Objective:To explore the developmental trajectory and influencing factors of kinesiophobia in patients undergoing percutaneous coronary intervention (PCI) .Methods:By convenient sampling, totally 217 patients undergoing PCI who enrolled from two tertiary hospitals in Guangdong Province from March 2022 to July 2023. The demographic data of the patients was collected , and kinesiophobia was measured using the Tampa scale for kinesiophobia heart(TSK-SV-Heart) at one day pre-discharge, 2 weeks, 1 month, and 4 months post-discharge. Data analysis was conducted using SPSS 25.0 and Mplus 8.7 softwares. Growth mixture modelling, chi-square test, and polynomial Logistic regression were used for data processing and analysis.Results:Three different kinesiophobia trajectory classes were identified in patients within 4 months after PCI: sustained high level of kinesiophobia group (C1 group, 22.6%(49/217)), moderate level of kinesiophobia with a rapid decrease group (C2 group, 47.4%(103/217)), and rapid decrease of kinesiophobia followed an increase group (C3 group, 30.0%(65/217)). Polynomial Logistic regression results showed that, females ( B=1.136, OR=3.113, 95% CI=1.155-8.389) , patients with NYHA Ⅱ/Killip class Ⅱ or above ( B=1.135, OR=3.112, 95% CI=1.380-7.017) were more likely to develop into the C1 compared with the C2 group. Compared with the C3 group, patients with NYHA Ⅱ/Killip class Ⅱ or above ( B=3.322, OR=27.712, 95% CI=5.251-146.244), and patients with coronary heart disease(CHD) more than two years ( B=3.855, OR=47.250, 95% CI=2.146-1 040.535)were more likely to develop into the C1 group. Compared with the C3 group, patients with NYHA Ⅱ/Killip class Ⅱ or above ( B=-2.187, OR=0.112, 95% CI=0.022-0.565), patients with three or more comorbidities ( B=-2.711, OR=0.066, 95% CI=0.008-0.528), and patients with CHD more than two years ( B=-2.376, OR=0.093, 95% CI=0.011-0.783) were more likely to develop into the C2 group. Conclusion:Kinesiophobia level in patients undergoing PCI presents a curvilinear decrease within 4 months after PCI.Different kinesiophobia trajectory classes can be observed. Sex, NYHA/Killip class, course of CHD, and comorbidity affect the development trajectory of different subgroups.

Objective:To explore the developmental trajectory and influencing factors of kinesiophobia in patients undergoing percutaneous coronary intervention (PCI) .Methods:By convenient sampling, totally 217 patients undergoing PCI who enrolled from two tertiary hospitals in Guangdong Province from March 2022 to July 2023. The demographic data of the patients was collected , and kinesiophobia was measured using the Tampa scale for kinesiophobia heart(TSK-SV-Heart) at one day pre-discharge, 2 weeks, 1 month, and 4 months post-discharge. Data analysis was conducted using SPSS 25.0 and Mplus 8.7 softwares. Growth mixture modelling, chi-square test, and polynomial Logistic regression were used for data processing and analysis.Results:Three different kinesiophobia trajectory classes were identified in patients within 4 months after PCI: sustained high level of kinesiophobia group (C1 group, 22.6%(49/217)), moderate level of kinesiophobia with a rapid decrease group (C2 group, 47.4%(103/217)), and rapid decrease of kinesiophobia followed an increase group (C3 group, 30.0%(65/217)). Polynomial Logistic regression results showed that, females ( B=1.136, OR=3.113, 95% CI=1.155-8.389) , patients with NYHA Ⅱ/Killip class Ⅱ or above ( B=1.135, OR=3.112, 95% CI=1.380-7.017) were more likely to develop into the C1 compared with the C2 group. Compared with the C3 group, patients with NYHA Ⅱ/Killip class Ⅱ or above ( B=3.322, OR=27.712, 95% CI=5.251-146.244), and patients with coronary heart disease(CHD) more than two years ( B=3.855, OR=47.250, 95% CI=2.146-1 040.535)were more likely to develop into the C1 group. Compared with the C3 group, patients with NYHA Ⅱ/Killip class Ⅱ or above ( B=-2.187, OR=0.112, 95% CI=0.022-0.565), patients with three or more comorbidities ( B=-2.711, OR=0.066, 95% CI=0.008-0.528), and patients with CHD more than two years ( B=-2.376, OR=0.093, 95% CI=0.011-0.783) were more likely to develop into the C2 group. Conclusion:Kinesiophobia level in patients undergoing PCI presents a curvilinear decrease within 4 months after PCI.Different kinesiophobia trajectory classes can be observed. Sex, NYHA/Killip class, course of CHD, and comorbidity affect the development trajectory of different subgroups.

