Aim To investigate the correlation between the new version of the European System for Cardiac Op-erative Risk Evaluation Ⅱ(EuroSCORE Ⅱ)score,Gensini score and the occurrence of major adverse cardiovascular e-vents(MACE)after percutaneous coronary intervention(PCI)in patients with coronary heart disease(CHD).Meth-ods A total of 203 CHD patients undergoing PCI treatment admitted to the Department of Cardiovascular Surgery of the First Affiliated Hospital of Air Force Military Medical University from January 2021 to March 2023 were selected as the study objects.Depending on whether MACE happened or not,they were divided into MACE group and non-MACE group.The clinical data of the two groups of patients was compared.Pearson's correlation coefficient was used to analyze the cor-relation between EuroSCOREⅡscore and Gensini score;Logistic regression model was used to evaluate the risk factors for the development of MACE after PCI in patients with CHD;and ROC curves was used to analyze the predictive value of pre-dictive indexes for the development of MACE after PCI in patients with CHD.Results In 203 cases of CHD patients who underwent PCI,65 of them experienced MACE during the 1-year postoperative follow-up(32.02%).The age,rate of history of diabetes mellitus,rate of Killip classification≥gradeⅡ,rate of≥2 diseased vessels,rate of≥2 stents,EuroSCOREⅡscore,and Gensini score of the MACE group were higher than those of the non-MACE group,and the differ-ences were all statistically significant(P<0.05).The results of the Pearson's correlation analysis indicated that there was a positive correlation between the EuroSCOREⅡscore and Gensini score(r=0.200,P=0.004).Logistic regression model analysis showed that age increase,Killip classification≥gradeⅡ,high EuroSCOREⅡscore,and high Gensini score were independent risk factors for the development of MACE after PCI in CHD patients(P<0.05).ROC curve anal-ysis showed that age increase,Killip classification≥gradeⅡ,EuroSCOREⅡscore,Gensini score,and combined predic-tion had statistical significance in determining the occurrence of MACE after PCI(P<0.05);The area under the curve(AUC)of combinedpredictionwas0.953,95%CI was 0.928～0.979,sensitivity was 0.892,specificity was 0.891,in-dicating high predictive value.Conclusion Age increase,Killip classification≥gradeⅡ,high EuroSCOREⅡscore,and high Gensini score are independent risk factors for the occurrence of MACE after PCI in patients with CHD,and all of them have a certain predictive value for MACE after PCI in patients with CHD,and the combined predictive value is higher.

