Objective:To optimize the smart follow-up workflow for day-case breast surgery patients using an action research approach and evaluate its effectiveness.Methods:A total of 648 post-discharge patients who underwent day-case breast surgery at the Day Surgery Unit of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences between February and May 2024 were selected by convenience sampling. Patients who received routine smart follow-up (automated+telephone) from February to March 2024 served as the baseline group. Patients enrolled in April 2024 ( n=218) and May 2024 ( n=202) formed the first and second cycle groups, respectively, in which the smart follow-up workflow was optimized iteratively using action research. Outcome indicators included automated recovery rate and total recovery rate of follow-up forms, as well as the incidence of postoperative discomfort symptoms. Results:The automated and total recovery rates of follow-up forms in the first and second cycle groups were significantly higher than those in the baseline group, with statistically significant differences observed ( P<0.01). The proportion of patients experiencing persistent chest distress was significantly lower in the first and second cycle groups compared to the baseline group, and further reduced in the second cycle group compared to the first, with statistically significant differences observed ( P<0.01). Pain levels in the first and second cycle groups were also significantly lower than those in the baseline group, with statistically significant differences observed ( P<0.01) . Conclusions:Optimizing the smart follow-up workflow for day-case breast surgery patients based on an action research approach can significantly improve the automated and overall recovery rates of follow-up forms, reduce postoperative discomfort, and enhance both the efficiency and quality of follow-up care.

Objective:To optimize the smart follow-up workflow for day-case breast surgery patients using an action research approach and evaluate its effectiveness.Methods:A total of 648 post-discharge patients who underwent day-case breast surgery at the Day Surgery Unit of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences between February and May 2024 were selected by convenience sampling. Patients who received routine smart follow-up (automated+telephone) from February to March 2024 served as the baseline group. Patients enrolled in April 2024 ( n=218) and May 2024 ( n=202) formed the first and second cycle groups, respectively, in which the smart follow-up workflow was optimized iteratively using action research. Outcome indicators included automated recovery rate and total recovery rate of follow-up forms, as well as the incidence of postoperative discomfort symptoms. Results:The automated and total recovery rates of follow-up forms in the first and second cycle groups were significantly higher than those in the baseline group, with statistically significant differences observed ( P<0.01). The proportion of patients experiencing persistent chest distress was significantly lower in the first and second cycle groups compared to the baseline group, and further reduced in the second cycle group compared to the first, with statistically significant differences observed ( P<0.01). Pain levels in the first and second cycle groups were also significantly lower than those in the baseline group, with statistically significant differences observed ( P<0.01) . Conclusions:Optimizing the smart follow-up workflow for day-case breast surgery patients based on an action research approach can significantly improve the automated and overall recovery rates of follow-up forms, reduce postoperative discomfort, and enhance both the efficiency and quality of follow-up care.

OBJECTIVE: To develop a drug-loaded composite microsphere that can simultaneously release the berberine (BBR) and naringin (NG) to repair infectious bone defects. METHODS: The NG was loaded on mesoporous microspheres (MBG) to obtain the drug-loaded microspheres (NG-MBG). Then the dual drug-loaded compound microspheres (NG-MBG@PDA-BBR) were obtained by wrapping NG-MBG with polydopamine (PDA) and modifying the coated PDA with BBR. The composite microspheres were characterized by scanning electron microscopy, X-ray diffraction, specific surface area and pore volume analyzer, and Fourier transform infrared spectroscopy; the drug loading rate and release of NG and BBR were measured; the colony number was counted and the bacterial inhibition rate was calculated after co-culture with Staphylococcus aureus and Escherichia coli for 12 hours to observe the antibacterial effect; the biocompatibility was evaluated by live/dead cell fluorescence staining and cell counting kit 8 assay after co-culture with rat's BMSCs for 24 and 72 hours, respectively, and the osteogenic property was evaluated by alkaline phosphatase (ALP) staining and alizarin red staining after 7 and 14 days, respectively. RESULTS: NG-MBG@PDA-BBR and three control microspheres (MBG, MBG@PDA, and NG-MBG@PDA) were successfully constructed. Scanning electron microscopy showed that NG-MBG@PDA-BBR had a rough lamellar structure, while MBG had a smooth surface, and MBG@PDA and NG-MBG@PDA had a wrapped agglomeration structure. Specific surface area analysis showed that MBG had a mesoporous structure and had drug-loading potential. Low angle X-ray diffraction showed that NG was successfully loaded on MBG. The X-ray diffraction pattern contrast showed that all groups of microspheres were amorphous. Fourier transform infrared spectroscopy showed that NG and BBR peaks existed in NG-MBG@PDA-BBR. NG-MBG@PDA-BBR had good sustained drug release ability, and NG and BBR had early burst release and late sustained release. NG-MBG@PDA-BBR could inhibit the growth of Staphylococcus aureus and Escherichia coli, and the antibacterial ability was significantly higher than that of MBG, MBG@PDA, and NG-MBG@PDA ( P<0.05). But there was a significant difference in biocompatibility at 72 hours among microspheres ( P<0.05). ALP and alizarin red staining showed that the ALP positive area and the number of calcium nodules in NG-MBG@PDA-BBR were significantly higher than those of MBG and NG-MBG ( P<0.05), and there was no significant difference between NG-MBG@PDA and NG-MBG@PDA ( P>0.05). CONCLUSION NG-MBG@PDA-BBR have sustained release effects on NG and BBR, indicating that it has ideal dual performance of osteogenesis and antibacterial property.
Rats ; Animals ; Osteogenesis ; Delayed-Action Preparations/pharmacology* ; Microspheres ; Berberine/pharmacology* ; Anti-Bacterial Agents/pharmacology* ; Escherichia coli

