Objective To explore the application effects of a discharge planning service program based on King's Goal Attainment Theory in patients undergoing transcatheter heart valve surgery.Methods Using convenience sampling method,80 patients who underwent transcatheter heart valve surgery at a tertiary comprehensive hospital in Zhejiang Province from August 2023 to January 2024 were selected as the research subjects.Among them,40 patients from November 2023 to January 2024 were selected as an experimental group.A discharge preparation service plan for patients undergoing transcatheter heart valve surgery based on King's Goal Attainment Theory was adopted.Totally 40 patients who underwent transcatheter heart valve surgery from August to October 2023 were selected as a control group and underwent routine measures for discharge preparation.The differences in the scores of the discharge preparation scale,discharge guidance quality scale,self-management scale for patients after mechanical heart valve replacement surgery,and unplanned readmission rate were compared between 2 groups before and after intervention.Results During the application of the plan,a total of 2 cases were excluded,and 38 cases were included in the experimental group and 40 cases were included in the control group.After intervention,the experimental group had higher scores in discharge readiness,discharge guidance quality,and self-management ability than the control group,and the differences were statistically significant(P＜0.001).The unplanned readmission rate within 30 days in the experimental group(2.63％)was lower than that in the control group(7.50％),and the difference was not statistically significant(P＞0.05).Conclusion The discharge preparation service plan for patients undergoing transcatheter heart valve surgery based on King's Goal Attainment Theory can improve the discharge preparation,discharge guidance quality,and self-management ability of patients undergoing transcatheter heart valve surgery,and has a positive effect on improving their quality of life.

AIM:To explore the role of miR-195-5p in mediating trastuzumab resistance in gastric cancer and to validate its potential as a therapeutic target along with its target gene GPRC5A.METH-ODS:Trastuzumab-resistant gastric cancer cell lines(NCI-N87 and MKN45)were established.Cell viabili-ty under trastuzumab treatment was assessed us-ing CCK-8 assays.Expression levels of miR-195-5p were determined by RT-qPCR.Transfection with miR-195-5p mimics was performed to evaluate changes in trastuzumab sensitivity and prolifera-tion.GPRC5A expression was also measured by RT-qPCR,and the targeting relationship between miR-195-5p and GPRC5A was confirmed using a dual-lu-ciferase reporter assay.RESULTS:Parental cells showed higher sensitivity to trastuzumab than re-sistant cells,with miR-195-5p expression signifi-cantly lower in the latter.Overexpression of miR-195-5p in resistant cells enhanced trastuzumab sen-sitivity and reduced proliferation.GPRC5A was found to be upregulated in resistant cells,and miR-195-5p directly targeted GPRC5A,affecting cell pro-liferation under trastuzumab treatment.CONCLU-SION:miR-195-5p may regulate trastuzumab sensi-tivity in gastric cancer by targeting GPRC5A,sug-gesting potential as a molecular marker for trastu-zumab therapy guidance.

Objective To explore the value of MRI subtraction technique(ST)for evaluating the efficacy of systemic therapy for advanced hepatocellular carcinoma(HCC)and predicting prognosis after combining with surgery.Methods Totally 35 patients with 39 HCC lesions who received systemic therapy+radical resection were retrospectively collected.Based on preoperative MRI,tumor activity ratio(recorded as tumor activityST)was obtained with ST,while tumor activity value(recorded as tumor activitypathology)was obtained through postoperative pathology,and their correlation was analyzed.The patients were regularly followed up after surgery,and the survival data were recorded.Receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of tumor activityST for predicting patients'survival status.Then the patients were divided into survival benefit group and no survival benefit group according to the cut-off value,and survival analysis was conducted.Results Tumor activityST was positively correlated with tumor activitypathology(r=0.900,P＜0.001).The median follow-up time was 32.93 months,during which 8 patients died,and the median survival time was 29.9 months.The area under the curve(AUC)of tumor activityST for predicting patients'survival status was 0.67,and the cut-off value was 0.36.Thirty patients with tumor activityST＜0.36 were enrolled in survival benefit group,while 5 patients≥0.36 were collected in no survival benefit group.The overall survival in survival benefit group was longer than that in no survival benefit group(P＜0.001).Conclusion MRI ST could be used to non-invasively evaluate the efficacy of systemic therapy for advanced HCC and predict prognosis after combining with surgery.

