Objective:To investigate and assess the situation of popularization and promotion of domestically innovative medical devices in Liaoning Province,so as to provide a basis for promoting the allocation policy of domestically innovation medical devices.Methods:Self-made questionnaire and on-site filling survey were conducted to implement investigation and analysis for the allocation situation of newly medical equipment of 188 medical institutions in 9 demonstration regions of the Project on Regional Application and Demonstration of Innovative Medical Equipment in Liaoning Province from 2015 to 2020.The allocation data of medical equipment between before(from 2015 to 2017)and after the demonstration projects were implemented(from 2018 to 2020)were compared.The occupancy rate of domestically medical devices(referred as"occupancy ratio of domestic device")was used as an evaluation indicator to assess the status of equipment allocation and application before and after the projects of application and demonstration were implemented in the region of innovative equipment for diagnosis and treatment.Results:In the 9 demonstrational regions of Liaoning province,the number of newly added domestic medical devices during the period from 2018 to 2020 increased from 1,608 units between 2015 and 2017 to 1,703 units.The occupancy ratio of newly added domestic devices increased from 72.7%to 84.9%.The occupancy ratio of domestic devices of newly added key equipment increased from 63.0%to 83.4%,and the growth rate reached 20.4%.In different districts and different grades of medical institution,the increase and application of domestically medical devices appeared difference.Conclusion:The occupancy rate of newly added domestically medical devices in 9 demonstration regions in Liaoning province has generally increased.However,there are still imbalances between different regions and different grades of medical institutions.The manufacturers of domestically medical devices still need strengthen brand building and marketing promotion,so as to further enhance market competitiveness of domestically medical devices.

Imaging examination is a crucial part in diagnosis and treatment of central nervous system infection(CNSI),involving complex imaging sequences and parameters.This consensus was jointly written by multiple CNSI imaging experts in China,aimed to standardize imaging examination of CNSI.

Objective:To investigate and assess the situation of popularization and promotion of domestically innovative medical devices in Liaoning Province,so as to provide a basis for promoting the allocation policy of domestically innovation medical devices.Methods:Self-made questionnaire and on-site filling survey were conducted to implement investigation and analysis for the allocation situation of newly medical equipment of 188 medical institutions in 9 demonstration regions of the Project on Regional Application and Demonstration of Innovative Medical Equipment in Liaoning Province from 2015 to 2020.The allocation data of medical equipment between before(from 2015 to 2017)and after the demonstration projects were implemented(from 2018 to 2020)were compared.The occupancy rate of domestically medical devices(referred as"occupancy ratio of domestic device")was used as an evaluation indicator to assess the status of equipment allocation and application before and after the projects of application and demonstration were implemented in the region of innovative equipment for diagnosis and treatment.Results:In the 9 demonstrational regions of Liaoning province,the number of newly added domestic medical devices during the period from 2018 to 2020 increased from 1,608 units between 2015 and 2017 to 1,703 units.The occupancy ratio of newly added domestic devices increased from 72.7%to 84.9%.The occupancy ratio of domestic devices of newly added key equipment increased from 63.0%to 83.4%,and the growth rate reached 20.4%.In different districts and different grades of medical institution,the increase and application of domestically medical devices appeared difference.Conclusion:The occupancy rate of newly added domestically medical devices in 9 demonstration regions in Liaoning province has generally increased.However,there are still imbalances between different regions and different grades of medical institutions.The manufacturers of domestically medical devices still need strengthen brand building and marketing promotion,so as to further enhance market competitiveness of domestically medical devices.