BackgroundInsomnia， a common sleep disorder， is robustly associated with cardiovascular diseases， diabetes， and psychiatric disorders， substantially impairing quality of life. Although clinically commonly used medications are effective， long-term use may lead to drug resistance and dependence. While the efficacy of Ganmai Dazao Decoction in improving insomnia is definite， its underlying molecular mechanisms remain unclear. ObjectiveTo explore the active ingredients and core targets of Ganmai Dazao Decoction in the treatment of insomnia， systematically reveal its potential molecular pharmacological mechanism， and to provide references for clinical application. MethodsIn November 2024， the active ingredients and related targets of Ganmai Dazao Decoction were screened from the INPUT database. Insomnia-related datasets were acquired from the Gene Expression Omnibus （GEO） database， followed by differential expression analysis using GEO2R to identify differentially expressed genes （DEGs） associated with insomnia. The shared targets were obtained through Venn diagrams， and the protein-protein interaction （PPI） network was constructed using the STRING database and Cytoscape 3.9.1. Enrichment analyses were conducted on the shared targets using Gene Ontology （GO） and the Kyoto Encyclopedia of Genes and Genomes （KEGG）. The top 3 key active ingredients and the top 10 core targets in terms of node degree values were selected. Molecular docking and molecular dynamics simulation of receptors and ligands were performed using AutoDock 4.4.6， and the results were visualized using Pymol 3.0.3 to further verify the stability of the receptor-ligand complex system. ResultsA total of 337 active ingredients and 5 265 drug-related targets in Ganmai Dazao Decoction were retrieved， along with 1 061 insomnia-related DEGs. 287 shared targets were identified between Ganmai Dazao Decoction and insomnia. The traditional Chinese medicine-active ingredients-shared targets-disease network showed that quercetin， catechins and kaempferol were the key components of Ganmai Dazao Decoction in treating insomnia. These three components alleviate insomnia by acting on ten core targets， including nuclear factor kappa B inhibitor alpha （NFKBIA）， fibronectin 1 （FN1）， interleukin-6 （IL6）， protein c-Fos （FOS）， histone acetyltransferase p300 （EP300）， histone deacetylase 1 （HDAC1）， transcription factor Jun （JUN）， heat shock protein HSP 90-alpha 1 （HSP90AA1）， glyceraldehyde 3-phosphate dehydrogenase （GAPDH）， and interleukin-1 beta （IL1β）. GO and KEGG enrichment analyses indicated that Ganmai Dazao Decoction may alleviate insomnia through the IL17 signaling pathways， lipid and atherosclerosis signaling pathways， and other mechanisms. The results of molecular docking demonstrated strong binding affinity between the 3 key components and the 10 core targets of Ganmai Dazao Decoction. Molecular dynamics simulations further confirmed the stability of the quercetin-GAPDH， catechin-HDAC1 and kaempferol-EP300 complexes. ConclusionThe key components of Ganmai Dazao Decoction， namely quercetin， catechin， and kaempferol， exert therapeutic effects on insomnia by targeting 10 core proteins and modulating multiple pathways， including the IL17 signaling pathway， lipids and atherosclerotic-related pathways. ［Funded by Chengdu Medical College Level Scientific Research Project （number， CYZYB23-01）］

Objective:To analyze the correlation between changes in the concentration of glyphosate (GLY) and its metabolites (AMPA) in patients with acute glyphosate poisoning and clinical symptoms, and to provide reference for the study of glyphosate toxicity.Methods:Urine samples from 5 patients with oral glyphosate poisoning admitted to the Emergency Department of Yangzhou Third Class A General Hospital from February to July 2021 were collected. Urine concentrations of GLY and AMPA were measured using derivatization gas chromatography-mass spectrometry, and analyzed based on the patient's clinical manifestations and treatment process.Results:The main symptoms of the patient after poisoning were acute gastrointestinal symptoms, such as nausea, vomiting, abdominal pain, etc. The concentration of GLY in the patient's urine reached its maximum on the first day and gradually decreased over time. On the day of discharge, the final concentration of GLY was 10% lower than the initial concentration. At discharge, the clearance rates of GLY in cases 1, 2, 3, and 4 were 96.97%, 95.91%, 96.87% and 92.87%, respectively.Conclusion:The glyphosate has a shorter maintenance time after entering the human body; There is no correlation between the concentration of glyphosate and its metabolites admitted to the hospital, the dose of poisoning, and clinical symptoms in poisoned patients.

