ObjectiveTo investigate the effects of Liuwei Dihuangwan on mammalian target of rapamycin （mTOR）-mediated synaptic plasticity in the prefrontal cortex-hippocampus circuit in the rat model of valproic acid （VPA）-induced autism spectrum disorder （ASD） and to explore its potential mechanism for reducing behavioral abnormalities in ASD rats. MethodsThirteen SD pregnant rats were randomized into the VPA group （10 rats） and the control group （3 rats）. On gestational day 13， the VPA group was intraperitoneally injected with VPA solution （600 mg·kg^-1）， while the control group was injected with an equal volume of normal saline. Male pups of 21 days old from both groups underwent behavioral tests to screen the ASD model rats （32 rats）. These rats were then randomly assigned to the model （distilled water）， vitamin D （1 480 U·kg^-1）， low-dose （0.75 g·kg^-1） Liuwei Dihuangwan， and high-dose （1.5 g·kg^-1） Liuwei Dihuangwan groups， and normal male pups were selected as the blank group （distilled water）， with 8 rats in each group. Each group was treated with the corresponding drug or an equal volume of distilled water via gavage daily. After drug administration， behavioral tests were conducted again， followed by anesthesia and tissue collection. Nissl staining was carried out to observe the morphological changes of neurons in the prefrontal cortex and hippocampus. Transmission electron microscopy was used to observe changes in hippocampal synaptic structure. Immunohistochemistry and Western blot were employed to determine the expression of mTOR， phosphatidylinositol 3-kinase （PI3K）， and protein kinase B （Akt） in the prefrontal cortex， as well as synaptophysin-1 （SYP-1）， postsynaptic density 95 （PSD95）， and N-methyl-D-aspartate receptors （NMDARs） in the hippocampus. ResultsCompared with the control group， the model group exhibited severe growth retardation and developmental deformities， with abnormal behavioral performance and pathological damage to neurons and synapses in the prefrontal cortex and hippocampus. Compared with the model group， all treatment groups showed reduced behavioral abnormalities and pathological damage to neurons and synapses in the prefrontal cortex and hippocampus， with the most significant effects in the high-dose Liuwei Dihuangwan group. Immunohistochemistry and Western blotting results showed that compared with the control group， the model group exhibited significantly increased protein levels and phosphorylation ratios of p-mTOR， p-Akt， and p-PI3K in the prefrontal cortex （P<0.05， P<0.01）， and decreased protein levels of SYP-1 and PSD95 and increased protein level of NMDARs in the hippocampus （P<0.01）. Compared with those in the model group， the protein levels of p-mTOR， p-Akt， and p-PI3K in the prefrontal cortex decreased in the vitamin D and high-dose Liuwei Dihuangwan groups （P<0.05）， and the p-mTOR/mTOR， p-Akt/Akt， and p-PI3K/PI3K ratios in the prefrontal cortex declined in the vitamin D group （P<0.05）. The high-dose Liuwei Dihuangwan group showed a reduction in p-PI3K/PI3K ratio （P<0.05）. The protein level of SYP-1 and PSD95 in the hippocampus increased in the vitamin D， low-dose Liuwei Dihuangwan， and high-dose Liuwei Dihuangwan groups （P<0.05， P<0.01）， while the protein level of NMDARs decreased in the vitamin D and high-dose Liuwei Dihuangwan groups （P<0.01）. ConclusionLiuwei Dihuangwan significantly reduces VPA-induced ASD-like behaviors and enhances the regeneration and repair of neurons in the prefrontal cortex and synaptic structures in the hippocampus by downregulating of PI3K/Akt/mTOR expression in the prefrontal cortex， upregulating SYP-1 and PSD95 expression in the hippocampus， and inhibiting NMDARs expression.

Objective:To systematically evaluate the risk prediction model for readmission in patients after percutaneous coronary intervention, and to provide reference for medical staff to apply or optimize relevant risk assessment tools.Methods:China National Knowledge Infrastructure, VIP, Wanfang Data, China Biomedical Literature Database, and Cochrane Library, PubMed, Embase, CINAHL, Scopus and Web of Science were searched for the related studies on readmission risk prediction models in patients with percutaneous coronary intervention from the establishment of the databases to April 25, 2024. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies.Results:A total of eleven articles were included, involving sixteen readmission risk prediction models, with readmission rates ranging from 0.70% to 31.44% and the areas under subjects′working characteristic curves ranging from 0.604 to 0.899. Calibration methods were reported in ten models, five studies reported processing methods of missing data, and external validation was used in three studies. The overall risk of bias was higher. The top six predictors of repeated reports in the readmitted model were age, renal insufficiency, sex, congestive heart failure, diabetes and health insurance.Conclusions:The readmission risk prediction models had good predictive performance. However, the quality of the model methodology was limited. It is necessary to improve the research quality in data sources, measurement and definition of predictive factors, processing of missing data and model evaluation. In the future, data mining can be used to apply the readmission prediction model in the early stage of admission, so as to identify high-risk patients as early as possible and effectively prevent the occurrence of readmission.

