Objective:To explore applications of essential balm K-point stimulation on the swallowing rehabilitation in patients with minimally consciousness state, so as to provide reference for patients rehabilitation.Methods:This was a prospective randomized controlled study. A total of 60 minimally consciousness state patients were enrolled by convenience sampling method from Henan Provincial People Hospital from January to December 2021, who were divided into experimental group and control group according to the random number table method, with 30 cases in each group. Both groups received routine rehabilitation therapy, based on this, the control group was given routine K-point stimulation, the experimental group implemented essential balm K-point stimulation. Before and after 4 weeks of intervention, the Kubota water swallowing test and Coma Recovery Scale-revised (CRS-R) was used for assessment.Results:Before intervention, there was no significant difference in Kubota water swallowing test grade and CRS-R scores between two groups (both P>0.05). After 4-week intervention, Kubota water swallowing test Ⅰ-Ⅴ grade were 1, 6, 13, 7 and 3 cases in the control group, while 4, 12, 8, 3 and 3 cases in the experimental group, the difference was statistically significant ( Z = 2.09, P<0.05); the scores of oral motor/verbal function scale were (2.60 ± 1.16) in the experimental group, higher than in the control group (1.90 ± 0.32), the difference was statistically significant ( t = 2.18, P<0.05). Conclusions:Essential balm K-point stimulation can effectively promote swallowing function of patients with minimally consciousness state, and improve patient′s oral motor function.

Objective:To compare the clinical outcomes of endovascular therapy in acute stroke patients with anterior circulation tandem occlusions caused by atherosclerosis or dissection.Methods:A retrospective cohort study. A total of 98 patients with anterior circulation tandem lesions undergoing endovascular therapy in the Wuhan NO.1 Hospital (March 2016 to March 2022) were analyzed. Median age was 64(55,71) years old, and 82.7% (81/98 cases) were males. According to the lesion etiology, the patients were divided into atherosclerosis and dissection groups. The differences in clinical outcomes between the two groups were investigated, including favorable 90-day functional outcome (modified Rankin Scale score of 0-2), successful reperfusion (modified Thrombolysis in Cerebrovascular Infarction score of 2b-3), symptomatic intracranial hemorrhage, stroke-associated pneumonia, 90-day all-cause mortality, and average hospitalization days. Logistic regression analysis was used to adjust for potential confounders affecting functional outcomes in both groups, and to determine odds ratios and 95% confidence intervals.Results:Seventy-one patients were grouped into the atherosclerotic cause and 27 into the dissection cause cohorts. The rate of favorable 90-day functional outcome was 43.7% (31/71 cases) in the atherosclerosis group versus 55.6% (15/27 cases) in the dissection group (adjusted odds ratio=1.339; 95% confidence interval, 0.374-4.798; P=0.654). No significant differences were found in other clinical outcomes between the two groups (all P>0.05). Conclusion:The clinical prognosis of patients with tandem lesions caused by atherosclerotic stenosis or artery dissection was similar after endovascular therapy. Future studies are still needed to verify our results.

Objective : To the effects and potential mechanisms of ST3GAL5 on biological behaviors of Bladder Urothelial Carcinoma(BLCA) . Methods : Differentially expressed genes related to bladder cancer were identified using microarray analysis . Suitable bladder cancer cell lines were then screened . In vitro experimental measurements , including CCK8 , EdU , colony formation assays , transwell migration , flow cytometry apoptosis experiments , scratch assay , were used to evaluate the effects of ST3GAL5 on biological behaviors of BLCA . ST3GAL5 gene Kyoto Encyclopedia of Genes and Genomes ( KEGG) , gene set enrichment analysis ( GSEA) were analyzed using The Cancer Genome Atlas (TCGA) database . Finally , Western blot technology was used to verify the classical proliferation and metastasis related pathway factors . Results : The combination of bioinformatics analyses and experimental measurements demonstrate that ST3GAL5 expression is aberrantly down⁃regulated in human cell lines of BLCA . Through Cancer Cell Line Encyclopedia (CCLE) database , HT⁃1376 cell lines were successfully screened for vitro test . Upregulation of ST3GAL5 was found to suppress the malignant biological behaviour of bladder cancer. GSEA enrichment analyses exhibited that ST3GAL5 and its co⁃expressed genes inhibited cell proliferation , invasion and metastasis of bladder urothelial carcinoma by activation of the PPAR pathway and inhibition of the PI3K/AKT pathway . The results of Western blot experiments verified that the key proteins of the PPAR signaling pathway showed a significant increase and the key proteins of the PI3K/AKT signaling pathway showed a significant decrease ( P <0. 05) after ST3GAL5 overexpression in bladder cancer. Conclusion ST3GAL5 gene might act as an oncogenic suppressor gene in bladder cancer , possibly inhibit the proliferation , invasion and metastasis of bladder cancer cells by activating the PPAR signaling pathway and inhibiting related molecules in the PI3K/AKT signaling pathway .

