ObjectiveTo explore the distribution pattern of tongue image characteristics in patients with glucolipid metabolic disorders and its main syndromes. MethodsA total of 841 patients with glucolipid metabolic disorders （disease group）， and 380 healthy subjects （control group） were included. The disease group was classified into three syndrome types： 283 cases of liver depression and spleen deficiency syndrome， 311 cases of phlegm-dampness obstruction syndrome， and 247 cases of qi stagnation and blood stasis syndrome. Tongue image data were collected using the TFDA-1 Tongue Diagnosis Instrument， and the TDAS V3.0 software was used to analyze the color， texture， and morphological features of the tongue body （TB） and tongue coating （TC） in patents with different syndromes of disease group （including lightness （L）， red-green axis （a）， yellow-blue axis （b）， luminance （Y）， difference between red signal and brightness （Cr）， difference between blue signal and brightness （Cb）， contrast （CON）， angular second moment （ASM）， entropy （ENT）， mean value （MEAN）， tongue coating area/tongue surface area （perAll）， and tongue coating area/non-coated area （perPart））. Logistic regression analysis was conducted to identify influencing factors for different syndrome types of glucolipid metabolic disorders. ResultsThe tongue body indicators TB-L， TB-Y， and TB-Cb in the disease group were significantly higher than those in the control group， while TB-a， TB-b， and TB-Cr were significantly lower. The tongue coating indicators TC-L， TC-Y， TC-Cb， perAll， and perPart in the disease group were significantly higher than those in the control group， while TC-a， TC-b， and TC-Cr were significantly lower （P＜0.05）. Comparing with the different syndromes in disease group， the TB-L and TB-Y of the liver depression and spleen deficiency syndrome， and the phlegm-damp obstruction syndrome were higher than those of the qi stagnation and blood stasis syndrome； the TB-a and TB-Cr of the phlegm-damp obstruction syndrome were lower than those of the qi stagnation and blood stasis syndrome； the perAll of the phlegm-damp obstruction syndrome was higher than that of the qi stagnation and blood stasis syndrome （P＜0.05）. In the analysis of the morphological characteristics of tongue signs， more spotted tongue in disease group compared with control group， more teeth-marked tongue in liver depression and spleen deficiency syndrome than the other two syndromes， more greasy coating in phlegm-damp obstruction syndrome， and more stasis spots of tongue in qi stagnation and blood stasis syndrome （P＜0.05）. Logistic regression analysis identified that greasy coating， spotted tongue， stasis spots of tongue， tooth-marked tongue， perAll， and TB-Cb are the influencing factors of liver depression and spleen deficiency syndrome； greasy coating， tooth-marked tongue， TC-Cb， and TC-Cr are the influencing factors of phlegm-damp obstruction syndrome； cracked tongue， stasis spots of tongue， tooth-marked tongue， and TB-Y are the influencing factors of qi stagnation and blood stasis syndrome （P＜0.05）. ConclusionCompared to healthy individuals， patients with glycolipid metabolic disorder have darker tongue color and thicker， greasy tongue coating. Glycolipid metabolic disorder patients of liver depression and spleen deficiency syndrome exhibit a reddish tongue with finer textures and more tooth marks； patients of phlegm-damp obstruction syndrome have lighter tongue coating with a coarser texture and a higher prevalence of greasy coating； patients of qi stagnation and blood stasis syndrome display lower tongue brightness with a higher prevalence of blood stasis spots.

Objective To establish a rat model of venous thrombosis in a plateau hypobaric hypoxic environment and to investigate the effect of this environment on venous thrombosis.Methods A total of 144 healthy male SD rats were assigned randomly to four groups(n=36 rats per group):a plains sham operation(A)group,plains operation(B)group,plateau altitude 6000 m+sham operation(C)group,and plateau altitude 6000 m+surgery(D)group.Rats in A and B groups were maintained in a plains normoxic environment,while rats in C and D groups C and D were subjected to a plateau environment.Rats in the surgical groups underwent quantitative constriction to incompletely obstruct the inferior vena cava blood flow.Each group was further divided into subgroups based on time:1,3,5,7,14,and 21 d(n=6 rats per group).Regular vascular ultrasound monitoring was conducted,and blood samples were taken for whole blood viscosity testing and the assessment of inflammatory indicators,including endothelin-1(ET-1),interleukin-6(IL-6)and tissue factor(TF).Coagulation function was evaluated through the activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB)and D-dimer.After the observation period,the experimental animals were sacrificed and the limbs were removed.Thrombus samples were stained with hematoxylin/eosin(HE),and the thrombus wet mass was measured.Results The thrombosis incidence was significantly higher in the plateau D group than in B group,accompanied by a marked increase in blood viscosity and hematocrit(P＜0.01).Additionally,levels of ET-1,IL-6,and TF were significantly elevated(P＜0.05),indicating a coagulation disorder.Conclusions A plateau hypoxic environment model can be successfully simulated by quantitative coarctation of the inferior vena cava,combined with a specialized environmental chamber.The findings of this study suggest that a plateau hypoxic environment promotes venous thrombosis.

