Objective To explore the characteristics and influencing factors of taste abnormalities in patients with differentiated thyroid cancer(DTC)after 131I treatment.Methods A total of 206 DTC patients who received 131I treatment in the First Affiliated Hospital of Nanchang University from August 2023 to December 2023 were followed up for taste abnormalities,dry mouth,and parotid gland swelling.General clinical data including sex,age,and tumor TNM staging were collected.Based on the presence of taste abnormalities,the patients were divided into abnormal taste group and normal taste group.The differences in general data between the two groups were compared,and multiple logistic regression analysis was used to explore the influencing factors of taste abnor-malities.Results Totally,42.23%of the patients experienced taste abnormalities,including 68 patients with varying degrees of reduced taste,3 patients with a loss of taste,6 patients with taste sensitivity,24 patients with taste hallucinations,and 14 patients with both reduced taste and taste hallucinations.The shortest time for the onset of taste abnormalities was 2 days after 131I treatment,and the longest time was 20 days,with a median time of 7 days;The duration ranged from a minimum of 3 days to a maximum of 60 days,with a median of 14 days.The proportion of dry mouth and parotid gland swelling in patients with abnormal taste was higher than that in those with normal taste,showing statistical significance(P=0.004,0.014,respectively).However,there was no statistical significance in terms of sex age,and tumor TNM stage(P>0.05).Multivariate logistic regression analysis showed that dry mouth and parotid gland swelling were risk factors for taste abnormalities in DTC patients treated with 131I(P=0.007,0.024,respectively).Conclusion Abnormal taste is a common adverse reaction in DTC patients after 131I treatment,typically transient,with a median onset time of 7 days post-treatment and a median duration of 14 days.The primary manifestation is reduced taste,with dry mouth and parotid gland swelling identified as risk factors for its occurrence.

The clinical data of a patient with differentiated thyroid carcinoma(DTC)who developed physiological thymic uptake after postoperative iodine-131(131I)therapy were analyzed,and the 3-year follow-up changes in the patient's condition were reviewed.Combined with the literatures and the diagnosis and treatment process,the causes of possible false positives in whole-body scans after iodine therapy for DTC and the mechanism,clinical features,and identification methods of benign thymic 131I uptake were discussed to improve clinicians' understanding and diagnostic ability regarding such conditions and avoid unnecessary multiple iodine treatments.The patient,a 28-year-old female,showed mediastinal imaging after the first 131I treatment,with more pronounced mediastinal iodine uptake during the second treatment.SPECT/CT localized the uptake to enlarged thymus tissue.The stimulated thyroglobulin(Tg)levels before two 131I treatments were high but gradually decreased.Apart from thymic uptake,no other examination evidence suggested DTC metastases.Subsequent follow-up for 3 years showed no pathological changes in the thymus,confirming physiological thymic uptake.Thymic 131I uptake is a common cause of false-positive whole-body scans in post-thyroidectomy patients.When post-131I therapy whole-body imaging shows only mediastinal uptake,especially in the young patients undergoing multiple 131I treatments where thymic 131I uptake intensity increases with successive treatments,even with elevated Tg levels,comprehensive use of imaging results such as SPECT/CT is essential to determine if it is normal thymus,thereby avoiding unnecessary repeated therapies.

Objective To explore the characteristics and influencing factors of taste abnormalities in patients with differentiated thyroid cancer(DTC)after 131I treatment.Methods A total of 206 DTC patients who received 131I treatment in the First Affiliated Hospital of Nanchang University from August 2023 to December 2023 were followed up for taste abnormalities,dry mouth,and parotid gland swelling.General clinical data including sex,age,and tumor TNM staging were collected.Based on the presence of taste abnormalities,the patients were divided into abnormal taste group and normal taste group.The differences in general data between the two groups were compared,and multiple logistic regression analysis was used to explore the influencing factors of taste abnor-malities.Results Totally,42.23%of the patients experienced taste abnormalities,including 68 patients with varying degrees of reduced taste,3 patients with a loss of taste,6 patients with taste sensitivity,24 patients with taste hallucinations,and 14 patients with both reduced taste and taste hallucinations.The shortest time for the onset of taste abnormalities was 2 days after 131I treatment,and the longest time was 20 days,with a median time of 7 days;The duration ranged from a minimum of 3 days to a maximum of 60 days,with a median of 14 days.The proportion of dry mouth and parotid gland swelling in patients with abnormal taste was higher than that in those with normal taste,showing statistical significance(P=0.004,0.014,respectively).However,there was no statistical significance in terms of sex age,and tumor TNM stage(P>0.05).Multivariate logistic regression analysis showed that dry mouth and parotid gland swelling were risk factors for taste abnormalities in DTC patients treated with 131I(P=0.007,0.024,respectively).Conclusion Abnormal taste is a common adverse reaction in DTC patients after 131I treatment,typically transient,with a median onset time of 7 days post-treatment and a median duration of 14 days.The primary manifestation is reduced taste,with dry mouth and parotid gland swelling identified as risk factors for its occurrence.

