Objective:To evaluate the effect of venous excess ultrasound score (VExUS Score) in the acute kidney injury(AKI) in Patients with sepsis, so as to reduce the risk of disease and improve the prognosis of patients.Methods:This experiment was a single-center prospective cohort study. Include septic patients with AKI who were admitted to the Department of Emergency Intensive Care Unit of the First Affiliated Hospital of Anhui Medical University from February 2022 to February 2023, Those with inadequate window, inferior vena cava (IVC) thrombus, age<18 years and known case of cirrhosis with portal hypertension were excluded from the study. Patients underwent ultrasound examination with serial determination till AKI resolved or patient is initiated on dialysis.Results:Totally 86 patients were enrolled for the study. The mean age was (60.43±15.48) with 50 (58.1%) males. Mean sequential organ failure assessment (SOFA) score was (6.23±1.87). 38 patients (44.2%) were in AKI stage 1, while 24 patients (27.9%) were in AKI stage 2 and stage 3 each. 52 patients (60.5%) had VExUS grade Ⅲ. Resolution of AKI injury showed significant correlation with improvement in VExUS grade ( p value 0.003). Similarly, there was significant association between changes in VExUS grade and fluid balance ( p value 0.005). There was no correlation between central venous pressure (CVP), left ventricular function, and right ventricular function with change in VExUS grade. Conclusions:The study shows a significant correlation between the VExUS Score and AKI staging, With improvement in kidney function, there is decline in the VExUS grade as well. Moreover VExUS Score might reliably demonstrate venous congestion and aid in the clinical decision to perform fluid removal.

BACKGROUND:Overweight or obesity is the most significant risk factors for knee osteoarthritis.Time-restricted diet shows an effective effect in preventing overweight or obesity.Whether infrapatellar fat pad,an important component of the knee joint,is affected by time-restricted diet and thus influences knee osteoarthritis remains unclear. OBJECTIVE:To employ a high-fat diet-induced rat model to investigate the effect of weight loss by time-restricted diet on infrapatellar fat pad,thereby providing evidence for early prevention and treatment of obesity-related knee osteoarthritis. METHODS:Fifteen male Sprague-Dawley rats were randomly divided into three groups(n=5 per group).Rats in the control group were allowed to eat at will for 24 hours and were fed the defined control diet(12%fat);rats in the high-fat diet group were allowed to eat at will for 24 hours and were fed the high-fat diet(45%fat);and rats in the high-fat diet with time-restricted diet group were fed the high-fat diet only from 9:00(2 hours after the light)to 17:00(2 hours before the dark).After 8 weeks of feeding,mDixon-Quant sequence was used to assess proton density fat fraction in the infrapatellar fat pad and subcutaneous adipose tissue in the right inguinal region.ELISA was used to quantify differences adipokine.Sirius red staining was used to evaluate changes in fibrosis of the infrapatellar fat pad.The expressions of uncoupling protein-1 in the infrapatellar fat pad and subcutaneous adipose tissue in the right inguinal region as well as leptin,adiponectin and tumor necrosis factor-α in the infrapatellar fat pad were detected by immunohistochemistry staining. RESULTS AND CONCLUSION:After 8 weeks of feeding,compared with the high-fat diet group,the body mass of rats in the control group(P=0.036)and the high-fat diet with time-restricted diet group(P=0.003)was significantly reduced.The proton density fat fraction in the infrapatellar fat pad in the high-fat diet group was significantly higher than that in the control group(P<0.001)and the high-fat diet with time-restricted diet group(P=0.004),while there was no significant difference in the proton density fat fraction of the subcutaneous adipose tissue among the three groups.The serum leptin levels of rats in the high-fat diet group were significantly higher than those in the control group(P=0.030)and the high-fat diet with time-restricted diet group(P=0.018).Compared with the high-fat diet group,the infrapatellar fat pad fibrosis characterized by Sirius red staining in the control group(P<0.001)and the time-restricted diet group(P=0.003)was significantly decreased.The expression of leptin in IFP of the high-fat diet group was significantly higher than that of the control group(P<0.001)and the high-fat diet with time-restricted diet group(P<0.001).The expression of adiponectin in the infrapatellar fat pad of the high-fat diet group was significantly lower than that of the control group(P=0.004)and the high-fat diet with time-restricted feeding group(P=0.048).However,there was no positive expression of uncoupling protein-1 in the infrapatellar fat pad and subcutaneous adipose tissue of all the three groups,and no positive expression of tumor necrosis factor-α in the infrapatellar fat pad.To conclude,time-restricted diet could retard the fibrosis of the infrapatellar fat pad,reduce the proton density fat fraction of the infrapatellar fat pad,and affect the level of adipokine in serum and infrapatellar fat pad.Time-restricted diet may become a simple and effective option for the treatment and prevention of obesity-related knee osteoarthritis.

