BackgroundMonitoring the blood concentrations of antipsychotic drugs and their metabolites can guide the adjustment of clinical treatment plans， improving therapeutic efficacy while reducing adverse effects. However， there is currently a lack of a method that can accurately and efficiently quantitatively detect multiple antipsychotic drugs and their metabolites. ObjectiveTo establish a ultra-high performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS） method for the simultaneous identification and quantitation of 12 antipsychotic drugs and their main metabolites in human serum. MethodsUsing UPLC-MS/MS technology， protein precipitation method was employed for sample pretreatment. An Agela Technologies Durashell C₈ chromatographic column （50 mm×3.0 mm， 5 μm） was selected for chromatographic separation with gradient elution. The flow rate was 0.4 mL/min， and the total analysis time was 5 minutes. The column temperature was 40℃. The mass spectrometry detection was carried out in the multiple reaction monitoring （MRM） mode， and the isotope internal standard method was used for quantification. ResultsThe relative standard deviation （RSD） of the internal standard normalization matrix effect factor for 12 antipsychotic drugs and their main metabolites at low and high quality concentrations was all less than 15%. The extraction recovery rate was 85% to 115%. They showed good linear relationships within their respective standard curve ranges （r>0.995）. At low， medium， and high quality concentrations， the accuracy was 85.24% to 114.71%， and the RSD of intra-batch and inter-batch precision was all ≤14.15%， with good stability. ConclusionAll the analytical performance indicators of this method meet the verification requirements， providing an analytical means for the quantitative detection of antipsychotic drugs and their main metabolites in human serum. ［Funded by The Third Batch of Science and Technology Projects in Chaozhou City in 2023 （number， 202303GY02）］

Objective: To construct an evaluation index system of cervical cancer prevention and control literacy, so as to provide an assessment tool for cervical cancer prevention and control literacy. Methods: The preliminary framework for cervical cancer prevention and control literacy was designed based on literature review. Twenty-one experts with both theoretical and practical experience in cervical cancer prevention and control were invited to participate in two rounds of Delphi consultation. The weights of indicators were determined by the percentage weighting method and product method, and the response rate, authority level, opinion concentration degree, and coordination degree of experts were evaluated. Results: Twenty-one experts participated in the consultation, including 3 males and 18 females. There were 11 experts with a doctor's degree, 7 with a master's degree and 3 with a bachelor's degree. All of them had senior professional titles and had more than 10 years of working experience. The recovery rates of the two rounds of consultations were 100.00% and 95.24%, the authority coefficients were 0.963 and 0.948, and Kendall's coefficients of concordance were 0.175 and 0.148 (both P<0.05), respectively. The final cervical cancer prevention and control literacy evaluation index system included 3 primary indicators (basic knowledge and concepts: 0.334; healthy lifestyle and behaviors: 0.338; basic skills: 0.328), 12 secondary indicators, with "capability to accurately acquire, comprehend, evaluate and apply health information" having the highest weight (0.166), and 51 tertiary indicators, with "HPV vaccination" (0.086), "consulting on relevant issues" (0.082), and "expressing personal perspectives" (0.080) having relatively higher weights. Conclusion The evaluation index system of cervical cancer prevention and control literacy serves as a valid assessment tool for women of appropriate age, providing the reference for developing targeted health education to enhance cervical cancer prevention and control literacy.