Objective:To systematically evaluate the risk prediction model for readmission in patients after percutaneous coronary intervention, and to provide reference for medical staff to apply or optimize relevant risk assessment tools.Methods:China National Knowledge Infrastructure, VIP, Wanfang Data, China Biomedical Literature Database, and Cochrane Library, PubMed, Embase, CINAHL, Scopus and Web of Science were searched for the related studies on readmission risk prediction models in patients with percutaneous coronary intervention from the establishment of the databases to April 25, 2024. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies.Results:A total of eleven articles were included, involving sixteen readmission risk prediction models, with readmission rates ranging from 0.70% to 31.44% and the areas under subjects′working characteristic curves ranging from 0.604 to 0.899. Calibration methods were reported in ten models, five studies reported processing methods of missing data, and external validation was used in three studies. The overall risk of bias was higher. The top six predictors of repeated reports in the readmitted model were age, renal insufficiency, sex, congestive heart failure, diabetes and health insurance.Conclusions:The readmission risk prediction models had good predictive performance. However, the quality of the model methodology was limited. It is necessary to improve the research quality in data sources, measurement and definition of predictive factors, processing of missing data and model evaluation. In the future, data mining can be used to apply the readmission prediction model in the early stage of admission, so as to identify high-risk patients as early as possible and effectively prevent the occurrence of readmission.

Objective:To explore the "Internet + nursing service" model based on the nurse-patient safety needs, and provide reference for development of "Internet + nursing service".Methods:The First Affiliated Hospital of Sun Yatsen University established a "Internet+ nursing service" management team in December 2019, developed an information platform, formulated and implemented a specific plan of the "Internet+ nursing service" model, including service objects, service projects and service modes. After the smooth operation of this model, the statistics of the nursing service projects and service times that had been carried out from September 2020 to March 2021, as well as the satisfaction of 21 patients who received nursing services would be counted.Results:From September 2020 to March 2021, 21 patients were provided with 55 on-site nursing services, and 151 operations in 16 projects were completed. No nursing-related adverse events occurred. The patients gave all five-star evaluations to the door-to-door service, the satisfaction score was 5 points, and the overall evaluation was 99.88 points.Conclusions:The pilot work of "Internet + nursing service" based on the nurse-patient safety needs has met the care needs of discharged patients and the safety needs of door-to-door services, guarantee the safety of nurses' door-to-door service effectively. And it provides reference for the development and improvement of "Internet + nursing service" related safety work in tertiary A-level hospitals.

Objective To investigate the expression level of serum miR-486-5p in patients with pancreatic cancer and the value of serum miR-486-5p combined with carbohydrate antigen 19-9 (CA19-9) in predicting the resectability of pancreatic cancer. Methods A total of 60 patients who were diagnosed with pancreatic cancer in Qingdao Municipal Hospital from September 2018 to December 2020 were enrolled, among whom 32 patients had resectable or borderline resectable pancreatic cancer (operable group) and 28 had unresectable pancreatic cancer (non-operable group), and a benign pancreatic disease group with 30 patients and a healthy control group with 44 individuals were also established. Quantitative real-time PCR was used to measure the serum level of miR-486-5p in each group, and the relative expression level of miR-486-5p was calculated to analyze its association with the clinical features of pancreatic cancer, including age, sex, tumor location, tumor size, TNM stage, lymphatic metastasis, and distant metastasis. The Mann-Whitney U test was used for comparison of non-normally distributed continuous variables between two groups, and the chi-square test was used for comparison of categorical variables. The receiver operating characteristic (ROC) curve was plotted, and a binary logistic regression analysis was used to calculate the combined predictive value and then investigate the value of serum miR-486-5p combined with CA19-9 in predicting the resectability of pancreatic cancer. Results The relative expression level of serum miR-486-5p in the operable group [2.16 (1.38~3.30)] and the non-operable group [4.65 (2.80~9.90)] was significantly higher than that in the benign pancreatic disease group [1.01 (0.52~1.53)] and the healthy control group [0.99 (0.24~1.01)] (all P < 0.001). There were significant differences in the number of patients with low or high expression of miR-486-5p between the patients with different TNM stages, presence or absence of lymphatic metastasis, and presence or absence of distant metastasis ( χ 2 =13.765, 5.157, and 6.638, all P < 0.05). Compared with CA19-9 alone, miR-486-5p+CA19-9 had a significantly better value in distinguishing the operable group from the benign pancreatic disease group (area under the ROC curve [AUC]=0.87, 95% confidence interval [ CI ]: 0.760-0.942; with a sensitivity of 81.3% and a specificity of 83.3%), distinguishing the operable group from the healthy control group (AUC=0.92, 95% CI : 0.836-0.970; with a sensitivity of 90.6% and a specificity of 86.4%), and distinguishing the operable group from the non-operable group (AUC=0.94, 95% CI : 0.884-0.998; with a sensitivity of 85.7% and a specificity of 93.7%) ( Z =2.841, 2.510, and 2.387, all P < 0.05), and the optimal cut-off values were 3.12, 3.21, and 6.63, respectively. Conclusion MiR-486-5p can be used as a serum biomarker for the diagnosis of pancreatic cancer, and miR-486-5p combined with CA19-9 has a better clinical value than CA19-9 alone in predicting the resectability of pancreatic cancer in the patients with benign pancreatic diseases and the healthy population.

