Objective To investigate the risk factors of hemodynamic instability after carotid artery stenting by meta-analysis.Methods Ten databases were searched:PubMed,ProQuest,ScienceDirect,Embase,Cochrane Library,Web of Science,China Knowledge Network,Wanfang Data,VIP Information Database,and China Biomedical Database.The search date was from inception until 2 February 2024,and meta-analysis was performed using Stata 16.0 statistical software.Results A total of 27 studies with 4199 subjects and 22 influencing factors were included.The studies showed a 37.4％(95％CI 30.3％-44.8％)incidence of haemodynamic instability after carotid stenting,Meta-analysis determined that age＞60 years(P＜0.001),hypertension(P＜0.001),calcified plaque(P＜0.001),stenosis＞70％(P=0.008),eccentric plaque(P=0.002),distance from the largest stenosis to the carotid bifurcation≤ 10 mm(P＜0.001),stenosis involvement of the balloon or bifurcation(P＜0.001),balloon post-dilation(P=0.003),open-loop stenting(P＜0.001),dilated balloon diameter≥5 mm(P=0.002),repeat balloon dilation(P=0.011)and balloon dilation pressure≥8 atm(P＜0.001)are risk factors for intraoperative and postoperative haemodynamic instability in patients undergoing carotid artery stenting surgery.Statin use was a protective factor(P＜0.001).Conclusions Medical staff working in the clinic should assess the patient's condition preoperatively,identify risk factors that may lead to haemodynamic instability,and avoid unnecessary intraoperative stimulation of patients who are already in a high-risk state.Reduce postoperative clinical complications in patients with carotid artery stenosis and improve patient recovery.

AIM To study the chemical constituents from the petroleum ether fraction of the roots of Gypsophila licentiana Hand.-Mazz.METHODS Silica gel,Sephadex LH-20 and semi-preparative HPLC were used for isolation and purification,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Eighteen compounds were isolated and identified as dibutyl phthalate(1),glyceryl arachidate(2),bis(2-ethylhexyl)terephthalate(3),9,12-octadecadienoic acid(Z,Z)-methyl ester(4),(3'S,4'S)-3'-acetoxy-4'-angeloyloxy-3',4'-dihydroseselin(5),3-(4-hydroxy-3-methoxyphenyl)-propanoic acid(6),bis(2-ethylhexyl)phthalate(7),2,2'-oxybis(1,4)-di-tert-butylbenzene(8),gypsogenin(9),3-keto,16α-hydroxy,24-noroleanolic acid(10),3-oxo-olean-12-en-28-oic acid(11),10-eicosenoic acid(12),hexacosanic acid(13),enniatin B(14),(R,Z)-21-methyl-8-pentatriacontene(15),ethyl gallate(16),stellarine A(17),pentacosane(18).CONCLUSION All compounds are isolated from this plant for the first time.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective:To detect the level of N6-methyladenosine(m6A)methylation modifier regulator in peripheral blood mononuclear cell(PBMC)of patients with rheumatoid arthritis(RA),and to investigate its expression level and clinical significance in RA.Methods:PBMC from 50 RA patients and 36 healthy controls(HC)were examined by RT-qPCR to compare the mRNA expres-sion levels of m6A methylation modifier regulators(METTL3,METTL14,WTAP,ALKBH5,FTO,YTHDF2)on PBMC from RA and HC groups and their correlation with laboratory test data was analyzed.Results:①The expression levels of m6A methylation modifica-tion regulators on PBMC in peripheral blood were significantly lower in the RA group than in the HC group,and the differences were statistically significant;②The expression levels of METTL3,METTL14,WTAP and YTHDF2 on PBMC of RA patients were negatively correlated with rheumatoid factor;③The expression levels of YTDHF2 on PBMC of RA patients were negatively correlated with inflam-matory indexes CRP,ESR,N,N%,NLR and dNLR,and positively correlated with L%and LMR;the expression levels of WTAP on PBMC of RA patients were negatively correlated with N,N%,NLR and dNLR,and positively correlated with L%and LMR;④The expression level of YTDHF2 on PBMC of RA patients increased significantly after treatment,and the difference was statistically signifi-cant;⑤The expression levels of m6A methylation modifier regulators on PBMC of RA patients were positively correlated with each other;⑥Logistic regression analysis showed that the decreased expression levels of FTO and YTHDF2 in PBMC of RA patients were risk factors for the development of RA.Conclusion:The expression levels of m6A methylation-modified regulators on PBMC are gener-ally reduced in the RA group.m6A methylation-modified regulators are clearly correlated with inflammation levels,autoantibody pro-duction and disease severity,and can be used as an indicator to assess the severity and activity of the disease.