Objective To investigate the underlying mechanisms of the effect of Fufang Changtai Decoction(FFCT)in inhibiting colorectal cancer(CRC)through the ferroptosis pathway using network pharmacology combined with experimental validation.Methods The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and Swiss Target Prediction databases were employed for the systematic screening of potent active ingredients and therapeutic targets of FFCT.In addition,the identification of CRC-associated genes and ferroptosis-related genes(FRGs)was accomplished using the Gene Cards and FerrDb databases,respectively.Venn diagrams,coupled with Cytoscape software,facilitated the comprehensive analysis of key FRGs involved in FFCT's intervention in CRC by mapping the TCM compound-therapeutic target network.Transmission electron microscopy was used to examine the mitochondrial ultrastructure of SW480 and HCT116,2 Human CRC cell lines,after treatment with FFCT-containing serum.Intracellular reactive oxygen species(ROS)levels were measured using a ROS detection kit.To assess the role of ferroptosis,ferroptosis inhibitor liproxstatin-1(Lip-1)was co-administered with FFCT-containing serum.The effects on cancer cell viability and proliferation were evaluated using CCK-8 and colony formation assays.Key molecular targets involved in the regulatory effects of FFCT on the expression of FRGs were further analyzed using PCR Array and Western blot.The findings were then validated with human CRC tissue microarrays.Results A total of 103 active ingredients of FFCT,739 therapeutic targets,9 101 disease-related genes,and 564 FRGs were identified.Venn diagram analysis identified 81 FRGs associated with FFCT intervention.Network analysis revealed that NQO1,TP53,and PTGS2 served as hub nodes in the regulatory network.Findings from the in vitro experiments showed that FFCT induced ferroptosis changes,including mitochondrial condensation,membrane thickening,and cristae reduction,in SW480 and HCT116 cells.FFCT treatment significantly increased intracellular ROS levels in a dose-dependent manner(P<0.05)and reduced cancer cell viability and proliferative capacity(P<0.01).These inhibitory effects were partially reversed by Lip-1,suggesting that FFCT's antitumor activity was closely associated with the ferroptosis pathway.PCR Array and Western blot analyses further confirmed that FFCT significantly downregulated NQO1 mRNA and protein expression in cancer cells(P<0.001),which was consistent with network pharmacology predictions.Immunofluorescence analysis of clinical CRC tissue microarrays revealed that NQO1 expression was significantly higher in tumor tissues than in adjacent non-tumor tissues(P<0.001).Conclusion FFCT may induce intracellular ferroptosis by downregulating the oncogenic gene NQO1,thereby exerting anti-CRC effects.

Objective To establish a rat model of venous thrombosis in a plateau hypobaric hypoxic environment and to investigate the effect of this environment on venous thrombosis.Methods A total of 144 healthy male SD rats were assigned randomly to four groups(n=36 rats per group):a plains sham operation(A)group,plains operation(B)group,plateau altitude 6000 m+sham operation(C)group,and plateau altitude 6000 m+surgery(D)group.Rats in A and B groups were maintained in a plains normoxic environment,while rats in C and D groups C and D were subjected to a plateau environment.Rats in the surgical groups underwent quantitative constriction to incompletely obstruct the inferior vena cava blood flow.Each group was further divided into subgroups based on time:1,3,5,7,14,and 21 d(n=6 rats per group).Regular vascular ultrasound monitoring was conducted,and blood samples were taken for whole blood viscosity testing and the assessment of inflammatory indicators,including endothelin-1(ET-1),interleukin-6(IL-6)and tissue factor(TF).Coagulation function was evaluated through the activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB)and D-dimer.After the observation period,the experimental animals were sacrificed and the limbs were removed.Thrombus samples were stained with hematoxylin/eosin(HE),and the thrombus wet mass was measured.Results The thrombosis incidence was significantly higher in the plateau D group than in B group,accompanied by a marked increase in blood viscosity and hematocrit(P＜0.01).Additionally,levels of ET-1,IL-6,and TF were significantly elevated(P＜0.05),indicating a coagulation disorder.Conclusions A plateau hypoxic environment model can be successfully simulated by quantitative coarctation of the inferior vena cava,combined with a specialized environmental chamber.The findings of this study suggest that a plateau hypoxic environment promotes venous thrombosis.

