1.Effect of stretch on taurine upregulated gene 1-mediated miR-545-3p/cannbinoida receptor 2 pathway regulating distraction osteogenesis in rats.
Mengzhu ZHANG ; Bin WANG ; Zixin WANG ; Yalong WU ; Yongxin ZHENG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(5):598-604
OBJECTIVE:
To investigate the effect of stretch on long non-coding RNA taurine upregulated gene 1 (TUG1)-mediated miR-545-3p/cannbinoida receptor 2 (CNR2) pathway regulating bone regeneration in the distraction area of rats during distraction osteogenesis.
METHODS:
Thirty-six 10-week-old male Sprague Dawley rats were randomly divided into 3 groups ( n=12 in each group): group A (femoral fracture+injection of interfering RNA), group B (distraction osteogenesis+injection of interfering RNA), and group C (distraction osteogenesis+injection of TUG1). Groups A and B were injected with 60 μg of interfering RNA at the beginning of incubation period (immediate after operation), the beginning of distraction phase (7 days after operation), and the end of distraction phase (21 days after operation), and group C was injected with 60 μg of synthetic TUG1 in vivo interfering sequence at the same time. The general situation of rats in each group was observed during the experiment. The mineralization of fracture space or distraction area was observed by X-ray films at 21, 35, and 49 days after operation. At 49 days after operation, the samples of the distraction area were taken for HE staining to observe the mineralization, and real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expressions of osteoblast-related genes such as TUG1, miR-545-3p, CNR2, alkaline phosphatase (ALP), osteocalcin (OCN), and osteopontin (OPN). Blood samples were collected from the abdominal aorta of the rats, and the expressions of ALP and C terminal telopeptide of type Ⅰ (CTX-Ⅰ) protein were detected by ELISA assay.
RESULTS:
The results of X-ray film and HE staining observations showed that osteogenesis in group C was superior to groups A and B at the same time point. The results of qRT-PCR showed that the relative mRNA expressions of TUG1, CNR2, ALP, OCN, and OPN in group C were significantly higher than those in group A and group B, and the relative mRNA expression of miR-545-3p in group C was significantly lower than that in group A and group B ( P<0.05). The relative mRNA expressions of TUG1 and ALP in group B were significantly higher than those in group A, and the relative mRNA expression of miR-545-3p in group B was significantly lower than that in group A ( P<0.05). There was no significant difference in the relative mRNA expressions of CNR2, OCN, and OPN between group A and group B ( P>0.05). The results of ELISA showed that the expressions of ALP and CTX-Ⅰ protein were significantly higher in group C than in group A and group B, and in group B than in group A ( P<0.05).
CONCLUSION
Under the action of stretch, the expression of TUG1 in the femoral distraction area of rats increases, which promotes the expression of CNR2 by inhibiting the expression of miR-545-3P, which is helpful to the mineralization of the extension area and osteogenesis.
Animals
;
MicroRNAs/genetics*
;
Rats, Sprague-Dawley
;
Male
;
Osteogenesis, Distraction/methods*
;
Rats
;
RNA, Long Noncoding/metabolism*
;
Osteopontin/genetics*
;
Osteogenesis
;
Bone Regeneration
;
RNA, Small Interfering/genetics*
;
Osteocalcin/genetics*
;
Alkaline Phosphatase/metabolism*
;
Osteoblasts/cytology*
;
Signal Transduction
;
Femoral Fractures/surgery*
2.Overview of host-directed antiviral targets for future research and drug development.
Xiaoxia GU ; Mengzhu ZHENG ; Ya GAO ; Shuang LIN ; Xiaotian ZHANG ; Chunmei CHEN ; Hucheng ZHU ; Weiguang SUN ; Yonghui ZHANG
Acta Pharmaceutica Sinica B 2025;15(4):1723-1751
Viruses constitute a significant group of pathogens that have caused numerous fatalities and substantial economic losses in recent years, particularly with the emergence of coronaviruses. While the impact of SARS-CoV-2 appears to be diminishing in daily life, only a limited number of drugs have received approval or emergency use authorization for its treatment. Given the high mutation rate of viral genomes, host-directed agents (HDAs) have emerged as a preferred choice due to their broad applicability and lasting effectiveness. In contrast to direct-acting antivirals (DAAs), HDAs offer several advantages, including broad-spectrum antiviral activities, potential efficacy against future emerging viruses, and a lower likelihood of inducing drug resistance. In our review article, we have synthesized known host-directed antiviral targets that span diverse cellular pathways and mechanisms, shedding light on the intricate interplay between host cells and viruses. Additionally, we have provided a brief overview of the development of HDAs based on these targets. We aim for this comprehensive analysis to offer valuable perspectives and insights that can guide future antiviral research and drug development efforts.
