Objective To observe the repair effect and mechanism of Danhuang Powder-containing serum on high glucose-induced vascular endothelial cell injury.Methods Danhuang Powder-containing serum was prepared.Human umbilical vein endothelial cells(HUVECs)were cultured to be divided into control group,recombinant human epidermal growth factor(called"growth factor"for short)group,Danhuang Powder group,high glucose group,high glucose+growth factor group,and high glucose+Danhuang Powder group.After corresponding intervention in each group for 48 hours,the cell ultrastructure and autophagy were observed under transmission electron microscope,apoptosis was detected by flow cytometry,and the protein expression levels of vascular endothelial growth factor(VEGF),epidermal growth factor(EGF)and basic fibroblast growth factor(bFGF)in the cells were detected by Western Blot.Results(1)The intra-mitochondrial ridges in the control group were clearly visible,autophagosomes and autolysosomes were fewer;mitochondria in the high glucose group were swollen and irregular,and appeared vacuolated;and the more typical autophagy-like structures were seen in the high glucose+Danhuang Powder group.(2)Compared with the high glucose group and high glucose+growth factor group,the apoptosis rate of cells in the high glucose+Danhuang Powder group was significantly decreased(P<0.05).(3)Compared with the high glucose group and the high glucose+growth factor group,the protein expression levels of VEGF,EGF and bFGF in the cells of the high glucose+Danhuang Powder group were significantly increased(P<0.05).Conclusion Danhuang Powder-containing serum can reduce the high glucose-induced damage in HUVEC cells,and its mechanism may be related to the activation of mitochondrial autophagy,and the inhibition of apoptosis,as well as the up-regulation of the expression of VEGF,EGF and bFGF.

ObjectiveTo elucidate the critical role of rehabilitation medical records (including electronic records) in rehabilitation medicine's clinical practice and management, comprehensively analyzed the structure, core content and data standards of rehabilitation medical records, to develop a standardized medical record data architecture and core dataset suitable for rehabilitation medicine and to explore the application of rehabilitation data in performance evaluation and payment. MethodsBased on the regulatory documents Basic Specifications for Medical Record Writing and Basic Specifications for Electronic Medical Records (Trial) issued by National Health Commission of China, and referencing the World Health Organization (WHO) Family of International Classifications (WHO-FICs) classifications, International Classification of Diseases (ICD-10/ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI Beta-3), this study constructed the data architecture, core content and data standards for rehabilitation medical records. Furthermore, it explored the application of rehabilitation record summary sheets (home page) data in rehabilitation medical statistics and payment methods, including Diagnosis-related Groups (DRG), Diagnosis-Intervention Packet (DIP) and Case Mix Index. ResultsThis study proposed a systematic standard framework for rehabilitation medical records, covering key components such as patient demographics, rehabilitation diagnosis, functional assessment, rehabilitation treatment prescriptions, progress evaluations and discharge summaries. The research analyzed the systematic application methods and data standards of ICD-10/ICD-11, ICF and ICHI Beta-3 in the fields of medical record terminology, coding and assessment. Constructing a standardized data structure and data standards for rehabilitation medical records can significantly improve the quality of data reporting based on the medical record summary sheet, thereby enhancing the quality control of rehabilitation services, effectively supporting the optimization of rehabilitation medical insurance payment mechanisms, and contributing to the establishment of rehabilitation medical performance evaluation and payment based on DRG and DIP. ConclusionStructured rehabilitation records and data standardization are crucial tools for quality control in rehabilitation. Systematically applying the three reference classifications of the WHO-FICs, and aligning with national medical record and electronic health record specifications, facilitate the development of a standardized rehabilitation record architecture and core dataset. Standardizing rehabilitation care pathways based on the ICF methodology, and developing ICF- and ICD-11-based rehabilitation assessment tools, auxiliary diagnostic and therapeutic systems, and supporting terminology and coding systems, can effectively enhance the quality of rehabilitation records and enable interoperability and sharing of rehabilitation data with other medical data, ultimately improving the quality and safety of rehabilitation services.