Objective:To analyze the effects of different doses of butorphanol on prolactin, serotonin and lipid hydrogen peroxide after cesarean section.Methods:A total of 124 women who underwent cesarean section in the Affiliated Hospital of Jining Medical University from January 2023 to January 2024 were prospectatively selected as study subjects, and divided into the study group 1 (41 cases), study group 2 (41 cases) and study group 3 (42 cases) according to random number table method. All three groups underwent patient-controlled analgesia after surgery, and 0.2 mg fentanyl was used as analgesic drug. However, the doses of butorphanol were 100 mg/L in the study group 1, 120 mg/L in the study group 2, and 140 mg/L in the study group 3. The level of PRL and first lactation time before and after surgery were compared among the three groups at different time points, serotonin and LHP levels were compared among the three groups at different time points after surgery, Ramsay and visual analog scale (VAS) scores were compared among the three groups at different time points after surgery, and the occurrence of adverse reactions and satisfaction with analgesic effect were compared among the three groups.Results:At 24, 48 and 72 h after operation, the level of PRL in the study group 3 was higher than that in the study group 2 and study group 1: (383.02 ± 47.57) μg/L vs. (376.39 ± 46.83), (302.88 ± 41.38) μg/L; (412.38 ± 40.22) μg/L vs. (394.82 ± 38.30), (315.09 ± 37.93) μg/L; (434.39 ± 39.39) μg/L vs. (427.48 ± 40.27), (344.39 ± 42.78) μg/L, there were statistical differences ( P<0.05). The first lactation time in the study group 2 and study group 3 was lower than that in the study group 1: (50.31 ± 6.52), (49.54 ± 6.27) h vs. (53.91 ± 8.42) h, there was statistical difference ( P<0.05). At 2 h (T 1), 12 h (T 2), 24 h (T 3) and 48 h (T 4) after surgery, the levels of serotonin in the study group 3, study group 2 and study group 1 were increased successively, and the levels of LHP were decreased successively, there were statistical differences ( P<0.05). At 30 min after surgery (T 0), T 1, T 2, T 3 and T 4, the Ramsay score in the study group 3, study group 2 and study group 1 were increased successively, and the VAS score were decreased successively, there were statistical differences ( P<0.05). There was no significant difference in the incidence of adverse reactions among the three groups ( P>0.05). The total satisfaction of study group 3 was higher than that of study group 2 and study group 1: 92.86%(39/42) vs. 73.17%(30/41), 68.29%(28/41), there was statistical difference ( Z = 2.52, P = 0.008). Conclusions:Butorphanol 140 mg/L has a more significant analgesic effect after cesarean section, and can improve the levels of serum PRL, serotonin and LHP, reduce the occurrence of adverse reactions, and improve the satisfaction of analgesia

Objective:This study aims to investigate the relationship between plague epidemics and environmental factors in Lincang City.Methods:Epidemiological survey data and environmental factors (including altitude, temperature, rainfall, and season) from plague occurrence sites in Lincang City from 1990 to 2020 were collected from Lincang Center for Disease Control and Prevention and the data sharing platform of the data sharing service network of the China Meteorological Administration, and analyzed using multiple correspondence analysis (MCA).Results:From 1990 to 2005, a total of 38 outbreaks of plague among rodents had been reported, 17 of which involved human beings. Since 2006, the plague had entered a dormant period, with no further epidemics reported up to 2020. The plague epidemic in Lincang City exhibited a clear seasonal variation, with the primary epidemic season occurred from autumn to early winter, peaking in September and October. Furthermore, the plague epidemic in Lincang City exhibited a pronounced spatial aggregation, with the primary affected regions including Linxiang County, Gengma Dai and Va Autonomous County, Zhenkang County, and Yun County. MCA showed that the Cronbach' α coefficients of all variables in the first and second dimensions were 0.87 and 0.82, respectively, and the characteristic roots were 3.27 and 2.91, respectively. The cumulative contribution rate of the two dimensions was 84.60%. Plague outbreaks were more likely in winter in areas at altitudes of > 1 400 - 1 650 m with 1 000 - 1 200 mm average annual rainfall and 16.0 - 17.9 ℃ average annual temperature, with increased severity. Regions at altitudes of > 500 - 700 m and > 900 - 1 150 m, with average annual rainfall of < 1 000, 1 201 - 1 400 and > 1 600 mm and average annual temperature of 18.0 - 19.9 ℃, showed a higher susceptibility to plague outbreaks, with notably pronounced incidences.Conclusions:The prevalence of plague epidemics is closely related to the local climatic conditions of natural foci in Lincang City. Therefore, it is imperative to enhance the monitoring of these climatic conditions, particularly meteorological data, to facilitate more effective prevention and control of plague outbreaks.