BACKGROUND:Traumatic brain injury is a condition in which the normal function of the brain is disrupted by a bump or impact to the head.It is necessary to find effective treatments and objective targets that can help doctors diagnose the injury status and restore the brain function of patients. OBJECTIVE:To explore the effect of electroacupuncture combined with low-frequency transcranial ultrasound stimulation on the electroencephalographic signals of rats with traumatic brain injury. METHODS:Forty 6-week-old SPF male Sprague-Dawley rats were randomly divided into five groups:sham group,model group,electroacupuncture group,low-frequency transcranial ultrasound stimulation group and combined group(electroacupuncture+low-frequency transcranial ultrasound stimulation),with eight rats in each group.Feeney weight-drop method was used to establish the animal model of traumatic brain injury.In the sham group,the bone window was only opened without impact.Interventions were started at 1 day after modeling.Electroacupuncture in the electroacupuncture group,low-frequency transcranial ultrasound stimulation in the low-frequency transcranial ultrasound stimulation group,and electroacupuncture+low-frequency transcranial ultrasound stimulation in the combined group were performed for days in total.The modified neurological severity scale score for assessing rats'neurological deficits was performed at 8 hours after modeling.The percentage of spontaneous alternation behavior in the Y-maze was measured at 7 days after modeling.Then,the electroencephalographic signals were collected and electroencephalographic data of α,β,θ,and δ waves were extracted by fast Fourier transform,and the value of oscillation amplitude and energy ratio were calculated in α,β,θ,and δ waves,as well as the Lempel-Ziv complexity and sample entropy. RESULTS AND CONCLUSION:Compared with the sham group,the modified neurological severity scale scores in the model group,electroacupuncture group,low-frequency transcranial ultrasound stimulation group and combined group were significantly increased at 8 hours after modeling(P<0.05).Compared with the sham group,the value of oscillation amplitude in δ wave and the value of δ energy ratio were significantly increased in the model group at 7 days after modeling,meanwhile the percentage of spontaneous alternation behavior in Y-maze,and the value of α/β energy ratio,Lempel-Ziv complexity,and sample entropy were significantly decreased(P<0.05).Compared with the model group,the value of oscillation amplitude in α and δ waves was significantly decreased in the combined group(P<0.05),while the value of α/β energy ratio was significantly increased(P<0.05)and the value of δ energy ratio was significantly decreased(P<0.05)in the electroacupuncture group,low-frequency transcranial ultrasound stimulation group and combined group.Compared with the electroacupuncture group and low-frequency transcranial ultrasound stimulation group,the value of δ energy ratio was significantly decreased in the combined group(P<0.05),while the percentage of spontaneous alternation behavior,the value of α/β energy ratio,the Lempel-Ziv complexity,and the sample entropy were significantly increased(P<0.05).To conclude,abnormal electroencephalographic signals can appear in rats with traumatic brain injury,while the electroacupuncture combined with low-frequency transcranial ultrasound stimulation can alleviate the abnormal electroencephalographic signals in rats,which suggests the electroencephalographic frequency domain value and nonlinear features can be used to assess the severity of traumatic brain injury.

Aim To investigate the correlation between the new version of the European System for Cardiac Op-erative Risk Evaluation Ⅱ(EuroSCORE Ⅱ)score,Gensini score and the occurrence of major adverse cardiovascular e-vents(MACE)after percutaneous coronary intervention(PCI)in patients with coronary heart disease(CHD).Meth-ods A total of 203 CHD patients undergoing PCI treatment admitted to the Department of Cardiovascular Surgery of the First Affiliated Hospital of Air Force Military Medical University from January 2021 to March 2023 were selected as the study objects.Depending on whether MACE happened or not,they were divided into MACE group and non-MACE group.The clinical data of the two groups of patients was compared.Pearson's correlation coefficient was used to analyze the cor-relation between EuroSCOREⅡscore and Gensini score;Logistic regression model was used to evaluate the risk factors for the development of MACE after PCI in patients with CHD;and ROC curves was used to analyze the predictive value of pre-dictive indexes for the development of MACE after PCI in patients with CHD.Results In 203 cases of CHD patients who underwent PCI,65 of them experienced MACE during the 1-year postoperative follow-up(32.02%).The age,rate of history of diabetes mellitus,rate of Killip classification≥gradeⅡ,rate of≥2 diseased vessels,rate of≥2 stents,EuroSCOREⅡscore,and Gensini score of the MACE group were higher than those of the non-MACE group,and the differ-ences were all statistically significant(P<0.05).The results of the Pearson's correlation analysis indicated that there was a positive correlation between the EuroSCOREⅡscore and Gensini score(r=0.200,P=0.004).Logistic regression model analysis showed that age increase,Killip classification≥gradeⅡ,high EuroSCOREⅡscore,and high Gensini score were independent risk factors for the development of MACE after PCI in CHD patients(P<0.05).ROC curve anal-ysis showed that age increase,Killip classification≥gradeⅡ,EuroSCOREⅡscore,Gensini score,and combined predic-tion had statistical significance in determining the occurrence of MACE after PCI(P<0.05);The area under the curve(AUC)of combinedpredictionwas0.953,95%CI was 0.928～0.979,sensitivity was 0.892,specificity was 0.891,in-dicating high predictive value.Conclusion Age increase,Killip classification≥gradeⅡ,high EuroSCOREⅡscore,and high Gensini score are independent risk factors for the occurrence of MACE after PCI in patients with CHD,and all of them have a certain predictive value for MACE after PCI in patients with CHD,and the combined predictive value is higher.