Objective:To detect the level of N6-methyladenosine(m6A)methylation modifier regulator in peripheral blood mononuclear cell(PBMC)of patients with rheumatoid arthritis(RA),and to investigate its expression level and clinical significance in RA.Methods:PBMC from 50 RA patients and 36 healthy controls(HC)were examined by RT-qPCR to compare the mRNA expres-sion levels of m6A methylation modifier regulators(METTL3,METTL14,WTAP,ALKBH5,FTO,YTHDF2)on PBMC from RA and HC groups and their correlation with laboratory test data was analyzed.Results:①The expression levels of m6A methylation modifica-tion regulators on PBMC in peripheral blood were significantly lower in the RA group than in the HC group,and the differences were statistically significant;②The expression levels of METTL3,METTL14,WTAP and YTHDF2 on PBMC of RA patients were negatively correlated with rheumatoid factor;③The expression levels of YTDHF2 on PBMC of RA patients were negatively correlated with inflam-matory indexes CRP,ESR,N,N%,NLR and dNLR,and positively correlated with L%and LMR;the expression levels of WTAP on PBMC of RA patients were negatively correlated with N,N%,NLR and dNLR,and positively correlated with L%and LMR;④The expression level of YTDHF2 on PBMC of RA patients increased significantly after treatment,and the difference was statistically signifi-cant;⑤The expression levels of m6A methylation modifier regulators on PBMC of RA patients were positively correlated with each other;⑥Logistic regression analysis showed that the decreased expression levels of FTO and YTHDF2 in PBMC of RA patients were risk factors for the development of RA.Conclusion:The expression levels of m6A methylation-modified regulators on PBMC are gener-ally reduced in the RA group.m6A methylation-modified regulators are clearly correlated with inflammation levels,autoantibody pro-duction and disease severity,and can be used as an indicator to assess the severity and activity of the disease.

Objective:To observe the application effect of hyperbaric oxygen combined with task oriented training in hemiplegic patients after cerebral infarction.Methods:106 hemiplegic patients after cerebral infarction admitted to Xinglin Hospital of Xiamen from March 2022 to June 2024 were prospectively selected and randomly divided into control group(received task oriented training,n=53)and observation group(received hyperbaric oxygen combined with task oriented training,n=53).Berg balance scale(BBS),clinical spasticity index(CSI),national institute of health stroke Scale(NIHSS),motor function[fugl-meyer motor function assessment scale(FMA),motor assessment scale(MAS)],walking ability[functional ambulation category(FAC),6-minute walking distance(6MWD)],quality of life and self-care ability[quality of life scale for stroke(SS-QOL),activity of daily living(ADL)]before intervention and 8 weeks after intervention were compared between the two groups.Result:Compared with control group 8 weeks after intervention,the observation group had higher BBS,FMA,MAS,FAC,SS-QOL,ADL scores,and 6MWD,while had lower NIHSS and CSI scores(P＜0.05).Conclusion:Hyperbaric oxygen combined with task oriented training in hemiplegic patients after cerebral infarction,can effectively improve patients' motor function,balance ability,and self-care ability,enhance their quality of life,and reduce neurological damage.

Objective:To observe the application effect of hyperbaric oxygen combined with task oriented training in hemiplegic patients after cerebral infarction.Methods:106 hemiplegic patients after cerebral infarction admitted to Xinglin Hospital of Xiamen from March 2022 to June 2024 were prospectively selected and randomly divided into control group(received task oriented training,n=53)and observation group(received hyperbaric oxygen combined with task oriented training,n=53).Berg balance scale(BBS),clinical spasticity index(CSI),national institute of health stroke Scale(NIHSS),motor function[fugl-meyer motor function assessment scale(FMA),motor assessment scale(MAS)],walking ability[functional ambulation category(FAC),6-minute walking distance(6MWD)],quality of life and self-care ability[quality of life scale for stroke(SS-QOL),activity of daily living(ADL)]before intervention and 8 weeks after intervention were compared between the two groups.Result:Compared with control group 8 weeks after intervention,the observation group had higher BBS,FMA,MAS,FAC,SS-QOL,ADL scores,and 6MWD,while had lower NIHSS and CSI scores(P＜0.05).Conclusion:Hyperbaric oxygen combined with task oriented training in hemiplegic patients after cerebral infarction,can effectively improve patients' motor function,balance ability,and self-care ability,enhance their quality of life,and reduce neurological damage.