Objective:To investigate the application value of ultrasound-guided multimodal examinations in the diagnosis of lymph node mycobacterial infection.Methods:The clinical data of 42 patients with suspected lymph node mycobacterial infection who were initially diagnosed at the Affiliated Hospital of Shaoxing University from January 2019 to December 2020 were retrospectively analyzed. All patients underwent an ultrasound-guided lymph node-negative pressure puncture. Acid-fast staining, bacterial culture, pathological examination or their combination were used to screen lymph nodes for mycobacterial infection. The results were compared with those of acid-fast staining and bacterial culture of sputum and bronchoalveolar lavage fluid smears.Results:The combined application of acid fast staining, bacterial culture, and pathological examination for the puncture fluid smear showed a positive rate of 71.4% (30/42), which was significantly higher than the positive rate [26.2% (11/42)] for acid fast staining of the puncture fluid smear, the positive rate [42.9% (18/42)] for bacterial culture of the puncture fluid, and the positive rate [50.0% (21/42)] of pathological examination ( χ2 = 17.20, 7.00, 4.04, P < 0.001, P < 0.01, P = 0.040). The positive rate for sputum smear and bacterial culture was 21.4% (9/33). The positive rate for acid fast staining and bacterial culture of the bronchoalveolar lavage fluid was 28.6% (12/30). The differences were statistically significant ( χ2 = 21.11, 15.43, both P < 0.001). Conclusion:Ultrasound-guided negative pressure aspiration and puncture biopsy of lymph nodes combined with acid fast staining, bacterial culture, and pathological examinations can markedly increase the detection rate and diagnostic rate of mycobacterial infection.

Objective:To investigate the effect of time-restricted feeding (TRF) on bone marrow fat of proximal femur in obese rats induced by high-fat diet (HFD) using proton density fat fraction (PDFF).Methods:Totally 30 male Sprague-Dawley rats were stratified and randomly sampled into 6 subgroups according to body weight, with 5 rats each. Then 2 subgroups were combined into one group, and there were totally 3 groups. The rats in the control group were fed with normal diet, and the rats could eat as much as they wanted for 24 h; the rats in the HFD group were fed with high-fat diet, and the rats could eat as much as they wanted for 24 h; the rats in the HFD+TRF group were fed with high-fat diet only between 9 AM (2 h after light) and 17 PM. One subgroup of rats from each group was examined with MRI on the femur on day 28 of the experiment, and the other subgroup from each group was examined on day 56 to measure the bone marrow PDFF of proximal femur based on mDixon-Quant quantitative sequence images. The rats were executed at the end of the scanning period, and blood samples were collected to measure serum levels of leptin. One-way ANOVA or Kruskal-Wallis H test was used to compare the differences in body weight, PDFF, and serum levels of leptin among 3 groups. The LSD- t test was used for multiple comparisons. Results:On day 28 of the experiment, the differences in body weight, PDFF, and serum leptin among the 3 groups of rats were not statistically significant ( P>0.05). On day 56, the bone marrow PDFF of proximal femur of the rats in the control group, HFD group, and HFD+TRF group were (7.2±1.4)%, (9.7±2.4)%, and (11.2±3.6)%, respectively. The differences in body weight, PDFF, and serum levels of leptin among the 3 groups of rats were statistically significant ( F=6.95, P=0.010, F=5.98, P=0.007, F=4.54, P=0.034). The results of multiple comparisons showed that the body weight in the HFD group was higher than those in the control group (LSD- t=52.96, P=0.036) and the HFD+TRF group (LSD- t=82.74, P=0.003). The values of bone marrow PDFF of proximal femur in the HFD+TRF group was higher than that in the control group (LSD- t=4.01, P=0.012). The serum levels of leptin in the HFD group were higher than those in the control group (LSD- t=1.45, P=0.030) and the HFD+TRF group (LSD- t=1.62, P=0.018). Conclusion:TRF induces an increase in the values of bone marrow PDFF of proximal femur in conjunction with weight loss in obese rats induced by HFD, and the increase in bone marrow fat may be related to the decrease in serum leptin.