OBJECTIVE To establish an ultra performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)method for determination of dexmedetomidine(DEX)in plasma of beagle dogs and evaluate the pharmacokinetics and sedation after nasal,buccal and sublingual mucosal admin-istration.METHODS A UPLC-MS/MS method was established and validated for dertermination of DEX in plasma of beagle dogs.DEX was administered to the nasal cavity,buccal and sublingual mucous membranes of beagle dogs,respectively.Blood samples were collected at different time points.The plasma concentration of DEX was measured by the established UPLC-MS/MS method.Pharmacokinetic parameters were fitted by Phoenix software and the sedative effect at different mucous membrane sites was evaluated in conjunction with behavioral and Ramsay scores.RESULTS The linearity of DEX was fine within the range of 0.05-100 μg·L-1(r>0.999),which was validated methodologically to meet the requirements of quantitative detection.The plasma concentration of the drug peaked the fastest with nasal administration.Tmax was 0.25 h,Cmax(4.43±1.19)μg·L-1,and the AUC0-6h was(8.92±2.07)μg·h·L-1,compared with 0.92 and 1 h,(2.87±0.69),(2.70±0.41)μg·L-1,and(7.99±1.77),(7.01±2.09)μg·h·L-1 with buccal and sublingual administration.Nasal administration had the fastest onset at 7 min,with a Ramsay score of 4,and sedation lasted for 36 min,compared with 33 and 35 min,and 38 and 37 min for buccal and sublingual administration.CONCLUSION The proposed method is sensitive,reliable and applicable to quantitative analysis of DEX in plasma of beagle dogs.Administration of DEX to the nasal cavity mucosa has a faster onset and a better sedative effect than to the buccal and sublingual mucosa.

Objective·To compare the effectiveness of hydrodynamic debridement versus conventional debridement in the treatment of burn wounds through a systematic review,focusing on differences in time to complete healing after graft,time to debride a 1%total body surface area(TBSA)wound,hospitalization duration,skin graft survival rate at 7 d post-surgery,secondary debridement rate,and positive rate of bacterial culture of wound exudate at 3 d post-surgery,aiming to select a more effective debridement method for burn wounds requiring debridement.Methods·A systematic literature search was conducted in PubMed,Embase,Web of Science,Cochrane Library,CNKI,SinoMed,China Science and Technology Journal Database,and Wanfang Database,for studies comparing hydrodynamic debridement and conventional debridement in the treatment of burns.The search included articles published in Chinese and English,and the search period was from the inception of the databases to October 1,2024.The study type was randomized controlled trials(RCTs).After literature search and screening,the included studies was evaluated for quality,and relevant data were extracted.Qualitative variables were presented as relative risk(RR),and quantitative variables as mean difference(MD).Forest plots were created by using RevMan 5.4 software with fixed-or random-effects models.Funnel plots were generated and Egger's test was performed by using Stata 14.0 software.Results·Fifteen high-quality RCTs were included in this study,involving 1 261 patients with burn injuries requiring debridement.The analysis results showed that compared to the conventional debridement group,the hydrodynamic debridement group had significantly shorter time to complete healing after graft(MD=-3.29,95%CI-3.88?-2.70,P<0.001),shorter time required to debride a 1%TBSA wound(MD=-0.63,95%CI-0.76?-0.50,P<0.001),and reduced hospitalization duration(MD=-4.22,95%CI-6.17?-2.28,P<0.001).The skin graft survival rate at 7 d post-surgery in the hydrodynamic debridement group(MD=8.62,95%CI 7.21?10.04,P<0.001)was significantly higher,while the secondary debridement rate(RR=0.21,95%CI 0.12?0.37,P<0.001)and the positive rate of bacterial culture of wound exudate at 3 d post-surgery(RR=0.30,95%CI 0.17?0.53,P<0.001)were significantly lower compared with the conventional debridement group.There was no statistically significant difference in the postoperative infections rates between the two groups(RR=1.06,95%CI 0.66?1.69,P=0.820).Conclusion·In the treatment of burn wounds,hydrodynamic debridement outperforms traditional debridement.In the management of burn wounds,hydrodynamic debridement outperforms conventional debridement by shortening debridement and hospitalization durations,reducing the need for secondary debridement,decreasing early bacterial colonization,and improving skin graft survival.In terms of postoperative infection risk,no significant difference was observed between the two methods,indicating comparable safety profiles.

