Objective:To investigate the efficacy and safety of atorvastatin combined with indobufen in the treatment of elderly patients with diabetic kidney disease (DKD) complicated with large atheromatous ischemic stroke (LAA-IS) during convalescence.Methods:The clinical data of 102 elderly patients with DKD complicated with LAA-IS during convalescence from September 2018 to April 2022 in Baoding Second Central Hospital were retrospectively analyzed. Among them, 51 patients were treated with atorvastatin combined with indobufen (observation group), 51 patients were treated with atorvastatin combined with aspirin (control group), and both groups were treated continuously for 6 months. The prethrombotic state indexes, neurological function and quality of daily life, carotid artery ultrasound indexes, renal fibrosis indexes before treatment and after treatment were compared between two group. The prethrombotic state indexes included arachidonic acid (AA) and adenosine diphosphate (ADP) induction platelet aggregation rate, fibrinogen (FIB), protein C; the National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the neurological function, and the modified Barthel index (MBI) was used to evaluate the quality of daily life; carotid artery ultrasound indexes included carotid artery intima-media thickness (IMT) and maximum plaque area; the renal fibrosis indexes included transforming growth factor-β 1 (TGF-β 1), matrix metalloproteinase-9 (MMP-9), hyaluronic acid and platelet derived growth factor-BB (PDGF-BB). The adverse reactions were recorded. Results:There were no statistical differences in the all indexes before treatment between two groups ( P>0.05). In two groups, compared before treatment, the AA induction platelet aggregation rate, ADP induction platelet aggregation rate, FIB, NIHSS score, IMT and maximum plaque area after treatment were significantly lower, the protein C and MBI score were significantly higher, and there were statistical differences ( P<0.01); but there were no statistical differences after treatment between two groups ( P>0.05). The TGF-β 1, MMP-9, hyaluronic acid and PDGF-BB after treatment in two groups were significantly lower than before treatment, and the indexes in observation group were significantly lower than those in control group: (39.46 ± 6.89) μg/L vs. (45.04 ± 8.20) μg/L, (278.46 ± 49.39) μg/L vs. (327.30 ± 57.28) μg/L, (102.37 ± 20.62) μg/L vs. (116.84 ± 24.97) μg/L vs. (25.26 ± 4.45) μg/L vs. (28.13 ± 5.08) μg/L, with statistically significant differences( P<0.01). The incidence of adverse reactions in observation group was significantly lower than that in control group: 7.84% (4/51) vs. 23.53% (12/51), and there was statistical difference ( P<0.05). Conclusions:Compared with atorvastatin combined with aspirin, atorvastatin combined with indobufen in elderly patients with DKD complicated with LAA-IS during convalescence has the same effect in improving the related indicators of prethrombotic state, reducing neurological function deficit, improving the ability of daily living, and reversing carotid atherosclerosis. However, atorvastatin combined with indobufen can further protect renal function with higher safety.

