-polymerization.Critical SPE and UPLC-MS/MS parameters were optimized,and the method was applied to analyze antibiotic contamination in source water samples from 14 sources of centralized drinking water supply in Suzhou,China,to evaluate the practical application potential of the method.Results The PDA@PAN/MOF-801 NFMs adsorbent demonstrated efficient adsorption of 32 antibiotics from 6 classes through multiple retention mechanisms,including synergistic electrostatic interactions,hydrogen bonding,and π-π interactions.In combination with UPLC-MS/MS,the SPE method we developed enabled high-throughput detection of multiple antibiotics in source water,with limits of detection(LOD)being 0.001-0.05 ng/L and limits of quantitation(LOQ)being 0.005-500 ng/L.Spiked recoveries were 70.14%-111.50%.Intra-day relative standard deviation(RSD)was below 14.12%and the inter-day RSD was below 15.07%.The method demonstrated excellent sensitivity,accuracy,and precision.Conclusion In this study,we successfully developed an efficient analytical method based on a novel nanofiber membrane adsorbent.This approach provides a new technical reference for the high-throughput detection of multiple antibiotics in environmental waters and shows promising potential for practical applications.

Background Coal workers' pneumoconiosis is a serious occupational disease in China. Exhaled volatile organic compounds (VOCs) can serve as the "breath fingerprint" of internal pathological processes, which provides a theoretical basis for exhaled VOCs to be used as potential non-invasive biomarkers for early diagnosis of coal workers' pneumoconiosis. Objective To screen out the characteristic VOCs and important characteristic VOCs of exhaled air in patients with coal workers' pneumoconiosis, and to explore the potential of these VOCs as biomarkers for early non-invasive diagnosis of the disease. Methods In this study, 27 VOCs in the exhaled breath of 22 patients with stage I coal workers' pneumoconiosis, 77 workers exposed to dust, and 92 healthy controls were quantitatively detected by thermal desorption gas chromatography-mass spectrometry (TD-GC-MS). Substances with P<0.05 in univariate analysis and variable importance projection (VIP) >1 in supervised orthogonal partial least squares discriminant analysis (OPLS-DA) model were selected as the characteristic VOCs for early diagnosis of coal workers' pneumoconiosis. Age was included in the LASSO regression model as a covariate to screen out important characteristic VOCs, and the diagnostic performance was evaluated by receiver operating characteristic (ROC) curve. Spearman correlation was further used to explore the correlation between important characteristic VOCs and clinical lung function indicators. Results Through univariate analysis and OPLS-DA modeling, 8 VOCs were selected, including 2-methylpentane, 3-methylpentane, n-hexane, methylcyclopentane, n-heptane, methylcyclohexane, 4-methyl-2-pentanone, and 2-hexanone, in exhaled breath of patients with coal workers' pneumoconiosis. The concentrations of 4 VOCs, including 3-methylpentane, n-hexane, 4-methyl-2-pentanone, and 2-hexanone, showed a decreasing trend with the increase of dust exposure years. By LASSO regression, the important characteristic VOCs of the coal workers' pneumoconiosis group and the dust exposure group were n-hexane, methylcyclohexane and 4-methyl-2-pentanone, and the important characteristic VOCs of the coal workers' pneumoconiosis group and the healthy group were 2-methyl-pentane and 4-methyl-2-pentanone. The ROC analysis showed that the area under the curve (AUC) of n-hexane, methylcyclohexane, and 4-methyl-2-pentanone were 0.969, 0.909, and 0.956, respectively, and the AUC of combined diagnosis was 0.988 and its Youden index was 0.961, suggesting that these results can serve as a valuable reference for further research on early diagnosis. The Correlation analysis found that there was a positive correlation between n-hexane and lung function indicators in the important characteristic VOCs, indicating that it could indirectly reflect the obstruction of lung function ventilation, further proving that important characteristic VOCs have the potential to monitor lung function decline. Conclusion Three important characteristic VOCs selected in this study have the potential to be used as non-invasive biomarkers for early diagnosis and disease monitoring of coal workers' pneumoconiosis, and are worthy of further study and verification.

Objective:To evaluate the efficacy of drug-coated balloons (DCB) in hemodialysis patients with peripheral artery disease (PAD) involving infrapopliteal lesions.Methods:A retrospective analysis was conducted on 53 hemodialysis patients (56 limbs, 66 lesions) with infrapopliteal PAD who underwent DCB treatment between Dec 2018 and Dec 2021. The primary outcome was improvement in Rutherford classification, while secondary outcomes included target lesion revascularization (TLR) and wound healing rate. Safety endpoints were all-cause mortality, amputation-free survival, and amputation rate.Results:The mean lesion length was (145.2±78.4) mm, and 87.5% of patients were of Rutherford grade ≥4. The median follow-up period was 14 months. Rutherford classification significantly improved at 3 and 12 months ( P< 0.001). At 12 months, TLR was 16.6%, wound healing rate was 68.6%, amputation-free survival was 73.2%, all-cause mortality was 19.8%, and amputation rate was 8.9%. Multivariate Cox regression indicated that high WIfI risk ( HR=3.936, 95% CI: 1.079-14.355, P=0.038) was an independent predictor of amputation-free survival. Conclusion:DCB is effective and safe for hemodialysis patients with infrapopliteal artery disease, while high WIfI risk predicts poor prognosis.