OBJECTIVE To establish an ultra performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)method for determination of dexmedetomidine(DEX)in plasma of beagle dogs and evaluate the pharmacokinetics and sedation after nasal,buccal and sublingual mucosal admin-istration.METHODS A UPLC-MS/MS method was established and validated for dertermination of DEX in plasma of beagle dogs.DEX was administered to the nasal cavity,buccal and sublingual mucous membranes of beagle dogs,respectively.Blood samples were collected at different time points.The plasma concentration of DEX was measured by the established UPLC-MS/MS method.Pharmacokinetic parameters were fitted by Phoenix software and the sedative effect at different mucous membrane sites was evaluated in conjunction with behavioral and Ramsay scores.RESULTS The linearity of DEX was fine within the range of 0.05-100 μg·L-1(r>0.999),which was validated methodologically to meet the requirements of quantitative detection.The plasma concentration of the drug peaked the fastest with nasal administration.Tmax was 0.25 h,Cmax(4.43±1.19)μg·L-1,and the AUC0-6h was(8.92±2.07)μg·h·L-1,compared with 0.92 and 1 h,(2.87±0.69),(2.70±0.41)μg·L-1,and(7.99±1.77),(7.01±2.09)μg·h·L-1 with buccal and sublingual administration.Nasal administration had the fastest onset at 7 min,with a Ramsay score of 4,and sedation lasted for 36 min,compared with 33 and 35 min,and 38 and 37 min for buccal and sublingual administration.CONCLUSION The proposed method is sensitive,reliable and applicable to quantitative analysis of DEX in plasma of beagle dogs.Administration of DEX to the nasal cavity mucosa has a faster onset and a better sedative effect than to the buccal and sublingual mucosa.

Objective·To compare the effectiveness of hydrodynamic debridement versus conventional debridement in the treatment of burn wounds through a systematic review,focusing on differences in time to complete healing after graft,time to debride a 1%total body surface area(TBSA)wound,hospitalization duration,skin graft survival rate at 7 d post-surgery,secondary debridement rate,and positive rate of bacterial culture of wound exudate at 3 d post-surgery,aiming to select a more effective debridement method for burn wounds requiring debridement.Methods·A systematic literature search was conducted in PubMed,Embase,Web of Science,Cochrane Library,CNKI,SinoMed,China Science and Technology Journal Database,and Wanfang Database,for studies comparing hydrodynamic debridement and conventional debridement in the treatment of burns.The search included articles published in Chinese and English,and the search period was from the inception of the databases to October 1,2024.The study type was randomized controlled trials(RCTs).After literature search and screening,the included studies was evaluated for quality,and relevant data were extracted.Qualitative variables were presented as relative risk(RR),and quantitative variables as mean difference(MD).Forest plots were created by using RevMan 5.4 software with fixed-or random-effects models.Funnel plots were generated and Egger's test was performed by using Stata 14.0 software.Results·Fifteen high-quality RCTs were included in this study,involving 1 261 patients with burn injuries requiring debridement.The analysis results showed that compared to the conventional debridement group,the hydrodynamic debridement group had significantly shorter time to complete healing after graft(MD=-3.29,95%CI-3.88?-2.70,P<0.001),shorter time required to debride a 1%TBSA wound(MD=-0.63,95%CI-0.76?-0.50,P<0.001),and reduced hospitalization duration(MD=-4.22,95%CI-6.17?-2.28,P<0.001).The skin graft survival rate at 7 d post-surgery in the hydrodynamic debridement group(MD=8.62,95%CI 7.21?10.04,P<0.001)was significantly higher,while the secondary debridement rate(RR=0.21,95%CI 0.12?0.37,P<0.001)and the positive rate of bacterial culture of wound exudate at 3 d post-surgery(RR=0.30,95%CI 0.17?0.53,P<0.001)were significantly lower compared with the conventional debridement group.There was no statistically significant difference in the postoperative infections rates between the two groups(RR=1.06,95%CI 0.66?1.69,P=0.820).Conclusion·In the treatment of burn wounds,hydrodynamic debridement outperforms traditional debridement.In the management of burn wounds,hydrodynamic debridement outperforms conventional debridement by shortening debridement and hospitalization durations,reducing the need for secondary debridement,decreasing early bacterial colonization,and improving skin graft survival.In terms of postoperative infection risk,no significant difference was observed between the two methods,indicating comparable safety profiles.