3.Optimization of induction and cryopreservation methods for mouse bone marrow-derived macrophages
Qiong WEI ; Mengzhu ZHAO ; Xu CHENG ; Menghua LIU ; Dongmei ZHANG
Chinese Journal of Pathophysiology 2025;41(3):611-618
AIM:To explore suitable methods for the induction and cryopreservation of mouse bone marrow-derived macrophages(BMDMs).METHODS:Mouse fibroblasts(L929 cells)were cultured under varying conditions of temperature,seeding density,and serum concentration.The concentration of macrophage colony-stimulating factor(M-CSF)in the cell supernatant was measured using ELISA to determine the optimal conditions.Mouse bone marrow cells were extracted,and a differential adherence method was employed to pre-culture the bone marrow cells for 4 h,followed by flow cytometry to assess the proportion of resident macrophages.Flow cytometry was utilized to assess the ratio of F4/80 positive cells among the suspended and adherent cells.Induction of BMDMs was conducted using L929 cell supernatant or recombinant M-CSF for 7 d,and flow cytometry was applied to evaluate the proportion of F4/80 and CD11b double-positive cells.The morphologic changes during cell induction were observed under an inverted microscope,and the phagocytic ca-pacity and inflammatory response levels of BMDMs derived from C57BL/6N and C57BL/6J mice were evaluated using neu-tral red and ELISA methods.The cells were immediately cryopreserved after extraction,and then induced after recovery,or cryopreserved after successful induction and recovered.The cell morphology was observed under an inverted micro-scope,cell viability was assessed using the CCK-8 method,and phagocytic ability was measured using the neutral red method.RESULTS:The M-CSF concentration in the supernatant from L929 cells cultured at 33℃,10%fetal bovine se-rum(FBS)for 7 d was rich.Following 4 h of pre-culture,the proportion of F4/80 positive cells in adherent cells was sig-nificantly higher than that in suspended cells(P<0.01).After 7 d of induction with L929 cell supernatant or recombinant M-CSF,the proportions of F4/80+CD11b+cells showed no significant difference(P>0.05).Compared with the BMDMs derived from C57BL/6J mice,those from C57BL/6N mice exhibited stronger phagocytic capacity(P<0.01),and released lower levels of TNF-α(P<0.01)and IL-6(P<0.05),and higher levels of IL-1β(P<0.05).Compared with the BMDMs that were induced after recovery from initial cryopreservation,those cryopreserved immediately after extraction and in-duced upon recovery exhibited better macrophage morphology,higher cell viability(P<0.01),and enhanced phagocytic ability(P<0.01).CONCLUSION:The supernatant from L929 cells cultured at 33℃,10%FBS for 7 d is rich in M-CSF,successfully inducing bone marrow cells to differentiate into mouse BMDMs.The differential adherence method for pre-culturing can eliminate resident macrophages from the original bone marrow.The phagocytic capacity and inflammato-ry response levels differ between BMDMs derived from the C57BL/6N and C57BL/6J mouse subtypes.Cryopreserving bone marrow cells immediately after extraction and subsequently inducing them upon recovery is a preferable method for BMDM cryopreservation.
4.Effects of electroacupuncture on cognitive impairment and mitophagy mediated by KIF5A/Miro1 pathway in Parkinson's disease mice.
