Objective To explore the valve regurgitation status of left heart after the implantation of left ventricular assist device (LVAD) and its effect on prognosis of patients with LVAD implantation. Methods A total of 35 patients with cardiomyopathy who underwent magnetic levitation LVAD implantation at Zhongshan Hospital, Fudan University from February 2021 to July 2024 were retrospectively selected. Clinical data during hospitalization were collected, including preoperative basic data and postoperative valve regurgitation status. Telephone follow-ups were conducted to monitor patients’ survival status and transthoracic echocardiography was used to assess left valve function. Kaplan-Meier survival curves and log-rank test were employed to compare the survival rate of patients with different levels of valve regurgitation. Results The 35 patients had a mean age of (53.9±11.1) years, with 85.7% male, and 3 patients (8.6%) died during hospitalization. Preoperatively, 17 patients (48.6%) had moderate or greater mitral regurgitation, while all 35 patients had less than moderate aortic regurgitation. One month postoperatively, thirty patients were followed up, among which 24 patients (80%) had less than moderate mitral regurgitation, including 11 cases with alleviated regurgitation compared to pre-surgery; 6 patients (20%) had moderate or greater mitral regurgitation, including 4 cases with stable regurgitation and 2 cases with progression of regurgitation compared to pre-surgery; 2 patients (6.7%) had progression of aortic regurgitation to moderate or greater. The follow-up time was 1.2 (1.0, 2.1) years, with 1-year survival rate of 91.4% and 3-year survival rate of 71.1%. Survival analysis showed that the 3-year survival rate of patients with moderate or greater mitral regurgitation one month postoperatively was significantly lower than that of patients with less than moderate regurgitation (66.7% vs 83.3%, P＝0.046). Conclusions After the implantation of magnetic levitation LVAD, most patients showed improvement in mitral regurgitation, while aortic regurgitation remained unchanged. The degree of mitral regurgitation one month postoperatively is associated with prognosis.