Imaging examination is a crucial part in diagnosis and treatment of central nervous system infection(CNSI),involving complex imaging sequences and parameters.This consensus was jointly written by multiple CNSI imaging experts in China,aimed to standardize imaging examination of CNSI.

AIM:To investigate the effects of γ-synuclein on autophagy and apoptosis of colon cancer cells in-duced by endoplasmic reticulum stress,as well as the protective effect on the cells.METHODS:Gene expression profile chip analysis was performed to compare the cDNA expression profiles between human colon cancer HCT116 cells with γ-synu-clein knockdown and HCT116 cells with control siRNA,and to identify potential molecules related to autophagy and apop-tosis.In colon cancer cell lines,the functional effects of γ-synuclein on autophagy and apoptosis induced by thapsigargin(TG),an endoplasmic reticulum stress-inducing agent,were systematically explored by conducting immunofluorescence staining,Western blot,CCK-8 assay,flow cytometry,and transmission electron microscopy.Western blot was used to de-tect the expression of γ-synuclein protein,autophagy-related proteins[microtubule-associated protein 1 light chain 3(LC3),beclin-1,autophagy-related protein 5(ATG5)and ATG7],and apoptosis-related proteins[poly(ADP-ribose)polymerase(PARP),pro-caspase-3,and pro-caspase-9].To further analyze the mechanism of γ-synuclein in regulating autophagy and apoptosis,extracellular signal-regulated kinase(ERK)inhibitor PD98059,ERK inhibitor SP600125 and c-Jun N-terminal kinase(JNK)activator anisomycin were applied separately to test HCT116 cells transfected with γ-synu-clein siRNA.Subsequently,autophagy proteins,apoptosis proteins,and ERK and JNK pathway-related proteins were de-tected by Western blot.RESULTS:The TG-induced autophagy of colon cancer cells mainly occurred at the early stage(0～24 h),and apoptosis mainly occurred at the late stage(36～48 h).Endoplasmic reticulum stress up-regulated the ex-pression of γ-synuclein in colon cancer cells,which was associated with enhanced autophagy.γ-Synuclein promoted au-tophagy by activating ERK and JNK pathways at the early stage(0～24 h),and inhibited apoptosis by blocking JNK path-ways at the late stage(24～48 h)to protect HCT116 cells.In our model,γ-synuclein was observed to play a critical role in the transition from endoplasmic reticulum stress-induced autophagy to apoptosis.CONCLUSION:In the context of endo-plasmic reticulum stress,γ-synuclein promotes autophagy and inhibits apoptosis by regulating ERK and JNK signaling pathways,thus protecting colon cancer cells.This provides a potential idea for anti-tumor therapy.

Objective: Sialidosis type 2 has variants that are both catalytically inactive (severe), while sialidosis type 1 has at least one catalytically active (mild) variant. This study aimed to discuss the structural changes associated with these variants in a newly reported family carrying N-acetyl-α-neuraminidase-1 (NEU1) variants and explore the clinical characteristics of different combinations of variants in sialidosis type 1. Methods: First, whole-exome sequencing and detailed clinical examinations were performed on the family. Second, structural analyses, including assessments of energy, flexibility and polar contacts, were conducted for several NEU1 variants, and a sialidase activity assay was performed. Third, previous NEU1 variants were systematically reviewed, and the clinical characteristics of patients in the severe-mild and mild-mild groups with sialidosis type 1 were analyzed. Results: We report a novel family with sialidosis type 1 and the compound heterozygous variants S182G and V143E. The newly identified V143E variant was predicted to be a mild variant through structural analysis and was confirmed by a sialidase activity assay. Cherry-red spots were more prevalent in the severe-mild group, and ataxia was more common in the mild-mild group. Impaired cognition was found only in the severe-mild group. Moreover, patients with cherry-red spots and abnormal electroencephalographies and visual evoked potentials had a relatively early age of onset, whereas patients with myoclonus had a late onset. Conclusion Changes in flexibility and local polar contacts may be indicators of NEU1 pathogenicity. Sialidosis type 1 can be divided into two subgroups according to the variant combinations, and patients with these two subtypes have different clinical characteristics.