Objective:To examine the status of self-perceived aging, family function, and fear of disease progression among elderly patients with peptic ulcer disease (PUD), and to explore the mediating role of self-perceived aging in the relationship between family function and fear of disease progression.Methods:This was a cross-sectional study. Using a convenience sampling method, a total of 307 elderly patients with PUD hospitalized in the Third Hospital of Bethune, Jilin University between December 2023 and May 2024 were included. Data were collected using the General Information Questionnaire, the Brief Ageing Perceptions Questionnaire (B-APQ), the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), and the Chinese version of the Family Adaptability and Cohesion Evaluation Scales (FACES II-CV). The PROCESS macro in SPSS was used to construct and validate a mediation model to assess the mediating effect of self-perceived aging between family function and fear of disease progression among elderly patients with PUD.Results:A total of 307 questionnaires were distributed, with 276 valid responses obtained (effective response rate: 89.90%). The B-APQ score was (53.79±18.30), the FACES II-CV score was (92.17±16.39), and the FoP-Q-SF score was (30.16±6.02). Family function negatively predicted fear of disease progression directly, with a direct effect value of -0.083, accounting for 44.15% of the total effect (-0.083/-0.188). Self-perceived aging exerted a significant mediating effect between family function and fear of disease progression, with an indirect effect value of -0.105, representing 55.85% of the total effect (-0.105/-0.188) .Conclusions:This study reveals the mediating role of self-perceived aging in the relationship between family function and fear of disease progression in elderly PUD patients. The findings enrich the explanatory dimensions of psychosocial models in chronic disease management and underscore the importance of addressing family dynamics and aging perceptions in designing comprehensive interventions for elderly patients with digestive diseases.

Objective:To examine the status of self-perceived aging, family function, and fear of disease progression among elderly patients with peptic ulcer disease (PUD), and to explore the mediating role of self-perceived aging in the relationship between family function and fear of disease progression.Methods:This was a cross-sectional study. Using a convenience sampling method, a total of 307 elderly patients with PUD hospitalized in the Third Hospital of Bethune, Jilin University between December 2023 and May 2024 were included. Data were collected using the General Information Questionnaire, the Brief Ageing Perceptions Questionnaire (B-APQ), the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), and the Chinese version of the Family Adaptability and Cohesion Evaluation Scales (FACES II-CV). The PROCESS macro in SPSS was used to construct and validate a mediation model to assess the mediating effect of self-perceived aging between family function and fear of disease progression among elderly patients with PUD.Results:A total of 307 questionnaires were distributed, with 276 valid responses obtained (effective response rate: 89.90%). The B-APQ score was (53.79±18.30), the FACES II-CV score was (92.17±16.39), and the FoP-Q-SF score was (30.16±6.02). Family function negatively predicted fear of disease progression directly, with a direct effect value of -0.083, accounting for 44.15% of the total effect (-0.083/-0.188). Self-perceived aging exerted a significant mediating effect between family function and fear of disease progression, with an indirect effect value of -0.105, representing 55.85% of the total effect (-0.105/-0.188) .Conclusions:This study reveals the mediating role of self-perceived aging in the relationship between family function and fear of disease progression in elderly PUD patients. The findings enrich the explanatory dimensions of psychosocial models in chronic disease management and underscore the importance of addressing family dynamics and aging perceptions in designing comprehensive interventions for elderly patients with digestive diseases.

Objective:To evaluate the efficacy of drug-coated balloons (DCB) in hemodialysis patients with peripheral artery disease (PAD) involving infrapopliteal lesions.Methods:A retrospective analysis was conducted on 53 hemodialysis patients (56 limbs, 66 lesions) with infrapopliteal PAD who underwent DCB treatment between Dec 2018 and Dec 2021. The primary outcome was improvement in Rutherford classification, while secondary outcomes included target lesion revascularization (TLR) and wound healing rate. Safety endpoints were all-cause mortality, amputation-free survival, and amputation rate.Results:The mean lesion length was (145.2±78.4) mm, and 87.5% of patients were of Rutherford grade ≥4. The median follow-up period was 14 months. Rutherford classification significantly improved at 3 and 12 months ( P< 0.001). At 12 months, TLR was 16.6%, wound healing rate was 68.6%, amputation-free survival was 73.2%, all-cause mortality was 19.8%, and amputation rate was 8.9%. Multivariate Cox regression indicated that high WIfI risk ( HR=3.936, 95% CI: 1.079-14.355, P=0.038) was an independent predictor of amputation-free survival. Conclusion:DCB is effective and safe for hemodialysis patients with infrapopliteal artery disease, while high WIfI risk predicts poor prognosis.