Lamin B1 (LMNB1) is highly expressed in liver cancer tissues, and its influence and mechanism on the proliferation of hepatocellular carcinoma cells were explored by knocking down the expression of the protein. In liver cancer cells, siRNAs were used to knock down LMNB1. Knockdown effects were detected by Western blotting. Changes in telomerase activity were detected by telomeric repeat amplification protocol assay (TRAP) experiments. Telomere length changes were detected by quantitative real-time polymerase chain reaction (qPCR). CCK8, cloning formation, transwell and wound healing were performed to detect changes in its growth, invasion and migration capabilities. The lentiviral system was used to construct HepG2 cells that steadily knocked down LMNB1. Then the changes of telomere length and telomerase activity were detected, and the cell aging status was detected by SA-β-gal senescence staining. The effects of tumorigenesis were detected by nude mouse subcutaneous tumorigenesis experiments, subsequent histification staining of tumors, SA-β-gal senescence staining, fluorescence in situ hybridization (FISH) for telomere analysis and other experiments. Finally, the method of biogenesis analysis was used to find the expression of LMNB1 in clinical liver cancer tissues, and its relationship with clinical stages and patient survival. Knockdown of LMNB1 in HepG2 and Hep3B cells significantly reduced telomerase activity, cell proliferation, migration and invasion abilities. Experiments in cells and tumor formation in nude mice had demonstrated that stable knockdown of LMNB1 reduced telomerase activity, shortened telomere length, senesced cells, reduced cell tumorigenicity and KI-67 expression. Bioinformatics analysis showed that LMNB1 was highly expressed in liver cancer tissues and correlated with tumor stage and patient survival. In conclusion, LMNB1 is overexpressed in liver cancer cells, and it is expected to become an indicator for evaluating the clinical prognosis of liver cancer patients and a target for precise treatment.
Animals ; Mice ; Telomerase/metabolism* ; Carcinoma, Hepatocellular/genetics* ; Liver Neoplasms/genetics* ; Telomere Shortening ; In Situ Hybridization, Fluorescence ; Mice, Nude ; Telomere/pathology* ; Carcinogenesis