Objective:To compare the impact of preoperative pulmonary vascular resistance(PVR) levels on the prognosis of patients undergoing left ventricular assist device(LVAD)implantation.Methods:A retrospective analysis was conducted on the clinical data of 33 patients among September 2021 and June 2024, who underwent LVAD implantation at Zhongshan Hospital, Fudan University. 29 males and 4 females, with a mean age of(53.61±9.65)years old. The cohort included 30 cases of dilated cardiomyopathy, 2 cases of ischemic cardiomyopathy, and 1 case of noncompaction cardiomyopathy. Patients were grouped based on a preoperative PVR threshold of 3 WU, Preoperative data from Swan-Ganz catheterization, liver and renal function indicators, as well as other relevant clinical parameters were recorded. Patients were followed up to assess differences in survival outcomes.Results:Preoperative PVR was elevated in 18 cases(60%)of the patients, with a mean preoperative PVR of(3.16±1.71)WU. Immediate postoperative right heart catheterization was performed in 20 patients, showing a significant reduction in PVR from(3.85±1.72)WU preoperatively to(1.80±1.38)WU postoperatively( P<0.05). The cardiac index improved significantly from(1.95±0.63)L·min -1·m -2 preoperatively to(4.25±1.26)L·min -1·m -2 postoperatively( P<0.001). The mean follow-up duration was(14.78±12.06)months, no significant difference in postoperative survival was observed between the two groups(100% vs. 80%, P=0.667). Conclusion:Increased pulmonary resistance is often secondary to left heart dysfunction. After the implantation of a LVAD, pulmonary resistance can be improved. For patients with relatively normal right heart function before surgery, elevated pulmonary resistance does not affect the short-term outcomes of the implantation.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective To investigate the expression of ACTN1 in cutaneous squamous cell carcinoma (CSCC) and its association with clinicopathological features and prognosis. Methods A total of 150 patients with cutaneous squamous cell carcinoma (CSCC) and 100 healthy controls were enrolled in this study. The serum expres-sion levels of ACTN1 were measured using ELISA. All CSCC patients underwent post-surgical follow-up and were categorized into a poor prognosis group (n=69) and a good prognosis group (n=81). Additionally,the 69 patients in the poor prognosis group were further classified into an ACTN1 lower expression subgroup (n=35) and an ACTN1 higher expression subgroup (n=34) based on the median expression level of ACTN1. Logistic regression analysis was employed to identify risk factors associated with poor prognosis in CSCC patients. ROC curve analysis was conducted to evaluate the clinical utility of serum ACTN1 expression levels in predicting poor prognosis in CSCC patients. Kaplan-Meier (K-M) survival analysis was utilized to assess the relationship between serum ACTN1 expres-sion levels and the median time to poor prognosis in the 69 patients with poor prognosis. Furthermore,40 additional CSCC patients were recruited to compare the expression levels of ACTN1 in CSCC tissues and adjacent tissues using immunohistochemistry. Results The serum expression levels of ACTN1 in the Control group and the CSCC group were (12.12±2.26) ng/mL and (4.56±1.02) ng/mL,respectively. Compared to the Control group,the serum expres-sion level of ACTN1 in the CSCC group was significantly decreased,and the difference was statistically significant (t=31.37,P<0.001). In the poor prognosis group,the proportion of tumors with a diameter ≥ 5 cm,low degree of tumor cell differentiation,subadipocyte invasion depth,lymph node metastasis incidence,and serum ACTN1 expression levels were all significantly higher compared to the good prognosis group,with statistical significance (P<0.05). Logistic regression analysis revealed that lymph node metastasis (OR=3.253) and elevated ACTN1 expression (OR=2.894) were independent risk factors for poor prognosis following CSCC surgery. The area under the curve (AUC) for serum ACTN1 expression in predicting poor prognosis post-surgery in CSCC patients was 0.911. At a cut-off value of 13.19 ng/mL for ACTN1,the diagnostic sensitivity and specificity were 89.78％ and 92.12％,respectively. The median time to poor prognosis was 25 months in the ACTN1 low-expression group and 18.5 months in the ACTN1 high-expression group,respectively. The median time to poor prognosis was significantly shorter in the ACTN1 high-expression group compared to the low-expression group (HR=6.627,P<0.001). Among 40 CSCC tissue samples,32 cases exhibited higher ACTN1 expression,while 8 cases showed lower expression. In contrast,among 40 paracancerous tissue samples,11 cases had higher ACTN1 expression and 29 cases had lower expression. The higher expression rate of ACTN1 in CSCC tissues was significantly elevated compared to paracancerous tissues (x2=22.175,P<0.001). Conclusion The serum expression level of ACTN1 in CSCC patients was significantly elevated,suggesting its potential as a biomarker for assessing post-surgical prognosis in CSCC patients.

Ethanol (EtOH) is a common trigger for gastric mucosal diseases, and mitigating oxidative stress is essential for attenuating gastric mucosal damage. Capsaicin (CAP) has been identified as a potential agent to counteract oxidative damage in the gastric mucosa; however, its precise mechanism remains unclear. This study demonstrates that CAP alleviates EtOH-induced gastric mucosal injuries through two primary pathways: by suppressing the chemokine receptor 4 (CCR4)/Src/p47phox axis, thereby reducing oxidative stress, and by inhibiting the phosphorylation and nuclear translocation of nuclear factor-κB p65 (NF-κB) p65, resulting in diminished inflammatory responses. These findings elucidate the mechanistic pathways of CAP and provide a theoretical foundation for its potential therapeutic application in the treatment of gastric mucosal injuries.
Ethanol/toxicity* ; Animals ; Gastric Mucosa/metabolism* ; Signal Transduction/drug effects* ; Oxidative Stress/drug effects* ; Capsaicin/pharmacology* ; Male ; NADPH Oxidases/genetics* ; Mice ; Humans ; src-Family Kinases/genetics*

