Objective:To explore the application effect of high-fidelity intelligent simulator combined with scenario simulation for emergency response training in the Department of Radiology, and to improve the emergency preparedness of medical, nursing, and technical staff in managing contrast agent adverse reactions.Methods:From January to July 2024, 132 medical, nursing, and technical staff from the Department of Radiology of a tertiary hospital in Chengdu City, China were selected as the training subjects. The high-fidelity intelligent simulator combined with scenario simulation teaching mode was used to conduct emergency response training for the participants. The differences in theoretical knowledge and post competence regarding contrast agent adverse reactions among the staff were compared before and after the training. A self-made questionnaire was used to investigate their needs and satisfaction of the emergency response training. SPSS 26.0 was used for data analysis. The differences in theoretical knowledge and post competence scores before and after training were compared using the paired samples t test. Results:After the training, the average score of theoretical knowledge examination increased from (84.32±10.19) points to (90.34±7.87) points, and the difference was statistically significant ( P<0.001). After the training, the scores of knowledge reserve, operational skills, situational decision-making ability, professional literacy, comprehensive literacy, and overall post competency were all significantly higher than those before the training ( P<0.05). The satisfaction score of emergency response training was (4.17±0.25) points. Conclusions:High-fidelity intelligent simulator combined with scenario simulation training improved the emergency preparedness and teamwork of radiology staff in clinical emergencies. The training received high recognition and satisfaction from the participants, which is of great significance for clinical emergency response and patient safety.

Objective:To establish an oxidative stress injury model by using hydrogen peroxide (H 2O 2) to induce human ovarian granulosa cells COV434. Methods:Human ovarian granulosa cells line COV434 were randomly divided into 6 groups, control group was not treated, H 2O 2 groups were treated with H 2O 2 of 200 μmol/L, 400 μmol/L, 600 μmol/L, 800 μmol/L and 1 000 μmol/L for 0.5 h, 1 h, 2 h, 4 h and 6 h, respectively, and the cell viability was determined by CCK-8 method. The follow-up experiments were treated with different concentrations of H 2O 2 for 1 h. β-galactosidase staining was used to determine the degree of cell senescence. DCFH-DA fluorescence staining was determined by flow cytometry, and the level of reactive oxygen species (ROS) in cells was determined. JC-1 staining was used to determine the mitochondrial membrane potential of cells. Western blotting was used to determine the expression levels of apoptosis-related proteins Caspase-3 and Caspase-9. After the successful establishment of the model, in order to verify the usability of the cell model, the cells were pretreated with the antioxidant vitamin E for 12 h, followed by the addition of H 2O 2 for intervention, and the ROS level and mitochondrial membrane potential were measured. Results:The cell viability of the 200 μmol/L and 400 μmol/L groups decreased first and then increased compared with the control, and tended to be stable after 1 h of intervention, and there was no significant difference in cell viability at each time point (all P>0.05). When the concentration of H 2O 2 increased to 600 μmol/L, the cell viability gradually decreased with the treatment time and tended to stabilize after 1 h, and decreased significantly to nearly 50% ( P<0.001). When the concentration of H 2O 2 continued to increase to 800 μmol/L and 1 000 μmol/L, the cell viability gradually decreased with the treatment time and stabilized after 1 h, and decreased to less than 10% (all P<0.001). When the concentration of H 2O 2 was 200 μmol/L and 400 μmol/L, there was no significant difference in the ratio of β-galactosidase-positive cells and the relative ROS intensity after 1 h compared with the control (all P>0.05). When the concentration of H 2O 2 increased to 600 μmol/L, 800 μmol/L and 1 000 μmol/L, the ratio of β-galactosidase-positive cells and the relative ROS intensity increased significantly (β-galactosidase staining: P=0.011 at 600 μmol/L, P=0.003 at 800 μmol/L, P=0.005 at 1 000 μmol/L; the relative ROS intensity: P=0.002 at 600 μmol/L, P<0.001 at 800 μmol/L and 1 000 μmol/L). Compared with the control, the mitochondrial membrane potential of cells decreased gradually after intervention with different concentrations of H 2O 2, and was negatively correlated with H 2O 2 concentration (all P<0.001). There was no difference in the expression of Cleaved-Caspase-3 in the H 2O 2 group at 200 μmol/L compared with the control, and the expression was significantly increased at 400 μmol/L, 600 μmol/L, 800 μmol/L and 1 000 μmol/L (all P<0.001). The expressions of Caspase-3 and Caspase-9 were significantly increased in all H 2O 2 treated groups (all P<0.001). Compared with the model group, the relative ROS intensity of the vitamin E group was significantly reduced ( P=0.009), and the mitochondrial membrane potential was significantly increased ( P<0.001), but it could not be restored to the level of the control. Conclusion:Using 600 μmol/L H 2O 2 to continuously treat COV434 cells for 1 h can quickly establish a stable and effective oxidative stress injury model of human ovarian granulosa cells.