Objective To investigate the clinical effect of digital subtraction angiography(DSA)-guided foam sclerotherapy on lower limb varicose veins.Methods The relevant data of patients with lower limb varicose veins treated by DSA-guided foam sclerotherapy were analyzed retrospectively.At the same time,the safety and efficacy were compared before and after operation according to clinical etiology anatomy pathophysiology(CEAP)and clinical symptoms.Results Among the 278 affected limbs treated,2(0.72％)had neurological complications during treatment,8(2.88％)had chest tightness or cough during treatment,7(2.52％)had thrombophlebitis after treatment,and 28(10.07％)had hyperpigmentation after treatment.No serious complications such as skin necrosis,deep vein thrombosis(DVT)or pulmonary embolism(PE)occurred.There were 48 cases of grade C1 and 201 cases of grade C2 before treat-ment,while 244 cases of grade C0 and 26 cases of grade C1 after treatment,and the differences were statistically significant(P＜0.05).Conclusion DSA-guided foam sclerotherapy on lower limb varicose veins is a safe and effective minimally invasive treatment with high technical success rate.

The sewage treatment station is a critical pro-environment facility in hospitals.This study presents an overview of the sewage and waste gas treatment processes in a general hospital's sewage treatment station,outlining the current operational status and identifying existing issues.By implementing targeted management measures,including outsourcing services,specializa-tion of operations and maintenance staff,standardization of work protocols,digitization of data,and enhanced inspection and o-versight,the hospital has achieved improvements in the station's operational efficiency and management quality.These advance-ments provide essential support for the hospital's uninterrupted medical services.

Objective To evaluate the economic value of fluticasone furoate/umeclidinium/vilanterol(FF/UMEC/VI)powder for inhalation in the treatment of symptomatic chronic obstructive pulmonary disease patients with acute exacerbation risk from the perspective of the Chinese health system.Methods Based on subgroup analysis of the China cohort in the IMPACT trial,a four-state lifetime Markov model was established with a 3-month cycle.The model simulation period was 11 years.Clinical efficacy,health benefits,and cost data were obtained through published literature.The health outcomes included quality adjusted life year(QALY).Using 3 times Chinas per capita gross domestic product(GDP)in 2023 as the willingness-to-pay threshold,the cost-utility analysis method was used for analysis the economic viability of FF/UMEC/VI.The scenario analysis,one-way sensitivity analysis and probability sensitivity analysis were used to verify the robustness of the results.Results Compared with fluticasone furoate/vilanterol(FF/VI),FF/UMEC/VI in the treatment of symptomatic chronic obstructive pulmonary disease patients with acute exacerbation risk saved costs 8 118.66 yuan and obtained an additional 0.000 06 QALYs,giving it an economic advantage.Compared with umeclidinium/vilanterol(UMEC/VI),FF/UMEC/VI treatment paid 2 784.41 yuan more and received 0.000 45 QALYs less,making UMEC/VI more cost-utility.The scenario analysis results further confirmed the robustness of the model.The sensitivity analysis results showed that when the drug cost of FF/UMEC/VI per cycle decreases to 637.29 yuan,FF/UMEC/VI had economic benefits under a willingness-to-pay threshold of 3 times China's per capita GDP in 2023.Conclusion For patients with symptomatic chronic obstructive pulmonary disease at risk of acute exacerbation,FF/UMEC/VI is more cost-utility than FF/VI.Compared with UMEC/VI,FF/UMEC/VI has economic viability after price reducing.