AIM:To analyze the Pharmaceutical Care Network Europe(PCNE)classification system used for evaluating the drug related problems(DRPs)of tacrolimus concentration fluctuations in kidney transplant recipients.METHODS:Kidney transplant recipients were selected as the study subjects,who experienced fluctuations in tacrolim-us blood concentrations and clinical pharmacist in-tervention during outpatient follow-up.PCNE(9.0)classification system was used to evaluate the DRPs of tacrolimus.And the DRP problems,causes,inter-vention plans,acceptance and status were ana-lyzed.RESULTS:A total of 700 kidney transplant re-cipients were enrolled from July 2019 to December 2021,and 1014 DRPs were found.The problems of DRPs included the occurrence of adverse drug events(P2.1,60.16％)and poor treatment out-comes(P1.2,39.84％);The main reasons included dosage selection(C3,43％),others(C9,38.4％),and drug selection(C1,9.41％);Clinical pharmacists ac-tively intervened at the recipient level(I2,98.92％)and drug level(I3,1.08％);The acceptance rate of the intervention plan(A1.1+A1.3)reached 98.62％,and the complete implementation rate(A1.1)reached 72.09％;79.29％of DPRs were fully or par-tially resolved(O1.1 and O2.1).CONCLUSION:Clini-cal pharmacists can use PCNE to evaluate tacrolim-us therapeutic drug monitoring(TDM)related DRPs,help standardize TDM pharmaceutical ser-vice models,standardize TDM abnormal result in-terpretation and intervention workflows,and pro-mote safe and rational drug utilization.

AIM:In this study,bioinformatics tech-nology was used to explore the differentially ex-pressed genes in antibody-mediated rejection after renal transplantation,and to screen out the possi-ble mechanisms and potential therapeutic targets of AMR-related miRNAs after renal transplantation,in order to provide new idea for the targeted thera-py of AMR after transplantation.METHODS:The dataset GSE115816 was downloaded from the GEO database,and the differential expression of miR-NAs in stable renal transplantation(SGF)group and the antibody-mediated rejection(AMR)group after renal transplantation was analyzed online by using DESeq 2R software.TargetScan software predicted the related targets of miRNAs,and the differential-ly expressed genes(DEGs)were analyzed through through gene ontology(GO)enrichment analysis and Kyoto gene and genome encyclopedia(KEGG)enrichment analysis,then key genes were screened by String database and Cytoscape,and finally veri-fied by TargetScan online analysis.RESULTS:A total of 10 differentially expressed miRNAs were identi-fied in the AMR group by comparison with the SGF group,with the most significant difference in ex-pression of miR-144-5p.A total of 143 miR-144-5p related targets were predicted by Targetscan soft-ware.GO analysis showed that DEGs were mainly involved in angiogenesis,synaptic signaling,and transcriptional co-activator regulation.KEGG analy-sis showed that DEGs were mainly enriched in the thyroid hormone signaling pathway,human papillo-mavirus infection,and PI3K-AKT signaling pathway.The 10 Hug genes were screened by PPI network.Based on the 6 algorithms in cytoHubba,5 key genes were obtained by taking the intersection of the top 10 Hug genes of each algorithm,which were NCOA2,NCOA1,FOXO1,PAX3,and PPARGC1A.After the literature review,we found that FoxO1 plays an essential role in immune sys-tem diseases and kidney diseases.In our study,we chose FoxO1 as a potential target protein for miR-144-5p.Finally,TargetScan online analysis showed that miR-144-5p has a targeted binding site with the 3'UTR region of FoxO1.CONCLUSION:MiR-144-5p plays an important role in AMR after Kidney transplantation.MiR-144-5p targeting FoxO1 may be a potential therapeutic target and prognostic biomarker for AMR.