Objective:To investigate whether intratumoral Gemella haemolysans(G.haemolysans)enhances the efficacy of neoadjuvant chemoimmunotherapy(NACI)in esophageal squamous cell carcinoma(ESCC)-bearing mice and the underlying mechanism.Methods:Twenty-five 4-week-old female C57BL/6 mice were randomized into five groups(n=5 per group):negative control(NC)group,chemo-therapy group,G.haemolysans+chemotherapy group,NACI group,and G.haemolysans+NACI group.A germ-free mouse model was established in each group by administering antibiotic cocktail for 2 weeks.On day 0,ESCC-bearing mouse models were built through subcutaneous inoculation of either murine esophageal cancer cell line AKR or G.haemolysans-AKR cells.On day 7 when tumors formed under the skin,drugs were injected into the abdomen thrice weekly.On day 28 when the treatments were finished,the mice were sacrificed to harvest their tumors,and then the tumors were fixed in 4%paraformaldehyde.We located and quantified G.haemolysans within the tumors through fluorescence in situ hybridization,and characterized immune cell composition in the tumor immune microen-vironment(TIME)of the mice treated with NACI through multiplex immunohistochemistry and flow cytometry.Results:G.haemolysans significantly strengthened the efficacy of NACI in ESCC(P<0.05),whereas no chemosensitizing effects were observed on chemo-therapy in ESCC-bearing mice.G.haemolysans significantly en-hanced natural killer(NK)cell infiltration within the TIME(P<0.01).Conclusion:G.haemolysans improves NACI efficacy in ESCC-bearing mice by increasing NK cell recruitment in the TIME.

Purpose: Achieving high-quality immune reconstitution (IR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is directly associated with the patient’s ability to resist infections, prevent tumor relapses, and suppress graft-versus-host disease (GVHD). The status of CD4 + T cells is critical for reconstituting adaptive immunity after transplantation; however, the patterns of reconstitution and their influencing factors remain unclear. Methods: This retrospective cohort study involved 164 patients who underwent myeloablative allo-HSCT from April 2016 to May 2023. Based on the early post-transplantation CD4 + T cell counts, the cohort was divided into two groups: 73 patients with high-quality IR (HIR) and 34 patients with low-quality IR (LIR). LIR was associated with an increased risk of Epstein–Barr virus (EBV) reactivation following transplantation. Plasma EBV viral load was monitored weekly using quantitative PCR for the first 100 days post-transplantation. Results: The LIR group had a higher viral load at the time of the first EBV reactivation and a significantly earlier first reactivation compared to the HIR group. No significant differences were observed in overall survival, GVHD incidence, or relapse rates between the groups. A CD4 + T cell count of < 60 cells/μL within 30 days post-transplantation was associated with a higher incidence of EBV viremia compared to the control group. Conclusion These findings suggest that early CD4 + T cell counts may serve as a predictive marker for post-transplant EBV infection.

