Objective To construct a risk prediction model of pulmonary involvement based on chest CT and clinical feature in patients with primary Sjogren's syndrome(pSS),and to explore the risk prediction value of the model.Methods A total of 360 pSS patients who had been treated at Handan Hospital of Traditional Chinese Medicine from October 2020 to August 2023 were retrospectively selected as study objects,and were then divided into a modeling group(252 patients)and a verification group(108 patients)according to a ratio of 7∶3.The patients in the modeling group were divided into a control group(201 patients)and an involvement group(51 patients)based on presence or absence of lung involvement.The data on clinical characteristics and features of chest high-resolution CT(HRCT)in the modeling group was collected.Univariate analysis was performed among the groups to determine the relevant factors affecting lung involvement in pSS patients.Binary logistic regression analysis was performed on related factors to screen independent risk factors.A prediction model was established based on the independent risk factors.A verification and value analysis of the column-line prediction model were completed through data collection of the verification group.Results Age,disease course,cough,Raynaud's phenomenon,C-reactive protein(CRP),anti-SSA antibody,and HRCT were the relevant factors affecting lung involvement in pSS patients(all P＜0.05).Further binary logistic regression analysis showed that old age,prolonged disease course,cough and abnormal HRCT imaging were independent risk factors for lung involvement in SS patients(all P＜0.05).A nomogram risk prediction model was constructed based on independent factors.The model verification results indicated that the calibration chart showed better performance in the prediction model.The AUC of the area under the receiver operating characteristic(ROC)curve was 0.993 the modeling group and 0.995 in the validation group.Conclusions The clinical characteristics and the results of chest CT are closely related with lung involvement in patients with pSS.Old age,prolonged disease course,cough,and abnormal HRCT imaging are independent risk factors affecting lung involvement in patients with pSS.The prediction model established on this basis has a higher predictive value for the occurrence of lung involvement in patients receiving after-loading radiotherapy.

Multiple myeloma is one type of hematological malignancy, characterized by the proliferation and accumulation of monoclonal plasma cells in bone marrow. Bone marrow microenvironment plays a key supporting role in the proliferation and survival of myeloma cells, where a large number of immune cells exist but are functionally suppressed. Based on the studies of myeloma immune microenvironment in recent years, we summarize the recent advances and existing problems in the treatment of multiple myeloma and put forward some considerations and suggestions, to provide references for researchers in this field.

【Objective】 To investigate the main causes of blood donor deferral in domestic blood center. 【Methods】 The causes of donor deferral were classified into 12 categories as previous medical history, drug use, alcohol consumption, menstrual period, underweight, abnormal blood pressure, abnormal body temperature, abnormal hemoglobin (Hb), lipemic blood, positive hepatitis B surface antigen (HBsAg), elevated alanine aminotransferase (ALT) and others according to the comparison indicators of Asia-Pacific Blood Network (APBN) and the national standard Blood Donor Health Examination Requirements. The relevant data of the top 3 causes of donor deferral, voluntarily reported by the members of Practice Comparison Working Group of China’s Mainland Blood Collection and Supply Institutions from 2014 to 2019, were collected and a histogram was generated. 【Results】 The median donor deferral rate of 20 domestic blood centers from 2014 to 2019 was 12.14%, with the lowest at 0.18% and highest at 32.32%, respectively. The top three causes for donor deferral were elevated ALT, abnormal Hb and abnormal blood pressure in year 2014, 2015, 2018 and 2019; elevated ALT, lipemic blood and abnormal blood pressure in 2016; elevated ALT, abnormal Hb, and lipemic blood in 2017. 【Conclusion】 The main causes of donor deferral were elevated ALT, abnormal Hb, abnormal blood pressure and lipemic blood.

