Objective:To investigate the characteristics of serum immunoglobulin G (IgG) N-glycans in male patients with different subtypes and severity grades of androgenetic alopecia (AGA) .Methods:A cross-sectional study was conducted on male patients diagnosed with male-pattern hair loss (MPHL) or female-pattern hair loss (FPHL) who attended the Department of Dermatology, Huashan Hospital, Fudan University between June and December 2022. Clinical data were collected, and serum IgG N-glycans were quantitatively analyzed using ultra-performance liquid chromatography (UPLC) . The content of serum IgG N-glycan structures was compared between patients with different AGA subtypes and among patients with different severity grades of MPHL or FPHL, while derived traits were compared between patients with different AGA subtypes. Point-biserial correlation analysis was conducted to assess associations between serum IgG N-glycans and hair loss severity.Results:A total of 85 male patients with AGA were included, comprising 44 MPHL patients and 41 FPHL patients. No significant differences were observed between the two subgroups in terms of age, age at onset, or serum levels of testosterone, sex hormone-binding globulin, uric acid, and 25-hydroxyvitamin D (all P > 0.05) . UPLC showed 23 serum IgG glycans and 5 derived glycan traits (afucosylation, fucosylation, bisecting GlcNAc, terminal galactosylation, and terminal sialylation) . Compared with the MPHL patients, the FPHL patients exhibited significantly increased levels of N-glycans GP5, GP11, GP17, and GP20 (all P < 0.05) , significantly elevated levels of afucosylated IgG N-glycans ( P = 0.047) , but significantly reduced core fucosylated IgG N-glycans ( P = 0.047) . No significant differences in serum IgG N-glycan composition were observed among patients with varying severity grades of MPHL (all P > 0.05) . In the FPHL patients, the levels of N-glycans GP10 ( r = 0.32, P = 0.039) and GP22 ( r = -0.32, P = 0.045) were significantly positively and negatively correlated with hair loss severity respectively; receiver operating characteristic curve analysis showed that both GP10 and GP22 had moderate diagnostic value for predicting hair loss severity, with the area under the curve values being 0.69 (95% CI: 0.52 - 0.86) and 0.71 (95% CI: 0.55 - 0.86) , respectively. Conclusion:Serum IgG N-glycan profiles differed among male patients with different AGA subtypes, and N-glycans GP10 and GP22 may serve as potential biomarkers for early assessment of hair loss severity in male FPHL patients.

Objective To search,evaluate and synthesise the best available evidence on prevention strategies for unplanned extubation of nasogastric tube in adult inpatients and to offer a reference in management of safety and efficiency.Methods Literature on prevention strategies for unplanned extubation of nasogastric tube in adult inpatients was retrieved across BMJ Best Practice,UpToDate,JBI Center for Evidence Based Healthcare International Collaboration Library,Medlive,US National Guidelines Database,International Guidelines Collaboration Group,Scottish InterAcademy Guidelines Network,Ontario Registered Nurses Association of Canada,UK National Institute for Clinical Optimization,New Zealand Guidelines Research Group,PubMed,EMbase,Cochrane Library,Web of Science,EBSCO,CINAHL,CNKI,CBM Database,Wanfang Data and VIP Database,from the inception of databases to August 2024.Retrieved literature included guidelines,clinical decisions,recommended practices,evidence summaries,expert consensus and systematic reviews.Two researchers evaluated the literature methodologically and then summarised evidence from the included data.Results Fifteen publications(2 guidelines,1 clinical decision,3 recommended practices,7 evidences and 2 systematic reviews)were included.A total of 30 pieces of evidence were extracted and they were grouped into 7 themes:risk assessment,selection of nasogastric tube,depth of intubation,tube fixation,tube position,tube management and patient education.Conclusion Clinicians should integrate the best evidences into clinical practice and assess risk factors for unplanned extubation of nasogastric tube in adult inpatients.Personalised early intervention plans should be made to reduce or avoid the unplanned extubation.