Objective To investigate the relationship between carbohydrate antigen(CA)125 level and controlling nutritional status(CONUT)score in patients with primary liver cancer.Methods A total of 195 patients diagnosed with primary liver cancer in the First Affiliated Hospital of Nanchang University from Jan-uary 2016 to January 2020 were selected as the liver cancer group,and 195 healthy people were selected as the control group.CONUT score＜3 points were defined as normal nutrition(normal nutrition group,90 cases),CONUT score ≥3 points were defined as malnutrition(malnutrition group,105 cases).The clinical data and levels of CA125,albumin,lymphocyte count and cholesterol in each group were collected and compared.Spearman correlation analysis was used to analyze the correlation between nutritional status and CA125,and multivariate Logistic regression analysis was used to analyze the influencing factors of liver cancer combined with malnutrition.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated to evaluate the ability of CA125 to distinguish malnutrition.Results The level of CA125 in the liver cancer group was higher than that in the control group(P＜0.05),while the lymphocyte count and cholesterol level were lower than those in the control group(P＜0.05).The Child-Pugh score and CA125 level of the malnutrition group were higher than those of the normal nutrition group,and the differ-ences were statistically significant(P＜0.05).Spearman correlation analysis showed that CA125 level was positively correlated with CONUT score and Child-Pugh score(r=0.657,0.647,P＜0.001),and it was nega-tively correlated with albumin,lymphocyte count and cholesterol level(r=-0.623,-0.420,-0.272,P＜0.001).There were significant differences in the COUNT score and the incidence of malnutrition among liver cancer patients with different CA125 levels(P＜0.05).Multivariate Logistic regression analysis showed that elevated CA125 level(≥35 U/mL)was a risk factor for malnutrition in hepatocellular carcinoma(OR=5.560,P=0.002).The ROC curve showed that the AUC of CA125 in the diagnosis of liver cancer combined with malnutrition was 0.826(95％CI 0.768-0.884),the cut-off value of CA125 was 25.99 U/mL,the diag-nostic sensitivity was 73.5％,and the specificity was 81.1％.Conclusion There is a certain relationship be-tween CA125 level and nutritional status in patients with primary liver cancer,and the elevated CA125 level is a risk factor for hepatocellular carcinoma complicated with malnutrition.

AIM:To analyze the Pharmaceutical Care Network Europe(PCNE)classification system used for evaluating the drug related problems(DRPs)of tacrolimus concentration fluctuations in kidney transplant recipients.METHODS:Kidney transplant recipients were selected as the study subjects,who experienced fluctuations in tacrolim-us blood concentrations and clinical pharmacist in-tervention during outpatient follow-up.PCNE(9.0)classification system was used to evaluate the DRPs of tacrolimus.And the DRP problems,causes,inter-vention plans,acceptance and status were ana-lyzed.RESULTS:A total of 700 kidney transplant re-cipients were enrolled from July 2019 to December 2021,and 1014 DRPs were found.The problems of DRPs included the occurrence of adverse drug events(P2.1,60.16％)and poor treatment out-comes(P1.2,39.84％);The main reasons included dosage selection(C3,43％),others(C9,38.4％),and drug selection(C1,9.41％);Clinical pharmacists ac-tively intervened at the recipient level(I2,98.92％)and drug level(I3,1.08％);The acceptance rate of the intervention plan(A1.1+A1.3)reached 98.62％,and the complete implementation rate(A1.1)reached 72.09％;79.29％of DPRs were fully or par-tially resolved(O1.1 and O2.1).CONCLUSION:Clini-cal pharmacists can use PCNE to evaluate tacrolim-us therapeutic drug monitoring(TDM)related DRPs,help standardize TDM pharmaceutical ser-vice models,standardize TDM abnormal result in-terpretation and intervention workflows,and pro-mote safe and rational drug utilization.

