Objective:To explore the correlation between serum glucose regulated protein 78 (GRP78) and prohibitin1 1 (PHB1) with poor prognosis in emergency sepsis patients.Methods:A prospective study was conducted to select 99 patients with sepsis admitted to the emergency department of the Zibo 148 Hospital from January 2021 to January 2024 as the study subjects. After admission, serum GRP78 and PHB1 levels were tested, and the survival status of patients within 28 d of admission was statistically analyzed. In addition, 99 non-infected people who came to the Zibo 148 Hospital for physical examination during the same period were taken as the control group. The serum levels of GRP78 and PHB1 between patients with sepsis and the control group were compared. Baseline data and serological indicators of sepsis patients with different prognoses were compared. Correlation analysis, Logistic regression analysis and receiver operating characteristic curve (ROC) were used to explore the relationship between serum GRP78, PHB1 and poor prognosis in patients with emergency sepsis.Results:The serum levels of GRP78 and PHB1 in sepsis patients were higher than those in the control group: (125.08 ± 27.92) μg/L vs. (97.73 ± 15.62) μg/L, (186.65 ± 26.85) ng/L vs. (147.89 ± 24.63) ng/L, there was statistical difference ( P<0.05). Among the 99 patients with sepsis, 25 patients (25.25%) died within 28 d of admission. The deceased patients were included in the poor prognosis group, while the remaining 74 patients (74.75%) were included in the good prognosis group. The age of the poor prognosis group was older than that of the good prognosis group: (66.52 ± 4.72) years vs. (62.24 ± 3.67) years, the proportion of diabetes in the good prognosis group was higher: 72.00% (18/25)vs. 25.68%(19/74), the infectious shock group was higher than that of the good prognosis group: 60.00% (15/25) vs. 16.22%(12/74), and the serum GRP78 and PHB1 levels were higher than those in the good prognosis group: (149.50 ± 31.53) μg/L vs. (116.82 ± 21.13) μg/L, (209.91 ± 19.06) ng/L vs. (178.79 ± 24.51) ng/L, there were statistical differences ( P<0.05). The correlation analysis showed that age, diabetes, disease severity, serum GRP78, PHB1 were associated with poor prognosis of emergency sepsis patients (correlation coefficient was 0.428, 0.416, 0.427, 0.511, 0.506, P<0.05). Logistic regression analysis showed that serum GRP78, PHB1, age, diabetes and severity could affect the poor prognosis of emergency sepsis patients ( P<0.05). ROC curve was drawn, and the results indicated that the area under the curve value of serum GRP78 and PHB1 combined to predict poor prognosis in patients with emergency sepsis was 0.889 (95% CI 0.823 - 0.955), the sensitivity was 96.00%, and the specificity was 66.20%, which was higher than any single index. Conclusions:The occurrence of poor prognosis in patients with emergency sepsis is related to the increased expression of serum GRP78 and PHB1.Clinically, the risk of poor prognosis in patients with sepsis can be evaluated in advance by the levels of serum GRP78 and PHB1 detected at admission.

