Objective To investigate the relationship between the changes in P(cv-a)CO?/C(a-cv)O? ratio and hypoxic states in patients with hemorrhagic shock after effective fluid resuscitation.Methods Thirty hemorrhagic shock patients who were admitted to ICU Dongguan Eighth People's Hospital from October 1,2021 to November 30,2023 were selected as research objects.All the patients underwent early fluid resuscitation.Arterial and central venous blood gas analysis was performed,and arterial lactate concentration was measured before resuscitation,and at 2 h,6 h,12 h,and 24 h after resuscitation.The P(cv-a)CO2/C(a-cv)O2,the gradient of P(cv-a)CO2/C(a-cv)O2,and lactate clearance rate were calculated.Results There was a positive correlation between the P(cv-a)CO?/C(a-cv)O? ratio and lactate concentration,as well as between the gradient of P(cv-a)CO?/C(a-cv)O? and lactate clearance rate at each time point(P<0.05).There were significant differences in the P(cv-a)CO?/C(a-cv)O?,gradient of P(cv-a)CO?/C(a-cv)O?,and lactate clearance rate after resuscitation among patients with different prognoses(P<0.05).Conclusion The P(cv-a)CO2/C(a-cv)O2 and its change rate,as well as lactate clearance rate,can predict the prognosis of patients with hemorrhagic shock.

Objective:To investigate mevalonic acid(MEV)on reversing the antitumor effects of fluvastatin sodium(FS)on tongue squamous cell carcinoma(TSCC)cells.Methods:TSCC HSC-4 cells were treated with different concentrations of FS and MEV re-spectively or in combination.Cell counting kit-8,flow cytometry,wound healing,immunofluorescence and western blotting assays were conducted to examine cell proliferation,apoptosis and migration capacities,as well as the expression levels of Ras homolog family member A(RHOA),tissue factor(TF)and B-cell lymphoma-2-associated X(BAX)proteins,respectively.Results:FS inhibited HSC-4 cell proliferation and migration,decreased the expression of RHOA and TF,and increased BAX expression.MEV reversed the above antitumor effects of FS and promoted intracellular RHOA and TF expression.Conclusion:MEV reverses the antitumor effects of FS on HSC-4 cells in vitro.

Objective To investigate the association between the immune microenvironment and gene expression in endometrial cancer(EC)and discuss its predictive value for prognosis,and to identify critical immune-related genes through bioinformatics analysis and machine learning techniques and construct a prognostic model for providing new directions for personalized treatment of EC.Methods Based on data from the Cancer Genome Atlas(TCGA)program,tools such as DESeq2,edgeR,and limma were utilized to screen for differentially expressed genes.Immune-related genes were selected by integrating data from the Immunology Database and Analysis Portal(ImmPort).Machine learning algorithms including Lasso regression,univariate feature selection,Boruta and random forest were employed to refine the selection of feature genes.Univariate and multivariate Cox regression analyses were conducted to assess the prognostic value of the genes,followed by construction of a risk score model.Additionally,tumor immune infiltration was analyzed using CIBERSORT algorithm,and key gene expressions were validated through immunohistochemistry.Results The intersection of 3 difference analysis results and immune-related genes identified 62 differentially expressed immune genes,and 25 potential biomarkers which were selected by a variety of machine learning models were considered as prognosis related genes.Univariate and multivariate Cox regression analyses confirmed that INHBE,SLURP1 and TNFSF11 genes were significantly associated with survival in EC patients.The constructed risk score model effectively distinguished the survival rate of different prognostic groups,and was related to the degree of immune cell infiltration.Immunohistochemical analysis further verified the differences in the expression of these genes between tumor and normal tissues.Conclusion INHBE,SLURP1 and TNFSF11 are key prognostic biomarkers in EC immune microenvironment,and their expression levels are closely associated with immune cell infiltration and patient survival rate,providing theoretical basis for EC precision medicine.

Objective To investigate the association between the immune microenvironment and gene expression in endometrial cancer(EC)and discuss its predictive value for prognosis,and to identify critical immune-related genes through bioinformatics analysis and machine learning techniques and construct a prognostic model for providing new directions for personalized treatment of EC.Methods Based on data from the Cancer Genome Atlas(TCGA)program,tools such as DESeq2,edgeR,and limma were utilized to screen for differentially expressed genes.Immune-related genes were selected by integrating data from the Immunology Database and Analysis Portal(ImmPort).Machine learning algorithms including Lasso regression,univariate feature selection,Boruta and random forest were employed to refine the selection of feature genes.Univariate and multivariate Cox regression analyses were conducted to assess the prognostic value of the genes,followed by construction of a risk score model.Additionally,tumor immune infiltration was analyzed using CIBERSORT algorithm,and key gene expressions were validated through immunohistochemistry.Results The intersection of 3 difference analysis results and immune-related genes identified 62 differentially expressed immune genes,and 25 potential biomarkers which were selected by a variety of machine learning models were considered as prognosis related genes.Univariate and multivariate Cox regression analyses confirmed that INHBE,SLURP1 and TNFSF11 genes were significantly associated with survival in EC patients.The constructed risk score model effectively distinguished the survival rate of different prognostic groups,and was related to the degree of immune cell infiltration.Immunohistochemical analysis further verified the differences in the expression of these genes between tumor and normal tissues.Conclusion INHBE,SLURP1 and TNFSF11 are key prognostic biomarkers in EC immune microenvironment,and their expression levels are closely associated with immune cell infiltration and patient survival rate,providing theoretical basis for EC precision medicine.

