Objective To investigate the expression of Tropomyosin 4(TPM4)in thyroid cancer and its effects on the invasion and migration of thyroid cancer cells.Methods The expression level and prognostic value of TPM4 in thyroid cancer were analyzed based on bioinformatics,and its functional involvement was explored through Gene Set Enrichment Analysis(GSEA).In thyroid cancer K1 cells,lentiviral transfection was performed to establish the experimental group(TPM4 shRNA),the negative control group(empty lentiviral transfection),and the control group(untreated).Cell viability and proliferation were assessed using CCK-8 and BrdU assays.Transwell migration and invasion assays were performed to evaluate the effects of TPM4 on the migratory and invasive capacities of thyroid cancer cells.Results TPM4 expression was significantly upregulated in thyroid cancer(P<0.05)and correlated with TNM staging(P<0.05).Patients with higher TPM4 expression in advanced TNM stages exhibited poorer prognosis(P<0.05).GSEA results indicated that high TPM4 expression was enriched in gene sets associated with epithelial-mesenchymal transition,inflammatory response,P53 signaling pathway,and cell cycle.Following TPM4 knockdown in K1 cells,thyroid cancer cell growth was slowed(P<0.01),proliferative activity was decreased(P<0.001),and invasion and migration abilities were significantly impaired(P<0.001).Conclusion TPM4 is highly expressed in thyroid cancer and promotes the invasion and migration capabilities of thyroid cancer cells.

Objective: To explore the mechanism of cistanche deserticola(meat cistanche) in treating Alzheimer′s disease(AD) through network pharmacology, molecular docking, and animal experiments. Methods : Effective components of meat cistanche were mined from the TCMSP database, and AD-related targets were filtered using the SwissTargetPrediction, DisGeNET, and GeneCards databases. The intersection of these targets was analyzed using protein-protein interaction(PPI) networks. Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analyses were conducted via the Metascape database. Molecular docking of meat cistanche′s active components with core targets was performed using AutoDock Vina. Based on network pharmacology predictions, an AD model was established using 8-month-old SAMP8 mice, with Morris water maze tests assessing learning and cognitive functions, Nissl staining observing hippocampal neuron morphology, and enzyme-linked immunosorbent assays and Western blotting detecting the expression levels of cAMP signaling pathway-related proteins in hippocampal tissues. Results : Network pharmacology analysis predicted that meat cistanche might act on 74 AD targets through 8 active components. Molecular docking showed high affinity of active components like acteoside with core targets such as ESR1, BDNF, MAPK1, and APP. KEGG analysis indicated involvement in pathways related to cancer, cAMP signaling, and AD. Animal experiments demonstrated that meat cistanche effectively improved learning and cognitive impairments in AD mice and alleviated hippocampal neuron damage. ELISA and Western blotting results indicated that meat cistanche significantly increased the expression levels of cAMP, PKA, P-CREB in the cAMP pathway and promoted the expression of downstream neurotrophic factor BDNF. Conclusion Meat cistanche can improve learning and cognitive disorders in AD model mice and may exert therapeutic effects on AD by up-regulating the cAMP signaling pathway and the expression of downstream BDNF protein targets, thereby improving hippocampal neuron injury.

Central venous pressure(CVP)is a commonly used hemodynamic index in clinical practice,and the accuracy of its measurement results is influenced by the measurement technical specifications.Based on research evidence and clinical practice,this article interprets the main content of the group standard of CVP measurement technology,and proposes suggestions for its use.It aims to guide clinical nursing staff to correctly understand the principles and methods of CVP measurement,and promote the standardization of nursing practice and the accuracy of measurement results.

Objective A scoping review of studies on pulmonary prehabilitation in cardiac surgery patients was conducted to provide evidence support for the construction of a preoperative pulmonary rehabilitation program for cardiac surgery patients that suitable for China's national conditions.Methods In accordance with the scope review's research methodologies,databases including PubMed,Embase,Web of Science,CINAHL,CNKI and Wanfang were searched by the computer for relevant studies.The deadline for retrieval is from the establishment of databases to June,2024.The included literature was systematically analyzed.Results 26 articles were finally included.Among them,4 were quasi-experiment studies,while the other 22 were randomized controlled trials.Forms of the intervention included comprehensive breathing exercises,inspiratory muscle training,positive expiratory pressure,incentive spirometer training and balloon blowing training.The intervention initiation ranged from 10 weeks to 1 day preoperatively;the outcome measures included postoperative pulmonary complications,lung function metrics,the 6-Minute Walk Test,duration of mechanical ventilation,length of hospital stay,patient-reported outcomes and so on.Conclusion There remains a deficiency in standardized protocols for preoperative pulmonary rehabilitation training among patients undergoing cardiac surgery.High-quality studies should be conducted,and intervention strategies for pulmonary prehabilitation in cardiac surgery patients should be optimized and a unified evaluation standard system should be established.