BACKGROUND:Photoresponsive nanomaterials offer the combined advantages of nanomaterials and the unique benefits of light responsiveness.They find extensive applications in biomedical fields like tissue regeneration,biological imaging,disease diagnosis,drug delivery,and targeted therapy,making them a research hotspot in the field of functional materials.OBJECTIVE:To summarize the advantages and research progress of photoresponsive nanomaterials in bone tissue regeneration.METHODS:CNKI and PubMed databases were searched using the main English search terms"light-responsive,photoresponsive,nanomaterials,bone defect,bone regeneration,osteogenesis,osseointegration"and main Chinese search terms"light-responsive,nanomaterials,bone defect,bone regeneration,osseointegration."Relevant literature was selected based on inclusion and exclusion criteria,resulting in the inclusion of 59 articles for review.RESULTS AND CONCLUSION:The surface morphology of photoresponsive nanomaterials can promote bone tissue regeneration by directly modulating the gene expression and biological behavior of osteoblasts and indirectly regulating immune-related cells behavior.Photoresponsive nanomaterials can be utilized for photothermal and photodynamic antibacterial purposes to facilitate the repair of infectious bone defects.Mild photothermal stimulation generated by photoresponsive nanomaterials can effectively enhance osteogenesis by upregulating the expression and functionality of osteogenic-related genes and proteins.Photoresponsive nanomaterials can produce electrons under light exposure,thereby achieving non-invasive promotion of bone tissue regeneration by modulating local cellular potential changes.Drug release systems based on photoresponsive nanomaterials can undergo structural changes under specific light sources to promote drug release,providing targeted therapeutic strategies for bone tissue regeneration.

Objective:To explore the application and guiding value of bispectral index（BIS）in postoperative ventilator weaning in infants with congenital heart disease.Methods:A retrospective analysis was conducted on 81 cases of infants with congenital heart disease treated at Xuzhou Children's Hospital affiliated with Xuzhou Medical University from January 2022 to November 2023. The infants were divided into the successful weaning group（62 cases）and the failed weaning group（19 cases）based on the success of ventilator withdrawal. Univariate and multivariate Logistic analyses were performed on the clinical data of the two groups of infants，and ROC curves were plotted to analyze the predictive value of BIS for postoperative ventilator withdrawal failure in infants with congenital heart disease.Results:The mechanical ventilation time，ICU stay time，hospitalization time，and BIS values at 1 hour，2 hours，3 hours，4 hours，and 5 hours after sedation in the two groups of infants showed statistically significant differences（ P<0.05）. The results of the multivariate Logistic regression analysis indicated that BIS values at 1 hour，2 hours，3 hours，4 hours，and 5 hours after sedation are factors affecting the failure of postoperative ventilator weaning in infants with congenital heart disease（ P<0.05）. The ROC curve analysis revealed that the AUCs for predicting postoperative ventilator weaning failure in infants with congenital heart disease were 0.886，0.877，0.873，0.907，0.925，and 0.954 for BIS at 1 hour，2 hours，3 hours，4 hours，and 5 hours after sedation，and the combined prediction，respectively. The sensitivities and specificities were as follows：for BIS at 1 hour after sedation，94.7% and 67.7%；for BIS at 2 hours after sedation，84.2% and 93.5%；for BIS at 3 hours after sedation，84.2% and 83.9%；for BIS at 4 hours after sedation，89.5% and 79.0%；for BIS at 5 hours after sedation，84.2% and 85.5%；and for the combined prediction，100.0% and 90.3%. Conclusion:The use of BIS monitoring during the weaning of ventilators in infants after congenital heart disease surgery has certain predictive value for the success of the weaning process.

Objective:To explore the application and guiding value of bispectral index（BIS）in postoperative ventilator weaning in infants with congenital heart disease.Methods:A retrospective analysis was conducted on 81 cases of infants with congenital heart disease treated at Xuzhou Children's Hospital affiliated with Xuzhou Medical University from January 2022 to November 2023. The infants were divided into the successful weaning group（62 cases）and the failed weaning group（19 cases）based on the success of ventilator withdrawal. Univariate and multivariate Logistic analyses were performed on the clinical data of the two groups of infants，and ROC curves were plotted to analyze the predictive value of BIS for postoperative ventilator withdrawal failure in infants with congenital heart disease.Results:The mechanical ventilation time，ICU stay time，hospitalization time，and BIS values at 1 hour，2 hours，3 hours，4 hours，and 5 hours after sedation in the two groups of infants showed statistically significant differences（ P<0.05）. The results of the multivariate Logistic regression analysis indicated that BIS values at 1 hour，2 hours，3 hours，4 hours，and 5 hours after sedation are factors affecting the failure of postoperative ventilator weaning in infants with congenital heart disease（ P<0.05）. The ROC curve analysis revealed that the AUCs for predicting postoperative ventilator weaning failure in infants with congenital heart disease were 0.886，0.877，0.873，0.907，0.925，and 0.954 for BIS at 1 hour，2 hours，3 hours，4 hours，and 5 hours after sedation，and the combined prediction，respectively. The sensitivities and specificities were as follows：for BIS at 1 hour after sedation，94.7% and 67.7%；for BIS at 2 hours after sedation，84.2% and 93.5%；for BIS at 3 hours after sedation，84.2% and 83.9%；for BIS at 4 hours after sedation，89.5% and 79.0%；for BIS at 5 hours after sedation，84.2% and 85.5%；and for the combined prediction，100.0% and 90.3%. Conclusion:The use of BIS monitoring during the weaning of ventilators in infants after congenital heart disease surgery has certain predictive value for the success of the weaning process.

