Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10 /L vs preoperative 3.07×10 /L, P<0.001), with significant upregulation of CD11b (7.30×10 /L vs preoperative 3.05×10 /L, P<0.001) and CD54 (7.15×10 /L vs preoperative 2.99×10 /L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10 /L vs preoperative 1.12×10 /L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10 /L vs preoperative 1.12×10 /L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.

Objective:To analyze the correlation between the skin temperature variation trajectory in the radiation field and the occurrence of grade 2 or higher radiation dermatitis in female breast cancer patients during postoperative radiotherapy.Methods:This prospective cohort study used convenience sampling to select 103 breast cancer patients who underwent modified radical mastectomy and subsequent radiotherapy at the Fourth Hospital of Hebei Medical University from May 2022 to December 2022. All patients received three-dimensional conformal radiotherapy (3D-CRT), with an irradiation field covering the chest wall ± supraclavicular and infraclavicular lymphatic drainage regions, and a prescribed dose of 50 Gy delivered in 25 fractions. Skin temperature in the irradiated area was measured using an infrared thermometer before radiotherapy and on the days of the 5 th, 10 th, 15 th, 20 th, and 25 th fractions. The latent classes of skin temperature variation trajectories were identified using the Mplus latent class growth model, and logistic regression was applied to analyze the correlation between the skin temperature variation trajectory and the occurrence of grade 2 or higher radiation dermatitis. Results:The skin temperature variation trajectories in the irradiated field of breast cancer patients undergoing postoperative radiotherapy could be divided into two groups: the temperature non-increasing group (81/103) and the temperature increasing group (22/103). The Akaike information criterion (AIC) was 66.468, the Bayesian information criterion (BIC) was 116.528, and the entropy was 0.810, with a likelihood ratio test P-value of 0.037, and a Bootstrap-based likelihood ratio test P-value<0.001. After adjusting for covariates such as age and body mass index, logistic regression analysis showed that the risk of developing grade 2 or higher radiation dermatitis in the temperature increasing group was 6.92 times of that in the temperature non-increasing group ( OR=6.92, 95% CI = 2.30-20.82, P=0.001). Conclusions:There is group heterogeneity in the skin temperature variation trajectories of breast cancer patients undergoing radiotherapy, and patients with a rise in skin temperature have a higher risk of developing grade 2 or higher acute radiation dermatitis.

Objective:To explore the chain mediating role of general self-efficacy and humanistic care competence between oncology nurses' empathy and medical narrative competence, with a view to informing the development of targeted medical narrative competence enhancement strategies.Methods:Convenience sampling was used to select 1 104 oncology nurses from 17 ClassⅢ Grade A hospitals in Yunnan Province from May to August 2023 for the study. The General Information Questionnaire, Narrative Competence Scale, Chinese version of the Jefferson Scale of Empathy, Caring Ability Inventory, and General Self-Efficacy Scale were used to survey oncology nurses. Pearson correlation was used to analyze the correlation among oncology nurses' general self-efficacy, empathy, humanistic care competence, and medical narrative competence. Mediating effects were analyzed using Model 6 in the SPSS macro program PROCESS 4.0 plug-in. Bootstrap method was used to repeat the sampling 5 000 times for the chained mediating effect test.Results:A total of 1 104 questionnaires were distributed and the number of valid questionnaires recovered was 931, with a valid recovery rate of 84.33% (931/1 104). Among 931 oncology nurses, the scores of Narrative Competence Scale, Caring Ability Inventory, Chinese version of Jefferson Scale of Empathy, and General Self-Efficacy Scale were (151.52±17.61), (191.68±18.80), (95.31±13.96), and (27.59±6.02), respectively. There was a positive two-by-two correlation among oncology nurses' medical narrative competence, empathy, humanistic care competence, and general self-efficacy ( P<0.01). General self-efficacy and humanistic care competence acted as chain mediators between oncology nurses' empathy and medical narrative competence, with the mediating effect accounting for 43.13% of the total effect. Conclusions:General self-efficacy and humanistic care are mediating variables between oncology nurses' empathy and medical narrative competence. Nursing managers should focus on the cultivation of nurses' empathy, stimulate nurses' self-efficacy, and promote the practice of nursing humanistic care, which in turn improves oncology nurses' medical narrative competence and the quality of nursing services.