Objective To construct a prediction model for in-hospital mortality in the elderly(≥65 years)patients undergoing unsynchronous cardioversion in ICU and to evaluate its effectiveness.Methods A retrospective study was conducted on 276 elderly eligible patients in the ICU of the Ninth and the First Medical Centers of Chinese PLA General Hospital between June 2022 and August 2024.According to their clinical outcomes,they were divided into a non-in-hospital dead group(111 cases)and an in-hospital dead group(165 cases).Clinical data were collected,and pre-dictive factors for in-hospital mortality were screened.And then a nomogram prediction model was developed based on the obtained predictive factors,which was evaluated with ROC curve and deci-sion curve analyses.Results When compared to the non-in-hospital dead group,the in-hospital dead group had significantly higher heart rate,ratio of hemodialysis,and levels of alanine amin-otransferase,aspartate aminotransferase,lactate dehydrogenase,alkaline phosphatase,serum cre-atinine,blood glucose,lactate,low base excess,sequential organ failure assessment(SOFA)score,model for end-stage liver disease score,and larger proportions of ventricular fibrillation/flutter and structural heart disease induced by pulseless ventricular tachycardia,and had significantly lower Glasgow Coma Scale(GCS)(P＜0.05).Multivariate logistic regression analysis identified body temperature＞37℃(OR=0.426,95％CI:0.198-0.915,P=0.029),chronic obstructive pulmonary disease(OR=2.333,95％CI:1.217-4.473,P=0.011),GCS score(OR=0.622,95％CI:0.410-0.944,P=0.026),hemoglobin(OR=0.817,95％CI:0.715-0.934,P=0.003),lactate(OR=1.365,95％CI:1.174-1.587,P=0.000),heart rate＞100 bpm(OR=2.757,95％CI:1.397-5.441,P=0.003),and SOFA score(OR=1.112,95％CI:1.032-1.198,P=0.005)as pre-dictors of in-hospital mortality.ROC curve analysis showed an AUC value of above indicators combined together in the prediction was 0.797,with a sensitivity of 76.97％and a specificity of 65.77％.Calibration curve analysis demonstrated good consistency between predicted and observed outcomes.Decision curve analysis indicated favorable clinical utility of the model.Conclusion This study identifies independent risk factors for in-hospital mortality among elderly patients in the ICU who underwent asynchronous cardioversion.Based on these factors,a nomo-gram model is established,demonstrating good discrimination,calibration,and model fit,with high clinical applicability.

Objective:To investigate the effective ingredients and molecular mechanisms of Qizao oral liquid in the treatment of lead poisoning through network pharmacology and molecular docking technology.Methods:December 2023, the effective ingredients and their corresponding targets of Qizao oral liquid were searched from the TCM Systems Pharmacology database. Swiss Target Prediction was used to predict corresponding potential target genes of compounds. Targets associated with lead poisoning were obtained from GeneCards and OMIM databases. Cytoscape 3.10.1 software was employed to construct a components and corresponding target network as well as a components and corresponding target network, followed by visualization and cluster analysis. GO and KEGG enrichment analyses were conducted using the Metascape database, resulting in the generation of a signaling pathway-target network diagram. Molecular docking analysis between the principal compounds and target proteins was performed using Autodock 4.2.6 and Pymol 2.2.0 software to validate their underlying molecular mechanisms.Results:A total of 114 active chemical components, 361 potential targets, 2501 lead poisoning targets, and 191 intersection targets of "Qizao oral liquid and lead poisoning" were screened. Further analysis revealed that there were 2091 entries for GO biological processes and 202 KEGG signaling pathways. Enrichment analysis showed that the key targets were mainly enriched in cancer, lipid and atherosclerosis, PI3K-Akt signaling pathways. Molecular docking showed that there were 14 combinations with binding energy<-5 kcal/mol, among which PIK3R1-β-sitosterol binding energy was -9.71 kcal/mol.Conclusion:The primary active components found in Qizao oral liquid, such as β-sitosterol, nuciferine, stephanine, and stigmasterol, have the potential to modulate key targets including PIK3R1, AKT1, TP53, and NFKB1. These components are capable of influencing the PI3K-Akt signaling pathway as well as lipid and atherosclerosis pathways in order to mitigate the adverse effects of lead exposure.

