ObjectiveTo investigate the clinical application value of thromboelastographic parameters in assessing coagulation function by analyzing the thromboelastographic features of patients with primary liver cancer （PLC）， and to provide a basis for coagulation management and prognostic evaluation in liver cancer patients. MethodsA retrospective analysis was performed for 1 253 PLC patients who were admitted to The First Affiliated Hospital of Xi’an Jiaotong University from May 2015 to December 2022. According to the presence or absence of cirrhosis， the patients were divided into non-cirrhosis group with 262 patients and cirrhosis group with 991 patients， and according to the presence or absence of HBV infection， they were divided into HBV infection group with 1 055 patients and non-HBV infection group with 198 patients. The patients were stratified based on the severity of liver cirrhosis （Child-Pugh class and MELD score） and liver reserve function （indocyanine green retention rate at 15 minutes ［ICGR15］）， and thromboelastography was used to measure thromboelastographic parameters （reaction time ［R］， coagulation formation time ［K］， α-angle， maximum thrombosis amplitude ［MA］， and coagulation composite index ［CI］） and conventional coagulation markers. The t-test was used for comparison of normally distributed continuous data between two groups； a one-way analysis of variance was used for comparison between multiple groups， and the least significant difference t-test was used for further comparison between two groups. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the Kruskal-Wallis H test was used for comparison between multiple groups， and the Bonferroni correction method was used for further comparison between two groups. The chi-square test was used for comparison of categorical data between grouips， and the Spearman test was used for correlation analysis. ResultsAmong the 991 patients in the cirrhosis group， 826 had Child-Pugh class A （5 — 6 points）， and 165 had Child-Pugh class B （7 — 9 points）； 812 had an MELD score of <10， and 179 had an MELD score of ≥10； 679 had an ICGR15 of <10%， and 294 had an ICGR15 of ≥10%. Compared with the patients with Child-Pugh class A， the patients with Child-Pugh class B had a significantly longer K time and significant reductions in α-angle， MA， and CI （all P <0.001）； compared with the MELD score <10 group， the MELD score ≥10 group had a significantly longer K time and significant reductions in α-angle， MA， and CI （all P<0.001）； compared with the ICGR15 <10% group， the ICGR15 ≥10% group had a significantly longer K time and a significant reduction in MA （both P <0.001）. Among the 1 253 patients， MA was strongly positively correlated with fibrinogen and platelet count （r=0.675 and 0.667， both P<0.001）； The MA had a weak correlation with Child-Pugh score， MELD score， and ICGR15 （r=-0.112， -0.250， and -0.117， all P<0.001）， while the K time，α-angle and CI were weakly correlated with the MELD score （r=0.222， -0.184， and -0.183， all P<0.001），R time was negatively correlated with ICGR15 （r=-0.080， P=0.005）. The HBV infection group had significantly higher MA and CI than the non-HBV infection group （P<0.05）. ConclusionThromboelastography can sensitively identify the hypocoagulable state associated with the progression of liver cirrhosis and the hypercoagulable tendency in HBV-related liver cancer， which provides an important reference for individualized anticoagulant therapy in clinical practice.

Objective To investigate the epidemiological characteristics of patients with postcraniotomy meningitis(PM)caused by Gram-negative bacteria(GNB),and to evaluate the related risk factors for mortal-ity.Methods A total of 202 PM patients in Beijing Tiantan Hospital,Capital Medical University from May 2019 to December 2021 were retrospectively analyzed,including 54 cases in the death group and 148 cases in the survival group.The distribution of microorganisms in the two groups was analyzed,and Cox proportional hazards regression model was established to evaluate the risk factors of death.Results Among the 202 pa-tients with PM caused by GNB,with a mortality rate of 26.7%,Klebsiella pneumoniae(24.8%),Acinetobact-er baumannii(21.8%)and Escherichia coli(8.4%)were the top three isolated pathogens.The proportions of GNB distribution in the survival group and the death group were similar,but the bacteria distribution in the death group was more concentrate.Cox proportional hazards regression model results showed that hyperten-sion(HR=2.384,95%CI 1.229-4.626,P=0.010)and admission to ICU(HR=3.695,95%CI 1.412-9.670,P=0.008)were independent risk factors for death in patients with PM caused by GNB.Conclusion The mortality of PM caused by GNB is high.Hypertension and admission to ICU are independent risk factors for death of patients,and attention should be paid to prevention and treatment in clinical practice.

