OBJECTIVE To investigate the immunotoxicity and potential mechanism of Carthamus tinctorius extract on RBL-2H3 cells via direct induction and induction by sensitized serum prepared with an overdose of the extract. METHODS For direct induction by C. tinctorius extract， RBL-2H3 cells were divided into normal control group （no treatment） and C. tinctorius extract group （10 mg/mL）. For induction by sensitized serum prepared with an overdose of C. tinctorius extract， rats were divided into normal control group （no treatment）， adjuvant-treated group （1 mL adjuvant）， C. tinctorius extract-induced sensitization group （2.04 g/mL）， and ovalbumin （OVA）-induced sensitization group （50 mg/mL）. Sensitization was performed once every other day for a total of 3 times. Morphological changes of RBL-2H3 cells were observed， the degranulated rate of cells was counted， and histamine content was determined； the release rate of β -hexosaminidase （ β -Hex） was calculated， the levels of interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） and intracellular Ca²⁺ concentration were detected. RESULTS Under direct induction by C. tinctorius extract， compared with the normal control group， the volume of cells in the C. tinctorius extract group was significantly reduced and cell density decreased； the degranulation rate of cells， histamine content， β -Hex release rate， IL-6 and TNF-α levels， as well as intracellular Ca²⁺ concentration were all significantly increased （ P ＜0.01）. Under i nduction by sensitized serum prepared with an overdose of C. tinctorius extract， compared with the adjuvant-treated group， the above indicators in the C. tinctorius extract-induced sensitization group and the OVA-induced sensitization group showed consistent changes with those in the C. tinctorius extract group under direct induction， all being significantly elevated （ P ＜0.01）. CONCLUSIONS C. tinctorius extract may affect degranulation of RBL-2H3 cells and promote Ca²⁺ influx accompanied by the release of pro-inflammatory cytokines through two approaches： direct induction and induction by sensitized serum prepared under overdose administration. Its mechanism may be related to the activation of the calcium signaling pathway and the regulation of inflammatory pathways under the synergistic effect of multiple components.

