Objective To observe the value of digital subtraction angiography(DSA)iFlow parameters for predicting major amputation in patients with acute lower limb ischemia(ALLI)within 30 days after revascularization operation.Methods Totally 310 ALLI patients who underwent revascularization operation were retrospectively included and divided into major amputation group(n=36)and non-major amputation group(n=274)according to major amputation within 30 days after revascularization operation or not.iFlow parameters,including time to peak(TTP)and the Peak were obtained after processing of DSA images after revascularization.Receiver operating characteristic(ROC)curves were used to screen the optimal cut-off value of TTP and Peak for predicting major amputation post operation,and then TTP and Peak were dichotomized.The dichotomized TTP and Peak variables and other variables were admitted into a multivariate logistic regression to identify independent predictors of major amputation.Results TTP was higher and Peak was lower in major amputation group than those in non-major amputation group(both P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of TTP and Peak for predicting major amputation within 30 days post operation was 0.831 and 0.712,respectively,and the optimal cut-off value was 16 s and 1.53,respectively.Multivariate logistic regression analysis revealed that atrial fibrillation(AF)[OR(95％CI)=3.048(1.076,8.632)],livid skin appearance[OR(95％CI)=6.035(2.323,15.677)],TTP≥16 s after revascularization operation[OR(95％CI)=8.414(3.116,22.723)]and high myoglobin levels measured 48 h after operation[OR(95％CI)=1.001(1.001,1.001)]were all independent predictors of major amputation within 30 days in ALLI patients,but dichotomized Peak variable was not an independent predictor[OR(95％CI)=0.485(0.183,1.283),P=0.145].Conclusion TTP obtained through DSA iFlow was valuable for predicting major amputation in ALLI patients within 30 days after revascularization operation.

Objective To investigate the expression of Nucleophosmin 3(NPM3)in lung adenocarcinoma and its impact on the biological functions of the lung adenocarcinoma cell line H 292,with the goal of providing innovative insights for the diagno-sis and therapeutic strategies of lung adenocarcinoma.Methods The differential expression of the NPM3 gene between lung ad-enocarcinoma and normal controls was analyzed,along with its correlation with the clinicopathological characteristics and prog-nosis of lung adenocarcinoma patients,using the TCGA bioinformatics database.A cell model with reduced NPM3 expression(si-NPM3-H292)was developed by gene interference technology,and the efficiency of this knockdown was assessed by real-time fluorescence quantitative PCR(qRT-PCR)and Western blotting.The impact of NPM3 knockdown on the proliferative capacity of lung adenocarcinoma cells was evaluated by using CCK-8 and plate clone formation assays.The scratch and Transwell assays were employed to assess the effect of NPM 3 knockdown on the migratory potential of H 292 cells.The mRNA and protein ex-pression levels of markers associated with epithelial-mesenchymal transition(EMT)were determined by qRT-PCR and Western blotting.Additionally,the expression levels of proteins involved in the PI3K/Akt signaling pathway were examined by Western blotting.Results Analysis of the TCGA database indicated that NPM 3 is highly expressed in lung adenocarcinoma and is sig-nificantly associated with the clinicopathological classification of lung adenocarcinoma patients.The survival outcomes for pa-tients with high NPM 3 expression were notably worse than those with low expression(P＜0.05).The knockdown cell model was successfully established,and the proliferation and migration capabilities of H292 cells were significantly diminished after NPM3 knockdown(P＜0.05).Compared to the control group,mRNA and protein levels of E-cadherin were increased in si-NPM 3-H292 cells,while the expression level of N-cadherin was reduced at both mRNA and protein levels(P＜0.05).Although no significant change was observed in the protein expressions of Akt and PI3K in si-NPM3-H292 cells compared to the control,there was a decrease in phosphorylation levels,accompanied by an increase in protein expression of PTEN(P＜0.05).Conclusion NPM3 is highly expressed in lung adenocarcinoma,which is associated with poor prognosis of patients.NPM3 may facilitate the proliferation and migration of lung adenocarcinoma cells through regulation of the PI 3K/Akt signaling pathway.

