Objective To explore the basis of PERMA on the overall well-being and social support of elderly patients with maintenance hemodialysis(MHD).Methods A total of 60 elderly patients with MHD were selected from the blood purification center of a tertiary A hospital in Zhejiang Province from January to December 2022 as the study subjects.According to the different disease areas of the patients,they were randomly divided into an experimental group or a control group.Finally,30 patients were included in each group.The control group received routine care,and the experimental group received another 4-week bidirectional social support intervention based on the PERMA model.General well-being scale,social support rating scale,sleep duration,activity duration were used to evaluate the effect before intervention,4 weeks after intervention and 1 month after intervention.Results The results of repeated measurement ANOVA showed that there were statistically significant differences in general happiness score,social support score,sleep duration and activity duration in terms of time effect(P＜0.05),while there were statistically significant differences in general happiness score,social support score and sleep duration in terms of inter-group effect(P＜0.05).Social support score and sleep duration had statistically significant interac-tion effects(P＜0.05).Conclusion The bidirectional social support intervention based on well-being PERMA model can enhance the general well-being and social support level of elderly patients with MHD,and improve the sleep and activity status of elderly patients with MHD.

Objective To investigate the relationship between pre-treatment collateral circulation and long-term clinical outcomes in patients with acute vertebrobasilar artery occlusion(VBAO)undergoing endovascular treatment(EVT).Methods A retrospective analysis was conducted on 129 VBAO patients who underwent EVT.Patients were categorized into short-term(90 d)and long-term(1 year)outcome groups based on follow-up duration.Clinical data were collected,and the posterior circulation collateral score(PC-CS)based on magnetic resonance angiography(MRA)was evaluated.Inter-rater reliability of the MRA PC-CS was evaluated using Cohen's Kappa coefficient.The predictive value of MRA PC-CS for outcomes was analyzed using receiver operating characteristic(ROC)curves.Multivariate logistic regression analysis was employed to identify independent predictors of long-term outcomes.Results A total of 109 patients were included in the long-term follow-up,with 78 survivors and 31 deaths.The MRA PC-CS demonstrated high diagnostic efficacy for predicting long-term outcomes,with an area under the curve(AUC)of 0.85[95%confidence interval(CI)0.78-0.92,P＜0.000 1],with an optimal cutoff value of 5 points.Multivariate logistic regression analysis revealed that age[odds ratio(OR)1.07,95%CI 1.02-1.13,P=0.005],admission National Institutes of Health Stroke Scale(NIHSS)score(OR 1.08,95%CI 1.02-1.14,P=0.01),occipital lobe infarction(OR 3.96,95%CI 1.25-12.56,P=0.02),and MRA PC-CS≤5 points(OR 0.23,95%CI 0.06-0.84,P=0.03)were independent predictors of long-term outcomes.Conclusion The MRA PC-CS can independently predict adverse long-term functional outcomes in VBAO patients.

Objective:To explore the relationship between depressive symptoms and stressors among post-graduates and the role of coping styles and psychological suzhi between them.Methods:A total of 775 postgradu-ates were recruited.They were assessed with the Center for Epidemiological Studies Depression Scale(CES-D),Psychological Stressors Scale of Postgraduates(PSSP),Simplified Coping Style Questionnaire(SCSQ),and Col-lege Students Psychological Suzhi Brief Mental Health Version(CSPS-B-MH).Results:The detection rate of de-pression among postgraduates was 52.0％.Postgraduate stressors were positively associated with depression(β=0.47).Coping styles played a partial mediating role in the relationship between stressors and depression in postgrad-uates,with the mediation effect accounting for 24.76％of the total effect.Psychological suzhi was shown to moder-ate the effect of stressors on depression(β=-0.07)and positive coping on depression(β=-0.05).Conclusion:Postgraduate stressors could affect depression through the mediating role of coping styles and the moderating role of psychological suzhi.

Objective To investigate the relationship between pre-treatment collateral circulation and long-term clinical outcomes in patients with acute vertebrobasilar artery occlusion(VBAO)undergoing endovascular treatment(EVT).Methods A retrospective analysis was conducted on 129 VBAO patients who underwent EVT.Patients were categorized into short-term(90 d)and long-term(1 year)outcome groups based on follow-up duration.Clinical data were collected,and the posterior circulation collateral score(PC-CS)based on magnetic resonance angiography(MRA)was evaluated.Inter-rater reliability of the MRA PC-CS was evaluated using Cohen's Kappa coefficient.The predictive value of MRA PC-CS for outcomes was analyzed using receiver operating characteristic(ROC)curves.Multivariate logistic regression analysis was employed to identify independent predictors of long-term outcomes.Results A total of 109 patients were included in the long-term follow-up,with 78 survivors and 31 deaths.The MRA PC-CS demonstrated high diagnostic efficacy for predicting long-term outcomes,with an area under the curve(AUC)of 0.85[95%confidence interval(CI)0.78-0.92,P＜0.000 1],with an optimal cutoff value of 5 points.Multivariate logistic regression analysis revealed that age[odds ratio(OR)1.07,95%CI 1.02-1.13,P=0.005],admission National Institutes of Health Stroke Scale(NIHSS)score(OR 1.08,95%CI 1.02-1.14,P=0.01),occipital lobe infarction(OR 3.96,95%CI 1.25-12.56,P=0.02),and MRA PC-CS≤5 points(OR 0.23,95%CI 0.06-0.84,P=0.03)were independent predictors of long-term outcomes.Conclusion The MRA PC-CS can independently predict adverse long-term functional outcomes in VBAO patients.