OBJECTIVES: To construct a quantitative index system with the integrated medical and nursing care assessment for the elderly service needs, this system can assess the cost of medical and care services accurately and objectively, so as to provide scientific basis for the allocation of old-age service resources in China. METHODS: Based on the survival needs of the Existence, Relation and Growth theory, an index system is constructed through literature analysis, group discussion, and expert correspondence. Analytic hierarchy process was used to determine the weights of indicators at all levels. The 3-grades service items corresponding to each index were quantified through the measurement of working hours, and the medical and nursing care needs of 624 disabled/demented elderly people over 60 years old in Changsha were investigated to evaluate their reliability and validity. RESULTS: The authoritative coefficients of the 2 rounds of expert correspondence were 88.5% and 88.6%, respectively, and the opinion coordination coefficients were 0.159 and 0.167, respectively. The final quantitative evaluation index system included 4 first-level indicators, 17 second-level indicators, and 105 third-level indicators. The service time of doctor ranged from 6.01 to 22.64 min, the service time of nurses ranged from 0.77 to 24.79 min, and the service time of caregiver ranged from 0.12 to 51.88 min. The Cronbach's αcoefficient was 0.73, the split-half reliability was 0.74, the content validity was 0.93, and the calibration validity was 0.781. CONCLUSIONS The quantitative evaluation index system of medical and nursing service need for the elderly can be used to accurately evaluate the medical and nursing service need.
Humans ; Aged ; Middle Aged ; Reproducibility of Results ; Surveys and Questionnaires ; Delphi Technique ; Nursing Care ; China

Animals ; SARS-CoV-2 ; Antibodies, Neutralizing ; Macaca mulatta ; COVID-19/prevention & control* ; Antibodies, Viral ; Vaccines

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Objective:To compare the clinical efficacy and safety of ledipasvir/sofosbuvir (LDV/SOF) and elbasvir/grazoprevir (EBR/GZR) in treatment of patients with chronic hepatitis C (CHC).Methods:The clinical data of 143 patients with genotype 1b CHC treated in Huzhou Central Hospital from January 2020 to December 2021 were retrospectively analyzed, including 74 cases treated with LDV/SOF and 69 cases treated with EBR/GZR. The virological response after 4 and 12 weeks of treatment and 12wk after drug withdrawal was determined; and the serological and liver inflammation indexes before and after treatment in two groups were compared. SPSS 25.0 software was used for statistical analysis of the data.Results:The virological response rates of the LDV/SOF group and EBR/GZR group were 97.30% and 98.55%, 98.65% and 100.00%, 97.30% and 98.55% after 4 and 12 weeks of treatment and 12 weeks after the end of treatment, respectively (all P > 0.05). At the end of treatment, the liver inflammation indexes ALT, AST and GGT in the two groups were significantly lower than the baseline levels ( Z=-7.470 and -6.974, -9.757 and -6.832, -3.578 and -4.054, P<0.01). Adverse reactions in both groups were mild, and no serious adverse events occurred. Conclusion:Both LDV/SOF and EBR/GZR have good clinical efficacy in the treatment of genotype 1b CHC patients. And the patients are well tolerated.

OBJECTIVE: In order to further decrease and reduce the serious adverse events of silicone rubber endotracheal intubation in clinical use, especially in anesthesia and intensive care. METHODS: Through the first stage analysis on the registration and certification of endotracheal intubation products in China, adverse events of products in recent five years in Zhejiang province, domestic and foreign literature of adverse events of products, retrieval of product citation standards, content integrity of product instructions, and expert seminar on serious adverse events, combined with the air leakage of endotracheal intubation products in recent two years, product material and clinical application with normative aspects. RESULTS: Silicone rubber endotracheal intubation products in clinical intensive care have certain clinical safety risks, especially for long-term use of critically ill patients. CONCLUSIONS According to the four cases of serious adverse events of silicone rubber endotracheal intubation in the clinical intensive care unit, we put forward some suggestions for the manufacturers, clinical users and regulatory agencies to further decrease and reduce the serious adverse events of silicone rubber endotracheal intubation.
China ; Critical Care ; Critical Illness ; Humans ; Intensive Care Units ; Intubation, Intratracheal/adverse effects*

With high accuracy and precision,next generation sequencing (NGS) has provided a powerful tool for clinical testing of genetic diseases.To follow a standardized experimental procedure is the prerequisite to obtain stable,reliable,and effective NGS data for the assistance of diagnosis and/or screening of genetic diseases.At a conference of genetic testing industry held in Shanghai,May 2019,physicians engaged in the diagnosis and treatment of genetic diseases,experts engaged in clinical laboratory testing of genetic diseases and experts from third-party genetic testing companies have fully discussed the standardization of NGS procedures for the testing of genetic diseases.Experts from different backgrounds have provided opinions for the operation and implementation of NGS testing procedures including sample collection,reception,preservation,library construction,sequencing and data quality control.Based on the discussion,a consensus on the standardization of the testing procedures in NGS laboratories is developed with the aim to standardize NGS testing and accelerate implementation of NGS in clinical settings across China.