Objective:To investigate the effect of enteral nutrition support on quality of life and therapeutic effect in patients with metastatic colorectal cancer.Methods:A total of 100 patients with metastatic colorectal cancer admitted to Anqing Petrochemical Hospital from Jan. 2020 to Dec. 2023 were selected and divided into parenteral nutrition group and enteral+parenteral nutrition group with 50 cases each using random number table method. The parenteral nutrition group received parenteral nutrition, and the parenteral + parenteral nutrition group was supplemented with enteral nutrition. The therapeutic effect, nutritional indexes, intestinal flora, survival time and quality of life before and after treatment were compared between the two groups.Results:The effective rate of enteral + off-site nutrition group was 76.00%, that of parenteral nutrition group was 54.00%, and that of enteral + off-site nutrition group was higher than that of parenteral nutrition group ( P<0.05). There were no significant differences in nutritional indexes, flora imbalance grade or QLQ-C30 score between the two groups before intervention ( P>0.05). After the intervention, the albumin and total protein in the enteral + parenteral nutrition group were (38.76±6.02) g/L, (64.09±6.71) g/L, the number of normal microbiota disorder cases was 46, the survival time was (17.055±4.33) months, the physical function score was (74.59±7.55) points, and the emotional function score was (78.94±7.96) points, cognitive function score (88.95±9.03) points, role function score (85.49±8.61) points, social function score (81.45±8.27) points. In the parenteral nutrition group, the albumin was (34.51±5.47) g/L, the total protein was (58.91±6.55) g/L, the number of normal microbiota disorder cases was 33, the survival time was (12.48±3.59) months, the physical function score was (67.21±6.81) points, and the emotional function score was (73.55±7.78) points, cognitive function score was (83.47±8.55) points, role function score was (80.14±8.26) points, social function score was (76.93±7.827) points, and enteral + off-site nutrition group was higher than parenteral nutrition group ( P<0.05). In the enteral + off-site nutrition group, the transferrin was (1.45±0.57) g/L, and there were 2 cases of class II flora dysregulation and 2 cases of class III flora dysregulation; in the off-site nutrition group, the transferrin was (1.71±0.61) g/L, and the number of class II flora dysregulation was 8 cases and the number of class III flora dysregulation was 9 cases. Enteral + off-site nutrition group was lower than parenteral nutrition group ( P<0.05) . Conclusion:Enteral + parenteral nutrition support Enteral nutrition support can help improve the treatment effect of metastatic colorectal cancer, improve the nutritional status and survival time of patients, and improve the quality of life of patients.

Objective To explore the value of bronchial diastolic response (BDR) test in predicting the cough variant asthma (CVA) in patients with chronic cough or negative result of BDR test. Methods A total of 140 patients with chronic cough and negative result of BDR test were selected and treated with inhaled corticosteroids (ICS) and long-acting β2-agonists for 4 weeks, and their lung functions were detected before and after treatment. Receiver operating characteristic (ROC) curve was used to evaluate the predictive values of the forced expiratory volume in the first second as a percentage of predicted value (FEV₁ %), exhaled nitric oxide (FeNO), forced expiratory flow at 25 % to 75 %(FEF_{25 % to 75 %})and forced expiratory flow rate in 25 % to 75 % (FEF %_{25 % to 75 %}) alone or their combined diagnosis. Results After treatment, there were 98 cases diagnosed as negative for CVA and 42 cases diagnosed as positive for CVA. In combination of evaluation indexes, the top three combinations for CVA diagnosis were FEF %_{25 % to 75 %}+△FEV₁ %, FEF_{25 % to 75 %} +FeNO, and △FEV₁ +△FEV₁ %. Venn diagram of the combined prediction showed that there was an overlap in CVA positive diagnostic patients with FeNO ≥ 41.50×10^-9 mol/L, △FEV₁ % ≥ 5.90 %, and FEF %_{25 % to 75 %} ≤ 61.99 %. Conclusion After treatment, patient's showing FeNO ≥ 41.50×10^-9 mol/L, △FEV₁ % ≥ 5.90 % and FEF %_{25 % to 75 %} ≤ 61.99 % can be used to predict CVA and the response to anti-asthma treatment.