Objective:To investigate the characteristics of serum immunoglobulin G (IgG) N-glycans in male patients with different subtypes and severity grades of androgenetic alopecia (AGA) .Methods:A cross-sectional study was conducted on male patients diagnosed with male-pattern hair loss (MPHL) or female-pattern hair loss (FPHL) who attended the Department of Dermatology, Huashan Hospital, Fudan University between June and December 2022. Clinical data were collected, and serum IgG N-glycans were quantitatively analyzed using ultra-performance liquid chromatography (UPLC) . The content of serum IgG N-glycan structures was compared between patients with different AGA subtypes and among patients with different severity grades of MPHL or FPHL, while derived traits were compared between patients with different AGA subtypes. Point-biserial correlation analysis was conducted to assess associations between serum IgG N-glycans and hair loss severity.Results:A total of 85 male patients with AGA were included, comprising 44 MPHL patients and 41 FPHL patients. No significant differences were observed between the two subgroups in terms of age, age at onset, or serum levels of testosterone, sex hormone-binding globulin, uric acid, and 25-hydroxyvitamin D (all P > 0.05) . UPLC showed 23 serum IgG glycans and 5 derived glycan traits (afucosylation, fucosylation, bisecting GlcNAc, terminal galactosylation, and terminal sialylation) . Compared with the MPHL patients, the FPHL patients exhibited significantly increased levels of N-glycans GP5, GP11, GP17, and GP20 (all P < 0.05) , significantly elevated levels of afucosylated IgG N-glycans ( P = 0.047) , but significantly reduced core fucosylated IgG N-glycans ( P = 0.047) . No significant differences in serum IgG N-glycan composition were observed among patients with varying severity grades of MPHL (all P > 0.05) . In the FPHL patients, the levels of N-glycans GP10 ( r = 0.32, P = 0.039) and GP22 ( r = -0.32, P = 0.045) were significantly positively and negatively correlated with hair loss severity respectively; receiver operating characteristic curve analysis showed that both GP10 and GP22 had moderate diagnostic value for predicting hair loss severity, with the area under the curve values being 0.69 (95% CI: 0.52 - 0.86) and 0.71 (95% CI: 0.55 - 0.86) , respectively. Conclusion:Serum IgG N-glycan profiles differed among male patients with different AGA subtypes, and N-glycans GP10 and GP22 may serve as potential biomarkers for early assessment of hair loss severity in male FPHL patients.

Objective To search,evaluate and synthesise the best available evidence on prevention strategies for unplanned extubation of nasogastric tube in adult inpatients and to offer a reference in management of safety and efficiency.Methods Literature on prevention strategies for unplanned extubation of nasogastric tube in adult inpatients was retrieved across BMJ Best Practice,UpToDate,JBI Center for Evidence Based Healthcare International Collaboration Library,Medlive,US National Guidelines Database,International Guidelines Collaboration Group,Scottish InterAcademy Guidelines Network,Ontario Registered Nurses Association of Canada,UK National Institute for Clinical Optimization,New Zealand Guidelines Research Group,PubMed,EMbase,Cochrane Library,Web of Science,EBSCO,CINAHL,CNKI,CBM Database,Wanfang Data and VIP Database,from the inception of databases to August 2024.Retrieved literature included guidelines,clinical decisions,recommended practices,evidence summaries,expert consensus and systematic reviews.Two researchers evaluated the literature methodologically and then summarised evidence from the included data.Results Fifteen publications(2 guidelines,1 clinical decision,3 recommended practices,7 evidences and 2 systematic reviews)were included.A total of 30 pieces of evidence were extracted and they were grouped into 7 themes:risk assessment,selection of nasogastric tube,depth of intubation,tube fixation,tube position,tube management and patient education.Conclusion Clinicians should integrate the best evidences into clinical practice and assess risk factors for unplanned extubation of nasogastric tube in adult inpatients.Personalised early intervention plans should be made to reduce or avoid the unplanned extubation.

Objective To study the effect of the lentivirus encoding acidic fibroblast growth factor transfecting human adipose-derived stem cells (ADSCs) on the cell cycle and proliferation of ADSCs.Methods ADSCs were isolated and extracted by enzymatic digestion from the liposuction aspirate.ADSCs were cultured,identified and osteogenic induced reagent was used to induce differentiation of ADSCs towards bone cells.To obtain lentivirus encoding FGF-1,the plasmid PWPXLd FGF-1 was co-transfected with plasmid psPAX2,pMD2.G in 293T cells.ADSCs were infected with lentivirus encoding FGF-1.Expression of green fluorescent protein (GFP) in infected FGF-1 was observed by fluorescence microscope and expression of FGF-1 in ADSCs was verified by Western blot analysis.Flow cytometry was used to detect the cell cycle of ADSCs infected with lentivirus encoding FGF-1.EDU assay was performed to examine cell viability.Results Lentivirus encoding FGF-1 was obtained.After ADSCs being infected green fluorescence was found in about 70％ ADSCs,and overexpression of FGF-1 protein was detected in infceted cells by Western blot analysis.The percentage of G2/M phase cells was significantly increased compared with the control group,and the proliferation of ADSCs infected with lentivirus encoding FGF-1 was promoted as compared with the control group.Conclusions FGF-1 can enhance G2/M phase of ADSCs and promote the proliferation of ADSCs.