Objective:To investigate the risk factors of spinal cord injury after FET for ATAAD.Methods:We analyzed perioperative data of 111 patients with ATAAD who underwent FET in the First Affiliated Hospital of Nanjing Medical University from January 2020 to October 2021.Results:Eleven(9.9%)of 111 patients had postoperative spinal cord injury, which showed varying degrees of paralysis or paraplegia. There was no significant difference in age, sex, medical history, cardiopulmonary bypass time, aortic cross-clamping time, circulatory arrest time and FET length between spinal cord injury group and non-spinal cord injury group( P>0.05). Univariate analysis showed that aortic true lumen away from the spinal side( P<0.001) and the number of segmental arteries originating from the true lumen<3 in T9-L3( P<0.001), left subclavian artery involvement( P<0.05) and stent coverage at T8 or beyond( P<0.05) was associated with postoperative spinal cord injury. Multivariate Logistic analysis showed that aortic true lumen away from the spinal side( P<0.001) and the number of segmental arteries originating from the true lumen<3( P<0.001) in T9-L3 and left subclavian artery involvement( P<0.05) were independent risk factors for postoperative spinal cord injury. Conclusion:The pathogenesis of spinal cord injury is complicated. This study suggests that the occurrence of spinal cord injury is significantly related to aortic true lumen away from the spinal side and the number of segmental arteries originating from the true lumen<3 in T9-L3 and left subclavian artery involvement. It is of great clinical significance to identify the high risk factors of postoperative spinal cord injury as early as possible.

Objective:To explore the effect of the discharge preparation plan based on community linkage in the out-of-hospital continuous nursing of chronic obstructive pulmonary disease (COPD) patients.Methods:From March 2019 to March 2020, convenience sampling was used to select 206 COPD patients hospitalized in the Respiratory Department of Henan Provincial People's Hospital. The patients were randomly divided into the observation group and the control group, with 103 cases in each group. The control group received routine management of COPD, and the observation group implemented a community-linked discharge preparation plan on the basis of the control group, and carried out a six-month intervention. The COPD Assessment Test (CAT) score, Patient Assessment of Chronic Illness Care (PACIC) score, body mass index, degree of airflow obstruction, dyspnea and exercise capacity (BODE) index, and the patient readmission rate during the intervention period were compared between the two groups before and after the intervention.Results:After the intervention, the item scores and total scores of the CAT of the observation group were lower than those of the control group. Except for cough and sputum, the differences in the other items and total scores were statistically significant ( P<0.05) . The item scores and total scores of the CAT of the observation group after intervention were lower than those before intervention, and the differences were statistically significant ( P<0.05) . The dimension scores and total score of the PACIC of the observation group after the intervention were higher than those before the intervention, and were higher than those of the control group after the intervention, and the difference was statistically significant ( P<0.05) . The BODE index score of the observation group after intervention was lower than that of the control group, and the difference between the two groups was statistically significant ( P<0.05) . The readmission rate in the observation group within six months was 13.59% (14/103) , which was lower than 31.07% (32/103) in the control group, and the difference between the two groups was statistically significant (χ 2=9.068, P=0.003) . Conclusions:The discharge preparation plan based on community linkage can improve the quality of life and lung function of COPD patients, increase the patient's recognition of chronic disease management, reduce the rate of hospital readmission, and achieve the overall quality improvement in continuous nursing of patients.

A 38-year-old female patient with recurrence of breast cancer accompanied by liver metastasis received intravenous infusion of sintilimab 200 mg on the first day and 21 days was a cycle. Before the immunotherapy, her function of liver, kidney, and thyroid was normal. Three days after the medication, the patient developed rash and itching on skin of waist. After that, diffuse erythema and desquamation appeared on skin of her whole body and blisters appeared on both upper limbs and back. At the same time, she developed blurred vision, increased eye secretions, and foreign-body sensation. Laboratory tests showed alanine aminotransferase (ALT) 123 U/L, aspartate aminotransferase (AST) 342 UL, γ-Glutamyltransferase (γ-GT) 907 U/L, alkaline phosphatase (ALP) 424 U/L, serum creatinine (Scr) 95.6 μmol/L, uric acid 691.0 μmol/L, and thyroid-stimulating hormone (TSH) 20.87 mU/L. She was diagnosed with rash, hypothyroidism, kidney injury, conjunctivitis, and liver injury, which were considered to be associated with sintilimab. After 16 days of symptomatic treatments such as IV infusions of methylprednisolone sodium succinate for injection and magnesium isoglycyrrhizinate injection, oral administration of levothyroxine sodium and Haikun Shenxi capsules (海昆肾喜胶囊), levofloxacin eye drops, and skin care, her rash was subsided, blisters were absorbed, and the discomfort in the eyes disappeared. Laboratory tests showed ALT 111 UL, AST 122 U/L, γ-GT 1 430 U/L, ALP 321 U/L, Scr 56.0 μmol/L, uric acid 243.0 μmol/L, and TSH 13.60 mU/L.

