Atrial fibrillation is the most common type of chronic cardiac arrhythmia. Catheter ablation and left atrial appendage occlusion are effective treatment methods for atrial fibrillation， but these procedures require anesthesia support. However， anesthetic drugs often cause side effects such as nausea， vomiting， involuntary movements， and respiratory depression. This paper presents a case of a successful one-stop procedure for cryoballoon ablation and left atrial appendage occlusion of atrial fibrillation performed entirely under acupuncture anesthesia. Thirty minutes before the procedure， acupuncture needles were inserted perpendicularly at bilateral Neiguan （PC 6）， Lieque （LU 7）， Ximen （PC 4） and （LU 6）. After obtaining the deqi （得气） sensation， an electroacupuncture device was connected， and electroacupuncture anesthesia was used for pain control throughout the procedure. The patient exhibited good tolerance and cooperation， with electroacupuncture anesthesia completely replacing intravenous anesthetics， ensuring the smooth completion of the surgery. Postoperative follow-up showed favorable outcomes.

Objective To construct plasmids and knock out HIF-1α gene expression in an naked mole rat skin fibroblasts(NSF)cell line using CRISPR/Cas9 genomic editing technology,to provide an in vitro cell model for studying the mechanism of hypoxia tolerance and the occurrence and development of hypoxia-related diseases in naked mole rats.Methods We designed four pairs of single guide RNA(sgRNA)sequences targeting exons 1～4 of the NSF HIF-1αgene and successfully constructed an expression plasmid.The plasmid with the optimal sgRNA was identified and transfected into 293T cells,and the supernatant was used for detecting the virus titer.Lentivirus particles carrying sgRNAs of HIF-1α were transfected into NSF cells which express Cas9 protein,based on a previous protocol.After transfection,fluorescence signals were observed under a fluorescence microscope,and HIF-1α expression in NSF cells was detected by Western Blot and T7 endonuclease 1(T7E1)analysis.Results Sanger sequencing showed that the designed sgRNA was successfully inserted into pX459 and pKLV2-U6-sgRNA2 vectors,demonstrating successful construction of a recombinant plasmid for transfection.T7E1 digestion successfully removed three bands and the target efficiency of sgRNA was 54％.Western Blot showed that the HIF-1α gene was successfully knocked out and its protein level was significantly reduced in NSF cells from naked mole rats(P=0.0019).There were no obvious morphological changes in HIF-1α-knockout cells under the microscope,and gene knockout had no obvious effect on cell proliferation.Conclusions We successfully constructed an HIF-1α-knockout cell line using CRISPR/Cas9 technology,to provide an experimental basis for further studies of the biological function of HIF-1α,as well as the mechanism of hypoxia tolerance in naked mole rats.The result also provide a theoretical foundation for the prevention and treatment of hypoxia-related diseases.