Mengzhu LI ; Jiafan CHEN ; Mengxuan CHEN ; Haiyan LI ; Zhenyi ZHANG ; Da GAO ; Weicong ZENG ; Lijun ZHAO ; Meiling ZHU
Chinese Acupuncture & Moxibustion 2025;45(8):1111-1119
OBJECTIVE:
To explore the improvement effect of electroacupuncture (EA) based on Xingnao Kaiqiao acupuncture (acupuncture for regaining consciousness and opening orifices) on cognitive impairment in mice with Parkinson's disease (PD), and to explore its regulatory mechanisms on the kinesin family member 5A (KIF5A)/mitochondrial Rho GTPase 1 (Miro1) pathway and mitophagy in prefrontal cortical neurons.
METHODS:
A total of 70 male C57BL/6J mice of clean grade were randomly divided into a normal group (12 mice), a sham operation group (12 mice), and a model pre-screening group (46 mice). Unilateral stereotaxic injection of 6-hydroxydopamine (6-OHDA) into the medial forebrain bundle was adopted to establish the PD model in the model pre-screening group. Twenty-four mice after successful modeling were randomly selected and divided into a model group and an EA group, 12 mice in each one. In the EA group, acupuncture was applied at "Shuigou" (GV26) and bilateral "Sanyinjiao" (SP6) and "Neiguan" (PC6), ipsilateral "Sanyinjiao" (SP6) and "Neiguan" (PC6) were connected to EA respectively, with disperse-dense wave, 5 Hz/20 Hz in frequency, 0.5 mA in current intensity, 20 min a time, 6 times a week for 30 days. Cognitive function was assessed by Y-maze and Morris water maze tests; morphology of prefrontal cortex was observed by H.E. staining; reactive oxygen species (ROS) level in prefrontal cortex was detected by fluorescence probe method; mitochondrial morphology and autophagosome ultrastructure were observed by transmission electron microscopy; the mRNA expression of tyrosine hydroxylase (TH) was detected by quantitative real-time PCR; the protein expression of TH, KIF5A, Miro1, p62, Parkin and PTEN induced kinase 1 (PINK1) was detected by Western blot.
RESULTS:
Compared with the sham operation group, both the model group and the EA group exhibited increased rotation number of per minute (P<0.001). Compared with the sham operation group, in the model group, the novel arm exploration time of Y-maze test was shortened (P<0.001), the escape latency of Morris water maze test was prolonged (P<0.05) and the platform crossing number of Morris water maze test was reduced (P<0.01); in the prefrontal cortex, the number of cellular vacuole and neurons with karyopyknosis was increased (P<0.001), and mitochondrial autophagosomes could be observed; in the prefrontal cortex, the relative expression of ROS was increased (P<0.001), the protein and mRNA expression of TH was decreased (P<0.001), the protein expression of Miro1, PINK1, Parkin was increased (P<0.001, P<0.01), the protein expression of KIF5A and p62 was decreased (P<0.001). Compared with the model group, in the EA group, the novel arm exploration time of Y-maze test was prolonged (P<0.01), the escape latency of Morris water maze test was shortened (P<0.05) and the platform crossing number of Morris water maze test was increased (P<0.05); in the prefrontal cortex, the number of cellular vacuole and neurons with karyopyknosis was decreased (P<0.001), and the number of mitochondrial autophagosomes reduced and the mitochondrial morphology was improved; in the prefrontal cortex, the relative expression of ROS was decreased (P<0.01), the protein and mRNA expression of TH was increased (P<0.001, P<0.01), the protein expression of Miro1, PINK1, Parkin was decreased (P<0.001, P<0.01, P<0.05), the protein expression of KIF5A and p62 was increased (P<0.01, P<0.05).
CONCLUSION
Xingnao Kaiqiao electroacupuncture effectively alleviates cognitive impairment and damage of neuronal function in PD mice, its mechanism may be related to the regulation of KIF5A/Miro1 pathway, hence reducing the mitophagy in prefrontal cortical neurons.
