Rhabdomyolysis is a clinical syndrome characterized by damage to the integrity of skel-etal muscle cell membranes,massive release of intracellular contents(such as myoglobin,creatine ki-nase,and electrolytes)into the bloodstream,thereby triggering systemic pathophysiological responses.Its most common and severe complication is acute kidney injury,primarily resulting from the combined effects of myoglobin deposition in renal tubules and renal ischemia.Due to lack of specific early clini-cal manifestations,patients are often misdiagnosed or experience delayed treatment,which can lead to exacerbation of the condition and even life-threatening consequences.This article reports a case of a patient who presented with unexplained rhabdomyolysis at onset and subsequently developed acute kid-ney injury during the course of the disease.A systematic analysis and discussion of the potential etiolo-gy are conducted based on the patient's clinical features and laboratory test results.

Objective:Based on the process theory of stress effect, the mediating effect of health literacy and perceived social support between perceived control and fatigue symptom of asthmatic patients was analyzed, which provide the evidence for the formulation of intervention programs to relieve fatigue in patients.Methods:Adopting a cross-sectional survey design, from January 2019 to November 2023, asthmatic patients at The First Affiliated Hospital of Anhui Medical University (Feidong County People′s Hospital) were selected by convenience sampling method and investigated by the General Information Questionnaire, Fatigue Severity Scale, Perceived Control of Asthma Questionnaire, Health Literacy Management Scale, and Perceived Social Support Scale. Pearson correlation analysis was used to investigate the correlation between fatigue symptom, perceived control, health literacy, and perceived social support in asthma patients. A structural equation model was constructed using AMOS24.0 software and conduct mediation analysis.Results:A total of 260 questionnaires were distributed, and 241 valid questionnaires were collected. There were 110 males and 131 females aged (55.48 ± 15.03) years old. The scores of Fatigue Severity Scale, Perceived Control of Asthma Questionnaire, Health Literacy Management Scale, and Perceived Social Support Scale were (4.27 ± 1.68), (31.72 ± 8.51), (85.71 ± 19.36), (46.97 ± 11.79) points, respectively. Pearson correlation analysis showed that fatigue symptom was negatively correlated with perceived control, health literacy, and perceived social support ( r=-0.719, -0.716, -0.767, all P<0.01). The mediating model showed that perceived control had a significant direct effect on fatigue symptom ( β=-0.204, 95% CI-0.252--0.169). Moreover, perceived control also indirectly affected fatigue symptom through the independent mediating effect of health literacy ( β=-0.378, 95% CI-0.405--0.202), the independent mediating effect of perceived social support ( β=-0.227, 95% CI-0.381--0.203), and the chain mediating effect of health literacy and perceived social support ( β=-0.089, 95% CI-0.142--0.025), which accounting for 77.3% of the total effect. Conclusions:Health literacy and perceived social support play a mediating role in the correlation between perceived control and fatigue symptom, which can promote health literacy and perceived social support and thus alleviate fatigue symptom in asthmatic patients.

Objective:Based on the process theory of stress effect, the mediating effect of health literacy and perceived social support between perceived control and fatigue symptom of asthmatic patients was analyzed, which provide the evidence for the formulation of intervention programs to relieve fatigue in patients.Methods:Adopting a cross-sectional survey design, from January 2019 to November 2023, asthmatic patients at The First Affiliated Hospital of Anhui Medical University (Feidong County People′s Hospital) were selected by convenience sampling method and investigated by the General Information Questionnaire, Fatigue Severity Scale, Perceived Control of Asthma Questionnaire, Health Literacy Management Scale, and Perceived Social Support Scale. Pearson correlation analysis was used to investigate the correlation between fatigue symptom, perceived control, health literacy, and perceived social support in asthma patients. A structural equation model was constructed using AMOS24.0 software and conduct mediation analysis.Results:A total of 260 questionnaires were distributed, and 241 valid questionnaires were collected. There were 110 males and 131 females aged (55.48 ± 15.03) years old. The scores of Fatigue Severity Scale, Perceived Control of Asthma Questionnaire, Health Literacy Management Scale, and Perceived Social Support Scale were (4.27 ± 1.68), (31.72 ± 8.51), (85.71 ± 19.36), (46.97 ± 11.79) points, respectively. Pearson correlation analysis showed that fatigue symptom was negatively correlated with perceived control, health literacy, and perceived social support ( r=-0.719, -0.716, -0.767, all P<0.01). The mediating model showed that perceived control had a significant direct effect on fatigue symptom ( β=-0.204, 95% CI-0.252--0.169). Moreover, perceived control also indirectly affected fatigue symptom through the independent mediating effect of health literacy ( β=-0.378, 95% CI-0.405--0.202), the independent mediating effect of perceived social support ( β=-0.227, 95% CI-0.381--0.203), and the chain mediating effect of health literacy and perceived social support ( β=-0.089, 95% CI-0.142--0.025), which accounting for 77.3% of the total effect. Conclusions:Health literacy and perceived social support play a mediating role in the correlation between perceived control and fatigue symptom, which can promote health literacy and perceived social support and thus alleviate fatigue symptom in asthmatic patients.

