Objective:To retrieve, evaluate and summarize the best evidence for the management of oral intake in stroke patients with dysphagia.Methods:A systematic search was conducted in Chinese and English databases and subject-specific professional websites for clinical decisions, best practices, guidelines, systematic reviews, expert consensuses and evidence summaries on the management of oral intake in stroke patients with dysphagia. The retrieval time limit was from the establishment of the database to March 31, 2024. The included literatures were screened, quality-evaluated, and evidence was extracted and summarized.Results:A total of 16 articles were included, including three clinical decisions, four guidelines, four expert consensuses, four evidence summaries and one systematic review. A total of 28 pieces of evidence were summarized from eight aspects, namely, swallowing function screening, nutritional risk screening, feeding management, oral medication management, water drinking management, oral care, aspiration management, and training and education.Conclusions:This study systematically summarizes the best evidence for the management of oral intake in stroke patients with dysphagia, providing scientific guidance and strategic support for the improvement of patients' long-term quality of life.

Objective:To retrieve, evaluate and summarize the best evidence for the management of oral intake in stroke patients with dysphagia.Methods:A systematic search was conducted in Chinese and English databases and subject-specific professional websites for clinical decisions, best practices, guidelines, systematic reviews, expert consensuses and evidence summaries on the management of oral intake in stroke patients with dysphagia. The retrieval time limit was from the establishment of the database to March 31, 2024. The included literatures were screened, quality-evaluated, and evidence was extracted and summarized.Results:A total of 16 articles were included, including three clinical decisions, four guidelines, four expert consensuses, four evidence summaries and one systematic review. A total of 28 pieces of evidence were summarized from eight aspects, namely, swallowing function screening, nutritional risk screening, feeding management, oral medication management, water drinking management, oral care, aspiration management, and training and education.Conclusions:This study systematically summarizes the best evidence for the management of oral intake in stroke patients with dysphagia, providing scientific guidance and strategic support for the improvement of patients' long-term quality of life.

[摘 要] 目的：构建靶向CD70分子的重组免疫毒素，通过表达、纯化制备PE38与抗CD70纳米抗体重组蛋白，体外抗肿瘤实验探究重组蛋白是否对高表达CD70分子的阳性肿瘤细胞具有杀伤活性。方法：通过基因工程手段，将CD70纳米抗体Nb 2B3基因片段通过一个连接子与pET21a-PE38基因片段相连，获得重组表达载体pET21a-Nb 2B3-PE38并转入BL21（DE3）感受态细胞中进行表达、纯化与鉴定。用间接ELISA及FACS法检测Nb 2B3-PE38与CD70分子的结合活性，MTT法检测Nb 2B3-PE38对高表达CD70分子的肾透明细胞癌786-O细胞的体外杀伤活性，Annexin Ⅴ-FITC/PI双染法检测Nb 2B3-PE38对786-O细胞凋亡的影响。结果：成功构建抗CD70纳米抗体重组免疫毒素Nb 2B3-PE38，纯化获得纯度>90%的重组蛋白，SDS-PAGE及WB检测结果表明目的蛋白正确表达，分子量为56 000。纯化后的Nb 2B3-PE38能与重组CD70抗原及786-O细胞表面的CD70分子特异性结合；25 µg/mL Nb 2B3-PE38即对786-O细胞产生极显著的杀伤作用（P<0.001），并且促进786-O细胞的细胞凋亡（P<0.01），其杀伤效应强于阳性对照顺铂（P<0.01）。结论：成功制备了特异性靶向CD70分子的免疫毒素Nb 2B3-PE38，其能够有效杀伤786-O细胞并诱导细胞凋亡且效果强于顺铂。

Objective:To analyze levels of oral Streptococcus sanguinis( Ss)in middle-aged and elderly patients with primary microvascular angina(PMVA)and changes in vascular endothelial function. Methods:In this case-control study, 21 middle-aged and elderly patients diagnosed with PMVA at the Department of Cardiology, Hangzhou Red Cross Hospital between January 2019 and July 2022(the PMVA group)were recruited, with ages ranging from 45 to 80(63.4±12.3)years, while 23 healthy individuals receiving health checkups during the same period served as the control group, with ages ranging from 48-76(62.5±6.5)years.The 21 middle-aged and elderly PMVA patients underwent tests for the measurement of subgingival plaque Ss levels of the oral cavity and levels of plasma vascular von Willebrand factor(VWF)and homocysteine(Hcy). Pearson linear regression analysis was conducted.Results:Ss was not found in subgingival plaque of the oral cavity in the control group, but low levels of Ss were detected in patients from the PMVA group(percentage: 1.754×10 -4; 6.218×10 -5, 4.450×10 -4). The VWF level in the PMVA group was higher than in the control group[(20.22 ± 4.44)μg/L vs.(12.00 ± 6.60)μg/L, t=4.890, P<0.01]. There was no statistical difference in the Hcy level between the PMVA group and the control group[(15.28±6.40)μmol/L vs.(12.86±2.63)μmol/L, t=1.615, P>0.05]. There was no significant correlation between Ss levels and VWF levels in the PMVA group( r=0.038, P>0.05). Conclusions:Ss can be detected in subgingival plaque of the oral cavity in PMVA patients, but not in healthy middle-aged and elderly people.The VWF level in PMVA patients is significantly higher than in healthy people, indicating that vascular endothelial function is impaired in middle-aged and elderly PMVA patients.However, there is no correlation between subgingival plaque Ss levels of the oral cavity and VWF levels in PMVA patients.