Objective: To understand the prevalence of elevated blood pressure and its association with dietary patterns in children and adolescents in China, providing evidence for developing dietary intervention of hypertension in children and adolescents. Methods: Data were derived from the China Children s Nutrition and Health System Survey and Application Project(2019-2021). A stratified cluster random sampling method was used to include 7 933 participants from 28 survey sites in seven major regions of Northeast, North, Northwest, East, Central, South and Southwest China. Multivariate Logistic regression models were used to analyze associations between demographic characteristics, nutritional status and elevated blood pressure. Exploratory factor analysis identified dietary patterns, which were divided into three quartile groups (T3, T2, T1) based on factor scores (compliance for dietary pattern) from high to low, and multivariate Logistic regression model assessed the correlation between elevated blood pressure and dietary patterns. Results: The prevalence of elevated blood pressure was 15.4% among Chinese children aged 7-17 years. Significant differences were observed across nutritional status (reference: underweight; normal weight: OR =1.57; overweight: OR = 2.61 ; obesity: OR =3.85), urban/rural residence (reference: rural; urban: OR =0.86), and paternal education (reference: junior high school and below; bachelor degree or above: OR =0.68) ( P <0.05). The detection rates of high blood pressure in T3 group children and adolescents with four dietary patterns (staple food, animal based food, snacks, vegetables and fruits) were 15.7%, 14.6%, 16.8%, and 15.8%, respectively. After adjusting for residence, paternal education, and nutritional status, the "snack dietary pattern" (mainly candy, sugar sweetened beverages, and processed snacks) showed positive associations with elevated blood pressure in T2 ( OR =1.21) and T3 ( OR =1.19) tertiles ( P <0.05). Conclusions The snack dietary pattern is a related factor for elevated blood pressure in children and adolescents. Restricting unhealthy snack intake may promote cardiovascular health.

Objective Taking a tertiary hospital in Beijing as an example,to investigate patients'continuous use inclination towards utilizing Internet diagnosis and treatment,dissect the influential factors and elucidate the pathway through which these factors exert their impact,and propose recommendations for optimizing internet diagnosis and treatment services in the hospital.Methods Based on the model of continuous use of information system and the model of success of information system,it constructed a structural equation model of the willingness to use Internet diagnosis and treatment service continuously and put forward the hypotheses,conducted a questionnaire survey.Descriptive analysis,reliability and validity tests,structural model analysis and hypothesis testing were conducted using Excel and SmartPLS 4.0 software to validate the research hypotheses.Results The information quality,service quality,and system quality of Internet diagnosis and treatment services have a positive effect on patients'willingness to continue to use them,with perceived usefulness and user satisfaction playing a major mediating role.Conclusion Internet hospitals should establish skill training and medical record review mechanisms,improve service processes and communication norms,optimize system design and user experience,enhance interactivity and personalized services,to promote the sustainable development of Internet diagnosis and treatment services in entity medical institutions.

Comprehensive performance appraisal,continuous optimization of performance appraisal indicators,reform of internal performance appraisal methods,and linking the appraisal results to salary allocation are important measures for the high-quality development of public hospitals.It is based on the performance allocation mechanism improvement in case hospital under the requirements of high-quality development.The implementation of performance reform practice based on incremental assessment has achieved the social benefits improvement,income structure optimization,performance distribution equity improvement,and more refined management of disciplines and other management objectives,with a view to providing lessons and references for medical colleagues to follow up to deepen the performance reform and improve the performance distribution.

Objective Evaluate the effects of different solvent extracts from Jujing Pills on improving retinal damage in kidney Yang deficiency aging mice and explore the underlying mechanism.Methods A composite modeling method of subcutaneous injection of D-galactose and hind limb injection of hydrocortisone was used to establish a kidney Yang deficiency type aging mouse model,and various solvent extract of Jujing Pills were given for intervention treatment.The improvement effect of different solvent extracts of Jujing Pills on aging mice with kidney Yang deficiency was evaluated by observing physical signs,measuring serum oxidative stress marker levels,and cyclic nucleotide levels.Optical coherence tomography(OCT)was used to detect the condition of the mouse retina,HE staining was used to detect the degree of retinal cell damage,TUNEL staining was used to detect retinal cell apoptosis,assay kit was used to detect oxidative stress factor expression,enzyme-linked immunosorbent assay was used to detect the expression of ciliary neurotrophic factor(CNTF),brain-derived neurotrophic factor(BDNF),and nerve growth factor(NGF)in the mouse eyeball,and Western blotting(WB)was used to quantitatively analyze the expression levels of apoptosis and neurotrophic pathway related proteins in the mouse retina tissue.Results Compared with the control group,the model group mice showed slow weight gain,reduced activity,decreased expression of antioxidant factors such as superoxide dismutase(SOD)and glutathione(GSH)in serum(P<0.01),and decreased cAMP/cGMP ratio(P<0.01).Different solvent extracts of Jujing Pills significantly increased the expression of antioxidant factors such as SOD and GSH(P<0.05),reduced the production of oxidative product malondialdehyde(MDA)(P<0.01),and increased the cAMP/cGMP ratio(P<0.01);Significantly increased the retinal thickness of model mice(P<0.01),improved retinal damage and inhibited retinal cell apoptosis(P<0.01),and significantly downregulated the ratio expression levels of Cleaved Caspase-3 and Caspase-3(P<0.01);The expression of CNTF,BDNF,and NGF was upregulated by water extracted medicinal residue alcohol extract,water extracted alcohol sediment,and total extract(P<0.01).The phosphorylation levels of CREB and ERK in the eyeball were significantly upregulated by water extracted medicinal residue alcohol extract and total extract(P<0.05).Conclusion Different solvent extracts of Jujing Pills can exert different pharmacological effects on improving retinal damage in aging mice with kidney yang deficiency model.Its mechanism of action is related to improving retinal apoptosis caused by oxidative stress and increasing the expression of nutritional factors.

