Objective:To observe the effectiveness and safety of different doses of esketamine combined with propofol for intravenous administration in the child patients undergoing enhanced computed tomography(CT)examination,and to clarify the optimal clinical dose of esketamine in combination with propofol for sedation.Methods:This study is a randomized,controlled,double-blind(blinded to subjects and evaluators),and single-center clinical trial.A total of 120 preschool children undergoing enhanced CT examination were randomly divided into propofol group(P group),propofol+0.3 mg·kg-1 esketamine group(P+K3 group),and propofol+0.5 mg·kg-1 esketamine group(P+K5 group),and there were 40 cases in each group.All the children were given 2mg·kg-1 propofol,and additional propofol was administered in increments of 1 mng·kg-1 until the sedation criteria for entering the CT room were met[Modified Observer's Assessment of Alertness/Sedation(MOAA/S)score ≤3].The vital signs of the children were observed and recorded at four time points:before sedation(T0),when sedation was satisfactory(T1),during contrast agent injection(T2),and upon awakening(T3).The examination time,time to satisfactory sedation(from the start of sedation to MOAA/S score≤3),and awakening time(from the end of the examination to MOAA/S score＞4)of the children in various groups were recorded.The total dose of propofol and the proportion of cases requiring additional propofol were compared among various groups.Adverse reactions during induction,examination,and after awakening were also compared among various groups.Results:There were no significant differences in general conditions of the children in three groups(P＞0.05).Hemodynamic parameters:at T2,compared with P group,the SpO2 levels of the children in P+K3 group and P+K5 group were increased(P＜0.05);at T1,compared with P group,the SBP levels of the children in P+K3 group and P+K5 group were increased(P＜0.05).There were no significant differences in examination time of the children in three groups(P＞0.05).Compared with P group and P+K3 group,the time to satisfactory sedation of the children in P+K5 group was shorter(P＜0.05).Compared with P group,the awakening time of the children in P+K3 group and P+K5 group was shorter(P＜0.05).Compared with P group and P+K3 group,the total dose of propofol of the children in P+K5 group was decreased(P＜0.05),and the proportion of cases requiring additional propofol was lower(P＜0.05).Adverse reaction indicators:compared with P group,the incidence of respiratory depression of the children in P+K3 group and P+K5 group was lower(P＜0.05),and the incidence of nausea and vomiting was lower(P＜0.05).Compared with P group and P+K3 group,the incidence of movement during the examination of the children in P+K5 group was lower(P＜0.05),and the incidence of dizziness was higher(P＜0.05).There were no significant differences in the incidence of increased airway secretions of the children in three groups(P＞0.05).Conclusion:The use of 0.5 mg·kg-1 esketamine combined with 2 mg·kg-1 propofol for intravenous administration in the child patients for enhanced CT examination sedation can improve the efficiency of such examinations and offers high safety and effectiveness.

Objective:To explore the application of the early clinical exposure concept-guided question-answer teaching model combined with the ORTCC (objectives, rules, training, check, and culture) model in endocrine teaching reform.Methods:Sixty-two students who interned at Beijing Anzhen Hospital of Capital Medical University from August 2022 to August 2023 were divided into control group and observation group according to the order of student number, with 31 students in each group. The control group received traditional teaching, while the observation group received early clinical exposure concept-guided question-answer teaching combined with the ORTCC model. At the end of the internship, the two groups were compared in terms of theoretical and practical assessment scores and comprehensive competency assessment scores. SPSS 22.0 was used to perform the t-test. Results:The theoretical assessment score of the control group was (87.00±3.86) points, while that of the observation group was (91.26±4.34) points, with a statistically significant difference between the two groups ( t=4.09, P<0.001). The observation group also showed significantly higher scores of clinical practice assessment and comprehensive competency assessment than the control group ( P<0.05). Conclusions:The combination of question-answer teaching guided by the early clinical exposure concept and the ORTCC model is helpful for endocrine interns to master theoretical knowledge and acquire clinical practical skills and comprehensive abilities, effectively improving the quality of internship teaching.