BACKGROUND:Photoresponsive nanomaterials offer the combined advantages of nanomaterials and the unique benefits of light responsiveness.They find extensive applications in biomedical fields like tissue regeneration,biological imaging,disease diagnosis,drug delivery,and targeted therapy,making them a research hotspot in the field of functional materials.OBJECTIVE:To summarize the advantages and research progress of photoresponsive nanomaterials in bone tissue regeneration.METHODS:CNKI and PubMed databases were searched using the main English search terms"light-responsive,photoresponsive,nanomaterials,bone defect,bone regeneration,osteogenesis,osseointegration"and main Chinese search terms"light-responsive,nanomaterials,bone defect,bone regeneration,osseointegration."Relevant literature was selected based on inclusion and exclusion criteria,resulting in the inclusion of 59 articles for review.RESULTS AND CONCLUSION:The surface morphology of photoresponsive nanomaterials can promote bone tissue regeneration by directly modulating the gene expression and biological behavior of osteoblasts and indirectly regulating immune-related cells behavior.Photoresponsive nanomaterials can be utilized for photothermal and photodynamic antibacterial purposes to facilitate the repair of infectious bone defects.Mild photothermal stimulation generated by photoresponsive nanomaterials can effectively enhance osteogenesis by upregulating the expression and functionality of osteogenic-related genes and proteins.Photoresponsive nanomaterials can produce electrons under light exposure,thereby achieving non-invasive promotion of bone tissue regeneration by modulating local cellular potential changes.Drug release systems based on photoresponsive nanomaterials can undergo structural changes under specific light sources to promote drug release,providing targeted therapeutic strategies for bone tissue regeneration.

Objective To investigate the effect of Danhuangsan on high glucose-induced vascular endothelial cell injury based on PINK 1/Parkin signaling pathway,and to explore its specific mechanism.Methods Human um-bilical vein endothelial cells were cultured in vitro and randomly divided into control group,growth factor group,Danhuangsan group,high glucose group,high glucose+growth factor group,high glucose+Danhuangsan group,with 3 cases in each group,treated for 48 hours.Cell scratch test was used to detect cell migration rate,and Transwell test was used to detect cell invasion rate.Immunofluorescence was used to detect the expression of anti-apoptotic protein Bcl-2,Beclin-1 and pro-apoptotic protein Bax.Western blot was used to detect the protein expression levels of PINK 1,Parkin and LC 3-Ⅱ.Results Cell scratch test and Transwell test showed that under normal environment and high glucose treatment,Danhuangsan could reduce the cell migration and invasion rate(P＜0.05).Immunofluorescence assay showed that under normal environment and high glucose treatment,Danhuang-san up-regulated the expression levels of Bcl-2 and Beclin-1 protein in cells(P＜0.05).Western blot results showed that under normal environment and high glucose treatment,Danhuangsan increased the protein expression levels of PINK 1,Parkin and LC 3-Ⅱ in cells and down-regulated the expression levels of Bax protein(P＜0.05),and the effects of Danhuang powder were significantly better than those of blank serum and growth factor(P＜0.05).Conclusion Danhuangsan can alleviate high glucose-induced endothelial cell injury by activating PINK 1/Parkin pathway,and the mechanism may be related to promoting mitophagy and enhancing the repair of damage.