Objective To investigate the expression of ACTN1 in cutaneous squamous cell carcinoma (CSCC) and its association with clinicopathological features and prognosis. Methods A total of 150 patients with cutaneous squamous cell carcinoma (CSCC) and 100 healthy controls were enrolled in this study. The serum expres-sion levels of ACTN1 were measured using ELISA. All CSCC patients underwent post-surgical follow-up and were categorized into a poor prognosis group (n=69) and a good prognosis group (n=81). Additionally,the 69 patients in the poor prognosis group were further classified into an ACTN1 lower expression subgroup (n=35) and an ACTN1 higher expression subgroup (n=34) based on the median expression level of ACTN1. Logistic regression analysis was employed to identify risk factors associated with poor prognosis in CSCC patients. ROC curve analysis was conducted to evaluate the clinical utility of serum ACTN1 expression levels in predicting poor prognosis in CSCC patients. Kaplan-Meier (K-M) survival analysis was utilized to assess the relationship between serum ACTN1 expres-sion levels and the median time to poor prognosis in the 69 patients with poor prognosis. Furthermore,40 additional CSCC patients were recruited to compare the expression levels of ACTN1 in CSCC tissues and adjacent tissues using immunohistochemistry. Results The serum expression levels of ACTN1 in the Control group and the CSCC group were (12.12±2.26) ng/mL and (4.56±1.02) ng/mL,respectively. Compared to the Control group,the serum expres-sion level of ACTN1 in the CSCC group was significantly decreased,and the difference was statistically significant (t=31.37,P<0.001). In the poor prognosis group,the proportion of tumors with a diameter ≥ 5 cm,low degree of tumor cell differentiation,subadipocyte invasion depth,lymph node metastasis incidence,and serum ACTN1 expression levels were all significantly higher compared to the good prognosis group,with statistical significance (P<0.05). Logistic regression analysis revealed that lymph node metastasis (OR=3.253) and elevated ACTN1 expression (OR=2.894) were independent risk factors for poor prognosis following CSCC surgery. The area under the curve (AUC) for serum ACTN1 expression in predicting poor prognosis post-surgery in CSCC patients was 0.911. At a cut-off value of 13.19 ng/mL for ACTN1,the diagnostic sensitivity and specificity were 89.78％ and 92.12％,respectively. The median time to poor prognosis was 25 months in the ACTN1 low-expression group and 18.5 months in the ACTN1 high-expression group,respectively. The median time to poor prognosis was significantly shorter in the ACTN1 high-expression group compared to the low-expression group (HR=6.627,P<0.001). Among 40 CSCC tissue samples,32 cases exhibited higher ACTN1 expression,while 8 cases showed lower expression. In contrast,among 40 paracancerous tissue samples,11 cases had higher ACTN1 expression and 29 cases had lower expression. The higher expression rate of ACTN1 in CSCC tissues was significantly elevated compared to paracancerous tissues (x2=22.175,P<0.001). Conclusion The serum expression level of ACTN1 in CSCC patients was significantly elevated,suggesting its potential as a biomarker for assessing post-surgical prognosis in CSCC patients.