Objective To evaluate the influence of the wearing position of dosimeters outside lead aprons on effective dose estimation for interventional radiology workers, analyze the differences between single and double dosimeter methods in effective dose estimation, and provide a reference for the personal dose monitoring of interventional radiology workers. Methods This study employed a combined approach of on-site monitoring and Monte Carlo simulation to evaluate the impact of the wearing position of dosimeters outside lead aprons on effective dose estimation, as well as the differences between effective doses measured using single and double dosimeters. Interventional radiology workers wore dosimeters at three positions: the neck outside the lead collar, the left chest outside the lead apron, and inside the lead apron. Effective doses were estimated using the single and double dosimeter methods specified in GBZ 128-2019 Specifications for individual monitoring of occupational external exposure, and the impact of different wearing positions on the estimation results was compared. Geant4 Monte Carlo simulations were used to model dose distributions at the neck outside the lead collar and at the left chest outside the lead apron for operators performing cardiovascular interventions under tube voltages of 70, 80, 90, and 100 kVp and exposure angles of posteroanterior (PA), anteroposterior (AP), and left anterior oblique 45° (LAO45°) positions. The study assessed the impact of dosimeter wearing position on effective dose estimation. Results Monte Carlo simulations demonstrated that neck doses consistently exceeded left chest doses across different tube voltages and exposure angles, with neck-to-chest dose ratios of 0.80-0.90. Under identical tube voltage conditions, AP showed the highest doses, followed by LAO45°, and PA demonstrated the lowest doses. The single and double dosimeter methods exhibited consistent patterns in effective dose estimation. Single dosimeter method generally yielded higher effective doses with relative deviations of 9.9% to 83%, though these deviations decreased under high tube voltages. Field monitoring data indicated that most interventional radiology workers maintained relative deviations between single and double dosimeter calculations below 6%, with neck-to-chest dose ratios of 0.95-1.1. The estimation patterns remained consistent across both methods, though single dosimeter method showed slightly higher results. Conclusion Under PA, AP, or LAO45°, the doses at the neck consistently exceeded those at the left chest. Therefore, when wearing lead protective equipment, the dosimeter should be properly positioned at the neck outside the lead collar to accurately reflect the radiation doses of surgeons. Some interventional radiology workers improperly positioned the dosimeter (intended at the neck outside the lead collar) at the left chest outside the lead apron, and this may result in an underestimation of the effective dose.

BACKGROUND:Activation of nuclear factor-κB/NOD-like receptor thermal protein domain associated protein 3(NLRP3)signaling leads to endothelial dysfunction,oxidative stress,and plays a key role in the initiation of lipid metabolism disorders and arteriosclerosis.However,currenty,the effect of walnut oil and peanut oil on skeletal muscle inflammatory factors in arteriosclerotic rats remains unclear.OBJECTIVE:To discuss the effect and mechanism of walnut oil and peanut oil on atherosclerosis.METHODS:Forty 8-week-old SD male rats were randomly divided into normal control group(n=10)and high fat group(n=30)after 1 week of adaptive feeding.The atherosclerosis model was established by high-fat diet combined with vitamin D3 injection.The rats with successful modeling were randomly divided into model group(n=10),peanut oil group(n=8)and walnut oil group(n=8).The latter two groups were gavaged with peanut oil or walnut oil for 4 weeks(5 days/week,1.2 g/kg per day).After the intervention,ELISA was used to detect the related indexes of blood lipids in rats.The morphological changes of aorta were observed by hematoxylin-eosin staining.The RT-qPCR and western blot assay were used to detect nuclear factor-κB,NLRP3,Caspase-1,interleukin-1β,interleukin-18 mRNA and nuclear factor-κB,NLRP3,interleukin-1β protein expression levels in skeletal muscle.The protein expressions of nuclear factor-κB and NLRP3 were detected by immunofluorescence immunohistochemical staining.RESULTS AND CONCLUSION:(1)Compared with the normal control group,the aortic wall of rats in the model group was thickened,the damage and lipid precipitation were more serious,the blood lipid levels and arteriosclerosis index were significantly increased(P＜0.01).The mRNA levels of nuclear factor-κB,NLRP3,Caspase-1,interleukin-1β,and interleukin-18,and the protein expressions of nuclear factor-κB,NLRP3,and interleukin-1β in skeletal muscle were significantly increased(P＜0.01).(2)Compared with model group,the vulnerable area of aortic tissue in peanut oil group and walnut oil group was significantly reduced,the levels of total cholesterol,triglyceride,low density lipoprotein cholesterol in serum,and atherosclerosis index were decreased(P＜0.01),and the mRNA expressions of nuclear factor-κB,NLRP3,Caspase-1,interleukin-1β,and interleukin-18 and the protein expressions of nuclear factor-κB,NLRP3,and interleukin-1β in skeletal muscle were significantly decreased(P＜0.01 or P＜0.05).(3)Compared with peanut oil group,the serum total cholesterol,triglyceride,and low density lipoprotein cholesterol levels in walnut oil group were significantly decreased(P＜0.01 or P＜0.05),and the mRNA levels of nuclear factor-κB,NLRP3,Caspase-1,interleukin-18,and the protein levels of nuclear factor-κB,NLRP3,interleukin-1β decreased significantly in skeletal muscle(P＜0.01 or P＜0.05).It is concluded that both peanut oil and walnut oil have ameliorative effect on atherosclerotic damage,which may be related to nuclear factor-κB/NLRP3 signaling pathway,and walnut oil has better ameliorative effect than peanut oil.

