Objective To systematically evaluate the risk factors for postoperative delirium (POD) in patients undergoing pneumonectomy. Methods PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP databases were searched from the inception to November 7, 2024 for cross-sectional studies, case-control studies, and cohort studies on POD in patients undergoing pneumonectomy. Two researchers independently screened the literature, extracted data, and evaluated the quality of the literature. RevMan 5.4.1 software was used for meta-analysis. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the literature. Results A total of 12 studies were included, with 5 574 patients. The NOS scores of the literature were all≥6 points. Meta-analysis results showed that age (≥60 years) [OR=2.43, 95%CI (2.01, 2.93), P<0.01], American Society of Anesthesiologists (ASA) classification (Ⅳ) [OR=8.74, 95%CI (5.23, 14.61), P<0.01], history of diabetes [OR=12.81, 95%CI (10.45, 15.71), P<0.01], history of cerebrovascular disease [OR=3.00, 95%CI (2.46, 3.67), P<0.01], depression [OR=7.27, 95%CI (5.46, 9.67), P<0.01], squamous cell carcinoma [OR=4.79, 95%CI (1.83, 12.51), P<0.01], malnutrition [OR=5.25, 95%CI (3.35, 8.25), P<0.01], sleep disorders [OR=2.79, 95%CI (2.28, 3.42), P<0.01], and duration of one-lung ventilation during surgery [OR=1.32, 95%CI (1.11, 1.57), P<0.01] were all risk factors for POD, while high body mass index (BMI) [OR=0.96, 95%CI (0.95, 0.97), P<0.01] was a protective factor for POD. Conclusion Age (≥60 years), ASA classification (Ⅳ), history of diabetes, history of cerebrovascular disease, depression, squamous cell carcinoma, malnutrition, sleep disorders, and duration of one-lung ventilation during surgery are independent risk factors for POD, while high BMI is a protective factor.

Objective To screen the predictors of early initiation of continuous renal replacement therapy(CRRT)in children with sepsis and construct a linear model,based on LASSO regression analysis.Methods A total of 55 children diagnosed with sepsis at Jiangmen Maternity and Child Health Care Hospital from April 2023 to February 2025.They were divided into CRRT group(n=17)and non-CRRT group(n=38)based on CRRT treatment usage.Using LASSO regression screening,predictive factors were identified and a Logistic regression model was established.The model's performance was evaluated using receiver operating characteristic(ROC)curve and calibration curve.Results There were significant differences in age,respiratory rate,body temperature,and mechanical ventilation between two groups(P＜0.05).Through LASSO regression analysis,four independent predictors of respiratory rate,body temperature,blood glucose,and C-reactive protein were identified.The constructed model demonstrated an area under the ROC curve of 0.94(95％CI:0.87-1.00),indicating good calibration accuracy.Conclusion The column line model based on body temperature,respiratory rate,blood glucose and C-reactive protein can effectively predict the need for early initiation of CRRT in sepsis children.

Objective To screen the predictors of early initiation of continuous renal replacement therapy(CRRT)in children with sepsis and construct a linear model,based on LASSO regression analysis.Methods A total of 55 children diagnosed with sepsis at Jiangmen Maternity and Child Health Care Hospital from April 2023 to February 2025.They were divided into CRRT group(n=17)and non-CRRT group(n=38)based on CRRT treatment usage.Using LASSO regression screening,predictive factors were identified and a Logistic regression model was established.The model's performance was evaluated using receiver operating characteristic(ROC)curve and calibration curve.Results There were significant differences in age,respiratory rate,body temperature,and mechanical ventilation between two groups(P＜0.05).Through LASSO regression analysis,four independent predictors of respiratory rate,body temperature,blood glucose,and C-reactive protein were identified.The constructed model demonstrated an area under the ROC curve of 0.94(95％CI:0.87-1.00),indicating good calibration accuracy.Conclusion The column line model based on body temperature,respiratory rate,blood glucose and C-reactive protein can effectively predict the need for early initiation of CRRT in sepsis children.

Objective Neuromuscular electrical stimulation(NMES)-evoked kinesthetic information in muscle spindle can be purely extracted from the mixed motor and sensory afferents using Ischemic nerve block(INB).This study aims to investigate the somatosensory cortical response evoked by NMES activating muscle spindle afferents in forearm.Methods All subjects performed four experimental tasks designed according to a 2×2 factors,including one factor of the INB state(without INB and within INB)and the other of the stimulation intensity(above and below motor threshold).During the experiment,we recorded EEG data with 64 channels and then beta event-related desynchronization(Beta ERD)were utilized quantize somatosensory cortical excitability evoked by the tasks.The subjective perception about the sensation and movement of the right hand were evaluated by a psychophysical test after the right wrist was performed by INB.Results INB significantly reduced beta ERD on the contralateral somatosensory cortex evoked by NMES above the motor threshold,and there was significant difference of NMES-evoked beta ERD values on the contralateral somatosensory cortex between above and below motor threshold.Meanwhile,contralateral dominance of NMES-evoked beta ERD on the somatosensory cortex was transferred to ipsilateral hemisphere under INB.Conclusion INB can significantly reduce NMES-evoked somatosensory cortical response above motor threshold and decrease cortical perception on the stimulus intensity,which may be due to INB resulting in rapid functional reorganization of somatosensory cortex.