Objective:To explore and describe clinicopathological characteristics and prognosis of patients with double primary breast cancer (BC) and thyroid cancer (TC).Methods:Medical records of 98 patients diagnosed with double primary breast and thyroid cancer in National Cancer Center (NCC)/Cancer Hospital between January 1, 2001 and December 31, 2020 were retrospectively collected. All of the patients were followed up until January 1, 2021 to acquire survival data. Univariate survival analysis was conducted by Kaplan-Meier method, and multivariate survival analysis was carried out using the Cox proportional hazard model.Results:All of 98 patients in the group were women. The age at diagnosis of the first tumor ranged from 26-72 years old, and the median age was 47 years old. The BC recurring TC (breast methyl) group included 18 cases, TC recurring BC (methyl breast) group included 60 cases, BC and TC simultaneously occurred group (the two are diagnosed within 3 months) included 20 cases. There were statistically significant differences in breast cancer pathological grading, breast cancer postoperative radiotherapy, and combined with other tumors in breast methyl group, methyl breast group and the simultaneous group ( P<0.05). Among the 98 patients, 14 had recurrence and metastasis, and 7 died. The patients who died from tumors were all those with TC recurrence of BC. There were no statistically significant differences in the death, recurrence and metastasis of patients in the breast methyl group, methyl breast group and the simultaneous group ( P>0.05). Univariate analysis showed that BC stage and estrogen receptor (ER) were related to overall survival ( P<0.05), while the family history of BC, BC stage, and ER were not related with the recurrence and metastasis ( P<0.05). Multivariate analysis showed that BC family history, ER positive, and the order of tumor diagnosis (TC recurring BC) were independent influencing factors for the recurrence and metastasis ( P<0.05). Conclusion:ER negative is a poor prognostic factor for the double primary breast and thyroid cancer.

Objective:To explore and describe clinicopathological characteristics and prognosis of patients with double primary breast cancer (BC) and thyroid cancer (TC).Methods:Medical records of 98 patients diagnosed with double primary breast and thyroid cancer in National Cancer Center (NCC)/Cancer Hospital between January 1, 2001 and December 31, 2020 were retrospectively collected. All of the patients were followed up until January 1, 2021 to acquire survival data. Univariate survival analysis was conducted by Kaplan-Meier method, and multivariate survival analysis was carried out using the Cox proportional hazard model.Results:All of 98 patients in the group were women. The age at diagnosis of the first tumor ranged from 26-72 years old, and the median age was 47 years old. The BC recurring TC (breast methyl) group included 18 cases, TC recurring BC (methyl breast) group included 60 cases, BC and TC simultaneously occurred group (the two are diagnosed within 3 months) included 20 cases. There were statistically significant differences in breast cancer pathological grading, breast cancer postoperative radiotherapy, and combined with other tumors in breast methyl group, methyl breast group and the simultaneous group ( P<0.05). Among the 98 patients, 14 had recurrence and metastasis, and 7 died. The patients who died from tumors were all those with TC recurrence of BC. There were no statistically significant differences in the death, recurrence and metastasis of patients in the breast methyl group, methyl breast group and the simultaneous group ( P>0.05). Univariate analysis showed that BC stage and estrogen receptor (ER) were related to overall survival ( P<0.05), while the family history of BC, BC stage, and ER were not related with the recurrence and metastasis ( P<0.05). Multivariate analysis showed that BC family history, ER positive, and the order of tumor diagnosis (TC recurring BC) were independent influencing factors for the recurrence and metastasis ( P<0.05). Conclusion:ER negative is a poor prognostic factor for the double primary breast and thyroid cancer.

As indications of radiotherapy in the treatment of breast cancer continue to expand, more and more patients need radiotherapy after mastectomy. With the development of breast reconstruction, radiotherapy and its timing will affect breast reconstruction while patients benefit from tumor treatment and may lead to different postoperative complications and cosmetic effects. How to optimize the comprehensive therapeutic strategies of postoperative breast reconstruction and radiotherapy for breast cancer, especially the techniques of breast reconstruction and the choices of radiotherapy timing, has become an issue of common concerns of multidisciplinary treatment involving radiotherapy, breast surgery, and plastic surgery. This paper aims to review and summarize the latest high-quality research in this field including the impact of radiotherapy and its timing on tissue expander/prosthetic breast reconstruction, rate of prosthetic reconstruction, and postoperative patient satisfaction so that scholars can understand the latest research progress of radiotherapy and breast reconstruction and clinicians can optimize therapeutic regimens.