Objective:To explore the application of analogical thinking combined with situational teaching method to create a happy learning situation in ophthalmic nursing practice teaching.Methods:A total of 90 nursing students who had practice in Department of Ophthalmology, Xijing Hospital, Air Force Medical University, from October 2020 to January 2022 were selected as the research objects. According to different teaching methods, they were divided into control group and observation group. The control group ( n=45) adopted conventional teaching, while the observation group ( n=45) adopted analogical thinking combined with situational teaching method. The two groups of nursing students were evaluated by comprehensive examination results, teaching effect questionnaire and students' overall satisfaction with their teachers. SPSS 22.0 was used for t-test and Chi-square test. Results:The test scores of theoretical knowledge [(85.39±1.57) vs. (84.41±1.34)] and nursing skills [(87.52±0.04) vs. (82.64±0.05)] of observation group were both higher than those of control group. In the observation group, the students' awareness of medication safety, professional interest and independent learning, cooperation and organization ability, independent thinking and independent learning ability, the purpose of multi-disciplinary knowledge integration, information and knowledge range improvement, clinical thinking communication ability enhancement, flexible application of theoretical knowledge, practical operation ability enhancement, and the cultivation of innovation consciousness were all improved. And all the scores were better than those of the control group. The satisfaction of teachers in the observation group on students' learning attitude, language expression, calling communication ability and independent problem-solving ability was higher than that in the control group ( P < 0.05). Conclusion:The combination of analogical thinking and the situational teaching method to create a happy learning situation can improve the average scores of nursing students and nursing skills, and significantly improve the satisfaction of students to the teachers.

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

Objective : The polishing effects of different compositions of chairside polishing systems on polyetheretherketone (PEEK) were compared to provide a reference for the rational selection of polishing systems for this material in clinical settings. Methods : A total of 108 specimens were made from ShushijieTMPEEK crown and bridge materials, Bio-PAEK® dental PEEK, and BioHPP® PEEK. Thirty-six specimens of each material were randomly divided into 6 groups on average based on their polishing technique: OptiDisc®, Super-Snap® Rainbow Technique Kit, VITA ENAMIC®Clinical Polishing Set, Sof-LexTM Diamond Polishing System, Visio.lign Finishing Kit for Composite Veneers, and CERAMAGE Polishing Kit, LavaTM Ultimate ceramic and VITA ENAMIC ceramics were set as the control groups, and 6 specimens were made in each material, polished by Sof-LexTM Diamond Polishing System and VITA ENAMIC® Polishing Set clinical, respectively, according to the manufacturers’ suggestions. The surface roughness (Ra value and Sa value) and gloss of each set were measured. The surface morphologies of the polished specimens were observed by scanning electron microscopy. Results : Surface roughness (Ra value and Sa value) and gloss were mainly influenced by the type of polishing system, and they varied between PEEK material types. The Sof-LexTM Diamond Polishing System produced the highest surface roughness and the lowest gloss values for PEEK materials, while the Super-Snap® Rainbow Technique Kit, Visio.lign Finishing Kit for Composite Veneers and CERAMAGE Polishing Kit resulted in low surface roughness values. The Visio.lign Finishing Kit for Composite Veneers and CERAMAGE Polishing Kit exhibited high gloss values. Polishing paste particles were observed embedded on the surfaces of the PEEK materials polished by the Visio.lign Finishing Kit for Composite Veneers; the surfaces of specimens polished by the CERAMAGE Polishing Kit were smooth, without polishing paste particle residue. Using the same polishing system, the best polishing results were obtained with BioHPP® among the PEEK materials tested. The surface roughness values of the three tested PEEK materials polished by the CERAMAGE Polishing Kit were similar to those of the LavaTM Ultimate ceramic and VITA ENAMIC ceramic, but the gloss was higher than that of both. Conclusion CERAMAGE Polishing Kit was recommended for polishing all three tested PEEK materials, achieving a good polishing effect, with similar surface roughness and higher gloss characteristics comparable to those of polished computer-aided design and manufacturing (CAD/CAM) resin-matrix ceramics.

