Objective To investigate the radon activity concentrations in subways of Nanning City and assess the average annual effective doses for subway staff and passengers due to radon exposure. Methods Sixty-three stations across the subway lines 2, 3, and 5 were selected as study sites. Radon activity concentrations were measured using the scintillation counting method with scintillation vials. Results The radon activity concentrations in subway lines 2, 3, and 5 were 7.9-24.4, 12.0-26.2, and 12.6-18.2 Bq/m³, respectively. The average radon activity concentrations for these three lines were (17.4 ± 4.6), (19.1 ± 4.1), and (14.6 ± 1.7) Bq/m³, respectively. Statistical analysis using SPSS 26.0 software revealed a significant difference in radon activity concentrations among these stations (P<0.01). Considering the data in previous research, the average radon activity concentration across all stations in the subway lines of Nanning City was determined to be 17.4 Bq/m³. The estimated average annual effective dose due to radon exposure was 0.131 mSv for subway staff and 0.033 mSv for passengers. Conclusion The radon activity concentrations in the subway lines of Nanning City were significantly lower than the national standard limit (400 Bq/m³). The annual effective doses from radon exposure for both subway staff and passengers were below the limits specified in the Basic Standards for Protection Against Ionizing Radiation and for the Safety of Radiation Sources (GB18871—2002). The health impact of radon and its progeny on subway staff and passengers in the subway lines of Nanning City was extremely low and can be considered negligible.

Objective To investigate the effects of salidroside (Sal) on mitochondrial autophagy in ischemic cardiomyopathy (ICM) rats by modulating the PTEN-induced kinase 1 (PINK1)/E3 ubiquitin ligase (Parkin) signaling pathway. Methods Thirty SD rats were randomly divided into control group, model group, low-dose Sal group, high-dose Sal group, mitochondrial autophagy inhibitor (Mdivi-1) group and high-dose Sal + Mdivi-1 group, with five rats in each group. The ICM rat model was established. The left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular end-diastolic diameter (LVIDd) and left ventricular end-systolic diameters (LVIDs) were analyzed. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of lactate dehydrogenase (LDH), cardiac troponin I (cTnI), creatine kinase (CK) and N-terminal pro-brain natriuretic peptide (NT-proBNP). Hematoxylin and eosin (HE) staining was performed to observe pathological changes in myocardial tissue, and transmission electron microscopy was used to examine mitochondrial structure. The levels of reactive oxygen species (ROS), malondialdehyde (MDA) and superoxide dismutase (SOD) were measured. Western blot analysis was conducted to determine the expression levels of microtubule-associated protein light chain 3 (LC3), Beclin1, p62, PINK1 and Parkin in myocardial tissue. Results Compared with the control group, the model group showed more severe myocardial tissue and mitochondrial damage. The LVEF, LVFS, SOD and p62 levels in the model group were significantly lower than those in the control group, while the LVIDd, LVIDs, LDH, cTnI, CK, NT-proBNP, ROS, MDA, LC3II/LC3I, Beclin1, PINK1 and Parkin levels were significantly higher (P < 0.05). Compared with the model group, the low-dose and high-dose Sal groups exhibited reduced myocardial and mitochondrial damage. The LVEF, LVFS, SOD, LC3II/LC3I, Beclin1, PINK1 and Parkin levels in the low-dose and high-dose Sal groups were significantly higher than those in the model group, while the LVIDd, LVIDs, LDH, cTnI, CK, NT-proBNP, ROS, MDA and p62 levels were significantly lower (P < 0.05). Compared with the model group, the Mdivi-1 group showed more severe myocardial and mitochondrial damage. The LVEF, LVFS, SOD, LC3II/LC3I, Beclin1, PINK1 and Parkin levels in the Mdivi-1 group were significantly lower than those in the model group, while the LVIDd, LVIDs, LDH, cTnI, CK, NT-proBNP, ROS, MDA and p62 levels were significantly higher (P < 0.05). Compared with the low-dose Sal group, the high-dose Sal group demonstrated further improvement in myocardial and mitochondrial damage. The LVEF, LVFS, SOD, LC3II/LC3I, Beclin1, PINK1 and Parkin levels in the high-dose Sal group were significantly higher than those in the low-dose Sal group, while the LVIDd, LVIDs, LDH, cTnI, CK, NT-proBNP, ROS, MDA and p62 levels were significantly lower (P < 0.05). Mdivi-1 significantly inhibited mitochondrial autophagy and suppressed the activation of the PINK1/Parkin signaling pathway and the improvement in cardiac function induced by Sal (P < 0.05). Conclusion Sal may improve myocardial injury in ICM rats by activating the PINK1/Parkin signaling pathway and promoting mitochondrial autophagy.