OBJECTIVE: To observe the characteristics of changes in non-invasive hemodynamic parameters in neonates with septic shock so as to provide clinical reference for diagnosis and treatment. METHODS: A observational study was conducted. The neonates with sepsis complicated with septic shock or not admitted to neonatal intensive care unit (NICU) of the First Affiliated Hospital of Shantou University Medical College were enrolled as the study subjects, who were divided into preterm infant (< 37 weeks) and full-term infant (≥ 37 weeks) according to the gestational age. Healthy full-term infants and hemodynamically stable preterm infants transferring to NICU after birth were enrolled as controls. Electronic cardiometry (EC) was used to measure hemodynamic parameters, including heart rate (HR), mean arterial pressure (MAP), stroke volume (SV), stroke volume index (SVI), cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR) and systemic vascular resistance index (SVRI), before treatment in the septic shock group, at the time of diagnosis of sepsis in the sepsis without shock group, and before the discharge from the obstetric department or on the day of transferring to NICU in the control group. RESULTS: Finally, 113 neonates with complete data and parental consent for non-invasive hemodynamic monitoring were enrolled, including 32 cases in the septic shock group, 25 cases in the sepsis without shock group and 56 cases in the control group. In the septic shock group, there were 17 cases at the compensated stage and 15 cases at the decompensated stage. There were 21 full-term infants (20 cured or improved and 1 died) and 11 premature infants (7 cured or improved and 4 died), with the mortality of 15.62% (5/32). There were 18 full-term infants and 7 premature infants in the sepsis without shock group and all cured or improved without death. The control group included 28 full-term infants and 28 premature infants transferring to NICU after birth. Non-invasive hemodynamic parameter analysis showed that SV, SVI, CO and CI of full-term infants in the septic shock group were significantly lower than those in the sepsis without shock group and control group [SV (mL): 3.52±0.99 vs. 5.79±1.32, 5.22±1.02, SVI (mL/m²): 16.80 (15.05, 19.65) vs. 27.00 (22.00, 32.00), 27.00 (23.00, 29.75), CO (L/min): 0.52±0.17 vs. 0.80±0.14, 0.72±0.12, CI (mL×s^-1×m^-2): 40.00 (36.67, 49.18) vs. 62.51 (56.34, 70.85), 60.01 (53.34, 69.68), all P < 0.05], while SVR and SVRI were significantly higher than those in the sepsis without shock group and control group [SVR (kPa×s×L^-1): 773.46±291.96 vs. 524.17±84.76, 549.38±72.36, SVRI (kPa×s×L^-1×m^-2): 149.27±51.76 vs. 108.12±12.66, 107.81±11.87, all P < 0.05]. MAP, SV, SVI, CO and CI of preterm infants in the septic shock group were significantly lower than those in the control group [MAP (mmHg, 1 mmHg ≈ 0.133 kPa): 38.55±10.48 vs. 47.46±2.85, SV (mL): 2.45 (1.36, 3.58) vs. 3.96 (3.56, 4.49), SVI (mL/m²): 17.60 (14.20, 25.00) vs. 25.50 (24.00, 29.00), CO (L/min): 0.32 (0.24, 0.63) vs. 0.56 (0.49, 0.63), CI (mL×s^-1×m^-2): 40.01 (33.34, 53.34) vs. 61.68 (56.68, 63.35), all P < 0.05], while SVR and SVRI were similar to the control group [SVR (kPa×s×L^-1): 1 082.88±689.39 vs. 656.63±118.83, SVRI (kPa×s×L^-1×m^-2): 126.00±61.50 vs. 102.37±11.68, both P > 0.05]. Further analysis showed that SV, SVI and CI of neonates at the compensation stage in the septic shock group were significantly lower than those in the control group [SV (mL): 3.60±1.29 vs. 4.73±1.15, SVI (mL/m²): 19.20±8.33 vs. 26.34±3.91, CI (mL×s^-1×m^-2): 46.51±20.34 vs. 61.01±7.67, all P < 0.05], while MAP, SVR and SVRI were significantly higher than those in the control group [MAP (mmHg): 52.06±8.61 vs. 48.54±3.21, SVR (kPa×s×L^-1): 874.95±318.70 vs. 603.01±111.49, SVRI (kPa×s×L^-1×m^-2): 165.07±54.90 vs. 105.09±11.99, all P < 0.05]; MAP, SV, SVI, CO and CI of neonates at the decompensated stage in the septic shock group were significantly lower than those in the control group [MAP (mmHg): 35.13±6.08 vs. 48.54±3.21, SV (mL): 2.89±1.17 vs. 4.73±1.15, SVI (mL/m²): 18.50±4.99 vs. 26.34±3.91, CO (L/min): 0.41±0.19 vs. 0.65±0.15, CI (mL×s^-1×m^-2): 43.34±14.17 vs. 61.01±7.67, all P < 0.05], while SVR and SVRI were similar to the control group [SVR (kPa×s×L^-1): 885.49±628.04 vs. 603.01±111.49, SVRI (kPa×s×L^-1×m^-2): 114.29±43.54 vs. 105.09±11.99, both P > 0.05]. CONCLUSIONS Full-term infant with septic shock exhibit a low cardiac output, high vascular resistance hemodynamic pattern, while preterm infant with septic shock show low cardiac output and normal vascular resistance. At the compensated stage the hemodynamic change is low output and high resistance type, while at the decompensated stage it is low output and normal resistance type. Non-invasive hemodynamic monitoring can assist in the identification of neonatal septic shock and provide basis for clinical diagnosis and treatment.
Humans ; Shock, Septic/physiopathology* ; Infant, Newborn ; Hemodynamics ; Female ; Male ; Case-Control Studies ; Infant, Premature