Objective To observe the effect of Renshen(ginseng)-Yuzhu(fragrant solomonseal rhizome)on inflammatory factors and inflammasomes in depression rats,and to explore the antidepressant mechanism of Renshen-Yuzhu.Methods Fifty male SD rats were divided into the blank group,model group,fluoxetine group(2.1 mg/kg),Renshen-Yuzhu low-dose group(1.89 g/kg),and Renshen-Yuzhu high-dose group(5.67 g/kg),with ten rats in each group.Except for the blank group,the rats in the other groups were treated with chronic unpredictable mild stress to establish a depression rat model.On the second day after the end of modeling,the rats in each group were given the corresponding drugs once daily for 14 days.After modeling and dosing,body weight,forced swimming immobility time,and sucrose preference rate were measured.After dosing,hematoxylin-eosin staining was used to detect neuronal damage in the cerebral cortex,enzyme-linked immunosorbent assay was used to detect the contents of interleukin-4(IL-4),interleukin-23(IL-23),and interleukin-27(IL-27)in cortex,real-time PCR was used to detect the mRNA expression of interleukin-24(IL-24)in cortex,and the protein expressions of nucleotide-binding oligomerization domain-like receptor protein 1(NLRP1),absent in melanoma 2(AIM2),and nucleotide-binding oligomerization domain-like receptor protein 4(NLRC4)were detected by Western blotting.Results After dosing,compared with the blank group,the body weight of the model group decreased,the sucrose preference rate decreased,the swimming immobility time was prolonged,the neuronal tissue in cortex was destroyed,the content of IL-4 in cortex decreased,the contents of IL-23 and IL-27 in cortex increased,and the protein expressions of NLRP1,AIM2 and NLRC4 in cortex increased(P＜0.01).Compared with the model group,the body weight of rats in each administration group increased,the sucrose preference rate increased,the swimming immobility time was shortened,the damage of neuronal tissues in cortex improved,the content of IL-4 in cortex increased,the contents of IL-23 and IL-27 in cortex decreased,and the protein expressions of NLRP 1,AIM2 and NLRC4 in cortex decreased(P＜0.05).Conclusion Renshen-Yuzhu couplet medicines can improve the depressive-like behavior and exert antidepressant effect in chronic stress rats,and its mechanism may be related to the inhibition of NLRP 1,NLRC4,AIM2 inflammasome activation and its mediated inflammatory response in cortex,reducing pro-inflammatory cytokines,and increasing the level of antiinflammatory cytokines.

A new definition of metabolic dysfunction-associated fatty liver disease (MAFLD) has recently been proposed. We aim to examine the associations of MAFLD, particularly its discordance from non-alcoholic fatty liver disease (NAFLD), with the progression of elevated brachial-ankle pulse wave velocity (baPWV) and albuminuria in a community-based study sample in Shanghai, China. After 4.3 years of follow-up, 778 participants developed elevated baPWV and 499 developed albuminuria. In comparison with the non-MAFLD group, the multivariable adjusted odds ratio (OR) of MAFLD group for new-onset elevated baPWV was 1.25 (95% confidence interval (CI) 1.01-1.55) and 1.35 (95% CI 1.07-1.70) for albuminuria. Participants without NAFLD but diagnosed according to MAFLD definition were associated with higher risk of incident albuminuria (OR 1.77; 95% CI 1.07-2.94). Patients with MAFLD with high value of hepamet fibrosis score or poor-controlled diabetes had higher risk of elevated baPWV or albuminuria. In conclusion, MAFLD was associated with new-onset elevated baPWV and albuminuria independently of body mass index, waist circumference, and hip circumference. Individuals without NAFLD but diagnosed as MAFLD had high risk of albuminuria, supporting that MAFLD criteria would be practical for the evaluation of long-term risk of subclinical atherosclerosis among fatty liver patients.
Humans ; Pulse Wave Analysis ; Albuminuria ; Ankle Brachial Index ; Non-alcoholic Fatty Liver Disease/diagnosis* ; Vascular Stiffness ; Prospective Studies ; Risk Factors ; China/epidemiology*