Objective:To explore the chain mediating role of general self-efficacy and humanistic care competence between oncology nurses' empathy and medical narrative competence, with a view to informing the development of targeted medical narrative competence enhancement strategies.Methods:Convenience sampling was used to select 1 104 oncology nurses from 17 ClassⅢ Grade A hospitals in Yunnan Province from May to August 2023 for the study. The General Information Questionnaire, Narrative Competence Scale, Chinese version of the Jefferson Scale of Empathy, Caring Ability Inventory, and General Self-Efficacy Scale were used to survey oncology nurses. Pearson correlation was used to analyze the correlation among oncology nurses' general self-efficacy, empathy, humanistic care competence, and medical narrative competence. Mediating effects were analyzed using Model 6 in the SPSS macro program PROCESS 4.0 plug-in. Bootstrap method was used to repeat the sampling 5 000 times for the chained mediating effect test.Results:A total of 1 104 questionnaires were distributed and the number of valid questionnaires recovered was 931, with a valid recovery rate of 84.33% (931/1 104). Among 931 oncology nurses, the scores of Narrative Competence Scale, Caring Ability Inventory, Chinese version of Jefferson Scale of Empathy, and General Self-Efficacy Scale were (151.52±17.61), (191.68±18.80), (95.31±13.96), and (27.59±6.02), respectively. There was a positive two-by-two correlation among oncology nurses' medical narrative competence, empathy, humanistic care competence, and general self-efficacy ( P<0.01). General self-efficacy and humanistic care competence acted as chain mediators between oncology nurses' empathy and medical narrative competence, with the mediating effect accounting for 43.13% of the total effect. Conclusions:General self-efficacy and humanistic care are mediating variables between oncology nurses' empathy and medical narrative competence. Nursing managers should focus on the cultivation of nurses' empathy, stimulate nurses' self-efficacy, and promote the practice of nursing humanistic care, which in turn improves oncology nurses' medical narrative competence and the quality of nursing services.

Objective:To analyze the correlation between the skin temperature variation trajectory in the radiation field and the occurrence of grade 2 or higher radiation dermatitis in female breast cancer patients during postoperative radiotherapy.Methods:This prospective cohort study used convenience sampling to select 103 breast cancer patients who underwent modified radical mastectomy and subsequent radiotherapy at the Fourth Hospital of Hebei Medical University from May 2022 to December 2022. All patients received three-dimensional conformal radiotherapy (3D-CRT), with an irradiation field covering the chest wall ± supraclavicular and infraclavicular lymphatic drainage regions, and a prescribed dose of 50 Gy delivered in 25 fractions. Skin temperature in the irradiated area was measured using an infrared thermometer before radiotherapy and on the days of the 5 th, 10 th, 15 th, 20 th, and 25 th fractions. The latent classes of skin temperature variation trajectories were identified using the Mplus latent class growth model, and logistic regression was applied to analyze the correlation between the skin temperature variation trajectory and the occurrence of grade 2 or higher radiation dermatitis. Results:The skin temperature variation trajectories in the irradiated field of breast cancer patients undergoing postoperative radiotherapy could be divided into two groups: the temperature non-increasing group (81/103) and the temperature increasing group (22/103). The Akaike information criterion (AIC) was 66.468, the Bayesian information criterion (BIC) was 116.528, and the entropy was 0.810, with a likelihood ratio test P-value of 0.037, and a Bootstrap-based likelihood ratio test P-value<0.001. After adjusting for covariates such as age and body mass index, logistic regression analysis showed that the risk of developing grade 2 or higher radiation dermatitis in the temperature increasing group was 6.92 times of that in the temperature non-increasing group ( OR=6.92, 95% CI = 2.30-20.82, P=0.001). Conclusions:There is group heterogeneity in the skin temperature variation trajectories of breast cancer patients undergoing radiotherapy, and patients with a rise in skin temperature have a higher risk of developing grade 2 or higher acute radiation dermatitis.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Purpose: This study aimed to elucidate whether lncRNA ZFAS1 is involved in neuronal apoptosis and inflammation in temporal lobe epilepsy (TLE). Materials and Methods: Ninety-six TLE patients were recruited, and their peripheral venous blood was gathered to determine Zfas1 expression with polymerase chain reaction. Neurons were separated from hippocampal tissue of newborn SD rats, and siZfas1 or pcDNA3.1-Zfas1 was transfected into the neurons. Inflammatory cytokines released by neurons were determined, and neuronal activities were evaluated through MTT assay, colony formation assay, and flow cytometry. Results: Serum levels of Zfas1 were higher in TLE patients than in healthy controls (p<0.05). Furthermore, Zfas1 expression in neurons was raised by pcDNA3.1-Zfas1 and declined after silencing of Zfas1 (p<0.05). Transfection of pcDNA-Zfas1 weakened the viability and proliferation of neurons and increased neuronal apoptosis (p<0.05). Meanwhile, pcDNA3.1-Zfas1 transfection promoted lipopolysaccharide-induced release of cytokines, including tumor necrosis factor-α, interleukin (IL)-1, IL-6, and intercellular adhesion molecule-1 (p<0.05), and boosted NF-κB activation by elevating the expression of NF-κB p65, pIκBα, and IKKβ in neurons (p<0.05). Conclusion Our results indicated that lncRNA ZFAS1 exacerbates epilepsy development by promoting neuronal apoptosis and inflammation, implying ZFAS1 as a promising treatment target for epilepsy.