A 38-year-old female patient with recurrence of breast cancer accompanied by liver metastasis received intravenous infusion of sintilimab 200 mg on the first day and 21 days was a cycle. Before the immunotherapy, her function of liver, kidney, and thyroid was normal. Three days after the medication, the patient developed rash and itching on skin of waist. After that, diffuse erythema and desquamation appeared on skin of her whole body and blisters appeared on both upper limbs and back. At the same time, she developed blurred vision, increased eye secretions, and foreign-body sensation. Laboratory tests showed alanine aminotransferase (ALT) 123 U/L, aspartate aminotransferase (AST) 342 UL, γ-Glutamyltransferase (γ-GT) 907 U/L, alkaline phosphatase (ALP) 424 U/L, serum creatinine (Scr) 95.6 μmol/L, uric acid 691.0 μmol/L, and thyroid-stimulating hormone (TSH) 20.87 mU/L. She was diagnosed with rash, hypothyroidism, kidney injury, conjunctivitis, and liver injury, which were considered to be associated with sintilimab. After 16 days of symptomatic treatments such as IV infusions of methylprednisolone sodium succinate for injection and magnesium isoglycyrrhizinate injection, oral administration of levothyroxine sodium and Haikun Shenxi capsules (海昆肾喜胶囊), levofloxacin eye drops, and skin care, her rash was subsided, blisters were absorbed, and the discomfort in the eyes disappeared. Laboratory tests showed ALT 111 UL, AST 122 U/L, γ-GT 1 430 U/L, ALP 321 U/L, Scr 56.0 μmol/L, uric acid 243.0 μmol/L, and TSH 13.60 mU/L.

Objective: To investigate the predictors of death after endovascular mechanical thrombectomy (EMT) in patients with acute vertebrobasilar occlusive stroke (VBOS). Methods: Patients with acute VBOS treated with EMT in Wuhan No. 1 Hospital were enrolled retrospectively. The demographic and clinical data were collected. According to whether the patients died at 90 d after procedure, they were divided into survival group and death group. The demographic and clinical data were compared between the two groups. Multivariate logistic regression analysis was used to determine the independent risk factors for death at 90 d after EMT. Results: A total of 47 patients were enrolled. The median age was 62 years, 34 were males (72.3%), the median baseline National Institutes of Health Stroke Scale (NIHSS) score was 16, 42 patients (89.4%) had recanalization (modified Thrombolysis in Cerebral Infarction[mTICI] 2b/3 grade), and 12 (25.5%) died within 90 d after procedure. Univariate analysis showed that the baseline NIHSS score (26 [21-28]vs. 12 [5-23]; Z=-3.165, P=0.002), percentage of neutrophil (81.61% ±11.82% vs. 72.20% ±12.09%; t=-2.137, P=0.033), neutrophil/lymphocyte ratio (10.54±7.17 vs. 4.98±3.57; t=-2.393, P=0.017), and incidence of sICH (25.0% vs. 2.9%; χ²=5.627, P=0.018) in the death group were significantly higher than those in the survival group, while the percentage of lymphocyte (12.00%±9.04% vs. 20.67%±10.39%; t=-2.429, P=0.015) was significantly lower than that of the survival group. Multivariate logistic regression analysis showed that high baseline NIHSS score (odds ratio [OR] 1.243, 95% confidence interval [CI] 1.046-1.318; P=0.038), high neutrophil/lymphocyte ratio (OR 1.278, 95% CI 1.002-1.630; P=0.049) and symptomatic intracranial hemorrhage (OR 5.088, 95% CI 1.065-38.718; P=0.046) were the independent predictors for death. Conclusion High baseline NIHSS score, high neutrophil/lymphocyte ratio and symptomatic intracranial hemorrhage are the independent predictors for death within 90 d after EMT in patients with acute VBOS.

Objective To construct nursing sensitive indicators applicable to operating room,in order to provide standard and quantitative basis for nursing quality monitoring in operating room.Methods Based on American's National Database of Nursing Quality Indicators (NDNQI) and literature review,the key content of indicators and scientific measurement methods were determined by one round of internal inquiry and two rounds of expert consultation using Delphi technique.Results Operating room nursing quality sensitive indicators system was constructed,which contained 14 indicators.The expert authority coefficients were greater than 0.80 and the variation coefficients of each index were less than 0.3.The results were reliable.Conclusion A set of specialized,sensitive and practical nursing sensitive indicators were needed to facilitate sustainable development of operating room.

Objective To study the effect of different personality on procrastination behavior of university students.Methods 126 university students were assessed by the General Procrastination Scale (GPS) and the big five personality inventory short form(NEO-FFI).Results GPS score of the student was(53.26±9.92).There were 84.9％ students respectively had different level of procrastination behavior.There were no significant differences in university students by gender and grades.There were significant negative correlation between procrastination and personality factor of conscientiousness (r=-0.563,P＜0.01) and significant negative correlation with agreeableness (r=-0.236,P＜0.01) and extraversion.The big five personality factors of conscientiousness can effectively predict the procrastination behavior of college students.Conclusion Procrastination is a very common phenomenon in the university students.The students with lower conscientiousness,agreeableness and extraversion of big five personality have more procrastination behavior.