Objective:To construct an evaluation index system for risk cognition and protection capability of interns at department of radiology for ionizing radiation,and explore its value in assessing risk cognition and protection capability of interns at department of radiology for ionizing radiation.Methods:Guided by the Knowledge-Attitude-Practice(KAP)theory,the relevant literatures that were published between January 1,2014,and December 31,2024 were searched from Chinese and English databases included China National Knowledge Infrastructure(CNKI),Wanfang,VIP Chinese Scientific Journals Database(VIP)and PubMed by using keywords such as"intern,""ionizing radiation and protection,""teaching,""indicator,""Delphi method,"and"KAP theory".Preliminary evaluation indicators were drafted based on interviews with 10 staff at department of radiology of Peking University People's Hospital.The Delphi method involving 21 experts from different provinces and cities of China was conducted over two rounds to finalize the index system.An online questionnaire survey by using Questionnaire Star was adopted to distribute questionnaires with evaluation index system for risk knowledge and protection capability of interns at department of radiology for ionizing radiation,and a total of 50 interns at department of radiology from Heilongjiang,Beijing,and Guangdong were investigated by the questionnaire.Results:Both the response and validity rates of the expert inquiry letters of two rounds for evaluation index system for risk knowledge and protection capability of interns at department of radiology for ionizing radiation were 100%.Experts'authority coefficients of two rounds were respectively 0.910 and 0.928,and the coordination coefficients of experts'opinions were respectively 0.318 and 0.342.The finalized evaluation index system comprised of 3 first-level indicators(theoretical knowledge,safety culture of ionizing radiation,and operational behavior),and 10 second-level indicators,and 46 third-level indicators.The scores of interns at department of radiology for the survey questionnaire of risk knowledge and protection capability about ionizing radiation was(177.57±29.68 points),indicating they were moderate level for risk knowledge and protection capability about ionizing radiation.Conclusion:The evaluation index system for risk knowledge and protection capability of interns at department of radiology for ionizing radiation has higher scientific nature and reliability,which can provide references for assessing the relevant theoretical and operational capability of interns,and conducting training with target.

Objective:To construct an evaluation index system for risk cognition and protection capability of interns at department of radiology for ionizing radiation,and explore its value in assessing risk cognition and protection capability of interns at department of radiology for ionizing radiation.Methods:Guided by the Knowledge-Attitude-Practice(KAP)theory,the relevant literatures that were published between January 1,2014,and December 31,2024 were searched from Chinese and English databases included China National Knowledge Infrastructure(CNKI),Wanfang,VIP Chinese Scientific Journals Database(VIP)and PubMed by using keywords such as"intern,""ionizing radiation and protection,""teaching,""indicator,""Delphi method,"and"KAP theory".Preliminary evaluation indicators were drafted based on interviews with 10 staff at department of radiology of Peking University People's Hospital.The Delphi method involving 21 experts from different provinces and cities of China was conducted over two rounds to finalize the index system.An online questionnaire survey by using Questionnaire Star was adopted to distribute questionnaires with evaluation index system for risk knowledge and protection capability of interns at department of radiology for ionizing radiation,and a total of 50 interns at department of radiology from Heilongjiang,Beijing,and Guangdong were investigated by the questionnaire.Results:Both the response and validity rates of the expert inquiry letters of two rounds for evaluation index system for risk knowledge and protection capability of interns at department of radiology for ionizing radiation were 100%.Experts'authority coefficients of two rounds were respectively 0.910 and 0.928,and the coordination coefficients of experts'opinions were respectively 0.318 and 0.342.The finalized evaluation index system comprised of 3 first-level indicators(theoretical knowledge,safety culture of ionizing radiation,and operational behavior),and 10 second-level indicators,and 46 third-level indicators.The scores of interns at department of radiology for the survey questionnaire of risk knowledge and protection capability about ionizing radiation was(177.57±29.68 points),indicating they were moderate level for risk knowledge and protection capability about ionizing radiation.Conclusion:The evaluation index system for risk knowledge and protection capability of interns at department of radiology for ionizing radiation has higher scientific nature and reliability,which can provide references for assessing the relevant theoretical and operational capability of interns,and conducting training with target.

The smooth implementation of anesthesia medical services by nurse anesthetists is significant. However, there is currently no unified standard for the training resources, content, evaluation, and certification of nurse anesthetists. This paper summarizes the training resources, training content, assessment and certification, and job responsibilities of nurse anesthetists in China and looks forward to the future, providing a reference for standardizing and improving the training of nurse anesthetists in China.