Objective:To improve the accuracy of cone-beam CT (CBCT) image registration by using a dose-guided registration algorithm based on multi-objective optimization.Methods:A total of 28 sets of CBCT images of 6 patients with lung cancer and 5 patients with cervical cancer admitted to Harbin Medical University Cancer Hospital in 2022 were retrospectively analyzed. Using the results of bone-based registration as the starting points for dose registration algorithm, the dose fluence weighted mean square errors of each displacement point in surrounding three-dimensional space were calculated, and the candidate displacement points were selected by unsupervised k-means clustering method. The three-dimensional dose distribution of each candidate displacement point was calculated by using the limited size pencil beam algorithm, and the dose histogram indexes were extracted as the optimization variables of the multi-objective optimization algorithm. After the Pareto optimal solution set obtained using multi-objective genetic algorithm, the optimal unique solution was then determined based on the predetermined objective weight scheme.Results:After dose optimization registration, the values of D 90%, D 95%, D 98%, D mean and conformity index (CI) of planning target volume (PTV) of lung cancer patients were increased by 0.23 Gy, 0.49 Gy, 1.05 Gy, 0.15 Gy, 0.03 compared with conventional registration, respectively, and no significant difference was found for the organs at risk (OAR). For cervical cancer cases, the values of D 90%, D 95%, D 98%, D mean and CI of PTV were increased by 0.72 Gy, 1.15 Gy, 2.53 Gy, 0.24 Gy, 0.05 compared with conventional registration, respectively, whereas the evaluation indexes of partial OAR were decreased by 1.06-1.81 Gy. Conclusion:The proposed dose-guided registration algorithm can improve the dose coverage for the target area, decrease the dose for OAR and reduce residual error of rigid registration algorithm, which can be implemented as part of online adaptive radiotherapy.

Background: Xylazole (Xyl) is a veterinary anesthetic that is structurally and functionally similar to xylazine. However, the effects of Xyl in vitro remain unknown. Objectives: This study aimed to investigate the anesthetic mechanism of Xyl using fetal rat nerve cells treated with Xyl. Methods: Fetal rat nerve cells cultured for seven days were treated with 10, 20, 30, and 40 μg/ mL Xyl for 0, 5, 10, 15, 20, 25, 30, 45, 60, 90, and 120 min. Variations of amino acid neurotransmitters (AANTs), Nitric oxide-Cyclic GMP (NO-cGMP) signaling pathway, and ATPase were evaluated. Results: Xyl decreased the levels of cGMP and NO in nerve cells. Furthermore, Xyl affected the AANT content and Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase activity in nerve cells. These findings suggested that Xyl inhibited the NO-cGMP signaling pathway in nerve cells in vitro. Conclusions This study provided new evidence that the anesthetic and analgesic effects of Xyl are related to the inhibition of the NO-cGMP signaling pathway.

