Objective To investigate the relationship of serum levels of neurofilament light chain protein(NFL)and chemerin with cerebral ischemia after interventional therapy in elderly patients with unruptured intracranial aneurysms.Methods A total of 258 patients with unruptured in-tracranial aneurysms undergoing stent-assisted coil embolization in our hospital from January 2020 to January 2024 were enrolled.They were divided into a cerebral ischemia group(52 cases)and a non-cerebral ischemia group(206 cases).The serum NFL and chemerin levels were detected.Multivariate logistic regression analysis was conducted to analyze the risk factors for cerebral is-chemia in the patients after interventional surgery.Results The cerebral ischemia group had sig-nificantly higher ratio of implantation of 3 stents,larger diameter of aneurysms,increased levels of NFL and chemerin before operation,10 min from the start of operation and 24 h after operation,and longer operation time than the non-cerebral ischemia group(P＜0.05,P＜0.01).Larger aneu-rysm diameter,longer operation time,and higher NFL and chemerin levels were the risk factors for cerebral ischemia in patients with unruptured intracranial aneurysm after interventional sur-gery(P＜0.05,P＜0.01).The AUC value of aneurysm diameter,operation time,NFL and chemerin,and combination of these indicators in predicting cerebral ischemia in patients with un-ruptured intracranial aneurysm after interventional surgery was 0.772,0.794,0.826,0.837,and 0.920,respectively,with that of the combination higher than that of each indicator alone(P＜0.05).Conclusion For the elderly patients with unruptured intracranial aneurysms,the increases of serum NFL and chemerin levels are associated with cerebral ischemia after stent-assisted coil embolization,which can predict the risk of cerebral ischemia after interventional therapy.

Objective To investigate the relationship of serum levels of neurofilament light chain protein(NFL)and chemerin with cerebral ischemia after interventional therapy in elderly patients with unruptured intracranial aneurysms.Methods A total of 258 patients with unruptured in-tracranial aneurysms undergoing stent-assisted coil embolization in our hospital from January 2020 to January 2024 were enrolled.They were divided into a cerebral ischemia group(52 cases)and a non-cerebral ischemia group(206 cases).The serum NFL and chemerin levels were detected.Multivariate logistic regression analysis was conducted to analyze the risk factors for cerebral is-chemia in the patients after interventional surgery.Results The cerebral ischemia group had sig-nificantly higher ratio of implantation of 3 stents,larger diameter of aneurysms,increased levels of NFL and chemerin before operation,10 min from the start of operation and 24 h after operation,and longer operation time than the non-cerebral ischemia group(P＜0.05,P＜0.01).Larger aneu-rysm diameter,longer operation time,and higher NFL and chemerin levels were the risk factors for cerebral ischemia in patients with unruptured intracranial aneurysm after interventional sur-gery(P＜0.05,P＜0.01).The AUC value of aneurysm diameter,operation time,NFL and chemerin,and combination of these indicators in predicting cerebral ischemia in patients with un-ruptured intracranial aneurysm after interventional surgery was 0.772,0.794,0.826,0.837,and 0.920,respectively,with that of the combination higher than that of each indicator alone(P＜0.05).Conclusion For the elderly patients with unruptured intracranial aneurysms,the increases of serum NFL and chemerin levels are associated with cerebral ischemia after stent-assisted coil embolization,which can predict the risk of cerebral ischemia after interventional therapy.