Objective:To explore the status quo of palliative care needs of patients with end-stage heart failure, and analyze its influencing factors.Methods:This study was a cross-sectional study. From December 2019 to December 2020, convenience sampling was used to select 83 patients with end-stage heart failure in a Heart Failure Treatment Center of a Class Ⅲ Grade A hospital in Qingdao as the research object. The General Information Questionnaire and the Palliative Care Needs Scale for Patients with End-stage Heart Failure were used to investigate the patients. Multiple linear regression was used to analyze the influencing factors. A total of 83 questionnaires were distributed and 76 valid questionnaires were returned with the valid response rate of 91.57%.Results:Among 76 patients with end-stage heart failure, the total score of the Palliative Care Needs Scale for Patients with End-stage Heart Failure was (110.87±20.77) , of which the information needs dimension score (29.61±6.69) was the highest. The results of multiple linear regression analysis showed that the serum sodium concentration, the number of comorbidities, and the educational background were the influencing factors of the palliative care needs of patients with end-stage heart failure ( P<0.05) , which explained 30.6% of the total variation of the palliative care needs. Conclusions:Patients with end-stage heart failure have a high demand for palliative care. Nursing staff should provide personalized palliative care for patients with end-stage heart failure according to their own characteristics.

Objective:To explore the expression of serum miR-224-5p in PDAC and its significance for early clinical diagnosis.Methods:From August 2018 to April 2020, 40 patients with PDAC (11 patients with early PDAC, 29 patients with advanced PDAC), 21 patients with chronic pancreatitis and 40 healthy volunteer controls admitted in Qingdao Municipal Hospital were enrolled. The level of serum miR-224-5p in each group was detected by qRT-PCR method, and the correlation with clinicopathological parameters was analyzed. The receiver-operating characteristic (ROC) curve of miR-224-5p, CA19-9 and miR-224-5p combined with CA19-9 were drawn, and the sensitivity and specificity of the diagnosis were calculated.Results:The serum miR-224-5p levels in early PDAC group, middle and late PDAC group, chronic pancreatitis group and healthy control group were 3.21(2.01, 4.60), 4.70(3.50, 8.26), 1.72(1.02, 2.78) and 1.38(0.89, 2.11), respectively; and the level of serum miR-224-5p in the middle and late PDAC group was significantly higher than that in the early PDAC group, and that in the early PDAC group was significantly higher than that in the chronic pancreatitis group and the healthy control group, and all the differences were statistically significant ( P<0.05). The sensitivity of serum miR-224-5p combined with CA19-9, miR-224-5p, and CA19-9 in the diagnosis of overall PDAC was 95.0%, 85.0% and 67.5%, respectively; and the specificity was 70.0%, 82.5% and 87.5%, respectively. The sensitivity for early PDAC was 90.9%, 72.7% and 63.6%, and the specificity was 85.0%, 72.5% and 87.5%, respectively. MiR-224-5p combined with CA19-9 has the highest specificity in the diagnosis of PDAC. The level of serum miR-224-5p in patients with PDAC was correlated with TNM stage, lymph node metastasis and distant metastasis (all P values <0.05). Conclusions:The expression of serum miR-224-5p was significantly up-regulated in patients with early PDAC, and The level of serum miR-224-5p in patients with PDAC was correlated with TNM stage, lymph node metastasis and distant metastasis. The sensitity of serum miR-224-5p and miR-224-5p combined with CA19-9 for early PDAC diagnosis were superior to CA19-9 alone, which can be used as a potential sensitive biological marker for early screening of PDAC.