Animals
;
Electroacupuncture
;
Male
;
Mice
;
Parkinson Disease/physiopathology*
;
Cognitive Dysfunction/psychology*
;
Kinesins/genetics*
;
Humans
;
Mitophagy
;
Mice, Inbred C57BL
;
rho GTP-Binding Proteins/genetics*
;
Mitochondria/genetics*
;
Prefrontal Cortex/metabolism*
5.Effect of Modified Xiangsha Liujunzitang on Hepatic Kupffer Cell Inflammation Mediated by Intestinal-derived LPS in Rats with Hyperlipidemia and Spleen Deficiency Syndrome
Mengzhu CHE ; Lianqun JIA ; Dongyu MIN ; Guoyuan SUI ; Qi ZHANG ; Guanlin YANG ; Yunhao CUI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(16):77-86
ObjectiveThe study aims to investigate the intervention effect of modified Xiangsha Liujunzitang (M-XSLJZ) on intestinal-derived lipopolysaccharide (LPS)-activated Kupffer cell inflammation in rats with hyperlipidemia spleen deficiency syndrome. MethodsSeventy male SD rats were randomly divided into seven groups (n=10): blank control (CON), high-fat diet without spleen deficiency (HFD), high-fat diet with spleen deficiency (SD-HFD), M-XSLJZ low-, medium-, and high-dose groups (XS-L, XS-M, XS-H), and western medicine control (R). Spleen deficiency was induced in SD-HFD, XS-L, XS-M, XS-H, and R groups via irregular diet combined with exhaustive swimming for 15 days. The CON group received a standard diet, while other groups were fed a high-fat diet for 10 weeks to establish the hyperlipidemia model. After successful modeling, rats were treated for 8 weeks: M-XSLJZ was administered at 3.51, 7.02, 14.04 g·kg-1 in XS-L, XS-M, and XS-H groups, respectively. The R group received 9×10-4 g·kg-1 of a reference drug. D-xylose excretion rate was measured by the phloroglucinol method. Blood lipids were assessed using an automated biochemical analyzer. Hematoxylin-eosin (HE) staining was used to evaluate the pathological conditions of the liver, and oil red O staining was used to observe the lipid deposition in the liver. The levels of LPS, portal vein serum LPS, LPS-binding protein (LBP), serum interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA). Immunofluorescence was used to evaluate CD86 expression and CD68/TLR4 co-localization in the liver. Protein levels of TLR4, MyD88, NF-κB p65, and p-NF-κB p65 in Kupffer cells were analyzed via Western blot automated protein analysis. Hepatic IL-6, TNF-α, and IL-1β mRNA and protein levels were measured using Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot. ResultsCompared with the CON group, the SD-HFD group showed a decrease in D-xylose excretion (P<0.01). TC, TG, HDL-C, and LDL-C increased (P<0.05, P<0.01). A large number of hepatic lipid vacuoles and orange-red lipid droplet deposition appeared in the liver. Ileal LPS, portal LPS, and LBP increased (P<0.05, P<0.01). The levels of serum IL-6, TNF-α, and IL-1β increased (P<0.01). The expression of CD86 was upregulated (P<0.01), and the co-expression of CD68 and TLR4 was enhanced. The protein levels of TLR4, MyD88, and p-p65 in Kupffer cells increased (P<0.01). The mRNA and protein levels of IL-6, TNF-α, and IL-1β increased (P<0.05, P<0.01). Compared with the HFD group, the SD-HFD group exhibited decreased D-xylose excretion (P<0.01), higher HDL-C, LDL-C (P<0.05), increased portal LBP and LPS (P<0.05), increased serum IL-6 and TNF-α (P<0.01), upregulated CD86 (P<0.01), enhanced CD68/TLR4 co-expression, and higher TNF-α mRNA/protein (P<0.05). Compared with the SD-HFD group, all M-XSLJZ treatment groups showed reduced TC, TG, and LDL-C (P<0.05, P<0.01). XS-H and R groups displayed improved hepatic lipid deposition. XS-H and R groups had lower ileal LPS, portal LPS, and LBP levels (P<0.05, P<0.01). All M-XSLJZ treatment groups exhibited reduced serum IL-6, IL-1β, and TNF-α (P<0.01). The XS-H group showed downregulated CD86 (P<0.01) and weakened CD68/TLR4 co-expression. The XS-H group had reduced TLR4, MyD88, and p-NF-κB p65 in Kupffer cells (P<0.01). XS-H and R groups showed lower IL-6, TNF-α, and IL-1β mRNA/protein (P<0.05, P<0.01). ConclusionM-XSLJZ may exert its lipid-lowering effects by inhibiting intestinal-derived LPS and alleviating Kupffer cell inflammation in the liver.