Objective To formulate the 2025 edition of the Pharmacopoeia of the People's Republic of China of prefilled syringe silicone oil determination method,and to interpret the method content.Methods The prefilled syringe was added silicone solvent ethyl acetate to the roll edge of the sleeve and let it stand for extraction for 5 minutes,then put the silicon solvent in the evaporating dish dried at 105 ℃ to constant weight,then add 1mL ethyl acetate into the sleeve for rinsing and placing in the same evaporating dish,and then dry in a water bath at 105℃ to constant weight.The content of silicone oil in the sleeve of the prefilled syringe was calculated according to the quality difference.Results The reliability of the experimental method was verified by the ultimate extraction test,standard recovery test,and precision investigation.The results showed that the ultimate extraction could be achieved after 5 minutes of extraction with ethyl acetate.The recovery rate of the method was 100.0％-101.6％,and the precision was 3.5％.Conclusion The formulation of the determination method refers to the measurement method of silicone oil content in relevant standards at home and abroad,combined with the problems existing in the measurement of silicone oil content in daily tests,to further improve the operability of the detection method,the method is simple,efficient,feasible and reliable.

Objective To formulate the 2025 edition of the Pharmacopoeia of the People's Republic of China of prefilled syringe silicone oil determination method,and to interpret the method content.Methods The prefilled syringe was added silicone solvent ethyl acetate to the roll edge of the sleeve and let it stand for extraction for 5 minutes,then put the silicon solvent in the evaporating dish dried at 105 ℃ to constant weight,then add 1mL ethyl acetate into the sleeve for rinsing and placing in the same evaporating dish,and then dry in a water bath at 105℃ to constant weight.The content of silicone oil in the sleeve of the prefilled syringe was calculated according to the quality difference.Results The reliability of the experimental method was verified by the ultimate extraction test,standard recovery test,and precision investigation.The results showed that the ultimate extraction could be achieved after 5 minutes of extraction with ethyl acetate.The recovery rate of the method was 100.0％-101.6％,and the precision was 3.5％.Conclusion The formulation of the determination method refers to the measurement method of silicone oil content in relevant standards at home and abroad,combined with the problems existing in the measurement of silicone oil content in daily tests,to further improve the operability of the detection method,the method is simple,efficient,feasible and reliable.

Objective:To investigate the combined application of cytology, cell block histology and immunohistochemistry to improve the diagnostic accuracy of solid pancreatic lesions in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) samples.Methods:The pathological data of EUS-FNA in 311 cases of solid pancreatic lesions submitted to the Second Hospital of Hebei Medical University, Shijiazhuang, China from May 2019 to September 2023 were retrospectively analyzed. The cases included pancreatic ductal adenocarcinoma (PDAC, 172 cases), solid pseudopapillary neoplasm (SPN, 12 cases), neuroendocrine tumors (PNET, 14 cases) and chronic pancreatitis (113 cases). The cytological features of smears, the histology of cell block sections and the diagnostic markers in PDAC, SPN and PNET were analyzed. The diagnostic accuracies of cytology, cell block histology/immunohistochemistry and combination of the two methods for classifying these pancreatic solid lesions were evaluated.Results:Irregular arrangement of atypical (cancer) cells, anisonucleosis and nuclear atypia were the typical cytological features of PDAC, while presence of pseudopapillae with a myxoid/hyalinized fibrovascular core and low adhesion/salt-and-pepper chromatin were diagnostic features of SPN and NET, respectively. Immunohistochemical results showed that CK7 and CK19 were the most sensitive markers of pancreatic ductal epithelia, and the diffuse strong expression of S-100P (102/111, 91.9%) and aberrant expression of p53 (80/111, 72.1%) were important immunophenotypic markers of PDAC. Various degrees of CDX2 expression could be found in 66.4% PDAC. The expression of CD10, PR, vimentin, CD99 and cyclinD1 and the aberrant expression of β-catenin were the immunophenotypic features of SPN, while the expression of CgA, Syn and CD56 were indispensable immunemarkers for the diagnosis of PNET. Overall, cytology had higher sensitivity than cell block histology (93.9% versus 82.8%) and lower specificity (92.9% versus 99.1%), while the combination of the two methods significantly improved the sensitivity to 96.9% in solid pancreatic lesions. The combination of cytology and cell block histology could significantly improve the diagnostic efficacy of EUS-FNA in PDAC.Conclusions:Integrated diagnosis based on cytology (including rapid on-site evaluation), cell block histology and immunohistochemical findings could significantly improve the diagnostic yield of EUS-FNA in classifying solid pancreatic lesions.