Antibody-drug conjugates (ADCs) are gradually revolutionizing clinical cancer therapy. The antibody-drug conjugate linker molecule determines both the efficacy and the adverse effects, and so has a major influence on the fate of ADCs. An ideal linker should be stable in the circulatory system and release the cytotoxic payload specifically in the tumor. However, existing linkers often release payloads nonspecifically and inevitably lead to off-target toxicity. This defect is becoming an increasingly important factor that restricts the development of ADCs. The pursuit of ADCs with optimal therapeutic windows has resulted in remarkable progress in the discovery and development of novel linkers. The present review summarizes the advance of the chemical trigger, linker‒antibody attachment and linker‒payload attachment over the last 5 years, and describes the ADMET properties of ADCs. This work also helps clarify future developmental directions for the linkers.

Thirty-six puerperas who underwent emergency cesarean section at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 24, 2020 to February 9, 2020, who all wore medical surgical masks, were retrospectively included in this study. Anesthesia management was performed under tertiary medical protection measures. A dedicated anesthesia equipment was separately sterilized. Narcotic drugs were used for one patient only, and disposable medical supplies were used for anesthetic supplies. Contact transmission should be avoided when a neonate required resuscitation, and early isolation and nucleic acid testing were provided for the neonates. The rate of suspected cases of novel coronavirus (2019-nCoV) was 11% , and the rate of clinically diagnosed cases was 17% before surgery. The rate of clinically diagnosed cases of 2019-nCoV was 22%, the rate of confirmed cases was 8%, and the total positive rate of diagnosis was 31% after surgery. The rate of neuraxial anesthesia was 86%, the rate of general anesthesia was 14%, the time of spinal puncture was (15±7) min, the time of tracheal intubation under general anesthesia was (2.1±1.3) min, the operation time was (95±36) min, and blood loss was (276±166) ml. The Apgar score of newborns was 8.8 ± 0.5. There was 1 neonate whose mother was diagnosed as having 2019 novel coronavirous disease after operation, an oropharyngeal swab specimen was obtained at 36 h of birth, and the swab was tested positive for 2019-nCoV by nucleic acid testing. As of February 10, 2020, an anesthesiologist involved in the operation was diagnosed to have infection by 2019-nCoV. In conclusion, diagnosis of 2019 novel coronavirous disease during pregnancy is more difficult, it is necessary to perform anesthesia management for cesarean section under tertiary medical protection. Although the difficulty in anesthesia operation is increased under tertiary medical protection, anesthesiologists can carry out standardized anesthesia management and guarantee the safety of maternal and infants and anesthesiologists themselves as long as they are rigorously trained and adhere to protective protocols.

Thirty-six puerperas who underwent emergency cesarean section at Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 24, 2020 to February 9, 2020, who all wore medical surgical masks, were retrospectively included in this study.Anesthesia management was performed under tertiary medical protection measures.A dedicated anesthesia equipment was separately sterilized.Narcotic drugs were used for one patient only, and disposable medical supplies were used for anesthetic supplies.Contact transmission should be avoided when a neonate required resuscitation, and early isolation and nucleic acid testing were provided for the neonates.The rate of suspected cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 11% , and the rate of clinically diagnosed cases was 17% before surgery.The rate of clinically diagnosed cases of SARS-CoV-2 was 22%, the rate of confirmed cases was 8%, and the total positive rate of diagnosis was 31% after surgery.The rate of neuraxial anesthesia was 86%, the rate of general anesthesia was 14%, the time of spinal puncture was (15±7) min, the time of tracheal intubation under general anesthesia was (2.1±1.3) min, the operation time was (95±36) min, and blood loss was (276±166) ml.The Apgar score of newborns was 8.8±0.5.There was 1 neonate whose mother was diagnosed as having coronavirus disease 2019 after operation, an oropharyngeal swab specimen was obtained at 36 h of birth, and the swab was tested positive for SARS-CoV-2 by nucleic acid testing.As of February 10, 2020, an anesthesiologist involved in the operation was diagnosed to have infection by SARS-CoV-2.In conclusion, diagnosis of coronavirus disease 2019 during pregnancy is more difficult, it is necessary to perform anesthesia management for cesarean section under tertiary medical protection.Although the difficulty in anesthesia operation is increased under tertiary medical protection, anesthesiologists can carry out standardized anesthesia management and guarantee the safety of maternal and infants and anesthesiologists themselves as long as they are rigorously trained and adhere to protective protocols.