6.Screening and validation of key molecular targets for dihydromyricetin in ameliorating diabetic nephropathy
Xingran LIU ; Mengzhu NIU ; Yuan GAO ; Dandan CHEN ; Baowen ZHANG ; Dekun LIU ; Xiaoqian LIU ; Xianjuan KOU
Journal of Army Medical University 2025;47(21):2663-2677
Objective To investigate the potential mechanism by which dihydromyricetin(DHM)ameliorates diabetic nephropathy(DN),and to screen and validate its possible key molecular targets.Methods A DN model was established using db/db mice,and 100 mg/(kg·d)DHM was administered via gavage 5 d per week for totally 10 weeks.Renal morphological changes were observed after staining to evaluate the effects of DHM.GSE161885 and GSE270526 datasets were obtained from the Gene Expression Omnibus(GEO)database and analyzed in combination with the GeneCards database to screen for DN-related differentially expressed genes(DEGs).Protein-protein interaction(PPI)network and molecular docking were employed to predict potential DHM targets.Western blotting and immunofluorescence staining were performed to detect the effects of DHM on pyroptosis-related pathways in the renal tissues of db/db mice and in high glucose(HG)-induced human renal tubular epithelial cells(HK-2).The specific NLR family pyrin domain containing protein 3(NLRP3)inhibitor MCC950 was also used to validate the predicted mechanism.Results In vivo experiments showed that DHM significantly ameliorated renal pathological damage in db/db mice,alleviated glomerular hypertrophy and mesangial expansion,and markedly reduced Paller scores(P<0.001).Immunofluorescence staining revealed significantly weakened fluorescence signals for α-smooth muscle actin(α-SMA),fibronectin,and collagen Ⅰ in renal tissues.Western blot results showed that the expression levels of collagen Ⅰ,collagen Ⅲ,α-SMA,and transforming growth factor beta 1(TGF-β1)were significantly decreased(P<0.05).A total of 16 DN-related DEGs were identified.Enrichment analysis revealed that these genes were primarily enriched in pathways such as viral protein interactions,cytokine-cytokine receptor interaction,and the AGE-RAGE signaling pathway in diabetic complications,and were primarily involved in gene functions such as the positive regulation of lymphocyte-mediated immunity,positive regulation of adaptive immune response,and chemokine activity.Molecular docking confirmed NLRP3 as a potential target of DHM.In vivo validation showed that DHM significantly down-regulated gasdermin-D(GSDMD)fluorescence signals and inhibited the expression of pyroptosis-related proteins including NLRP3,Caspase 1,Cleaved-Caspase 1,interleukin 18(IL-18),and GSDMD(P<0.05).In vitro studies further confirmed that both DHM and the specific NLRP3 inhibitor MCC950 alleviate high glucose-induced fibrosis and pyroptosis in HIC-2 cells.Conclusion DHM can ameliorate the progression of DN,and its mechanism is related to inhibiting NLRP3 inflammasome-mediated pyroptosis,thereby alleviating renal inflammation and fibrosis.