Objective:To explore the application effect of woven mesh unit method in teaching nursing students in clinical internship.Methods:The 300 nursing interns in Chongqing University Jiangjin Hospital who interned in 2022 were included in the traditional group, and the 300 nursing interns who interned in 2023 were included in the reform group. The traditional group received traditional teaching, while the reform group received woven mesh unit teaching. The two groups of nursing students were compared for the assessment scores (theoretical assessment scores and practical operation scores), emergency response abilities (warning ability, emergency response ability, and recovery and summary ability), and evaluation of clinical teaching quality. The t-tests, chi-square test, and rank-sum test were conducted using SPSS 26.0. Results:The theoretical assessment scores and practical operation scores of the reform group were significantly higher than those of the traditional group [(79.15±9.27) vs. (74.58±9.16), (81.25±8.35) vs. (76.04±8.25)]. The scores and total scores of the early warning ability, emergency response ability, and recovery and summary ability of the reform group were significantly higher than those of the traditional group [(15.28±2.36) vs. (12.91±2.42), (38.76±7.37) vs. (34.15±7.29), (21.25±5.14) vs. (18.73±5.07), (75.29±9.86) vs. (65.79±9.76)]. The clinical teaching quality grade of teachers in the reform group was significantly higher than that of the traditional group [high quality (88.67% vs. 79.00%)/medium quality (11.33% vs. 16.67%)/low quality (0.00% vs. 4.33%)].Conclusions:The application of woven mesh unit method in teaching nursing students in clinical internship can effectively improve their theoretical assessment scores, practical operation level, and emergency response ability, as well as the quality of clinical teaching.

Objective:To explore the application effect of woven mesh unit method in teaching nursing students in clinical internship.Methods:The 300 nursing interns in Chongqing University Jiangjin Hospital who interned in 2022 were included in the traditional group, and the 300 nursing interns who interned in 2023 were included in the reform group. The traditional group received traditional teaching, while the reform group received woven mesh unit teaching. The two groups of nursing students were compared for the assessment scores (theoretical assessment scores and practical operation scores), emergency response abilities (warning ability, emergency response ability, and recovery and summary ability), and evaluation of clinical teaching quality. The t-tests, chi-square test, and rank-sum test were conducted using SPSS 26.0. Results:The theoretical assessment scores and practical operation scores of the reform group were significantly higher than those of the traditional group [(79.15±9.27) vs. (74.58±9.16), (81.25±8.35) vs. (76.04±8.25)]. The scores and total scores of the early warning ability, emergency response ability, and recovery and summary ability of the reform group were significantly higher than those of the traditional group [(15.28±2.36) vs. (12.91±2.42), (38.76±7.37) vs. (34.15±7.29), (21.25±5.14) vs. (18.73±5.07), (75.29±9.86) vs. (65.79±9.76)]. The clinical teaching quality grade of teachers in the reform group was significantly higher than that of the traditional group [high quality (88.67% vs. 79.00%)/medium quality (11.33% vs. 16.67%)/low quality (0.00% vs. 4.33%)].Conclusions:The application of woven mesh unit method in teaching nursing students in clinical internship can effectively improve their theoretical assessment scores, practical operation level, and emergency response ability, as well as the quality of clinical teaching.

OBJECTIVE:To investigate the effects of sufentanil combined with dexmedetomidine on ICU acquired weakness(ICU-AW)of AECOPD patients receiving mechanical ventilation. METHODS:A total of 120 AECOPD patients in ICU of our hospital during Oct. 2015-Oct. 2016 were divided into group A and B according to random number tablet,with 60 cases in each group. Group A was given analgesia and sedation of sufentanil combined with propofol;group B was given analgesia and sedation of sufentanil combined with dexmedetomidine. RAAS sedation score and British Medical Research Committee(MRC)score were compared between 2 groups before treatment and 7 d after treatment. The incidence of ICU-AW,delirium and tracheal extubation were observed. The staying time in ICU,total hospitalization time and the occurrence of ADR were compared between 2 groups after diagnosed as ICU-AW. RESULTS:After treatment,the scores of RASS sedation degree scale in 2 groups were decreased significantly compared to before treatment,with statistical significance (P<0.05);there was no statistical significance between 2 groups(P>0.05). MRC score of group A was decreased significantly compared to before treatment,and significantly lower than group B,with statistical significance(P<0.05). There was no statistical significance in MRC score of group B before and after treatment(P>0.05). After 7 d of treatment,the incidence of ICU-AW in group B was significantly lower than group A(40.00% vs. 56.67%);the incidence of tracheal extubation in group B was significantly higher than group A(70.00% vs. 53.33%),the incidence of delirium was significantly lower than group A(13.33% vs. 20.00%);the staying time in ICU and total hospitalization time in group B after diagnosed as ICU-AW were significantly shorter than group A,with statistical significance(P<0.05). There was no statistical significance in the total incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Compared with sufentanil combined with propofol, sufentanil combined with dexmedetomide shows similar analgesia and sedation effect,but has better influence on the muscle strength of the patient,reducing the incidence of ICU-AW and delirium,shortening the duration of mechanical ventilation,staying time in ICU and total hospitalization time in AECOPD patients receiving mechanical ventilation,with similar safety.