Objective:To explore the correlation between serum glucose regulated protein 78 (GRP78) and prohibitin1 1 (PHB1) with poor prognosis in emergency sepsis patients.Methods:A prospective study was conducted to select 99 patients with sepsis admitted to the emergency department of the Zibo 148 Hospital from January 2021 to January 2024 as the study subjects. After admission, serum GRP78 and PHB1 levels were tested, and the survival status of patients within 28 d of admission was statistically analyzed. In addition, 99 non-infected people who came to the Zibo 148 Hospital for physical examination during the same period were taken as the control group. The serum levels of GRP78 and PHB1 between patients with sepsis and the control group were compared. Baseline data and serological indicators of sepsis patients with different prognoses were compared. Correlation analysis, Logistic regression analysis and receiver operating characteristic curve (ROC) were used to explore the relationship between serum GRP78, PHB1 and poor prognosis in patients with emergency sepsis.Results:The serum levels of GRP78 and PHB1 in sepsis patients were higher than those in the control group: (125.08 ± 27.92) μg/L vs. (97.73 ± 15.62) μg/L, (186.65 ± 26.85) ng/L vs. (147.89 ± 24.63) ng/L, there was statistical difference ( P<0.05). Among the 99 patients with sepsis, 25 patients (25.25%) died within 28 d of admission. The deceased patients were included in the poor prognosis group, while the remaining 74 patients (74.75%) were included in the good prognosis group. The age of the poor prognosis group was older than that of the good prognosis group: (66.52 ± 4.72) years vs. (62.24 ± 3.67) years, the proportion of diabetes in the good prognosis group was higher: 72.00% (18/25)vs. 25.68%(19/74), the infectious shock group was higher than that of the good prognosis group: 60.00% (15/25) vs. 16.22%(12/74), and the serum GRP78 and PHB1 levels were higher than those in the good prognosis group: (149.50 ± 31.53) μg/L vs. (116.82 ± 21.13) μg/L, (209.91 ± 19.06) ng/L vs. (178.79 ± 24.51) ng/L, there were statistical differences ( P<0.05). The correlation analysis showed that age, diabetes, disease severity, serum GRP78, PHB1 were associated with poor prognosis of emergency sepsis patients (correlation coefficient was 0.428, 0.416, 0.427, 0.511, 0.506, P<0.05). Logistic regression analysis showed that serum GRP78, PHB1, age, diabetes and severity could affect the poor prognosis of emergency sepsis patients ( P<0.05). ROC curve was drawn, and the results indicated that the area under the curve value of serum GRP78 and PHB1 combined to predict poor prognosis in patients with emergency sepsis was 0.889 (95% CI 0.823 - 0.955), the sensitivity was 96.00%, and the specificity was 66.20%, which was higher than any single index. Conclusions:The occurrence of poor prognosis in patients with emergency sepsis is related to the increased expression of serum GRP78 and PHB1.Clinically, the risk of poor prognosis in patients with sepsis can be evaluated in advance by the levels of serum GRP78 and PHB1 detected at admission.

Objective To explore the public attitude towards kidney xenotransplantation in China by constructing and validating the prediction model based on xenotransplantation questionnaire. Methods A convenient sampling survey was conducted among the public in China with the platform of Wenjuanxing to analyze public acceptance of kidney xenotransplantation and influencing factors. Using random distribution method, all included questionnaires (n=2 280) were divided into the training and validation sets according to a ratio of 7:3. A prediction model was constructed and validated. Results A total of 2 280 questionnaires were included. The public acceptance rate of xenotransplantation was 71.3%. Multivariate analysis showed that gender, marital status, resident area, medical insurance coverage, religious belief, vegetarianism, awareness of kidney xenotransplantation and whether on the waiting list for kidney transplantation were the independent influencing factors for public acceptance of kidney xenotransplantation (all P<0.05). The area under the curve (AUC) of receiver operating characteristic (ROC) of the prediction model in the training set was 0.773, and 0.785 in the validation set. The calibration curves in the training and validation sets indicated that the prediction models yielded good prediction value. Decision curve analysis (DCA) suggested that the prediction efficiency of the model was high. Conclusions In China, public acceptance of kidney xenotransplantation is relatively high, whereas it remains to be significantly enhanced. The prediction model based on questionnaire survey has favorable prediction efficiency, which provides reference for subsequent research.

Objective:To investigate the current situation of falls in patients with amyotrophic lateral sclerosis (ALS) and analyze the influencing factors.Methods:A total of 110 ALS patients admitted to Department of Neurology of Peking University Third Hospital from February to April 2023 were selected as the research objects by the convenient sampling method. The Self-designed Patient General Data and Disease-related Questionnaire and Morse Fall Scale (MFS) were used for questionnaire investigation.Results:A total of 100 ALS patients were included, and the incidence of falls in ALS patients was 45.0% (45/100). Binomial Logistic regression analysis showed that gait abnormality, high risk of fall and abnormal muscle strength of lower extremity were risk factors for fall in ALS patients ( P<0.05) . Conclusions:Abnormal gait, high risk of falls and abnormal lower limb muscle strength are independent factors affecting falls in ALS patients, and they are important aspects in preventing and managing falls in ALS patients.

Objective:To explore the application effect of information sharing assisted decision-making intervention in knee replacement patients.Methods:A total of 94 inpatients undergoing knee replacement in Department of Orthopedics in Xinxiang Central Hospital from January to December 2022 were selected by the convenient sampling method, and they were divided into the control group and the observation group according to random number table method, with 47 cases in each group. The control group adopted routine clinical decision-making management, while the observation group implemented information sharing assisted decision-making intervention based on the control group. On the 5th day after surgery, Control Preference Scale (CPS), Chinese version of Preparation Decision Making Scale (PreDM) and Decision Participation Satisfaction Scale were used to evaluate the decision participation, decision readiness and decision satisfaction of patients in two groups.Results:In the control group, active, cooperative and passive decision-making participation accounted for 21.28% (10/47), 27.66% (13/47) and 51.06% (24/47), respectively. In the observation group, 42.55% (20/47), 44.68% (21/47) and 12.77% (6/47) of the participants were active, cooperative and passive, respectively. There was a statistically significant difference in the distribution of decision participation between the two groups ( P<0.01). The PreDM score and decision participation satisfaction score of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:Information sharing assisted decision-making intervention can effectively improve the decision-making participation of knee replacement patients and improve their decision-making readiness and satisfaction.