Objective:To explore the potential categories of psychological distress in spousal caregivers of stroke patients and differences in quality of life between categories, in order to provide a theoretical basis for early clinical identification and provision of individualized and targeted interventions for psychological distress in spousal caregivers of stroke patients and improvement of their quality of life.Methods:A total of 207 spouse caregivers of stroke patients hospitalized in three class 1-Grade A hospitals in Yinchuan city of Ningxia Hui Autonomous Region, who met the inclusion and exclusion criteria were selected from December 2020 to July 2021 by convenience sampling method as study subjects. The general information questionnaire, Kessler Psychological Distress Scale, and the Mos 36-Item Short from Health Survey were used for a cross-sectional survey.Results:A total of 203 spousal caregivers of stroke patients were finally investigated, 46 males and 157 females with a age of (58.65 ± 9.66) years. Psychological distress among spousal caregivers of stroke patients was categorized into 3 potential categories:no distress group (40%, 81/203), listlessness group (45%, 91/203) and helplessness and restlessness group (15%, 31/203). The psychological distress subgroup was a factor influencing the quality of life of spousal caregivers of stroke patients ( t=-10.03, P<0.05), explaining 33.0% of the variance in quality of life. Conclusions:Psychological distress in spousal caregivers of stroke patients is significantly heterogeneous. Those in the helplessness and restlessness group have the lowest quality of life and should be given focused attention and early intervention.

OBJECTIVETo explore the mechanism of acupuncture on promoting the restoration of interstitial cells of Cajal (ICCs).

METHODSThirty SD rats were randomly divided into a blank group, a model group and an acupuncture group, ten rats in each one. The rats in the model group and acupuncture group were treated with colonic anastomosis to establish the model. After successful establishment of the model, the rats in the acupuncture group were treated with acupuncture at bilateral "Zusanli" (ST 36), "Sanyinjiao" (SP 6) and "Taichong" (LR 3) for 15 min, once a day for 10 days. Rats in the model group and blank group were put into the fixator for 15 min at the same time daily. The propulsive rate of small intestine was measured in each group. Colonic tissues were collected to detect c-kit expression by using immunohistochemistry. The nitricoxide (NO) content was measured by nitrate reductase method and nitric oxide synthase (NOS) activity was measured by method of L-arginine.

RESULTSCompared with the blank group, the propulsive rate of small intestine in the model group was decreased; NO content was increased; iNOS activity was elevated; cNOS activity was declined; total NOS (tNOS) activity was increased and the counting of c-kit positive ICCs was decreased (all P < 0.05). Compared with the model group, the propulsive rate of small intestine in the acupuncture group was increased; NO content was decreased; iNOS activity was reduced; cNOS activity was elevated; NOS activity was decreased and the counting of c-kit positive ICCs was increased (all P < 0.05).

CONCLUSIONAcupuncture can regulate NO content and NOS activity in postoperative restoration environment of ICCs, which may participate in the process of acupuncture promoting the restoration of ICCs.