Dysfunction of the diaphragm is a common problem in mechanically ventilated patients and is closely related to various adverse outcomes.This review summarizes the evaluation methods of diaphragm function,the association between diaphragm dysfunction and adverse clinical outcomes in critically ill mechanically ventilated patients,and the protective effect of diaphragm function on adverse outcomes related to mechanical ventilation.The aim is to provide references for medical staff to optimize evaluation techniques,develop personalized nursing plans,and improve patients' quality of life and health outcomes.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective:To investigate the effect of β-elemene on mitochondrial structure and function of the A549 cells of non-small cell lung cancer(NSCLC),and to elucidate the mechanism of β-elemene in the treatment of NSCLC.Methods:The A549 cells at logarithmic growth stage were divided into blank control group(0 mng·L-1 β-elemene),low,medium and high doses of β-elemene groups(10,25 and 50 mg·L-1),and solvent control group(0.5％ethanol in equal volume).After treatment for 24 h,the cell activities in various groups were detected by MTT assay;the morphology changes of mitochondria in the cells in various groups was observed by transmission electron microscope;the levels of adenosine 5′-triphosphate(ATP)in the cells in various groups were detected by colorimetry;the mitochondrial membrane potential of the A549 cells in various groups were detected by JC-1 flow cytometry;mitochondrial membrane permeability transfer hole assay was used to detect the mitochondrial membrane permeabilities of the cells in various groups.Results:The MTT results showed that compared with blank control group,the cell activities in low,medium and high doses of β-elemene groups were decreased gradually(P＜0.05),while the cell activity in solvent control group had no significant change,and the difference was not significant(P＞0.05).The transmission electron microscope results showed that compared with blank control group,the mitochondria of A549 cells in low,medium and high doses ofβ-elemene groups showed swelling,vacuolation,disordered arrangement and dissolution,while the mitochondrial morphology of the A549 cells in solvent control group had no significant changes.The colorimetric method results showed that compared with blank control group,the ATP levels in the A549 cells in low,medium and high dose β-elemene groups were gradually decreased(P＜0.05),while the ATP level in the A549 cells in solvent control group had no significant change,and the difference was not significant(P＞0.05).The JC-1 flow cytometry method results showed that compared with blank control group,the mitochondrial membrane potential of the A549 cells in low,medium and high doses ofβ-elemene groups were decreased,and the percentages of the cells in Q2-4 region were increased(P＜0.05);the percentage of the A549 cells in the Q2-4 region in solvent control group had no significant change.The results of mitochondrial membrane permeability transfer hole experiment showed that compared with blank control group,the mitochondrial membrane permeabilities of the A549 cells in low,medium and high doses of β-elemene groups were increased,and the percentages of the cells in M4 region were increased(P＜0.05);the mitochondrial membrane permeability of the A549 cells and the percentage of the M4 cells in solvent control group had no significant changes,and the difference was not significant(P＞0.05).Conclusion:β-elemene can inhibit the proliferation of the A549 cells,and the mechanism may be that the mitochondrial structure of A549 cells is damaged by reducing the level of ATP and mitochondrial membrane potential,changing the mitochondrial morphology and increasing the mitochondrial membrane permeability.

OBJECTIVES: To develop a risk prediction model for left ventricular adverse remodeling (LVAR) based on cardiac magnetic resonance (CMR) parameters in patients undergoing percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI). METHODS: A total of 329 acute STEMI patients undergoing primary PCI at 8 medical centers from January, 2018 to December, 2021 were prospectively enrolled. The parameters of CMR, performed at 7±2 days and 6 months post-PCI, were analyzed using CVI42 software. LVAR was defined as an increase >20% in left ventricular end-diastolic volume or >15% in left ventricular end-systolic volume at 6 months compared to baseline. The patients were randomized into training (n=230) and validation (n=99) sets in a 7∶3 ratio. In the training set, potential predictors were selected using LASSO regression, followed by univariate and multivariate logistic regression to construct a nomogram. Model performance was evaluated using receiver-operating characteristic (ROC) curves, area under the curve (AUC), calibration curves, and decision curve analysis. RESULTS: LVAR occurred in 100 patients (30.40%), who had a higher incidence of major adverse cardiovascular events than those without LVAR (58.00% vs 16.16%, P<0.001). Left ventricular global longitudinal strain (LVGLS; OR=0.76, 95% CI: 0.61-0.95, P=0.015) and left atrial active strain (LAAS; OR=0.78, 95% CI: 0.67-0.92, P=0.003) were protective factors for LVAR, while infarct size (IS; OR=1.05, 95% CI: 1.01-1.10, P=0.017) and microvascular obstruction (MVO; OR=1.26, 95% CI: 1.01-1.59, P=0.048) were risk factors for LVAR. The nomogram had an AUC of 0.90 (95% CI: 0.86-0.94) in the training set and an AUC of 0.88 (95% CI: 0.81-0.94) in the validation set. CONCLUSIONS LVGLS, LAAS, IS, and MVO are independent predictors of LVAR in STEMI patients following PCI. The constructed nomogram has a strong predictive ability to provide assistance for management and early intervention of LVAR.
Humans ; Percutaneous Coronary Intervention ; Prospective Studies ; ST Elevation Myocardial Infarction/diagnostic imaging* ; Ventricular Remodeling ; Magnetic Resonance Imaging ; Male ; Female ; Middle Aged ; Risk Factors ; Aged ; Risk Assessment