BACKGROUND:In recent years,the application of exosomes of periodontal ligament stem cells in periodontal tissue regeneration engineering has been widely studied,but the effect of exosomes on periodontal ligament stem cells derived from inflammatory environment is still unclear.OBJECTIVE:To investigate the effects of exosomes secreted by periodontal ligament stem cells from healthy and inflammatory environments on the proliferation and differentiation of periodontal ligament stem cells from inflammatory environments.METHODS:Human periodontal ligament stem cells from healthy and inflammatory tissues were isolated and cultured by enzyme digestion method.Exosomes were extracted from two kinds of periodontal ligament stem cells using ultracentrifugation.Passage 3 periodontal ligament stem cells derived from inflammatory tissue were selected and cultured in three groups.Cells in the blank group were cultured routinely.The healthy exosome group was added with exosomes secreted by peripheral ligament stem cells derived from healthy tissue.The inflammatory exosome group was added with exosomes secreted by human periodontal ligament stem cells derived from inflammatory tissue.Cell proliferation and cloning were detected.The expression of alkaline phosphatase,the formation of mineralized nodules,and the expression of mRNA and protein of genes related to osteogenesis were detected under osteogenic differentiation.RESULTS AND CONCLUSION:(1) CCK-8 assay and clonal formation test showed that compared with the blank group,two kinds of exosomes could promote the proliferation and colony formation of periodontal ligament stem cells from inflammatory tissue (P<0.05),and the effect of the healthy exosome group was stronger than that of the inflammatory exosome group (P<0.05).(2) Alkaline phosphatase and alizarin red staining showed that compared with the blank group,the two kinds of exosomes could promote the expression of alkaline phosphatase and the formation of mineralized nodules in periodontal ligament stem cells from inflammatory tissue,and the promoting effect of the healthy exosome group was stronger than that of the inflammatory exosome group.RT-PCR and western blot assay showed that compared with the blank group,the two kinds of exosomes could promote the expression of alkaline phosphatase,RUNX2,and type Ⅰ collagen mRNA and protein in periodontal ligament stem cells from inflammatory tissue (P<0.05).The promoting effect of the healthy exosome group was stronger than that of the inflammatory exosome group (P<0.05).(3) The results showed that exosomes secreted by human periodontal ligament stem cells could promote the proliferation and osteogenic differentiation of periodontal ligament stem cells derived from inflammatory environments,and the promoting effect of exosomes secreted by human periodontal ligament stem cells derived from healthy tissues was better than that from human periodontal ligament stem cells derived from inflammatory tissues.

Objective To investigate the effects of different contrast injection schemes on the image quality of triple-rule-out com-puted tomography angiography(TRO-CTA).Methods A total of 691 patients with acute chest pain who underwent TRO-CTA exami-nation from multiple centers were prospectively selected and randomly divided into mixed group and unmixed group according to dif-ferent contrast injection methods.The image quality of aorta,pulmonary artery and coronary artery in the two groups was evaluated subjectively and objectively and the radiation dose was calculated.Results There were no significant differences in subjective image quality scores,aorta and coronary CT values,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)between the two groups(P>0.05),while there were significant differences in pulmo-nary CT values,SNR,CNR and radiation dose between the two groups(P<0.05).Conclusion The utilization of a mixed contrast injection scheme in TRO-CTA can satisfy diagnostic require-ments while ensuring a low proportional dosage and reduced radiation dose,which has clinical application value.

Aim To investigate the relationship between sleep deprivation and vascular aging,as well as the un-derlying mechanisms.Methods Male Sprague-Dawley rats were divided into control group,senescence group,sleep deprivation group,and sleep deprivation+senescence group,with 6 rats in each group.The modified level table method deprived rats of sleep duration.Senescence-associated β-galactosidase(SA-β-Gal)staining was used to detect the senes-cence status of rat vascular tissue.The mRNA and protein expression of tumor suppressor protein p53,silent information regulator 1(SIRT1)and clock gene cryptochrome 1(CRY1)was detected by real-time fluorescence quantification PCR(RT-qPCR),Western blot and immunohistochemistry.Results Compared with the control group,the intensity of SA-β-Gal staining was increased in the vascular tissues of the senescence group rats,the expression level of p53 was elevat-ed,the expression level of SIRT1 was decreased.Similar changes were observed in the sleep deprivation group and the sleep deprivation+senescence group,including intensified SA-β-Gal staining,elevated p53 levels,and reduced SIRT1 lev-els in vascular tissues.Additionally,compared with the control group,the sleep deprivation group showed reduced CRY1 levels in vascular tissues,while only CRY1 mRNA levels were reduced in the sleep deprivation+senescence group.Fur-thermore,compared with the senescence group,the sleep deprivation+senescence group exhibited intensified SA-β-Gal staining,increased p53 level,decreased SIRT1 level,and reduced CRY1 mRNA level in vascular tissues.Conclusion Sleep deprivation may promote the expression of vascular aging-related factors,potentially through the inhibition of CRY1 expression in vascular tissues.