Objective To analyze the research progress and development trend of xenotransplantation in China.Methods Literatures related to xenotransplantation in Chinese and English were searched from CNKI and Web of Science Core Collection databases from January 1,2014 to December 31,2023.Visualization analysis of the research progress,hot topics and research frontiers in this field was performed by CiteSpace software and R language from the aspects of number of publications,keywords,distribution of journal origin,core author cooperation network,main research institutions,and citation of key literatures,etc.Results Chinese scholars published 684 articles in Chinese and 624 articles in English,ranking 2nd worldwide.The top 3 Chinese journals regarding the number of publications were Organ Transplantation,Practical Journal of Organ Transplantation(Electronic Version)and Acta Laboratorium Animalis Scientia Sinica.The top 3 English journals were Xenotransplantation,Frontiers in Immunology and Scientific Reports.The top 5 authors regarding the number of publications in Chinese were Pan Dengke,Cai Zhiming,Mou Lisha,Li Xiao and Dou Kefeng.The top 5 authors regarding the number of publications in English were Mou Lisha,Cai Zhiming,Dai Yifan,Wang Yi and Pan Dengke.High-frequency Chinese keywords included xenotransplantation,immune rejection,transplantation,xenogenic,animal model,xenogeneic bone,liver transplantation,gene editing,kidney transplantation,burn and bone transplantation.High-frequency English keywords were expression,xenotransplantation,cells,transplantation and survival.Conclusions In recent years,certain research achievement and global influence have been obtained in the field of xenotransplantation in China,involving a variety of disciplines and a wide range of research contents.However,cooperation among different institutions is still lacking.In the future,cross-regional and interdisciplinary communication and cooperation should be prompted.Resource sharing and integration should be strengthened to maintain rapid and steady advancement in this field.

Objective:To evaluate the feasibility of coronary artery calcium (CAC) detection, quantification and risk classification using ultra-low-dose chest CT (ULD-CT) combined with a calcium-aware algorithm.Methods:A total of 115 patients were prospectively enrolled from April to October 2022 at Zhejiang Provincial People′s Hospital, who underwent a standard calcium scoring CT (CACS-CT) scan followed by an additional ULD-CT scan. CACS-CT adopted a prospective ECG-triggered sequence scan with a tube voltage of 120 kVp, and the reconstruction algorithm with Qr36 (group CACS-CT Qr). ULD-CT adopted non-ECG-triggered high-pitch scan with a tube voltage of Sn 100 kVp, and the standard algorithm Qr36 (group ULD-CT Qr) and calcium-aware algorithm Sa36 (group ULD-CT Sa) were respectively used to reconstruct two groups of images. Taking the CAC detection of CACS-CT as a reference, the accuracy of ULD-CT for detecting CAC was calculated, and kappa was used to evaluate the agreement of CAC detection between scanning protocols. The agreement of CACS quantification between scanning protocols was assessed using intraclass correlation coefficients (ICC) and Bland-Altman plots, and the agreement of risk classification between scanning protocols was assessed using weighted kappa. Results:The CAC was found in 66.96% (77/115) of patients in CACS-CT Qr. Taking the CAC detection in CACS-CT Qr as a reference, the sensitivity of CAC detection in ULD-CT Qr and ULD-CT Sa was 96.1% and 97.4%, respectively, and the specificity was 94.73% (k= 0.902, 0.921). The CACS for ULD-CT Qr and ULD-CT Sa was lower than that for CACS-CT Qr (3.6, 6.2 vs. 8.5; P< 0.001), but strongly correlated with CACS for CACS-CT Qr ( r= 0.983, P< 0.001). The mean difference in CACS for ULD-CT Sa and CACS-CT Qr was smaller (12.33), and the agreement was better (ICC= 0.992). The agreement of risk classifications between ULD-CT Sa and CACS-CT Qr was relatively high (weighted k= 0.936), and the reclassification rate (6.08%) was relatively low. The effective radiation dose for ULD-CT was reduced by approximately 77.22% compared with that for CACS-CT. Conclusions:It is feasible to evaluate CACS using Non-ECG-triggered ULD-CT combined with a calcium-aware algorithm.