Objective:To evaluate the association between erectile dysfunction(ED)and myocardial infarction(MI)using two sample Mendelian randomization.Methods:A Mendelian randomization study was conducted using comprehensive data on ED and MI from extensive genome-wide association data.Using inverse variance weighted analysis for causal relationships,and correct for confounding factors using multivariate Mendelian randomization,the potential mediating effects were evaluated as well.Based on Gene-card data,the genes related to ED and MI were identified.Molecular docking was used to reveal spontaneously bound drug molecules.Results.Our study found that exposure to ED was a risk factor for MI(OR:1.001 0,95％CI:1.000 2-1.001 8,P=0.017 7),which also held true in the validation dataset(OR:1.028 5,95％CI:1.005 0-1.052 6,P=0.017 2).No statistically significant heterogeneity or horizontal pleiotropy was found.The results of reverse Mendelian randomization analysis showed any reverse causal re-lationship between ED and MI.In multivariate Mendelian randomization analysis,after excluding confounding factors(excluding tri-glycerides and high-density lipoprotein),the P-value remained less than 0.05,and the OR ranged from 1.000 1 to 1.000 7,indica-ting that ED was still a risk factor for MI.In the mediation analysis,it was found that the current mediation ratio of smoking to MI was 13.06％.In summary-data-based mendelian randomization analysis,it was found that the gene PTPN11 was a common target gene for MI and ED(OR=0.990,P＜0.001).Subsequent molecular docking with sildenafil,clopidogrel,and dapoxetine could spontaneous-ly bind to the PTPN11 gene receptor.Conclusion:There is a causal relationship between ED and MI,with smoking as a potential mediating factor,and the gene PTPN11 being a co-target gene.

BACKGROUND:The development of calcium phosphate bone cement is limited due to its poor mechanical properties and weak osteogenic ability.Silicate bioactive glass is highly favored due to its excellent biological activity and osteogenic ability.Simultaneously,fiber structures can enhance the mechanical strength of materials.OBJECTIVE:To investigate the mechanical properties,biocompatibility,and osteogenic effect of silicate bioactive glass fiber composite calcium phosphate bone cement.METHODS:Different mass percentages(0％,10％,and 20％)of silicate bioactive glass fiber were added to the solid phase of calcium phosphate bone cement,mixed with the liquid phase and cured for 48 hours to obtain silicate bioactive glass fiber composite calcium phosphate bone cement.The mechanical properties,setting time,and ion precipitation of the cement were characterized.The three groups of bone cement extracts were co-cultured with MC3T3-E1 cells.The cell compatibility of the materials was evaluated by CCK-8 assay,live/dead staining,and phalloidin staining.After osteogenic induction,the osteogenic induction ability of the materials was evaluated by alkaline phosphatase staining,alizarin red staining,RUNX2 immunofluorescence staining,and RT-PCR.RESULTS AND CONCLUSION:(1)With the increase of silicate bioactive glass fiber content,the compressive strength and flexural strength of bone cement increased,and the setting time was prolonged.When bone cement was immersed in simulated body fluid,the precipitation of silicon ions,calcium ions,and phosphorus ions could be detected.Moreover,with the increase of silicate bioactive glass fiber content,the mass concentration of silicon ions and phosphorus ions released by bone cement increased,and the mass concentration of calcium ions decreased.(2)Live/dead staining and phalloidin staining results exhibited that silicate bioactive glass fiber composite calcium phosphate bone cement had no toxic effect on MC3T3-E1 cells.CCK-8 assay results showed that silicate bioactive glass fiber composite calcium phosphate bone cement could promote the proliferation of MC3T3-E1 cells.(3)With the increase of silicate bioactive glass fiber content in bone cement,the alkaline phosphatase activity and extracellular calcium deposition of MC3T3-E1 cells increased,the expression of RUNX2 protein increased,and the expression of alkaline phosphatase,osteocalcin,osteopontin,and RUNX2 mRNA expression increased.(4)The results indicate that silicate bioactive glass fibers can enhance the mechanical properties and osteogenic induction ability of calcium phosphate bone cement,among which 20％silicate bioactive glass fibers have a more obvious effect.

