Objective This study aimed to explore the current status of home-based fatigue among patients after cardiac surgery and analyze its influencing factors.Methods From January 2023 to December 2023,we retrospectively collected data from 200 patients who underwent cardiac surgery and were discharged for more than 3 months from Guangdong Provincial People's Hospital.The Multidimensional Fatigue Inventory-20,Overall Pain Assessment Scale,Cardiac Rehabilitation Inventory and Self-efficacy for Managing Chronic Disease 6-Item Scale were used to assess the patients.Results Overall fatigue of patients at home after cardiac surgery was at a moderate level.A stepwise multiple linear regression analysis revealed that anxiety during cardiac rehabilitation(β=7.476,P=0.001),severe pain(β=11.939,P=0.001),and frequency of discomfort symptoms(P＜0.001)significantly positively predicted post-cardiac surgery fatigue,whereas self-efficacy in chronic disease management(β=-6.974,P＜0.001)significantly negatively predicted it.Conclusions Fatigue among home-based patients after cardiac surgery requires further improvement and is associated with cardiac rehabilitation anxiety,pain severity,self-efficacy,and frequency of discomfort symptoms.Healthcare providers could develop targeted continuity interven-tions based on these influencing factors to reduce fatigue levels and promote recovery among home-based patients after cardiac surgery.

BACKGROUND: The addition of growth factiors is commonly applied to improve the osteogenic differentiation of stem cells. However, for human pluripotent stem cells (hPSCs), their complex differentiation processes result in the unknown effect at different stages. In this study, we focused on the widely used bone forming peptide-1 (BFP-1) and investigated the effect and mechanisms of its addition on the osteogenic induction of hPSCs as a function of the supplementation period. METHODS: Monolayer-cultured hPSCs were cultured in osteogenic induction medium for 28 days, and the effect of BFP-1 peptide addition at varying weeks was examined. After differentiation for varying days (0, 7, 14, 21 and 28), the differentiation efficiency was determined by RT–PCR, flow cytometry, immunofluorescence, and alizarin red staining assays. Moreover, the expression of marker genes related to germ layers and epithelial-mesenchymal transition (EMT) was investigated at day 7. RESULTS: Peptide treatment during the first week promoted the generation of mesoderm cells and mesenchymal-like cells from hiPSCs. Then, the upregulated expression of osteogenesis marker genes/proteins was detected in both hESCs and hiPSCs during subsequent inductions with BFP-1 peptide treatment. Fortunately, further experimental design confirmed that treating the BFP-1 peptide during 7–21 days showed even better performance for hESCs but was ineffective for hiPSCs. CONCLUSION The differentiation efficiency of cells could be improved by determining the optimal treatment period.Our study has great value in maximizing the differentiation of hPSCs by adding osteogenesis peptides based on the revealed mechanisms and promoting the application of hPSCs in bone tissue regeneration.

Objective:To identify the factors influencing acute kidney injury (AKI) following abdominal surgery in elderly patients and develop a predictive model based on the LASSO regression.Methods:The medical records of American Society of Anesthesiologists (ASA) Physical Status classificationⅠ-Ⅳ patients, aged ≥60 yr, with operation time ≥ 2 h, undergoing elective abdominal surgery under anesthesia in the General Hospital of Ningxia Medical University from May 2021 to May 2023, were retrospectively collected. AKI was diagnosed based on the Kidney Disease: Improving Global Outcomes organization guidelines. The patients were divided into 2 groups based on whether AKI occurred within 7 days after surgery: AKI group and non-AKI group. The least absolute shrinkage and selection operator algorithm was performed to reduce the dimension of unbalanced factors between AKI group and non-AKI group and the known risk factors for AKI. A nomogram prediction model was developed by integrating the optimized features derived from the LASSO regression model into multivariate logistic regression analysis. Internal validation was performed using the Bootstrap method, and the predictive ability and accuracy of the prediction model were assessed through the calibration curve, area under the receiver operating characteristic curve, Brier index and decision curve analysis.Results:Five hundred and ninety patients were finally included in this study, with 62 cases (10.5%) suffered postoperative AKI. The results of multivariate logistic regression analysis showed that increased age ( OR=1.06, 95% confidence interval [ CI] 1.01-1.11, P=0.048), higher ASA classification ( OR=2.32, 95% CI 1.21-4.45, P=0.011), preoperative coronary heart disease ( OR=1.89, 95% CI 1.01-3.61, P=0.049), and longer surgical duration ( OR=1.01, 95% CI 1.01-1.02, P=0.004) were risk factors for AKI after abdominal surgery, and the intraoperative use of dexmedetomidine ( OR=0.22, 95% CI 0.08-0.59, P=0.003) and increased postoperative albumin concentrations ( OR=0.91, 95% CI 0.85-0.98, P=0.017) were protective factors for postoperative AKI in elderly patients ( P<0.05). A risk prediction model was constructed based on the 9 identified factors of age, ASA classification, Charlson Comorbidity Index, preoperative coronary heart disease, preoperative hemoglobin concentration, preoperative estimated glomerular filtration rate, surgical duration, intraoperative use of dexmedetomidine and postoperative albumin concentration. A nomogram was plotted to visualize the model and verify it, showing that the Brier score of the model was 0.079, with a discrimination of 0.844, sensitivity of 84.4%, and specificity of 70.2%. Two hundred bootstrap resamples were used for internal validation, yielding a receiver operating characteristic curve of 0.821 with a 95% confidence interval of 0.79 to 0.90. The clinical decision curve indicated significant net benefits when the threshold probability of the model was between 0.03 and 0.45. Conclusions:Increased age, higher ASA classification, preoperative coronary heart disease, and longer surgical duration are risk factors, and the intraoperative use of dexmedetomidine and increased postoperative albumin concentrations are protective factors for postoperative AKI in elderly patients. The AKI prediction model following abdominal surgery developed based on age, ASA classification, Charlson Comorbidity Index, preoperative coronary heart disease, preoperative hemoglobin concentration, preoperative estimated glomerular filtration rate, surgical duration, intraoperative use of dexmedetomidine and postoperative albumin concentration has good predictive value in elderly patients.

