Objective To investigate the risk factors of subdelirium syndrome in adult ICU patients,then establish a risk prediction model and have it verified.Method A total of 380 adult ICU patients in our hospital between June 2022 and January 2024 were selected in this study.Among the patients,224(70％)were assigned to the model group and 114(30％)to the validation group.Independent risk factors were screened by comparison of the general data,disease and treatment,laboratory indicators and other relevant data between the patients with and without subdelirium.A risk prediction model was established with Logistic regression.Results A risk prediction model was finalised and established.It composed six risk factors of age(OR=1.023),APACHE Ⅱ score(OR=1.093),critical care pain observation tool(OR=2.216),duration of mechanical ventilation(OR=1.003),constraint(OR=2.615)and sepsis(OR=2.081).In internal validation,it was found that the calibration curve closely overlapped with the ideal curve and the area under the ROC curve was 0.816,with a predictive cut off value of 85 points.In external validation,the calibration curve was found closely overlapped with the ideal curve and the area under ROC curve was 0.808.Conclusion The risk prediction model for subdelirium syndrome in adult ICU patients established in the study has good consistency and prediction efficiency,thereby it provides a basis for early clinical screening and intervention of subdelirium syndrome.

Objective To investigate the risk factors of subdelirium syndrome in adult ICU patients,then establish a risk prediction model and have it verified.Method A total of 380 adult ICU patients in our hospital between June 2022 and January 2024 were selected in this study.Among the patients,224(70％)were assigned to the model group and 114(30％)to the validation group.Independent risk factors were screened by comparison of the general data,disease and treatment,laboratory indicators and other relevant data between the patients with and without subdelirium.A risk prediction model was established with Logistic regression.Results A risk prediction model was finalised and established.It composed six risk factors of age(OR=1.023),APACHE Ⅱ score(OR=1.093),critical care pain observation tool(OR=2.216),duration of mechanical ventilation(OR=1.003),constraint(OR=2.615)and sepsis(OR=2.081).In internal validation,it was found that the calibration curve closely overlapped with the ideal curve and the area under the ROC curve was 0.816,with a predictive cut off value of 85 points.In external validation,the calibration curve was found closely overlapped with the ideal curve and the area under ROC curve was 0.808.Conclusion The risk prediction model for subdelirium syndrome in adult ICU patients established in the study has good consistency and prediction efficiency,thereby it provides a basis for early clinical screening and intervention of subdelirium syndrome.

Long-term inflammation will develop into chronic inflammation and become inflammatory diseases.Antibiotics are commonly used in clinical practice to treat inflammatory diseases.But patients are prone to drug resistance.So we need to find new treatment.Chlorogenic acid is an organic compound extracted from honeysuckle and other plants.Its anti-inflammatory activity is strong,and it has a significant anti-inflammatory effect on inflammatory diseases in various systems.It has been shown that chlorogenic acid can regulate inflammation-related signaling pathways,such as nuclear factor κB(NF-κB)canonical signaling pathway,NF-κB atypical signaling pathway,nuclear factor-erythroid 2-related factor 2(Nrf2)canonical signaling pathway,and Nrf2 atypical signaling pathway,etc.It can up-regulate the expression of anti-inflammatory cytokines such as interleukin(IL)-4,IL-10,IL-13 and down-regulate the expression of pro-inflammatory cytokine such as IL-1β,IL-6,and IL-8.Although chlorogenic acid has a strong anti-inflammatory effect,but clinical trials and application still face many difficulties.In the future,the anti-inflammatory molecular mechanism of chlorogenic acid should be further studied to explore its clinical application value and improve new ideas for the treatment of inflammatory diseases.

CD4+T cells have strong plasticity and can be polarized intovarious effector cells such as Th1,Th2,Th17 and Treg cells.Then they participate in the regulation of various inflammatory diseases.Its polarization can not only promote development of disease,but also inhibit progression of disease.Direction of polarization may also be different in different diseases or in different stages of the same disease.Therefore,this review aims to summarize and explore the regulatory role of CD4+T cell polarization in different inflam-matory diseases and its significance for disease prevention and treatment.