Immunotherapy drugs are a class of medications that treat diseases by modulating the function of immune system.As frontline therapies in clinical practice,they play a particularly crucial role in alleviating disease symptoms and improving adverse prognoses caused by severe inflammation.In recent years,with the rapid development of internet technology and the continuous innova-tion in the technology industry,various national directives have been issued,urging schools to strengthen online teaching and promote the development of"Internet+education".Online teaching,unaffected by time or geographical constraints,has facilitated resource sharing and stimulated student interest.However,in practice,both singular online or offline teaching models have their drawbacks.This article takes the severe inflammation immunotherapy drugs as an example,integrating the concept of intersubjectivity in teaching to explore a"two-line"teaching mode in immunotherapy drugs.This study views students as the main body of learning,emphasizes the importance of individual learning,and solves the drawbacks of"one-line"teaching mode.Exploration and application of intersubjective"two-line"teaching mode has guiding significance for educational reform in the internet era.

Background::Transplant renal artery stenosis (TRAS) is a vascular complication after kidney transplantation associated with poor outcomes. This study aimed to analyze the efficacy and safety of low-dose aspirin for preventing TRAS.Methods::After kidney transplantation, patients were enrolled from January 2018 to December 2020 in Henan Provincial People’s Hospital. A total of 351 enrolled recipients were randomized to an aspirin group with low-dose intake of aspirin in addition to standard treatment ( n = 178), or a control group with only standard treatment ( n = 173). The patients was initially diagnosed as TRAS (id-TRAS) by Doppler ultrasound, and confirmed cases were diagnosed by DSA (c-TRAS). Results::In the aspirin and control groups, 15.7% (28/178) and 22.0% (38/173) of the recipients developed id-TRAS, respectively, with no statistical difference. However, for c-TRAS, the difference of incidence and cumulative incidence was statistically significant. The incidence of c-TRAS was lower in the aspirin group compared with the control group (2.8% [5/178] vs. 11.6% [20/173], P = 0.001). Kaplan–Meier estimates and Cox regression model identified the cumulative incidence and hazard ratio (HR) of TRAS over time in two groups, showing that recipients treated with aspirin had a significantly lower risk of c-TRAS than those who were not treated (log-rank P = 0.001, HR = 0.23, 95% confidence interval [CI]: 0.09–0.62). The levels of platelet aggregation rate ( P < 0.001), cholesterol ( P = 0.028), and low-density lipoprotein cholesterol ( P = 0.003) in the aspirin group were decreased compared with the control group in the third-month post-transplantation. For the incidence of adverse events, there was no statistical difference. Conclusion::Clinical application of low-dose aspirin after renal transplant could prevent the development of TRAS with no significant increase in adverse effects.Trial Registration::Clinicaltrials.gov, NCT04260828.

Objective:To investigate the clinical efficacy of posteromedial approach through anterior border of tibialis posterior tendon combined with posterolateral approach in open reduction and internal fixation of Klammer type II/III posterior pilon variant fracture.Methods:A retrospective case series study was conducted on 37 patients with posterior pilon variant fracture treated by posteromedial approach through anterior border of tibialis posterior tendon combined with posterolateral approach in Jiangsu Province People's Hospital and its Liyang branch between January 2015 and December 2019. There were 17 males and 20 females, aged 25-65 years［（49.5±9.3）years］. Klammer classification was type II in 20 patients and type III in 17 patients. The quality of fracture reduction, incision healing and postoperative complications were observed. The loss of fracture reduction or implant failure was detected during the follow-up. The fracture union time was recorded. At the final follow-up, the residual pain was assessed by the visual analogue scale（VAS）and the ankle function by the American Orthopedic Foot and Ankle Society（AOFAS）ankle-hindfoot score.Results:All patients were followed up for 12-20 months［（15.6±1.2）months］. An anatomic fracture reduction was observed in all patients, showing the incision healing by first intention. No skin necrosis, posteromedial neurovascular bundle injury, deep venous thrombosis, checkrein deformity or other complications occurred. During the follow-up, there was no reduction loss or implant failure. The fracture healing time ranged from 11 to 16 weeks［（13.2±1.4）weeks］. At the final follow-up, the VAS was decreased from 6-9 points［（8.0±0.8）points］preoperatively to 0-2 points［（1.2±0.6）points］（ P<0.01）. At the final follow-up, the AOFAS ankle-hindfoot score ranged from 80 to 100 points［（89.7±4.6）points］, which showed excellent results in 15 patients and good in 22 patients, with the excellence rate of 100%. Conclusion:The posteromedial approach through anterior border of tibialis posterior tendon combined with posterolateral approach in open reduction and internal fixation of Klammer type II/III posterior pilon variant fracture can achieve good fracture reduction, with low incidence of complications, pain relief and satisfactory ankle function recovery.