Objective: To study the expression of H O X A 1 0 gene in endometrial carcinoma and its effect on the apoptosis, migration and invasion of Ishikawa cells. Methods: Twenty-one cases of endometrial carcinoma tissue samples and 25 cases of normal endometrial tissue samples from patients treated at the Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital from 2012 to 2013 were collected for this study. The mRNA and protein expressions of H O X A 1 0 in endometrial carcinoma and normal endometrial tissues were separately tested by Realtime-qPCR (qRT-PCR) and Western blotting. Ishikawa cells were infected with adenovirus-flagHOXA10 at different multiplicity (5, 10, 20 MOI), and infected by adenovirus-flag-lacz (20 MOI) as control; And the cell apoptosis was tested by Flow Cytometry. Ishikawa cells were transfected with 50 nmol/L si-HOXA10 plasmids and 50 nmol/L si-NC plasmids, as down-regulation group and down-regulation control group, respectively. Ishikawa cells were infected with 20 MOI adenovirus-flagHOXA10 and 20 MOI adenovirus-flag-lacz, as up-regulation group and up-regulation control group, respectively. The ability of migration and invasion was detected by transwell assay. Results: The results of qRT-PCR and Western blotting showed that the expressions of H O X A 1 0 mRNA and protein in endometrial carcinoma samples were both significantly lower than normal samples [mRNA: (0.56± 0.14)vs (1.36±0.33), P<0.01; protein: (1.01±0.25) vs (2.10±0.71), P<0.001]. After the up-regulation of H O X A 1 0 gene in Ishikawa cell line, the cell apoptosis rate in ad-flag-HOXA10 groups (5, 10, 20 MOI) was significantly raised, and most of which was in the early apoptosis [(50.92±8.79)%, (55.17±4.07)%, (76.10±3.65)% vs (7.74 ± 0.15)%, all P <0.01]. The number of migrated cells was markedly up-regulated in si-HOXA10 group [(248±25) vs (135±15), P <0.01] but markedly down-regulated in ad-flag-HOXA10 group [(50±6) vs (100±13), P <0.01]. The number of invasive cells was markedly up-regulated in si-HOXA10 group [(131±18) vs (66±9), P <0.01] but markedly down-regulated in ad-flag-HOXA10 group [(34±8) vs (60±4), P <0.01]. Conclusions: Both mRNAand protein expressions of H O X A 1 0 were down-regulated in endometrial carcinoma samples than in normal endometrium. Up-regulation of H O X A 1 0 gene in Ishi kawa cell line can promote cell apoptosis and inhibit cell migration and invasion.

Objective Oxidative stress (OS) plays a crucial role in ischemic stroke. Grape seed procyanidin extract (GSPE) was reported to be a critical regulator of OS. We hypothesized that GSPE might also be protective in ischemia-reperfusion brain injury. This study aimed to explore whether GSPE administration can protect mice from ischemia-reperfusion brain injury.Methods Transient middle cerebral artery occlusion (MCAO) was conducted followed by reperfusion for 24 hours to make ischemia-reperfusion brain injury in mice that received GSPE (MCAOG, n=60) or normal saline (MCAONS, n=60). Sham-operated mice (GSPE group and normal saline group) were set as controls. The neurological severity score (NSS) was used to evaluate neural function impairment 1 hour, 24 hour, 3 days and 7 days after MCAO. Mice underwent brain T2WI imaging with a 3T animal MRI scanner 24 hours after reperfusion, and the stroke volume of brains were calculated according to abnormal signal intensity. Immunohistopathological analysis of brain tissues at 24 h after reperfusion was performed for neuronal nuclear antigen (NeuN), CD34, Bcl-2, and Bax. Glutathione peroxidation (GSH-Px) activity and the level of malonaldehyde (MDA) of brain tissue were also examined. The above indexes were compared among the groups statistically.Results Significant functional improvement was observed 24 hours after MCAO in MCAOG group compared to MCAONS group (P<0.05). MCAOG group had smaller cerebral stroke volume (22.46 ± 11.45 mmvs. 47.84±9.06 mm, P<0.05) than MCAONS group 24 hours after MCAO. More mature NeuN-immunoreactive neurons and more CD34-positive cells in peri-infarct zones were observed in brain tissue of MCAOG mice 24 h after MCAO than that of MCAONS mice (both P<0.05). MCAONS mice had significantly higher number of Bax-positive cells in brain tissue than MCAOG (P<0.05). The mean MDA level was significantly lower (P<0.05) and the GSH-Px activity was significantly higher (P<0.05) in brains of MCAOG mice compared to those of MCAONS mice.Conclusion GSPE administration protects mice from ischemia-reperfusion brain injury through attenuating oxidative stress and apoptosis, promoting angiogenesis, and activating antioxidant enzyme GSH-Px. GSPE may represent a new therapeutical direction for the treatment of ischemia-reperfusion brain injury.
Animals ; Apoptosis ; drug effects ; Brain ; blood supply ; Glutathione Peroxidase ; metabolism ; Grape Seed Extract ; pharmacology ; Infarction, Middle Cerebral Artery ; Male ; Mice ; Mice, Inbred C57BL ; Neuroprotective Agents ; pharmacology ; Oxidative Stress ; Proanthocyanidins ; pharmacology ; Reperfusion Injury ; drug therapy ; metabolism