Objective:To develop an online interactive cytopathological training program, and to evaluate it for improving the cytopathological diagnostic ability of endoscopists in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreas.Methods:A total of 5 500 cytopathological images were collected from 194 patients with pancreatic solid mass who underwent EUS-FNA in Nanjing Drum Tower Hospital from August 2018 to August 2019. The cell type in each cytopathological picture was labeled by senior cellular pathologists, which was used to build a learning and testing platform for online interactive cytopathological training. Five endoscopists without cytopathological background were invited to participate in this training. Sensitivity, specificity, positive predictive value and negative predictive value of endoscopists in differential diagnosis of cancer and non-cancer before and after training were compared to evaluate the effect of the online interactive cytopathological training program on improving the ability of endoscopists in diagnosis of cytopathology.Results:A cytopathological training platform for endoscopists to learn and take online test was successfully built. Before training, sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diagnosis of cancer and non-cancer for endoscopists were 0.55 (95% CI: 0.53-0.58), 0.32 (95% CI: 0.30-0.35), 0.43 (95% CI: 0.41-0.45), 0.44 (95% CI: 0.41-0.47) and 0.43 (95% CI: 0.42-0.45), respectively. After training, the above indicators were 0.96 (95% CI: 0.95-0.97), 0.70 (95% CI: 0.68-0.73), 0.74 (95% CI: 0.72-0.76), 0.95 (95% CI: 0.94-0.96) and 0.81 (95% CI: 0.80-0.83), respectively, which were significantly improved compared with those before ( P<0.001). Conclusion:The online interactive cytopathological training program can improve the understanding and diagnostic ability of endoscopists in pancreatic cytopathology, help to implement rapid on-site evaluation in the process of EUS-FNA, and improve the diagnostic efficiency of EUS-FNA.

OBJECTIVE To study the spectru m-toxicity relationship of in vitro hepatotoxicity of aqueous extract from Euodia rutaecarpa. METHODS The aqueous extract from 16 batches of E. rutaecarpa from different habitats were prepared. The fingerprints of aqueous extract from E. rutaecarpa were established by ultra high performance liquid chromatography （UPLC） method and Similarity Evaluation System of TCM Fingerprint （2012A edition ），and common peaks were identified and the similarity was evaluated. Using normal human hepatocytes L 02 as subject ，inhibitory effect of aqueous extract from 16 batches of E. rutaecarpa to them were investigated. The spectrum-toxicity relationship of UPLC fingerprint of aqueous extract from E. rutaecarpa with the hepatotoxicity of hepatocytes L 02 was analyzed by grey relational analysis （GRA）and partial least squares regression analysis （PLSR）. The corresponding compound of the chromatographic peak with the greatest correlation with the in vitro hepatotoxicity of E. rutaecarpa were isolated ，prepared and identified. RESULTS There were 27 common peaks in UPLC fingerprints of aqueous extract from 16 batches of E. rutaecarpa ，with similarity of 0.375-0.995. Totally 9 peaks were confirmed ，i.e. neochlorogenic acid （peak 5），chlorogenic acid （peak 9），cryptochlorogenic acid （peak 10），caffeic acid （peak 12），rutin （peak 16），hyperin（peak 17），dehydroevotarine（peak 19），evotarine（peak 24），rutecarpine（peak 25）. The aqueous extract from 16 batches of E. rutaecarpa showed significant inhibitory effect on the growth of L 02 cells（P＜0.05 or P＜0.01），and the inhibitory rate ranged from 6.68％ to 67.95％. GRA showed that there were 18 common peaks with correlation degree greater than 0.8，which were peak 8＞peak 3＞peak 23＞peak 7＞peak 4＞peak 9＞peak 12＞peak 2＞peak 19＞peak 6＞ 4928381。E-mail：799247687@qq.com peak 15＞peak 5＞peak 1＞peak 17＞peak 21＞peak 26＞ peak 20＞peak 14 in descending order of correlation degree. PLSR showed that there were 14 peaks with regression coefficient＞0 and variable importance projection value ＞1，and the order of regression coefficient was peak 8＞peak 3＞peak 23＞ peak 2＞peak 7＞peak 4＞peak 12＞peak 9＞peak 19＞peak 5＞peak 17＞peak 26＞peak 10＞peak 15. Peak 8 had the greatest correlation with in vitro hepatotoxicity，and the corresponding compound of this peak was identified as 6-O-trans caffeoyl gluconic acid. CONCLUSIONS The in vitro hepatotoxicity of aqueous extract from E. rutaecarpa is the result of multiple component interaction，among which 6-O-trans caffeoyl gluconic acid shows closest relation with in vitro hepatotoxicity.

Objective To investigate the diagnostic value of endoscopic ultrasonography(EUS)for esophageal submucosal tumor(SMT). Methods Clinical data of 388 patients with esophageal SMT, who underwent EUS and endoscopic treatment in Tianjin Medical University General Hospital were collected from May 2010 to September 2016. The golden standard for the origin of esophageal SMT was the diagnosis during endoscopic treatment, and the golden standard of pathological type was the combination of postoperative pathological and immunohistochemical findings. The diagnostic accuracy of EUS for esophageal SMT was evaluated. Results The conventional endoscopy revealed that 31.70%(123/388)and 43.81%(170/388)esophageal SMTs were located in the middle and lower segments of esophagus,respectively. The diagnostic consistency of EUS for the origin of lesion was 71.51%(251/351), while the diagnostic consistency of EUS for lesion originated from the muscularis mucosae, submucosa and muscularis propria layer was 92.90%(170/183), 34.38%(11/32), and 51.47%(70/136), respectively. The diagnostic consistency of EUS for the type of lesion was 81.00%(260/321), while the diagnostic consistency of leiomyoma, esophageal cyst, and lipoma were 88.42%(252/285), 14.81%(4/27), and 80.00%(4/5), respectively. Conclusion EUS can preliminarily diagnose the origin and pathological type of esophageal SMT,but there are limitations on the diagnosis of uncommon lesions,which need combination of pathological and immunohistochemical findings.