This article reports the pharmacotherapy process of a clinical pharmacist participating in the treatment of acute liver injury caused by nintedanib in a patient with lung cancer complicated with interstitial pneumonia.Clinical pharmacist analyzed the rapid increase of liver enzymes in patients by excluding their past drug use history,stopping suspicious drugs and searching domestic and foreign literature,and determined that the association with nidanib was very likely according to RUCAM scale.The clinical pharmacies suggesteded stopping nintedanib and taking liver protection treatment actively.The clinician adopted the suggestion,and finally the patient's liver function improved after 20 days of treatment.Clinical pharmacists demonstrate their value by analyzing the causes and characteristics of liver injury in patients,assisting physicians in the timely identification and management of adverse reactions,and participating in clinical practice.This article can provide a reference for the diagnosis and treatment of similar cases of acute liver injury.

Objective To preliminarily explore the efficacy of chimeric antigen receptor T cells(CAR-T)targeting CD 123 in the treatment of acute myeloid leukemia(AML)and the role of dasatinib in the treatment of CD123 targeting CAR-T induced side effects.Methods Clinical data of 1 patient with relapsed AML admitted to No.920 Hospital of PLA Joint Logistic Support Force in September,2019 were collected.The patient relapsed after previous multi-line chemotherapy and was treated with CD123 targeting CAR-T therapy.The routine blood changes of the patient after treatment were observed.Dasatinib was used when agranulocytosis occurred,40 mg orally 3 times per day,and was stopped when agranulocytosis was relieved.Changes in blood cells,CAR-T amplification,and disease control were observed.The patient was followed up for over 1 year.Results Flow cytometry for bone marrow showed that minimal residual disease negative result was observed in 30 d after infusion.The patient remained disease-free for over 1 year.After CD 123 CAR-T cells infusion,significant expansion of CAR-T cells was observed,accompanied by granulocyte deficiency and cytokine release syndrome(CRS).After using dasatinib,inhibition of CAR-T cell expansion was observed,accompanied by blood cell recovery,and CRS symptoms were alleviated.After stop of dasatinib,CAR-T cells expanded again and blood cells decreased again.Conclusion CAR-T cells targeting CD 123 have certain efficacy in the treatment for relapsed AML.Dashatinib has a blocking effect on the amplification and function of CAR-T,which can alleviate bone marrow suppression caused by CD 123 targeting CAR-T and avoid severe CRS.

BACKGROUND:Clinical studies have shown that aerobic exercise is an important supplement to the clinical treatment of patients with pulmonary hypertension,which can alleviate the disease condition,increase exercise tolerance and improve the quality of life.However,it is not clear whether patients at different stages of pulmonary hypertension can benefit equally from exercise training. OBJECTIVE:To compare the intervention effects of early or late aerobic training on right heart failure in rats with pulmonary hypertension and explore its possible mechanism. METHODS:Sixty male Wistar rats were randomly divided into control group,model sedentary group,model early exercise group and model late exercise group,with 15 rats in each group.The model of pulmonary hypertension was established by intraperitoneal injection of monocrotaline(60 mg/kg)in the latter three groups.The model early exercise group was given 8 weeks of treadmill aerobic exercise(60%maximum running speed,60 minutes per day,5 days a week)after modeling,while the model late exercise group was trained for 6 weeks after 2 weeks of modeling.The control and model sedentary groups were fed quietly in the rat cage for 8 weeks.After training,the exercise performance,right ventricular hemodynamics,cardiopulmonary function,cardiopulmonary histopathology,reactive oxygen species level in mitochondria,activity of mitochondrial respiratory chain complex and expressions of myocardial tissue proteins were detected. RESULTS AND CONCLUSION:Compared with the model sedentary group,exercise performance and right ventricular function improved(P<0.05),myocardial collagen content,endothelin-1,tumor necrosis factor-α/interleukin-10 ratio and β-myosin heavy chain/α-myosin heavy chain ratio decreased(P<0.05),vascular endothelial growth factor and sarcoplasmic reticulum calcium-adenosine triphosphate enzyme expression increased(P<0.05),immunofluorescence intensity of mitochondrial reactive oxygen species and the protein expression of 3-nitrotyrosine decreased(P<0.05),the activities of complex I,II,IV and V increased in the model early exercise and model late exercise groups(P<0.05),but there were no significant changes in right ventricular maximum pressure,pulmonary acceleration time and pulmonary artery wall area/total vascular area ratio(P>0.05).Compared with the model late exercise group,the model early exercise group further improved exercise performance and right ventricular function,and downregulated collagen content,brain natriuretic peptide protein expression,tumor necrosis factor-α/interleukin-10 ratio and β-myosin heavy chain/α-myosin heavy chain ratio(P<0.05).To conclude,although pulmonary vascular remodeling and right ventricular overload persist in rats with pulmonary hypertension,exercise training at different stages of the disease has a cardioprotective effect.The mechanism is related to the improvement of cardiac remodeling,neurohormone system imbalance,inflammatory response and mitochondrial oxidative stress.Greater benefit is gained from initiating exercise in the early stage of the disease.