Based on the introduction of the concept and characteristics of the wearable medical devices,the paper elaborates the development situation of wearable medical devices at home and abroad,focuses on the statement of the functions of wearable medical devices in medical practice including achieving dynamic monitoring,providing medical diagnosis data,finding out the causes of diseases,achieving early treatment of diseases,promoting medical level,improving medical techniques,and relieving the situation of medical resources shortage of China,and meanwhile analyzes the problems of wearable medical devices and the healthcare industry.

Early diagnosis and intervention is an important way to delay the progress of Alzheimer′s disease (AD).Compared with cerebrospinal fluid, blood sampling is not invasive and easy to be obtained in clinic practice.In this study, the serum samples of 9 controls, 10 AD and 12 mild cognitive dysfunction (MCI) patients were analyzed and compared through one by one analysis to screen potential markers for AD diagnosis.The experimental results showed that VGFYESDVMGR of α-2-macroglobulin peptide was closely related to the late stage of AD disease, and the large amount degradation of apolipoprotein C-Ⅲ, histone H1.2 and histone H1.4 was significantly related to early stages of AD progression.The characteristics of serum peptidome were different for the early and late AD, and these four proteins may be used as potential biomarkers of AD disease.In addition, the obvious ladder sequence characteristic was observed for apolipoprotein C-Ⅲ and histone H1, which could partly explain why the peptides distribution in different samples was somewhat contingent.On the contrary, the distribution at protein level was more stable.Finally, it was confirmed that the peptides of proteins such as fibrinogen α-chain, thymosin β-4 and patchy proteins were the dominant peptides in all serum samples.Overall, this study showed that the method of using serum peptidomics to diagnose AD was possible.The results may provide evidence and references for the large-scale clinical validation of AD.

A novel probe (DNSBN) towards biothiols on the basis of 4-hydroxynaphthalimide as fluorophores and 2, 4-dinitrobenzenesulfonyloxy group as specific recognition site was designed and synthesized.The result of absorption and fluorescence spectral analyses indicated that the probe had high sensitivity and selectivity towards cysteine (Cys), homocysteine (Hcy) and glutathione (GSH), and the detection was not affected by other 17 kinds of natural amino acids.Meanwhile, it was confirmed that DNSBN was a ratiometric probe through the fluorescence titration experiment, and the fluorescent intensity at 555 nm had a high linear relationship with biothiols concentration in the range of 0-20 μmol/L.The detection limits (3σ) of Cys, Hcy and GSH were 25.9, 92.0 and 77.9 nmol/L, respectively.The absorption, emission and mass spectra indicated that biothiols could be engaged in nucleophilic substitution reaction with 2,4-dinitrobenzenesulfonate, which induced the sulfonic esters decomposed.With the departure of receptor unit, the d-PeT progress (donor-excited photoinduced electron transfer) was blocked with an obvious colorimetric and fluorescence change.Finally, HeLa cell imaging experiments verified that DNSBN had good biocompatibility and could be used to detect exogenous biothiols.