The objective of this study was to examine the effects of electroacupuncture on the expression of ATP-binding cassette transporter A1(ABCA1),ATP-binding cassette transporter G1(ABCG1),and class B type Ⅰ scavenger receptor(SR-B Ⅰ)genes and proteins in peritoneal macrophages of atherosclerotic rabbits.The study aimed to explore the mechanism underlying the treatment of atherosclerosis(AS)with electroacupuncture.Methods Twenty-six male New Zealand rabbits were randomly divided into the negative control group(n=7)and the modeling group(n=19)using a random number table method.The negative control group rabbits were fed a regular diet,while the modeling group was induced with a combination of high-fat feed and common carotid artery balloon injury surgery to create an AS model.After successful modeling,the rabbits in the modeling group were further divided into the model group,the electroacupuncture group,and the atorvastatin group,with 6 rabbits in each group.The rabbits in the electroacupuncture group received electroacupuncture at"'Neiguan'(PC6)","'Zusanli'(ST36)",and"'Guanyuan'(ST25)"acupoints,using a density wave,a current of 1 mA,and a frequency of 4 Hz/20 Hz,once a day.The needle was retained for 20 minutes each time,and a total of 4 courses of treatment were conducted,with 6 days per course.The rabbits in the atorvastatin group were administered atorvastatin calcium tablet suspension(1 mg/kg)orally once a day,for 6 days per course,with a total of 4 courses.After the interventions,HE staining was performed to observe the morphological changes in the common carotid artery tissue of the rabbits.Peritoneal macrophages were collected from the rabbits,and the mRNA expression levels of ABCA1,ABCG1,and SR-B Ⅰ were measured using real-time fluorescence PCR.The protein expression levels of ABCA1,ABCG1,and SR-B Ⅰ were detected using Western blotting.Results The negative control group exhibited smooth intima of common carotid artery in rabbits,while the model group displayed damaged intima of common carotid artery,thickened artery walls,and the formation of atherosclerotic plaques.The electroacupuncture group and atorvastatin group showed significant improvements in wall thickening and a reduction in plaque area.Compared with the negative control group,the mRNA and protein expressions of ABCA1,ABCG1,and SR-B Ⅰ in peritoneal macrophages of rabbits in the model group were reduced(P＜0.01).Compared with the model group,the electroacupuncture group and atorvastatin group exhibited increased mRNA and protein expressions of ABCA1,ABCG1,and SR-B Ⅰ in abdominal macrophages of rabbits(P＜0.01).Furthermore,the atorvastatin group demonstrated increased mRNA levels of ABCG1 and SR-B Ⅰ,as well as increased protein expressions of ABCA1,ABCG1,and SR-B Ⅰ in peritoneal macrophages of rabbits,in comparison to the electroacupuncture group(P＜0.01).Conclusion Electroacupuncture can enhance the expressions of ABCA1,ABCG1,and SR-B Ⅰ mRNA and protein in abdominal macrophages of AS rabbits,thereby promoting the process of cholesterol reverse transport.This may be one of the mechanisms underlying the effectiveness of acupuncture in the treatment of AS.

Objective:To explore the effects of pulmonary rehabilitation exercise on anxiety and quality of life in patients with first diagnosed lung cancer undergoing chemotherapy.Methods:A total of 78 patients who received chemotherapy for first diagnosed lung cancer admitted to the Affiliated Hospital of Qingdao University from May 2018 to May 2020 were selected as research objects by the convenient sampling method. 39 patients admitted from May 2018 to May 2019 were set as control group and 39 patients admitted from June 2019 to May 2020 were set as the intervention group. The control group was given lung cancer nursing routine, while the intervention group was given 16-week lung rehabilitation exercise intervention on the basis of the control group. Self-Rating Anxiety Scale (SAS) and European Organization for Research and Treatment (EORTC-QLQ-C30) were used to compare the scores of anxiety and quality of life between the two groups before intervention and 16 weeks after intervention.Results:Before intervention, there was no statistically significant difference in anxiety score and quality of life score between the two groups ( P>0.05) . After intervention, consistent results were obtained through intention to treat (ITT) analysis and per-protocol (PP) analysis. The anxiety score of the intervention group was lower than that of the control group, the role function, emotional function, social function and general health status of the quality of life scores were higher than that of the control group and the scores of fatigue, shortness of breath and loss of appetite were lower than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Pulmonary rehabilitation exercise can improve anxiety and quality of life in patients with first-diagnosed lung cancer treated with chemotherapy, but its long-term effects still need further follow-up evaluation.

Objective:To retrieve, evaluate and summarize the relevant evidence on the management of hyperphosphatemia in adult maintenance hemodialysis patients.Methods:Domestic and foreign databases and relevant professional websites were searched for best practices, evidence summaries, guidelines, expert consensus and systematic reviews on hyperphosphatemia in adult maintenance hemodialysis patients. The retrieval time was from the establishment of the databases to January 2023. The methodological quality of the included articles was evaluated, and the best evidence was extracted and summarized.Results:A total of 13 articles were included, including 2 clinical decisions, 4 guidelines and 7 systematic reviews. A total of 23 evidences were summarized from 5 aspects, including blood phosphorus monitoring, adequate dialysis, diet control, drug management and health education.Conclusions:This study summarizes the best evidence on the management of hyperphosphatemia in maintenance hemodialysis patients and provides a reference for clinicians to manage hyperphosphatemia in adult maintenance hemodialysis patients.

