Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

OBJECTIVE To investigate the impact of cerebral ischemia-reperfusion(CIR)injury on glucuronidation of IMM-H004 in the brain.METHODS IMM-H004,a neuroprotective agent,underwent glucuronidation primarily mediated by uridine diphosphate glucuronosyltransferases(UGT)to form IMM-H004G,which was subsequently hydrolyzed back to IMM-H004 by β-glucuronidase.① Cellular experiments:human glial cells(HEB)and human neuroblastoma cells(SH-SY5Y)cell lines were assigned to two groups:a normal control group and an oxygen-glucose deprivation/reoxygenation(OGD/R)model group.An OGD/R model was established by subjecting the cells to one-hour oxygen-glucose deprivation,followed by reoxygenation.Cell viability was assessed using the methylthiazolyldi-phenyl-tetrazolium bromide(MTT)assay.The mRNA levels of UGT and its regulatory factor,nuclear factor erythroid 2 related factor 2(Nrf2),were measured by real-time fluorescence quantitative PCR(RT-qPCR).The content of IMM-H004G glucuronidated from IMM-H004,and the content of IMM-H004 hydrolyzed from IMM-H004G were determined using liquid chromatography-tandem mass spectrometry(LC-MS/MS).② Animal experiments:Male SD rats were randomly assigned to three groups:a normal control group,a CIR model group,and a sham operation group.Rats in the normal control group received no surgical interventions while those in the CIR model group underwent four-vessel occlusion surgery to induce acute CIR injury.Rats in the sham operation group was treated the same way as the CIR model group except for the four-vessel occlusion.The activities of UGT and β-glucuronidase in brain tissues were determined by LC-MS/MS.IMM-H004 was administered via intracerebroventricular injec-tion,and the concentrations of IMM-H004 and IMM-H004G in different regions of the brain were deter-mined using LC-MS/MS to investigate the impact of CIR injury on IMM-H004 metabolism.RESULTS① Cellular experiments:Compared with the control group,OGD/R injury reduced the viability of HEB and SH-SY5Y cells to 72.30%and 53.56%,respectively.In HEB cells,OGD/R injury significantly down-regulated the mRNA expressions of UGT1A1,UGT1A7 and UGT1A8,resulting in a reduction of IMM-H004G production to 50.05%-68.95%of the normal level,while hydrolytic metabolism remained unaf-fected.No significant changes were observed in SH-SY5Y cells.②Animal experiments:CIR injury had no impact on the activity of UGT or β-glucuronidase in rat brain tissues.In addition,the distribution of IMM-H004 and IMM-H004G across different brain regions remained unchanged.CONCLUSION These findings show that OGD/R injury reduces UGT-mediated glucuronidation of IMM-H004,whereas CIR injury does not significantly affect its metabolism in the brain,suggesting the presence of compen-satory mechanisms in brain tissues that help maintain drug homeostasis.

Widespread utilization of glyphosate has led to environmental residues,posing potential threats to ecological systems and human health.Traditional methods for detection of glyphosate are limited by specialized equipment and operational techniques,resulting in inefficient responses.Therefore,it is urgent to develop a convenient,sensitive and accurate detection method for detection of glyphosate.Herein,a new naphthalenesulfonamide-based"Turn-on"fluorescent probe was synthesized using 2-chloroaniline and dansyl chloride as raw materials through a one-step process,which showed a good linear relationship between the glyphosate concentration in concentration range of 0.003-70 μmol/L and the fluorescence intensity(R2=0.995),with a detection limit of 2.73 nmol/L(S/N=3).Analytical techniques such as nuclear magnetic resonance(NMR)spectroscopy and high-resolution mass spectrometry(HRMS)were used to investigate the interaction mechanism between the fluorescent probe and glyphosate.The results indicated that a nucleophilic substitution reaction occurred between the probe and the secondary amine(—NH—)of glyphosate,inducing a photoinduced electron transfer(PET)effect which enhanced the fluorescence intensity by 11.2 times.The probe showed good anti-interference ability towards coexisting metal ions,anions and pesticides in water.When applied to determination of glyphosate in the samples such as tap water,river water(Xiangxi River Reservoir),soil,soybeans,and corn,the spiking recoveries ranged from 94.7％to 109.9％,demonstrating the high accuracy and broad applicability of this detection method.A portable test strip based on this fluorescent probe was developed for rapid semi-quantitative analysis of glyphosate.The developed method was rapid,sensitive,and portable,providing theoretical and technical support for on-site measurement of environmental contaminants.