Objective:To establish an oxidative stress injury model by using hydrogen peroxide (H 2O 2) to induce human ovarian granulosa cells COV434. Methods:Human ovarian granulosa cells line COV434 were randomly divided into 6 groups, control group was not treated, H 2O 2 groups were treated with H 2O 2 of 200 μmol/L, 400 μmol/L, 600 μmol/L, 800 μmol/L and 1 000 μmol/L for 0.5 h, 1 h, 2 h, 4 h and 6 h, respectively, and the cell viability was determined by CCK-8 method. The follow-up experiments were treated with different concentrations of H 2O 2 for 1 h. β-galactosidase staining was used to determine the degree of cell senescence. DCFH-DA fluorescence staining was determined by flow cytometry, and the level of reactive oxygen species (ROS) in cells was determined. JC-1 staining was used to determine the mitochondrial membrane potential of cells. Western blotting was used to determine the expression levels of apoptosis-related proteins Caspase-3 and Caspase-9. After the successful establishment of the model, in order to verify the usability of the cell model, the cells were pretreated with the antioxidant vitamin E for 12 h, followed by the addition of H 2O 2 for intervention, and the ROS level and mitochondrial membrane potential were measured. Results:The cell viability of the 200 μmol/L and 400 μmol/L groups decreased first and then increased compared with the control, and tended to be stable after 1 h of intervention, and there was no significant difference in cell viability at each time point (all P>0.05). When the concentration of H 2O 2 increased to 600 μmol/L, the cell viability gradually decreased with the treatment time and tended to stabilize after 1 h, and decreased significantly to nearly 50% ( P<0.001). When the concentration of H 2O 2 continued to increase to 800 μmol/L and 1 000 μmol/L, the cell viability gradually decreased with the treatment time and stabilized after 1 h, and decreased to less than 10% (all P<0.001). When the concentration of H 2O 2 was 200 μmol/L and 400 μmol/L, there was no significant difference in the ratio of β-galactosidase-positive cells and the relative ROS intensity after 1 h compared with the control (all P>0.05). When the concentration of H 2O 2 increased to 600 μmol/L, 800 μmol/L and 1 000 μmol/L, the ratio of β-galactosidase-positive cells and the relative ROS intensity increased significantly (β-galactosidase staining: P=0.011 at 600 μmol/L, P=0.003 at 800 μmol/L, P=0.005 at 1 000 μmol/L; the relative ROS intensity: P=0.002 at 600 μmol/L, P<0.001 at 800 μmol/L and 1 000 μmol/L). Compared with the control, the mitochondrial membrane potential of cells decreased gradually after intervention with different concentrations of H 2O 2, and was negatively correlated with H 2O 2 concentration (all P<0.001). There was no difference in the expression of Cleaved-Caspase-3 in the H 2O 2 group at 200 μmol/L compared with the control, and the expression was significantly increased at 400 μmol/L, 600 μmol/L, 800 μmol/L and 1 000 μmol/L (all P<0.001). The expressions of Caspase-3 and Caspase-9 were significantly increased in all H 2O 2 treated groups (all P<0.001). Compared with the model group, the relative ROS intensity of the vitamin E group was significantly reduced ( P=0.009), and the mitochondrial membrane potential was significantly increased ( P<0.001), but it could not be restored to the level of the control. Conclusion:Using 600 μmol/L H 2O 2 to continuously treat COV434 cells for 1 h can quickly establish a stable and effective oxidative stress injury model of human ovarian granulosa cells.