Objective:To explore the pathological differences of surgically resected specimens of advanced esophageal squamous cell carcinoma (ESCC) to different neoadjuvant therapies (neoadjuvant radiochemotherapy and toripalimab combined with neoadjuvant radiochemotherapy).Methods:Thirty patients diagnosed with advanced ESCC who underwent surgical operation after neoadjuvant therapy in Jiangsu Cancer Hospital from October 2020 to September 2021 were included. Among them, 15 patients received neoadjuvant radiochemotherapy (radiochemotherapy group) and 15 patients were treated with toripalimab combined with radiochemotherapy (immunotherapy combined with radiochemotherapy group). Surgically resected specimens were collected. The histopathological features of primary esophageal lesions and the responses of involved lymph nodes were analyzed and compared between two groups.Results:The major pathological response (MPR) rate in the radiochemotherapy group was 10/15, and 14/15 in the immunotherapy combined with radiochemotherapy group ( P=0.17). The pathological complete response (pCR) rate of the primary lesions in the radiochemotherapy group was 7/15, and 10/15 in the immunotherapy combined with radiochemotherapy group ( P=0.46). In the radiochemotherapy group, the incidence rate of tertiary lymphoid structure (TLS) was 7/15, and 12/15 in the immunotherapy combined with radiochemotherapy group ( P=0.02). The incidence rate of necrosis in the radiochemotherapy group was 6/15, and 1/15 in the immunotherapy combined with radiochemotherapy group ( P=0.03). In addition, the incidence rate of foam cell infiltration in the radiochemotherapy group was 6/15, and 13/15 in the immunotherapy combined with radiochemotherapy group ( P=0.01). Furthermore, the pCR rate of involved lymph nodes in the radiochemotherapy group was 7/33, and 11/12 in the immunotherapy combined with radiochemotherapy group ( P<0.001). Conclusion:Compared with the radiochemotherapy group, the incidence of TLS and foam cell infiltration is higher, the incidence of necrosis is lower and clinical efficacy of involved lymph nodes is higher in the immunotherapy combined with radiochemotherapy group, prompting that toripalimab combined with neoadjuvant radiochemotherapy exert higher synergistic immune effect.

Background: ZNF460 is a member of the zinc finger protein family transcription factors, and is involved in the regulation of a variety of cellular functions. It has been demonstrated to be closely related to digestive system cancers. Aims: To analyze the expression level of ZNF460 in hepatocellular carcinoma (HCC), and explore the effect and potential mechanisms of ZNF460 on tumor cell proliferation. Methods: Immunohistochemical staining was used to determine the expression level of ZNF460 in tissue microarray of 76 HCC and paired adjacent tissues, and the correlation between ZNF460 expression and TNM staging was analyzed. The effect of ZNF460 on HCC cell proliferation was evaluated by CCK‑ 8 and colony formation assays. Genes positively related to ZNF460 expression in HCC were screened through LinkedOmics database, and the KEGG and GSEA pathway enrichment analyses were performed; the possible downstream molecules of ZNF460 were explored and verified by overexpression or knockdown of ZNF460 in HCC cells combined with luciferase reporter assay and other experiments. Results: ZNF460 was highly expressed in HCC and was positively correlated with TNM staging. ZNF460 promoted the proliferation of HCC cells, and the underlying mechanism might be associated with the transcriptional activation of ZDHHC7, the coding gene of palmitoyl transferase DHHC7 and the subsequent STAT3 palmitoylation and phosphorylation. Conclusions: ZNF460 is highly expressed in HCC and promotes cell proliferation and tumor progression via STAT3 activation. It might be a promising molecular marker and therapeutic target for HCC.