Objective : investigate the correlation between the ossification of the styloid hyoid ligament and Bell’s facial paralysis and provide a reference for clinical diagnosis and treatment. Methods: A case of ossification of the bilateral stylohyoid ligament with Bell's facial palsy caused by ossification of the bilateral stylohyoid ligament was diagnosed by clinical manifestations, differential diagnosis and imaging examination. The surgical plan was determined, and combined surgical resection of the ossified area of the styloid hyoid ligament and the greater horn of the hyoid was performed. Postoperative cefoxitin sodium anti-inflammatory treatment, methylprednisolone hormone treatment, acyclovir antiviral treatment, mecobalamin nutritional neurotherapy, and the relevant literature were analyzed. Results: The patient experienced pain when swallowing before surgery, disappearance of right frontal ridges, incomplete eyelid closure, and ptosis of mouth corners. An MRI scan of the brain excluded intracranial space-occupying lesions and resulted in the diagnosis of Bell’s facial paralysis. High-resolution CT of the styloid process confirmed ossification of the styloid hyoid ligament. Styloid process shortening and partial hyoid resection were performed under general anesthesia. Half a month after discharge, the symptoms of sore throat and pain in swallowing disappeared, facial nerve function recovered well, right eyelid closure function recovered well, and right mouth droop improved. The facial nerve function basically returned to normal after 1 month of follow-up. A review of the relevant literature showed that ossification of the stylohyoid ligament to form pseudojoint dilation can locally stimulate the peripheral facial nerve and lead to facial paralysis symptoms. Conclusion Ossification of the styloid hyoid ligament is usually characterized by pharyngeal pain, which can be confirmed by imaging examination. Ossification of the styloid hyoid ligament with facial paralysis is rare in the clinic, so it is necessary to make a clear diagnosis and treat the symptoms.

Objective:To explore the effect of emotion control game based on Snyder hope theory on anxiety of children and their parents.Methods:From June to December 2021, 92 preschool children who received operation and their parents in the Second Affiliated Hospital of Wenzhou Medical University were selected as the study subject. The subjects were divided into two groups according to the time of admission, among which 46 children and their parents admitted from June to September 2021 were taken as the control group, with routine nursing. A total of 46 children and their parents admitted from October to December 2021 were taken as the study group, and emotion control game based on Snyder hope theory was implemented on the basis of the control group. The scores of the Chinese version of the modified Yale Perioperative Anxiety Scale (Cm-YPAS) one day before operation and at the time of entering the Operating Room were compared between the two groups of children, and the scores of the Generalized Anxiety Disorder-7 (GAD-7) and the Newcastle Satisfaction with Nursing Scale (NSNS) of the parents of preschool children one day before operation and at the time of discharge of the two groups were compared.Results:During the intervention, there were 3 cases of dropout children in the study group and two cases of dropout children in the control group, and 43 and 44 children completed the study respectively. The Cm-YPAS scores of children in the two groups at the time of entering the Operating Room were statistically higher than those of children one day before operation; When entering the Operating Room, the Cm-YPAS score of children in the study group was lower than that in the control group, with a statistically significant difference ( P<0.05) . The GAD-7 scores of parents of children in the study group were lower than those in the control group one day before operation and at the time of discharge, and the difference was statistically significant ( P<0.05) . At the time of discharge, the NSNS scores of parents in the study group were higher than those in the control group, with a statistically significant difference ( P<0.05) . Conclusions:In preoperative nursing, emotion control game based on Snyder hope theory for preschool children can effectively reduce their preoperative anxiety, and the anxiety of their parents during perioperative period, and improve parents' satisfaction with nursing.