Background/Aims: Lyon consensus differentiates acid exposure time (AET) as physiological, borderline, and pathological. Mean nocturnal baseline impedance (MNBI) and post-reflux swallow-induced peristaltic wave index (PSPWi) are believed to increase diagnostic yield of gastroesophageal reflux disease (GERD) and correlate with symptom outcome of proton pump inhibitor (PPI) treatment. We aim to explore the clinical characteristics and the correlation of pH-impedance parameters with PPI response in Chinese patients with different AET levels. Methods: We retrospectively investigated 177 patients with typical reflux symptoms who received esophageal function tests. The demographics, GERD questionnaire scores, the proportion of esophagitis and PPI responders, and manometric and pH-impedance parameters were compared among patients with AET < 4%, 4-6%, and > 6%. In patients with AET ≥ 4%, manometric and pH-impedance parameters were compared between PPI responders and non-responders. Results: Among 177 patients, 69 (39.0%) had AET 4-6%, and 53 (29.9%) had AET > 6%. The demographics, esophagogastric junction type, and occurrence of ineffective esophageal motility were similar between patients with AET 4-6% and > 6%, but different from AET < 4%. MNBI and PSPWi were different among different AET levels, but similar between PPI responders and non-responders in patientswith AET ≥ 4%. Conclusions It is reasonable to set 4% as a threshold to define pathological AET in Chinese patients. MNBI and PSPWi could identify GERD patients, but may not correlate with PPI response of Chinese GERD patients.

Objective:To investigate the mechanism of crush syndrome (CS) induced by crush injury on myocardial cells in rats.Methods:Thirty two male Sprague Dawley (SD) rats were randomly divided into control group, CS-0 group, CS-12 group and CS-24 group with 8 rats in each group. CS model was made by self-made extruder and perfused with 4% paraformaldehyde for 0, 12 and 24 h. The morphological changes of myocardial tissue were observed by hematoxylin staining. The apoptosis of cardiomyocytes was detected by terminal dexynucleotide transferase-mediated nick end labeling (TUNEL). The levels and activities of malondialdehyde (MDA), superoxide dismutase (SOD), lactose dehydrogenase (LDH), interleukin-6 (IL-6), interleukin-1 β (IL-1 β), tumor necrosis factor-α (TNF- α) in myocardial homogenate were detected by enzyme-linked immunosorbent assay (ELISA). The expressions of Caspase-3, Bax, Bcl-2 and necrosis factor-κB (NF-κ B) were detected by Western blot.Results:Compared with the control group, the myocardial tissue of CS model group had different degrees of morphological damage; compared with the control group, the apoptosis rate, Caspase-3 and Bax protein expression levels of CS-0 group, CS-12 group and CS-24 group were significantly increased ( P<0.05), and the expression level of Bcl-2 protein was significantly decreased ( P<0.05); compared with the control group, the levels of MDA, LDH, IL-6, IL-1β, TNF-α and p65 protein phosphorylation in the myocardial homogenate of CS-0 group, CS-12 group and CS-24 group were significantly increased ( P<0.05), and SOD activity was significantly decreased ( P<0.05). Conclusions:CS may inhibit oxidative stress and induce inflammatory reaction by activating NF-κ B pathway, thus damaging myocardial cells in rats.

Objective To study the level of mindfulness,mental toughness and clinical practice of nursing internship, to analyze the relationship between the level of mindfulness and mental toughness and clinical practice, to further improve the level and ability of nursing internship in clinical practice. Methods A total of 298 nursing internship in our hospital from January 2014 to December 2016 were included in the study. The level of mindfulness, resilience and clinical practice ability of all nursing internship were examined. The level of mindfulness, resilience and clinical practice ability of nursing students were analyzed. The relationship between mindfulness level, resilience and clinical practice ability of nursing students in our hospital were observed. Results The score of male nursing internshipin observation and description dimensions were 3.36±0.45, 3.52±0.43, significantly higher than female nursing internship 3.02 ± 0.41, 3.19 ± 0.38, the difference was statistically significant (t=6.815, 7.028, P<0.05). The scores of male nursing internship in individual ability, social ability, planning style, social resources and family cohesion dimensions were 4.82±0.36, 5.09±0.46, 4.06±0.42, 4.73±0.35, 5.04± 0.39, which were higher than those of female nursing students 4.51 ± 0.34, 4.89 ± 0.42, 3.91 ± 0.38, 4.58 ±0.31, 4.88 ± 0.32, the difference was statistically significant (t=3.268-6.847, P<0.05). Male nursing internship in the use of theoretical knowledge, communication and clinical skills scores were 3.35 ± 0.38, 3.76±0.45, 3.59±0.46, lower than that of female nursing internship 3.56±0.39, 3.54±0.42, 3.42±0.41, the difference was statistically significant (t=4.678, 2.851, 2.243, P<0.05). The level of mindfulness and the level of resilience of the male and female nursing internship were positively correlated with the ability of clinical practice (r=0.823- 0.884,P<0.05). Conclusions The level of mindfulness and mental toughness is the influencing factors of nursing internship in clinical practice ability, through the cultivation of the level of mindfulness and mental toughness for clinical nursing internship, we can effectively improve the clinical practice ability of nursing students,improve the level of nursing and ensure medical safety.