Objective:To explore the application effect of high-fidelity intelligent simulator combined with scenario simulation for emergency response training in the Department of Radiology, and to improve the emergency preparedness of medical, nursing, and technical staff in managing contrast agent adverse reactions.Methods:From January to July 2024, 132 medical, nursing, and technical staff from the Department of Radiology of a tertiary hospital in Chengdu City, China were selected as the training subjects. The high-fidelity intelligent simulator combined with scenario simulation teaching mode was used to conduct emergency response training for the participants. The differences in theoretical knowledge and post competence regarding contrast agent adverse reactions among the staff were compared before and after the training. A self-made questionnaire was used to investigate their needs and satisfaction of the emergency response training. SPSS 26.0 was used for data analysis. The differences in theoretical knowledge and post competence scores before and after training were compared using the paired samples t test. Results:After the training, the average score of theoretical knowledge examination increased from (84.32±10.19) points to (90.34±7.87) points, and the difference was statistically significant ( P<0.001). After the training, the scores of knowledge reserve, operational skills, situational decision-making ability, professional literacy, comprehensive literacy, and overall post competency were all significantly higher than those before the training ( P<0.05). The satisfaction score of emergency response training was (4.17±0.25) points. Conclusions:High-fidelity intelligent simulator combined with scenario simulation training improved the emergency preparedness and teamwork of radiology staff in clinical emergencies. The training received high recognition and satisfaction from the participants, which is of great significance for clinical emergency response and patient safety.

Objective To construct a prediction model for in-hospital mortality in the elderly(≥65 years)patients undergoing unsynchronous cardioversion in ICU and to evaluate its effectiveness.Methods A retrospective study was conducted on 276 elderly eligible patients in the ICU of the Ninth and the First Medical Centers of Chinese PLA General Hospital between June 2022 and August 2024.According to their clinical outcomes,they were divided into a non-in-hospital dead group(111 cases)and an in-hospital dead group(165 cases).Clinical data were collected,and pre-dictive factors for in-hospital mortality were screened.And then a nomogram prediction model was developed based on the obtained predictive factors,which was evaluated with ROC curve and deci-sion curve analyses.Results When compared to the non-in-hospital dead group,the in-hospital dead group had significantly higher heart rate,ratio of hemodialysis,and levels of alanine amin-otransferase,aspartate aminotransferase,lactate dehydrogenase,alkaline phosphatase,serum cre-atinine,blood glucose,lactate,low base excess,sequential organ failure assessment(SOFA)score,model for end-stage liver disease score,and larger proportions of ventricular fibrillation/flutter and structural heart disease induced by pulseless ventricular tachycardia,and had significantly lower Glasgow Coma Scale(GCS)(P＜0.05).Multivariate logistic regression analysis identified body temperature＞37℃(OR=0.426,95％CI:0.198-0.915,P=0.029),chronic obstructive pulmonary disease(OR=2.333,95％CI:1.217-4.473,P=0.011),GCS score(OR=0.622,95％CI:0.410-0.944,P=0.026),hemoglobin(OR=0.817,95％CI:0.715-0.934,P=0.003),lactate(OR=1.365,95％CI:1.174-1.587,P=0.000),heart rate＞100 bpm(OR=2.757,95％CI:1.397-5.441,P=0.003),and SOFA score(OR=1.112,95％CI:1.032-1.198,P=0.005)as pre-dictors of in-hospital mortality.ROC curve analysis showed an AUC value of above indicators combined together in the prediction was 0.797,with a sensitivity of 76.97％and a specificity of 65.77％.Calibration curve analysis demonstrated good consistency between predicted and observed outcomes.Decision curve analysis indicated favorable clinical utility of the model.Conclusion This study identifies independent risk factors for in-hospital mortality among elderly patients in the ICU who underwent asynchronous cardioversion.Based on these factors,a nomo-gram model is established,demonstrating good discrimination,calibration,and model fit,with high clinical applicability.

Objective:To investigate the effective ingredients and molecular mechanisms of Qizao oral liquid in the treatment of lead poisoning through network pharmacology and molecular docking technology.Methods:December 2023, the effective ingredients and their corresponding targets of Qizao oral liquid were searched from the TCM Systems Pharmacology database. Swiss Target Prediction was used to predict corresponding potential target genes of compounds. Targets associated with lead poisoning were obtained from GeneCards and OMIM databases. Cytoscape 3.10.1 software was employed to construct a components and corresponding target network as well as a components and corresponding target network, followed by visualization and cluster analysis. GO and KEGG enrichment analyses were conducted using the Metascape database, resulting in the generation of a signaling pathway-target network diagram. Molecular docking analysis between the principal compounds and target proteins was performed using Autodock 4.2.6 and Pymol 2.2.0 software to validate their underlying molecular mechanisms.Results:A total of 114 active chemical components, 361 potential targets, 2501 lead poisoning targets, and 191 intersection targets of "Qizao oral liquid and lead poisoning" were screened. Further analysis revealed that there were 2091 entries for GO biological processes and 202 KEGG signaling pathways. Enrichment analysis showed that the key targets were mainly enriched in cancer, lipid and atherosclerosis, PI3K-Akt signaling pathways. Molecular docking showed that there were 14 combinations with binding energy<-5 kcal/mol, among which PIK3R1-β-sitosterol binding energy was -9.71 kcal/mol.Conclusion:The primary active components found in Qizao oral liquid, such as β-sitosterol, nuciferine, stephanine, and stigmasterol, have the potential to modulate key targets including PIK3R1, AKT1, TP53, and NFKB1. These components are capable of influencing the PI3K-Akt signaling pathway as well as lipid and atherosclerosis pathways in order to mitigate the adverse effects of lead exposure.