Objective:To construct a reliability management model of medical equipment in the department of respiratory and critical care medicine,and to explore its application effect in the management of medical equipment in the department of respiratory and critical care medicine.Methods:Taking the reliability of equipment management content and management methods as evaluation indexes,standardized procedures of equipment use,cleaning and emergency management were formed,and a reliability management model for medical equipment in the department of respiratory and critical care medicine was constructed.A total of 63 medical devices in clinical use in the Department of Respiratory and Critical Care Medicine of Beijing Anzhen Hospital,Capital Medical University from January 2022 to January 2023 were selected.According to different management modes,conventional management mode(32 devices)and reliability management mode(31 devices)were adopted respectively.The equipment management index score,equipment goal achievement degree and equipment management defect rate,and the equipment management recognition scores of the engineers,equipment operation technicians and doctors of equipment use management were compared between the two management modes.Results:The average recognition scores of the engineers,operating technicians and doctors for the use of equipment of the reliability management model were(90.66±5.25)points,(91.54±4.14)points and(92.17±5.17)points,respectively,which were higher than those of the conventional management model,the difference was statistically significant(t=14.249,13.773,12.267,P<0.05).The average scores of equipment resource allocation,information technology,technical support and management performance indicators of the reliability management mode were(90.25±4.12)points,(92.45±3.26)points,(91.47±2.78)points and(90.25±3.11)points,respectively,which were higher than those of conventional management mode,the difference was statistically significant(t=12.122,18.379,15.581,14.141,P<0.05).The average scores of equipment use standardization,cleaning completion and emergency management timeliness of reliability management mode were(92.36±3.25)points,(90.69±3.69)points and(91.87±3.01)points,respectively,which were higher than those of the conventional management mode,the difference was statistically significant(t=14.953,15.030,14.401,P<0.05).The number of equipment damaged,repaired and factory repair of the reliability management mode was 1,1 and 2,respectively,and the defect rates were 3.22%,3.22%and 6.45%,respectively,which were lower than those of the conventional management mode,the difference was statistically significant(x2=8.581,9.908,8.782,P<0.05).Conclusion:The application of reliability-based medical equipment management model to the medical equipment management of respiratory and critical care medicine can improve the quality of equipment management and operation,reduce the failure rate of equipment,and improve the service level of equipment.

Objective:To investigate the efficacy and safety of linaclotide(LIN) combined with polyethylene glycol(PEG) for bowel preparation in patients with functional constipation (FC).Methods:From August 1, 2022 to April 30, 2023, a total of 300 patients with FC (FC group) and 300 subjects with non-functional constipation (NFC, NFC group) undergoing colonoscopy at the Affiliated Hospital of Qingdao University were selected. According to simple random sampling method, both FC group and NFC group were divided into 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup, respectively, with 100 cases in each group and a total of 6 subgroups. All subjects were enrolled based on a random number table and received the corresponding bowel preparation protocols. The Ottawa bowel preparation score (OBPS) and the rate of adequate bowel preparation were calculated. Ordered logistic regression analysis was used to analyze the independent influencing factors of OBPS. The incidence of adverse events (such as bloating) and the repetition rate of regimen intention were analyzed. One-way ANOVA, least significant difference analysis, and chi-square test were used for statistical analysis.Results:The OBPS of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 6.06±1.67, 3.86±2.20, and 4.06±2.03, respectively, while the OBPS of the 3 corresponding subgroups in the NFC group were 5.08±1.92, 3.42±2.04, and 3.63±1.93, respectively. The OBPS scores of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were lower than those of the 3 L PEG subgroup within the respective group, and the differences were statistically significant ( t=7.16, 7.55, 4.59, and 6.06; all P<0.001). The rates of adequate bowel preparation of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 83.0% (78/94), 95.6% (87/91), and 96.8% (92/95), respectively, while the rates of adequate bowel preparation of the 3 subgroups in the NFC group were 88.0% (88/100), 96.9%(94/97), and 97.0%(96/99), respectively. The rates of adequate bowel preparation of 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were higher than those of the 3 L PEG subgroup in the respective group, and the differences were statistically significant( χ2=10.04, 7.64, 5.74, and 5.55, P=0.001, 0.008, 0.029, 0.029). The FC group was divided into 2 L PEG+ LIN compared to 3 L PEG+ LIN subgroup, as well as 3 L PEG+ LIN compared to 3 L PEG subgroup for ordinal logistic regression analysis, and the result showed that the bowel preparation regimen was an independent influencing factor for OBPS ( OR=0.940 and 3.072, 95% confidence interval 0.368 to 1.483 and 1.564 to 3.252; both P<0.001). The incidence of abdominal distension of the 3 L PEG subgroup in FC group and NFC group was higher than that of the 2 L PEG+ LIN subgroup in the respective group (11.7%(11/94) vs. 3.2%(3/95), 12.0%(12/100) vs. 4.0%(4/99)), and the differences were statistically significant( χ2=5.03 and 4.26, P=0.028 and 0.045). The repetition rates of regimen intention of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC groups were higher than that of the 3 L PEG subgroup in respective group (93.7%(89/95), 93.4%(85/91) vs. 80.9%(76/94); 92.9%(92/99), 92.8%(90/97) vs. 82.0%(82/100)), and the differences were statistically significant ( χ2=5.25, 8.70, 4.31, and 5.40; P=0.009, 0.015, 0.020, and 0.023). Conclusions:The 2 L PEG+ LIN regimen can effectively decrease OBPS, improve qualified rate of bowel preparation and repetition rate of regimen intention, and reduce adverse events and the amount of fluid intake, in order to improve the tolerance and compliance of patients. Therefore, the 2 L PEG+ LIN regimen is recommended as a bowel preparation for colonoscopy in patients with FC.