Objective: To investigate the clinical avalue of real time threshold manual triggering technique in the lower extremity arterial CT angiography .Methods :A total of 70 patients with clinically suspected lower extremity arterial disease underwent lower extremity arterial CT examination ,and the patients were randomly divided into two groups .In the first group 35 patients ,the automatic threshold triggering technique was used .After the threshold reached to 150 Hu ,6 s was delayed before scanning .The other group of 35 patients with manual triggering was used to observe the time density curve .When the peak value was stable ,scanning was started at once .The delay time of the two groups was analyzed and the image quality of the two groups was evaluated .The image quality evaluation included the branch level ,the smooth degree of the arterial edge , the interference of the vein and the CT value of the arterial segment .Results:There were significant differences in the starting delay time of the two trigger modes (P=0 .002 ,P<0 .05) ,and the auto trigger group was earlier than the manual triggering group .Between the two trigger modes ,there was no significant difference in the distal branches and vessel edge of abdominal‐iliac artery and femoral popliteal artery display ability .In the lower limb artery ,the image quality of manual triggering group was higher than that of the automatic trigger group ,the two groups had statistical significance (P=0 .004 , P=0 .003) .The same as to the distal branch and the edge of the vessel of the foot (P=0 .003 ,P=0 .003) .Two sets of images in the lower limb vein interference score had no significant difference ( P> 0 .05 ) .CT value had no significant difference in abdominal‐iliac artery ,femoral‐calf and popliteal arteries between the two groups ,while that in the dorsalis pedis artery had statistical significance between the two groups (P=0 .006) .Four levels of CT values in manual triggering group were higher than those in the automatic trigger group .Conclusions :Real time threshold manual triggering technique takes into account the individual differences of patients ,so the patient's delay scan time can be evaluated better and higher quality of lower extremity arterial images can be acquired .

Objective To observe bone formation of compound of autologous periosteum cells plus calcium alginate gelatin in animal body and investigate the best mixing ratio of the two components.Methods A total of 96 healthy adult New Zealand rabbits were randomly divided into six groups (Groups A,B,C,D,E and control group).The excised bilateral periostea from rabbits in each experimental group were all made into 0.4 ml cell suspensions.The compounds were prepared by blending 0.4 ml calcium alginate gelatin with 1,1/4,1/16,1/64 and 1/256 of the periosteum cell suspension respectively,and then were applied to autologous right radial defect area.Gross observation,X-ray examination and histological study were carried out at 2,4,8,12 weeks postoperatively.Levels of serum alkaline phosphatase and serum calcium were determined as well.Results The compounds containing periosteum cell suspension with cell counts of 1/4 or 1/16 and calcium alginate gelatin reached the best osteogenesis.Conclusion Compound of autologous periosteum cell suspension-calcium alginate gelatin induces obvious bone formation and is worthy of clinical application,for it has advantages of satisfactory bone defect repair and easy operation.

In this research,enzyme linked immunoassay (ELISA) was used to assay the fibrinogen (FIG) adsorbed on the Ti-O films and on the low temperature isotropic carbon (LTIC) films which were planted in the femoral arteries of 6 mongrel dogs for six months, respectively. The Ti-O films were planted in the dogs' left femoral arteries; the LTIC films as controls were planted in the dogs' right femoral arteries. The contents adsorbed in these two kinds of films were examined by scanning electron microscopy (SEM). The quantities of FIG adhered or denatured on the Ti-O films or LTIC films determined by ELISA, and the platelets adhered on the two kinds of films examined by SEM were of significant difference between the two groups. In the blood vessel, the amount of FIG adhered on biomaterial was related to its component and construction. FIG released electron to the biomaterial and induced the unfolding of C term of the gamma-chain of FIG, and the conjugation point and effect point were exposed. In conclusion, the biomaterial, which has the capability for resisting the electron release from FIG as well as for maintaining the invariable electric condition, will have excellent hemocompatibility.
Adsorption ; Animals ; Dogs ; Fibrinogen ; metabolism ; Heart Valve Prosthesis ; Histocompatibility ; Molecular Conformation ; Platelet Adhesiveness ; Prostheses and Implants ; Surface Properties ; Titanium ; chemistry