Objective:To examine the clinical value of rapid detection of drug-resistant bacteria by immunochromatography and the effects of rapid detection on the prognosis of patients with severe intra-abdominal infection complicated by carbapenem-resistant Enterobacteriaceae (CRE) bloodstream infection.Methods:This was a retrospective cohort study. We analyzed clinical data of 73 patients with severe abdominal infections with sepsis or septic shock complicated by CRE bloodstream infection admitted to the general surgery department of Jinling Hospital between February 2022 and February 2023. Patients were divided into a colloidal gold immunochromatographic assay (GICA) group (17 patients) and conventional testing group (56 patients) based on whether a GICA for CRE had been performed on the patients' first blood culture sample during the diagnosis and treatment process. There were no statistically significant differences between the GICA and conventional testing groups in age ([55.9±17.3] vs. [47.6±16.4] years), sex ([16 men vs. one woman ] vs. [41 men vs. 15 women]), median Charlson comorbidity index (3.0[2.0,4.0] vs. 3.0[2.0, 4.8]), septic shock (10 vs. 39), or acute kidney injury (8 vs. 40) (all P>0.05). Both groups routinely underwent traditional bacterial identification and drug susceptibility testing. Additionally, patients in the GICA group were tested directly for positive blood cultures using a GICA carbapenemase test kit. The main outcomes were mortality rates on Days 28 and 90 after the first identification of CRE bloodstream infection in both groups. We also compared the microbial clearance rate, duration of hospitalization and intensive care unit stay, and time from onset of CRE bloodstream infection to initiation of targeted and appropriate antibiotics between the two groups. Results:The rate of microbial clearance of bloodstream infection was significantly greater in the GICA group than in the conventional testing group (15/17 vs. 34/56 [60.7%], χ 2=4.476, P=0.034), whereas the 28-day mortality tended to be lower in the GICA than conventional testing group [5/17 vs. 44.6% [25/56], χ 2=1.250, P=0.264). The 90-day mortality (8/17 vs. 53.6% [30/56], χ 2=0.222, P=0.638), median duration of hospitalization (37.0 [18.0, 46.5] days vs. 45.5 [32.2, 64.8] days, Z=-1.867, P=0.062), and median duration of intensive care unit stay (18.0 [6.5, 35.0] days vs. 32.0 [5.0, 51.8] days, Z=-1.251, P=0.209). The median time between the onset of bloodstream infection and administration of antibiotics was 49.0 (38.0, 69.0) hours in the GICA group, which is significantly shorter than the 163.0 (111.8, 190.0) hours in the conventional testing group ( Z=-5.731, P<0.001). The median time between the onset of bloodstream infection and administration of appropriate antibiotics was 40.0 (34.0, 80.0) hours in the GICA group, which is shorter than in the conventional testing group (68.0 [38.2, 118.8]) hours; however, this difference is not statistically significant ( Z=-1.686, P=0.093). Conclusions:GICA can provide information on carbapenemase- producing pathogens faster than traditional drug sensitivity testing, enabling early administration of the optimal antibiotics. The strategy of 'carbapenemase detection first' for managing bacterial infection has the potential to improve prognosis of patients and reduce mortality rate.