Objective:To investigate the efficacy and safety of linaclotide(LIN) combined with polyethylene glycol(PEG) for bowel preparation in patients with functional constipation (FC).Methods:From August 1, 2022 to April 30, 2023, a total of 300 patients with FC (FC group) and 300 subjects with non-functional constipation (NFC, NFC group) undergoing colonoscopy at the Affiliated Hospital of Qingdao University were selected. According to simple random sampling method, both FC group and NFC group were divided into 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup, respectively, with 100 cases in each group and a total of 6 subgroups. All subjects were enrolled based on a random number table and received the corresponding bowel preparation protocols. The Ottawa bowel preparation score (OBPS) and the rate of adequate bowel preparation were calculated. Ordered logistic regression analysis was used to analyze the independent influencing factors of OBPS. The incidence of adverse events (such as bloating) and the repetition rate of regimen intention were analyzed. One-way ANOVA, least significant difference analysis, and chi-square test were used for statistical analysis.Results:The OBPS of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 6.06±1.67, 3.86±2.20, and 4.06±2.03, respectively, while the OBPS of the 3 corresponding subgroups in the NFC group were 5.08±1.92, 3.42±2.04, and 3.63±1.93, respectively. The OBPS scores of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were lower than those of the 3 L PEG subgroup within the respective group, and the differences were statistically significant ( t=7.16, 7.55, 4.59, and 6.06; all P<0.001). The rates of adequate bowel preparation of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 83.0% (78/94), 95.6% (87/91), and 96.8% (92/95), respectively, while the rates of adequate bowel preparation of the 3 subgroups in the NFC group were 88.0% (88/100), 96.9%(94/97), and 97.0%(96/99), respectively. The rates of adequate bowel preparation of 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were higher than those of the 3 L PEG subgroup in the respective group, and the differences were statistically significant( χ2=10.04, 7.64, 5.74, and 5.55, P=0.001, 0.008, 0.029, 0.029). The FC group was divided into 2 L PEG+ LIN compared to 3 L PEG+ LIN subgroup, as well as 3 L PEG+ LIN compared to 3 L PEG subgroup for ordinal logistic regression analysis, and the result showed that the bowel preparation regimen was an independent influencing factor for OBPS ( OR=0.940 and 3.072, 95% confidence interval 0.368 to 1.483 and 1.564 to 3.252; both P<0.001). The incidence of abdominal distension of the 3 L PEG subgroup in FC group and NFC group was higher than that of the 2 L PEG+ LIN subgroup in the respective group (11.7%(11/94) vs. 3.2%(3/95), 12.0%(12/100) vs. 4.0%(4/99)), and the differences were statistically significant( χ2=5.03 and 4.26, P=0.028 and 0.045). The repetition rates of regimen intention of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC groups were higher than that of the 3 L PEG subgroup in respective group (93.7%(89/95), 93.4%(85/91) vs. 80.9%(76/94); 92.9%(92/99), 92.8%(90/97) vs. 82.0%(82/100)), and the differences were statistically significant ( χ2=5.25, 8.70, 4.31, and 5.40; P=0.009, 0.015, 0.020, and 0.023). Conclusions:The 2 L PEG+ LIN regimen can effectively decrease OBPS, improve qualified rate of bowel preparation and repetition rate of regimen intention, and reduce adverse events and the amount of fluid intake, in order to improve the tolerance and compliance of patients. Therefore, the 2 L PEG+ LIN regimen is recommended as a bowel preparation for colonoscopy in patients with FC.