7.Sodium tanshinone ⅡA sulfonate inhalation attenuates pulmonary hyper-tension associated with chronic obstructive pulmonary disease in mice
Runhua HOU ; Siting WANG ; Hongping ZHANG ; Ruanyuan YE ; Zeping YANG ; Mengzhu LI ; Guanqing ZHEN ; Jiarui FAN ; Chunyun ZHANG ; Rui CHEN ; Defu LI
Chinese Journal of Pathophysiology 2025;41(9):1713-1720
AIM:To investigate the effects of nebulized sodium tanshinone ⅡA sulfonate(STS)in a mouse model of pulmonary hypertension associated with chronic obstructive pulmonary disease(COPD-PH).METHODS:A to-tal of 32 healthy SPF-grade male C57BL/6 mice were randomly divided into 4 groups:control(CTL,n=8)group,COPD-PH(CS+LPS,n=8)group,STS-treated COPD-PH(CS+LPS+STS,n=8)group,and STS(n=8)group.The COPD-PH model was established through whole-body exposure to cigarette smoke(CS)combined with lipopolysaccharide(LPS)in-halation.Mice were subjected to cigarette smoke exposure in a chamber(9 cigarettes/h,2 h/session,2 sessions/d,6 d/week)for 60 d,except on days of LPS inhalation.On days 1 and 14,COPD-PH model mice received LPS(7.5 μg/mouse in 50 μL saline)via intranasal inhalation,while the CTL and STS groups received an equivalent volume of saline.STS was administered via nebulized inhalation(5 mg/kg,30 min per session,twice daily)immediately before CS exposure.At the end of the modeling period,lung function and right heart pressure were assessed.Bronchoalveolar lavage fluid(BALF)was collected for inflammatory cell counting.Levels of interleukin-6(IL-6)in BALF supernatants and plasma were measured using ELISA.Pathological changes in the airway and lung tissues were evaluated.RESULTS:(1)Com-pared to CTL mice,those exposed to CS and LPS exhibited lesions characteristic of COPD-PH,including emphysema,lung inflammation,decreased lung function,and increased right ventricular systolic pressure(RVSP)and right ventricu-lar hypertrophy index(RVHI)(P<0.05);(2)COPD-PH mice showed significantly elevated IL-6 levels in both BALF and plasma(P<0.05);(3)STS treatment alleviated emphysema and lung inflammation,improved lung function,prevent-ed increases in RVSP and the RV/(LV+S)ratio,and reduced IL-6 levels in both BALF and plasma(P<0.05).CON-CLUSION:The results indicate that nebulized inhalation of STS significantly slows the progression of COPD-PH,likely due to its ability to inhibit lung inflammation and reduce IL-6 expression in the lungs.
8.Disinfection effect of periodic hypochlorous acid on water supply pipeline and metagenomic next-generation sequencing for water specimens
Hong ZHOU ; Xiaodong GAO ; Meixia WANG ; Mengzhu ZHANG ; Jun YANG ; Jing ZHUANG ; Hua XU ; Wei SUN ; Qingfeng SHI
Chinese Journal of Infection Control 2025;24(9):1244-1249
Objective To explore the disinfection effect of periodic hypochlorous acid infusion on water supply pipelines.Methods Water specimens from 6 water outlets of central sterile supply department were collected at baseline for microbial culture.After introducing a slightly acidic hypochlorous acid water generator,water speci-mens were collected every 10 days.Continuous disinfection with hypochlorous acid was carried out on the 1st-3rd day,and discontinued on the 4th-10th day.Water specimens of 6 water outlets were collected on the 1st,4th,7th,and 10th day of each cycle,in total 3 cycles.Microbial culture and metagenomic next-generation sequencing(mNGS)analysis were conducted simultaneously on all water specimens from the outlets of the endoscope cleaning tank.Results Before disinfection of the pipeline,a total of 18 bottles of water specimens were collected.Bacterial count of water specimens from 10 bottles(55.56%)was between 102 and 104 CFU/mL,mainly Sphingomonas ad-hesins and Bacillus cereus.After disinfection,only 2 out of 72 water specimens(2.78%)exceeded the bacterial lim-it.The mNGS results showed that three most dominant bacterial genera in the pre-disinfection water specimens were Sphingomonas,Methylobacterium,and Ralstonia,with stringent mapped reads number(SMRN)ranging from 10 000 to 100 000;while the most dominant bacterial genera in post-disinfection water specimens were Lacto-baci-llus,Ralstonia,Acinetobacter,and Bradyrhizobium.PCoA analysis showed that there was a statistically sig-nificant difference in β-diversity of water specimens before and after disinfection(P<0.05).Conclusion Periodic hypochlorous acid infusion disinfection can effectively remove bacterial biofilms in water pipelines,but there is a risk of bacterial biofilm recovery during disinfection suspension.In the future,monitoring and management of medical water should be strengthened.