Objective:To examine the clinical value of rapid detection of drug-resistant bacteria by immunochromatography and the effects of rapid detection on the prognosis of patients with severe intra-abdominal infection complicated by carbapenem-resistant Enterobacteriaceae (CRE) bloodstream infection.Methods:This was a retrospective cohort study. We analyzed clinical data of 73 patients with severe abdominal infections with sepsis or septic shock complicated by CRE bloodstream infection admitted to the general surgery department of Jinling Hospital between February 2022 and February 2023. Patients were divided into a colloidal gold immunochromatographic assay (GICA) group (17 patients) and conventional testing group (56 patients) based on whether a GICA for CRE had been performed on the patients' first blood culture sample during the diagnosis and treatment process. There were no statistically significant differences between the GICA and conventional testing groups in age ([55.9±17.3] vs. [47.6±16.4] years), sex ([16 men vs. one woman ] vs. [41 men vs. 15 women]), median Charlson comorbidity index (3.0[2.0,4.0] vs. 3.0[2.0, 4.8]), septic shock (10 vs. 39), or acute kidney injury (8 vs. 40) (all P>0.05). Both groups routinely underwent traditional bacterial identification and drug susceptibility testing. Additionally, patients in the GICA group were tested directly for positive blood cultures using a GICA carbapenemase test kit. The main outcomes were mortality rates on Days 28 and 90 after the first identification of CRE bloodstream infection in both groups. We also compared the microbial clearance rate, duration of hospitalization and intensive care unit stay, and time from onset of CRE bloodstream infection to initiation of targeted and appropriate antibiotics between the two groups. Results:The rate of microbial clearance of bloodstream infection was significantly greater in the GICA group than in the conventional testing group (15/17 vs. 34/56 [60.7%], χ 2=4.476, P=0.034), whereas the 28-day mortality tended to be lower in the GICA than conventional testing group [5/17 vs. 44.6% [25/56], χ 2=1.250, P=0.264). The 90-day mortality (8/17 vs. 53.6% [30/56], χ 2=0.222, P=0.638), median duration of hospitalization (37.0 [18.0, 46.5] days vs. 45.5 [32.2, 64.8] days, Z=-1.867, P=0.062), and median duration of intensive care unit stay (18.0 [6.5, 35.0] days vs. 32.0 [5.0, 51.8] days, Z=-1.251, P=0.209). The median time between the onset of bloodstream infection and administration of antibiotics was 49.0 (38.0, 69.0) hours in the GICA group, which is significantly shorter than the 163.0 (111.8, 190.0) hours in the conventional testing group ( Z=-5.731, P<0.001). The median time between the onset of bloodstream infection and administration of appropriate antibiotics was 40.0 (34.0, 80.0) hours in the GICA group, which is shorter than in the conventional testing group (68.0 [38.2, 118.8]) hours; however, this difference is not statistically significant ( Z=-1.686, P=0.093). Conclusions:GICA can provide information on carbapenemase- producing pathogens faster than traditional drug sensitivity testing, enabling early administration of the optimal antibiotics. The strategy of 'carbapenemase detection first' for managing bacterial infection has the potential to improve prognosis of patients and reduce mortality rate.

Objective:To investigate the clinical effect of medial plantar flap combined with free groin flap in the reconstruction of heel defect.Methods:The patients with heel skin and soft tissue defects admitted to the Department of Burns & Plastic and Hand & Foot Surgery of Yulin No.2 Hospital from October 2015 to December 2020 were retrospectively analyzed. After emergency debridement, a plantar medial island flap was used to repair the foot heel defect, a free groin flap was used to repair the medial plantar donor site, and the groin donor site was closed primarily. Postoperatively routine anti-infection, spasmolysis, anticoagulation, expanding treatment were performed after the procedure. The blood supply, survival of the flap, and the healing of the donor area of the flap were observed. The shape and function of the heel were observed in follow-up.Results:Eight patients were enrolled, including 7 males and 1 female, aged from 20 to 71 years, with an average of 32.2 years. There were 5 cases of heel trauma, 1 case of heel squamous cell carcinoma, 1 case of heel frostbite, and 1 case of heel ulcer. The wound area of the heel was 4 cm×3 cm-7 cm×6 cm. The surgical procedure was smooth, and the incision range of the heel island flap and groin flap was 0.5-1.0 cm larger than that of the heel wound. All 8 patients had primary healing after the operation. Follow-up for 3-12 months showed that all patients were satisfied with heel shape, sensory function and walking function. There was no depression, scar hyperplasia, and contracture in the medial plantar donor area, and no local skin ulcer. There is only a linear scar in the groin donor area.Conclusions:Medial plantar island flap combined with a free groin flap can repair the defect of the heel, and the affected foot has good healing, certain sensory function, and satisfactory curative effect.