Objective:To analyze the correlation between changes in the concentration of glyphosate (GLY) and its metabolites (AMPA) in patients with acute glyphosate poisoning and clinical symptoms, and to provide reference for the study of glyphosate toxicity.Methods:Urine samples from 5 patients with oral glyphosate poisoning admitted to the Emergency Department of Yangzhou Third Class A General Hospital from February to July 2021 were collected. Urine concentrations of GLY and AMPA were measured using derivatization gas chromatography-mass spectrometry, and analyzed based on the patient's clinical manifestations and treatment process.Results:The main symptoms of the patient after poisoning were acute gastrointestinal symptoms, such as nausea, vomiting, abdominal pain, etc. The concentration of GLY in the patient's urine reached its maximum on the first day and gradually decreased over time. On the day of discharge, the final concentration of GLY was 10% lower than the initial concentration. At discharge, the clearance rates of GLY in cases 1, 2, 3, and 4 were 96.97%, 95.91%, 96.87% and 92.87%, respectively.Conclusion:The glyphosate has a shorter maintenance time after entering the human body; There is no correlation between the concentration of glyphosate and its metabolites admitted to the hospital, the dose of poisoning, and clinical symptoms in poisoned patients.

A case of 22 year-old man with Cronkhite-Canada syndrome who responded to adequate glucocorticoids and azathioprine was reported. The pathogenesis, diagnosis, treatment and prognosis of Cronkhite-Canada syndrome were also discussed in details in order to provide clinical experience for clinicians.

A case of 22 year-old man with Cronkhite-Canada syndrome who responded to adequate glucocorticoids and azathioprine was reported. The pathogenesis, diagnosis, treatment and prognosis of Cronkhite-Canada syndrome were also discussed in details in order to provide clinical experience for clinicians.

Objective:To investigate the related factors that affect the timing and prognosis of early tracheostomy in patients with multiple rib fractures.Methods:A retrospective case series study was conducted on medical data of 222 patients with multiple rib fractures who underwent tracheostomy in Affiliated Hospital of Yangzhou University from February 2013 to October 2019，including 160 males and 66 females，with the age of 18 to 85 years ［（49.5 ± 16.3）years］. According to the practice management guidelines for tracheostomy timing and the use of propensity score matching technology，there were 118 patients with tracheostomy within 7 days of tracheal intubation （early group） and 104 patients with tracheostomy after 7 days of tracheal intubation （late group） before matching，and there were 87 patients in early group and 87 patients in late group after matching. Data were compared between groups including the gender，age，underlying disease，injury severity score （ISS），Glasgow coma score （GCS），number of fractured ribs，total number of rib fractures （NTRF），first rib fracture，flail chest，traumatic brain injury，combined injuries （spine，maxillofacial，sternum），acute respiratory distress syndrome （ARDS），volume fraction of pulmonary contusion（VPC），blood lactic acid （within 24 hours of admission），hemothorax，pneumothorax，mechanical ventilation time，duration of tracheostomy，time from tracheal intubation to incision，length of hospital stay，length of stay in ICU，closed thoracic drainage，number of fiberoptic bronchoscopy，multi-drug resistant bacteria infection，ventilator-associated pneumonia，antibiotic use time，duration of sedative and analgesic drugs used and 28-day mortality. The multivariate Logistic regression analysis was used to predict independent risk factors for early tracheostomy. The Pearson method was used to compare the relationship between multiple factors. The receiver operating characteristic （ROC） curve was used to predict indicators that affect the prognosis of patients with early tracheostomy，and calculate the best cut-off value. The Kaplan-Meier single factor and COX multivariate survival were used to analyze the relevant factors affecting the 28-day mortality of patients.Results:（1） In early group，the NTRF，ARDS and VPC were higher than those in late group，and the time from tracheal intubation to incision and 28-day mortality rate were lower than those in late group （ P < 0.05），while the two groups showed no significant differences in the gender，age，underlying diseases and ISS （ P > 0.05）. （2） The multivariate Logistic regression analysis showed that there was statistical significance in NTRF （ OR = 1.775，95% CI 1.439-2.188），ARDS（ OR = 3.740，95% CI 1.441-9.711），VPC （ OR = 1.087，95% CI 1.052-1.124） （ P < 0.05）； the Pearson method analysis showed a significant correlation between VPC and NTRF （ r = 0.369， P < 0.05） and a low degree of correlation between ARDS and VPC （ r = 0.179， P < 0.05），but there was no significant correlation between ARDS and NTRF （ r = 0.132， P > 0.05）. （3） The ROC curve analysis showed that the area under the curve （AUC） of the VPC and NTRF ［AUC = 0.832 （95% CI 0.770-0.893），AUC = 0.804 （95% CI 0.740-0.868）］ were significantly higher than those of the number of rib fractures ［AUC = 0.437（95% CI 0.352-0.523），GCS ［AUC = 0.519 （95% CI 0.432-0.605）］ and ISS ［AUC = 0.484 （95% CI 0.398-0.571）］ （ P < 0.05）. After calculating the Yorden index，the best cut-off value for VPC was 23.9，and the best cut-off value for NTRF was 8.5. （4） The Kaplan-Meier single factor and multivariate COX model survival analysis showed that the 28-day survival ratio of patients with early tracheostomy was significantly better than that of late tracheostomy （ P < 0.05）. Conclusions:The NTRF，ADRS and VPC are independent risk factors for the timing and prognosis of early tracheostomy. There is a significant correlation between VPC and NTRF. The VPC ≥ 23.9% and or NTRF ≥ 8.5 can be used to predict early tracheostomy in patients with multiple rib fractures. Early tracheostomy may benefit the 28-day survival of patients with multiple rib fractures.