Background::Histological healing is closely associated with improved long-term clinical outcomes and lowered relapses in patients with ulcerative colitis (UC). Here, we developed a novel diagnostic criterion for assessing histological healing in UC patients.Methods::We conducted a retrospective cohort study in UC patients, whose treatment was iteratively optimized to achieve mucosal healing at Shanghai Tenth People’s Hospital of Tongji University from January 2017 to May 2022. We identified an inflammatory cell enumeration index (ICEI) for assessing histological healing based on the proportions of eosinophils, CD177 + neutrophils, and CD40L + T cells in the colonic lamina propria under high power field (HPF), and the outcomes (risks of symptomatic relapses) of achieving histological remission vs. persistent histological inflammation using Kaplan-Meier curves. Intrareader reliability and inter-reader reliability were evaluated by each reader. The relationships to the changes in the Nancy index and the Geboes score were also assessed for responsiveness. The ICEI was further validated in a new cohort of UC patients from other nine university hospitals. Results::We developed an ICEI for clinical diagnosis of histological healing, i.e., Y = 1.701X 1 + 0.758X 2 + 1.347X 3 - 7.745 (X 1, X 2, and X 3 represent the proportions of CD177 + neutrophils, eosinophils, and CD40L + T cells, respectively, in the colonic lamina propria under HPF). The receiver operating characteristics curve (ROC) analysis revealed that Y <-0.391 was the cutoff value for the diagnosis of histological healing and that an area under the curve (AUC) was 0.942 (95% confidence interval [CI]: 0.905-0.979) with a sensitivity of 92.5% and a specificity of 83.6% ( P <0.001). The intraclass correlation coefficient (ICC) for the intrareader reliability was 0.855 (95% CI: 0.781-0.909), and ICEI had good inter-reader reliability of 0.832 (95% CI: 0.748-0.894). During an 18-month follow-up, patients with histological healing had a substantially better outcome compared with those with unachieved histological healing ( P <0.001) using ICEI. During a 12-month follow-up from other nine hospitals, patients with histological healing also had a lower risk of relapse than patients with unachieved histological healing. Conclusions::ICEI can be used to predict histological healing and identify patients with a risk of relapse 12 months and 18 months after clinical therapy. Therefore, ICEI provides a promising, simplified approach to monitor histological healing and to predict the prognosis of UC.Registration::Chinese Clinical Trial Registry, No. ChiCTR2300077792.

Objective: To investigate the neuroprotective effect of mesenchymal stem cells (MSC) combined with low⁃intensity transcranial ultrasound (LITUS) treatment on traumatic brain injury (TBI) . Methods: Seventy⁃two SD rats were randomly divided into four groups , namely , control group , TBI group , MSC injection group , and combined treatment group , with 18 rats in each group. TBI model was established by applying a pneumatic controlled cortical impingement instrument. Within 24 h after surgery , MSC was injected into the injury site by microinjector and microinjector pump using in situ injection. After injection , the injury site was treated with LITUS for 28 consecutive days using an ultrasound stimulator. The modified neurological functioning score ( mNSS) was performed on rats in each group at 1 , 3 , 7 , 14 , 21 and 28 days postoperatively , and then the brains were extracted to detect pathological changes at the injury site and the mRNA and protein expression of brain⁃derived neurotrophic factor (BDNF) , growth associated protein⁃43 ( GAP⁃43) , postsynaptic density protein⁃95 ( PSD⁃95 ) and glial fibrillary acidic protein(GFAP) by HE staining , immunohistochemistry , Western blot and RT⁃PCR. Results: Compared with the control group , the mNSS score increased in the TBI group (P < 0. 05) , the expression of GAP⁃43 and PSD⁃95 decreased , and the expression of GFAP increased ( P < 0. 05 ) ; Compared with the TBI group , the mNSS score of MSC group was lower (P < 0. 05) , the expression of BDNF , GAP⁃43 , PSD⁃95 increased , and the expression of GFAP decreased (P < 0. 05) ; mNSS scores were lower in the combined treatment group than those in the MSC group (P < 0. 05) , the expression of BDNF , GAP⁃43 , PSD⁃95 increased , and the expression of GFAP decreased (P < 0. 05) . Conclusion The mechanism by which MSC combined with LITUS exerts neuroprotective effects in TBI may be related to the promotion of BDNF , GAP⁃43 , and PSD⁃95 expression and reduction of GFAP expression.