The objective assessment of hearing loss is one of the critical components in forensic clini-cal research.Auditory brainstem response(ABR)is an important method for objectively assessing hearing levels.It is divided into various types based on different stimulus signals,each with its own characteris-tics and applications.Among them,narrow-band Chirp ABR,due to its frequency specificity,fulfills the basic requirements for objective assessment of forensic audiology,promising to be an important method of objective hearing assessment in forensic medicine.This article reviews the development history,charac-teristics and clinical applications of Chirp ABR,and envisions its application prospects in forensic audi-tory identification.

OBJECTIVE To investigate the impact of cerebral ischemia-reperfusion(CIR)injury on glucuronidation of IMM-H004 in the brain.METHODS IMM-H004,a neuroprotective agent,underwent glucuronidation primarily mediated by uridine diphosphate glucuronosyltransferases(UGT)to form IMM-H004G,which was subsequently hydrolyzed back to IMM-H004 by β-glucuronidase.① Cellular experiments:human glial cells(HEB)and human neuroblastoma cells(SH-SY5Y)cell lines were assigned to two groups:a normal control group and an oxygen-glucose deprivation/reoxygenation(OGD/R)model group.An OGD/R model was established by subjecting the cells to one-hour oxygen-glucose deprivation,followed by reoxygenation.Cell viability was assessed using the methylthiazolyldi-phenyl-tetrazolium bromide(MTT)assay.The mRNA levels of UGT and its regulatory factor,nuclear factor erythroid 2 related factor 2(Nrf2),were measured by real-time fluorescence quantitative PCR(RT-qPCR).The content of IMM-H004G glucuronidated from IMM-H004,and the content of IMM-H004 hydrolyzed from IMM-H004G were determined using liquid chromatography-tandem mass spectrometry(LC-MS/MS).② Animal experiments:Male SD rats were randomly assigned to three groups:a normal control group,a CIR model group,and a sham operation group.Rats in the normal control group received no surgical interventions while those in the CIR model group underwent four-vessel occlusion surgery to induce acute CIR injury.Rats in the sham operation group was treated the same way as the CIR model group except for the four-vessel occlusion.The activities of UGT and β-glucuronidase in brain tissues were determined by LC-MS/MS.IMM-H004 was administered via intracerebroventricular injec-tion,and the concentrations of IMM-H004 and IMM-H004G in different regions of the brain were deter-mined using LC-MS/MS to investigate the impact of CIR injury on IMM-H004 metabolism.RESULTS① Cellular experiments:Compared with the control group,OGD/R injury reduced the viability of HEB and SH-SY5Y cells to 72.30%and 53.56%,respectively.In HEB cells,OGD/R injury significantly down-regulated the mRNA expressions of UGT1A1,UGT1A7 and UGT1A8,resulting in a reduction of IMM-H004G production to 50.05%-68.95%of the normal level,while hydrolytic metabolism remained unaf-fected.No significant changes were observed in SH-SY5Y cells.②Animal experiments:CIR injury had no impact on the activity of UGT or β-glucuronidase in rat brain tissues.In addition,the distribution of IMM-H004 and IMM-H004G across different brain regions remained unchanged.CONCLUSION These findings show that OGD/R injury reduces UGT-mediated glucuronidation of IMM-H004,whereas CIR injury does not significantly affect its metabolism in the brain,suggesting the presence of compen-satory mechanisms in brain tissues that help maintain drug homeostasis.

Objective:To compare the therapeutic efficacy and safety of local anesthesia and spinal anesthesia for the patients with varicocele(VC)who underwent microsurgical varicocelectomy(MV).Methods:We retrospectively analyzed the data of VC patients who underwent MV treatment at the Andrology Department of the Affiliated Ruikang Hospital of Guangxi University of Chinese Medicine from May 2020 to March 2023.Cases with complete clinical data and follow-up evaluation were selected and divided into a control group(spinal anesthesia)and an observation group(local anesthesia)according to different anesthesia methods.The surgical time(including anesthesia time),visual analogue scale(VAS)score for pain,hospital stay,treatment cost,sperm concentration,for-ward motile sperm rate,and normal sperm morphology rate after three months of surgery,as well as postoperative complications and re-currence rate were compared between the two groups.Results:A total of 107 eligible cases were included,with 56 cases in the con-trol group and 51 cases in the observation group.There was no significant difference in the VAS score for pain during and after four hours of surgery,as well as postoperative complications,and recurrence rate between the two groups(P＞0.05).There was an signif-icant increase in sperm concentration,forward motile sperm rate,and normal sperm morphology rate in both of two groups after three months of surgery(P＜0.05).However,there was no significant difference between the two groups three months after surgery(P＞0.05).The surgical time and hospital stay were shorter than those of the control group(P＜0.05).And the treatment cost in observa-tion group was lower than that of the control group(P＜0.05).Conclusion:Both local anesthesia and lumbar anesthesia for MV treatment of VC have good efficacy and safety.However,patients treated with MV under local anesthesia for VC have obvious advanta-ges in terms of operation time(including anesthesia time),hospital stay,and treatment cost,which is worthy of clinical promotion and application.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