Objective To investigate the predictive value of serum N-terminal pro brain natriuretic peptide NT-proBNP in left ventricular diastolic dysfunction(LVDD) in septic shock patients.Methods According to retrospective analysis of clinical data 96 patients with septic shock were divided into LVDD group and non-LVDD group.General clinical data,APACHE scores,NT-proBNP,Troponin I(TNI),creatinine,procalcitonin,D-dimer and lactic acid within the first 24 hours after admission were recorded,and multi-factors logistic regression analysis was conducted to find independent risk factors for left ventricular diastolic dysfunction in septic shock patients Receiver operating characteristic curve ROC was constructed to indicate the predictive value.Results There were no significant differences in general clinical data,procalcitonin,D-dimer and lactic acid between two groups.Compared with non-LVDD group the levels of NT-proBNP [lgNT-proBNP (3.66±0.38) vs.(3.03±0.59),P =0.000],TNI [lgTNI(-1.45±0.86)vs.(-2.36±0.82),P ＜ 0.01] and creatinine [(186.12±124.24)vs.(101.16±57.01),P ＜ 0.01] in LVDD group were significantly higher.It was shown by multi-factors logistic regression analysis that NT-proBNP (OR=8.731,95％CI;1.541-49.466,P=0.014) was an independent risk factor for left ventricular diastolic dysfunction in septic shock patients.The area under the curve AUC of NT-proBNP was 0.813 with the cut-off value of 1 725 pg/μL,sensibility =88.6％,specificity =62.1％.Conclusion NT-proBNP was avaluable indicator in predicting left ventricular diastolic dysfunction in septic shock patients.

Objective To analyze clinical characteristics and risk factors of pulmonary hypertension (PH) in patients with sepsis.Methods According to retrospective analysis of clinical data 136 cases with sepsis were divided into PH group and non-PH group.The clinical data,laboratory findings and ultrasonic cardiographic findings were recorded and compared between two groups.Multi-factors Logistic regression analysis was performed to find the independent risk factors of PH in patients with sepsis,and receiver operating characteristic curve ROC was constructed to indicate the predictable value.Results Of 136 patients with sepsis,32 (23.5％) developed PH.The PH group had higher NT-proBNP [lgNT-proBNP (3.67±0.41) vs.(3.33±0.59),P=0.003],higher E peak [(86.12±30.43) vs.(67.73±21.49),P=0.008],higher E/A peak [(1.09±0.46) vs.(0.83±0.29),P=0.014],higher left atrium diameter (LAD) [(36.49±5.97) vs.(31.32±4.69),P=0.001] and lower oxygenation index [(291.90±51.62) vs.(326.40±88.16),P=0.017] than the non-PH group (P ＜ 0.05).It was shown by multi-factors Logistic regression analysis that LAD (OR=1.198,P=0.010) was an independent risk factor of PH in patients with sepsis.The area under the curve AUC of LAD was 0.723,with the cut-off value of 31 mm (sensibility 82.6％,specificity 49.0％).Conclusions LAD was an independent risk factor of sepsis-associated pulmonary hypertension in sepsis patients.

The article analyzed the problems in Emergency Medicine and illuminated the character-istics of the teaching model based on micro-course , and pointed out that the introduction of the micro course into the emergency training was the inevitable trend of the development of teaching. Combined with the real case of emergency training, the article described the micro teaching structure and implementation plan in detail, namely with the WeChat public number as the platform for teaching, setting up the curricu-lum according to the differences of the training staff, setting up the interactive communication area, taking into account the basic theory and expanding the study, to achieve the repeatability, individuation, interac-tivity and convenience of the teaching.