Objective:To established a method for the detection of soluble programmed death ligand 1 (PD-L1) protein in serum based on the poly nanoantibody of lumazine synthase(LS).Methods:A dual nanobody-based sandwich ELISA was established with a competitive ELISA to screen nanobodies recognizing different epitopes of PD-L1 as paired antibodies. To improve sensitivity, PD-L1 nanobody P3C8 and lumazine synthase(LS) were fused, and nanobodies were obtained in polymeric forms as sPD-L1 protein captures, so as to develop an LS-displayed polymeric nanobody-based sandwich ELISA (LSNbs-ELISA) method to detect sPD-L1.Results:Compared with the Nbs-ELISA method, the LSNbs-ELISA method is approximately 11-fold more sensitive for sPD-L1 detection. The limit of detections (LODs) of Nbs-ELISA and LSNbs-ELISA for sPD-L1 in serum were 2.87 ng/ml and 0.255 ng/ml, respectively. Both assays were highly specific for the detection of sPD-L1 and did not react with structure-related proteins PD-1, CD27, CD70, CD137, and CD147 when spiked into the human serum.Conclusions:The Nbs-ELISA and LSNbs-ELISA assays both have high sensitivity and specificity for detecting sPD-L1 in serum and could have potential clinical applications.

Objective To analyze the distribution and antimicrobial resistance of bloodstream pathogens in surgical intensive care unit (SICU) and medical intensive care unit (MICU) of Fujian Provincial Hospital in the past four and half years for better use of antimicrobial drugs.Methods A retrospective analysis was carried out for the bloodstream pathogens isolated from SICU and MICU patients from January 2012 to June 2016.The clinical data and outcomes of patients were also reviewed.Results A total of 329 strains of isolates were recovered from blood samples in SICU,including gram-negative bacteria (53.5％),gram-positive bacteria (39.2％),and fungi (7.3％);258 strains were collected from MICU,including gram-negative bacteria (57.8％),gram-positive bacteria (36.0％),and fungi (6.2％).A.baumannii,K.pneumonia and E.coli were the top three gram-negative species in both SICU and MICU.The main gram-positive species were coagulase-negative Staphylococcus and Enterococcusfaecium.Overall,386 cases of bloodstream infections were diagnosed,including 226 cases in SICU (202 cases of single bacterial infection and 24 cases of multiple bacterial infection),and 160 cases in MICU (138 cases of single bacterial infection and 22 cases of multiple bacterial infection).A.baumannii isolates showed significantly higher rate of resistance to antibiotics in SICU than in MICU,while the K.pneumoniae and E.coli isolates in MICU showed higher resistance rates to cephalosporins,quinolones,penicillins and carbapenems than the corresponding isolates in SICU.The coagulase negative Staphylococcus and E.faecium isolates in MICU were associated with significantly higher resistance rates to quinolones and tigecycline than those strain in SICU.The bloodstream infections due to K.pneumoniae,E.coli and E.faecium were associated with higher mortality in MICU than in SICU,while the bloodstream infections due to A.baumannii were associated with higher mortality in SICU than in MICU.The total mortality rate of bloodstream infections was higher in MICU than in SICU.Conclusions SICU and MICU share similar profile of main bloodstream pathogens even though the disease spectrum was different between SICU and MICU.All the bloodstream pathogens isolated from MICU patients except A.baumannii showed significantly higher antimicrobial resistance rates than the isolates from SICU.The mortality rate associated with bloodstream infection was also higher in MICU patients than in SICU.

Objective:To evaluate the effect of occlusal adjustment on the restoration of the idiopathic cervical lesions.Methods:295 teeth with dental idiopathic cervical lesions in 83 patients were divided into 2 groups,142 teeth with occlusal interference were included in group 1 and the 153 without occlusal interference in group 2.The deffects of all the teeth were filled with Z350 nano-resin and followed up for 2 years.Then the teeth with treatment failure were divided into the experimental group (A,30 from group 1 and 14 from group 2) and the control group(B,30 from group 1 and 15 from group 2).The idiopathic cervical lesions of all teeth were filled with Z350 nano-resin,the occlusion of the corresponding teeth in group A was adjusted at the same time,that of group B was not treated.The cases were followed up for 1 year.Results:The success rate of group 1 and group 2 was 57.75％ and 81.05％ repectively (P ＜ 0.05).A subsequently treatment and 1 year follow-up showed that the success rate of gorup A and B for the cases with treatment failure of group 1 was 83.33％ and 56.67％ (P ＜ 0.05),for group 2 was 85.72％ and 40％ (P ＜ 0.05) respectively.Conclusion:The occlusal adjustment is benefit to the clinical effect of the treatment outcome of idiopathic cervical lesions.