Objective:To explore patients and nurses' attitude and willingness of "Internet + nursing services", and provide a reference for better "Internet + nursing services".Methods:In July 2019, totally 579 inpatients and 1 176 nurses from The First Affiliated Hospital of Sun Yat-sen University were selected by convenient sampling. A self-designed Questionnaire on the Status Quo of Patients and Nurses' Attitude and Willingness "Internet + Nursing Services" was used to explore the current status of these patients and nurses' willingness and costs of "Internet + nursing services". χ 2 test was employed to compare the differences between the two. Results:Among respondents, totally 73.40% (425/579) patients and 71.09% (836/1 176) nurses agreed to carry out "Internet + nursing services". A total of 45.08% (261/579) patients and 50.26% (591/1 176) nurses thought that the most needed on-site service items were catheter replacement and wound dressing change. Both patients and nurses believed that on-site services were most helpful to patients with immobility, accounting for 56.18% (325/579) and 52.98% (623/1 176) , respectively. The willingness of nurses to provide on-site services was lower than that of patients to receive on-site services. The cost of nurses' on-site services was higher than the patients' willingness to pay. Patients' concerns about medical risks were higher than those of nurses, while their personal safety concerns were lower than those of nurses. Nurses hoped that the time spent on on-site services was shorter than the needs of patients, and the differences were statistically significant ( P<0.05) . Conclusions:Patients and nurses support the development of "Internet + nursing services". Most patients accept nurses to provide on-site services, while some nurses hold a wait-and-see attitude towards on-site services. Moreover, there is a big gap between the two parties in terms of service costs, risks and duration. Therefore, when carrying out "Internet + nursing services", it is necessary to balance the needs of patients and nurses, formulate practical service plans, and satisfy both nurses and patients to achieve a win-win situation.

OBJECTIVE: To investigate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG), measured by preoperative ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT), in risk stratification of patients with endometrial carcinoma (EC). METHODS: The patients with pathological diagnosis of EC who underwent preoperative ¹⁸F-FDG PET/CT imaging were retrospectively selected for analysis of the prognostic values of PET parameters in risk classification and lymph node metastases (LNMs). Receiver-operating-characteristic analysis was used to analyze the correlation of PET parameters cutoff values with deep myometrial invasion (MI), lymphovascular space involvement and LNM for prognostic values in risk stratification. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for detection of LNM are 83.3%, 99.7%, 90.9%, 99.5% and 99.2%, respectively. The MTV and TLG of primary lesion of EC in the patients with LNM are notably higher than those in patients without LNM, p<0.010. The MTV and TLG of the EC primary lesions in high-risk patients are significantly higher than those in low-risk patients (p<0.010), but the maximum standardized uptake value (SUVmax) is not. The MTV and TLG of primary lesions were superior to SUVmax for predicting of deep MI, LNM and high-risk of EC (p<0.005). CONCLUSION: MTV and TLG of primary lesions are more valuable in predicting risk stratification of EC patients. Preoperative ¹⁸F-FDG PET/CT imaging is useful in predicting the LNM of EC and may help guide pelvic lymphadenectomy to avoid unnecessary pelvic lymphadenectomy in EC patients with low-risk stratification.
Classification ; Diagnosis ; Electrons ; Endometrial Neoplasms ; Female ; Glycolysis ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Metabolism ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography ; Retrospective Studies ; Risk Assessment ; Sensitivity and Specificity ; Tumor Burden

Development of new radiopharmaceuticals is crucial for the advance of nuclear medicine and molecular imaging. In recent years, significant progress has been made in the development of radiopharmaceuticals based on radioactive metal nuclides such as ⁶⁴Cu. Copper is a transition metal element necessary for human physiology. Disorders of copper metabolism not only cause hereditary Wilson disease and Menkes disease, but also play an important role in the development of malignant tumors. In addition to radiolabeling for probes, ⁶⁴Cu can be used for PET diagnostic imaging of copper metabolism disorders. ⁶⁴CuCl₂ is a useful radiotracer that can be used to track the dynamic flow of copper ions in human body copper metabolism by PET imaging. In recent years, many preclinical and clinical studies of ⁶⁴CuCl₂ radiotracer have achieved good results, and have attracted a lot of attention in the field of nuclear medicine and molecular imaging. In this article, the progress in the development of ⁶⁴CuCl₂ as a radiotracer for PET diagnostic imaging of hereditary copper metabolism disorders and copper hypermetabolic tumors is reviewed, and further research studies and potential clinical application of ⁶⁴CuCl₂ PET/CT imaging is prospected.