Objective:To explore the clinical characteristics and prognostic factors of patients with acute glyphosate poisoning, and to provide reference for the comprehensive treatment and prognosis judgment of acute glyphosate poisoning.Methods:The complete hospitalized medical records data of 40 patients with acute glyphosate poisoning who were treated in the emergency department of Affiliated Hospital of Yangzhou University from 2014 to 2019 were collected in August 2020. According to the outcome during the follow-up period of 90 d after discharge from hospital, patients were divided into survival group ( n=33) and treatment failure group ( n=7) . The clinical characteristics of the two groups were analyzed. The influencing factors of prognosis were analyzed by binary logistic regression, and the receiver operating characteristic (ROC) curve was used to evaluate the value of white blood cell count level at admission to the prognosis of patients with acute glyphosate poisoning. Results:The average age of the 40 glyphosate poisoning patients was (57.70±19.72) years old, the oral dose was 100 (50, 200) ml, the hospital stay was 4.0 (1.0, 5.0) d, and the fatality rate was 17.5% (7/40) . The main clinical manifestations were the symptoms of the digestive tract, respiratory tract, cardiovascular system and nervous system. Logistic regression showed that white blood cell level at admission was an influencing factor for the prognosis of patients with acute glyphosate poisoning ( OR=1.148, 95% CI: 1.124-1.791, P=0.003) . The ROC curve showed that the best diagnostic cut-off value of white blood cell level at admission to the prognosis of acute glyphosate poisoning was 14.65×10 9/L, the area under the curve (AUC) was 0.9351. The sensitivity was 100.00%, and the specificity was 84.85%. Conclusion:High level of white blood cell at admission is a risk factor for the prognosis of acute glyphosate poisoning, and white blood cell level at admission has a certain predictive value for the prognosis of acute glyphosate poisoning.

Objective:To explore the clinical characteristics and prognostic factors of patients with acute glyphosate poisoning, and to provide reference for the comprehensive treatment and prognosis judgment of acute glyphosate poisoning.Methods:The complete hospitalized medical records data of 40 patients with acute glyphosate poisoning who were treated in the emergency department of Affiliated Hospital of Yangzhou University from 2014 to 2019 were collected in August 2020. According to the outcome during the follow-up period of 90 d after discharge from hospital, patients were divided into survival group ( n=33) and treatment failure group ( n=7) . The clinical characteristics of the two groups were analyzed. The influencing factors of prognosis were analyzed by binary logistic regression, and the receiver operating characteristic (ROC) curve was used to evaluate the value of white blood cell count level at admission to the prognosis of patients with acute glyphosate poisoning. Results:The average age of the 40 glyphosate poisoning patients was (57.70±19.72) years old, the oral dose was 100 (50, 200) ml, the hospital stay was 4.0 (1.0, 5.0) d, and the fatality rate was 17.5% (7/40) . The main clinical manifestations were the symptoms of the digestive tract, respiratory tract, cardiovascular system and nervous system. Logistic regression showed that white blood cell level at admission was an influencing factor for the prognosis of patients with acute glyphosate poisoning ( OR=1.148, 95% CI: 1.124-1.791, P=0.003) . The ROC curve showed that the best diagnostic cut-off value of white blood cell level at admission to the prognosis of acute glyphosate poisoning was 14.65×10 9/L, the area under the curve (AUC) was 0.9351. The sensitivity was 100.00%, and the specificity was 84.85%. Conclusion:High level of white blood cell at admission is a risk factor for the prognosis of acute glyphosate poisoning, and white blood cell level at admission has a certain predictive value for the prognosis of acute glyphosate poisoning.