ObjectiveTo compare the feasibility of establishing the rat model of acute coronary syndrome with combined blood stasis and poison by lipopolysacharide （LPS） injection， ligation of coronary artery and different combinations of the two methods. MethodA total of 225 male SD rats were randomly divided into sham operation group， simple coronary artery ligation group， first injected LPS group ［LPS（5 mg·kg）injection 24 h before coronary artery ligation］ and follow injected LPS group ［LPS（5 mg·kg）injection 10 min after coronary artery ligation］. The indexes of each group were detected at 3， 24， 72 h after modeling， and the model was comprehensively evaluated. The general state and macroscopic evaluation indexes of traditional Chinese medicine （TCM） syndrome （tongue and pulse） of rats in each group were observed. ECG and echocardiography were used to evaluate cardiac function， and the myocardial ischemia and infarction areas were measured by Evans blue/2，3，5-triphenyltetrazolium chloride （TTC） staining. The content of creatine kinase isoenzyme （CK-MB）， lactate dehydrogenase （LDH）， creatine kinase （CK）， and troponin T （cTnT） in serum as well as interleukin-1 β （IL-1β） and IL-6 changes were determined by biochemical method or enzyme-linked immunosorbent assay （ELISA）. Hematology analyzer was adopted to determine the white blood cell （WBC） count， and the four coagulation indexes， platelet aggregation rate， hemorheology and other coagulation evaluation indexes were also detected. The myocardial tissue was observed by hematoxylin-eosin（HE）staining. ResultAfter 3 h of modeling， compared with the conditions in sham operation group， the R， G and B values of tongue of rats （P<0.01）， pulse amplitude （P<0.01）， and cardiac function in simple coronary artery ligation group were decreased， and the color of hypoglossal veins became purple（P<0.01）. The content of CK， LDH， cTnT， IL-1β and IL-6 in serum（P<0.05）， myocardial infarction area（P<0.01）， and total number of WBCs （P<0.05）were increased. Compared with simple coronary artery ligation group， first injected LPS group and follow injected LPS group had increased hypoglossal veins， decreased R value of tongue and elevated cTnT content （P<0.01）， while follow injected LPS group had reduced B value of tongue， decreased cardiac output （CO）（P<0.05）， increased IL-1β content， and thinned left ventricular anterior walls at end-systole （LVAWs）（P<0.01）. After 24 h of modeling， compared with sham operation group， simple coronary artery ligation group presented significantly decreased R， G and B values of tongue， lengthened purplish dark hypoglossal veins （P<0.01）， reduced pulse amplitude（P<0.01） and cardiac function， enlarged myocardial infarction area（P<0.01）， increased whole blood viscosity， platelet aggregation rate， fibrinogen （FIB）， shortened prothrombin time （PT） and thrombin time （TT）（P<0.01）， and elevated total number of WBCs （P<0.01）and content of CK， LDH， cTnT and IL-6 in serum（P<0.05）. Compared with the conditions in simple coronary artery ligation group， the pulse amplitude， R， G and B values of tongue （P<0.01）， and ejection fraction （EF） and fractional shortening （FS） scores （P<0.05）dropped， and hypoglossal veins were deepened and lengthened（P<0.05）， and cTnT content was increased（P<0.01）in first injected LPS group and follow injected LPS group. However， follow injected LPS group had thinned LVPWs， increased LDH content， platelet aggregation rate（P<0.05）， myocardial infarction area， and total number of WBC， level of IL-1β（P<0.05）， and shortened TT（P<0.01）. Additionally， 72 h after modeling， compared with sham operation group， simple coronary artery ligation group showed significantly reduced pulse amplitude， lowered R， G and B values of tongue， thickened and lengthened hypoglossal veins（P<0.01）， decreased cardiac function， and increased content of cTnT， FIB， whole blood viscosity（P<0.01），platelet aggregation rate， level of IL-6 and IL-1β（P<0.05）. Compared with the conditions in simple coronary artery ligation group， the hypoglossal veins of the first injected LPS group and the follow injected LPS group were more purple， and the content of cTnT was boosted（P<0.01）， whereas follow injected LPS group had decreased pulse amplitude， R， G and B values of tongue， EF and FS scores （P<0.05）， and enlarged myocardial infarction area（P<0.01）. ConclusionCompared with the other modeling methods and models at different modeling time， the established model by LPS injection 10 min after coronary artery ligation for 24 h was more consistent with the clinical characteristics of acute coronary syndrome with combined blood stasis and poison.