We studied the status of parasite pollution in fish and shrimps in Fujian Province,and provided basis for prevention and control of parasite pollution and food safety in aquatic products.Stratified random sampling method was used,and Fujian Province was divide into Eastern,Southern,Western,Northern and Central five regions of Fujian province.Based on the data collected from the five regions between 2012 and 2016,digestion and compression methods were conducted to detect the levels of parasite metacercariae and larvae in both freshwater and marine products.Results showed that the total parasitoid infection rate was 5.15％ (130/2 524).The infection rate of trematode metacercariae and nematode larvae were 3.72％ (94/2524) and 1.43％ (36/2 524),respectively.Twenty-eight marine aquatic species were investigated and the infection rate was 17.25 ％ (88/510),in the form of Anisakis infection.The parasite infection rates in the five regions were 10.38％ (27/260) in Mindong,5.84％ (27/462) inMinnan,4.63％ (30/648) in Minxi,4.64％ (29/625) in Minbei and 9.91％ (103/1 039) in Minzhong.The freshwater products in Fujian Province have been polluted by parasites and are area-depended.The infection rate of marine aquatic products is kept in a high level.Fujian Province should strengthen the food safety and health publicity,take effective prevention and control strategies,and use early warning mechanisms to insure the food safety in province.

The metastasis-associated lung adenocarcinoma transcription 1 (MALAT1) is a highly conserved long non-coding RNA (lncRNA) gene. However, little is known about the pathological role of lncRNA MALAT1 in glioma. In the present study, we explored the expression level of lncRNA MALAT1 in primary glioma tissues as well as in U87 and U251 glioma cell lines. Using qRT-PCR, we found that the expression of lncRNA MALAT1 was significantly increased in glioma tissues compared with that of paracancerous tissues. Meanwhile, the expression of MALAT1 was highly expressed in U98 and U251 cells. In order to explore the function of MALAT1, the expression of MALAT1 was greatly reduced in U87 and U251 cells transfected with siRNA specifically targeting MALAT1. Consequently, cell viability of U87 and U251 cells were drastically decreased after the knockdown of MALAT1. Concomitantly, the apoptosis rate of the two cell lines was dramatically increased. Furthermore, the expression levels of some tumor markers were reduced after the knockdown of MALAT1, such as CCND1 and MYC. In summary, the current study indicated a promoting role of MALAT1 in the development of glioma cell.
*Apoptosis ; Biomarkers, Tumor/genetics/metabolism ; Blotting, Western ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Cyclin D1/genetics/metabolism ; Down-Regulation ; Flow Cytometry ; Glioma/metabolism/pathology ; Humans ; Proto-Oncogene Proteins c-myc/genetics/metabolism ; *RNA Interference ; RNA, Long Noncoding/antagonists & inhibitors/genetics/*metabolism ; RNA, Small Interfering/metabolism ; Real-Time Polymerase Chain Reaction

Objective To study the changes of plasma endotoxin and procalcitonin in patients with esophagogastric varices and provide a theoretical basis for prophylactic antibiotics after endoscopic treatment. Methods Fifty cases of patients with esophageal and gastric varices accepted the endoscopic treatment.The patients were divided into antibiotic group (32 cases)and non-antibiotic group (18 cases).The plasma endotoxin and procalcitonin were measured before and on the first day and 7th day after endoscopic treatment.Results The plasma levels of endotoxin and procalcitonin were not significantly different on the first and 7th day after endoscopic treatment compared with preoperative levels in antibiotic group.But in non-antibiotic group,the levels significantly increased on 7th day after endoscopic treatment compared with preoperative levels (P <0.05).And in patients of Child-Pugh A grade,the level of plasma procalcitonin significantly increased on 7th day after endoscopic treatment compared with preoperative levels (P <0.01), but the procalcitonin was not significantly different on the first and 7th day after operation.And in patients of Child-Pugh B and C grades,the levels of plasma endotoxin and procalcitonin significantly increased on the 7th day(P <0.01).Conclusion The levels of plasma endotoxin and procalcitonin in non-antibiotic group increase after endoscopic treatment,which suggests the risk of infection.Prophylactic antibiotics after endo-scopic treatment should be considered for the patients of Child-Pugh B and C grades.