Acupuncture Points ; Acupuncture Therapy ; Anastomosis, Surgical ; Animals ; Colon ; metabolism ; surgery ; Colonic Diseases ; enzymology ; metabolism ; surgery ; therapy ; Female ; Humans ; Interstitial Cells of Cajal ; enzymology ; metabolism ; Male ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type II ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To investigate the effect of acupuncture combined with antidepressant on behavioral changes and 5-hydroxytryptamine 1A and 2A receptor ( 5-HT1AR and 5-HT2AR) mRNA expression in nucleus raphes dorsalis (NRD) of sleep deprivation depression (SDD) rats. Methods Eight normal Sprague Dawley (SD) rats were caged together without any stimulus or treatment, serving as the normal group. Thirty-two SD rats were given solitary raise for 21 days, together with chronic unpredictable mild stress ( CUMS) and rapid eye movement ( REM) sleep deprivation to establish the model. Twenty-eight rats completed the modeling successfully, and were divided into model group, acupuncture group, medicine group, and combination group, 7 rats in each group. Rats in the model group were given modeling treatment but without any intervention. Rats in the acupuncture group were given acupuncture on acupoint Yintang, Shenting and bilateral Taichong, acupuncture stimulation lasting 15 s every 10 min and acupuncture retention for 20 min in each day. Rats in the medicine group were given gastric gavage of Zoloft solution (0.83 mg·kg-1·d-1) and Alprazolam solution (0.067 mg· kg-1·d-1) , and rats in the combination group were given both acupuncture and medicine intervention. The intervention for the three intervention groups lasted for 7 days. Results Compared with the normal group, body weight, Open-field scores and sucrose preference of the model rats were significantly decreased on modeling day 7, 14, 21 (P<0.05). On modeling day 28, body weight and Open-field scores of each intervention group were significantly increased compared with those of the model group (P<0.05), and Open-field scores of combination group differed from those of acupuncture group and medicine group ( P<0.05). Only sucrose preference of combination group was improved significantly compared with the model group (P<0.05). Compared with the model group, NRD 5-HT1AR mRNA expression level was increased in the combination group (P<0.05), and NRD 5-HT2AR mRNA expression level was down-regulated in all of the three intervention groups ( P<0.05). Conclusion Acupuncture and antidepressant treatment covering 7 days can evoke rapid effect on SDD rats, which can improve the slow effect of antidepressant.

Objective To summarize the clinical experience of intractable epistaxis under nasal endoscope in the treatment of elderly people .Methods 312 cases of endoscope of intractable epistaxis patients were retrospectively analyzed.Results Nasal septum and olfactory corresponding head of middle turbinate bleeding site was mainly the upper part of the nasal cavity and the split-plot,back-end middle turbinate at the back of the nose and nasal were fol-lowed,as well as inferior turbinate and the rear end of inferior nasal meatus ,the Littell nasal septum of the front nose were bleeding less .After nasal endoscopic radio hemostatic therapy or local packing treatment with expansive sponge , 310 cases were cured,2 cases were invalid.The total efficiency was up to 99.4%.During the following 3 months,there was no recurrence .Conclusion For the elderly intractable epistaxis hemostatic therapy ,under nasal endoscope oper-ation method,radio hemostatic therapy or local packing treatment with expansive sponge is simple and effective ,which is worthy of popularization and application .

OBJECTIVE: To analysis the therapeutic procedure on the recurrent congenital fistula or cyst in lateral cervical part. METHOD: Thirty-nine cases with recurrent congenital fistula or cyst in lateral cervical part were enrolled in this study including 12 cases from the first branchial cleft, 6 from the second branchial cleft and 21 from the third branchial cleft. RESULT: All the cases underwent fistula or cyst excision for 2 to 5 times in their whole therapeutic process, not counting the incision and drainage. During 9 months to 17 years follow-up, fistula or cyst in 6 cases relapsed,including 1 fistula from the first branchial cleft,3 fistulae from the second branchial cleft, 1 fistula and 1 cyst from the third branchial cleft, respectively. One case with recurrent fistula from the first branchial cleft was diagnosed temporal verrucous carcinoma six months after the third fistula excision operation and died one year after the forth operation probably due to the intracranial metastasis of temporal bone verrucous carcinoma. In two cases, the fistulae went through the thyroid gland to the piriform fossa and both the fistulae and part of the thyroid glands were resected. In the patients whose inner orificium fistulae were found and ligated effectively,no recurrence occurred during the followed-up period. CONCLUSION The key point to cure the recurrent congenital fistula or cyst in lateral cervical part lies in proper occasion of operation, stain tracing in operation and reasonable program of operation.
Adolescent ; Adult ; Aged ; Branchioma ; congenital ; surgery ; Child ; Child, Preschool ; Female ; Fistula ; congenital ; surgery ; Humans ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Young Adult

BACKGROUND AND OBJECTIVEThe actual evaluation of immunological function is significant for studing the tumor development and devising a treatment in time. The aim of this study is to evaluate the immunological function of advanced lung cancer patients systematically, and to discuss the clinical significance.