ObjectiveTo establish the quality standard of Liangditang benchmark samples. MethodUltra performance liquid chromatography-quadrupole time-of-flight mass spectrometry （UPLC-QTOF-MS） was used to qualitatively analyze the chemical composition of Liangditang on the basis of molecular and fragment ion peak information with cracking law. The mobile phase was methanol （A）-0.05% phosphate aqueous solution （B） for gradient elution （0-10 min， 5%-23.5%A； 10-20 min， 23.5%A； 20-58 min， 23.5%-63%A； 58-60 min， 63%-90%A）， the flow rate was 0.8 mL·min^-1， and the detection wavelength was 254 nm. Electrospray ionization was employed under positive ion mode， the detection range was m/z 100-1 700. Key quality attributes and sources were determined by comparing with single medicine and reference substances. Through mass transfer analysis of multiple batches from decoction pieces to benchmark samples， high performance liquid chromatography （HPLC） for determining the contents of index components and HPLC detection of characteristic maps were established. Through the determination of 15 batches of benchmark samples， the content range of the index components and the common peaks of the characteristic map were determined. Thin layer chromatography （TLC） was applied to the identification of 5 medicines in the formula. Moisture and dry extract yield of the benchmark samples were determined by drying method. ResultA total of 27 compounds were inferred from the benchmark samples of Liangditang， among which 9 compounds were confirmed by comparison with the control， including catalpol， harpagide， gallic acid， albiflorin， paeoniflorin， verbascoside， angoroside C， cinnamic acid and harpagoside. A method for determining the characteristic maps of the benchmark samples were established and 13 peaks were assigned， and the characteristic peaks were mainly derived from wine-processed products of Rehmanniae Radix， Scrophulariae Radix and wine-processed products of Paeoniae Radix Alba. The similarity between the characteristic map of 15 batches of benchmark samples and the control characteristic map was >0.9. Methods for the determination of paeoniflorin， harpagoside， L-hydroxyproline and glycine were established， and the contents of these four components in 15 batches of benchmark samples were within ±30% of the corresponding mean value， and the transfer rate of decoction pieces to the benchmark samples was stable and controllable. TLC was established to identify 5 prescription drugs （except Ejiao） with two kinds of test solutions， and the results showed that the method had good specificity. The average dry extract yield was 48.06%， and the average moisture was 5.58%， which were within the range of ±10% and ±30% of their mean values， respectively. ConclusionThe quality standard of Liangditang benchmark samples was as follows：the similarity between the benchmark samples and the control characteristic map is >0.9， the contents of paeoniflorin， harpagoside， L-hydroxyproline and glycine are 217-403， 24-46， 634-1 178， 1 253-2 328 mg per dose， the dry extract yield is 43.0%-53.0%， the moisture is 4.0%-7.0%， under the set detection conditions， the benchmark samples have corresponding characteristic spots by comparing with the control herbs of 5 medicines. This quality standard is stable and reliable， which fills the gap in the quality control of Liangditang， and can provide a reference for the establishment of the quality standard of Liangditang granules.

Objective:To investigate the role of LncRNA ZBED3-AS1 in osteoblast proliferation and differentiation in osteoporotic rats through regulating miR-339-5p/Notch 1.Methods:The rat models of sham operation (Sham) group and model (Model) group were established, and the bone mineral density (BMD) of rats was examined. Rat osteoblasts were isolated and the expression of ZBED3-AS1 and miR-339-5p was detected by qRT-PCR. The osteoblasts of rats in Sham group and Model group were divided into different groups and transfected. CCK8, alizarin red (AR-S) staining and alkaline phosphatase (ALP) staining were used to detect the proliferation and differentiation ability of cells in each group. The distribution of ZBED3-AS1 in cells was determined by FISH assay. Double luciferase report confirmed the relationship between ZBED3-AS1 and miR-339-5p as well as miR-339-5p and Notch 1.Western blot was used to detect the expression of Notch pathway related factors.Results:The bone mineral density of femur in Model group was significantly lower than that in Sham group ( P=0.0057) . Compared with Sham group, the expression of ZBED3-AS1 in osteoblasts of Model group was lower, while that of miR-339-5p was higher (all P<0.05) . Overexpression of ZBED3-AS1 could promote the proliferation and differentiation of osteoblasts, while knockdown of ZBED3-AS1 could inhibit the proliferation and differentiation of osteoblasts (all P<0.05) . ZBED3-AS1 could regulate miR-339-5p as ceRNA (all P<0.05) . Overexpression of miR-339-5p can inhibit the proliferation and differentiation of osteoblasts, which can be partially saved by overexpression of ZBED3-AS1. Notch 1 was confirmed as a target of miR-339-5p, at the same time, interfering with the expression of ZBED3-AS1/miR-339-5p can affect the expression of Notch-1 protein, and the regulation of ZBED3-AS1/miR-339-5p on osteoblasts may be realized through Notch pathway. Conclusion:ZBED3-AS1 can be used as ceRNA to regulate miR-339-5p, and then affect the proliferation and differentiation of osteoblasts in osteoporotic rats.