When patients with malignant tumors are in the terminal stage of life, palliative care centered on the patient and their family plays a crucial role in improving the quality of life for advanced cancer patients and their families. As the core practitioners of palliative care, oncology nurses' cognition and practice of palliative care are closely related to the quality of palliative care for cancer patients. This paper analyzes the current state and influencing factors of the cognition and practice of palliative care from the perspective of oncology nurses and proposes improvement strategies, aiming to provide a reference for nursing managers to formulate targeted improvement programs and improve relevant systems.

We reported the clinical,imaging,and treatment process of a patient with severe cranial penetrating injury caused by a nail from a nail gun that accidentally shot into the eye and penetrated into the skull while working.The patient was admitted to the Qingpu Branch of Zhongshan Hospital,Fudan University after being injured by the nail gun.The patient was admitted to the hospital 1 hour after injury with coma.After admission,the foreign body was completely removed and part of the hematoma was cleared through emergency surgery.After surgery,there were high-risk complications such as cerebral edema peak,intracranial hypertension,intracranial infection,cerebrospinal fluid leakage,and intracranial pseudoaneurysm.The patient eventually regained consciousness and was transferred to rehabilitation treatment.

BACKGROUND:Exercise interventions play a key role in disease prevention and treatment,which can effectively activate the nuclear factor erythroid2-related factor 2(Nrf2)signaling pathway to prevent the occurrence and development of insulin resistance.However,the potential mechanism of Nrf2-targeting exercise therapy strategies in alleviating insulin resistance remains unclear.OBJECTIVE:Based on the relationship between Nrf2,insulin resistance and exercise,to analyze the mechanism and influence of different exercise modes on the activation of Nrf2,thereby elucidating the potential mechanism of Nrf2-targeting exercise therapy strategies in the process of alleviating insulin resistance.METHODS:"Diabetes mellitus,insulin,insulin resistance,nuclear factor E2 related factor 2,oxidative stress,ferroptosis,autophagy,inflammatory response,exercise"were used as search terms in Chinese and English.WanFang Database,CNKI,Google Scholar and PubMed database were searched for relevant literature from inception to October 2024,and a total of 127 core related articles were obtained according to the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)Keap1/Nrf2 signaling pathway,as an important endogenous antioxidant stress pathway,plays an important role in insulin resistance.Activation of Keap1/Nrf2 signaling pathway can enhance the antioxidant capacity of cells,reduce oxidative stress and inflammation,improve insulin signaling,and thus protect insulin resistance.(2)A variety of exercise methods(including aerobic exercise,resistance exercise and high-intensity intermittent exercise)can effectively activate Nrf2 signal,improve the activity of antioxidant kinase and enhance the antioxidant capacity of cells,so as to alleviate oxidative stress damage to a certain extent.(3)By activating Nrf2 signaling pathway,exercise can up-regulate the activity of antioxidant enzymes such as Heme oxygenase 1,superoxide dismutase,catalase,glutathione peroxidase,glutathione,and enhance the antioxidant capacity of cells.In addition,it can also regulate the key enzymes and proteins in the ferroptosis pathway,such as glutathione peroxidase 4,membrane iron transport protein 1,and ferritin heavy chain 1,inhibit the ferroptosis pathway and promote the balance of iron metabolism.In autophagy,the expression of autophagy related genes p62 and ATG5/7 can be enhanced,and the level of microtubule-associated protein 1 light chain 3 is increased,thus regulating autophagy process.At the same time,the activity of tumor necrosis factor-α,nuclear factor-κB,interleukin-6,interleukin-1β and other pro-inflammatory cytokines is decreased,and the inflammatory response can be effectively inhibited.These combined effects can reduce oxidative stress damage,increase insulin sensitivity and improve insulin signaling,and thus have a positive effect on improving insulin resistance.(4)Given that the Keap1/Nrf2 signaling pathway plays an important role in the pathogenesis and treatment of insulin resistance,exercise therapy strategies targeting the Keap1/Nrf2 signaling pathway will help promote the development of"exercise+drug"precision medicine for insulin resistance.