Objective To explore the function of BCRP in ovary cancer and establisment of BCRP expressing ovary cancer cell line 3AO/BCRP.Methods We construct the BCRP expressing cell line 3AO/BCRP.Extract the total RNA of MCF-7 cells,clone the whole length of BCRP gene by RT-PCR and ligate the gene to pcDNA3.1(-),transfect the positive clones to 3AO cells and select positive cell clones with G418,identify the survival cells by MTT,efflux assay,western blot.Results The multidrug resistance index of 3AO/BCRP to mitoxantrone increased to 11.58 times;the efflux of 3AO/BCRP to mitoxantrone enhanced;the relative level of BCRP mRNA in 3AO/BCRP increased and western blot indicate that the 3AO/BCRP cells can express more protein than 3AO cells.Conclusion 3AO/BCRP is a reliable BCRP expressing cell model,the establishment of this cell line has laid basis for further study of the mechanism of BCRP.

OBJECTIVE Evaluation of imaging navigation system during endoscopic sinus surgury and compared endoscopic sinus surgery with and without image guidance, analyzing a number of parameters that can impact on efficacy. METHODS Retrospective review of 76 imaging-navigated endoscopic sinus surgery with image-guidance systems at our department between Jan 2000 and May 2003, including 20 consecutive pituitary adenoma patients and 10 nasal-sinus ossifying fibroma. The control group consisted of 10 nasal-sinus ossifying fibroma patients between Jan 1997 and May 2003 and 20 consecutive pituitary adenoma patients between Jan 1999 and May 2003 who underwent ESS without image guidance. The main outcomes measured were analysis of the using times of different diseases, the user's satisfication in different diseases, and compared pituitary adenoma/ossifying fibroma ESS with and without image guidance. RESULTS The using times of different diseases are different, the user feel satisfication in all cases but the degree is different with diseases. The patient's characterisitics of the two groups of pituitary adenoma/ossifying fibroma were similar in age and gendle. There are no statistically significant differences in estimated blood loss, operative time, anesthesia time. CONCLUSION Imaging navigation systems in different nasal-sinus diseases are all useful. Our experience illustrates the importance of the learning curve, we believe that the problems we had with those systems were largely operator-dependent and that these can be overcome with proper experience and training. For small group patients, it's no evidence to show in ESS can make more complete resection of nasal-sinus ossifying fibroma, but has evidence to show no more cost.

OBJECTIVE To recognize the frontal recess cells and analyze their distributional characteristics during image navigation assisted endoscopic sinus surgery. METHODS 20 cases(39 sides)of chronic sinusitis with nasal polyps were observed in this study. The fontal recess cells and frontal sinus were opened under the endoscope and the distributional characteristics were observed and recorded, and then confirmed by the image navigation system. RESULTS Centred on frontal sinus ostium, frontal recess cells were divided into three areas: the agger nasi cell(ANC)and frontal cells(FC)are located in front of frontal sinus ostium(FS); frontal septum cells(IFSSC)and terminal cells(RT)are located at the same plane of FS; supra-ethmoidal bulla recess(SBR), frontal bulla cell(FBC)and super-obital cells(SOEC)are in the posterior area. The coincidence of identification for ANC, FCI and II, SBR, FBC and IFSSC under endoscope and image navigation is 100%, the coincidence of identification for FS is 89.7%, SOEC 80%, RT 71.4% and FC III and IV 60%. CONCLUSION The distribution of the frontal recess cells around the frontal ostium showed a fixed pattern.It would well benefit the orientation of frontal ostium and the opening of frontal sinus. Furthermore, it is significant for the orientation and opening of the frontal recess cells.