Objective:To observe the changes of left ventricular energy loss(EL) and apical wall shear stress(WSS) in patients with ventricular aneurysm by using vector flow mapping (VFM).Methods:Twenty-seven patients with ventricular aneurysm were selected as the case group, and they were divided into the ventricular aneurysm group(16 cases) and ventricular aneurysm thrombus group(11 cases) according to whether the apex of the heart was accompanied by thrombosis. Twenty healthy people were collected as the control group. Ventricular structure and cardiac function parameters were measured and the VFM offline analysis was performed. Systolic and diastolic phases were determined based on time-flow curve(T-F curve) and the open-close of valves, the corresponding left ventricular energy loss and the parameters of the WSS of the apex segment of the heart were obtainedand then compared between groups.Results:①In diastolic and systolic phases, EL values of left ventricular apical segment in ventricular aneurysm group and ventricular aneurysm thrombus group were lower than that in control group (all P<0.05). ②In diastolic phase, the peak WSS values of septal apical, lateral apical and anterior apical segments in ventricular aneurysm group and ventricular aneurysm thrombus group were lower than those in control group (all P<0.05), and the mean WSS of anterior apical segment in aneurysm group was lower than that in control group ( P<0.05). ③In systolic phase, the peak WSS values of anterior wall in ventricular aneurysm group and ventricular aneurysm thrombus group were lower than those in control group, and the mean WSS of anterior wall in ventricular aneurysm group was lower than that in control group (all P<0.05). The mean WSS of anterior wall in ventricular aneurysm thrombus group was higher than that in ventricular aneurysm group( P<0.05). Conclusions:VFM technology can quantitatively evaluate the EL and WSS of patients with left ventricular aneurysm, and provide a new perspective for further understanding of intracardiac hemodynamics in patients with left ventricular aneurysm with or without thrombus.

Objective To explore the influencing factors of coal workers''''cognitive function. Meth-ods There was a physical examination on 3205 workers in the coal mine enterprise.The physical examina-tion included height,weight,blood pressure,blood routine examination and routine urine test,and Mini Men-tal State Examination (MMSE) was used to evaluate the cognitive function.The coal workers were divided in-to cognitive dysfunction group (84 cases) and cognitive function normal group (3121 cases) according to MMSE scores.Logistic regression analysis was used to explore the influencing factors of cognitive function. Results The prevalence of cognitive dysfunction was 2. 62％ in coal workers. The age of the cognitive dys-function group(47.27±8.24) was significantly higher than that in the cognitive function normal group (41.39 ±8.65)(P<0.05),and the degree of culture in cognitive dysfunction group was significantly lower than those in the cognitive function normal group (χ2= 46. 610, P<0. 01 ) . The low density lipoprotein cholesterol ((2.72±0.65)mmol/L),urine pH(5.54±1.51) in the cognitive dysfunction group were significantly lower than those in the cognitive function normal group((2.89±0.73)mmol/L,(5.92±1.28))(P<0.05). The lo-gistic regression analysis showed that age, culture level, BMI, low density lipoprotein cholesterol, urine pH were the impacting factors of cognitive dysfunction. Conclusion Cognitive dysfunction is influenced by age, culture level,BMI and low density lipoprotein cholesterol. The higher of the age and the lower of the culture level,BMI,low density lipoprotein cholesterol,urine pH,the more vulnerable to cognitive dysfunction.

Objective To observe the clinical curative effect of Zoladex combined with Sanjie analgesic capsule in treatment of endometriosis.Methods 80 patients with endometriosis treated in our hospital from January 2016 to December 2016 were randomly divided into two groups,with 40 cases in each group.The study group was given Zoladex needle and Sanjiezhentong capsule treatment;The control group were given Sanjie Zhentong capsule.Prostaglandin F2a(PCF2a), CA125, visual analogue scale(VAS), clinical efficacy and adverse reactions were compared between the two groups.Results After treatment, the PCF2a and CA125 in the study group were significantly higher than those in the control group, the difference was statistically significant(t=4.167, t=3.533, P<0.05).There was no significant difference in VAS score between the two groups(t=0.961, P>0.05).The total effective rate of the study group was 90%, and the control group was 75%, the difference was statistically significant(x2=5.741, P<0.05)., there were 4 cases of adverse reactions(10%)in the study group,and 10 cases in the control group(25%), the difference was statistically significant(x2=7.792, P<0.05).Conclusion Zoladex needle combined with Sanjiezhentong capsule, can effectively relieve the pain caused by endometriosis, reduce adverse reaction, improve the clinical efficacy, suitable for use in clinical research.