Aim To investigate the therapeutic effects of a newly developed Tadalafil tablet on pulmonary fi-brosis induced by paraquat(PQ)in rats,as well as its impact on histone acetylation levels in epithelial cells.Methods SD rats were randomly divided into four groups:the control group(control),the model group(PQ),the Tadalafil new tablet treatment group(N-Tad,1 mg·kg-1),and the positive control drug treatment group(Cialis,5 mg·kg-1).The model group and treatment group rats were intraperitoneally injected with PQ(30 mg·kg-1).Two hours after the initial treatment,the rats in the treatment group re-ceived N-Tad or Cialis via gavage,while the control and model groups were administered an equal volume of physiological saline by gavage once daily for 28 days.The weight gain rate and lung tissue index for each group of rats were calculated.Additionally,the effects of N-Tad treatment on lung tissue structural damage and collagen deposition in rats with PQ-in-duced pulmonary fibrosis were observed using HE stai-ning,Masson trichrome staining,and immunohisto-chemical techniques.By employing the Western blot technique,the effects of Tadalafil intervention on the expression of the epithelial marker E-cadherin(E-Cad),the stromal marker fibronectin(Fn),and the histone acetylation marker acetylated histones(Ac-his-tones)in A549 cells were observed.Results Com-pared to the control group,rats with PQ-induced pul-monary fibrosis exhibited a significant decrease in the rate of body weight growth,an increase in lung tissue index(P＜0.05),and a notable increase in the expression and distribution of the fibrosis marker alpha-smooth muscle actin(α-SMA)in lung tissue.The structure of the lung tissue was disrupted,accompanied by the deposition of interstitial collagen fibers.Both N-Tad and Cialis treatments could significantly enhance the rate of weight gain,decrease the lung tissue index,inhibit the expression of α-SMA,and reduce the depo-sition of interstitial collagen in the lung tissue of rats with pulmonary fibrosis.Notably,low-dose N-Tad treatment was comparable to high-dose Cialis treat-ment.At the cellular level,Tadalafil significantly in-hibited the high expression of Fn induced by transfor-ming growth factor beta 1(TGF-β1)in A549 cells.It also upregulated the expression of E-cadherin and sig-nificantly increased the levels of acetylated histones(P＜0.05).Conclusions N-Tad promotes histone acetylation in alveolar epithelial cells,significantly in-hibits epithelial-mesenchymal transition,increases E-cadherin expression,and improves lung tissue structur-al damage and collagen deposition caused by PQ.Ad-ditionally,it offers the advantage of a lower effective dose compared to Cialis,providing a new option for the treatment of pulmonary fibrosis.

Objective To investigate the risk factors of hemodynamic instability after carotid artery stenting by meta-analysis.Methods Ten databases were searched:PubMed,ProQuest,ScienceDirect,Embase,Cochrane Library,Web of Science,China Knowledge Network,Wanfang Data,VIP Information Database,and China Biomedical Database.The search date was from inception until 2 February 2024,and meta-analysis was performed using Stata 16.0 statistical software.Results A total of 27 studies with 4199 subjects and 22 influencing factors were included.The studies showed a 37.4％(95％CI 30.3％-44.8％)incidence of haemodynamic instability after carotid stenting,Meta-analysis determined that age＞60 years(P＜0.001),hypertension(P＜0.001),calcified plaque(P＜0.001),stenosis＞70％(P=0.008),eccentric plaque(P=0.002),distance from the largest stenosis to the carotid bifurcation≤ 10 mm(P＜0.001),stenosis involvement of the balloon or bifurcation(P＜0.001),balloon post-dilation(P=0.003),open-loop stenting(P＜0.001),dilated balloon diameter≥5 mm(P=0.002),repeat balloon dilation(P=0.011)and balloon dilation pressure≥8 atm(P＜0.001)are risk factors for intraoperative and postoperative haemodynamic instability in patients undergoing carotid artery stenting surgery.Statin use was a protective factor(P＜0.001).Conclusions Medical staff working in the clinic should assess the patient's condition preoperatively,identify risk factors that may lead to haemodynamic instability,and avoid unnecessary intraoperative stimulation of patients who are already in a high-risk state.Reduce postoperative clinical complications in patients with carotid artery stenosis and improve patient recovery.