Objective:To investigate the effect of circ_0084927 as a molecular sponge adsorbing miR-623 to target and regulate EZH2 gene on immune escape in breast cancer (BC) cells.Methods:Bioinformatics websites were used to predict the circ_0084927/miR-623/EZH2 regulatory axis, which was then validated with the aid of dual luciferase reporter assay. BC cells were co-cultured with CD8+ T cells and theflow cytometry assays were performed to detect apoptotic rate and the proportion of T cells in the co-transfected microenvironment.Results:The expression level of EZH2 and circ_0084927 were significantly upregulated in BC patient tissue samples compared to paracancerous tissue, while miR-623 expression was dramatically diminished ( P<0.05) . circ_0084927 can be used as an effective diagnostic index of BC (AUC= 0.813 8, P<0.000 1) . Compared with apoptosis rate of CD8+ T cells (34.17±3.06) and percentage of T cells (26.55±2.83) , circ_0084927 inhibition caused a decrease in the apoptosis rate of CD8+ T cells (22.37±2.05) and an increase in the proportion of CD8+ T cells (31.88±3.03) in the co-transfected environment, but this effect was partiallycounteractedby overexpression of EZH2. miR-623 inhibited CD8+ T cell apoptosis. Circ_0084927 attenuated the inhibitory effect of miR-623 on immune escape (both P<0.05) . Conclusion:circ_0084927 regulates the miR-623/EZH2 axis to promote immune escape of BC cells, suggesting targeting circ_0084927 may be a potential way to improve the efficacy of immunotherapy for BC.

Colorectal cancer (CRC) belongs to multiple diseases of traditional Chinese medicine (TCM).CRC can exhibit sophisticated clinical manifestations and various TCM syndromes (Zheng).Modem studies have revealed that syndromes (Zheng) of CRC are related to pathological characteristics,cell types,staging and prognosis.Surgery,chemotherapy and other modem treatments can influence the manifestations of syndromes (Zheng) of CRC.Modern TCM doctors have extensively studied the biomedical basis of syndromes (Zheng) of CRC,including accumulation of damp-heat (Shi-Re-Yun-Jie),blood stasis (Yu-Xue-Nei-Zu),spleen (Pi) deficiency (Pi-Qi-Kui-Xu),deficiency of qi and blood (Qi-Xue-Liang-Xu),deficiency of yin of liver (Gan) and kidney (Shen) (Gan-Shen-Yin-Xu) and other syndromes (Zheng).These investigations may contribute to the objective and standardization study of syndromes (Zheng) in CRC.

Objective To investigate the self-perceived burden (SPB) of diabetic retinopathy (DR) patients after diabetic retinopathy and its influencing factors, and analyze the correlation between them. Methods Self-designed general questionnaire and self-rating questionnaires including SPB scale, etc. were used in the survey. All survey information was imported into Excel database. SPSS 18.0 statistical software was used for the descriptive analysis, single-factor analysis and multiple-factor analysis. Results The average SPB score of DR patients after surgery was (28.22±7.11) points, and was in a mild level. Working condition, children condition, the time span since diagnosis and the knowledge of vitrectomy all had positive effect on SPB. Conclusions The SPB of DR patients after surgery is at a mild level. The SPB of patients after DR surgery is mainly influenced by their working condition, children condition, the time span since diagnosis and the knowledge of vitrectomy.

Objective To explore the effects of training evaluation cycle mode applied for enhancement of core competence of nurses in Ophthalmic Operating Room .Methods A total of 60 nurses were assessed evaluation of training requirements , training plans , training implementation and training results by using training evaluation cycle mode , and promptly revised scheme based on the assessment results .The investigation had been carried out for nurses′professional knowledge , skills and comprehensive ability , satisfaction of nurses , doctors and patients in 2011 , 2012 and 2013 .Results Professional knowledge and skills , comprehensive response ability gained (84.63 ±4.69),(83.27 ±3.79) and (88.67 ±4.66),which were all statistically higher than those in 2011 and 2012 (F=20.24, 14.30, 32.45;P<0.01).The satisfactions of nurses, doctors and patients had no statistical difference between 2011 and 2012 (P >0.05), but had statistical difference between 2012 and 2013 (P<0.05).Conclusions Training evaluation cycle mode is feasible to improve the core competence of nurses in Ophthalmology Operation Room .