Objective:To investigate the current status of early pain in patients after total knee arthro-plasty under enhanced recovery mode and analyze the influencing factors.Methods:In the study,142 patients with total knee arthroplasty of a hospital in Beijing were investigated by convenient sampling.Visual analog scale(VAS)was used to describe the degree of pain(including resting pain and activity pain)within 3 days after operation,and the nature and location of pain and satisfaction with the analgesic effect of the patients were recorded.The influencing factors included age,gender,place of residence,education level,body mass index(BMI),years of pain,chronic medical history,surgical history,surgi-cal duration,whether to indwell a drainage tube,type of carer,severity of the disease,sleep quality,anxiety,depression,and preoperative pain level.The investigation tools of influencing factors were the general information questionnaire of patients,pain assessment questionnaire,Pittsburgh sleep quality index(PSQI),self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Firstly,single factor analysis was carried out on the included influencing factors,and then multiple stepwise regression analysis was carried out on the statistically significant variables to clarify the main influencing factors of early pain in patients after total knee arthroplasty.Results:The peak pain of the patient occurred at night on the first postoperative day and in the afternoon on the second postoperative day,with resting pain scores of(2.5±1.2)and(2.7±1.1),and activity pain scores of(3.8±1.5)and(4.0±1.6);the most common pain site was posterior knee pain(68,47.9％),followed by anterior knee combined with posterior knee pain(32,22.5％),anterior knee pain(27,19.1％),anterior knee combined with me-dial knee pain(10,7.0％),and anterior knee combined with lateral knee pain(5,3.5％);the nature of pain was mostly composed of soreness combined with swelling pain(58,40.8％),while the rest in-cluded simple soreness(26,18.3％),simple swelling pain(24,16.9％),hot burning pain(10,7.0％),pricking pain(9,6.3％),spasmodic traction pain(5,3.5％),tearing pain(4,2.8％),knife cutting pain(3,2.2％),and stabbing pain combined with soreness(3,2.2％);the patients who were satisfied and very satisfied with the analgesic effect were 114(80.3％).The results of univariate analysis showed that there were significant differences in sleep quality,disease severity,types of care-givers and depression score(P＜0.05).The results of multiple stepwise regression analysis showed that the main factors affecting the patients'early postoperative pain were preoperative sleep quality,depres-sion,the Knee Society score and the type of care(P=0.002).Conclusion:Most patients under en-hanced recovery after surgery are satisfied with the effect of pain control after operation.Medical staff can carry out predictive intervention in patients'sleep quality,depression to reduce the patients'early post-operative pain.At the same time,the research results suggest that choosing family members to accompany the patients can effectively improve the patients'early postoperative pain experience.

Objective:To identify the effective concentrations of Ropivacaine in the modified fascial iliac compartment block(FICB)that would not affect the movement of the affected limb but would offer effective pain relief after total knee arthroplasty(TKA)in elderly patients.In addition, adverse reactions within 24 hours of FICB were examined.Methods:This study was a prospective, single-arm sequential trial.Forty-five elderly patients treated with TKA at the First Affiliated Hospital of Soochow University between September 2021 and March 2022 were selected, with an American Society of Anesthesiologists(ASA)score of Ⅰ or Ⅱ.All patients were given ultrasound-guided FICB on the surgical side under general anesthesia and 10 minutes before the operation, and the injection volume was 30 ml.According to preliminary experiments and relevant literature, the initial concentration of Ropivacaine was 0.1%, and the concentration for the next patient was determined using a modified Dixon sequential method.If the quadriceps femoris muscle strength score of the first patient was ≥4, there was no resting pain[visual analogue scale(VAS)score ≤1], and the VAS score during activity was ≤3, the concentration for the next patient would be reduced.Conversely, the concentration would be increased.The Ropivacaine concentration was increased or decreased by 0.01% each time and the trial would be stopped after 12 reentries.The median effective concentration(ED50), 95% effective concentration(ED95)and corresponding 95% confidence interval(CI)of ropivacaine were calculated using the probit model.Meanwhile, adverse reactions within 24 hours of FICB were monitored.Results:Of 43 elderly patients who completed the trial, the intervention was effective in 23 and ineffective in 20.While ensuring that postoperative limb movement in elderly patients was not affected, a single injection of 30 ml ropivacaine through FICB was able to effectively inhibit postoperative pain, and the ED50 and ED95 of ropivacaine were 0.072%(95% CI: 0.065%-0.078%)and 0.093%(95% CI: 0.084%-0.124%), respectively.Within 24 hours of FICB, 2 patients had lower limb weakness and could not get out of bed and walk, and 5 patients had severe pain and needed additional analgesics.No other adverse reactions were found. Conclusions:The effective ED50 and ED95 of Ropivacaine for postoperative pain relief in elderly patients after TKA are 0.072% and 0.093%, respectively.And the incidence of adverse reactions is low.