9.Analysis of medical malpractice cases of cardiovascular diseases--A study of second-instance cases in henan province
Mengzhu ZHANG ; Yewei YAO ; Caiyuan LIU ; Liya MA ; Zhe ZHENG ; Haojie QIN ; Xinmin PAN
Chinese Journal of Forensic Medicine 2025;40(4):405-410
Objective To analyze the characteristics,causes,influencing factors of compensation,and appraisal features of second-instance medical malpractice cases involving cardiovascular diseases in Henan Province from 2017 to 2022,and to provide reference for forensic appraisal and judicial trial.Methods Cases were retrieved from China Judgments Online between 2017 and 2022.A total of 1,957 documents were reviewed,including 1,397 medical malpractice cases and 130 cardiovascular disease cases.Results The total compensation awarded in these second-instance cases was 27.04 million yuan,with a median of 158,600 yuan.Cases involving patient death accounted for 80.00%(104/130).Among 107 cases with first-instance appraisals,55.14%(59/107)raised objections,while 74.62%(97/130)of the second-instance trials upheld the original judgment.The most common degree of responsibility borne by medical institutions was secondary responsibility(41.54%,54/130).The top three medical faults were:inadequate observation and management of patient conditions(46.15%),omission of auxiliary examinations(37.50%),and insufficient notification(36.54%).In terms of violations-including medical record documentation,inappropriate treatment,misdiagnosis or missed diagnosis,out-of-scope practice,and improper medication use-the actual proportions in judgments(24/113,34/113,12/113,7/113,14/113)were all significantly lower than the patients' claims(all P<0.05).Conclusion Cardiovascular medical malpractice cases in second-instance trials involve substantial compensation and a high proportion of death outcomes.Both medical institutions and patients should pay greater attention to first-instance trials.Appraisal organizations should proactively provide explanation and education regarding issues likely to raise patient doubts,thereby reducing unnecessary appeals.They should also avoid hasty revisions of appraisal opinions when faced with objections and instead focus on improving the quality and credibility of appraisals.In determining medical faults,emphasis should be placed on evaluating whether there was inadequate patient monitoring and management,omission of auxiliary examinations,and insufficient notification.
10.Application research of immersive virtual reality technology in pediatric patients undergoing elective surgery under general anesthesia
Ju ZHANG ; Lili WEI ; Chen XIN ; Jing WANG ; Yan HAN ; Yanyan YANG ; Mengzhu SUN
Chinese Journal of Nursing 2025;60(6):671-676
Objective To explore the application effect of immersive virtual reality(IVR)technology and different viewing content in pediatric patients with general anesthesia during elective surgery,and to provide references for clinical implementation.Methods A total of 180 pediatric patients who underwent elective surgery under general anesthesia in a tertiary hospital in Qingdao from February to October 2023 were selected as study population using convenient sampling method.According to the operation time,60 pediatric patients who underwent surgery from May to July 2023 were included in the immersive panoramic surgical education group,and they could watch the panoramic surgical education video immersively on the basis of routine care.A total of 60 pediatric patients who underwent surgery from August to October 2023 were included in the immersive animation group to watch cartoons immersively on the basis of routine care.A total of 60 pediatric patients who underwent surgery from February to April 2023 were included in the control group and routine preoperative care was implemented.The preoperative anxiety levels,anesthesia induction compliance,and incidence of emergence agitation were compared in the 3 groups by the modified Yale Preoperative Anxiety Scale-Short Form(mYPAS-SF),anesthesia induction cooperation grade,and the Pediatric Anesthesia Emergence Delirium scale(PAED).Results There were statistically significant differences in preoperative anxiety level,anesthesia induced compliance and incidence of emergence agitation during awakening between the 3 groups(P<0.001).Among them,the preoperative anxiety level of the immersive panoramic surgical education group and the immersive animation group was lower than that of the control group,and the difference was statistically significant(P<0.001).The anesthesia induced compliance degree of the immersive panoramic surgical education group and the immersive animation group was better than that of the control group,and the difference was statistically significant(P<0.017),and the incidence of emergence agitation in the immersive panoramic surgical education group was lower than that of the control group,and the difference was statistically significant(P=0.004).Conclusion The use of IVR technology to watch panoramic surgical education videos and cartoons can help reduce the preoperative anxiety level and improve anesthesia induction cooperation degree of pediatric patients with general anesthesia during elective surgery,but the intervention effect of panoramic surgical education videos is better in improving the emergence agitation.

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