B-cell-specific moloney murine leukemia virus integration site 1(BMI1)molecule is one of the members of the family of the Polycomb group(PcG)protein.As a crucial marker of stem cells,it maintains the normal physiological functions of the or-ganisms through regulating expression of the related genes transcriptionally.It was reported that BMI1 is also a crucial molecule which affects pathogenesis and progression of malignant tumors.Therefore,it plays an important role in regulating self-renewal,migration,invasion,drug-resistance,and as well as immune evasion of cancer stem cells(CSCs),which is associated with recurrence and metas-tasis of cancer.In this review,based on the research progresses during recent years,molecular structure and biological function of BMI1 were illustrated.Furthermore,regulation and its mechanisms of BMI1 molecule on the self-renewal,migration and invasion,drug-resistance and immune evasion of CSCs were also elaborated.It indicated that investigation of BMI1 molecule as a novel potential target in cancer immunotherapy would be much valuable and significant.

Objective:To evaluate the relationship between the mechanism of curcumin attenuating lidocaine-induced neurotoxicity and autophagy.Methods:In vitro human neuroblastoma SH-SY5Y cells at the logarithmic phase were divided into 3 groups ( n=12 each) using the random number table method: blank control group (C group), lidocaine group (Lid group), and curcumin + lidocaine group (Cur + Lid group). The cells were incubated with complete medium containing 1.0 μmol/L curcumin for 24 h, and the other groups were incubated with fresh medium for 24 h under the same conditions in Cur+ Lid group. Then the medium was incubated with the complete medium containing 4.0 mmol/L lidocaine for 24 h in Lid and Cur+ Lid groups, and the medium was replaced with the fresh medium and the cells were incubated for 24 h under the same conditions in group C. At the end of incubation or culture, the cell viability was detected by CCK-8 method, the level of autophagosomes was detected by the MDC method, and the expression of P62, microtubule-associated protein light chain 3-Ⅱ (LC3-Ⅱ) and LC3-Ⅰ was detected by Western blot, and the LC3-Ⅱ/LC3-Ⅰ ratio was calculated. Results:Compared with group C, the cell viability was significantly decreased, the level of autophagosomes was increased, the expression of LC3-Ⅱ was up-regulated, the expression of LC3-Ⅰ was down-regulated, the LC3-Ⅱ/LC3-Ⅰ ratio was increased, and the expression of P62 was down-regulated in Lid and Cur+ Lid groups ( P<0.05). Compared with Lid group, the cell viability and level of autophagosome were significantly increased, the expression of LC3-Ⅱ was up-regulated, the expression of LC3-Ⅰ was down-regulated, the LC3-Ⅱ/LC3-Ⅰ ratio was increased, and the expression of P62 was down-regulated in Cur+ Lid group ( P<0.05). Conclusions:The mechanism by which curcumin reduces the neurotoxicity induced by lidocaine may be related to the activation of autophagy.

Recently, malaria incidence has sharply resurgence in the border area of northern Myanmar, with the parasite incidence rate in 2023 being 21.47 times (95% CI: 18.84-24.48) that of 2019 in Kachin State's Razan and nearby areas. This resurgence caused the number of imported malaria cases to increase from 188 in 2019 to 398 in 2023 in Yunnan Province. In addition to the impact of military conflict, the border malaria joint prevention and control cooperation mechanism and malaria control measures established between China and Myanmar have failed to be implemented effectively due to the impact of the international COVID-19 epidemic. Hence, it is recommended that relevant departments evaluate the quality and effectiveness of the current cross-border transmission measures for malaria in the China-Myanmar border area from a technical perspective, and provide a large demand for primaquine, which can block the spread of malaria and cure vivax malaria, in response to the current prevalent characteristics of vivax malaria predominating in northern Myanmar. Moreover, to effectively reduce the mortality of imported malaria patients and prevent re-importation and transmission, it is necessary to enhance clinical physicians' knowledge, awareness, and vigilance regarding malaria diagnosis and treatment in the Yunnan border region, as well as China's ability and quality of appropriate response to imported malaria.