BACKGROUND:This study aims to explore whether Xuebijing(XBJ)can improve intestinal microcirculation dysfunction in sepsis and its mechanism. METHODS:A rat model of sepsis was established by cecal ligation and puncture(CLP).A total of 30 male SD rats were divided into four groups:sham group,CLP group,XBJ+axitinib group,and XBJ group.XBJ was intraperitoneally injected 2 h before CLP.Hemodynamic data(blood pressure and heart rate)were recorded.The intestinal microcirculation data of the rats were analyzed via microcirculation imaging.Enzyme-linked immunosorbent assay(ELISA)kits were used to detect the serum levels of interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)in the rats.Histological analysis and transmission electron microscopy were used to analyze the injury of small intestinal microvascular endothelial cells and small intestinal mucosa in rats.The expression of vascular endothelial growth factor A(VEGF-A),phosphoinositide 3-kinase(P13K),phosphorylated P13K(p-PI3K),protein kinase B(Akt),and phosphorylated Akt(p-Akt)in the small intestine was analyzed via Western blotting. RESULTS:XBJ improved intestinal microcirculation dysfunction in septic rats,alleviated the injury of small intestinal microvascular endothelial cells and small intestinal mucosa,and reduced the systemic inflammatory response.Moreover,XBJ upregulated the expression of VEGF-A,p-PI3K/total P13K,and p-Akt/total Akt in the rat small intestine. CONCLUSION:XBJ may improve intestinal microcirculation dysfunction in septic rats possibly through the VEGF-A/PI3K/Akt signaling pathway.

Objective To design a post-structured technology-based clinical disease database system to solve the problems of the traditional disease database system in dependence on manual judgment,lack of auxiliary annotation and poor availability of electronic medical record data.Methods An entity recognition model was constructed with I2B2 standard and bi-directional long short-term memory(BiLSTM)model to form a medical record template library,and some relational templates were generated and complex medical entities were extracted to realize post-structuring of electronic medical records.Then a clinical disease database system was established based on the post-structured electronic medical record technology,which was composed of the modules for medical record structuring,structured assessment,data annotation,routine functions and system management.Results The system developed transformed the text of electronic medical records into structured language,contributed to data element extraction and intelligent structured service and enhanced the efficiency of clinical treatment and scientific research.Conclusion The system developed improves the data availability of clinical diseases,reduces the workload of user data processing,ensures the quality of data application and lays a foundation for assisted decision making during clinical treatment and scientific research.[Chinese Medical Equipment Journal,2024,45(4):20-26]

Objective To explore the effects of different test positions on quantitative muscle strength of wrist and finger flexor muscle groups and to establish a standardized muscle strength test protocol for each muscle group.Methods Forty healthy subjects (12 males and 28 females) were recruited.A portable digital quantitative muscle strength tester,Micro FET2TM,was used to measure the flexor muscle strength of each finger and the wrist joint at the 30° extension,0° neutral,and 30° flexion,respectively.Palmar abduction strength of the thumb was measured at 30° and 60°,respectively.Ten subjects were randomly selected from the 40 subjects,and the quantitative muscle strength of each muscle group was tested again by the same operator after an interval of 10 to 15 days.Results Except for the fact that in males,there was no significant difference in flexor muscle strength of thumb and wrist joint between 30° of wrist extension and neutral 0° position,the muscle strength of the other fingers flexion and wrist palmar flexor showed the following characteristics:30° of wrist extension>neutral 0° posi-tion>30° of flexion,and the PAST was 30°>60°;The flexor muscle strength of all the subjects was thumb>index finger>middle finger>ring finger>little finger;All muscle strength values of male were greater than those of female,and the difference was statistically significant (P<0.05);There was no significant difference between the left and right side muscle strength values of all subjects (P>0.05).The reliability of muscle strength values measured at different times in 10 subjects was good.Conclu-sion The quantitative muscle strength of each muscle group of the hand and wrist is affected by the test position,and a standardized and uniformed test position should be adopted in the actual identification.Micro FET2TM has good reliability for hand and wrist quantitative muscle strength testing.The 30° ex-tension of the wrist can be used as the best standardized test position for the flexion muscle strength of each finger and wrist joint.The 30° position can be used as the best standardized test position for PAST.