Objective To characterize the distribution and assess the exposure to phthalic acid esters （PAEs） in the indoor dust of Shanghai City. Methods Samples were collected from 33 sampling sites， including homes， hotels， offices and public places， in Shanghai in 2018， 2019， and 2020. The samples were pretreated by 100 sieves， extracted and concentrated， and then analyzed by gas chromatography-mass spectrometry in selected ion mode （SIM）. Results Results on the characteristics of PAEs in indoor dust in different places showed that concentrations of PAEs were in a range of <0.01-2 464 mg·kg^-1.The average concentration of 16 PAEs was 613 mg·kg^-1. Bis（2-ethylhexyl） phthalate （DEHP）， di-iso-butyl phthalate （DiBP）， di-n-butyl phthalate （DBP） and di-n-octyl phthalate （DnOP） were the main components of PAEs in indoor dust， accounting for approximately 99.5% of 16 PAEs. The intake of DEHP， DBP， DEP and BBP was lower than the tolerable daily intake （TDI） and reference doses （RfD） set by EU CSTEE and U.S. EPA. Conclusion Average daily dose （ADD） via indoor dust is estimated， and the order of intake through different pathways is hand-oral intake>skin contact>respiratory inhalation. Exposure risk of PAEs in children is greater than that in adults.

OBJECTIVE To evaluate the correlation between 5-HTR1A gene C- 1019G polymorphism and the efficacy of antidepressants. METHODS PubMed，Embase，Cochrane Library ，CNKI，Wanfang database ，CBM and VIP database were searched for domestic and foreign literatures on the correlation between 5-HTR1A gene C- 1019G polymorphism and antidepressant efficacy. The retrieval time limit was from the inception to February 2022. According to different outcome measures of drug response，Stata 14.0 and RevMan 5.4 software were used for meta-analysis of efficacy group and remission group ，respectively. RESULTS A total of 18 literature were included. The combined results showed that among recessive gene model in valid group ， the correlation of 5-HTR1A gene C- 1019G polymorphism with the efficacy of antidepressants had statistically significance in Asian population（GG vs. CG+CC ，OR＝0.751，95％CI＝0.585-0.964，P＝0.024）. There was statistical significance in the correlation of 5-HTR1A gene C- 1019G polymorphism and the efficacy of antidepressants in China （GG vs. CG+CC ，OR＝0.677，95％CI＝ 0.508-0.901，P＝0.007）. There was no statistical significance in the correlation of 5-HTR1A gene C- 1019G polymorphism and the efficacy of antidepressants in remission group （P＞0.05）. CONCLUSIONS In the effective group ，5-HTR1A gene C- 1019G polymorphism is correlated with the efficacy of antidepressants in the Asian population and the Chinese population ；while in the remission group ，it is not proved that this polymorphism is correlated with the efficacy of antidepressants.

Decision-making aid for cancer patients is of great significance in the diagnosis and treatment for diseases. Breast cancer is one of the most common malignant tumors in women all over the world, and breast cancer patients have become the main target population for decision-aided research. Application of decision-making assistance for patients in Western countries has developed to a certain extent, while relevant research in China is still at the early stage. There are kinds of intervention forms for patients' decision aids, including traditional brochures and videos, decision aids systems, decision coaching, multidisciplinary breast cancer teams, etc. The tools for decision-making quality evaluation include the patients' awareness for decision-making, participation, decision-making conflict, decision-making satisfaction, decision-making regret, which can provide important guidance for the application of decision-making aid treatment in breast cancer patients in the future.
Breast Neoplasms/therapy* ; China ; Decision Making ; Emotions ; Female ; Humans ; Personal Satisfaction