After being treated with acupuncture, some patients with idiopathic tinnitus may experience a short-term aggravation of tinnitus symptoms on the original basis. These symptoms can be gradually relieved and the overall condition fluctuates towards recovery. This phenomenon has brought some difficulties to patients and clinicians. Based on the academic view of TCM, "destroying pathogens and re-building balance", and in association with the existing understanding of acupuncture in modern medicine for tinnitus, this paper briefly discusses the mechanism and influencing factors of symptom fluctuation in patients with idiopathic tinnitus after acupuncture treatment in terms of both TCM and modern medicine, and proposes the future direction in the research of symptom fluctuation, so as to promote the recognition of clinicians and patients on symptom fluctuation and make rational use of its positive effects. Besides, it is hoped that more researchers will pay attention to symptom fluctuation and advance the exploration of it in academic field.
Humans ; Tinnitus/physiopathology* ; Acupuncture Therapy ; Male ; Female

To summarize the nursing care for a patient with extremely severe obese and multiple myeloma complicated with status epilepticus.The key points of nursing include:a multidisciplinary rescue team was established to accurately and comprehensively assess the patient's obesity level;based on the degree of obesity,a goal-directed sedation and analgesia strategy was implemented;airway management measures were optimized for difficult intubation,and lung-protective ventilation strategies were strictly followed with adjusted mechanical ventilation parameters;implementing precise fluid management,closely monitoring electrolyte levels,and reducing triggers for seizure episodes;sequential nutrition support combined with trophic feeding was provided,along with personalized enteral nutrition;early mobilization was initiated to prevent deep vein thrombosis;a skin protection strategy was implemented to establish a safe skin barrier.After meticulous treatment and nursing care,the patient's condition improved,and she was discharged.

To summarize the nursing care for a patient with extremely severe obese and multiple myeloma complicated with status epilepticus.The key points of nursing include:a multidisciplinary rescue team was established to accurately and comprehensively assess the patient's obesity level;based on the degree of obesity,a goal-directed sedation and analgesia strategy was implemented;airway management measures were optimized for difficult intubation,and lung-protective ventilation strategies were strictly followed with adjusted mechanical ventilation parameters;implementing precise fluid management,closely monitoring electrolyte levels,and reducing triggers for seizure episodes;sequential nutrition support combined with trophic feeding was provided,along with personalized enteral nutrition;early mobilization was initiated to prevent deep vein thrombosis;a skin protection strategy was implemented to establish a safe skin barrier.After meticulous treatment and nursing care,the patient's condition improved,and she was discharged.

Objective To investigate the expression of Nucleophosmin 3(NPM3)in lung adenocarcinoma and its impact on the biological functions of the lung adenocarcinoma cell line H 292,with the goal of providing innovative insights for the diagno-sis and therapeutic strategies of lung adenocarcinoma.Methods The differential expression of the NPM3 gene between lung ad-enocarcinoma and normal controls was analyzed,along with its correlation with the clinicopathological characteristics and prog-nosis of lung adenocarcinoma patients,using the TCGA bioinformatics database.A cell model with reduced NPM3 expression(si-NPM3-H292)was developed by gene interference technology,and the efficiency of this knockdown was assessed by real-time fluorescence quantitative PCR(qRT-PCR)and Western blotting.The impact of NPM3 knockdown on the proliferative capacity of lung adenocarcinoma cells was evaluated by using CCK-8 and plate clone formation assays.The scratch and Transwell assays were employed to assess the effect of NPM 3 knockdown on the migratory potential of H 292 cells.The mRNA and protein ex-pression levels of markers associated with epithelial-mesenchymal transition(EMT)were determined by qRT-PCR and Western blotting.Additionally,the expression levels of proteins involved in the PI3K/Akt signaling pathway were examined by Western blotting.Results Analysis of the TCGA database indicated that NPM 3 is highly expressed in lung adenocarcinoma and is sig-nificantly associated with the clinicopathological classification of lung adenocarcinoma patients.The survival outcomes for pa-tients with high NPM 3 expression were notably worse than those with low expression(P＜0.05).The knockdown cell model was successfully established,and the proliferation and migration capabilities of H292 cells were significantly diminished after NPM3 knockdown(P＜0.05).Compared to the control group,mRNA and protein levels of E-cadherin were increased in si-NPM 3-H292 cells,while the expression level of N-cadherin was reduced at both mRNA and protein levels(P＜0.05).Although no significant change was observed in the protein expressions of Akt and PI3K in si-NPM3-H292 cells compared to the control,there was a decrease in phosphorylation levels,accompanied by an increase in protein expression of PTEN(P＜0.05).Conclusion NPM3 is highly expressed in lung adenocarcinoma,which is associated with poor prognosis of patients.NPM3 may facilitate the proliferation and migration of lung adenocarcinoma cells through regulation of the PI 3K/Akt signaling pathway.