Significant research progress has been made in the development of antibody-drug conjugates (ADCs) for the treatment of ad-vanced breast cancer (ABC),ushering new hope for patients with this refractory disease. Through the conjugation of specific antibodies with highly potent cytotoxic drugs,tumor cells can be precisely targeted and killed while minimizing damage to normal tissues. ADCs such as trastuzumab-emtansine (T-DM1) and trastuzumab deruxtecan (T-DXd),have shown excellent efficacy in the treatment of HER2-positive ABC,significantly prolonging patient survival. Furthermore,ADCs targeting triple-negative breast cancer (TNBC),such as sacituzumab govitecan (SG),have also achieved positive results in clinical trials. With the continuous research,development,and optimization of ADCs,as well as the exploration of combination treatment strategies,ADCs are expected to play an increasingly important role in the treatment of ABC in the future. This article provides an overview of the research progress of ADCs in the treatment of ABC,exploring their efficacy and safety. We aim to offer more treatment options and renewed hope for patients with ABC.

Objective This study aimed to explore the current status of home-based fatigue among patients after cardiac surgery and analyze its influencing factors.Methods From January 2023 to December 2023,we retrospectively collected data from 200 patients who underwent cardiac surgery and were discharged for more than 3 months from Guangdong Provincial People's Hospital.The Multidimensional Fatigue Inventory-20,Overall Pain Assessment Scale,Cardiac Rehabilitation Inventory and Self-efficacy for Managing Chronic Disease 6-Item Scale were used to assess the patients.Results Overall fatigue of patients at home after cardiac surgery was at a moderate level.A stepwise multiple linear regression analysis revealed that anxiety during cardiac rehabilitation(β=7.476,P=0.001),severe pain(β=11.939,P=0.001),and frequency of discomfort symptoms(P＜0.001)significantly positively predicted post-cardiac surgery fatigue,whereas self-efficacy in chronic disease management(β=-6.974,P＜0.001)significantly negatively predicted it.Conclusions Fatigue among home-based patients after cardiac surgery requires further improvement and is associated with cardiac rehabilitation anxiety,pain severity,self-efficacy,and frequency of discomfort symptoms.Healthcare providers could develop targeted continuity interven-tions based on these influencing factors to reduce fatigue levels and promote recovery among home-based patients after cardiac surgery.

Significant research progress has been made in the development of antibody-drug conjugates (ADCs) for the treatment of ad-vanced breast cancer (ABC),ushering new hope for patients with this refractory disease. Through the conjugation of specific antibodies with highly potent cytotoxic drugs,tumor cells can be precisely targeted and killed while minimizing damage to normal tissues. ADCs such as trastuzumab-emtansine (T-DM1) and trastuzumab deruxtecan (T-DXd),have shown excellent efficacy in the treatment of HER2-positive ABC,significantly prolonging patient survival. Furthermore,ADCs targeting triple-negative breast cancer (TNBC),such as sacituzumab govitecan (SG),have also achieved positive results in clinical trials. With the continuous research,development,and optimization of ADCs,as well as the exploration of combination treatment strategies,ADCs are expected to play an increasingly important role in the treatment of ABC in the future. This article provides an overview of the research progress of ADCs in the treatment of ABC,exploring their efficacy and safety. We aim to offer more treatment options and renewed hope for patients with ABC.