【Objective】 To investigate the effects of preoperative ureteroscopy (URS) on the intravesical recurrence (IVR) in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). 【Methods】 The clinical data of 241 UTUC patients treated during May 2012 and Jan.2020 in the Second Hospital of Laozhou University were retrospectively analyzed. The patients were divided into URS before RNU group (URS group) and non-URS before RNU group (non-URS group). The cumulative IVR rate, progression-free survival (PFS) and overall survival (OS) after RNU were compared, and the survival curve was drawn. Cox proportional hazards models were used to assess risk factors affecting IVR. 【Results】 Of the 241 patients, 64 (26.6%) were included in the URS group and 177 (73.4%) in the non-URS group. In the URS group, 49 underwent biopsy and 15 did not. All patients were followed up for a median of 44 (3 to 122) months, with a median time to recurrence of 12 (3 to 56) months. IVR occurred in 18 patients (28.1%) in the URS group and 25 (14.1%) in the non-URS group. Kaplan-Meier survival analysis showed that the cumulative IVR rate was higher in the URS group than in the non-URS group (all P<0.05), regardless of whether patients had a history of bladder cancer (BC) or not, while PFS was lower in the URS group than in the non-URS group (P=0.007). Cox multivariate regression analysis showed that URS (P=0.031) and complicated renal pelvis tumor and ureteral tumor (P=0.004) were independent risk factors for IVR. 【Conclusion】 Preoperative URS increases the incidence of IVR in patients with UTUC, and routine preoperative use of URS is not recommended.

Familial pheochromocytoma belongs to autosomal dominant inheritance, and has complex and variable clinical manifestations. A child with bilateral PHEO was admitted to our hospital. His grandmother, father and brother were all diagnosed with PHEO, and his aunt was diagnosed with paraganglioma. The child underwent laparoscopic left partial adrenalectomy and open surgery for the contralateral tumor, and was in good postoperative condition. The blood pressure returned to normal and there was no local recurrence and metastasis during the follow-up of 8 months after the second operation.

Objective To investigate the establishment of a six-gene-edited pig-to-non-human primate kidney xenotransplantation model. Methods The kidney of humanized genetically-edited pig (GTKO/β4GalNT2KO/CMAHKO/hCD55/hCD46/hTBM) was transplanted into a cynomolgus monkey. The survival of the recipient and kidney condition after blood perfusion were observed. The parenchymal echo, blood flow changes, and size of the kidney were monitored on a regular basis. Routine blood test, kidney function test and electrolyte assessment were carried out. Dynamic changes of urine, feces and body mass were monitored. At the end of life, the transplant kidney, heart, liver, spleen, lung, and cecum were collected for pathological examination. Results The recipient died at postoperative 7 d. After blood flow was restored, the kidney was properly perfused, the organ was soft and the color was normal. At the end of the recipient's life, a slight amount of purulent secretion was attached to the ventral side of the kidney, with evident congestion and swelling, showing the appearance of "red kidney". Postoperatively, the echo of renal parenchyma was increased, blood flow was decreased, the cortex was gradually thickened, and a slight amount of effusion surrounded the kidney and abdominal cavity over time. In the recipient, the amount of peripheral red blood cells, hemoglobin, albumin, and platelets was progressively decreased, and serum creatinine level was increased to 308 μmol/L at postoperative 7 d, whereas the K⁺ concentration did not significantly change. Light yellow urine was discharged immediately after surgery, diet and drinking water were resumed within postoperative 3 h, and light yellow and normal-shape stool was discharged. The reddish urine was gradually restored to normal color within postoperative 1 d, which were consistent with the results of the routine urine test. A large amount of brown bloody stool was discharged twice in the morning of 2 d after surgery. Omeprazole was given for acid suppression, and the stool returned to normal at postoperative 4 d. The β₂-microglobulin level was increased to 0.75 mg/L at postoperative 7 d. The body mass was increased by 1.7 kg. Autopsy pathological examination showed interstitial edema and bleeding of the transplant kidney, a large amount of infiltration of lymphocytes and macrophages, infiltration of lymphocytes in the arteriole wall and arterial cavity, accompanied by arteritis changes, lymphocyte infiltration in the cecal stroma and congestion in the spleen tissues. No significant abnormal changes were observed in other organs. Conclusions The humanized genetically-edited pig-to-non-human primate kidney xenotransplantation model is successfully established, and postoperative survival of the recipient is 1 week.