OBJECTIVE: To explore the safety, effectiveness and feasibility of 3D laparoscopy in thyroidectomy via modified chest and mammary areola approach comparing with 2D. METHOD: Twenty six cases received 3D laparoscopic thyroidectomy (3D group) and 34 cases experienced 2D (2D group). We compared the indexes about general status, operation time, operative blood loss, duration and overall volume of postoperative drainage, complications, etc between two groups. RESULT: Eight cases of thyroid cancer were detected in 3D group and 3 cases in 2D group. While there was no statistical difference between two groups with respect to other observation indexes such as other general status, operation time, operative blood loss, duration and overall volume of postoperative drainage, complications, etc. CONCLUSION 3D laparoscopic thyroidectomy via modified chest and mammary areola approach is a safe, effective and feasible procedure, and it may substitute the place of 2D in the future.
Blood Loss, Surgical ; Breast ; surgery ; Drainage ; Humans ; Laparoscopy ; methods ; Postoperative Period ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods ; Treatment Outcome

OBJECTIVE: To explore the safety and feasibility of endoscopic thyroidectomies through modified chest and mammary areola approach. METHOD: We retrospectively analyzed 122 cases of endoscopic thyroidectomies through a modified chest and mammary areola approach without extensive dissection of thoracic flap. The information about general status, surgical procedures and techniques, complications, etc. were summarized and discussed. RESULT: One hundred and twenty-one cases were operated successfully while 1 case was converted to video-assisted thyroidectomy through infraclavicular approach. The maximum diameter of the mass was (2.05 ± 1.06) cm, mean operation time was (88.61 ± 27.87) min, the operative blood loss was (31.23 ± 16.14) ml, duration of postoperative drainage was (3.54 ± 0.88) d and overall drainage volume was (139.09 ± 95.93) ml. Parathyroid glands were detected in specimens of 9 cases while no case of permanent postoperative hypocalcaemia was displayed. 6 cases of hoarseness were developed. One case experienced conversion surgery, all the others obtained satisfactory cosmetic result. All cases were followed up for 0-24 months without relapse and metastasis of the disease. CONCLUSION Endoscopic thyroidectomy via a modified chest and breast areola approach can facilitated the procedure and avoid extensive dissection of thoracic flap, and proved to be safe and effective.
Blood Loss, Surgical ; Breast ; surgery ; Drainage ; Endoscopy ; Feasibility Studies ; Humans ; Postoperative Complications ; Retrospective Studies ; Surgical Flaps ; Thyroidectomy ; methods

Objective To observe whether pressure boost could induce changes in intracardiac pressures,and also to investigate the mechanism involved.Methods Seventeen healthy volunteers [13 males and 4 females,with an age range of 25.76 ± 5.16 years,and average age of 18-34] were recruited for the study.Without the knowledge of the examiners and examinees about the purpose of the research,they entered the hyperbaric chamber.The examiners detect the intraocular pressures (IOP) of the examinees with the Japanese NIDEK NT-2000 non-contact tonometer under the following conditions:(1) baseline intraocular pressures at rest.(2) during the stay at atmospheric pressure for 30 min without breathing pure oxygen; after breathing pure oxygen for 10 min at atmospheric pressure.(3) compression to a pressure of 60 kPa at a rate of 2.0 kPa/s without breathing pure oxygen; (4) during the stay at the pressure of 60 kPa for 30 min without breathing pure oxygen ; (5) after decompression to 0 kPa pressure,also without breathing pure oxygen.Results Average intraocular pressures measured during their stay at atmospheric pressure for 30 min without breathing pure oxygen,after breathing pure oxygen for 10 min at atmospheric pressure and after decompression to 0 kPa pressure without breathing pure oxygen were (13.57 ±3.04),(13.86 ± 3.16) and (13.33 ± 3.12) mmHg respectively.No statistical significance could be seen in measured data,as compared with that of the baseline intraocular pressures [(13.48 ± 2.87) mmHg] (P ＞ 0.05).Average intraocular pressures measured after they were compressed to 60 kPa without breathing pure oxygen and during their stay at 60 kPa for 30 min without breathing pure oxygen were (16.06 ±2.48) and (15.65 ± 2.54) mmHg respectively,and statistical difference could be seen,when compared with that of the baseline intraocular pressures(P ＞ 0.01).Conclusions When there was a pressure boost,most people would display elevated IOP due to poor response to pressure,only a few people would experience IOP drop also due to poor response to pressure and IOP of still a few people would remain basically unchanged.