Magnetic anchoring technology provides a new development opportunity for current minimally invasive surgery. The magnetic anchoring abdominal video system based on this technology can effectively improve the operability and minimally invasiveness of single-port laparoscopic surgery. The development history of magnetically anchored abdominal video system was reviewed, and the design features and deficiencies of various types of magnetically anchored video devices were compared and analyzed. The evolution characteristics of the magnetic anchored video system are explained from minimally invasive and intelligent perspectives, and the challenges and opportunities of magnetic anchored video system are summarized and prospected.
Abdomen ; Laparoscopy ; Magnetics ; Minimally Invasive Surgical Procedures

Objective:To investigate the cognition of the diagnosis and management of bronchiectasis among respiratory specialists.Methods:Between May and June 2020, a questionnaire survey based on expert consensus and guidelines was conducted among respiratory specialists from 50 hospitals from Sichuan and Yunnan provinces. Total 691 questionnaires were distributed and 641 were received. 601 valid questionnaires were chosen for further analysis with an effective recovery rate of 87.0%. The respondents were required to finish the e-questionnaires independently in terms of cognition of diagnosing, severity assessment, treatments and Chinese medicines of bronchiectasis. The responses were collected online and the cognitive levels were evaluated by calculating the correct rates of corresponding questions.Results:540 (89.9%) of the respondents agreed that high-resolution computed tomography (HRCT) was the gold standard for diagnosing of bronchiectasis, but 318 (52.9%) had an incomplete understanding of common radiographic manifestations of bronchiectasis, and different cognitive degrees of common radiographic manifestations of bronchiectasis existed among respondents with different qualifications or working in different levels of hospitals ( P<0.05). Only 118 (19.6%) of the respondents were familiar with severity assessments of bronchiectasis, but 65 (55.1%) of the 118 respondents said they won′t apply these severity assessments to patient during their clinical works. For the treatment of patients with stable bronchiectasis, airway clearance techniques were most recommended by specialists surveyed [410 (68.2%)], among which, postural drainage was the most known method [559 (93.0%)]. For patients undergoing an acute exacerbation, most respondents recommended antibiotics [600 (99.8%)] as the primary treatment, and examinations such as sputum culture [544 (90.5%)], inflammatory markers [523 (87.0%)] should be performed as well. 504 (83.9%) thought that pseudomonas aeruginosa was the most common conditioned pathogen for bronchiectasis. For patients with frequent exacerbations (≥3 per year), 385 (64.1%) of the respondents supported the therapeutic effect of long-term antibiotics, however, among the 385 respondents supporting long-term antibiotics, only [113 (29.4%)] were willing to recommend long-term antibiotic treatment actively during their clinical practice. Besides, 304 (50.6%) respondents held a positive attitude to the clinical effect of traditional Chinese medicine therapies. Among 304 respondents holds the point of supporting, only 86 (28.3%) were willing to recommend traditional Chinese medicine to patients actively, differences about the attitude and clinical behaviors were found between respondents working in different levels of hospitals ( P<0.05). Conclusions:Respiratory specialists′ cognition on diagnosis and treatments of bronchiectasis remains inadequate, and cognitive levels differ among respondents working in different levels of hospitals. There is a gap between respondents′ cognition and clinical practice. Further education and trainings are necessary for improving respiratory specialists′ knowledge for timely diagnosis and standard treatment of bronchiectasis.

Objective To investigate the efficacy of lower cervical spine fracture and dislocation treated by Halo-vest reduction combined with anterior decompression and internal fixation.Methods From January 2009 to December 2012,26 cases of lower cervical spine fracture and dislocation underwent Halovest reduction combined with anterior decompression and internal fixation.There were 18 males and 8 females,aged 19-64 years (mean,42.1 years).Injury resulted from traffic crashes in 11 cases,high falls in 9,and hit by heavy objects in 6.Segment of injury was C5/6in 10 cases,C6/7in 9,C3/4in 4,and C4/5in 3.Prior to anterior decompression/internal fixation and fusion,the Halo-vest external fixation was performed.Neurological performance was evaluated after operation.Results All the patients were followed up for 24-36 months (mean,27.4 months).According to the X-ray films and CT scan at the final follow-up,the alignment of the cervical spine was maintained and the implanted bone was completely fused without internal fixation breaking or loosening.Preoperative neurological status according to the Frankel grading was grade A in 6 cases,grade B in 8,grade C in 7,and grade E in 2.After operation,there were 5 cases in grade A,3 in grade B,4 in grade C,5 in grade D,and 9 in grade E.All together,6 cases presented two-grade improvement in neurological status,13 one-grade improvement,and 5 no changes (P ＜ 0.05).Conclusion Halo-vest reduction combined with anterior decompression and internal fixation is safe and effective in treatment of lower cervical spine fracture and dislocation.