Objective:To investigate the clinical effect of medial plantar flap combined with free groin flap in the reconstruction of heel defect.Methods:The patients with heel skin and soft tissue defects admitted to the Department of Burns & Plastic and Hand & Foot Surgery of Yulin No.2 Hospital from October 2015 to December 2020 were retrospectively analyzed. After emergency debridement, a plantar medial island flap was used to repair the foot heel defect, a free groin flap was used to repair the medial plantar donor site, and the groin donor site was closed primarily. Postoperatively routine anti-infection, spasmolysis, anticoagulation, expanding treatment were performed after the procedure. The blood supply, survival of the flap, and the healing of the donor area of the flap were observed. The shape and function of the heel were observed in follow-up.Results:Eight patients were enrolled, including 7 males and 1 female, aged from 20 to 71 years, with an average of 32.2 years. There were 5 cases of heel trauma, 1 case of heel squamous cell carcinoma, 1 case of heel frostbite, and 1 case of heel ulcer. The wound area of the heel was 4 cm×3 cm-7 cm×6 cm. The surgical procedure was smooth, and the incision range of the heel island flap and groin flap was 0.5-1.0 cm larger than that of the heel wound. All 8 patients had primary healing after the operation. Follow-up for 3-12 months showed that all patients were satisfied with heel shape, sensory function and walking function. There was no depression, scar hyperplasia, and contracture in the medial plantar donor area, and no local skin ulcer. There is only a linear scar in the groin donor area.Conclusions:Medial plantar island flap combined with a free groin flap can repair the defect of the heel, and the affected foot has good healing, certain sensory function, and satisfactory curative effect.

Objective:To explore the micro RNA (miR)-193b-3p expression in hippocampus tissues of neonatal sepsis rats, as well as its role in neuroinflammatory response and possible mechanisms.Methods:Twenty-four 2-d-old SD rats were randomly divided into control group, lipopolysaccharide (LPS) group, negative control group, and miR-193b-3p group ( n=6); except for the negative control group, the rats in the other 3 groups were intraperitoneally injected with LPS to establish sepsis models; in miR-193b-3p group and NC group, 5 μL miR-193b-3p mimics/controls (20 nmol/L)were injected into the lateral ventricle 3 d before LPS injection. In vitro, PC12 cells were divided into control group, LPS group, miR-193b-3p group, and LPS+miR-193b-3p group; miR-193b-3p mimics were transfected into cells of miR-193b-3p group and LPS+miR-193b-3p group; cells in the LPS group and LPS+miR-193b-3p group were exposed to 100 ng/mL LPS. The miR-193b-3p downstream target gene was analyzed by gene microarray and dual luciferase reporter. Neurobehavioral scale used to assess the neurological function at specific time points in each group. The mRNA expression levels of miR-193b-3p and cytokines (interleukin [IL]-1β, IL-6, tumor necrosis factor [TNF]-α) in the brain tissues or PC12 cells were analyzed by real-time fluorescence quantification PCR (RT-qPCR). The protein expression levels of retinoic acid-related orphan receptor α (RORα), neuronal nuclear antigen (NeuN), ionized calcium binding adaptor molecule-1 (IBA-1) and glial fibrillary acidic protein (GFAP) were detected by double-labelling immunofluorescence. The protein expression levels of RORα in PC12 cells were detected by immunofluorescence staining. Results:(1) Gene microarray and dual luciferase reporter analysis confirmed that RORα was the target gene of miR-193b-3p. (2) As compared with those in rats of the negative control group, the neurobehavioral scores in rats of the LPS group were significantly decreased since 6 h of LPS injection and reached to the lowest at 24 h after LPS ( P<0.05). As compared with those in the negative control group, the IL-1β, IL-6, and TNF-α mRNA expression levels in the hippocampus of LPS group were significantly increased, while the miR-193b-3p expression was significantly decreased ( P<0.05). (3) As compared with those in negative control group (3.23±0.92), the neurobehavioral scores in rats of the miR-193b-3p group (7.51±0.84) 48 h after LPS injection were significantly higher ( P<0.05). As compared with those in the negative control group, the IL-1β, IL-6 and TNF-α mRNA expression levels in the hippocampus of the miR-193b-3p group were significantly deceased, while the miR-193b-3p expression was significantly higher ( P<0.05). (4) As compared with that in negative control group, the number of NeuN(+)RORα(+) cells in the hippocampus of the LPS group was significantly reduced ( P<0.05); as compared with negative control group, miR-193b-3p group had significantly increased number of NeuN(+)RORα(+) cells in the hippocampus ( P<0.05). (5) As compared with the control group, the LPS group had significantly decreased RORα expression, and significantly increased TNF-α, IL-1β and IL-6 mRNA expression in PC12 cells ( P<0.05). As compared with those in the LPS group, the RORα expression was significantly increased, and the TNF-α, IL-1β and IL-6 mRNA expression levels in PC12 cells were significantly decreased in LPS+miR-193b-3p group ( P<0.05). Conclusion:The miR-193b-3p inhibits the neuroinflammatory response in neonatal sepsis rats by regulating its target molecule RORα mRNA expression in hippocampal neurocyte.