Objective:To investigate the genetic risk factors and prognosis of 190 patients with myelodysplastic syndrome(MDS). Methods:The clinical data of 190 patients with MDS admitted to the Department of Hematology,The First Affiliated Hospital of Chongqing Medical University from January 2015 to October 2020 were analyzed retrospectively,and the genetic background and survival curve of the patients were also analyzed. Results:MDS patients with higher risk according to International Prognostic Score System(IPSS)stratification at the time of initial diagnosis had more frequent and complex types of gene mutation and chromosomal abnormalities,indicating poor prognosis.The choice of treatment is associated with the prognosis of MDS patients with intermediate risk(IPSS stratification),and the relative risk of the overall survival rate of patients treated with hypomethylating agents is higher than that of patients on concomitant medication. Conclusion:MDS patients with higher-risk(IPSS stratification)have more complex genetic risk factors and lower survival rate than those with lower-risk(IPSS stratification).MDS patients with multiple genetic risk factors have a poor prognosis,and the type of gene mutation is a predictor of prognosis.

Objective:To analyze the application value of PAD (Presentation-Assimilation-Discussion) class and case teaching combined with brainstorming in the practice teaching of nursing students in the department of cardiovascular surgery.Methods:A total of 81 undergraduate nursing students who practiced in the Department of Cardiovascular Surgery, The First Affiliated Hospital of Air Force Medical University from June 2019 to April 2020 were selected as the research objects. They were randomly divided into the control group ( n=40, brainstorming teaching) and the observation group ( n=41, PAD class combined with case teaching). After one month of intervention, the teaching effect on the two groups of nursing students were evaluated through the nursing students' clinical communication ability scale, Chinese version of self-assessment of clinical reflection and reasoning (SACRR), and competency inventory for registered nurse (CIRN). And the teaching quality was assessed by the clinical nursing teacher teaching behavior assessment scale. SPSS 22.0 was used for t-test. Results:The scores of each dimension and total scores of clinical communication ability scale, Chinese version SACRR and CIRN of nursing students in the observation group were higher than those in the control group ( P<0.05). The scores of nursing teaching behavior evaluation of clinical teachers in the observation group were higher than those in the control group ( P<0.05). Conclusion:The combination of PAD class and case teaching with brainstorming can improve the clinical communication ability of nursing students in cardiovascular surgery practice, help to promote the transformation of their clinical thinking ability, improve their core competences, and play an important role in improving the teaching quality.

To evaluate the psychological symptoms of patients with Crohn disease (CD), and to explore the risk factors affecting quality of life (QOL) in CD patients, 50 adult patients with CD, and 50 healthy controls were enrolled. Psychological questionnaires including self-rating anxiety scale (SAS), self-rating depression scale (SDS), the inflammatory bowel disease questionnaire (IBDQ) and the short form-36 health survey (SF-36) were completed. The results showed both the SAS (40.3±8.5 VS 37.6±7.0) and the SDS (47.1±11.1 VS 41.8±9.6) in CD patients were significantly higher than those in the healthy controls ( t=5.4, P<0.05; t=10.6, P<0.05). The IBDQ scores revealed the physical symptoms scores were 49.50±7.62, systemic symptoms scores 23.92±5.07, emotional functions scores 57.13±15.62, and social function scores 22.15±9.08 in CD active phase. However, the above scores were 60.12±4.01, 26.24±3.97, 67.34±15.17, and 25.44±2.03 respectively in the remission phase. Four subscale items of IBDQ in CD active phase were significant lower than those in the remission phase (all P<0.05). The subscale items of SF-36 scores (PF, RP, BP, GH, VT, SF, RE, MH) in CD patients were significant lower than those in healthy controls (all P<0.05). The SF-36 items scores of PF,RP and MH in the remission phase were significant higher than those in the active phase (all P<0.05). The SF-36 items scores of GH and VT in patients with malnutrition were significant lower than those with nutrition (both P<0.05). Multivariate regression analysis showed that disease status and nutritional risk ( P<0.05) significantly affected the patients' IBDQ scores. Factors including sex, age, marital status, education background, medical insurance, use of biologicals, surgery treatment had little influence on the total score of IBDQ ( P>0.05). Psychological conseling and treatment in the active phase may improve QOL of CD patients.