Objective To investigate the effect of carrimycin on the biological function of pancreatic cancer cells. Methods Pancreatic cancer cell lines MIA PaCa-2, BxPC-3, Panc-1, and PATU 8988 were treated with carrimycin at concentrations of 0 (control group), 2, 4, 8, and 16 μmol/L for 24, 48, and 72 hours. MTT assay was used to measure cell viability; EdU cell proliferation assay was used to observe the effect of carrimycin on DNA replication of pancreatic cancer cells; colony formation assay was used to observe the effect of carrimycin on the proliferation of pancreatic cancer cells; flow cytometry was used to analyze the effect of carrimycin on the cell cycle of pancreatic cancer cells; wound healing assay was used to analyze the effect of carrimycin on the migration of pancreatic cancer cells; Western blot was used to measure the expression levels of the markers such as epithelial-mesenchymal transition (EMT) and cell cycle-dependent protein kinase inhibitor 1A (P21); immunofluorescence assay were used to measure the expression levels of EMT-related markers. An 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. Results Compared with the control group, carrimycin significantly inhibited the proliferative activity of MIA PaCa-2, BxPC-3, Panc-1, and PATU 8988 cells in a concentration- and time-dependent manner (all P < 0.01); carrimycin at concentrations of 4, 8, and 16 μmol/L significantly reduced DNA replication in MIA PaCa-2 cells ( t =2.378, 4.984, and 18.970, all P < 0.05) and BxPC-3 cells ( t =4.879, 6.089, and 9.521, all P < 0.01); after treatment with carrimycin at concentrations of 4, 8, and 16 μmol/L, colony formation ability significantly decreased with the increase in drug concentration in MIA PaCa-2 cells ( t =5.889, 11.240, and 15.840, all P < 0.001) and BxPC-3 cells ( t =6.717, 15.800, and 18.850, all P < 0.001). After treatment with carrimycin at concentrations of 4, 8, and 16 μmol/L, there was a significant increase in the proportion of cells in G1 phase in MIA PaCa-2 cells ( t =9.071, 12.280, and 19.360, all P < 0.0001) and BxPC-3 cells ( t =3.061, 4.962, and 8.868, all P < 0.05), and there was a significant reduction in the proportion of cells in S phase in MIA PaCa-2 cells ( t =2.316, 4.165, and 5.562, all P < 0.05) and BxPC-3 cells ( t =2.424, 3.264, and 5.744, all P < 0.05). Western blot further demonstrated that compared with the control group, the expression level of the cell cycle-related protein P21 gradually increased with the increase in the concentration of carrimycin in MIA PaCa-2 cells ( t =5.437, 6.453, and 8.799, all P < 0.001) and BxPC-3 cells ( t =25.130, 44.750, and 52.960, all P < 0.000 1). Wound healing assay showed that after treatment for 12, 24, and 48 hours, carrimycin at concentrations of 0, 4, 8, and 16 μmol/L significantly reduced the lateral migration of MIA PaCa-2 cells (all P < 0.05) and BxPC-3 cells (all P < 0.05). Western blot showed that compared with the control group, carrimycin treatment at concentrations of 4, 8, and 16 μmol/L significantly upregulated the expression of the epithelial marker E-cadherin in MIA PaCa-2 cells ( t =2.388, 4.899, and 5.819, all P < 0.05) and BxPC-3 cells ( t =2.533, 5.836, and 6.774, all P < 0.05) and significantly downregulated the expression of the interstitial marker Snail in MIA PaCa-2 cells ( t =12.440, 14.830, and 16.800, all P < 0.000 1) and BxPC-3 cells ( t=5.039, 5.893, and 7.725, all P < 0.01), and it also significantly downregulated the expression of the interstitial marker Vimentin in MIA PaCa-2 cells ( t =3.105, 7.752, and 11.200, all P < 0.05) and BxPC-3 cells ( t =2.555, 4.883, and 9.153, all P < 0.05). Conclusion Carrimycin can effectively inhibit the proliferation, migration, and EMT process of pancreatic cancer cells, thereby exerting an antitumor biological activity.

Objective: To investigate the prevalence and influencing factors of electronic cigarette (e-cigarette) use among adolescents in Haidian District, Beijing, so as to provide insights into tobacco control among adolescents. Methods: The students in junior high school, high school and vocational high school were recruited from Haidian District using the stratified cluster random sampling method in October of 2019, and subjects' demographic features and use of e-cigarettes were collected using the Questionnaire for Survey on Tobacco Prevalence among Adolescents in China in 2019. The factors affecting e-cigarette use were identified among adolescents using the multivariable logistic regression analysis. Results: A total of 658 adolescents were investigated, including 315 junior high school students ( 47.87% ), 221 high school students ( 33.59% ), and 122 vocational high school students ( 18.54% ), and there were 261 boys ( 39.66% ), and 397 girls ( 60.34% ). There were 605 students that had heard of electronic cigarettes ( 91.95% ), 63 students that had used e-cigarettes (9.57%), and 23 students with current use of e-cigarettes ( 3.50% ), and there were 39 students that had never used electronic cigarettes but had a tendency of use in the future ( 6.55% ). Multivariable logistic regression analysis identified parental smoking ( OR=2.408, 95%CI: 1.179-4.916 ), close friends' smoking ( OR=3.597, 95%CI: 1.715-7.544 ) and cigarette smoking ( OR=23.029, 95%CI: 11.092-47.812 ) as factors affecting e-cigarette use among adolescents. Conclusions The prevalence of electronic cigarette uses is 9.57% among adolescents in Haidian District, Beijing. Parental smoking, peer smoking and use of cigarettes may facilitate the use of e-cigarettes among adolescents.