Objective:To investigate the current status of dietary behaviors of children with inflammatory bowel disease (IBD) , explore the types of exclusion diet, screen out unreasonable dietary behaviors, and analyze the reasons leading to their behaviors, so as to provide a basis for developing individualized dietary health education plan.Methods:From January 2018 to December 2019, convenience sampling was used to select 60 IBD children who were treated and hospitalized in the Gastroenterology Department and their main caregivers of the Children's Hospital of Nanjing Medical University as research subjects. All subjects were investigated with the self-designed IBD Patients Dietary Behaviors Questionnaire. Single factor analysis and multiple linear regression analysis were performed on the influencing factors of the dietary behavior of IBD children. A total of 60 questionnaires were issued and 50 were validly recovered with a valid recovery rate of 83.3%.Results:The score of dietary behaviors of IBD children was (34.68±2.77) , and the standard score was (86.70±6.91) . Education level and residence were the effects of the dietary behavior scores of the main caregivers of children with IBD. In terms of the attitude of the main caregivers to the exclusion diet, there were unreasonable exclusion behaviors such as lack of crude fiber food, and dairy products.Conclusions:The overall dietary behaviors of IBD children are relatively good, but there are still some unreasonable dietary behaviors and excessive reliance on the exclusion diet, and the main influencing factors include the education level and residence of their caregivers. It is recommended that medical staff emphasize individualization when formulating dietary health education plan to achieve the goal of standardizing the dietary behavior of IBD children, promoting growth and development, and reducing symptom deterioration and recurrence.

Objective: To explore the clinical effect of negative pressure wound therapy (NPWT) in emergency limb-salvage operation of destructive injury of limb. Methods: From July 2014 to December 2017, 43 patients with destructive injury of limb in one side conformed to the inclusion criteria were admitted to our hospital. The patients were divided to NPWT group of 24 patients [ 21 males and 3 females, aged (38±10) years] and routine dressing change group of 19 patients [ 17 males and 2 females, aged (37±10) years] according to their treatment methods. After the emergency debridement, fracture external fixation, neurovascular exploration, and microsurgical repair were performed, NPWT were applied on wounds of patients in NPWT group and routine dressing change treatment on wounds of patients in routine dressing change group. On 7 to 10 days after the emergency operation, incidence of arterial embolism of patients in the two groups were calculated, and condition of wound infection of patients in the two groups were observed. Complete wound healing time and survival condition of limb were recorded. Data were processed with independent sample t test or chi-square test. Results: Incidence of arterial embolism of patients in NPWT group on 7 to 10 days after the emergency operation was 6.67% (3/45), which was close to 5.56% (2/36) of patients in routine dressing change group (χ²=0.043, P>0.05). There was 1 patient with wound infection in NPWT group on 7 to 10 days after the emergency operation, obviously less than 6 patients in routine dressing change group (χ²=5.847, P<0.05). Complete wound healing time of patients in NPWT group was (30±4) d, significantly shorter than (36±8) d of patients in routine dressing change group (t=2.813, P<0.01). Limbs of 24 patients in NPWT group survived, which was close to 18 patients in routine dressing change group (χ²=1.293, P>0.05). Conclusions NPWT can significantly reduce tthe wound infection rate and shorten the time of wound healing of limb with destructive injury after emergency operation, which is worthy of popularization in clinic.

Objective To analyze the current status of studies related to home enteral nutrition (HEN) in China,and provide scientific basis for the research and management of HEN in China.Methods We searched CNKI and WanFang Data since it built to January 1st,2018.The included studies were screened and categorized by publication information,study type,subjects of the study,topic,interventions and outcomes.Descriptive analysis was conducted after extraction of information.Results A total of 153 studies were included,of which 37 were observational studies,102 were experimental studies,12 were case report,and 2 were exploring articles.Since 2012,the number of studies has been increasing.Most of the subjects were elderly people who were diagnosed with diseases of digestive system,head and neck tumors and diseases of nervous system.These studies were featured as small sample size and short intervention time,follow-ups by telephone and home visit,less than 1/4 providing professional nutrition support team,and outcomes mainly as complication,nutritional biochemical indices,anthropometric indices and prognosis.Conclusion HEN in China is still in its infancy.The number of relative studies is still small and quality of literatures is very low,but it has been increasing.At present,there are some problems in the implementation of HEN in China,such as lack of standardized management model and professional team,short-term intervention,and single follow-up mode.The elderly and patients with digestive disease,head and neck tumors and nervous disease are the key subjects;more professional nutrition support team and scientific management model should be established in the future.