Objective To explore the relationship between the inhibitory effect of quercetin on AC16 cardiomyocyte proliferation and the Wnt/β-catenin signaling pathway,the relationship between quercetin(quercetin,QCT)and the proliferation of AC16 cardiomyocytes through in vitro was investigated.Methods AC16 cells were stimulated with different concentrations of QCT.The effects of QCT on AC16 cell proliferation were detected by inverted microscope photography,trypan blue counting,and CCK-8 assay.Western blot was used to detect the effects of QCT on the expression of phosphorylated β-catenin(p-β-catenin),c-Myc,β-catenin,low density lipoprotein receptor-related protein 5(LRP5),and LRP6.The effect of quercetin on cell proliferation was detected after overexpressing β-catenin ΔN,LRP5,and LRP6 genes,and after silencing LRP5 and LRP6 genes by trypan blue counting.Results Compared with the control group,QCT could decrease the number of AC16 cells and inhibit the proliferation rate,which was concentration-dependent.At the protein expression level,10 and 20 μmol/L QCT led to an significant upregulated modification of p-β-catenin protein(P<0.05)and significant downregulation of c-Myc,β-catenin,LRP5,and LRP6 protein expression(P<0.05)in AC16 cells.Therefore,10 μmol/L QCT was chosen as the intervention concentration.Overexpression of β-catenin ΔN,LRP5,and LRP6 genes in AC16 cells significantly rescued the cell proliferation inhibition caused by 10 μmol/L QCT compared to the drug-only group(P<0.05).Conversely,silencing LRP5 and LRP6 genes led to inhibition of AC16 cell proliferation,and the combination with 10 μmol/L QCT did not exacerbate the inhibition(P>0.05).Conclusion The quercetin could inhibit the Wnt/β-catenin signaling pathway via significant downregulation of LRP5/6,thereby attenuate cell proliferation of AC16 cardiomyocytes.

Objective:This study aims to investigate the relationship between plague epidemics and environmental factors in Lincang City.Methods:Epidemiological survey data and environmental factors (including altitude, temperature, rainfall, and season) from plague occurrence sites in Lincang City from 1990 to 2020 were collected from Lincang Center for Disease Control and Prevention and the data sharing platform of the data sharing service network of the China Meteorological Administration, and analyzed using multiple correspondence analysis (MCA).Results:From 1990 to 2005, a total of 38 outbreaks of plague among rodents had been reported, 17 of which involved human beings. Since 2006, the plague had entered a dormant period, with no further epidemics reported up to 2020. The plague epidemic in Lincang City exhibited a clear seasonal variation, with the primary epidemic season occurred from autumn to early winter, peaking in September and October. Furthermore, the plague epidemic in Lincang City exhibited a pronounced spatial aggregation, with the primary affected regions including Linxiang County, Gengma Dai and Va Autonomous County, Zhenkang County, and Yun County. MCA showed that the Cronbach' α coefficients of all variables in the first and second dimensions were 0.87 and 0.82, respectively, and the characteristic roots were 3.27 and 2.91, respectively. The cumulative contribution rate of the two dimensions was 84.60%. Plague outbreaks were more likely in winter in areas at altitudes of > 1 400 - 1 650 m with 1 000 - 1 200 mm average annual rainfall and 16.0 - 17.9 ℃ average annual temperature, with increased severity. Regions at altitudes of > 500 - 700 m and > 900 - 1 150 m, with average annual rainfall of < 1 000, 1 201 - 1 400 and > 1 600 mm and average annual temperature of 18.0 - 19.9 ℃, showed a higher susceptibility to plague outbreaks, with notably pronounced incidences.Conclusions:The prevalence of plague epidemics is closely related to the local climatic conditions of natural foci in Lincang City. Therefore, it is imperative to enhance the monitoring of these climatic conditions, particularly meteorological data, to facilitate more effective prevention and control of plague outbreaks.