Objective:To explore the role of methyltransferase-like 3 (METTL3) on endometrial decidualization.Methods:Bioinformatics was used to analyze the expression of 26 N6-methyladenosine (m6A) regulators in recurrent implantation failure (RIF), recurrent spontaneous abortion (RSA) and the decidualization of endometrial stromal cells. Using Medroxyprogesterone and Dibutyryl-cAMP to induce human endometrial stromal cell s (HESCs)decidualization, we examined changes in the expression of total m6A, METTL3, Forkhead framing protein O1 (FOXO1), and decidualization markers insulin-like growth factor binding protein 1 (IGFBP1) and prolactin in the control and decidualization group. Constructing HESC models with METTL3 interference using lentivirus, we used CCK-8 and Edu to detect proliferation in the negative control and knockdown METTL3 group. Lentiviral transfection was successfully followed by induction of decidualization, and we examined changes in the expression of FOXO1 and decidualization markers.Results:The results of bioinformatics analysis showed that the expression of METTL3 was significantly downregulated in the endometrium of patients with RIF and RSA ( P=0.014, P=0.016), while it was significantly upregulated in the endometrium with decidualization ( P=0.029). In vitro, induction of HESCs decidualization increased in the expression levels of total m6A, METTL3, and FOXO1 proteins in the decidualization group ( P=0.015, P=0.016, P=0.004). Knocking down METTL3 resulted in a decrease in FOXO1 protein expression in HESCs ( P=0.009). The CCK-8 and Edu results showed that the proliferation of HESCs was inhibited after knocking down METTL3. After inducing the knockdown of METTL3 in vitro, there was no statistically significant difference in the expression levels of IGFBP1 mRNA, PRL mRNA, and FOXO1 protein in HESCs compared with the negative control group (all P>0.05). Conclusion:In endometrial stromal cells, METTL3 can regulate the expression of FOXO1, promote the expression of IGFBP1 and PRL, and affect the decidualization of endometrial cells.

Objective:To explore the role of methyltransferase-like 3 (METTL3) on endometrial decidualization.Methods:Bioinformatics was used to analyze the expression of 26 N6-methyladenosine (m6A) regulators in recurrent implantation failure (RIF), recurrent spontaneous abortion (RSA) and the decidualization of endometrial stromal cells. Using Medroxyprogesterone and Dibutyryl-cAMP to induce human endometrial stromal cell s (HESCs)decidualization, we examined changes in the expression of total m6A, METTL3, Forkhead framing protein O1 (FOXO1), and decidualization markers insulin-like growth factor binding protein 1 (IGFBP1) and prolactin in the control and decidualization group. Constructing HESC models with METTL3 interference using lentivirus, we used CCK-8 and Edu to detect proliferation in the negative control and knockdown METTL3 group. Lentiviral transfection was successfully followed by induction of decidualization, and we examined changes in the expression of FOXO1 and decidualization markers.Results:The results of bioinformatics analysis showed that the expression of METTL3 was significantly downregulated in the endometrium of patients with RIF and RSA ( P=0.014, P=0.016), while it was significantly upregulated in the endometrium with decidualization ( P=0.029). In vitro, induction of HESCs decidualization increased in the expression levels of total m6A, METTL3, and FOXO1 proteins in the decidualization group ( P=0.015, P=0.016, P=0.004). Knocking down METTL3 resulted in a decrease in FOXO1 protein expression in HESCs ( P=0.009). The CCK-8 and Edu results showed that the proliferation of HESCs was inhibited after knocking down METTL3. After inducing the knockdown of METTL3 in vitro, there was no statistically significant difference in the expression levels of IGFBP1 mRNA, PRL mRNA, and FOXO1 protein in HESCs compared with the negative control group (all P>0.05). Conclusion:In endometrial stromal cells, METTL3 can regulate the expression of FOXO1, promote the expression of IGFBP1 and PRL, and affect the decidualization of endometrial cells.