AIM:In this study,bioinformatics tech-nology was used to explore the differentially ex-pressed genes in antibody-mediated rejection after renal transplantation,and to screen out the possi-ble mechanisms and potential therapeutic targets of AMR-related miRNAs after renal transplantation,in order to provide new idea for the targeted thera-py of AMR after transplantation.METHODS:The dataset GSE115816 was downloaded from the GEO database,and the differential expression of miR-NAs in stable renal transplantation(SGF)group and the antibody-mediated rejection(AMR)group after renal transplantation was analyzed online by using DESeq 2R software.TargetScan software predicted the related targets of miRNAs,and the differential-ly expressed genes(DEGs)were analyzed through through gene ontology(GO)enrichment analysis and Kyoto gene and genome encyclopedia(KEGG)enrichment analysis,then key genes were screened by String database and Cytoscape,and finally veri-fied by TargetScan online analysis.RESULTS:A total of 10 differentially expressed miRNAs were identi-fied in the AMR group by comparison with the SGF group,with the most significant difference in ex-pression of miR-144-5p.A total of 143 miR-144-5p related targets were predicted by Targetscan soft-ware.GO analysis showed that DEGs were mainly involved in angiogenesis,synaptic signaling,and transcriptional co-activator regulation.KEGG analy-sis showed that DEGs were mainly enriched in the thyroid hormone signaling pathway,human papillo-mavirus infection,and PI3K-AKT signaling pathway.The 10 Hug genes were screened by PPI network.Based on the 6 algorithms in cytoHubba,5 key genes were obtained by taking the intersection of the top 10 Hug genes of each algorithm,which were NCOA2,NCOA1,FOXO1,PAX3,and PPARGC1A.After the literature review,we found that FoxO1 plays an essential role in immune sys-tem diseases and kidney diseases.In our study,we chose FoxO1 as a potential target protein for miR-144-5p.Finally,TargetScan online analysis showed that miR-144-5p has a targeted binding site with the 3'UTR region of FoxO1.CONCLUSION:MiR-144-5p plays an important role in AMR after Kidney transplantation.MiR-144-5p targeting FoxO1 may be a potential therapeutic target and prognostic biomarker for AMR.

Objective:To investigate the application effect of the best evidence for prevention of perioperative delirium in elderly patients with hip fracture.Methods:Using the convenient sampling method, a total of 62 elderly patients with hip fractures admitted to the Trauma Department of Provincial Hospital Affiliated to Shandong First Medical University from January to August 2021 were selected as the control group, and 62 elderly patients with hip fractures admitted from September 2021 to April 2022 were selected as the observation group. At the same time, 17 nurses from the same department were selected as the research objects. According to the standard procedures and clinical conversion system application methods of the Evidence Based Clinical Evidence Practice System at the Joanna Briggs Institute in Australia, the best evidences were applied to the prevention of delirium in elderly hip fracture patients during the perioperative period. Before and after the application of evidence, the compliance rates of the review indicators, the scores of knowledge and attitude on prevention of delirium in elderly patients with hip fracture and the occurrence of delirium in patients were compared.Results:After the application of evidence, the compliance rates of review indicators were higher than those before the application, and the differences were statistically significant ( P < 0.05). The knowledge accuracy and attitude scores of delirium prevention in elderly nurses with hip fractures during perioperative period were higher than those before application, and the differences were statistically significant ( P<0.05). The number of delirium cases in the observation group was lower than that in the control group, and the duration of delirium was shorter than that in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The clinical application of the best evidence for perioperative delirium prevention in elderly hip fractures can improve nurses' awareness and attitude towards perioperative delirium prevention in elderly hip fractures, and reduce the occurrence of delirium in patients.

Posterior cruciate ligament (PCL) plays an important role in maintaining the stability of knee. PCL injury is often accompanied by serious axial and rotational instability, and severe PCL injury is likely to be combined with injuries to the anterior cruciate ligament, medial collateral ligament and other tissues which are often repaired by necessary posterior cruciate ligament reconstruction (PCLR) to restore their physiological functions. However, PCLR research is not as common as the research into the anterior cruciate ligament reconstruction, not only due to controversies in the anatomy and mechanics of PCL but also due to a higher failure rate and more complications following PCLR. This situation is closely related to the anatomical characteristics of the PCL tibial insertion. The present review deals with the anatomy, mechanics and clinical research of the PCL tibial insertion in order to provide more references for PCLR operators.