OBJECTIVE: To compare the efficacy and safety of combined radiofrequency ablation (RFA) and transcatheter arterial chemoembolization (TACE) with RFA alone for hepatocellular carcinomas (HCC). MATERIALS AND METHODS: Randomized controlled trial (RCT) studies that compared the clinical or oncologic outcomes of combination therapy of TACE and RFA versus RFA for the treatment of HCC were identified through literature searches of electronic databases (Pubmed, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure, and Google Scholar). Hazard ratios (HRs) or odds ratios (ORs) with their corresponding 95% confidence interval (CI) were combined as the effective value to assess the summary effects. The strength of evidence was rated by the Grading of Recommendations Assessment, Development, and Evaluation system. RESULTS: Six RCTs with 534 patients were eligible for inclusion in this meta-analysis. The meta-analysis showed that the combination of TACE and RFA is associated with a significantly longer overall survival (HR = 0.62, 95% CI: 0.49-0.78, p < 0.001) and recurrence-free survival (HR = 0.55, 95% CI: 0.40-0.76, p < 0.001) in contrast with RFA monotherapy. The seemingly higher incidence of major complications in the combination group compared with RFA group did not reach statistical significance (OR = 1.17, 95% CI: 0.39-3.55, p = 0.78). CONCLUSION: In patients with HCC, the combination of TACE and RFA is associated with significantly higher overall survival and recurrence-free survival, as compared with RFA monotherapy, without significant difference in major complications.
Carcinoma, Hepatocellular/*surgery ; Catheter Ablation/adverse effects/*methods ; Chemoembolization, Therapeutic/adverse effects/*methods ; China ; Combined Modality Therapy ; Disease-Free Survival ; Humans ; Liver Neoplasms/*surgery ; Odds Ratio ; Proportional Hazards Models ; Treatment Outcome

Purpose To exp1ore the c1inicopatho1ogica1 features,diagnosis and differentia1 diagnosis of mu1ti1ocu1ar cystic rena1 ce11 carcinoma( MCRCC). Methods 18 cases of MCRCC were reported by microscopy,immunohistochemistry,differentia1 diagnosis and were fo11owed-up. Results A11 patients were adu1ts inc1uding twe1ve ma1es and six fema1es who aged from 26 to 68 years(mean 55. 6 years). Imaging studies revea1ed a po1ycystic mass,with c1ear boundary. Gross1y,the cut surface of the tumors had more cysts of va-rying sizes,containing serous or b1oody f1uid. Microscopica11y,the cyst wa11s of tumors were often covered with a few simp1e c1ear ce11s,stratified epithe1ium or devoid of epithe1ium. The septa contained aggregates of epithe1ia1 ce11s with transparent cytop1asm which showed gradeⅠ nuc1ear features,these characteristics were diagnostic c1ues of MCRCC. Immunohistochemica11y the c1ear ce11 was positive for CD10,vimentin,EMA and Ki-67 showed 1ow pro1iferative activity. 18 case were fo11owed up,mean fo11ow-up 43 months, no case recurred or with metastasis. Conclusion MCRCC is a rare histo1ogica1 subtype of rena1 ce11 carcinoma with more favorab1e prognosis. It shou1d be distinguished from cystic change of c1ear ce11 rena1 carcinoma and cysts of kidney 1esion.

Objective In order to improve cirrhotic liver management,each aspect of the liver's complex blood flow must be understood.This study investigates the protective effect of portal vein occlusion,with hepatic artery preservation,on cirrhotic liver after ischemia and reperfusion.Methods Carbon tetrachlorideand induced cirrhotic rats and normal rats were randomly assigned into 4 groups:normal sham operation (N-SO),cirrotic sham operation (C-SO),portal triad clamping (PTC),and portal vein clamping without hepatic artery inflow control (PVC).During the occlusion,the total 3-minute blood loss from the liver surface cut was weighed.At 1,6,and 24 hours post reperfusion,the serum alapine amino transferas (ALT),the adenosine triphosphate (ATP) of liver tissue,the malonolialdehgde (MDA) of liver tissue,and the morphological changes were evaluated.Result The amount of hemorrhage between the groups ranked as follows:PTC ＜ PVC ＜ N-SO ＜ C-SO (P＜0.05).At 1,6,and 24 hours post reperfusion.the ALT and MDA levels of the groups ranked as follows:PTC ＞ PVC ＞ C-SO ＞ N-SO (P＜0.05).Additionally,each group's ATP level ranked as follows:PTC ＜ PVC ＜ C-SO ＜ N-SO (P＜0.05).With histopathological examination,the hepatic injuries of the PTC and PVC group were more severe than those of the C-SO group,especially in the PTC group.Conclusion Therefore,the technique of portal vein clamping and hepatic artery inflow control can reduce the ischemic reperfusion injury of the cirrhotic rats' liver.