BACKGROUND:Exercise interventions play a key role in disease prevention and treatment,which can effectively activate the nuclear factor erythroid2-related factor 2(Nrf2)signaling pathway to prevent the occurrence and development of insulin resistance.However,the potential mechanism of Nrf2-targeting exercise therapy strategies in alleviating insulin resistance remains unclear.OBJECTIVE:Based on the relationship between Nrf2,insulin resistance and exercise,to analyze the mechanism and influence of different exercise modes on the activation of Nrf2,thereby elucidating the potential mechanism of Nrf2-targeting exercise therapy strategies in the process of alleviating insulin resistance.METHODS:"Diabetes mellitus,insulin,insulin resistance,nuclear factor E2 related factor 2,oxidative stress,ferroptosis,autophagy,inflammatory response,exercise"were used as search terms in Chinese and English.WanFang Database,CNKI,Google Scholar and PubMed database were searched for relevant literature from inception to October 2024,and a total of 127 core related articles were obtained according to the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)Keap1/Nrf2 signaling pathway,as an important endogenous antioxidant stress pathway,plays an important role in insulin resistance.Activation of Keap1/Nrf2 signaling pathway can enhance the antioxidant capacity of cells,reduce oxidative stress and inflammation,improve insulin signaling,and thus protect insulin resistance.(2)A variety of exercise methods(including aerobic exercise,resistance exercise and high-intensity intermittent exercise)can effectively activate Nrf2 signal,improve the activity of antioxidant kinase and enhance the antioxidant capacity of cells,so as to alleviate oxidative stress damage to a certain extent.(3)By activating Nrf2 signaling pathway,exercise can up-regulate the activity of antioxidant enzymes such as Heme oxygenase 1,superoxide dismutase,catalase,glutathione peroxidase,glutathione,and enhance the antioxidant capacity of cells.In addition,it can also regulate the key enzymes and proteins in the ferroptosis pathway,such as glutathione peroxidase 4,membrane iron transport protein 1,and ferritin heavy chain 1,inhibit the ferroptosis pathway and promote the balance of iron metabolism.In autophagy,the expression of autophagy related genes p62 and ATG5/7 can be enhanced,and the level of microtubule-associated protein 1 light chain 3 is increased,thus regulating autophagy process.At the same time,the activity of tumor necrosis factor-α,nuclear factor-κB,interleukin-6,interleukin-1β and other pro-inflammatory cytokines is decreased,and the inflammatory response can be effectively inhibited.These combined effects can reduce oxidative stress damage,increase insulin sensitivity and improve insulin signaling,and thus have a positive effect on improving insulin resistance.(4)Given that the Keap1/Nrf2 signaling pathway plays an important role in the pathogenesis and treatment of insulin resistance,exercise therapy strategies targeting the Keap1/Nrf2 signaling pathway will help promote the development of"exercise+drug"precision medicine for insulin resistance.