METHODSThe nucleated cell amounts of advanced lung cancer patients and the healthy individuals were counted. The immune cell subsets and the levels of IL-4, INF-gamma, perforin and granzyme in CD8+T cells by the flow cytometry were measured. The proliferation activity and the inhibition ratio of immune cells to several tumor cell lines were evaluated by MTT assay.

RESULTSThe absolute amounts and subsets of T, B, NK cells of advanced lung cancer patients were lower than the healthy individuals (P < 0.05); However, the proportion of regulatory T cells of advanced lung cancer patients (4.00 +/- 1.84)% was lower than the healthy individuals (1.27 +/- 0.78)% (P < 0.05). The positive rates of IFN-gamma perforin, granzyme in CD8+T cells decreased while them in IL-4 did not in the advanced lung cancer patients compared to the healthy control group (P < 0.05). The proliferation activity of immune cells, the positive rate of PPD masculine and the inhibition ratio to tumor cells in the advanced lung cancer patients was lower than the healthy subsets obviously (P < 0.05).

CONCLUSIONThere was a significant immune depression in the advanced lung cancer patients compared to the healthy individuals.

Adult ; Aged ; CD8-Positive T-Lymphocytes ; immunology ; metabolism ; Cell Line, Tumor ; Female ; Flow Cytometry ; Granzymes ; metabolism ; Humans ; Interferon-gamma ; metabolism ; Interleukin-4 ; metabolism ; Lung Neoplasms ; immunology ; pathology ; Male ; Middle Aged ; Perforin ; metabolism

Objective: To discuss the correlation between myeloid derived suppressor cells (MDSCs) and hepatic trans-planted tumor and to explore new ways to inhibit the development of hepatic cancer. Methods: We established the animal models with H_(22) hepatic carcinoma cells transplanted to the anterior right limb. Then the MDSCs morphology was observed with confocal microscopy and the proportion of MDSCs in blood and spleen was measured with flow cytometry. The 36 mice were divided into three groups: the control group, the low-dose group (2mg/kg) and the high-dose group (4mg/kg). Then As_2O_3 was injected twice a week to the mice before repeating the aforementioned measures. The direct effects of As_2O_3 on MDSCs cultured with H_(22)-ascites supernatant was observed. Results: At 25 days after transplantion, the tumor weight was increased to 5.67g, and the proportion of MDSCs in blood and spleen was increased to 20.46% and 9.50%, re-spectively. There was a positive correlation between hepatic transplanted tumor and MDSCs in blood and spleen and the relative factors were 0.95 and 0.96, respectively (t=-5.270 and 5.939, P<0.05). With the effect of As_2O_3, the proportion of MD-SCs in blood in low-dose group and high-dose group was 11.31% and 10.00% at 28 days after treatment, lower than that in the control group (t=3.193 and 5.486, P<0.05), and there was also a statistical difference between the high-dose group and low-dose group (t=3.066, P<0.05). The proportion of MDSCs in the spleen in low-dose group and high-dose group was 10.90% and 9.04% at 28 days, lower than that in the control group (t=3.586.and 5.279, P<0.05), but there was no statistical difference between the high-dose group and low-dose group (1=1.298, P>0.05). In vitro, the proportion of MDSCs in nutrient fluid was increased to 12.67% at 12 days after treatment with H_(22)-ascites supematant, and was decreased to 7.44% at 18 days after treatment with As_2O_3. Conclusion: The proportion of MDSCs in H_(22) tumor-bearing mice is increased because of tu-mor development. There is a positive correlation between MDSCs and hepatic transplanted tumor. As_2O_3 can decrease MD-SCs and inhibit tumor growth.