Inositol 1,4,5-trisphosphate receptor 1 (ITPR1) is an important intracellular channel for releasing Ca²⁺. In order to investigate the effects of the ITPR1 overexpression on Ca²⁺ concentration and lipid content in duck uterine epithelial cells and its effects on calcium transport-related genes, the structural domain of ITPR1 gene of duck was cloned into an eukaryotic expression vector and transfected into duck uterine epithelial cells. The overexpression of the ITPR1 gene, the concentration of Ca²⁺, the lipid content, and the expression of other 6 calcium transport-related genes was determined. The results showed that the concentration of Ca²⁺ in uterine epithelial cells was significantly reduced after transfection (P<0.05), the triglyceride content was significantly increased (P<0.01), and the high-density lipoprotein content was significantly decreased (P<0.01). The correlation analysis results showed that the overexpression of the C-terminal half of the ITPR1 gene was significantly positively correlated with the total cholesterol content (P<0.01), which was significantly positively correlated with the low-density lipoprotein content (P<0.05). The overexpression of the N-terminal half of the ITPR1 gene was significantly positively correlated with the triglyceride content (P<0.01), which was significantly negatively correlated with the concentration of Ca²⁺ (P<0.05). RT-qPCR results of 6 calcium transport-related genes showed that the overexpression of the C-terminal half of the ITPR1 gene significantly inhibited the expression of the IP3R2, VDAC2 and CAV1 genes, and the overexpression of the N-terminal half of the ITPR1 gene significantly promoted the expression of the IP3R3 and CACNA2D1 genes. In conclusion, the ITPR1 gene overexpression can promote Ca²⁺ release in duck uterus epithelial cells, promote the synthesis of triglyceride, low-density lipoprotein and cholesterol, and inhibit the production of high-density lipoprotein, and the ITPR1 gene overexpression affected the expression of all 6 calcium transport-related genes.
Animals ; Calcium/metabolism* ; Ducks/genetics* ; Epithelial Cells ; Female ; Inositol ; Inositol 1,4,5-Trisphosphate Receptors ; Lipids ; Uterus

Stearoyl-CoAdesaturase-1 (SCD-1) is a key regulator of monounsaturated fatty acid synthesis. It plays a vital role in lipid synthesis and metabolism. Ca²⁺ is an important cation in the body and plays an important role in the organism. The aims of this study were to investigate the correlation of SCD-1 gene overexpression with lipid indexes and calcium ion level. The pcDNA3.1 (+) + SCD-1 +Flag eukaryotic expression vector and cultured duck uterine epithelial cells were co-transfected. The overexpression of SCD-1 gene was measured using the Flag Label Detection Kit. Ca ions and lipid contents were detected through Fluo-3/AM Calcium Ion Fluorescence Labeling method and Lipid Measuring Kit, respectively. SCD-1 gene overexpression was negatively correlated with triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C), and positively correlated with Ca ion, total cholesterol (TC), very low-density lipoprotein cholesterol (VLDL-C) and low density lipoprotein cholesterol (LDL-C) levels. Meanwhile, Ca ion was positively correlated with TG, LDL-C and HDL-C contents, and negatively correlated with TC and VLDL-C levels. Overexpression of SCD-1 gene could regulate Ca ion secretion, as well as lipid synthesis and transport in duck uterine epithelial cells.
Animals ; Calcium ; metabolism ; Coenzyme A Ligases ; genetics ; Ducks ; Epithelial Cells ; chemistry ; enzymology ; Gene Expression ; Ions ; Lipids ; genetics ; Triglycerides ; metabolism

Exosomes are extracellular vesicles released from various cellular sources and are widely present in body fluids. Bioactive substances such as microRNAs, mRNAs, and proteins are encapsulated in exosomes, which can activate various signaling pathways and play important roles in early warning of stroke and neurovascular unit repair. This article reviews the signal transduction of exosomes in cerebral ischemia.