Objective:To construct a quantitatively diagnostic nomogram model by analyzing the clinical information of patients and the features of multi-modality ultrasound images of thyroid lesions, so as to preoperatively predict the malignant probability of suspicious thyroid nodules and provide effective references for clinical decision-making.Methods:A total of 933 patients, 1 121 thyroid nodules of C-TIRADS 3-5 categories, who underwent surgery in the Second Affiliated Hospital of Harbin Medical University from September 1, 2020 to June 10, 2021 were collected. The nodules were randomly divided into training ( n=897) and test groups ( n=224) in 8∶2 ratio. Finally, the diagnostic performance was evaluated by area under the curve (AUC). Results:①After preliminary screening by univariate analysis, multivariate analysis showed that age, echogenicity, orientation, echogenic foci, margin, posterior features, and elastic score were significantly correlated with benign and malignant nodules (all P<0.001), and the difference of halo between benign and malignant nodules was also statistically significant ( P=0.012). ②The AUC of nomogram was up to 0.903(95% CI=0.862-0.944) in the test set, and 0.889(95% CI=0.832-0.946) and 0.960(95% CI=0.925-0.994) in nodules with maximum diameter of ≤10 mm and of >10 mm respectively, which showed high diagnostic performance. Conclusions:The nomogram model could accurately differentiate malignant from benign thyroid nodules preoperatively, with the highest diagnostic performance for the nodules with maximum diameter of >10 mm, and effectively avoid the unnecessary fine-needle biopsy and surgical operation.

OBJECTIVE: To compare the mRNA level of cell proliferation-related genes Twist1, SIRT1, FGF2 and TGF-β3 in placenta mesenchymal stem cells (PA-MSCs), umbilical cord mensenchymals (UC-MSCs) and dental pulp mesenchymal stem cells (DP-MSCs). METHODS: The morphology of various passages of PA-MSCs, UC-MSCs and DP-MSCs were observed by microscopy. Proliferation and promoting ability of the three cell lines were detected with the MTT method. Real-time PCR (RT-PCR) was used to determine the mRNA levels of Twist1, SIRT1, FGF2, TGF-β3. RESULTS: The morphology of UC-MSCs and DP-MSCs was different from that of PA-MSCs. Proliferation ability and promoting ability of the PA-MSCs was superior to that of UC-MSCs and DP-MSCs. In PA-MSCs, expression level of Twist1 and TGF-β3 was the highest and FGF2 was the lowest. SIRT1 was highly expressed in UC-MSCs. With the cell subcultured, different expression levels of Twist1, SIRT1, FGF2, TGF-β3 was observed in PA-MSCs, UC-MSCs and DP-MSCs. CONCLUSION Up-regulated expression of the Twist1, SIRT1 and TGF-β3 genes can promote proliferation of PA-MSCs, UC-MSCs and DP-MSCs, whilst TGF-β3 may inhibit these. The regulatory effect of Twist1, SIRT1, FGF2 and TGF-β3 genes on PA-MSCs, UC-MSCs and DP-MSCs are different.
Cell Differentiation ; Cell Proliferation/genetics* ; Cells, Cultured ; Dental Pulp/cytology* ; Female ; Fibroblast Growth Factor 2/genetics* ; Humans ; Mesenchymal Stem Cells/cytology* ; Nuclear Proteins/genetics* ; Placenta/cytology* ; Pregnancy ; Sirtuin 1/genetics* ; Transforming Growth Factor beta3/genetics* ; Twist-Related Protein 1/genetics* ; Umbilical Cord/cytology*