Objective To explore the relationship between the inhibitory effect of quercetin on AC16 cardiomyocyte proliferation and the Wnt/β-catenin signaling pathway,the relationship between quercetin(quercetin,QCT)and the proliferation of AC16 cardiomyocytes through in vitro was investigated.Methods AC16 cells were stimulated with different concentrations of QCT.The effects of QCT on AC16 cell proliferation were detected by inverted microscope photography,trypan blue counting,and CCK-8 assay.Western blot was used to detect the effects of QCT on the expression of phosphorylated β-catenin(p-β-catenin),c-Myc,β-catenin,low density lipoprotein receptor-related protein 5(LRP5),and LRP6.The effect of quercetin on cell proliferation was detected after overexpressing β-catenin ΔN,LRP5,and LRP6 genes,and after silencing LRP5 and LRP6 genes by trypan blue counting.Results Compared with the control group,QCT could decrease the number of AC16 cells and inhibit the proliferation rate,which was concentration-dependent.At the protein expression level,10 and 20 μmol/L QCT led to an significant upregulated modification of p-β-catenin protein(P<0.05)and significant downregulation of c-Myc,β-catenin,LRP5,and LRP6 protein expression(P<0.05)in AC16 cells.Therefore,10 μmol/L QCT was chosen as the intervention concentration.Overexpression of β-catenin ΔN,LRP5,and LRP6 genes in AC16 cells significantly rescued the cell proliferation inhibition caused by 10 μmol/L QCT compared to the drug-only group(P<0.05).Conversely,silencing LRP5 and LRP6 genes led to inhibition of AC16 cell proliferation,and the combination with 10 μmol/L QCT did not exacerbate the inhibition(P>0.05).Conclusion The quercetin could inhibit the Wnt/β-catenin signaling pathway via significant downregulation of LRP5/6,thereby attenuate cell proliferation of AC16 cardiomyocytes.

Objective To explore the value of MRI subtraction technique(ST)for evaluating the efficacy of systemic therapy for advanced hepatocellular carcinoma(HCC)and predicting prognosis after combining with surgery.Methods Totally 35 patients with 39 HCC lesions who received systemic therapy+radical resection were retrospectively collected.Based on preoperative MRI,tumor activity ratio(recorded as tumor activityST)was obtained with ST,while tumor activity value(recorded as tumor activitypathology)was obtained through postoperative pathology,and their correlation was analyzed.The patients were regularly followed up after surgery,and the survival data were recorded.Receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of tumor activityST for predicting patients'survival status.Then the patients were divided into survival benefit group and no survival benefit group according to the cut-off value,and survival analysis was conducted.Results Tumor activityST was positively correlated with tumor activitypathology(r=0.900,P＜0.001).The median follow-up time was 32.93 months,during which 8 patients died,and the median survival time was 29.9 months.The area under the curve(AUC)of tumor activityST for predicting patients'survival status was 0.67,and the cut-off value was 0.36.Thirty patients with tumor activityST＜0.36 were enrolled in survival benefit group,while 5 patients≥0.36 were collected in no survival benefit group.The overall survival in survival benefit group was longer than that in no survival benefit group(P＜0.001).Conclusion MRI ST could be used to non-invasively evaluate the efficacy of systemic therapy for advanced HCC and predict prognosis after combining with surgery.

AIM:To explore the role of miR-195-5p in mediating trastuzumab resistance in gastric cancer and to validate its potential as a therapeutic target along with its target gene GPRC5A.METH-ODS:Trastuzumab-resistant gastric cancer cell lines(NCI-N87 and MKN45)were established.Cell viabili-ty under trastuzumab treatment was assessed us-ing CCK-8 assays.Expression levels of miR-195-5p were determined by RT-qPCR.Transfection with miR-195-5p mimics was performed to evaluate changes in trastuzumab sensitivity and prolifera-tion.GPRC5A expression was also measured by RT-qPCR,and the targeting relationship between miR-195-5p and GPRC5A was confirmed using a dual-lu-ciferase reporter assay.RESULTS:Parental cells showed higher sensitivity to trastuzumab than re-sistant cells,with miR-195-5p expression signifi-cantly lower in the latter.Overexpression of miR-195-5p in resistant cells enhanced trastuzumab sen-sitivity and reduced proliferation.GPRC5A was found to be upregulated in resistant cells,and miR-195-5p directly targeted GPRC5A,affecting cell pro-liferation under trastuzumab treatment.CONCLU-SION:miR-195-5p may regulate trastuzumab sensi-tivity in gastric cancer by targeting GPRC5A,sug-gesting potential as a molecular marker for trastu-zumab therapy guidance.