Humans ; Transcriptome/genetics* ; East Asian People ; Genetic Predisposition to Disease ; Genome-Wide Association Study ; Pulmonary Disease, Chronic Obstructive/genetics* ; Polymorphism, Single Nucleotide/genetics*

ObjectiveTo conduct a content analysis of the policy framework, core contents and priority areas of rehabilitation of physical activity and exercise in health service (RPAEHS) using World Health Organization (WHO) theory of six building blocks of health service, and to explore the policy framework, action strategies and implementation methods of RPAEHS at macro, meso and micro levels.MethodsBased on WHO Rehabilitation in Health Systems and Rehabilitation in Health Systems: A Guide to Action, together with their accompanying use tools and other policy documents, a content analysis approach was applied to explore the policy framework as well as action strategies, core contents and priority development areas of RPAEHS. ResultsRPAEHS is an integral part of modern rehabilitation, based on the International Classification of Functioning, Disability and Health (ICF) theory of functioning, disability, and health, and the concept of person-centeredness, with measures to meet the needs of RPAEHS, integrated into the health service continuum, and contributing to the sustainable development goal of universal health coverage. The development of RPAEHS involves six major areas: leadership and governance, financing, human resources, service delivery, rehabilitation sports equipment/technology/facilities, and RPAEHS monitoring and evaluation, and information systems. In the area of RPAEHS regulations, policies and governance, the state formulate laws and regulations, policy documents, and action guidelines for the development of RPAEHS to enhance government leadership and governance; broaden the funding channels for RPAEHS and optimize the funding allocation programs; improve the RPAEHS personnel training system, match RPAEHS professionals to the three levels of health and health services, and ensure that people with functioning who have RPAEHS needs can access the different levels of the health system; improve the utilization and accessibility of assistive technologies and products; and establish a monitoring and evaluation mechanism for services and health information system with big data to provide a scientific research base and data support for evidence-based related research. ConclusionRPAEHS is a series of health-related measures that use physical activity and exercise as the fundamental means to address the physical function and structure, activity and participation, and environmental and personal factors of people with functioning. RPAEHS interventions involve prevention, treatment, rehabilitation and health promotion, with the ultimate goal of promoting maximum functioning, quality of life, and well-being for people with functioning. The development of RPAEHS needs to approach from six health service components: leadership and governance, financing, human resources, service delivery, equipment/technology/facilities, and health monitoring evaluation and information systems. The policy framework, priority areas, and their core components for rehabilitation sport are constructed at three levels: macro-level policy and governance framework, meso-level action strategies and implementation, and micro-level implementation practices and monitoring and evaluation. The priority areas of RPAEHS and their core contents are mainly involved in the fields: strengthening the leadership and governance, planning and coordination capacity of RPAEHS; constructing an appropriate RPAEHS funding mechanism; developing RPAEHS human resources; improving the coverage, accessibility, effectiveness and service quality of RPAEHS; developing RPAEHS assistive technologies and products; establishing RPAEHS monitoring and evaluation and information systems, and conducting related research.

Methods:Two thousand standard sections images werre collected from 2 000 clinical retrospective pediatric hip ultrasound videos from January 2019 to January 2021. All standard sections were annotated by the annotation team through the self-designed software based on Python 3.6 environment for image cross-media data annotation and manual review standardization process with unified standards. Among them, 1 753 were randomly selected for training the deep learning system, and the remaining 247 were used for testing the system. Further, 200 standard sections were randomly selected from the test set, and 8 clinicians independently completed the film reading annotation. The 8 independent results were then compared with the AI results.Results:The testing set consists of 247 patients. Compared with the clinician's measurements, the area under the receiver operating characteristic curve (AUC) of diagnosing hip joint maturity was 0.865, the sensitivity was 76.19%, and the specificity was 96.9%. The AUC of AI system interpretation under Graf detailed typing was 0.575, the sensitivity was 25.90%, the specificity was 89.10%. The 95% LoA of α-angle determined by Bland-Altman method, of -4.7051° to 6.5948° ( Bias -0.94, P<0.001), compared with clinicians' measurements. The 95% LoA of β-angle, of -7.7191 to 6.8777 ( Bias -0.42, P=0.077). Compared with those from 8 clinicians, the results of AI system interpretation were more stable, and the β-angle effect was more prominent. Conclusion:The AI system can quickly and accurately measure the Graf correlation index of standard DDH ultrasonic standard diagnosis plane.