Background: Hydrogen bonding interaction was considered to play a critical role in controlling drug release from transdermal patch. However, the quantitative evaluation of hydrogen bonding strength between drug and polar functional group was rarely reported, and the relationship between hydrogen bonding strength and controlled release capacity of pressure sensitive adhesive (PSA) was not well understood. The present study shed light on this relationship. Methods: Acrylate PSAs with amide group were synthesized by a free radical-initiated solution polymerization. Six drugs, , etodolac, ketoprofen, gemfibrozil, zolmitriptan, propranolol and lidocaine, were selected as model drugs. drug release and skin permeation experiments and pharmacokinetic experiment were performed. Partial correlation analysis, fourier-transform infrared spectroscopy and molecular simulation were conducted to provide molecular details of drug-PSA interactions. Mechanical test, rheology study, and modulated differential scanning calorimetry study were performed to scrutinize the free volume and molecular mobility of PSAs. Results: Release rate of all six drugs from amide PSAs decreased with the increase of amide group concentrations; however, only zolmitriptan and propranolol showed decreased skin permeation rate. It was found that drug release was controlled by amide group through hydrogen bonding, and controlled release extent was positively correlated with hydrogen bonding strength. Conclusion From these results, we concluded that drugs with strong hydrogen bond forming ability and high skin permeation were suitable to use amide PSAs to regulate their release rate from patch.

Objective:To explore the application effect of swallowing-feeding safety management of food flow test on improving postoperative swallowing function recovery of patients with laryngeal neoplasms.Methods:By the convenient sampling method, patients with laryngeal neoplasms who underwent open surgeries in Department of Otolaryngology Head and Neck Surgery in a Class Ⅲ Grade A hospital in Changsha from January to November 2019 were selected as research objects. A total of 33 patients who were admitted to hospital from January to May 2019 were set as the control group while 36 patients who were admitted from June to November 2019 were set as the experimental group. The control group was given regular diet guidance such as food type guidance, eating position and posture guidance, eating environment management, oral nursing and other routine eating guidance. The experimental group adopted a swallowing-feeding evaluation based on routine nursing and used the food flow test method to guide individualized eating plans based on the assessment results. The incidence of irritating cough during eating and days of gastric tube indwelling were compared between two groups. Functional Oral Intake Scale (FOIS) and Visual Analogue Scale (VAS) subjective score of eating sensation were used to compare intervention effects.Results:Difference in the incidence of irritating cough in patients with laryngeal neoplasms between two groups was statistically significant ( P<0.05) . The number of days of gastric tube indwelling in the experimental group was less than that in the control group, and the FOIS and VAS scores were higher than those in the control group, the differences between the two groups were statistically significant ( P<0.05) . Conclusions:Swallowing-feeding safety management of food flow test can provide accurate feeding guidance for patients with laryngeal neoplasms, which can improve the safety of eating, promote the recovery of swallowing function, reduce the retention time of the gastric tube and improve the subjective experience of eating.

[ ABSTRACT] AIM: To observe the effect of circadian rhythms on wound healing of mouse corneal epithelium. METHODS:The C57BL/6 male mice were used in the study.A part of corneal epithelium (2 mm in diameter) was struck off by a golf-like knife to form a round wound area.The dynamics of epithelial healing in the wound area were ob-served under microscope with fluorescein staining.In addition, with related antibodies and DAPI, the dynamic changes of the neutrophils, platelets and dividing cells were also investigated.RESULTS:The healing rates in LL group (12 h light/12 h light) and DD group (12 h dark/12 h dark) were obviously slower than that in LD group (12 h light/12 h dark), mainly showing delayed re-epithelialization, decreased epithelial cells, increased diameter of blood vessel, and delayed re-cruitment of neutrophils and platelets, but more cell number.CONCLUSION:Disruption of circadian rhythms significant-ly inhibits the wound healing of corneal epithelium, mainly through delaying the inflammation and re-epithelialization, but aggravating the inflammatory responses.