Objective To explore the immediate recanalization efficacy of flexible endoscopy-assisted retrograde ureteral catheterization for uretero-ileal anastomotic stenosis after Bricker ileal bladder surgery.Method A retrospective analysis was conducted on the clinical data of 17 patients who underwent Bricker ileal bladder surgery in the hospital from November 2016 to October 2022.There were a total of 28 sites of ureterileal anastomotic stenosises,all of which were treated with flexible endoscopy-assisted retrograde ureteral catheterization.Result There were 21 sites who successfully underwent recanalization after endoscopic treatment,the median length of hospital stay was 6(4.75,8.50)days.Among the 28 uretero-ileal anastomotic stenosises,21 sites were successfully recanalized immediately under endoscopy(10 on the left and 11 on the right),while 7 sites failed to recanalize immediately under endoscopy(4 on the left and 3 on the right).The 21 sites of successful immediate recanalization under endoscopy include:15 sites of simple retrograde placement of ureteral catheters,1 site of endoscopic ureterileal anastomotic dilation,net basket stone removal and retrograde stent placement,3 sites of retrograde ureteral stent placement under ultra-fine endoscopy,and 2 sites of retrograde ureteral stent placement under duodenoscopy.The total operation time of all patients was less than 50 minutes.Among the 17 patients,the urine drainage of the ureteral stent was unobstructed.There were varying degrees of abrasions and a small amount of bleeding at the bladder ileal and ureterileal anastomoses.No serious complications such as delayed bleeding,perforation,severe urinary tract infection,stent blockage or displacement occurred.Conclusion Flexible endoscopy-assisted retrograde ureteral catheterization are safe and effective for immediate recanalization of uretero-ileal anastomotic stenosis.It is worth applying in clinical practice.

Objective:To investigate whether changes in CT pulmonary angiography (CTPA) parameters before and after balloon pulmonary angioplasty (BPA) are correlated with treatment effects in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A retrospective study was conducted, including patients with CTEPH who underwent BPA treatment at Beijing Anzhen Hospital from November 2021 to Febbruary 2024. Clinical data and CTPA parameters were analyzed before the initial BPA session and at least 6 months after the final BPA session. Clinical data included WHO functional class, 6-minute walk distance (6MWD), and plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. The CTPA parameters included the widest diameter of the pulmonary artery diameter (dPA), ascending aorta diameter (dAA), the widest transverse diameter of the right atrium (dRA), the widest short-axis diameter of the right ventricle (dRV), the widest short-axis diameter of the left ventricle (dLV), and the diameter of right ventricular free wall thickness(dRVW). Multiple linear regression was applied to identify variables associated with the decrease in mean pulmonary artery pressure (mPAP) among the CTPA parameters.Results:All CTEPH patients underwent a total of 115 BPA treatments. Postoperatively, the WHO functional class of the patients improved compared to preoperative levels ( χ2=5.01, P<0.001), 6MWD improved ( t=4.50, P<0.001), and NT-proBNP levels decreased ( Z=4.47, P<0.001). Hemodynamic parameters, including mPAP, pulmonary vascular resistance, cardiac output, and cardiac index, were significantly improved postoperatively (all P<0.001). CTPA-related parameters, including dPA, dRA, dRV, dRVW, dPA/dAA, dRV/dLV, and dRA/dPA, significantly decreased compared to preoperative values (all P<0.001). Multiple linear regression analysis showed that the decrease in dPA ( β=0.314, P=0.037) and dRA ( β=0.334, P=0.046) were significantly correlated with the improvement in mPAP. Conclusions:Exercise tolerance, hemodynamics, and CTPA parameters in patients with CTEPH significantly improved after BPA treatment. The decrease in dPA and dRA were significantly correlated with the improvement in mPAP, suggesting that CTPA is a potentially novel, objective, effective, and noninvasive method for evaluating the therapeutic efficacy of BPA.