Objective To observe the value of digital subtraction angiography(DSA)iFlow parameters for predicting major amputation in patients with acute lower limb ischemia(ALLI)within 30 days after revascularization operation.Methods Totally 310 ALLI patients who underwent revascularization operation were retrospectively included and divided into major amputation group(n=36)and non-major amputation group(n=274)according to major amputation within 30 days after revascularization operation or not.iFlow parameters,including time to peak(TTP)and the Peak were obtained after processing of DSA images after revascularization.Receiver operating characteristic(ROC)curves were used to screen the optimal cut-off value of TTP and Peak for predicting major amputation post operation,and then TTP and Peak were dichotomized.The dichotomized TTP and Peak variables and other variables were admitted into a multivariate logistic regression to identify independent predictors of major amputation.Results TTP was higher and Peak was lower in major amputation group than those in non-major amputation group(both P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of TTP and Peak for predicting major amputation within 30 days post operation was 0.831 and 0.712,respectively,and the optimal cut-off value was 16 s and 1.53,respectively.Multivariate logistic regression analysis revealed that atrial fibrillation(AF)[OR(95％CI)=3.048(1.076,8.632)],livid skin appearance[OR(95％CI)=6.035(2.323,15.677)],TTP≥16 s after revascularization operation[OR(95％CI)=8.414(3.116,22.723)]and high myoglobin levels measured 48 h after operation[OR(95％CI)=1.001(1.001,1.001)]were all independent predictors of major amputation within 30 days in ALLI patients,but dichotomized Peak variable was not an independent predictor[OR(95％CI)=0.485(0.183,1.283),P=0.145].Conclusion TTP obtained through DSA iFlow was valuable for predicting major amputation in ALLI patients within 30 days after revascularization operation.

Objective The purpose of writing the"Expert consensus on the prevention and control of intracranial hypertension in adult critical illness"(here in after referred to as the"Consensus")aimed to standardize the nursing work related to the prevention and control of elevated intracranial pressure in adult critical illness,and prevent the occurrence of complications such as cerebral herniation.Methods Guided by evidence-based practice,domestic and foreign databases were searched for guidelines,expert consensuses,systematic evaluation,evidence summaries,and original research related to increased intracranial pressure.The search period is from database establishment to March 2024.The high-quality evidence and suggestions in the field was evaluated,extracted,and summarized to form a preliminary consensus.27 experts were invited to conduct 2 rounds of expert inquiry and 8 experts were invited to conduct 2 expert discussion meetings,to revise and improve the content of the initial draft,and to ultimately form a final consensus.Results The effective response rates for both rounds of inquiry questionnaires were 100％,with expert authority coefficients of 0.884,judgment coefficients of 0.964,and familiarity levels of 0.804.The Kendall harmony coefficients for 2 rounds of inquiry were 0.107 and 0.083(P＜0.01),respectively.The consensus includes 4 aspects,including identification,monitoring,prevention and control strategies,emergency treatment and care for increased intracranial pressure.Conclusion This"Consensus"has strong scientific validity and can provide reference basis for nurses to carry out prevention and control of intracranial pressure increase.

At present, as an acute stressor,COVID-19 has caused different effects on the public physical and mental health.Compared with healthy people, patients with mental illness may report more serious consequences after suffering from acute stress stimulation, such as aggravation of mental illness symptoms, disease recurrence and increased risk of suicide.The incidence rate of mental illness is high in China. Extensive attention should be paid about the impacts of the epidemic on patients with mental disorder.In order to understand the influence of acute stress on the patients with mental diseases,the relevant literatures, published at home and abroad in recent years, was searched and summarized, and the influence of acute stress on the patients with mental diseases was discussed, which would be helpful for psychiatrists to evaluate the changes of patients' condition in time and make reasonable clinical treatment plans.

At present, as an acute stressor,COVID-19 has caused different effects on the public physical and mental health.Compared with healthy people, patients with mental illness may report more serious consequences after suffering from acute stress stimulation, such as aggravation of mental illness symptoms, disease recurrence and increased risk of suicide.The incidence rate of mental illness is high in China. Extensive attention should be paid about the impacts of the epidemic on patients with mental disorder.In order to understand the influence of acute stress on the patients with mental diseases,the relevant literatures, published at home and abroad in recent years, was searched and summarized, and the influence of acute stress on the patients with mental diseases was discussed, which would be helpful for psychiatrists to evaluate the changes of patients' condition in time and make reasonable clinical treatment plans.